RESUMEN
Objetivo: Los trastornos de la voz son muy frecuentes en la población pediátrica, entre el 6% y el 23% de todos los niños presentan alguna forma de disfonía. La evaluación de la voz abarca los aspectos perceptuales, análisis acústico, métodos de diagnóstico visual, y cuestionarios que orientan al impacto sobre la calidad de vida. El objetivo de nuestro estudio es realizar la traducción, transculturalización y validación del cuestionario Children Voice Handicap Index (CVHI) a hispanohablantes latinoamericanos. Material y Método: El estudio se realizó en el Hospital Italiano de Buenos Aires, Argentina y en el Hospital de Niños Dr. Luis Calvo Mackenna de Santiago de Chile. Se incluyeron pacientes entre 8 y 15 años de edad. Se tradujo, transculturalizó y validó el CVHI para dicha población. Se realizó el cuestionario en dos grupos de pacientes: un grupo de niños con antecedentes de disfonías, n = 48 y el otro grupo pacientes de control, sin patología de la voz, n = 86. El cuestionario se aplicó a los niños, en presencia de sus cuidadores o padres, con la correspondiente conformidad. Resultados: Se encontró una diferencia significativa entre ambos grupos (p < 0,05) con una confianza interna óptima de 0,98 obtenida mediante alfa de Cronbach y una alta fiabilidad test-retest (correlación de Pearson = 0,96). Conclusión: La validación y transculturalización del CVHI para la población hispanohablante de latinoamérica presentó una adecuada validez y fiabilidad. Complementar la evaluación de la patología vocal con un sencillo cuestionario de auto-rrealización en población pediátrica, constituye una valiosa herramienta que completa el diagnóstico del impacto de la alteración de la voz en la calidad de vida.
Aim: Voice disorders are very common in the pediatric population, since between 6% and 23% of all children present some type of dysphonia. Voice evaluation includes perceptual aspects, acoustic analysis, visual diagnostic methods, and questionnaires that guide the impact on quality of life. The objective of this study is to carry out the translation, transculturalization and validation of the Children Voice Handicap Index (CVHI) questionnaire for Latin American Spanish speakers. Material and Method: The study was conducted at the Italian Hospital in Buenos Aires, Argentina and at the Dr. Luis Calvo Mackenna Children's Hospital in Santiago de Chile, Chile. Patients between 8 and 15 years of age were included. The CVHI was translated, transculturalized, and validated for said population. The questionnaire was carried out in two groups of patients: a group of children with a history of dysphonia, n = 48, and the other group, control patients, without voice pathology, n = 86. The questionnaire was applied to the children, in the presence of their caregivers or parents, with the corresponding consent. Results: A significant difference was found between both groups (p < 0.05) with an optimal internal confidence of 0.98 obtained using Cronbach's alpha and high test-retest reliability (Pearson's correlation = 0.96). Conclusion: The validation and transculturalization of the CVHI for the Spanish-speaking population of Latin America presented adequate validity and reliability. Complementing the evaluation of vocal pathology with a simple self-administration questionnaire in the pediatric population constitutes a valuable tool that completes the diagnosis of the impact of voice alteration on quality of life.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Trastornos de la Voz/diagnóstico , Trastornos de la Voz/epidemiología , Disfonía/diagnóstico , Disfonía/epidemiología , Argentina/epidemiología , Chile/epidemiología , Encuestas y Cuestionarios , AutoevaluaciónRESUMEN
Introducción: El hiatus glótico longitudinal es un signo descrito en la práctica clínica a partir de las fibrolaringoscopias de pacientes con patologías laríngeas. Objetivo: Describir la prevalencia de patologías laríngeas orgánicas y funcionales mediante videolaringoestroboscopia, y evaluar la frecuencia de hiatus longitudinal y su asociación con patología orgánica en pacientes adultos disfónicos. Material y Método: Se realizó un estudio retrospectivo y descriptivo durante 2018-2019 en un hospital de alta complejidad. Se incluyeron las videolaringoestroboscopia de pacientes mayores de 14 años que consultaron por disfonía. Las patologías laríngeas se categorizaron en orgánicas o funcionales. La asociación entre patología orgánica y el hiatus longitudinal se analizó mediante un análisis multivariado ajustado por confundidores. Resultados: Se incluyeron 310 pacientes de los cuales se analizaron 269. La media de edad fue 43,9 ± 7,09 años y el porcentaje de sexo femenino 65,8% (n: 177). La prevalencia de disfonía orgánica fue del 84,01% y de disfonía funcional, del 13,38%. La prevalencia de hiatus longitudinal fue del 23,79% (n: 64). Se observó una asociación, estadísticamente significativa entre la presencia de hiatus longitudinal y la presencia de patología orgánica con OR de12,64 (1,60-99,42; p: 0,01) ajustada por edad, sexo, tabaquismo y antigüedad de la disfonía. Conclusión: La prevalencia de patologías laríngeas orgánicas es mayor a la de funcionales y el hiatus longitudinal se asocia a patología orgánica ajustada por confundidores.
