Santos Karoline Weber Dos, Scheeren Betina, Maciel Antonio Carlos, Cassol Mauriceia
Speech Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
Radhiology, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.
Int Arch Otorhinolaryngol. 2015 Jan;19(1):61-6. doi: 10.1055/s-0034-1394129. Epub 2014 Oct 17.
Introduction Voice modification after swallowing may indicate changes in the transit of the bolus. Objective The aim of this study is to verify the use of perceptual voice analysis to detect oropharyngeal dysphagia. Study Design Case series. Methods Twenty-seven patients with dysphagia as diagnosed by videofluoroscopy and 25 without were evaluated. The sustained vowel /a/ was recorded before this exam and after swallowing different consistencies (pasty, liquid and solid). For the voice evaluation, the GRBAS scale (grade, roughness, breathiness, asthenia and strain) and the parameter "wet voice" were used. Three judges blinded to study group and time of emission performed voice analysis. Results Individuals with dysphagia showed significant decrease in grade of voice and asthenia and increase in strain after swallowing pasty substances, differing from individuals without dysphagia who showed no modification of the parameters after swallowing. The wet voice parameter showed no difference after swallowing in both study groups. Conclusion The decrease in grade and asthenia and increased strain are indicative of a swallowing disorder, indicating increased vocal strain to clean the vocal tract of food. The modification of vocal production after swallowing proved to be a trusted resource for detection of swallowing disorders.
吞咽后声音的改变可能表明食团通过情况的变化。目的:本研究旨在验证使用感知语音分析来检测口咽吞咽困难。研究设计:病例系列。方法:对27例经视频透视吞咽检查诊断为吞咽困难的患者和25例无吞咽困难的患者进行评估。在该检查前以及吞咽不同稠度(糊状、液体和固体)的食物后,记录持续元音/a/。对于语音评估,使用GRBAS量表(分级、粗糙度、气息声、无力和紧张度)和“湿声”参数。三名对研究组和发声时间不知情的评判员进行语音分析。结果:吞咽糊状食物后,吞咽困难患者的语音分级和无力程度显著降低,紧张度增加,这与无吞咽困难的患者不同,后者吞咽后参数无变化。在两个研究组中,吞咽后“湿声”参数均无差异。结论:分级和无力程度的降低以及紧张度的增加表明存在吞咽障碍,这表明为清理声道中的食物而增加了发声紧张度。吞咽后发声产生的改变被证明是检测吞咽障碍的可靠方法。