The effect of Wendler Glottoplasty to elevate vocal pitch in transgender women / 中华耳鼻咽喉头颈外科杂志

Objective: To evaluate the effect of Wendler Glottoplasty to elevate vocal pitch in transgender women. Methods: The voice parameters of pre-and 3-month post-surgery of 29 transgender women who underwent Wendler Glottoplasty in department of otorhinolaryngology head and neck surgery of Beijing Friendship Hospital from January, 2017 to October, 2020 were retrospectively analyzed. The 29 transgender women ranged in age from 19-47 (27.0±6.3) years old. Subjective evaluation was performed using Transsexual Voice Questionnaire for Male to Female (TVQMtF). Objective parameters included fundamental frequency (F0), highest pitch, lowest pitch, habitual volume, Jitter, Shimmer, maximal phonation time (MPT), noise to harmonic ratio (NHR) and formants frequencies(F1, F2, F3, F4). SPSS 25.0 software was used for statistically analysis. Results: Three months after surgery, the score of TVQMtF was significantly decreased [(89.9±14.7) vs. (50.4±13.6), t=11.49, P<0.001]. The F0 was significantly elevated [(152.7±23.3) Hz vs. (207.7±45.9) Hz, t=-6.03, P<0.001]. Frequencies of F1, F2 and F3 were significantly elevated. No statistical difference was observed in the frequencies of F4. The highest pitch was not significantly altered while the lowest pitch was significantly elevated [(96.8±17.7) Hz vs. (120.0±28.9) Hz, t=-3.71, P=0.001]. Habitual speech volume was significantly increased [(60.0±5.2) dB vs. (63.6±9.6) dB, t=-2.12, P=0.043]. Jitter, Shimmer, NHR and MPT were not obviously altered (P>0.05). Conclusions: Wendler Glottoplasty could notably elevate the vocal pitch, formants frequencies and degree of vocal femininity in transgender women without affecting phonation ability and voice quality. It can be an effective treatment modality for voice feminization.

Tipos de fibras de los músculos intrínsecos laríngeos de seres humanos: una revisión de la literatura / Fiber types in human intrinsic laryngeal muscles: a literature review

El estudio de las fibras musculares permite comprender con mejor detalle la composición de los músculos y sus características funcionales. Además, facilita la aplicación de programas de entrenamiento y rehabilitación basados en las vías energéticas que regulan la contracción muscular. Su estudio generalmente va unido al análisis de las cadenas pesadas de miosina (MyHC), las que informan sobre las características y propiedades funcionales del músculo. El objetivo de este trabajo fue sintetizar la evidencia científica disponible sobre la distribución de fibras musculares y de isoformas de cadenas pesadas de miosina de los músculos intrínsecos de la laringe de seres humanos. Se realizó una revisión sistemática de la literatura mediante el análisis de artículos encontrados en las bases de datos PubMed, EBSCOHost y SciELO. Los hallazgos informan sobre la existencia de fibras tónicas lentas y tipo I, II, IIA y IIX/IIB. Además, se reconoce la presencia de las isoformas MyHC-I, MyHC-IIA, MyHC-IIX, MyHC-Fetal, MyHC-L y MyHC-IIB. En conclusión, los músculos intrínsecos de la laringe presentan una mezcla de fibras y de isoformas de MyHC lentas y rápidas,la que obedece a adaptaciones y cambios evolutivos que han permitido, por ejemplo, las características fonatorias que presenta la voz del ser humano.

The study of muscle fibers allows the composition of muscles and their functional characteristics to be understood in greaterdetail. In addition, it makes it possible to applytraining and rehabilitation programs based on the energypathways that regulatemuscle contraction. Studying muscle fibers is generally associated withthe analysis of myosin heavy chains (MHC) which provide information on the functional characteristics and properties of muscles. The objective of this study was to synthesize the available scientific evidence onthe distribution of muscle fibers and myosin heavy chain isoforms present in the intrinsic laryngeal muscles of human beings. A systematic reviewof the literature was carried outand articles found on PubMed, EBSCOHost,and SciELOwere analyzed.The findings showthe presenceof slow-tonic, type I, type II, type IIA, and type IIX/IIB fibers. Additionally,isoforms MHC-I, MHC-IIA, MHC-IIX, MHC-Fetal, MHC-L, and MHC-IIB canbe found. In conclusion, intrinsic laryngeal muscles are composed ofa combination of slow and fast fibers and MHC isoforms, derived from evolutionary adaptations and changes which have given way, among other things, to the phonetic characteristics ofthe human voice.

Investimentos do Sistema Único de Saúde em avaliação miofuncional do sistema estomatognático / Investments of the Single Health System in myofunctional assessment of the stomatognatic system

Introdução: o sistema estomatognático é responsável por funções inatas e primordiais ao ser humano, como respiração, sucção, deglutição e fonação. O fonoaudiólogo é o profissional qualificado para realizar avaliação, diagnóstico e reabilitação desse sistema. Dessa forma, tais procedimentos são realizados por serviços de fonoaudiologia, e essa produtividade é lançada na plataforma correspondente do Sistema Único de Saúde (SUS) como "avaliação miofuncional do sistema estomatognático". Objetivo: analisar os investimentos do SUS destinados à avaliação miofuncional do sistema estomatognático no Brasil, no período de 2008 a 2021. Metodologia: trata-se de estudo ecológico, de caráter quantitativo, realizado com dados secundários disponibilizados na plataforma DataSUS/TABNet. Os dados coletados se referem a valores apresentados e aprovados para a avaliação miofuncional do sistema estomatognático, no período supracitado, no Brasil. Após a coleta, realizou-se a análise descritiva dos dados, com exposição dos valores absolutos e relativos, das taxas de crescimento e do déficit de repasses dos recursos financeiros. Resultados: no período estudado, foram realizadas 5,4 milhões de avaliações miofuncionais do sistema estomatognático, a um custo total de R$ 21,5 milhões com taxas de crescimento dos investimentos financeiros de até 64,1% ao longo dos anos. Observou-se que, em todo o período estudado, ocorreu déficit de repasses para procedimentos relacionados aos serviços de fonoaudiologia, chegando a taxas de 17464,6% de pagamentos não efetuados. Conclusão: constatou-se que houve aumento dos investimentos financeiros do SUS destinados ao procedimento de avaliação miofuncional. Contudo, foram notados, também, déficits de pagamentos pelas secretarias de saúde, destinados a uma parcela dos procedimentos realizados nos serviços de fonoaudiologia.

