RESUMO
OBJECTIVE: To analyze the voice formants (F1, F2, F3, and F4 in Hz) of seven oral vowels, in Brazilian Portuguese, [a, ε, e, i, É, o, and u] in adult individuals with congenital lifetime untreated isolated growth hormone deficiency (IGHD). STUDY DESIGN: This is a cross-sectional study. METHODS: Acoustic analysis of isolated vowels was performed in 33 individuals with IGHD, age 44.5 (17.6) years (16 women), and 29 controls, age 51.1 (17.6) years (15 women). RESULTS: Compared with controls, IGHD men showed higher values of F3 [i, e, and ε], P = 0.006, P = 0.022, and P = 0.006, respectively and F4 [i], P = 0.001 and lower values of F2 [u], P = 0.034; IGHD women presented higher values of F1 [i and e] P = 0.029 and P = 0.036; F2 [É] P = 0.006; F4 [É] P = 0.031 and lower values of F2 [i] P = 0.004. IGHD abolished most of the gender differences in formant frequencies present in controls. CONCLUSIONS: Congenital, severe IGHD results in higher values of most formant frequencies, suggesting smaller oral and pharyngeal cavities. In addition, it causes a reduction in the effect of gender on the structure of the formants, maintaining a prepubertal acoustic prediction.
Assuntos
Nanismo Hipofisário/fisiopatologia , Hormônio do Crescimento Humano/deficiência , Acústica da Fala , Qualidade da Voz , Acústica , Adulto , Idoso , Biomarcadores/sangue , Brasil , Estudos de Casos e Controles , Estudos Transversais , Nanismo Hipofisário/sangue , Nanismo Hipofisário/diagnóstico , Nanismo Hipofisário/genética , Feminino , Hormônio do Crescimento Humano/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Boca/crescimento & desenvolvimento , Faringe/crescimento & desenvolvimento , Índice de Gravidade de Doença , Fatores Sexuais , Medida da Produção da FalaRESUMO
OBJECTIVE: To evaluate the hearing status of growth hormone (GH)-naive adults with isolated GH deficiency (IGHD) belonging to an extended Brazilian kindred with a homozygous mutation in the GH-releasing hormone receptor gene. STUDY DESIGN: Cross-sectional. SETTING: Divisions of Endocrinology and Otorhinolaryngology of the Federal University of Sergipe. SUBJECTS AND METHODS: Twenty-six individuals with IGHD (age, 47.6 ± 15.1 years; 13 women) and 25 controls (age, 46.3 ± 14.3 years; 15 women) were administered a questionnaire on hearing complaints and hearing health history. We performed pure-tone audiometry, logoaudiometry, electroacoustic immittance, and stapedial reflex. To assess outer hair cell function in the cochlea, we completed transient evoked otoacoustic emissions (TEOAEs). To assess the auditory nerve and auditory brainstem, we obtained auditory brainstem responses (ABRs). RESULTS: Misophonia and dizziness complaints were more frequent in those with IGHD than in controls (P = .011). Patients with IGHD had higher thresholds at 250 Hz (P = .005), 500 Hz (P = .006), 3 KHz (P = .008), 4 KHz (P = .038), 6 KHz (P = .008), and 8 KHz (P = .048) and mild high-tones hearing loss (P = .029). Stapedial reflex (P < .001) and TEOAEs (P = .025) were more frequent in controls. There were no differences in ABR latencies. Hearing loss in patients with IGHD occurred earlier than in controls (P < .001). CONCLUSION: Compared with controls of the same area, subjects with untreated, congenital lifetime IGHD report more misophonia and dizziness, have predominance of mild high-tones sensorineural hearing loss, and have an absence of stapedial reflex and TEOAEs.
