Configuração das pregas vestibulares em laringes de pacientes com nódulo vocal

Abstract

Vocal nodules are among the most common laryngopathies that cause vocal functional disorders. The voice production mechanism is complex and demand interaction of different systems of the human body. The physiological role of the vocal folds as the glottic sound source is evident, however, there is no consensus regarding the vestibular foldsṕ articipation/influence in phonation. Aim: To verify if there is difference in the bidimensional configuration of the vestibular folds between two distinct groups of women, one with the diagnosis of vocal nodules and the other without vocal complaints and vocal fold lesions. Study design: clinical with transversal cohort. Material and Method: Ninety-six laryngeal images were evaluated, 48 from individuals without vocal complaints and 48 from patients with the diagnosis of vocal nodules. Angles were obtained and bilaterally measured in single frames of the vestibular folds during sustained phonation and those structures were morphologically classified as concave, linear or convex. Results: Among the 96 vestibular folds evaluated in each group, there was predominance of the concave form, followed by the linear and the convex ones. In the control group, there was a single convex vestibular fold, 27 were linear and 68 were concave folds. In the group of vocal nodules, 8 were convex, 15 were linear and 73 were concave folds. However, the differences among groups were not statistically significant as well as those among the angles, whose average measures were proven quite similar. Conclusion: In the female gender, the vestibular folds presented similar behavior regarding the morphology in both patients with vocal nodules and women without vocal complaints.

Modifications of Vestibular Fold Shape From Respiration to Phonation in Unilateral Vocal Fold Paralysis

“…Thus, in the present study, the straight line that theoretically corresponds to a 180 angle was actually placed between the angles of 176.4 and 183.0 (Table 1), as visual perception did not allow discrimination of differences among 180 angles within these parameters. According to previous reports that used similar methods in patients without voice complaints, nonconcave VeFs (convex and straight shapes) were exceptions; concavity was observed in 83% of subjects by Nemetz et al 10 and 70% by Tuma et al 11 However, our study in patients with unilateral vocal fold paralysis, the VeFs on the moving side were nonconcave. Our data suggest that the VeFs on the nonparalyzed side were nonconcave during phonation in all cases ( Table 2).…”

“…[5][6][7][8][9][10][11] However, pathologic variations of normal voice production permit us to assess both the anatomy and physiology of VeFs, as well as their role in voice production. Unilateral paralysis provides an ideal scenario for this type of investigation.…”

Efetividade da estimulação elétrica nervosa transcutânea (TENS) na terapia vocal de mulheres disfônicas: ensaio clínico, controlado, randomizado e cego

“…Na presença de disfonia comportamental pode ser observada posição elevada da laringe (RUBIN, BLAKE, MATHIESON, 2007;IZADI, SALEHI, 2013), encurtamento e retração dos músculos estilo-hioideo e esternocleidomastoideos e fraco mecanismo do músculo flexor do pescoço (RUBIN, BLAKE, MATHIESON, 2007). A área do vestíbulo laríngeo na presença desse tipo de alteração é menor, com dimensão ântero-posterior reduzida quando comparada com indivíduos vocalmente saudáveis (YAMASAKI et al, 2011;IZADI, SALEHI, 2013), pregas vestibulares de configuração côncava (TUMA et al, 2005), fenda à fonação do tipo dupla ou triangular médio-posterior (BRAGA et al 2006;BARATA et al, 2010), tempos máximos de fonação (BEBER, CIELO, SIQUEIRA, 2009;KURTS E CIELO, 2010;CIELO et al, 2012;ZIELIŃSKA-BLIŹNIEWSKA et al, 2013) e capacidade vital (ZIELIŃSKA-BLIŹNIEWSKA et al, 2013) reduzidos. Além disso, encontram-se parâmetros acústicos vocais desviados (KUMAR, 2011;MOURAO, BASSI, GAMA, 2011;IZADI, SALEHI, 2013), respiração superior (ZIELIŃSKA-BLIŹNIEWSKA et al, 2013) e qualidade vocal do tipo rugosa e soprosa (KUMAR, BAHT, PRASAD, 2010.…”

Análise acústica não linear da voz pós laringectomia parcial

“…A voz humana resulta da interação de fatores genéticos, anatômicos, características pessoais, como a personalidade, além de fatores sociais, econômicos e culturais, e ainda de aspectos emocionais únicos, próprios de cada indivíduo (TUMA et al, 2005). Ela é um recurso precioso, poderoso e, muitas vezes, desconhecido; inesgotável em possibilidades e como tal, não pode ser vista apenas, como mera vibração das pregas vocais.…”