Estudo normativo dos parâmetros acústicos vocais de crianças de 4 a 12 anos de idade sem sintomas vocais: estudo piloto

Análise vocal acústica é método simples e rápido de avaliação vocal e permite diferenciar vozes normais de alteradas. em crianças, poucas pesquisas analisam os parâmetros vocais acústicos normais nas diversas idades. OBJETIVOS: Estabelecer parâmetros acústicos vocais de normalidade em crianças de 4 a 12 anos. CASUÍSTICA E MÉTODOS: 240 crianças distribuídas por idade em quatro subgrupos: G1 (n-60; 4-5 anos), G2 (n-60; 6-7 anos), G3 (n-60; 8-9 anos) e G4 (n-60; 10-12 anos). Os pais responderam um questionário de avaliação e as crianças foram submetidas à avaliação da acuidade auditiva (Pesquisa das Emissões Otoacústicas Transientes), às análises vocais acústicas e ao exame otorrinolaringológico (nasofibroscopia/ videolaringoscopia). RESULTADOS: Foram estabelecidos os valores normais dos parâmetros acústicos vocais estudados de acordo com as faixas etárias e o gênero. Com o aumento da idade, observou-se diminuição de f0 e do APQ e aumento do SPI com diferença estatística. Os parâmetros vocais não diferiram entre os gêneros até a idade de 12 anos. CONCLUSÕES: A caracterização dos padrões vocais normativos de crianças é importante ferramenta para outras pesquisas. Algumas das alterações constatadas mostraram relação com a idade como a diminuição de f0 e do APQ e aumento do SPI, sem haver diferença com relação ao gênero.

A criança disfônica: diagnóstico, tratamento e evolução clínica

Os nódulos vocais são causas freqüentes de disfonias infantis, porém, através das vídeoendoscopias, outras lesões têm sido diagnosticadas na laringe infantil, como os cistos, sulcos, pontes e micromembranas, denominadas de lesões estruturais mínimas. OBJETIVO: Avaliar, em 71 crianças com disfonia agendadas nos ambulatórios de Foniatria da Faculdade de Medicina de Botucatu (Unesp) nos últimos cinco anos: sexo, idade, diagnósticos, tratamentos e evolução clínica. FORMA DE ESTUDO: Clínico retrospectivo. CASUÍSTICA E MÉTODO: Realizou-se estudo retrospectivo das avaliações otorrinolaringológicas e endoscópicas de 71 crianças com queixas de disfonia e idade entre 3 a 13 anos (45 meninos e 26 meninas). As crianças haviam sido submetidas a exame endoscópico com telescópio rígido ou nasofibroscópio flexível. Foram excluídas as crianças com disfonias funcionais ou com queixas de obstrução respiratória. RESULTADOS: Os principais diagnósticos foram: nódulo vocal (47 casos; 66,2%), cisto epidérmico (7 casos; 9,9%), cisto aberto fistulizado (6 casos; 8,4%), sulco vocal (5 casos; 7,1%), ponte + cisto (2 casos; 2,8%), micromembrana anterior (2 casos; 2,8%) e pólipo vocal (2 casos; 2,8%). As disfonias foram mais freqüentes entre os meninos (63,3%). A fonoterapia isolada foi o tratamento de escolha nos casos de nódulo vocal (evolução favorável), sulco vocal (evolução desfavorável) e micro-membrana (evolução desfavorável). Nas demais lesões (cistos, pontes e pólipos) o tratamento de escolha foi a cirurgia associada à fonoterapia, com resultados satisfatórios, exceto nos casos que recusaram a cirurgia. CONCLUSÃO: Os nódulos vocais são as principais causas de disfonias em crianças, porém as lesões estruturais mínimas mostraram-se também freqüentes, exigindo exame minucioso para o diagnóstico.