Introduction: Spindle-shaped glottic chink is a sign described in clinical practice from fibrolaryngoscopy of patients with laryngeal pathologies. Aim: to describe the prevalence of organic and functional laryngeal pathologies by videolaringostroboscopy, and to evaluate the frequency of spindle-shaped glottic chink and its association with organic pathology in dysphonic adult patients. Material and Method: A retrospective and descriptive study was conducted during 2018-2019 in a high complexity hospital. Patient's videostroboscopy older than 14 years old who consulted for dysphonia were included. Laryngeal pathologies were categorized into organic or functional diseases. The association between organic pathology and spindle-shaped glottic chink was analyzed using a multivariate analysis adjusted for confounders. Results: 310 patients were included of whom 269 patients were analyzed. The mean age was 43.9 ± 7.09 years and the percentage of female sex was 65.8 % (n: 177). The prevalence of organic dysphonia was 84.01% and of functional dysphonia, 13.38%. The prevalence of spindle-shaped glottic chink was 23.79% (n:64) (18.67-28.91%). A statistically significant association was observed between the presence of spindle-shaped glottic chink and the presence of organic pathology with OR of 12.64 (1.60- 99.42; p: 0.01) adjusted for age, sex, smoking status and history of dysphonia. Conclusion: The prevalence of organic laryngeal pathology is higher than functional and spindle-shaped glottic chink is associated with organic pathology adjusted for confounders.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Enfermedades de la Laringe/epidemiología , Disfonía/epidemiología , Distribución de Chi-Cuadrado , Enfermedades de la Laringe/diagnóstico , Epidemiología Descriptiva , Prevalencia , Distribución por Sexo , Distribución por Edad , Disfonía/diagnóstico , Laringoscopía/métodosRESUMEN
Introdução: A disfonia causa impacto na qualidade de vida e no mercado de trabalho, sendo sinto-ma importante para triagem de neoplasia laríngea. Objetivo: Realizar avaliação estatística de um grupo populacional da cidade de Guarulhos com queixa de disfonia. Método: Trata-se de um estudo transversal com utilização de amostra correspondente a 2.564 exames, videolaringoscópicos ou nasofibrolaringoscó-picos, de pacientes acima de 5 anos de idade, no município de Guarulhos da região metropolitana de São Paulo, pelo mesmo médico otorrinolaringologista e pelo mesmo fonoaudiólogo, entre os meses de abril de 2011 e abril de 2012. Avaliaram-se as alterações no diagnóstico da voz, levando em consideração idade e sexo dos pacientes. Foram descritos os sexos das pessoas segundo diagnósticos com uso de frequências absolutas e relativas e verificou-se a existência de associação entre sexo e diagnóstico através do uso de teste da razão de verossimilhanças (Kirkwood e Sterne, 2006). As idades foram descritas, segundo diagnósticos, com uso de medidas resumo (média, desvio-padrão (DP), mediana, mínimo e máximo), e foram comparadas as idades entre os diagnósticos, com uso de teste análise de variâncias (ANOVA) seguido de comparações múltiplas de Tukey (Neter et al., 1996). Os testes foram realizados com nível de significância de 5%. Resultados: Há maior frequência de homens com diagnóstico de neoplasias ou câncer que nos demais diagnósticos. Dos 2.564 exames, 477 apresentaram laringite crônica, sendo 69% do gênero feminino; 279 disfonia funcional, 63,4% do gênero feminino; 137 alterações estruturais míni-mas (AEM), 69,3% do gênero feminino; 36 disfunções neurológicas, sendo igualmente divididos entre os gêneros; e 12 apresentaram neoplasias, sendo 83,3% do masculino. Conclusão: Verificou-se maior número de alterações benignas no gênero feminino. Neoplasias e disfunções neurológicas predominaram no gênero masculino. A disfonia funcional e as AEM ocorrem em pacientes abaixo dos 40 anos, enquanto as demais ocorrem até em idades avançadas, acima dos 50 anos.
Introduction: Dysphonia impacts in quality of life and in the labor market, being an important symptom for screening laryngeal neoplasia. Objective: Perform a statistical evaluation of a population group in the city of Guarulhos complaining of dysphonia. Method: This is a cross-sectional study using a sample corresponding to 2,564 examinations, videolaryngoscopic or nasofibrolaryngoscopic, of pa-tients over 5 years of age, in the municipality of Guarulhos of the metropolitan region of São Paulo, by the same ENT physician and the same speech therapist, between April 2011 and April 2012. Changes in voice diagnosis were evaluated taking into account the age and gender of the patient. The sex of subjects was described according to diagnoses using absolute and relative frequencies, and the existence of an association between sex and diagnosis was verified through the use of likelihood ratio testing (Kirkwood and Sterne, 2006). Ages were described according to diagnoses using summary measurements (mean, standard deviation, median, minimum and maximum), and compared the ages between diagnoses, using variance analysis (ANOVA) followed by multiple comparisons by Tukey (Neter et al., 1996). The tests were performed with a significance level of 5%. Results: There is a higher frequency of men diagnosed with neoplasms or cancer than in other diagnoses. Of the 2,564 tests, 477 had chronic laryngitis, 69% in females; 279 functional dysphonia, 63.4% female; 137 minimal structural alterations (AEM), 69.3% female; 36 neurological dysfunctions, being equally divided between genders; and 12 presented neoplasms, 83.3% in males. Conclusion: There were a higher number of benign alterations in the female gender. Neoplasms and neurological dysfunctions predominated in males. Functional dysphonia and AEM occur in patients under 40 years of age, while the others occur even at advanced ages, above 50 years of age.
Introducción: La disfonía impacta en la calidad de vida y en el mercado laboral, siendo un sínto-ma importante para el cribado de la neoplasia laríngea. Objetivo: Realizar una evaluación estadística de un grupo poblacional de la ciudad de Guarulhos que se queja de disfonía. Método: Se trata de un estudio transversal que utiliza una muestra correspondiente a 2564 exámenes, videolaringoscópicos o nasofibrolaringoscópicos, de pacientes mayores de 5 años, en el municipio de Guarulhos de la región metropolitana de São Paulo, realizados por el mismo otorrinolaringólogo y el mismo logopeda, entre abril de 2011 y abril de 2012. Los cambios en el diagnóstico de voz se evaluaron teniendo en cuenta la edad y el sexo de las personas. Los sexos de las personas se describieron de acuerdo con los diagnósticos utilizando frecuencias absolutas y relativas, y la existencia de una asociación entre el sexo y el diagnóstico se verificó mediante el uso de pruebas de razón de probabilidad (Kirkwood y Sterne, 2006). Las edades se describieron de acuerdo con los diagnósticos utilizando mediciones resumidas (media, desviación estándar, mediana, mínima y máxima), y se compararon las edades entre los diagnósticos, utilizando el análisis de varianza (ANOVA) seguido de comparaciones múltiples de Tukey (Neter et al., 1996). Las pruebas se realizaron con un nivel de significancia del 5%. Resultados: Hay una mayor frecuencia de hombres diagnosticados con neoplasias o cáncer que en otros diagnósticos. De las 2.564 pruebas, 477 presentaban laringitis crónica, el 69% en mujeres; 279 disfonía funcional, el 63,4% mujeres; 137 alteraciones estructurales mínimas (AEM), el 69,3% mujeres; 36 disfunciones neurológicas, estando divididas por igual entre géneros; y 12 presentaban neoplasias, el 83,3% en varones. Conclusión: Hubo un mayor número de alteraciones benignas en el género femenino. Las neoplasias y las disfunciones neurológicas predominaron en los varones. La disfonía funcional y la AEM ocurren en pacientes menores de 40 años de edad, mientras que las otras ocurren incluso a edades avanzadas, por encima de los 50 años de edad.