Introduction: the stomatognathic system is responsible for innate and primordial functions for human beings, such as breathing, sucking, swallowing and phonation. The speech therapist is the qualified professional to carry out evaluation, diagnosis and rehabilitation of this system. Thus, such procedures are performed by speech therapy services, and this productivity is released on the corresponding platform of the Unified Health System (SUS) as "myofunctional assessment of the stomatognathic system". Objective: to analyze SUS investments for the myofunctional assessment of the stomatognathic system in Brazil, from 2008 to 2021. Methodology: this is an ecological study, of a quantitative nature, carried out with secondary data available on the DataSUS/TABNet platform. The data collected refer to values presented and approved for the myofunctional assessment of the stomatognathic system, in the aforementioned period, in Brazil. After collection, a descriptive analysis of the data was carried out, with exposure of absolute and relative values, growth rates and the deficit in transfers of financial resources. Results: in the studied period, 5.4 million myofunctional assessments of the stomatognathic system were performed, at a total cost of R$ 21.5 million, with growth rates of financial investments of up to 64.1% over the years. It was observed that, throughout the studied period, there was a deficit in transfers for procedures related to speech therapy services, reaching rates of 17464.6% of payments not made. Conclusion: it was found that there was an increase in SUS financial investments for the myofunctional assessment procedure. However, deficits in payments by the health secretariats were also noted, destined for a portion of the procedures performed in the speech-language pathology services.

Agenesias dentárias atípicas: relato de caso clínico / Atypical dental agenesis: clinical case report

A agenesia dentaria é uma anomalia de desenvolvimento caracterizada pela determinação congênita de menor numero de dentes, podendo estar associada a síndromes genéticas ou ocorrer isoladamente. Embora seja considerada uma das anomalias mais frequentes quando envolve terceiros molares, segundo pré-molares e incisivos laterais, sua ocorrência em dentes estáveis, tais como o canino e o primeiro molar permanente é rara. Desta forma, este relato apresentará o caso de uma paciente do sexo feminino, 8 anos idade, que iniciou tratamento de rotina na Clínica de Odontopediatria da UNIFENAS. Na anamnese não foi relatada pela responsável a ocorrência de alterações sistêmicas, nem queixa ou histórico odontológico relevante. No exame clínico odontológico, notou-se o não irrompimento do primeiro molar permanente superior direito (16). Diante dos exames de imagem, foi confirmada a agenesia do dente 16 e também do canino permanente superior direito (13). A agenesia, sobretudo de dentes estáveis e relevantes no arco dentário, pode comprometer o desenvolvimento adequado da oclusão, mastigação, fonação e estética. Desta maneira, é importante o diagnóstico precoce desta ocorrência com o objetivo de favorecer a elaboração de um adequado plano de tratamento e, minimizar as sequelas destas agenesias atípicas(AU)

Dental agenesis is a developmental anomaly characterized by the congenital determination of fewer teeth, may be associated with genetic syndromes or occur in an isolated form. Although it is considered one of the most frequent anomalies when it involves third molars, second lateral premolars and incisors, the occurrence in stable teeth, such as the permanent canine and the permanent first molar is rare. This report will present the case of an 8-year-old female patient who started routine treatment at the Pediatric Dentistry Clinic of UNIFENAS. In the anamnesis, the responsible person did not report the occurrence of systemic alterations, or a relevant dental complaint or history. On dental clinical examination, it was noticed the non-rupture of the permament maxillar right first molar (16). In view of the imaging tests, the agenesis of tooth 16 and also of the permanent maxillary right canine (13) was confirmed. Agenesis, especially of stable and relevant teeth in the dental arch, may compromise the proper development of occlusion, chewing, phonation and aesthetics. Thus, it is of paramount importance to early diagnosis of this occurrence in order to favor the development of an appropriate treatment plan in order to minimize the sequelae of these atypical agenesis(AU)

Efecto inmediato de dos ejercicios con tracto vocal semiocluido en el contacto glótico de usuarios ocupacionales de la voz / Immediate effect of two semi-occluded vocal tract exercises in glottal contact of occupational voice users

Introducción. Los docentes son usuarios ocupacionales de la voz con alto riesgo de desarrollar patologías vocales a causa de su labor. Para enfrentar esta proble-mática, suelen usarse ejercicios con tracto vocal semiocluido (TVSO), estrategia de educación/rehabilitación empleada para generar un cambio en el patrón de vibración de los pliegues vocales, minimizando el riesgo de lesión vocal al reducir el estrés de colisión al que se someten los tejidos. Diversos reportes han indicado que este tratamiento tiene efectos en el cociente de cierre (CQ), medida indirecta del estrés de colisión.Objetivo. Examinar el efecto fisiológico de dos ejercicios con TVSO en la actividad laríngea de profesores con esfuerzo vocal constante pero sin patología vocal. Metodología. Se registraron muestras de 43 profesores antes, durante y después de la realización de dos ejercicios con TVSO (vibración lingual y fonación en tubos). Las muestras de electroglotografía se analizaron para obtener el CQ. Resultados y conclusión. Se observó una diferencia significativa al comparar los valores del CQ antes y durante la realización de ambos ejercicios. No se encontraron cambios en este parámetro después de ejecutar la actividad. Estos hallazgos concuer-dan con reportes previos en los cuales el CQ tiende a aumentar durante la fonación en tubos; contrariamente, la realización de la vibración lingual tiende a decrecer el valor del CQ. Es posible que este comportamiento se deba a los mecanismos biome-cánicos particulares de cada ejercicio

Introduction. Teachers are occupational voice users with high risk of developing vocal pathologies due to their work. To face this situation, it is common the use of semi-occluded vocal tract (SOVT) exercises, a strategy of voice education/rehabil-itation implemented to induce a change in the vibration pattern of the vocal folds, mitigating, therefore, the risk of vocal lesion by reducing the collision stress applied to tissues. A variety of reports have indicated that this treatment has effects in the closed quotient (CQ), an indirect measure of collision stress. Aim. The purpose of this study was to examine the physiological effect of two dif-ferent SOVT exercises in larynx activity of teachers with constant vocal effort but without vocal pathology. Methods. 43 samples of teachers were recorded before, during and after executing two SOVT exercises (tongue trill and tube phonation). Electroglottographic samples were analyzed in order to obtain CQ. Results and conclusion. Both exercises had a significant difference of CQ scores when before and during conditions were compared. Any difference was found on this parameter after executing the activity. These findings agree with previous reports where CQ tends to increase during phonation through resonance tubes; on the con-trary, execution of tongue trill tends to decrease CQ values. This behavior might be because of the particular biomechanical mechanisms of each exercise