Caracterização do perfil comunicativo de crianças com distúrbios do espectro autístico com diferentes interlocutores

OBJETIVO: caracterizar e comparar o perfil comunicativo de crianças com distúrbios do espectro autístico com dois diferentes interlocutores. MÉTODO: participaram da pesquisa nove sujeitos, sendo quatro crianças do gênero masculino, com faixa etária variando entre cinco anos e oito meses e onze anos, com distúrbios do espectro autístico e cinco terapeutas de linguagem. Foram realizadas análises do perfil comunicativo dessas crianças com os dois diferentes interlocutores (terapeuta de linguagem da própria criança e terapeuta desconhecida). Para análise dos dados foi empregado o Protocolo de Pragmática e tratamento estatístico dos resultados (p < 0,05; Teste dos Postos Sinalizados de Wilcoxon). RESULTADOS: foram levantados o número de atos comunicativos, o meio pelo qual esses atos foram expressos (vocal, verbal e gestual) e as funções comunicativas. em média, o número de atos comunicativos expressos pelos sujeitos tanto com os terapeutas das próprias crianças (5,10 atos/min) como com a terapeuta desconhecida (4,93 atos/min) não foi estatisticamente significante. Observou-se na situação de interação com o próprio terapeuta que a média do percentual da ocorrência do meio comunicativo verbal (31,50%) e a média de funções mais interativas (33,25%) são maiores do que com terapeuta desconhecida. CONCLUSÃO: os diferentes interlocutores, estudados nesta pesquisa, não tiveram uma influência no perfil comunicativo destas crianças. Deste modo, sugerem-se novos estudos, com inclusão de outros interlocutores, a fim de estabelecer quais variáveis interacionais interferem estatisticamente no perfil comunicativo de crianças do espectro autístico, com o intuito de contribuir para a elaboração de melhores propostas terapêuticas para esta população.

Study of the elderly females' voice by phonetography

This study was carried out to investigate the voice characteristics of 40 healthy females with no voice disorders, ranging in age from 60 to 84 years ((X) over bar = 68.2 +/- 5.74 years). Measurements over all the entire phonational range were obtained by phonetography. The subjects were asked to sustain the vowel /a/ in modal register for a minimum of 5 seconds in the highest and lowest intensities after hearing the semitones C, E, G, and A, over all phonational ranges. The results indicated expansion of the low and reduction of high ends of the pitch range, decrease of the pitch numbers of the vocal range, restriction of the lowest and highest limits of the intensity, and reduction of either the maximum phonational range and the phonetogram area. The phonetography technique has shown efficacy to investigate the voice characteristics of elderly females.

Visual communication in Brazilian species of anurans from the Atlantic forest

Visual communication is widespread among several anuran families, but seems to be more common than currently thought. We investigated and compared visual communication in six species of an anuran community in the Brazilian Atlantic forest. Four are nocturnal species: Hyalinobatrachium uranoscopum (Centrolenidae), Hyla albomarginata, Hyla sp. (aff. ehrhardti), and Scinax eurydice (Hylidae), and two are diurnal species: Hylodes phyllodes and Hylodes asper ( Leptodactylidae). For H. uranoscopum, H. albomarginata, S. eurydice, and H. phyllodes, this is the first record of visual communication. Observations were made at Nucleo Picinguaba, Parque Estadual da Serra do Mar, in the Municipality of Ubatuba, State of São Paulo, Brazil. Descriptions of behaviour were based on individuals observed in the field, using sequence sampling with continuous tape recording for behavioural observations. Eight new behaviours are described: body wiping, face wiping, jump display, leg kicking, limb lifting, mouth opening, toe flagging, and vocal sac display. of the 42 anuran species known from Nucleo Picinguaba, at least six ( approximately 14%) display visual communication. The evolution of visual signals in these species may be related to the availability of ambient light, the structural complexity of the habitat, and/or the ambient noise. They may also have evolved to aid in the location of the individual, to avoid physical combat, and/or may be a by-product of seismic communication.