Asunto(s)
Humanos , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Disfonía/epidemiología , Disfonía/diagnóstico por imagen , Voz , Laringitis , Estudios Transversales , Interpretación Estadística de Datos , Laringoscopía , Neoplasias , Manifestaciones NeurológicasRESUMEN
Resumen Introducción: La disfonía infantil puede afectar negativamente la autoestima del niño y su calidad de vida relacionada con la voz. Objetivo: Describir los resultados del cuestionario Pediatric Voice Handicap Index (pVHI) en niños con patología vocal benigna. Material y Método: Se diseñó un estudio descriptivo en pacientes con patología vocal benigna entre 3 y 15 años en la Unidad de Voz del Hospital de Niños Dr. Luis Calvo Mackenna entre octubre de 2016 y febrero de 2020. La evaluación se realizó mediante un examen laringoscópico y el cuestionario pVHI para evaluar el impacto en la calidad de vida. Resultados: Se incluyeron 49 pacientes, 35 varones (71,4%) y 14 mujeres (28,6%). La edad media fue de 9,27 años. En el examen laringoscópico, el hallazgo más frecuente fueron los nódulos vocales. La puntuación media total en el pVHI fue de 38,77: 11,67 en la subescala o categoría funcional, 18,59 en la física y 8,42 en la emocional. En la evaluación de pVHI por género no existieron diferencias significativas. Conclusión: La patología vocal benigna en la edad pediátrica ocasiona un impacto negativo en la calidad de vida relacionada con la voz. El cuestionario pVHI es un valioso instrumento para evaluar dicha repercusión.
Abstract Introduction: Childhood dysphonia can negatively affect a child's self-esteem and voice-related quality of life. Aim: To describe the results of the Pediatric Voice Handicap Index (pVHI) questionnaire in children with benign vocal fold pathology. Material and Method: A descriptive study was designed in patients with benign vocal fold pathology between 3 and 15 years of age in the Voice Unit of the Dr. Luis Calvo Mackenna Children's Hospital between October 2016 and February 2020. The evaluation was carried out through a laryngoscopic examination and pVHI questionnaire to assess the impact on quality of life. Results: Forty-nine patients were included, 35 boys (71.4%) and 14 girls (28.6%). The mean age was 9.27 years. On laryngoscopic examination, the most frequent finding was vocal fold nodules. The total mean score on the pVHI was 38.77: 11.67 on the functional subscale, 18.59 on the physical subscale, and 8.42 on the emotional subscale. In the evaluation of pVHI by gender, no significant differences were found. Conclusion: Benign vocal fold pathology in pediatric age causes a negative impact on voice-related quality of life. The pVHI questionnaire is a valuable instrument to assess this repercussion.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Calidad de Vida , Trastornos de la Voz/diagnóstico , Trastornos de la Voz/epidemiología , Disfonía/diagnóstico , Disfonía/epidemiología , Epidemiología Descriptiva , Prevalencia , Encuestas y Cuestionarios , Distribución por Sexo , Distribución por Edad , Laringoscopía/métodosRESUMEN
Resumen Introducción: La prevalencia de patología vocal en niños fluctúa entre el 6% y el 23%. El cuestionario Pediatric Voice Handicap Index (pVHI) se ha transformado en el instrumento más utilizado a nivel internacional para determinar el impacto de la disfonía en la calidad de vida de los niños. Objetivo: Realizar la traducción, adaptación cultural y validación del Pediatric Voice Handicap Index al español chileno. Material y Método: Estudio transversal que incluyó a 151 niños y niñas entre 3 y 15 años. Se siguieron los 5 pasos recomendados por Beaton. La versión original del pVHI en inglés fue traducida al español por dos traductoras. Posteriormente, la versión traducida y unificada fue revisada por una lingüista chilena quien realizó la adaptación cultural al idioma español chileno. El cuestionario se aplicó a dos grupos de estudio, un grupo de niños con disfonía (n = 51) y un grupo control de niños sin alteraciones de la voz (n = 100) para obtener la versión final. Resultados: Se encontraron diferencias significativas entre el grupo de niños con disfonía y el grupo control en la puntuación global del pVHI y las diferentes subescalas (p < 0,001). Se encontró una consistencia interna óptima con un excelente alfa de Cronbach (α = 0,93), con una alta fiabilidad test-retest (puntuación de correlación de Pearson = 0,95). Conclusión: La versión chilena del cuestionario pVHI presenta un alto grado de validez y confiabilidad. Recomendamos su uso e implementación como protocolo estándar en la evaluación y seguimiento de la voz pediátrica.
