Modificação da voz após deglutição: compatibilidade com achados da videofluoroscopia

Santos, Karoline Weber dos; Scheeren, Betina; Maciel, Antonio Carlos; Cassol, Mauricéia

doi:10.1590/2317-1782/20172017004

Cited by 8 publications

(4 citation statements)

References 17 publications

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“…Dos pacientes rastreados, 4,2% apresentavam disfonia e é sabido que pacientes disfônicos apresentam risco de desenvolver algum grau de disfagia 19,24,26 , uma vez que alterações de coaptação glótica podem comprometer os eventos da fase faríngea levando à ocorrência de penetração/ aspiração em diferentes momentos e graus. Esse resultado pode estar relacionado aos diversos diagnósticos, procedimentos cirúrgicos e/ou dispositivos aos quais os pacientes foram submetidos.…”

Section: Resultsunclassified

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Rastreio do risco de disfagia em pacientes internados em um hospital universitário

et al. 2020

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Introdução: A presença da disfagia no ambiente hospitalar aumenta os custos de cuidado com a saúde e leva a maior tempo de internação hospitalar sobrecarregando, portanto, o sistema de saúde. Pacientes internados, por diferentes doenças de base, podem apresentar risco para disfagia com necessidade de intervenção fonoaudiológica. Objetivo: Rastrear o risco de disfagia em pacientes internados em um Hospital Universitário. Métodos: Estudo do tipo transversal descritivo realizado no período de março de 2016 a setembro de 2018 em um Hospital Universitário. Os dados foram coletados por meio de análise de prontuário e aplicação do instrumento de rastreio - Eating Assessment Tool (EAT-10). Os pacientes que pontuaram 3 ou mais foram classificados com risco de disfagia. Para análise estatística foi considerado o nível de 5% de significância. Resultados: O risco de disfagia foi identificado em 191 (7,8%) pacientes. Houve prevalência do sexo masculino, idade superior a 60 anos, e a doença de base prevalente foi cardiovascular. Observou-se que a Disfonia (4,2%), refluxo gastroesofágico (3,8%), uso de traqueostomia (1,1%) e via alternativa de alimentação (3,1%) foram fatores associados ao risco de disfagia. Conclusão: Observou-se risco de disfagia nos pacientes internados principalmente nos pacientes do sexo masculino, idosos e cardiopatas. Disfonia, refluxo gastroesofágico, uso de traquestomia e via alternativa de alimentação foram fatores associados ao risco de disfagia.

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Section: Resultsunclassified

“…Em outro estudo, Mãnas-Martínez et al 23 , por meio do EAT 10, verificaram 56,7% de risco de disfagia em pacientes idosos hospitalizados. O rápido envelhecimento populacional vem aumentando o número de idosos que necessitam de cuidados hospitalares, e justificam que estes pacientes sejam rastreados 5,20,21,23,24 .…”

Section: Discussionunclassified

Rastreio do risco de disfagia em pacientes internados em um hospital universitário

et al. 2020

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“…Changes in vital signs were observed in Group 3. During the functional swallowing assessment, pulse oximetry was used as a simple monitoring measure 1,30 . The SpO 2 analysis is based on the hypothesis that food aspiration would cause a bronchospasm reflex, thereby reducing ventilatory perfusion and resulting in oxygen desaturation 14,31 .…”

Section: Discussionmentioning

confidence: 99%

Clinical findings of speech therapy swallowing assessments in patients with oropharyngeal dysphagia following orotracheal intubation

