Estudo epidemiológico de disfonias em crianças de 4 a 12 anos

Abstract

Chi ldren dysphonia studies have reported an incidence of 4.4 to 30.3%. Goals:To establish the prevalence of dysphonia in children, based on the opinion of the parents, acoustic and vocal-perceptual assessments, associated symptoms, risk factors and videolaryngoscopy findings. Materials and Methods:The parents from 2,000 children answered a questionnaire about the vocal quality of their children, and these children were submitted to perceptual vocal, acoustic and videolaryngoscopy assessments. Results:We had 1,007 boys and 993 girls; sporadic symptoms were reported by 206 parents and permanent symptoms were reported by 123. In the perceptual assessment, the G parameter (degree of dysphonia) had a score of 0 in 694 voices; 1 in 1,065 and 2 in 228. There was f0 reduction with age and the remaining acoustic parameters were high in children with a G score of 2. Nodules, thickening and inflammation were the most common in the videolaryngoscopy exams. Conclusions:Parental judgment indicated a prevalence of dysphonia in 6.15%, and perceptual analysis yielded a value of 11.4%. Vocal symptoms were associated with a phonatory overload. sinonasal disorders, vocal abuse and noise were considered relevant risk factors. The acoustic analysis kept a direct association with the perceptual-auditory. Laryngeal lesions were found in the videolaryngoscopy exams, stressing nodules, thickening and inflammation. Braz J Otorhinolaryngol. 2011;77(6):736-46. BJORL ORIGINAL ARTICLE

Análise da qualidade de vida relacionada à voz na população infantil

“…Some studies have considered the results of auditory-perceptual assessment (11)(12)(13)(14) , some have considered parents' complaints about their children's voices (8,11) ; whereas others have used the laryngeal evaluation (4,15) . Considering the multidimensional nature of the voice function, the Committee on Phoniatrics of the European Laryngological Society suggests that vocal assessment include different approaches, such as auditory-perception, videostroboscopy, acoustics, aerodynamics, and subjective rating by the patient (16) .…”

“…Some studies show that the prevalence of pediatric dysphonia, evaluated by auditory-perceptual analysis, varies from 6 to 37.14% (11)(12)(13)(14) . These data corroborate the results obtained in this research, which showed prevalence of childhood dysphonia of 23.3%.…”

“…During the evaluations, all the examiners considered the peculiarities of the infantile voice, such as presence of discrete instability and breathiness during the emissions (11) . When performing the auditoryperceptual analysis, the speech-language therapists listened to a stimulus identified as anchor (vocal quality without change, selected by the researchers by consensus) to each group of 10 voices.…”

Tempo ideal de vibração sonorizada de língua em crianças disfônicas

“…Estudos com amostras maiores tendem a obter estimativas de efeito mais precisas e costumam apresentar maior poder 22 . A amostra do presente estudo foi pequena devido à dificuldade em encontrar crianças que sabiam executar a técnica de vibração de língua adequadamente, além da baixa prevalência da disfonia infantil na população 23,24 . Estudos com amostras maiores são necessários para que se analise o real efeito do exercício de vibração sonorizada de língua em crianças, uma vez que a literatura apresenta apenas um estudo na população pediátrica com a técnica do sopro sonorizado com canudo, mostrando efeitos positivos nos parâmetros acústicos no terceiro e quinto minuto após a realização do exercício.…”

Equivalência cultural da versão brasileira do Questionnaire des Symptômes Vocaux

“…Vocal symptoms usually happen due to bad vocal habits and improper vocal models. The main harmful habits reported by children are talking to struggle without rest, voice imitation and often live in a noisy home environment (4) ; and the main pediatric vocal symptoms are hoarseness and vocal fatigue, both arising from a phonatory overload caused by child vocal pattern using high intensity, stress and tension in the speech, which also enhances the occurrence of mass lesions (5) . Pediatric protocols for vocal self-assessment are incipient.…”