Abstract Introduction: The prevalence of vocal pathology in children fluctuates between 6% and 23%. The pediatric voice handicap index (pVHI) questionnaire has become the most widely used instrument to determine the impact of dysphonia on the quality of life of children. Aim: Perform the translation, cultural adaptation, and validation of the pediatric voice handicap index into Chilean Spanish. Material and Method: Cross-sectional study that included 151 boys and girls between 3 and 15 years old. The 5 steps recommended by Beaton were followed. The original version of the pVHI in English was translated into Spanish by two translators. Subsequently, the translated and unified version was reviewed by a Chilean linguist who made the cultural adaptation to the Chilean Spanish language. The questionnaire was applied to two study groups, a group of children with dysphonia (n = 51) and a control group of children without voice disorders (n = 100) to obtain the final version. Results: Significant differences were found between the group of children with dysphonia and the control group in the global pVHI score and the different subscales (p < 0.001). Optimal internal consistency was found with excellent Cronbach's alpha (α = 0.93), with high test-retest reliability (Pearson's correlation score = 0.95). Conclusion: The Chilean version of the pVHI questionnaire presents a high degree of validity and reliability. We recommend its use and implementation as a standard protocol in the evaluation and monitoring of pediatric voice.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Calidad de Vida , Disfonía/epidemiología , Chile/epidemiología , Estudios Transversales , Encuestas y CuestionariosRESUMEN
Background: Acoustic neuroma (AN) is a well-recognized cause of neurological morbidity, peripheral facial paralysis being one of the most prevalent. Phonatory dysfunction in the late post-operative term has not been properly addressed so far.Objective: The objective of this study is to describe the outcomes of phonatory function on the long-term follow-up of AN surgery and identify its prognostic factors.Material and methods: This cohort study included patients submitted to AN surgery from 1999 to 2014, with a mean follow up of 6.4 ± 4.5 years. To evaluate the phonatory function, we performed a combination of noninvasive acoustic and aerodynamic measurements including vocal intensity and stability, maximum declination rate of the glottal airflow (MDR) and transglottal pressure scale (TP).Results: 101 patients were studied. 25 (24.7%) presented a deficit in phonatory function. Women comprised 56% and the mean age was 42.4 ± 13.8 years (range19-80). 100% presented reduced expiratory airflow capacity with excessive manifestation of the laryngeal musculature (TP > 1,23s ;MDR/z/Asunto(s)
Disfonía/etiología
, Neuroma Acústico/cirugía
, Fonación
, Complicaciones Posoperatorias/diagnóstico
, Adulto
, Anciano
, Anciano de 80 o más Años
, Análisis de Varianza
, Disfonía/diagnóstico
, Disfonía/epidemiología
, Femenino
, Estudios de Seguimiento
, Humanos
, Músculos Laríngeos/fisiopatología
, Masculino
, Persona de Mediana Edad
, Neuroma Acústico/fisiopatología
, Calidad de Vida
, Adulto Joven
RESUMEN
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.
ABSTRACT Purpose To analyze the immediate effect of the air suction exercise on vocal quality and vocal self-assessment of teachers. Methods This is an intervention pilot study. Thirteen dysphonic teachers from private elementary schools participated in this study, with an average age of 35 years and ten months. The air suction exercise was performed ten times by each participant. The measured outcomes were: auditory-perceptual evaluation of voice, acoustic analysis, and vocal self-assessment. The data were analyzed using descriptive and inferential statistics. Results there was no difference in the acoustic and auditory-perceptual parameters measured before and after the intervention. There was a significantly higher proportion of teachers who self-evaluated the voice as better after the intervention. Conclusion the air suction exercise produces immediate positive effects on teachers' vocal self-assessment.
Asunto(s)
Humanos , Adulto , Calidad de la Voz , Entrenamiento de la Voz , Salud Laboral , Disfonía/epidemiología , Percepción Auditiva , MaestrosRESUMEN
OBJECTIVE: To evaluate the role of upper airway dysfunction, indicated by altered vocal quality (dysphonia), on the respiratory symptoms of children surviving very preterm birth. STUDY DESIGN: Children born <32 weeks of gestation participated in 2 separate assessments during midchildhood. The first visit assessed voice quality by a subjective evaluation using the Consensus Auditory-Perceptual Evaluation of Voice and a computerized analysis of the properties of the voice via the Acoustic Voice Quality Index. The second assessment recorded parentally reported respiratory symptoms and measures of lung function, including spirometry, lung volumes, oscillatory mechanics, and a cardiopulmonary exercise test. RESULTS: Preterm children (n = 35; median gestation 24.3 weeks) underwent paired voice and lung assessments at approximately 11 years of age. Preterm children with dysphonia (n = 25) reported significantly more respiratory symptoms than those with normal voices (n = 10) including wheeze (92% vs 40%; P = .001) and asthma diagnosed by a physician (60% vs 10%; P = .007). Lung function outcomes were generally not different between the dysphonic group and the group with normal voice (P > .05), except for the oscillatory mechanics measures, which were all at least 0.5 z score lower in the dysphonic group (Xrs8 mean difference = -0.91 z scores, P = .003; fres = 1.06 z scores, P = .019; AX = -0.87 z scores, P = .010; Rrs8 = 0.63 z scores, P = .068). CONCLUSIONS: The upper airway may play a role in the respiratory symptoms experienced by some very preterm children and should be considered by clinicians, especially when symptoms are in the presence of normal lung function and are refractory to treatment.
Asunto(s)
Displasia Broncopulmonar/complicaciones , Disfonía/epidemiología , Trastornos Respiratorios/epidemiología , Niño , Femenino , Humanos , Recien Nacido Extremadamente Prematuro , Recién Nacido , Masculino , Factores de Riesgo , Espirometría , Calidad de la VozRESUMEN
RESUMEN Introducción: La disfonía es un síntoma muy frecuente en la infancia, que genera mucha preocupación en los padres y que puede afectar negativamente en el desarrollo emocional de los niños. A pesar de esto en España carecemos de datos estadísticos de su prevalencia. Objetivo: Determinar la prevalencia de disfonía en los niños de edad escolar matriculados en el Colegio "Ensanche" de Teruel. Material y método: Se realizó un estudio descriptivo de corte transversal. Nuestra población de estudio fueron niños entre 6 y 12 años matriculados en el Colegio "Ensanche" de Teruel. Para la valoración de la voz utilizamos una escala visual analógica y el índice de discapacidad pediátrico modificado. Resultados: 200 niños cumplieron los criterios de inclusión, 103 fueron de sexo femenino (51,5%) y 97 masculinos (48,5%). El rango de edad fue de 7 a 12 años. El 57% de los padres identificaron alteraciones de la voz en sus hijos para un total de 114 niños, de los cuales 17 puntuaron en rango patológico (24 ±11) que representan el 8,5%. Conclusión: Detectamos trastornos de voz en 57% de los niños evaluados y de éstos el 8,5% obtuvo puntuaciones que ameritarían una visita al especialista.