Granulomatose de Wegener: reabilitação oral com prótese bucomaxilofacial / Wegener's granulomatosis: oral rehabilitation with maxillofacial prosthesis / Granulomatosis de Wegener: rehabilitación oral con prótesis bucomaxilofacial

Introdução: A granulomatose de Wegener é uma doença autoimune rara que ocorre através de mediadores imunológicos. Sua etiologia permanece desconhecida. No entanto, sabe-se que é caracterizada principalmente pela inflamação dos vasos sanguíneos que acometem preferencialmente as vias aéreas superiores, inferiores e os rins. A doença apresenta altas taxas de morbidade e mortalidade quando não tratada, seu principal tratamento é através do uso de corticoides e imunossupressores. Objetivo: realizar um relato de caso de Granulomatose de Wegener tratando a comunicação orosinusal através de prótese bucomaxilofacial e uma discussão baseada na literatura recente. Relato de caso: paciente do gênero masculino, 40 anos de idade, leucoderma, encaminhado ao serviço de Bucomaxilofacial do Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC) queixando-se de comunicação oronasal em região de palato. Foi tratado com prótese BMF obturadora, o que devolveu ao paciente a capacidade de fonação, deglutição e convívio social. Conclusão: o tratamento com a prótese BMF reestabelece o velamento velofaríngeo, corrige hipernasalidade, melhora a deglutição e dá conforto psicológico ao paciente com estabilidade protética funcional... (AU)

Introduction: Wegeners' Granulomatulosis is a rare autoimmune disease that acts through immunologic mediators. It's etymology remains unknown. However, it is known that it's mainly characterized by the inflammation of blood vessels that affect, by preference, upper and lower airways, as well as kidneys. The disease presents high rates of morbidity and mortality when not treated, and it's main treatments are corticoids and immunosuppressants. Objective: Perform a Wegener's Granulomatulosis case report treating orosinusal communication through the use of a bucomaxilofacial prosthesis and a discussion based on current literature. Case report: Male patient, 40 years of age, leucoderma, brought to the Bucomaxilofacial department of Federal University of Santa Catarina (HU UFSC) with complaints regarding oronasal communication in the palate region. The patient was treated with a BMF prosthetics, which has allowed the patient to resume normal social activities, as well as returning phonation and deglutition. Conclusion: Treatment with a BMF prosthetics reestablishes velopharyngeal veiling, assists in the correction of nasal voice, improves deglutition and offers the patient psychological comfort with functional prosthetic stability... (AU)

Introducción: la granulomatosis de Wegener es una enfermedad autoinmune rara que se presenta a través de mediadores inmunológicos. Su etiologia permanece desconocida. Sin embargo, se sabe que se caracteriza principalmente por la inflamación de los vasos sanguíneos que afectan preferentemente las vías respiratorias superiores e inferiores y los riñones. La enfermedad tiene altas tasas de morbilidad y mortalidad cuando no se trata, su principal tratamiento es mediante el uso de corticosteroides e inmunosupresores. Objetivo: realizar un reporte de caso de Granulomatosis de Wegener en el tratamiento de la comunicación orosinusal mediante prótesis maxilofacial y una discusión basada en la literatura reciente. Caso clínico: paciente de sexo masculino, 40 años, leucoderma, remitido al Servicio Maxilofacial del Hospital Universitario de la Universidad Federal de Santa Catarina (HU-UFSC) por comunicación oronasal en región paladar. Fue tratado con una prótesis obturatriz de BMF, que le devolvió al paciente la capacidad de hablar, tragar y socializar. Conclusión: el tratamiento con la prótesis BMF restablece el velo velofaríngeo, corrige la hipernasalidad, mejora la deglución y proporciona confort psicológico al paciente con estabilidad protésica funcional... (AU)

Atraso de escolaridade e dificuldade de socialização de pacientes com fissura labiopalatina não sindrômica / Scholar delay and socialization dificulty of patients with non syndromic cleft lip and palate

Dentre as principais consequências da fissura labial e/ou palatina não sindrômica (FL/ PNS) estão dificuldades com fonação e autoestima, a primeira uma questão funcional e a segunda um problema social derivado não raro de contextos de bullying que, dentre outros, podem levar o indivíduo à evasão escolar. O objetivo deste estudo foi avaliar o atraso de escolaridade e a dificuldade de socialização de pacientes com FL/PNS quando comparados a uma população não afetada da mesma faixa etária de 7 a 20 anos, atendidos na Universidade José do Rosário Vellano ­UNIFENAS, campus de Alfenas. Os sujeitos foram agrupados em duas categorias de indivíduos, o grupo caso composto por indivíduos com FL/PNS em tratamento no Centro Pró-Sorriso da UNIFENAS; e o grupo controle composto por indivíduos sem FL/PNS em tratamento nas clínicas de Odontopediatria e Integrada da UNIFENAS. Os resultados demonstraram que a proporção de pacientes com FL/PNS atrasados na escola foi de quase 5 vezes maior que o número de pacientes sem fissuras (p<0,01). Constatou-se que a presença da FL/PNS pode ser o ponto de partida para outros contribuintes, com interferências psicológicas e/ou sociais, interferindo negativamente no processo de socialização (bullying) do paciente (p=0,0018). Portanto devem ser tratadas com abordagem multidisciplinar, incluindo diversos profissionais, dentre eles pedagogos, psicólogos e odontólogos(AU)

Among the main consequences of Non Syndromic Cleft Lip and Palate (NSCLP) are the difficulties with phonation and self estime, the first being a functional issue na the later being social that is derived from, not rarely, bullying contexts, that among other things, may lead na individual to school evasion. The objective of this study was to avaluate the levels of scholarity of patients with NSCLP when compared to a non affected population of the same age in individuals from 7 to 20 years old, attended the Pediatric and Integrated Pediatric Clinic of UNIFENAS, Alfenas campus. The subjects were grouped into two categories of individuals, the case group was composed of individuals with FL/PNS with treatment at the ProSmile center at UNIFENAS. The control group was composed of individuals without FL/PNS in treatment at the clinics of pediatric and integrated denistry at UNIFENAS. The results demonstrated the number of patients with FL/PNS that presented scholar delay were almost 5 times the number of patients that didn't present FL/PNS (p<0,01). The presence of NFL/PNS may be the starting point for other contributors with psychological and/or social interferences, interfering negatively with the socialization process (bullying) of the patient (p=0,0018). They should be treated with a multidisciplinary manner, including multiple professionals, among them pedagogues, psychologist and dentist(AU)

Craniofacial and neurological manifestations in patients with Guillain-Barré syndrome / Manifestaciones neurológicas craneofaciales en pacientes con síndrome de Guillain-Barré

