Silva Ana Maria Toniolo da, Morisso Marcela Forgiarini, Cielo Carla Aparecida
Universidade Federal de São Paulo, Brazil.
Pro Fono. 2007 Jul-Sep;19(3):279-88. doi: 10.1590/s0104-56872007000300006.
Temporomandibular dysfunction is one of the most complex disorders of the body, capable of unchaining alterations in the mandibular movements which in turn can cause damage not only to speech articulation but also to the quality of voice. In the literature, the relationship between the symptomatology severity levels of this dysfunction and their influence on vocal production has been scarcely studied.
To verify the relationship between the symptomatology severity levels of temporomandibular dysfunction and vocal production.
Participants of this study were 24 females, with ages between 16 and 56 years, who were submitted to an anamnesis index questionnaire (Fonseca et al., 1994), to odontological and otolaryngological examinations and to a hearing evaluation. Later, the participants were submitted to a voice recording, using a digital recorder, for a perceptive-auditive analysis of voice parameters such as: vocal type, resonance, quality of emission, pitch and loudness and for the analysis of the acoustic parameters of the wide and narrow band spectrography and of the Multi Dimensional Voice Program (MDVP) -- Key Elementrics Real Time software.
Considering the parameters of the perceptive-auditive evaluation, it was observed that only individuals with severe symptomatology presented a statistically significant decrease in loudness (p = 0.013). The hoarse vocal quality was the most frequent type among the participants, with severities classified as mild and severe, followed by the breathy type. In the wide band spectrography, there was a statistically significant difference for the anti-resonance increase (p = 0.013) in individuals with severe temporomandibular dysfunction.
It was verified that the severity level causes a decrease in loudness, an increase of noise and alterations in voice resonance, interfering in the vocal quality of these individuals.
颞下颌关节紊乱病是人体最复杂的疾病之一，可引发下颌运动改变，进而不仅会损害言语清晰度，还会影响嗓音质量。在文献中，这种功能障碍的症状严重程度水平与其对嗓音产生的影响之间的关系鲜有研究。
验证颞下颌关节紊乱病的症状严重程度水平与嗓音产生之间的关系。
本研究的参与者为24名年龄在16至56岁之间的女性，她们接受了既往史指数问卷（丰塞卡等人，1994年）、牙科和耳鼻喉科检查以及听力评估。随后，使用数字录音机对参与者进行嗓音录音，以对嗓音参数进行感知 - 听觉分析，如：嗓音类型、共鸣、发声质量、音高和响度，并分析宽带和窄带频谱图以及多维度嗓音程序（MDVP）——Key Elementrics实时软件的声学参数。
考虑到感知 - 听觉评估的参数，观察到只有症状严重的个体在响度方面出现了具有统计学意义的下降（p = 0.013）。嘶哑的嗓音质量是参与者中最常见的类型，严重程度分为轻度和重度，其次是呼吸音类型。在宽带频谱图中，患有严重颞下颌关节紊乱病的个体在反共振增加方面存在统计学意义的差异（p = 0.013）。
已证实严重程度水平会导致响度降低、噪音增加和嗓音共鸣改变，从而影响这些个体的嗓音质量。