ABSTRACT Introduction: Dysphonia is a frequent symptom in childhood, which generates concern in parents and can negatively affect the emotional development of children. Despite this, in Spain, we lack statistical data on its prevalence. Aim: The aim of our study was to determine the prevalence of dysphonia in school- age children enrolled in the "Ensanche" de Teruel school. Material and method: A cross-sectional descriptive study was carried out. Our study population was children between 6 and 12 years enrolled in the "Ensanche" de Teruel school. For the evaluation of the voice, we used an analogue visual scale and the modified index of pediatric disability. Results: 200 children met the inclusion criteria, 103 were female (51.5%) and 97 male (48.5%). The age range was 7 to 12 years, 50.5% were between 10 and 11 years old. 57% of the parents identified voice alterations in their children for a total of 114 children, of which 17 children scored in pathological range (24 ±11) representing 8.5% of the total. Conclusions: We detected voice disorders in 57% of the children evaluated and of these, 8.5% obtained scores that would warrant a visit to the specialist.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Disfonía/epidemiología , España/epidemiología , Trastornos de la Voz/epidemiología , Epidemiología Descriptiva , Prevalencia , Estudios Transversales , Educación Primaria y Secundaria , Distribución por Edad y SexoRESUMEN
RESUMEN Introducción: La importancia del diagnóstico y manejo adecuado de los trastornos vocales en pacientes pediátricos, radica en que un mismo síntoma como la disfonía, puede tener etiologías de significación variable. Objetivo: Conocer la epidemiología y características de los pacientes pediátricos con disfonía crónica derivados a la Unidad de Voz del Hospital Dr. Luis Calvo Mackenna, y con ello generar un protocolo de diagnóstico y manejo coordinado entre fonoaudiólogos y otorrinolaringólogos. Material y método: Estudio prospectivo descriptivo con revisión de fichas clínicas y protocolos operatorios de pacientes que se controlan en la Unidad de Voz del Hospital Dr. Luis Calvo Mackenna. Resultados: En la unidad de voz hay en seguimiento 22 niños con una edad promedio de 10 años. Las lesiones diagnosticadas con mayor frecuencia mediante videonasolaringoscopía fueron los nódulos vocales (n =10) y el aumento de volumen asimétrico a nivel cordal (n =8). Se pudo realizar telelaringoscopía con videoestroboscopía en el 81,8% de los pacientes. Del total de pacientes en control, 10 requirieron laringoscopía directa. Conclusión: La disfonía en el niño suele ser un síntoma subestimado y, por ende, no tratado. Consideramos que una unidad de voz infantil debe preocuparse de evaluar sus pacientes con tecnología acorde a su edad y de realizar un seguimiento adecuado de los tratamientos.
ABSTRACT Introduction: Adequate diagnosis and proper management of voice disorders in pediatric patients lies in that the symptom dysphonia, can have etiologies of variable significance. Aim: To evaluate the epidemiology and characteristics of pediatric patients with chronic dysphonia that are referred to the voice unit of Dr. Luis Calvo Mackenna Hospital, and thereby generate a diagnostic protocol and coordinated management strategy between speech pathologist and otolaryngologist. Material and method: Prospective descriptive study with review of clinical files and operative protocols of patients followed-up at the voice unit of the Dr. Luis Calvo Mackenna Hospital. Results: In the voice unit, there are 22 children being followed up. The most frequently diagnosed lesions with videonasolaryngoscopy were vocal nodules (n=10) and asymmetric volume on the vocal cord (n=8). We performed telelaryngoscopy with videostroboscopy in 81.8% of patients. Of all the patients, 10 required direct laryngoscopy. Conclusions: Dysphonia in children is usually an underestimated symptom and, therefore, not treated. We believe that a children's voice unit should evaluate their patients with the appropriate technology according to the patients age, and to carry out an adequate follow-up of the treatments administered.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Disfonía/etiología , Disfonía/epidemiología , Voz , Estudios Prospectivos , Disfonía/terapia , Disfonía/diagnóstico por imagenRESUMEN
Objetivo: Caracterizar os aspectos sociodemográficos, organizacionais, estilo de vida, saúde-doença e vocais de professoras. Métodos: Estudo transversal e analítico envolvendo 146 docentes. Realizou-se análise bivariada por meio do teste qui-quadrado de Pearson. Resultados: A prevalência de alteração vocal crônica foi de 39,7%. As principais queixas autorreferidas foram: garganta seca, rouquidão, cansaço vocal, pigarro e falha na voz. Observou-se diferença estatisticamente significante para as variáveis: tempo de regência, ruído fora da escola, nenhum ou 1 copo de suco por dia, mais de uma dose alcoólica por vez, fala muito a demais no dia-a-dia, faltas e afastamento do trabalho por problema vocal, percepção de problema respiratório, diagnóstico médico de alergia respiratória, consulta médica para a voz e tratamento fonoaudiológico. Conclusão: Conhecer a prevalência e o perfil dos docentes com disfonia crônica são fatores importantes para atividades contínuas de promoção da saúde
Objective: The study's purpose has been to characterize the socio-demographic, organizational, lifestyle, health-disease and vocal aspects of teachers. Methods: It is both a cross-sectional and an analytical study that has involved 146 participating teachers. A bivariate analysis was performed through the Pearson's Chi-squared Test. Results: The prevalence of chronic vocal alteration was 39.7%. The main self-referred complaints were, as follows: dry throat, hoarseness, vocal fatigue, throat clearing and voice failure. A statistically significant difference was observed for the following variables: regency time, out-of-school noise, either none or one glass of juice per day, more than one alcoholic dose at a time, talks a lot on a daily basis, absences and work leave because of vocal issues, perception of respiratory problem, medical diagnosis of respiratory allergy, medical consultation for voice and speech-language therapy. Conclusion: Knowing both the prevalence and the profile of the chronic dysphonia bearing teachers are held as important factors for ongoing activities towards health promotion
Objetivo: Caracterizar los aspectos socio-demográficos, de organización, estilo de vida, salud-dolencia y vocales de las profesoras. Métodos: Estudio transversal y analítico involucrando 146 docentes. Se realizó un análisis bivariable por medio del test qui-cuadrado de Pearson. Resultados: Alteración vocal crónica 39,7%. Quejas autoreferidas: sequedad en la garganta, ronquera, cansancio vocal, irritación y fallo de la voz. Se observó una diferencia estadística significante para las variables: tiempo de desempeño, ruido fuera de la escuela, ningún ó 1 vaso de jugo diariamente, más de una dosis alcohólica al beber, hablar demasiado cotidianamente, faltas de descanso laboral por problema vocal, percepción del problema respiratorio, diagnóstico médico de alergia respiratoria, consulta médica para la voz y tratamiento fono-audiológico. Conclusión: Conocer el predominio y el perfil de docentes que padecen de disfonía crónica son factores importantes para las actividades continuadas de promoción de la salud
Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Condiciones de Trabajo , Trastornos de la Voz , Docentes , Disfonía/prevención & control , Disfonía/epidemiología , Riesgos Laborales , Salud LaboralRESUMEN
Contexto: A voz é uma importante ferramenta de trabalho para professores. Esses profissionais são frequentemente afastados da docência por distúrbios vocais, repercutindo no grande número de licença médica, restrição de função e readaptação profissional. Objetivo: Avaliar o perfil epidemiológico de professores afastados por distúrbios vocais e a repercussão da disfonia na diminuição das atividades laborais, na restrição de função e na readaptação profissional. Métodos: Estudo retrospectivo realizado entre janeiro de 2009 e dezembro de 2010, a partir da coleta de dados de prontuários da Secretaria de Estado de Educação do Distrito Federal, sobre os professores afastados por período superior a 30 dias. Resultados: Foram analisados 153 professores afastados por disfonia. A maior prevalência de distúrbios vocais ocorreu no gênero feminino (96,7%). Os nódulos vocais predominam no diagnóstico, representando 40% das lesões vocais encontradas. O tempo médio de afastamento foi de 120 dias. Aproximadamente 55% dos professores em licença médica estavam em restrição de função e ficaram em média 166 dias nessa condição. Ao todo, 25,5% dos professores foram readaptados e 73,8% retornaram à sala de aula. Conclusão: Adoecimento vocal é uma causa frequente de afastamento profissional, gerando grandes gastos anuais. Medidas preventivas e a consolidação de orientações quanto ao uso vocal reduziriam significativamente o número de professores em restrição ou readaptação de função.
Background: Voice is an important working tool for teachers. These professionals often stay away from work due to voice disorders, resulting in a high frequency of sick leave, function restriction and professional re-adaptation. Objective: To evaluate the epidemiological profile of teacher absenteeism due to voice disorders and the impact of dysphonia in reducing labor activities, function restriction and professional re-adaptation. Methods: A retrospective study of teachers away from work for more than 30 days was performed from January 2009 to December 2010 based on data collected from medical records at State Secretariat for Education, Federal District, Brazil. Results: A total of 153 teachers away from work due to dysphonia were analyzed. The highest prevalence of voice disorders was found among women (96.7%). Vocal nodules were the most prevalent diagnosis, corresponding to 40% of vocal lesions. The average time away from work was 120 days. About 55% of the teachers on sick leave exhibited function restriction and remained in that condition for 166 days, on average. In total, 25.5% of the teachers needed re-adaptation, and 73.8% were able to return to the classroom. Conclusion: Voice disorders are a frequent cause of sick leave, resulting in a high annual cost. Preventive measures and vocal orientation would significantly reduce the number of teachers with function restriction or requiring re-adaptation.
Asunto(s)
Trastornos de la Voz/epidemiología , Ausencia por Enfermedad , Disfonía/epidemiología , Enfermedades Profesionales , Enfermedades Profesionales/prevención & control , Brasil , Estudios RetrospectivosRESUMEN
OBJECTIVE/HYPOTHESIS: To verify the relationship between behavioral dysphonia and current depressive episodes in municipal elementary school teachers. We hypothesize that teachers with behavioral dysphonia will be more susceptible to psychiatric disorders. DESIGN: Cross-sectional study, quantitative, conducted across municipal schools in both rural and urban regions of Pelotas. METHOD: Five-hundred seventy-five teachers from urban and rural areas of the same Brazilian state were included. The full version of the Voice Handicap Index validated into Brazilian Portuguese was used to determine the presence of behavioral dysphonia. A profile of vocal behaviors was also used to quantify the number of phonotraumatic events. In addition, the Mini-International Neuropsychiatric Interview was used to determine current episodes of depression. Data were analyzed via correlative studies using chi-square and Poisson regression analyses. RESULTS: Across all teachers, the prevalence of dysphonia was 33.9% and 55% reported that they had already taken a leave because of their voice. Those teachers with a current depressive episode had a higher rate of dysphonia compared with those without depression (prevalence ratio [PR] 1.66; P < 0.000). Teachers who presented with a risk of serious vocal problems had a prevalence ratio of 2.58, indicating a greater proportion of dysphonia, whereas teachers classified as champions of abuse were five times more likely compared with those teachers with behaved or candidates for voice problems. CONCLUSIONS: There is an association between behavioral dysphonia and current depressive episodes in elementary school teachers.
Asunto(s)
Depresión/complicaciones , Disfonía/psicología , Docentes/estadística & datos numéricos , Enfermedades Profesionales/psicología , Adulto , Brasil/epidemiología , Estudios Transversales , Disfonía/complicaciones , Disfonía/epidemiología , Femenino , Humanos , Masculino , Enfermedades Profesionales/complicaciones , Enfermedades Profesionales/epidemiologíaRESUMEN
OJETIVOS: Determinar prevalência de disfonia y factores de riesgo asociados en profesores de establecimientos educacionales de la comuna de Santiago. METODOLOGÍA: Estudio descriptivo transversal en el que 402 profesores fueron evaluados mediante Protocolo Vocal y Cuestionario RPS (SUSESO-ISTAS 21). Se caracterizaron parámetros de voz de cada profesor mediante escala RASAT por 3 fonoaudiólogos especialistas, para conformar grupos de análisis de acuerdo al grado de afectación vocal presentado. Cada muestra de audio se analizó mediante software Praat. Los resultados se analizaron mediante el programa estadistico Systat. Se aplicó el Test Shapiro-Wilk, regresión logistica entre información de parámetros acústicos, resultados de protocolos SUSESO, y estadística descriptiva del Protocolo Vocal. RESULTADOS: La prevalencia de disfonía en el grupo estudiado corresponde al 75,5% de la muestra, incluyendo alteraciones leves y moderadas. Los principales factores de riesgo asociados son: edades sobre los 45 años, profesores de educación básica, tiempo de uso de voz sobre 5 horas diarias, presencia de RGE y consumo de cigarrillos. CONCLUSIONES: Existe alta prevalencia de disfonía en profesores. Éstos no tienen conciencia del problema y consultan tardíamente. Se presentan múltiples factores asociados a disfonía, relacionados al quehacer profesional y a conductas nocivas de profesores.
