Aplicação da técnica de emissão em tempo máximo de fonação em paciente com disfonia espasmódica adutora: relato de caso

Abstract

Adductor Spasmodic Dysphonia (ASD) is a neurological disorder of central motor processing, characterized by involuntary and inappropriate contractions of the phonatory muscles, producing hyperadduction of the vocal folds, which causes a tremulous, faltering and strained-strangled voice. The aim of this study was to describe the vocal, acoustic and laryngeal parameters measured for a female patient with ADS pre and post speech therapy using the Technique of Sustained Maximum Phonation Time (SMPT). This technique aims to promote increase in glottal resistance, improve phonatory stability, and enhance glottal coaptation. A 66-year-old female patient with ASD took part in this study. She was submitted to otorhinolaryngologic and speech-language assessment before and after the application of the SMPT technique. The results showed modification of vocal, acoustic and laryngeal parameters, such as re-classifying her dysphonia from G 3 R 1 B 1 A 0 S 3 I 3 to G 2 R 1 B 1 A 0 S 2 I 2 , her pitch from severe to adequate, her spectrographic trace from unstable to more stable, and an expressive increase in mean fundamental frequency and mean vocal intensity, besides improvement of her glottal efficiency, with closure of the anteroposterior glottal opening. Speech therapy using the SMPT technique was considered a suitable treatment option for this case, given the good results obtained, especially the improvements in vocal quality and phonatory stability. The importance of further studies with the aim to provide greater scientific evidence for the effectiveness of the technique when treating ASD is emphasized.

Classificação de Desvios Vocais baseadas em Características do Modelo Linear de Produção da Fala

“…Foram selecionados 120 sinais apenas do sexo feminino por que, segundo alguns estudos, a incidência de distúrbios vocais ocorre principalmente em mulheres [17]. Dos sinais selecionados: 30 são saudáveis e 90 são de vozes desviadas, sendo destes últimos, 30 sinais de vozes com o desvio rugosidade, 30 com soprosidade e 30 com o desvio tensão.…”

Effects of a Voice Therapy Program for Patients with Muscle Tension Dysphonia

“…Among the main types of direct therapy are facilitating and smoothing sounds, which serves to change the focus of resonance and promote greater coordination of respiration [16-19], the respiratory method, which facilitates respiratory control [12-17], body techniques, which use body movements and cervical and (para)laryngeal musculature massage to favor muscle relaxation and adequate muscle adjustment [5, 17, 20, 21], and phonation skills, which, besides promoting better vocal fold closure, stabilize the larynx and provide glottal resistance [17, 22-24]. …”