Following treatment of laryngeal tuberculosis, the incidence of dysphonia was very high. Speech therapy improved patients' vocal quality.
IntroductionLaryngeal tuberculosis (LTB) is the most frequent larynx granulomatous disease. In general there is lung involvement, but in an important proportion of cases you can find LTB without pulmonary disease. The lesions observed in LTB, such as ulceration and fibrosis, can interfere in the process of voice production. The involvement of the mucous lining of the vocal folds can change their flexibility and, consequently, change voice quality, and the main symptom is dysphonia present in almost 90% of cases.ObjectiveTo describe the anatomical characteristics and voice quality in LTB patients.Material and MethodA descriptive cross-sectional study was conducted with 24 patients.ResultThe most frequently affected sites were vocal folds in 87.5% patients, vestibular folds in 66.7%, epiglottis in 41.7%, arytenoid in 50%, aryepiglottic folds in 33.3%, and interarytenoid region in 33.3% patients. We found 95.8% cases of dysphonia. The voice acoustic analysis showed 58.3% cases of Jitter alterations, 83.3% of Shimmer and 70.8% of GNE.ConclusionVoice disorders found in active laryngeal tuberculosis are similar to those reported after clinical healing of the disease, suggesting that sequelae and vocal adjustments may install during the active phase of the disease, negatively impacting the process of vocal quality reestablishment.
RESUMO Objetivo analisar o efeito imediato do exercício de sucção de ar na qualidade vocal e na autoavaliação vocal de professoras. Métodos trata-se de um estudo piloto de intervenção. Participaram 13 professoras disfônicas da rede particular do ensino fundamental, com média de idade de 35 anos e 10 meses. O exercício de sucção de ar foi realizado dez vezes, por cada participante. Os desfechos mensurados foram: avaliação perceptivoauditiva da voz, análise acústica da voz e autoavaliação vocal. Os dados foram analisados por estatística descritiva e inferencial. Resultados não houve diferença nos parâmetros acústicos e perceptivoauditivos mensurados antes e após a intervenção. Houve proporção significativamente maior de professoras que autoavaliaram a voz como melhor, após a intervenção. Conclusão o exercício de sucção de ar produz efeitos imediatos positivos na autoavaliação vocal de professores.
IntroductionLeishmaniasis is considered as one of the six most important infectious diseases because of its high detection coefficient and ability to produce deformities. In most cases, mucosal leishmaniasis (ML) occurs as a consequence of cutaneous leishmaniasis. If left untreated, mucosal lesions can leave sequelae, interfering in the swallowing, breathing, voice and speech processes and requiring rehabilitation.ObjectiveTo describe the anatomical characteristics and voice quality of ML patients.Materials and MethodsA descriptive transversal study was conducted in a cohort of ML patients treated at the Laboratory for Leishmaniasis Surveillance of the Evandro Chagas National Institute of Infectious Diseases - Fiocruz, between 2010 and 2013. The patients were submitted to otorhinolaryngologic clinical examination by endoscopy of the upper airways and digestive tract and to speech-language assessment through directed anamnesis, auditory perception, phonation times and vocal acoustic analysis. The variables of interest were epidemiologic (sex and age) and clinic (lesion location, associated symptoms and voice quality.Results26 patients under ML treatment and monitored by speech therapists were studied. 21 (81%) were male and five (19%) female, with ages ranging from 15 to 78 years (54.5+15.0 years). The lesions were distributed in the following structures 88.5% nasal, 38.5% oral, 34.6% pharyngeal and 19.2% laryngeal, with some patients presenting lesions in more than one anatomic site. The main complaint was nasal obstruction (73.1%), followed by dysphonia (38.5%), odynophagia (30.8%) and dysphagia (26.9%). 23 patients (84.6%) presented voice quality perturbations. Dysphonia was significantly associated to lesions in the larynx, pharynx and oral cavity.ConclusionWe observed that vocal quality perturbations are frequent in patients with mucosal leishmaniasis, even without laryngeal lesions; they are probably associated to disorders of some resonance structures (larynx, pharynx and nasal and oral cavities) or even to compensation mechanisms caused by the presence of lesions in the upper airways and digestive tract.
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