OBJECTIVES: To determine prevalence of dysphonia and associated risk factors in teachers of educational establishments in the municipality of Santiago. METHODOLOGY: A cross sectional study in which 402 teachers were evaluated by questionnaire Vocal Protocol and RPS (SUSESO-ISTAS 21). Voice parameters of each teacher were characterized by scale RASAT 3 by audiologists specialists, to form discussion groups according to the degree of vocal damage presented. Each sample was analyzed by Praat audio software. The results were analyzed using Systat statistical program. The Shapiro-Wilk test, logistic regression information acoustic parameters, results SUSESO protocols, and descriptive statistics was applied Vocal Protocol. RESULTS: The prevalence of dysphonia in the studied group corresponds to 75,5% of the sample, including mild and moderate alterations. The main risk factors associated are: age over 45 years, basic education teachers, airtime voice over 5 hours a day, presence of GER and smoking. CONCLUSIONS: There is high prevalence of dysphonia in teachers. They are not aware of the problem and consult late. Multiple factors associated with dysphonia, professional work related to harmful behaviors and teachers are presented.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Disfonía/epidemiología , Maestros/estadística & datos numéricos , Enfermedades Profesionales/epidemiología , Modelos Logísticos , Chile , Epidemiología Descriptiva , Prevalencia , Estudios Transversales , Encuestas y Cuestionarios , Factores de Riesgo , Factores de Edad , Disfonía/diagnóstico , Enfermedades Profesionales/diagnósticoRESUMEN
PURPOSE OF REVIEW: Recent advances with regard to occupational voice disorders are highlighted with emphasis on issues warranting consideration when assessing, training, and treating professional voice users. RECENT FINDINGS: Findings include the many particularities between the various categories of professional voice users, the concept that the environment plays a major role in occupational voice disorders, and that biopsychosocial influences should be analyzed on an individual basis. Assessment via self-evaluation protocols to quantify the impact of these disorders is mandatory as a component of an evaluation and to document treatment outcomes. Discomfort or odynophonia has evolved as a critical symptom in this population. Clinical trials are limited and the complexity of the environment may be a limitation in experiment design. SUMMARY: This review reinforced the need for large population studies of professional voice users; new data highlighted important factors specific to each group of voice users. Interventions directed at student teachers are necessities to not only improving the quality of future professionals, but also to avoid the frustration and limitations associated with chronic voice problems. The causative relationship between the work environment and voice disorders has not yet been established. Randomized controlled trials are lacking and must be a focus to enhance treatment paradigms for this population.
Asunto(s)
Disfonía/diagnóstico , Disfonía/terapia , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/terapia , Adulto , Disfonía/epidemiología , Femenino , Humanos , Masculino , Enfermedades Profesionales/epidemiología , Entrenamiento de la VozRESUMEN
BACKGROUND: Vocal cord dysfunction is often misdiagnosed and mistreated as asthma, which can lead to increased and unnecessary medication use and increased health care utilization. OBJECTIVE: To develop a valid scoring index that could help distinguish vocal cord dysfunction from asthma. METHODS: We compared the demographics, comorbidities, clinical symptoms, and symptom triggers of subjects with vocal cord dysfunction (n = 89) and those with asthma (n = 59). By using multivariable logistic regression, we identified distinguishing features associated with vocal cord dysfunction, which were weighted and used to generate a novel score. The scoring index also was tested in an independent sample with documented vocal cord dysfunction (n = 72). RESULTS: We identified symptoms of throat tightness and dysphonia, the absence of wheezing, and the presence of odors as a symptom trigger as key features of vocal cord dysfunction that distinguish it from asthma. We developed a weighted index based on these characteristics, the Pittsburgh Vocal Cord Dysfunction Index. By using a cutoff of ≥4, this index had good sensitivity (0.83) and specificity (0.95) for the diagnosis of vocal cord dysfunction. The scoring index also performed reasonably well in the independent convenience sample with laryngoscopy-proven vocal cord dysfunction and accurately made the diagnosis in 77.8% of subjects. CONCLUSION: The Pittsburgh Vocal Cord Dysfunction Index is proposed as a simple, valid, and easy-to-use tool for diagnosing vocal cord dysfunction. If confirmed by a prospective evaluation in broader use, it may have significant clinical utility by facilitating a timely and accurate diagnosis of vocal cord dysfunction, thereby preventing misdiagnosis and mistreatment as asthma. Future prospective validation studies will need to be performed.
Asunto(s)
Asma/diagnóstico , Indicadores de Salud , Pulmón/fisiopatología , Disfunción de los Pliegues Vocales/diagnóstico , Pliegues Vocales/fisiopatología , Adulto , Asma/epidemiología , Asma/fisiopatología , Distribución de Chi-Cuadrado , Comorbilidad , Diagnóstico Diferencial , Disfonía/epidemiología , Disfonía/fisiopatología , Femenino , Humanos , Laringoscopía , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Odorantes , Pennsylvania , Faringe/fisiopatología , Fonación , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Ruidos Respiratorios/fisiopatología , Factores de Riesgo , Disfunción de los Pliegues Vocales/epidemiología , Disfunción de los Pliegues Vocales/fisiopatologíaRESUMEN
BACKGROUND: In recent decades several groups of researchers have been interested in describing and understanding vocal morbidity in teachers in order to explain the large number of teachers diagnosed with dysphonia and account for the absenteeism attributed to vocal disability. AIMS: To determine the proportion of teachers who reported a diagnosis of dysphonia and measure associations between individual and contextual factors and the event of interest. METHODS: Teachers were recruited from the city of Belo Horizonte and invited to complete a web-based institutional intranet questionnaire. RESULTS: In total, 649 teachers responded; 32% (CI 28.5-35.5) reported that they had received a physician diagnosis of dysphonia. This prevalence was significantly higher among female teachers (prevalence ratio (PR) 2.33; CI 1.41-3.85), and groups who reported limited technical resources and equipment (PR 1.56; CI 1.14-2.15), a diagnosis of gastritis (PR 1.59; CI 1.28-1.98), not being summoned for an annual physician examination (PR 0.47; CI 0.32-0.68), or absenteeism (PR 1.39; CI 1.06-1.81). CONCLUSIONS: The high prevalence of dysphonia in teachers was not associated with any individual variables, except for sex and comorbidity (diagnosis of gastritis). Limited technical resources and equipment were associated with dysphonia and suggests policy change is important in preventing dysphonia.