Introducción: Among the broad range of symptoms of the Guillain-Barré Syndrome (GBS), patients can present craniofacial manifestations. Consequently, the participation of the dental surgeon in the evaluation of the stomatognathic system using a multidisciplinary approach model is very important. Objective: To identify the craniofacial and neurological manifestations of the Guillain-Barré Syndrome in patients from three hospitals in the district of Lambayeque, Peru, in 2019. Material and Methods: A descriptive, prospective, and cross-sectional study was carried out in 59 patients diagnosed with GBS by means of a clinical evaluation carried out by previously calibrated neurologists (k=0.911). Additionally, an oral evaluation of the oral hygiene index, the periodontal status, and the oral pH was carried out. Data were processed using frequency distribution tables. Results: 4 4.07% of the patients presented at least one functional alteration, such as unilateral limitation for facial expressions (25.42%), dysphagia (18.64%), alteration in phonation (11.86%), and loss of the sense of taste (6.78%), showing involvement of the corresponding cranial nerves. In addition, unfavorable conditions of oral hygiene and acid pH were observed in some cases, which proved adverse for the periodontal structures of the patients. Conclusion: The study found craniofacial manifestations of GBS, such as cases of unilateral facial palsy, dysphagia, difficulty in phonation, and loss of the sense of taste, due to the alteration of the cranial nerves that command these functions. In addition, poor oral hygiene, and the presence of acidic pH in some patients created an adverse environment for the integrity of the periodontal structures

Introducción: El Síndrome de Guillain-Barré (SGB) dentro de su amplia sintomatología puede presentar manifestaciones craneofaciales, por lo que resulta importante la participación del cirujano dentista en la evaluación del sistema estomatognático desde un modelo de abordaje multidisciplinario. Objetivo: Identificar las manifestaciones neurológicas craneofaciales del Síndrome de Guillain-Barré en pacientes de tres establecimientos de salud de Lambayeque, Perú en el año 2019. Materiales y Metodos: Se realizó un estudio descriptivo, prospectivo y transversal, con 59 pacientes diagnosticados con SGB, mediante una evaluación clínica realizada por médicos neurólogos previamente calibrados (k=0,911). Adicionalmente se realizó una evaluación bucodental del índice de higiene oral, del estado periodontal y del pH bucal, siendo procesados los datos mediante tablas de distribución de frecuencias. Resultados: El 44,07% de pacientes presentaron por lo menos una alteración funcional, identificando limitación unilateral para expresiones faciales (25.42%), disfagia (18.64%), alteración en la fonación (11.86%) y pérdida del sentido del gusto (6.78%), evidenciando compromiso de los pares craneales correspondientes. Además se observaron condiciones desfavorables de higiene oral y de pH ácido en algunos casos, que resultaron adversas para las estructuras periodontales de los pacientes. Conclusión: Fueron encontradas manifestaciones craneofaciales del SGB, identificando casos con parálisis facial unilateral, disfagia, dificultad para la fonación y pérdida del sentido del gusto, debido a la alteración de los pares craneales que comandan esas funciones. Además las condiciones desfavorables de higiene oral y la presencia de pH ácido en algunos casos, propiciaron un ambiente adverso para la integridad de las estructuras periodontales.

Combined autologous fascia transplantation with autologous fascia and fat injection into the vocal fold for sulcus vocalis / 中华耳鼻咽喉头颈外科杂志

Objective: To assess voice outcomes after surgical technique for typeⅡ and type Ⅲ sulcus vocalis. Methods: The data of 39 cases of bilateral type Ⅱ-Ⅲ sulcus vocalis were collected and analyzed retrospectively. There were 29 patients with bilateral type Ⅲ sulcus vocalis, and 10 patients with type Ⅲ on one side and typeⅡon the contralateral vocal cord. All of vocal cords were applied autologous anterior rectus sheath fascia transplant, and 68 sides of vocal cords with type Ⅲ sulcus vocalis were also applied autologous fascia and fat injection. Two male patients, whose results from transplant and injection were not satisfied, were carried out cricothyroid myotomy one year after surgery. Subjective and objective voice evaluations were performed before and after operation. Results: One patient was found mild adhesion on the middle part of vocal cords, and all the other 38 patients recovered well and there were no complications. During 5-6 weeks after surgery, breathy voice was the feather. Then vocal quality and glottal closure were gradually improved and became steady in 12 months. It showed that all the subjective and objective parameters, except for fundamental frequency, were significantly improved (P<0.05), and obvious improvement was achieved in glottal closures and mucosal waves in 35 patients. Three patients obtained no significant vocal quality improvement after transplant and injection surgery, and two male patients of them achieved improvement in mucosal waves and MPT after bilateral cricothyroid muscle amputations. One patient, who was revealed with mild adhesion, achieved a satisfied result after adhesion separation and suture. All the patients who originally had feelings of fatigue and voice discontinuity during phonation gained significant improvement postoperatively. Steady function with no complications was observed during the 36 months (up to 5 years in 20 patients) follow-up period. Conclusions: Autologous fascia transplantation combined fascia and fat injcetion can lead to excellent long-term results, and it is a good treatment option for pathologic sulcus vocalis. Cricothyroid muscle amputations can reduce the tension, and may improve vibration property of the vocal fold in patients with pathological sulcus vocalis.

Eletroestimulação funcional associada à fonação em mulheres sem alterações vocais / Functional electrostimulation associated with phonation in women without vocal disorders

RESUMO Objetivo Verificar o efeito imediato da corrente elétrica excitomotora, denominada FES, na qualidade vocal e no tempo máximo de fonação (TMF), e possíveis desconfortos, em mulheres sem alteração vocal, com aplicação em intensidade máxima suportada (IMS) e associada à fonação. Método Estudo experimental com 20 mulheres adultas normofônicas. Elas emitiram a vogal /a/ sustentada e depois foi aplicada a FES durante emissão da mesma vogal. Foram cinco séries com três minutos de emissão cada, intercaladas com descanso passivo; o estímulo elétrico foi na IMS pela participante, ajustado por série. Antes e após as emissões as vozes foram gravadas e coletados os TMF e a intensidade dos estímulos. A qualidade vocal foi classificada por juízes. Foram comparados os dados pré e pós emissão/eletroestimulação em cada fase. A análise qualitativa foi realizada a partir de sintomas autorreferidos. Resultados Não houve diferença na qualidade vocal e nos TMF entre os momentos pré e pós nas duas fases. A diferença entre a IMS e a intensidade de percepção do estímulo foi maior na série 1 em relação à série 2. Houve aumento da IMS na série 5 em relação à série 1. Não foram relatados sintomas negativos imediatos ou em até 48 horas após os procedimentos. Conclusão A corrente FES em IMS, associada à fonação, não gerou mudança imediata na qualidade vocal, nos TMF ou desconfortos autorreferidos pelas mulheres sem alteração vocal, mesmo com aumento gradual do estímulo.

