Proposta de modelo de atendimento multidisciplinar para disfonias relacionadas ao trabalho: estudo preliminar

Abstract

A disfonia tem recebido um enfoque ocupacional crescente e torna-se necessário, ao otorrinolaringologista, atualizar a abordagem clínica dos trabalhadores que usam a voz como instrumento de trabalho, onde novas catagorias profissionais têm surgido e, com elas, as disfunções vocais conseqüentes às condições de trabalho. Hoje, há grandes preocupações com o prejuízo econômico e produtivo que o ditúrbio vocal possa gerar. Sabe-se que a disfunção vocal tem como característica a multicausalidade e, por isso, a avaliação, conclusão e emissão de relatórios médicos tornam-se incertos. Objetivo: Para melhor avaliar estes profissionais e garantir um atendimento com respaldo científico adequado, estabeleceu-se um protocolo multidisciplinar, que consiste em anamnese dirigida, exame físico, endoscopia laríngea, análise perceptiva da voz e aplicação do Voice Handicap Index (VHI). Forma de estudo: Coorte histó-rica transversal. Material e método: Para testar o uso do méto-do, em caráter preliminar, o protocolo foi aplicado em 15 profissionais que usavam a voz para trabalhar. Então, realizou-se um estudo retrospectivo com estes pacientes. Resultado: Demonstrou-se que 13,3% dos profissionais apresentaram performance vocal normal; 33,3%, disfonia funcional e 46%, disfonia orgânico-funcional. A disfunção vocal foi relacionada ao exercício do trabalho em 40% dos pacientes e em 46,6% ela foi descartada. Conclusão: Concluiu-se que o método é suficientemente abrangente e pode ser de utilidade ao otorrinolaringologista, para a avaliação clínico-ocupacional deste grupo de pacientes. Dysphoni a has an occupational view nowadays. A shift in the voice-oriented professional's clinical approach has been required. New voice-oriented job categories have emerged and, as a result, the voice disorder in the professional enviroment has increased. The economic and productivity harm due to voice disorders are a preocupation. Dysphonia has multiple causes and its evaluation, ethiological conclusion and occupational reports aren't defined yet. Aim: In order to obtain a more accurate and comprehensive evaluation, a multidisciplinary protocol was elaborated to ensure proper medical scientific support. It consists of anamnesis, physical exam, laryngeal endoscopy, perceptive voice analysis and Voice Handicap Index application (VHI). Study design: Transversal historic cohort. Material e método: In this preliminary study, the protocol was applied on 15 voice professionals with dysphonia. Results: 13,3% with normal voice performance; 33,3% with functional dysphonia; 46% with organic dysphonia. Dysphonia was related to the voice-oriented job in 40% cases and it was ruled out in 46,6%. Conclusion: We concluded that the protocol is complete enough to help otolaryngologists evaluate this workers' category. EricaPalavras-chave: disfonia, ocupacional, multidisciplinar.

Sintomas vocais e causas autorreferidas em professores

“…Moreover, associations between teachers' self-reported symptoms and causes were found, as outlined in Table 5. Researchers found that teachers were more likely to refer to vocal problems as age increases, the same way they found that teachers who did not have voice disorders are younger than those with voice changes 11,22 .…”

“…The authors of that study also said that more women in the pedagogical area are due to the fact that the profession is still seen as traditionally feminine 22 .…”

“…A study 22 points out that change occurrence in women glottic configuration during prolonged phonation and high loudness, possibly due to anatomical differences, favor voice disorders appearance. The authors of that study also said that more women in the pedagogical area are due to the fact that the profession is still seen as traditionally feminine 22 .…”

“…Nasal mucosa allergic inflammation, better known as allergic rhinitis, repeatedly occurs, with inhalant allergies, cause by dust mites and dust, being their main cause. Authors 12,22,25 emphasized that allergic rhinitis is a predisposing or aggravating factor for voice disorder contexts.…”

Grau de quantidade de fala e intensidade vocal de teleoperadores em ambiente laboral e extralaboral

“…Female call center agents reported a higher degree of talkativeness at work when compared to men (Table 1). According to the literature, the females have a higher a risk factor for developing voice disorders than males, given that the laryngeal proportion of this gender and the vocal folds vibration dosage associated with vocal load can lead to a laryngeal hyperfunction and consequently development of lesions (21)(22)(23)(24) . When degree of talkativeness and vocal loudness are compared in the two situations studied, innate and at work, it is observed a greater degree of talkativeness and vocal loudness at work (Table 2).…”