Asunto(s)
Disfonía/epidemiología , Disfonía/etiología , Docentes , Gastritis/epidemiología , Enfermedades Profesionales/epidemiología , Trastornos del Sueño-Vigilia/epidemiología , Estrés Psicológico/epidemiología , Absentismo , Adulto , Brasil/epidemiología , Comorbilidad , Estudios Transversales , Disfonía/prevención & control , Femenino , Gastritis/complicaciones , Gastritis/prevención & control , Humanos , Internet , Satisfacción en el Trabajo , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/etiología , Enfermedades Profesionales/prevención & control , Prevalencia , Factores de Riesgo , Distribución por Sexo , Trastornos del Sueño-Vigilia/complicaciones , Trastornos del Sueño-Vigilia/prevención & control , Encuestas y CuestionariosRESUMEN
UNLABELLED: Children dysphonia studies have reported an incidence of 4.4 to 30.3%. GOALS: To establish the prevalence of dysphonia in children, based on the opinion of the parents, acoustic and vocal-perceptual assessments, associated symptoms, risk factors and videolaryngoscopy findings. MATERIALS AND METHODS: The parents from 2,000 children answered a questionnaire about the vocal quality of their children, and these children were submitted to perceptual vocal, acoustic and videolaryngoscopy assessments. RESULTS: We had 1,007 boys and 993 girls; sporadic symptoms were reported by 206 parents and permanent symptoms were reported by 123. In the perceptual assessment, the G parameter (degree of dysphonia) had a score of 0 in 694 voices; 1 in 1,065 and 2 in 228. There was f0 reduction with age and the remaining acoustic parameters were high in children with a G score of 2. Nodules, thickening and inflammation were the most common in the videolaryngoscopy exams. CONCLUSIONS: Parental judgment indicated a prevalence of dysphonia in 6.15%, and perceptual analysis yielded a value of 11.4%. Vocal symptoms were associated with a phonatory overload. sinonasal disorders, vocal abuse and noise were considered relevant risk factors. The acoustic analysis kept a direct association with the perceptual-auditory. Laryngeal lesions were found in the videolaryngoscopy exams, stressing nodules, thickening and inflammation.
Asunto(s)
Disfonía/epidemiología , Distribución por Edad , Brasil/epidemiología , Niño , Preescolar , Disfonía/diagnóstico , Femenino , Humanos , Laringoscopía , Masculino , Prevalencia , Índice de Severidad de la Enfermedad , Distribución por Sexo , Encuestas y Cuestionarios , Grabación en Video , Calidad de la VozRESUMEN
Estudos sobre disfonias infantis apontam incidência entre 4,4 a 30,3 por cento das crianças. OBJETIVOS: Determinar a prevalência de disfonia em crianças, baseando-se nos julgamentos dos pais, nas ava-liações vocais perceptivas e acústicas, analisar sintomas associados, fatores de risco e achados vide-olaringoscópicos. CASUÍSTICA E MÉTODOS: Os pais de 2.000 crianças responderam questionário sobre qualidade vocal do filho. As crianças foram submetidas às avaliações vocais perceptiva, acústicas e videolaringoscopias. RESULTADOS: Participaram 1.007 meninos e 993 meninas. Sintomas esporádicos foram reportados por 206 pais e permanentes, por 123. Na avaliação perceptiva, o parâmetro G (Grau de disfonia) recebeu escore 0 em 694 vozes, 1 em 1065 e 2 em 228. Houve diminuição de f0 com a idade e os demais parâmetros acústicos mostraram-se mais elevados nas crianças com escore de G em 2. Nas videolaringoscopias, destacaram-se nódulos, espessamentos e inflamação. CONCLUSÕES: O julgamento dos pais indicou prevalência de disfonia em 6,15 por cento, e as análises perceptivas em 11,4 por cento. Os sintomas vocais relacionaram-se à sobrecarga fonatória. Quadros nasossinusais, abuso vocal e ruído foram importantes fatores de risco. As análises acústicas mantiveram relação direta com as perceptivo-auditivas. Lesões laríngeas foram detectadas nas videolaringoscopias, destacando nódulos, espessamentos e inflamação.
Children dysphonia studies have reported an incidence of 4.4 to 30.3 percent. GOALS: To establish the prevalence of dysphonia in children, based on the opinion of the parents, acoustic and vocal-perceptual assessments, associated symptoms, risk factors and videolaryngoscopy findings. MATERIALS AND METHODS: The parents from 2,000 children answered a questionnaire about the vocal quality of their children, and these children were submitted to perceptual vocal, acoustic and videolaryngoscopy assessments. RESULTS: We had 1,007 boys and 993 girls; sporadic symptoms were reported by 206 parents and permanent symptoms were reported by 123. In the perceptual assessment, the G parameter (degree of dysphonia) had a score of 0 in 694 voices; 1 in 1,065 and 2 in 228. There was f0 reduction with age and the remaining acoustic parameters were high in children with a G score of 2. Nodules, thickening and inflammation were the most common in the videolaryngoscopy exams. CONCLUSIONS: Parental judgment indicated a prevalence of dysphonia in 6.15 percent, and perceptual analysis yielded a value of 11.4 percent. Vocal symptoms were associated with a phonatory overload. sinonasal disorders, vocal abuse and noise were considered relevant risk factors. The acoustic analysis kept a direct association with the perceptual-auditory. Laryngeal lesions were found in the videolaryngoscopy exams, stressing nodules, thickening and inflammation.