Voice and Laryngeal Configuration of Men With Unilateral Vocal Fold Paralysis Before and After Medialization

Schwarz, Karine; Cielo, Carla Aparecida; Steffen, Nédio; Becker, Jéfferson; Jotz, Geraldo Pereira

doi:10.1016/j.jvoice.2010.07.010

Cited by 14 publications

(7 citation statements)

References 29 publications

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“…There was a reduction of hoarseness, roughness and breathiness (higher frequency of mild degree); asthenia (higher frequency from mild degree to normal); tension and instability (higher frequency of normality). This finding agrees with the results of the present case study, except for breathiness, which was moderate after the surgery 15 .…”

Section: Discussionsupporting

confidence: 93%

Fonoterapia com fonação em tubos em paciente com paralisia de prega vocal medializada cirurgicamente: estudo de caso

Lima

Cielo

Christmann³

2016

Rev. CEFAC

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RESUMO O objetivo deste estudo foi verificar as modificações vocais perceptivo-auditivas e acústicas ocorridas após um método de fonoterapia breve usando três modalidades de fonação em tubos em um sujeito do gênero masculino com paralisia unilateral de prega vocal medializada cirurgicamente. Paciente do gênero masculino, 29 anos e um mês de idade, com diagnóstico otorrinolaringológico de paralisia de prega vocal esquerda em abdução e encaminhado para cirurgia de medialização da prega vocal esquerda (Tiroplastia tipo I) e fonoterapia. Foram realizadas cinco coletas da emissão da vogal /a:/ em momentos distintos, sendo eles: antes da cirurgia; após dez dias da cirurgia (antes da fonoterapia); após seis dias de execução da técnica de fonação em tubo de látex imerso em água; após seis dias de execução de fonação em tubo de vidro imerso em água; após seis dias de execução da fonação em tubo de menor diâmetro. Foi realizada avaliação acústica de fonte glótica, espectrográfica e perceptivo-auditiva. A fonoterapia com os três diferentes exercícios de fonação em tubo, durante 18 dias de tratamento condensado, proporcionou na análise acústica, melhora da maioria das medidas de perturbação de frequência e de componentes surdos ou não sonorizados; da intensidade da cor do traçado da espectrografia de banda larga, da regularidade dos traçados espectrográficos e da definição dos formantes; na análise perceptivo-auditiva, houve redução de tensão, aspereza e soprosidade.

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Section: Discussionsupporting

confidence: 93%

Fonoterapia com fonação em tubos em paciente com paralisia de prega vocal medializada cirurgicamente: estudo de caso

Lima

Cielo

Christmann³

2016

Rev. CEFAC

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“…The vocal tract configuration interacts with VF oscillation; that is, vocal tract configuration constrains VF functioning during phonation [ 15 , 55 ]. After the onset of UVFP patients usually develop some compensatory adjustments at glottic and supraglottic level altering voice and vocal tract configuration [ 6 ]. The description of vocal tract configurations in subjects with UVFP could guide treatments and help prevent negative compensations [ 6 , 7 ].…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, vocal strain is a critical component in various vocal pathologies including UVFP. A neuronal dysphonia, such as UVFP, can alter the vibrational patterns of the Vocal Folds (VF) which leads to compensatory adjustments to the glottic and supraglottic structures that increase the vocal effort and vocal strain perception [ 6 , 7 ]. In addition to the perceptive alterations, UVFP also results in higher values of jitter and shimmer and lower values of the harmonics-to-noise ratio (HNR) [ 1 – 4 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, values of standard-deviation of fundamental frequency ( F 0) are reported as higher than normal because of the diminished control of the vibrational pattern of the VF, causing greater variability [ 9 – 11 ]. According to Schwarz et al [ 6 ], there is a need to describe and understand the UVFP patient's larynx configuration for a better and more individualised vocal intervention, preventing compensatory adjustments. Formant frequencies provide acoustic cues about the vocal tract configuration [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Acoustic Correlates of Compensatory Adjustments to the Glottic and Supraglottic Structures in Patients with Unilateral Vocal Fold Paralysis

Jesus

Martinez

Hall

et al. 2015

BioMed Research International

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The goal of this study was to analyse perceptually and acoustically the voices of patients with Unilateral Vocal Fold Paralysis (UVFP) and compare them to the voices of normal subjects. These voices were analysed perceptually with the GRBAS scale and acoustically using the following parameters: mean fundamental frequency (F0), standard-deviation of F0, jitter (ppq5), shimmer (apq11), mean harmonics-to-noise ratio (HNR), mean first (F1) and second (F2) formants frequency, and standard-deviation of F1 and F2 frequencies. Statistically significant differences were found in all of the perceptual parameters. Also the jitter, shimmer, HNR, standard-deviation of F0, and standard-deviation of the frequency of F2 were statistically different between groups, for both genders. In the male data differences were also found in F1 and F2 frequencies values and in the standard-deviation of the frequency of F1. This study allowed the documentation of the alterations resulting from UVFP and addressed the exploration of parameters with limited information for this pathology.

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“…Even the most experienced may have difficulties in assessing the characteristics of a patient with unilateral vocal fold paralysis. In one study 34 , the aspects with had the most reliability among the three ENT examiners in the pre and post-medialization assessment of the paralyzed vocal fold were: the paralyzed vocal fold position, its closeness to the vestibular Table 2. Agreement analysis between the auditory-perceptive assessments of the voices by the speech therapist examiners by means of the RASATI scale.…”

Section: Discussionmentioning

confidence: 99%

Voz e posição de prega vocal em homens com paralisia unilateral de prega vocal

Schwarz¹,

Cielo²,

Steffen³

et al. 2011

Braz. j. otorhinolaryngol. (Impr.)

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The paralyzed vocal fold positioning and the degree of dysphonia are important inputs when one is deciding upon treatment options for unilateral vocal fold paralysis (UVFP).Objective: To check voice characteristics and paralyzed vocal fold position in men with UVFP. Materials and Methods:This is a retrospective historical cross-sectional cohort study, with data from 24 men with UVFP with mean age of 60.7 years, submitted to voice assessment by three speech therapists and three ENT physicians used laryngeal images to classify the position of the paralyzed vocal fold. Results:The paralyzed vocal fold was found in the paramedian position in 45.83% of the cases; in the intermediary position in 25%; lateral in 20.83%, and it was in the median position in 4.16%; the dysphonia resulting from the UVFP was characterized by moderate hoarseness, roughness and stress in the voice; breathiness (most had severe breathiness); weakness and instability(mostly mild); the position of the paralyzed vocal fold had a significant influence on the general degree of vocal deviation. Conclusion:The general degree of dysphonia is associated with the paralyzed vocal fold position; dysphonia is characterized by hoarseness, breathiness, roughness and stress of moderate to severe levels. Braz J Otorhinolaryngol. 2011;77(6):761-7. ORIGINAL ARTICLE

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Voice and Laryngeal Configuration of Men With Unilateral Vocal Fold Paralysis Before and After Medialization

Cited by 14 publications

References 29 publications

Fonoterapia com fonação em tubos em paciente com paralisia de prega vocal medializada cirurgicamente: estudo de caso

Fonoterapia com fonação em tubos em paciente com paralisia de prega vocal medializada cirurgicamente: estudo de caso

Acoustic Correlates of Compensatory Adjustments to the Glottic and Supraglottic Structures in Patients with Unilateral Vocal Fold Paralysis

Voz e posição de prega vocal em homens com paralisia unilateral de prega vocal

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