The newborn pain cry: Descriptive acoustic spectrographic analysis

Introduction: Study the characteristics of pain vocal emission of newborns during venepuncture through acoustic analysis and relate it to NIPS pain scale and some variables of the newborns.Methods: Emissions of 111 healthy term newborns were recorded, whose lifetime varied from 24 to 72 h. The acoustic analysis was realized with GRAM 5.7 software verifying the occurrence of tense strangled voice quality, sounds, concentration of acoustic energy, breaks, double harmonic breaks and frequency instability, type of phonation, vocal attack and cough. The NIPS scale was realized during venepuncture and descriptive statistical analysis and correlation through Spearman test.Results: Hundred percent of the emissions had guttural sounds, vowels, hard vocal attack, frequency, breaks, double harmonic breaks and tense strangled voice quality; 34.2% higher fundamental frequency; 62.2% periods of emission absence and 100% occurrence of tracing instability, concentration of acoustic energy, inspiratory and expiratory phonation. The cough occurred in 14.4%. The signs of vocal tract constriction associated with all. The parameters. There was a negative correlation between the higher fundamental frequencies and the weight of newborns and positive correlation between cough and NIPS score.Conclusions: the newborn pain emission is tense and strident, the modifications of frequency and spectrographic tracing and the presence of sounds show laryngeal and vocal tract participation. The smaller the newborn weight, the bigger the presence of higher fundamental frequency with tense strangled voice quality and the bigger the NIPS score, the more frequent the cough. Such characteristics make pain crying peculiar, helping in the evaluation of pain during a procedure. (c) 2006 Elsevier B.V.. All rights reserved.

Description of a new species of Pseudopaludicola Miranda-Ribeiro, 1926 from the state of São Paulo, Southeastern Brazil (Anura, Leiuperidae)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The advertisement call of Dendropsophus nahdereri (Anura, Hylidae, Dendropsophini).

The Dendropsophus marmoratus group is composed of eight species known for their explosive breeding habits and morphologically characterized by a bark-like dorsum, warty skin around the lower lips and an extremely large vocal sac. Within this group, D. nahdereri is the only species with distribution restricted to the southern region of Brazil. Apart from the original description and its tadpole, nothing else is known about this species. Using a mechanistic definition of note, we describe the advertisement call of D. nahdereri, which is similar to the advertisement calls of other species of the group and frequently has "final pulseclusters" as defined in the text.

A Música Coral dos Primórdios do Século XX aos Primórdios do Século XXI: a Composição para Coros e a Performance do Repertório Moderno/Contemporâne

This paper is a small part of my Doctoral dissertation which is a large study about the practice and sonority in various choral music styles. Focusing on the choral music from the beginning of the 20th century to the present day, and based upon a bibliographical review, this article describes the characteristics of the choral composition and reflects on the performance aspects of the performance of modern and contemporary choral repertoire such as vocal tone color, intonation and non-traditional vocal techniques.

LESOES PRECOCES DA INTUBACAO ENDOTRAQUEAL

The authors studied the early lesions of laryngotracheal mucosa following intubation in 30 dogs who were intubated with high complacent canula during the period of 4 hours. After this period, biopsies of vocal cord, aritenois, cricoid and tracheal rings were performed. The most frequent histological findings were neutrophils and mononuclear inflammatory cell infiltration into the corion, vascular congestion and necrosis of epithelial cells. Based in these findings the authors recommend the use of canula with balonets of high complacence and the endoscopic follow up of the patients after extubation.

Redescription and reevaluation of the generic status of Leptodactylus dantasi (Amphibia, Anura, Leptodactylidae) and description of its unusual advertisement call

Leptodactylus dantasi Bokermann is redescribed from adult specimens collected in Parque Nacional da Serra do Divisor, State of Acre, Brazil, near the border between the Brazilian state of Acre and Peru. We propose the inclusion of this species in the genus Hydrolaetare. A new diagnostic character observed for the genus is the presence of fringes of fingers, and fringes and webbing of toes, finely serrate; the serrate edge of the fringe and webbing can be keratinized in males, females, and subadults. Hydrolaetare dantasi (Bokermann) is characterized by robust body and limbs, a broad and depressed head, slightly shorter than wide, and long, pointed and basally webbed toes. Hydrolaetare dantasi differs from the only other species in this genus, Hydrolaetare schmidti (Cochran and Goin), mainly by having toes webbed basally (fully webbed in H. schmidti). The advertisement call of H. dantasi is composed of two components; an initial note produced by the impact of the vocal sac against the ground and a second note corresponding to a long whistle of ascending frequency. The initial note is a percussive sound and represents an unusual form of sound emission in anurans; the second note is a vocalization.