ABSTRACT Purpose To verify the immediate effect of the Excitomotor Electrical Current, called Functional Electrical Stimulation (FES), on vocal quality, Maximum Phonation Time (MPT) and possible discomfort, in women without vocal alteration, with application at Maximum Supported Intensity (MSI) and associated with phonation. Methods Experimental study with 20 normophonic adult women. They emitted the sustained vowel / a / and then it was applied to FES during emission of the same vowel. There were five series with three minutes of emission each, interspersed with passive rest. The electrical stimulus was at the MSI by the participant, adjusted by series. Before and after the emissions the voices were recorded and the MPT and the intensity of the stimuli were collected. The vocal quality was rated by judges. Statistical analysis made it possible to compare pre and post emission / electrostimulation data in each phase. Qualitative analysis was performed based on self-reported symptoms. Results There was no difference in vocal quality and MPT between pre and post moments in both phases. The difference between MSI and stimulus perception intensity was greater in series 1 than in series 2. There was an increase in MSI in series 5 compared to series 1. No significant negative symptoms or within 48h after procedures were reported. Conclusion The FES at MSI, associated with phonation, did not generate an immediate change in vocal quality, in the MPT or self-reported discomforts by women without vocal alteration, even with a gradual increase in the stimulus, series by series.

High speed digital videolaringoscopy: evaluation of vocal nodules and cysts in women / Videolaringoscopia digital de alta velocidade: avaliação de nódulos e cistos de pregas vocais de mulheres

ABSTRACT Purpose To evaluate and compare the parameters of Digital kymography obtained through the High-speed Videolaryngoscopy of women without laryngeal disorders, of women with vocal fold nodules and of women with vocal cysts. Methods A cross-sectional observational study in which 60 women aged 18 years and 45 years were selected. Three study groups were formed: 20 women without laryngeal disorder forming the control group (Group 1), 20 women with diagnosis of vocal fold nodules forming Group 2 and 20 women with diagnosis of vocal cysts forming Group 3. Subsequently the participants were evaluated by High-speed Videolaryngoscopy for analysis and comparison of laryngeal images using Digital kymography. The laryngeal parameters processed by the program KIPS® were: minimum, maximum and mean opening; dominant amplitude of the left and right vocal folds; dominant frequency of the right and left vocal folds; and close. Results The analysis of Digital kymography suggests that the presence of the vocal fold nodules and the vocal cysts tend to restrict more to the maximum and minimum opening of the vocal fold and the dominant amplitude of the opening variation in the middle region of the glottis. Conclusion Digital kymography parameters were similar in the presence of vocal fold nodules and vocal cysts lesions.

RESUMO Objetivo Avaliar e comparar os parâmetros da videoquimografia digital obtidos pela videolaringoscopia de alta velocidade de mulheres sem alterações laríngeas, de mulheres com nódulos de prega vocal e de mulheres com cistos vocais. Método Estudo observacional transversal, no qual foram selecionadas 60 mulheres com idade entre 18 e 45 anos. Três grupos foram formados: 20 mulheres sem alterações laríngeas formando o grupo controle (Grupo 1), 20 mulheres com diagnóstico de nódulos nas pregas vocais formando o Grupo 2 e 20 mulheres com diagnóstico de cistos vocais formando o Grupo 3. Posteriormente, os participantes foram avaliados por Videolaringoscopia de alta velocidade para análise e comparação de imagens da laringe usando videoquimografia digital. Os parâmetros videoquimográficos avaliados pelo programa KIPS® foram: aberturas mínima, máxima e média; amplitudes da prega vocal direita e esquerda; frequências da abertura da prega vocal direita e esquerda; e fechamento. Resultados A análise da videoquimografia digital sugere que a presença dos nódulos e dos cistos de pregas vocais tendem a restringir a abertura máxima e média da prega vocal e a amplitude dominante da variação de abertura na região média da glote. Conclusão Os parâmetros da videoquimografia digital foram semelhantes na presença de nódulos nas pregas vocais e lesões de cistos vocais.

Maximum phonation time in the pulmonary function assessment / Tempo máximo de fonação para avaliação da função pulmonar

ABSTRACT Purpose: to evaluate the reliability of the maximum phonation time (MPT) and Vital Capacity intra and inter-examiner, by means of the single-breath counting test (CT) and the sustained /a/ phoneme, and the slow vital capacity (SVC). Methods: a reliability study carried out in three groups of healthy individuals, each group with 30 volunteers, allocated according to age. SVC was measured using a spirometer, while the MPT was assessed by the phoneme /a/ and CT. The data were analyzed using SPSS version 20.0. Initially, descriptive statistics were used and for data reliability, the intraclass correlation coefficient (ICC). Results: the Intraclass Correlation Coefficients (ICC) were considered excellent, with significant results above 0.92 for SVC and greater than 0.79 for CT and phoneme /a/. Regarding the inter-examiner evaluation, the ICCs were also significant for both SVC with values greater than 0.96, and for CT and the phoneme /a/ with values greater than 0.85. The error inherent in the technique was assessed using the standard error of the measurement for intra and inter-examiner analyses with values ranging from 1.79 to 3.29 for phoneme /a/, 3.20 to 6.58 for CT and 65, 05 to 206.73 for SVCml. Conclusion: phonation techniques with the phoneme /a/ and CT, as well as SVC, have an excellent reliability, due to intra and inter-examiner agreement measures.

RESUMO Objetivo: avaliar a concordância do tempo máximo de fonação (TMF) com a Capacidade Vital, intra e interexaminador, por meio da técnica de contagem numérica em uma única respiração (TC) e do fonema /a/ sustentado e da capacidade vital lenta (CVL). Métodos: trata-se de um estudo de concordância realizado em três grupos de indivíduos saudáveis, cada grupo com 30 voluntários, alocados de acordo a idade. A CVL foi mensurada por meio do espirômetro, enquanto o TMF foi avaliado pela emissão do fonema/a/ e da TC. Os dados foram analisados pelo programa SPSS versão 20.0. Inicialmente utilizou-se estatística descritiva e para concordância dos dados foi utilizado o coeficiente de correlação intraclasse (CCI). Resultados: os Coeficientes de Correlação Intraclasse (CCI) intraexaminadores foram considerados excelentes, com resultados significantes acima de 0,92 para a CVL e maiores que 0.79 para a TC e fonema/a/. Em relação à avaliação interexaminadores, os CCIs também foram significantes tanto para a CVL com valores maiores que 0,96 quanto para a TC e o fonema/a/ com valores maiores que 0,85. O erro inerente a técnica foi avaliada por meio do erro padrão da medida para as analises intra e interexaminadores com valores que variaram de 1,79 a 3,29 para fonema/a/, 3,20 a 6,58 para TC e 65,05 a 206,73 para CVLml. Conclusão: as técnicas de fonação com o fonema /a/ e TC, assim como a CVL, demonstraram uma excelente concordância intra e interexaminadores.