Vizioli

Balzan

Dornelles

et al. 2021

CBR

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Introduction: Endotracheal intubation has been associated with oropharyngeal dysphagia. The aim of this study was to identify the prevalence of oropharyngeal dysphagia among patients in an intensive care unit (ICU) by comparing patients requiring orotracheal intubation with those who did not undergo this procedure.Methods: This is a cross-sectional study that analyzed the medical records of 681 patients admitted to the ICU of Hospital de Clínicas de Porto Alegre between 2014 and 2017; inclusion criteria were patients aged 18 years and older who had been assessed by the hospital's Speech Therapy Service. Patients who had undergone tracheostomy, who had incomplete medical records or multiple speech-language assessments were excluded.Results: A total of 380 patients were included in the statistical analysis: 97 (25.5%) had not undergone orotracheal intubation (Group 1), 229 (60.3%) had undergone orotracheal intubation once (Group 2), and 54 (14.2%) had undergone orotracheal intubation on 2 or more occasions (Group 3). Regarding the Functional Oral Intake Scale (FOIS), 61.1% of patients in Group 3 received a FOIS I classification (p = 0.020), whereas 16.5% of patients from Group 1 received a FOIS V. Concerning their outcomes, 40.7% of patients in Group 3 died (p = 0.006), and 82.5% of patients in Group 1 were discharged from the ICU. Considering the severity of oropharyngeal dysphagia according to the Dysphagia Risk Evaluation Protocol (PARD), no statistically significant association was observed between groups (p = 0.261). Conclusions:In this study, the prevalence of oropharyngeal dysphagia was higher in patients who had undergone orotracheal intubation in the ICU.

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“…WVQ 특징은 흡인환자의 90% 이상에서 관찰될 정도로 그 빈 도는 매우 높고 (Linden & Siebens, 1983) 대다수 임상가들에게 인 정받는 증상이지만 (Daniel et al, 1998;Groves-Wright et al, 2010;Santos et al, 2015) 객관적으로 그 정의에 대해서는 합의되지는 않아 (Wright, 2007), wet-dysphonic (Murray et al, 1996), wet-hoarse (Linden & Siehens, 1983), wet phonation (Linden et al, 1993), impaired vocal quality (Mann & Hankey, 2001), voice change with swallow (Daniels et al, 1998) (Groher & Crary, 2011). 이런 질환은 노년층에서 빈번하게 발생하며 지역사회 노 인들을 추적 조사한 보고에 의하면 70% 이상에서 삼킴장애와 동반된 병적 상태를 보였다 (Groher & Crary, 2011).…”

Section: 서론unclassified

Acoustic analysis of wet voice among patients with swallowing disorders

Kang¹,

Koo²,

Sun³

et al. 2018

Phonetics Speech Sci.

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Wet voice quality (WVQ) is a characteristic that appears after swallowing. Although the concept is accepted by many clinicians worldwide, it is nevertheless ambiguous. In this study, we investigated WVQ in patients with swallowing disorders using acoustic analysis. A total of 106 patients diagnosed with penetration-aspiration by the videofluoroscopic swallowing study (VFSS) were recruited. A voice recording of vowel /a/ was conducted before and after the VFSS, and an acoustic analysis was then performed using PRAAT. Voice after VFSS was used for a perceptual judgment and divided into two groups: the Wet group (48 patients) and the Non-wet group (58 patients). At the post-VFSS stage, the two groups displayed significant differences in many acoustic parameters including F0_SD, Jitter, RAP, Shimmer, APQ, HNR, NHR, FUF, DVB, and CPP. The parameter affecting judging wetness resulted into Jitter and NHR by the logistic regression test. At the pre-VFSS stage, the two groups differed significantly in many acoustic parameters including Intensity, Jitter, RAP, Shimmer, NHR, FUF, DVB, and CPP. Both pre-and post-VFSS, the mean values of all significant parameters, except Intensity, HNR, and CPP, were higher in the Wet group. According to pre-and post-VFSS, the two groups displayed interactions in many parameters (Intensity, F0_SD, Jitter, RAP, Shimmer, APQ, HNR, NHR, FUF, DVB, and CPP). In particular, Intensity increased in both groups after the VFSS, although the increase in the Non-wet group was greater. Based on these results, it was conjectured that the WVQ after swallowing resulted from the secretion effect of the mucous membrane due to the dry laryngeal characteristic of elderly patients, rather than aspiration resulting in food on the vocal cords.

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Modificação da voz após deglutição: compatibilidade com achados da videofluoroscopia

Cited by 8 publications

References 17 publications

Rastreio do risco de disfagia em pacientes internados em um hospital universitário

Rastreio do risco de disfagia em pacientes internados em um hospital universitário

Clinical findings of speech therapy swallowing assessments in patients with oropharyngeal dysphagia following orotracheal intubation

Acoustic analysis of wet voice among patients with swallowing disorders

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