Assuntos
Nanismo Hipofisário/fisiopatologia , Perda Auditiva/fisiopatologia , Audição/fisiologia , Adulto , Audiometria de Tons Puros , Brasil/epidemiologia , Estudos Transversais , Nanismo Hipofisário/complicações , Feminino , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Emissões Otoacústicas Espontâneas , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To evaluate the consequences of lifetime, severe and untreated isolated growth hormone deficiency (IGHD) on vocal and laryngeal function. STUDY DESIGN: Cross-sectional. SUBJECTS AND METHODS: A total of 23 IGHD adult subjects and 22 controls were administered a questionnaire about vocal complaints and harmful voice habits, and underwent videolaryngostroboscopic examination, voice evaluation by perceptual-auditory analysis with GRBAS scale including grade of dysphonia, roughness, breathiness, asthenia and strain items, objective voice evaluation by maximum phonation time (MPT), and acoustic analysis. RESULTS: There was no difference in vocal complaints between IGHD subjects and controls. Vocal abuse and smoking were more frequent in IGHD subjects. IGHD subjects presented higher values for roughness, breathiness, and strain. Laryngopharyngeal reflux (LPR) signs and laryngeal constriction were more frequent in IGHD individuals. MPT was similar in the two groups. Fundamental frequency was higher in IGHD females and males. Harmonic to noise ratio was higher in IGHD in both genders and shimmer was lower in IGHD females. CONCLUSIONS: IGHD subjects have higher prevalence of signs of LPR and laryngeal constriction, with high pitch in both genders, which suggests a prominent role of IGHD on these parameters.
Assuntos
Nanismo Hipofisário/fisiopatologia , Laringe/fisiopatologia , Voz/fisiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estroboscopia , Distúrbios da Voz/etiologiaRESUMO
OBJECTIVE: To verify children's acceptance of nasal fiber optic examination in a school setting and to evaluate hypertrophy of adenoid vegetation and to determine its prevalence in this population. METHOD: A survey was performed of a representative (n = 368) sample of school age children at elementary school (aged 6 to 13 years old) who had been subjected to fiber optic examination, in Aracaju (SE), Brazil. All students were subjected to the same study protocol, carried out at school and with no need for sedation or restraint. RESULTS: All of the children tolerated the nasal fiber optic examination well, making possible a good evaluation of pharynx and nasal cavities. The prevalence of adenoid hypertrophy grade I was 50.6%, of grade II 35.1% and of grade III 14.3%. Grades II and III hypertrophy were related to an increase in obstructive symptoms. CONCLUSION: As this study performed in a school setting demonstrates, nasal fiber optic examination can be performed with excellent tolerance in settings other than hospitals and outpatient clinics, indicating that its usage could be increased and made available for an extended range of populations. The prevalence of adenoid hypertrophy in Aracaju is not comparable with prevalence rates observed in earlier studies because it this was a study of children without respiratory symptoms.
Assuntos
Tonsila Faríngea/patologia , Endoscopia/métodos , Nasofaringe/patologia , Exame Físico/estatística & dados numéricos , Adolescente , Obstrução das Vias Respiratórias/etiologia , Criança , Endoscopia/efeitos adversos , Feminino , Humanos , Hipertrofia/diagnóstico , Masculino , Obstrução Nasal/etiologiaRESUMO
OBJETIVO: Verificar a aceitação da videonasofaringoscopia por crianças, no ambiente escolar, para avaliação de vegetações adenoideanas e determinar a sua prevalência nessa população MÉTODO: Estudo transversal realizado em amostra proporcional (n = 368) de escolares da primeira série do ensino fundamental de Aracaju (SE), com idades entre 6 e 13 anos, submetidos a videonasofaringoscopia flexível. Todas se submeteram à mesma rotina de exame, feito na própria escola, sem a necessidade de contenção ou qualquer tipo de sedação. RESULTADOS: As crianças que foram submetidas a avaliação nasofibroscópica aceitaram bem o procedimento, permitindo a adequada avaliação das cavidades do nariz e nasofaringe. A prevalência de hipertrofia adenoideana grau I foi de 50,6 por cento, a de grau II foi de 35,1 por cento e a de grau III foi de 14,3 por cento. As hipertrofias adenoideanas graus II e III apresentam maior número de sintomas obstrutivos. CONCLUSÃO: A videonasofaringoscopia flexível pode ser realizada, com excelente aceitação, fora do ambiente hospitalar ou consultório, como mostra este estudo realizado em ambiente escolar, indicando que sua utilização pode ser mais ampla, tornando-a mais acessível a um maior número de pessoas. A prevalência dos três graus de hipertrofia adenoideana encontrada em Aracaju difere de alguns estudos por ter sido realizada em crianças não triadas para sintomas respiratórios.