Objetivos de intervención en voz: Una propuesta para su análisis y redacción / Voice therapy goals: a proposal for analysis and writing

Este artículo de reflexión aborda aspectos que dan cuenta de la complejidad en el planteamiento de objetivos en torno a los marcos de abordaje vocal contemporáneos. Se plantea la complejidad de la selección y redacción de objetivos para la interven-ción en voz holística y ecléctica, y desde ella, la necesidad de incorporar el modelo CIF y las recomendaciones de la ASHA para el desarrollo de objetivos centrados en la persona, tanto a corto como a largo plazo. Se propone la utilización del método de análisis SMART y su aplicación específica para objetivos de intervención de la voz. Además, se abordan los aspectos formales que se deben considerar para una redacción precisa. Finalmente, se ejemplifica la propuesta mediante un caso clínico. Esta propuesta pretende ser de utilidad para fines terapéuticos y/o para el ámbito académico, tanto en la discusión de la formulación y diseño de planes terapéuticos como en el pensamiento reflexivo asociado al abordaje vocal.

This reflective article addresses aspects that deal with the complexity of objective setting in contemporary vocal approach frameworks. It addresses the complexity in selecting and writing objectives for holistic and eclectic voice therapy and the need to incorporate the ICF model and ASHA recommendations for the development of person-centered goals in both the short and long term. The use of the SMART analysis method is proposed and its specific application for voice therapy goal. Also, the formal aspects to be considered for precise wording are addressed. Finally, the proposal is exemplified through a clinical case. This proposal is intended to be useful for therapeutic and/or academic purposes, both in discussing the formula-tion and design of therapeutic plans and the reflective thinking associated with the vocal approach.

Fisiología respiratoria: contribución de la estructura de la vía aérea y el pulmón a la función del aparato respiratorio / Contribution of the airways and lung structure to the respiratory system function

Conocer la estructura del sistema respiratorio es fundamental para comprender cómo realiza sus funciones, desde la principal, el intercambio gaseoso, hasta otras funciones no respiratorias tales como el equilibrio ácido-base, fonación, defensa pulmonar, metabolismo pulmonar y procesamiento de materiales bioactivos. El objetivo de esta revisión es describir los conocimientos actuales de la anatomía del aparato respiratorio y mencionar sus funciones tanto respiratorias como no respiratorias.

Knowing the structure of the respiratory system is essential to understand how it performs its various functions, from the main, gas exchange, to its non-respiratory functions such as acid-base balance, phonation, lung defense, pulmonary metabolism, and the handling of bioactive materials. The main objective of this review is to describe the updated knowledge of the respiratory system's anatomy and to mention its various respiratory and non-respiratory functions.

Voz do idoso: o avanço da idade gera diferentes impactos? / Aged voice: does advancing age generate different impacts?

RESUMO Objetivo Verificar se existem diferenças em aspectos vocais entre idosos com presbifonia, divididos em três faixas etárias. Método Participaram 60 idosos de ambos os sexos com idades entre 60 e 90 anos (média=72,3), com diagnóstico de presbifonia estabelecido em avaliação otorrinolaringológica. A partir da gravação das vozes foi realizada análise perceptivo-auditiva e acústica e os dados foram comparados por meio dos testes estatísticos com os participantes divididos nos grupos etários 60-70 anos, 71-80 anos e 81-90 anos. Resultados Ainda que os idosos dos três grupos tenham apresentado alterações em aspectos vocais variados, como instabilidade e ruído em frequências graves, aqueles com mais de 80 anos apresentaram maior grau de disfonia, rugosidade, soprosidade e pitch. Também foram observados neste grupo maiores desvios em jitter, shimmer e irregularidade e a medida GNE no limite da normalidade. Todas as diferenças foram estatisticamente significativas. A maioria dos idosos dessa faixa etária apresentou ainda alteração no diagrama de desvio fonatório e quebra de frequência. Conclusão Diversos aspectos perceptivo-auditivos e acústicos se apresentaram mais desviados nos idosos mais velhos, o que reforça a necessidade de serem consideradas essas especificidades tanto na avaliação dos efeitos do envelhecimento na voz quanto no desenvolvimento de ações para minimizar o declínio vocal.

ABSTRACT Purpose To verify if there are differences in the vocal aspects of older people from three different age groups with presbyphonia diagnosis. Methods Sixty older adults joined this study. They were both female and male, with an age range from 60 to 90 years old (average: 72.3) and with presbyphonia diagnosis established after otolaryngology evaluation. From their voice recordings, it was possible to make the acoustic and auditory-perceptual analysis. The data collected was compared through statistical tests considering the division of the participants into the following groups: 60-70 years old, 71-80 years old, and 81-90 years old. Results Even though the older people from all of the three groups have presented deviation in multiple vocal aspects such as instability and vocal noise in low frequencies, those with more than 80 years old have presented a higher deviation of the general grade of dysphonia, roughness, breathiness, and pitch. In this group, it was also observed higher deviations in jitter, shimmer, vocal breaks, and the GNE measure on the edge of normality. All the differences were statistically significant. The majority of the older participants from that group presented even a deviation in the phonatory deviation diagram and frequency break. Conclusion Various acoustic and auditory-perceptual aspects had a higher deviation in the older adults over 80 years old, which reinforces the need to consider those specificities in the evaluation of the vocal aging impacts and also in the development of actions to minimize vocal declination.