Laryngeal electromyography in movement disorders: Preliminary data

This study describes preliminary laryngeal electromyography (LEMG) data and botulinum toxin treatment in patients with dysphonia due to movement disorders. Twenty-five patients who had been clinically selected for botulinum toxin administration were examined, 19 with suspected laryngeal dystonia or spasmodic dysphonia (SD), 5 with vocal tremor, and 1 with Gilles de la Tourette syndrome (GTS). LEMG evaluations were performed before botulinum toxin administration using monopolar electrodes. Electromyography was consistent with dystonia in 14 patients and normal in 5, and differences in frequency suggesting essential tremor in 3 and Parkinson tremors in 2. The different LEMG patterns and significant improvement in our patients from botulinum toxin therapy has led us to perform laryngeal electromyography as a routine in UNICAMP movement disorders ambulatory.

O espectro médio de longo termo na pesquisa e na clínica fonoaudiológica.

BACKGROUND: One of the great difficulties in evaluating a voice is the judgment of quality through the perceptual auditive analysis--although frequently used--, as it is influenced by socioeconomic and cultural aspects as well as individual preferences. Many are the adjectives and methods used in this assessment, especially because of the subjectivity involved in the process, leading to incompatibilities between listeners and difficulties in reaching a consensus on the use of this or that terminology. In such a context, the voice laboratory and more specifically the acoustic computerized analysis, has guided and complemented speech-language treatments. Among the several possibilities of spectrographic analysis, the (Long-Term Average Spectrum--LTAS) quantifies the quality of voices, pointing differences between gender, age, professional--spoken and sang--and dysphonic voices. The LTAS has been used a lot in researches that investigate voice. As it evidences the contribution of the glottic source and of resonance to the quality of voice, it provides objective parameters for the evaluation of this aspect which usually depends on our auditive perception. AIM: to demonstrate how LTAS can be applied in voice research and in the speech-language therapy practice, describing both the technical aspects required for the production and interpretation of results, and its limitations. CONCLUSION: The area of voice research has developed a lot in these last two decades especially because of the advent of the voice and speech laboratory. For this reason, the knowledge about the applicability of more tools for voice analysis, as the LTAS, as well as the existing need for more studies in this area, will most certainly contribute for the creation of new research areas not only in the field of professional voice but also in the field of therapy.

Electroglottographic analysis of actresses and nonactresses' voices in different levels of intensity

Background: Previous studies with long-term average spectrum (LTAS) showed the importance of the glottal source for understanding the projected voices of actresses. In this study, electroglottographic (EGG) analysis was used to investigate the contribution of the glottal source to the projected voice, comparing actresses and nonactresses' voices, in different levels of intensity. Method: Thirty actresses and 30 nonactresses sustained vowels in habitual, moderate, and loud intensity levels. The EGG variables were contact quotient (CQ), closing quotient (QCQ), and opening quotient (QOQ). Other variables were sound pressure level (SPL) and fundamental frequency (F0). A KayPENTAX EGG was used. Variables were inputted in a general linear model. Results/Discussion: Actresses showed significantly higher values for SPL, in all levels, and both groups increased SPL significantly while changing from habitual to moderate and further to loud. There were no significant differences between groups for EGG quotients. There were significant differences between the levels only for F0 and CQ for both groups. Conclusion: SPL was significantly higher among actresses in all intensity levels, but in the EGG analysis, no differences were found. This apparently weak contribution of the glottal source in the supposedly projected voices of actresses, contrary to previous LTAS studies, might be because of a higher subglottal pressure or perhaps greater vocal tract contribution in SPL. Results from the present study suggest that trained subjects did not produce a significant higher SPL than untrained individuals by increasing the cost in terms of higher vocal fold collision and hence more impact stress. Future researches should explore the difference between trained and nontrained voices by aerodynamic measurements to evaluate the relationship between physiologic findings and the acoustic and EGG data. Moreover, further studies should consider both types of vocal tasks, sustained vowel and running speech, for both EGG and LTAS analysis. © 2013 The Voice Foundation.

Caracterização e classificação da deglutição orofaríngea do idoso institucionalizado: avaliaçao clínica fonoaudiológica

Pós-graduação em Bases Gerais da Cirurgia - FMB