da Costa Ananda Dutra, Vargas Amanda Pereira, Lucena Marcia Mendonça, Ruas Ana Cristina Nunes, Braga Fernanda da Silva Santos, Bom-Braga Mateus Pereira, Bom-Braga Frederico Pereira, do Valle Antonio Carlos Francesconi, Igreja Ricardo Pereira, Valete-Rosalino Cláudia Maria
National Institute of Infectious Diseases, Oswaldo Cruz Foundation, INI/FIOCRUZ, Rio de Janeiro, RJ, Brazil.
Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Rev Iberoam Micol. 2017 Jul-Sep;34(3):180-184. doi: 10.1016/j.riam.2017.01.003. Epub 2017 Jun 3.
Paracoccidioidomycosis (PCM) is a systemic mycosis of acute and chronic evolution, caused by species belonging to the genus Paracoccidioides. It is considered the most prevalent systemic endemic mycosis in Latin America, with cases in the tropical and subtropical regions. Residual PCM refers to the fibrotic scar sequelae resulting from the disease treatment which, when associated with collagen accumulation, leads to functional and anatomic alterations in the organs.
The aim of this study was to evaluate the vocal function of patients with residual PCM in upper airways and digestive tract.
We performed a cross-sectional study in 2010 in a cohort of 21 patients with residual PCM in upper airways and digestive tract.
The average age was 49.48±9.1 years, and only two (9.5%) patients were female. The study was performed in the 1-113 month-period (median 27) after the end of drug treatment. Five (23.8%) patients had alterations in the larynx as a sequela of the disease. However, all patients had vocal changes in vocal auditory perceptual analysis by GRBASI scale. The computerized acoustic analysis using the software Vox Metria, showed that 11 patients (52.4%) presented alterations in jitter, 15 (71.4%) in shimmer, 8 (38.1%) in F0, 4 (19%) in glottal to noise excitation (GNE), 7 (33.3%) in the presence of noise and 12 (57.1%) in the presence of vibratory irregularity.
The great frequency of alterations in residual PCM suggests that the patients in such phase could benefit from a multidisciplinary treatment, offering them integral monitoring of the disease, including speech rehabilitation after the PCM is healed.
副球孢子菌病(PCM)是一种急性和慢性进展的系统性真菌病,由副球孢子菌属的物种引起。它被认为是拉丁美洲最常见的系统性地方性真菌病,在热带和亚热带地区均有病例。残留PCM是指疾病治疗后产生的纤维化瘢痕后遗症,当与胶原蛋白积累相关时,会导致器官的功能和解剖结构改变。
本研究的目的是评估上呼吸道和消化道残留PCM患者的发声功能。
2010年,我们对一组21例上呼吸道和消化道残留PCM的患者进行了横断面研究。
平均年龄为49.48±9.1岁,只有两名(9.5%)患者为女性。该研究在药物治疗结束后的1 - 113个月期间(中位数为27个月)进行。五名(23.8%)患者因疾病后遗症出现喉部改变。然而,所有患者在GRBASI量表的发声听觉感知分析中均有发声变化。使用Vox Metria软件进行的计算机声学分析显示,11名患者(52.4%)在抖动方面存在改变,15名(71.4%)在闪烁方面存在改变,8名(38.1%)在基频方面存在改变,4名(19%)在声门噪声激励方面存在改变,7名(33.3%)存在噪声,12名(57.1%)存在振动不规则。
残留PCM改变的高频率表明,处于该阶段的患者可能受益于多学科治疗,为他们提供疾病的综合监测,包括PCM治愈后的言语康复。