Efeitos vocais imediatos produzidos pelo dispositivo Shaker® em mulheres com e sem queixa vocal / Immediate vocal effects produced by the Shaker® device in women with and without vocal complaints

RESUMO Objetivo Avaliar as modificações acústicas e de autopercepção obtidas após o primeiro, terceiro, quinto e sétimo minuto de prática da técnica de oscilação oral de alta frequência sonorizada, realizada com o dispositivo Shaker®. Método Participaram do estudo 27 mulheres com idade entre 18 e 41 anos com e sem queixa vocal. A vogal sustentada /ε/ foi registrada em tempo máximo de fonação antes (pré-exercício) e após o primeiro, terceiro, quinto e o sétimo minuto de execução da técnica de oscilação oral de alta frequência sonorizada com o dispositivo Shaker®. Foi realizada a análise acústica dos seguintes parâmetros: ruído, frequência fundamental, glottal to noise excitation, Jitter, Shimmer e número de harmônicos. Resultados Não houve diferenças significativas na comparação dos parâmetros acústicos entre as participantes com e sem sintomas vocais. Observou-se melhora na autopercepção do desconforto vocal nos grupos das mulheres com e sem sintomas vocais, comparando-se o momento antes da prática com o primeiro e terceiro minutos de prática. Houve redução dos valores de Jitter, ao comparar o momento antes da prática com os momentos após um e sete minutos e ao comparar os momentos após cinco e sete minutos de exercício, no grupo de mulheres com sintomas vocais. Conclusão A técnica com o Shaker® mostrou resultados positivos, tanto em indivíduos com sintomas quanto em indivíduos sem sintomas vocais.

ABSTRACT Purpose To evaluate the acoustic and self-perception modifications obtained after the first, third, fifth and seventh minutes of voice oral high-frequency oscillation practice accomplished with the Shaker® device. Methodology Twenty-seven women aged between 18 and 41 years with and without vocal complaint participated in the study. The sustained vowel / ε / was recorded at maximum phonation time before (pre-exercise) and after the first, third, fifth and seventh minutes of voice oral high-frequency oscillation practice accomplished with Shaker®. The acoustic analysis of the following parameters was performed: noise, fundamental frequency, glottal to noise excitation, Jitter, Shimmer and number of harmonics. Results There were no significant differences in the comparison of the acoustic parameters between the participants with and without vocal symptoms. It was observed an improvement in the self-perception of vocal discomfort in the groups of women with and without vocal symptoms, comparing the moment before the practice with the first and third minutes of practice. There was a reduction in Jitter values when comparing the time before practice with the moments after one and seven minutes and when comparing the moments after five and seven minutes of exercise in the group of women with vocal symptoms. Conclusion The Shaker® technique showed positive results both in individuals with symptoms and in individuals without vocal symptoms.

Amplificador de voz: efeitos na dose e na intensidade vocal de professoras sem disfonia / Voice amplifier: effects on dose and vocal intensity of teachers without dysphonia

RESUMO Objetivo Analisar a interferência do uso do amplificador de voz na dose vocal de professoras não disfônicas. Método Trata-se de um estudo experimental, comparativo intrassujeitos, composto por 20 professoras do ensino fundamental da Rede Municipal de Ensino de Belo Horizonte/MG. Após o consentimento as participantes, foram solicitadas a responder o questionário de Escala de Sintomas Vocais - ESV e posteriormente participaram de dois momentos do estudo, selecionados aleatoriamente. No primeiro momento as participantes utilizaram somente o dosímetro vocal e no segundo momento utilizaram o dosímetro vocal e o amplificador de voz. As medições foram registradas pelo aparelho durante 1h40m, na sala de aula que as professoras lecionavam. O espaço entre as duas medições foi de uma semana, sendo mantidas a mesma sala, mesmo horário e mesma disciplina lecionada, em ambos os momentos. Resultados O parâmetro intensidade foi o único que apresentou diferença com o uso de amplificação de voz. Conclusão O uso da amplificação de voz durante a docência de professoras não disfônicas não interfere nos parâmetros acústicos de frequência fundamental, e nas medidas de dose vocal. A intensidade da voz é menor quando o professor faz uso de amplificação vocal.

ABSTRACT Purpose Analyze the interference of using the voice amplifier in vocal dose of non-dysphonic teachers. Methods This is an experimental study comparing people from the same ambience compound for 20 teachers from municipal elementary school in Belo Horizonte/MG. After consent, the participants were requested to answer the vocal symptom scale questionnaire (ESV) and later participated in two different moments of the study, for which they randomly selected. In the first moment, the participants used only the vocal dosimeter and in the second, they used the vocal dosimeter and the voice amplifier. The measurements were recorded by the device for 1h40m, in the classroom that the teachers taught. The time between the two measurements was one week, with the same room, the same time and the same discipline being taught, at both times. Results The intensity parameter was the only one that showed difference with the use of the voice amplifier. Conclusion Use voice amplification while non-dysphonic teachers are teaching doesn't affect the fundamental frequency and vocal dose measure in the acoustics parameters. The vocal intensity is smaller when teacher uses the vocal amplification.

Consideraciones clínicas para fonoaudiólogos en el tratamiento de personas con COVID-19 y traqueostomía. Parte II: Mejorando la fonación para facilitar la comunicación / Clinical considerations for speech-language pathologists in the treatment of people with COVID-19 and tracheostomy. Part II: Improving phonation to facilitate communicatio

La enfermedad COVID-19 fue declarada pandemia por la Organización Mundial de la Salud. Su presentación más severa genera una condición que requiere tratamiento en unidades de cuidados intensivos, condición que al prolongarse en el tiempo requiere la implementación de una traqueostomía para facilitar la entrega de soporte ventilatorio invasivo. Si bien este dispositivo posee importantes ventajas que favorecen la recuperación y rehabilitación, también es cierto que genera diversas complicaciones en la comunicación de las personas, condición que se suma a los efectos propios del COVID-19 y la frecuente historia de intubación endotraqueal previa. El objetivo de este artículo es proveer orientaciones y herramientas clínicas para el tratamiento de la fonación para la comunicación en personas con traqueostomía y COVID-19. Se considera para ello las recomendaciones de la literatura existentes a la fecha, bajo un análisis pragmático y basado en nuestra experiencia de atender a más de 561 personas con esta condición. Se exponen las características de la comunicación en esta población, su tratamiento, consideraciones para el uso de técnicas específicas y orientaciones para la mejora de la calidad de vida. Siempre con un enfoque orientado al cuidado y protección de las/os usuarias/os y el equipo de salud, en particular fonoaudiólogas y fonoaudiólogos del país.

The COVID-19 disease was declared a pandemic by the World Health Organization. When most severe, it generates a condition that requires treatment in intensive care units, which, when extended in time, requires implementing of a tracheostomy to facilitate invasive ventilatory support. Although ventilatory support has important advantages that favor recovery and rehabilitation, it generates various complications for patients' communication, a condition that adds to the effects of COVID-19 and the frequent history of previous endotracheal intubation. The aim of this article is to provide guidance and clinical tools for the treatment of phonation to facilitate communication in people with tracheostomy and COVID-19. For this, the recommendations of the existing available literature are considered, under a pragmatic analysis and based on our experience of treating more than 561 infected patients. The characteristics of communication in this population, its treatment, considerations for the use of specific techniques and guidelines to improve quality of life are exposed. Always with an approach oriented to the care and protection of users and the health team, in particular speech-language pathologists in the country.

Fisiología del ejercicio en la práctica de la vocología colombiana: una necesidad / Exercise physiology in Colombian vocology practice: a necessity

En los últimos años, la vocología ha prestado un interés particular a la investigación y aplicación clínica de principios ­basados en la ciencia­ que permitan maximizar el aprendizaje y el control motor asociados al funcionamiento de la voz. El proceso de producción vocal ocurre gracias a la acción coordinada de los subsistemas de respiración, fonación y resonancia. Estos, a su vez, deben su operatividad a la activación de diversos músculos que parecen comportarse de forma similar a aquellos que componen las extremidades. Teniendo esto en cuenta, los principios del ejercicio que han demostrado efectividad para mejorar la fuerza y resistencia de la musculatura de las extremidades podrían aplicarse al entrenamiento de la voz. En primer lugar, en este documento se presentan algunos aspectos funcionales del tejido muscular, describiendo las fibras musculares tipo I y II y puntualizando en la distribución de dichas fibras en la musculatura que hace parte de los subsistemas de la función vocal. En segundo lugar, se exponen las adaptaciones fisiológicas derivadas del ejercicio (acondiciona-miento) así como de la degeneración propia de la inactividad (desacondicionamiento). Posteriormente, se hace una explicación del enfoque de ejercitación de resistencia progresiva junto a los cinco principios que lo definen, concentrada en su aplicación a la vocología. Finalmente, se argumenta la necesidad de incluir la ciencia del ejercicio en la práctica e investigación en vocología en el contexto colombiano a la luz de algunos reportes nacionales disponibles hasta la fecha.

In recent years, vocology has focused especially in research and clinical application of evidence-based principles that enhance motor learning and motor control related to voice function. The process of voice production occurs due to coordinated action of respiration, phonation and resonance subsystems. Likewise, the function of these subsystems is a result of the activation of a variety of muscles that seem to behave similarly to skeletal limb muscles. Taking this into account, exercise principles that improve strength and endurance of skeletal limb muscles may also be applied to im-prove performance of voice production. First, this article focuses on functional aspects of muscle tissue; muscle fiber types I and II are described and, in the same way, the distribution of these fibers in voice production muscles is pointed out. Second, phy-siological adaptations to training (conditioning) as well as detraining from inactivity (deconditioning) are portrayed. Afterwards, progressive resistance training is explai-ned next to its principles and its application to vocology. Finally, the paper argues the necessity of including exercise science into practice and research of vocology in Colombian context, based on some national reports available to date

Comparação do impacto imediato das técnicas de oscilação oral de alta frequência sonorizada e sopro sonorizado com tubo de ressonância em idosas vocalmente saudáveis / Comparison of the immediate effect of voiced oral high-frequency oscillation and flow phonation with resonance tube in vocally-healthy elderly women

RESUMO Objetivo Verificar e comparar os efeitos imediatos da técnica de oscilação oral de alta frequência sonorizada (OOAFS) e sopro sonorizado com tubo de ressonância na autopercepção de sintomas vocais/laríngeos e na qualidade vocal de idosas. Método Participaram 14 mulheres idosas que realizaram as técnicas OOAFS e sopro sonorizado com tubo de ressonância de silicone, com wash-out de uma semana. Todas responderam questões sobre frequência e intensidade dos sintomas vocais/laríngeos; foram submetidas à gravação da vogal sustentada /a/ e contagem de números, para análise perceptivo-auditiva e acústica vocal. Foram extraídos os tempos máximos de fonação (TMF). Em seguida, sorteou-se a técnica a ser realizada: OOAFS ou tubo de ressonância, por três minutos em tom habitual. Após exercício, os mesmos procedimentos da avaliação inicial foram repetidos e as idosas responderam a um questionário de autoavaliação sobre os efeitos das técnicas. Os dados foram comparados antes e após aplicação das técnicas por meio dos testes ANOVA, Wilcoxon e Mann-Whitney; para as sensações vocais após técnicas, aplicou-se teste Quiquadrado(p<0,05). Resultados Ao comparar as técnicas, verificou-se diminuição da rugosidade e melhora da ressonância na contagem dos números após tubo de ressonância e manutenção dos resultados após OOAFS. Não houve mais diferenças significantes para as demais variáveis estudadas entre os grupos. Conclusão O sopro sonorizado com tubo de ressonância melhora a qualidade vocal de mulheres idosas. Além disso, ambos os exercícios apresentaram semelhanças na autopercepção dos sintomas vocais/laríngeos e sensações, sugerindo que a OOAFS é segura e pode ser empregada na terapia de voz nesta população.

ABSTRACT Purpose To verify and compare the immediate effects of the voiced oral high-frequency oscillation (VOHFO) technique and the phonation into a silicone resonance tube in the elderly self-perception of vocal and laryngeal symptoms and in their voice quality. Methods 14 elderly women, over 60 years old, performed the VOHFO and phonation into a resonance tube technique (35cm in length and 9mm in diameter) with one-week interval between both to avoid carry-over effect. Initially, all participants answered questions regarding the frequency and intensity of their vocal/laryngeal symptoms. Recordings of the sustained vowel /a/ and counting numbers were performed for posterior perceptual and acoustic analyses of the voice quality. The maximum phonation time (MPT) for /a/, /s/, /z/ and counting numbers were also obtained. After that, a draw lot established which technique (VOHFO or resonance tube) would be initially applied for three minutes. After the exercise performance the same procedures were carried out and the elderly women answered a self-assessment questionnaire about the effect of the techniques in her voice, larynx, breathing and articulation. Comparison pre and post each technique were analyzed using ANOVA, Wilcoxon and Mann-Whitney tests. The sensations after the techniques were assessed using the Chi-square test (p<0.05). Results The comparison of both techniques showed decrease in roughness and improvement in resonance for counting numbers after the resonance tube and same outcomes post VOHFO. There were no significant differences for the other analyzed variables between groups. Conclusion The phonation into a resonance tube exercise improves the vocal quality of elderly women. In addition, both exercises are similar regarding self-perception of vocal / laryngeal symptoms and sensations post three minutes of the technique, suggesting that VOHFO can be safely applied in voice therapy for this population.