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Biomedical subjects

Mara Behlau

Publications and source records attributed to Mara Behlau.

12 recordsLinked to original sources

The effects of a specific speech and language training program on students of a radio announcing course.

The purpose of this study was to determine whether individuals show differences in speech and voice during reading of the same news before and after attending a radio announcing course. Twenty-five students of a Radio Announcing Course in Sao Paulo city, 17 men and 8 women, aged 19 to 55 years, participated in this study. The readings were recorded in a professional audio studio, and the speech samples were submitted to perceptual and acoustic analysis. For the perceptual analysis, the samples were randomly presented in pairs and five trained speech pathologists identified each recording as pre- and posttraining, and also justified their choices by indicating what parameters better based their judgment: type of voice, articulation and pronunciation, loudness, pitch, resonance, speech rate, respiratory coordination, and use of emphasis. The acoustic parameters analyzed were mean, minimum, and maximum fundamental frequency, frequency range, text duration, and pause duration. The perceptual analysis showed that the posttraining speech samples were considered the best productions in 80% of the evaluations. Emphasis characterized the readings (70.4%), followed by type of voice (44.8%) and pitch (40.8%). Acoustic analysis showed higher mean fundamental frequency and increase of frequency range posttraining. These results indicated richer modulation in the posttraining readings. There are differences in the readings of the same news pre- and posttraining in a radio announcing course, and the posttraining reading was considered the best production, indicating the positive effect of the training.

Adult↗

Perceptual identification and acoustic measures of the resonant voice based on "Lessac's Y-Buzz"--a preliminary study with actors.

This study aimed to verify whether the resonant voice based on Lessac's Y-Buzz can be perceived by listeners as resonant and different from habitual voice and to compare them to determine whether this sound exploration improves the vocal production. Nine newly graduated actors, six men and three women without voice complaints, were the subjects. They received a session of Lessac's Y-Buzz training from the primary investigator. Before training, they were asked to sustain the vowel /i/ at comfortable frequency and habitual loudness. After training, they were requested to sustain the Y-Buzz they had learned at a comfortable frequency and habitual loudness. Three speech-language pathologists (SLP) trained in voice developed an auditory-perceptive analysis. The pre- and posttraining voice samples were randomly spliced together, edited, and presented in pairs to perceptual judges who were asked to identify the most resonant of the pair. The voice samples were also acoustically compared through the Hoarseness Diagram and acoustic measures using the VoxMetria Software (CTS, version 2.0s, Brazil). The Y-Buzz trials were identified as resonant voice in 74% of the comparisons. The acoustic measures showed a statistically significant decrease of irregularity (P = 0.002) and shimmer (P = 0.38). The Hoarseness Diagram demonstrated how the resonant voice moved toward the normality for irregularity and noise components. The results showed that the resonant voice based on the Y-Buzz can be identified as resonant and different from normal voicing in the same subject, and it apparently implies a better vocal production demonstrating a significant decrease of shimmer and irregularity through the Hoarseness Diagram evaluation.

Adolescent↗

Education of speech-language pathologists and audiologists in Brazil.

The field of speech-language pathology (SLP) in Brazil, named 'fonoaudiologia', comprises both a therapeutic approach to communication disorders and audiology and was officially recognized on December 9, 1981 (law No. 6965). University programs exist since the 1960s. The undergraduate level is a 4-year honors Bachelor of Science program and requires at least a 3,700 h of coursework. Since 1996 four areas of specialization were established: language, audiology, voice and oral myology, requiring a minimum of 500 h of course. Graduate programs in the narrower sense,master's degree and doctorate, exist since the 1970s. Brazil is a 180-million inhabitant country with approximately 25,000 speech-language pathologists, of which 2,700 are specialists, 800 masters and 210 doctors. There are almost 100 undergraduate programs and 70 specialization courses; however, for master's degree and doctorate purposes there are only 8.

Audiology↗

Morphological and functional aspects of the senile larynx.

OBJECTIVE: To analyze the senile larynx, considering morphological aspects during respiration and functional aspects during phonation, comparing it to the young adult larynx. PATIENTS AND METHODS: A retrospective study was conducted of 100 laryngeal images of adults without vocal complaints, 50 laryngeal images of young adults aged 20-45 years and 50 laryngeal images of elderly individuals aged 65-85 years, of both genders. Images were produced by means of a rigid endoscope and stroboscopy. The morphological aspects analyzed were: laryngeal symmetry, vocal fold bowing, prominence of the vocal process and glottic proportion. The functional aspects analyzed were glottic closure, laryngeal vestibule behavior, phase (timing of closure) and amplitude symmetry of mucosal wave and tremor of laryngeal structures. RESULTS: Significant differences between the young adult larynx and the geriatric larynx were found for the following parameters: vocal fold bowing, prominence of the vocal process, glottic proportion, phase and amplitude symmetry of mucosal wave and tremor of laryngeal structures. CONCLUSION: The data suggests that the geriatric larynx differs from the young adult larynx in many characteristic aspects.

Adult↗

Laryngeal microweb and vocal nodules. Clinical study in a Brazilian population.

The etiology and pathogenesis of laryngeal microwebs are heterogeneous, and in most cases they are an incidental finding. It has also been suggested that microwebs could be a familial trait, representing a postblastogenic embryonic vestigial structure that might alter the biomechanical and vibratory properties of the vocal fold. Vocal nodules are small benign swellings along the margins of the vocal cords, with preferential location at the junction of the anterior and middle thirds, and usually resulting from mechanical trauma. The authors studied a sample of 107 patients with vocal nodules, looking for a possible correlation with microwebs due to the predicted involvement in the vibration of vocal cord margins. Glottic proportion, type of glottic closure, nodule location and the main complaints in patients with microwebs were compared with those in a sample of patients without microwebs. In the present study, microwebs were found in 9.4% of the patients, who showed much smaller glottic proportion than patients with micronodules only. Furthermore, vocal nodule location was not related to the presence and/or absence of laryngeal microwebs.

Adolescent↗

The neonate cry after cesarean section and vaginal delivery during the first minutes of life.

Although the option for vaginal delivery is most physiological, the achievement of cesarean section is very common in Brazil. The neonate cry represents the beginning of both processes, physiological adaptation and human vocal communication. The cry emission depends on the functioning of respiratory and laryngeal muscles, which are controlled by the nervous system. The acoustic analysis of neonate cry is useful in the assessment of healthy babies and can be used to characterize the signals of diseases through a previously multidisciplinary diagnosis, with immediate medical intervention. The present study compared the acoustic cry characteristics of 30 healthy newborn after a cesarean section and 30 healthy newborn after a vaginal delivery, of both genders, from the exact moment of birth until the first 5 min of life. Using the softwares VOXMETRIA and GRAM, it was possible to analyze the duration, frequency, intensity, occurrence, localization and inspiratory phonation, besides the type of spectrographic tracings. The acoustic cry characteristics of newborns after a C section and a vaginal delivery could evidence not only harmonic, expiratory, acute and strong emissions, but also emissions rich in sounds and varied in types of melody. The differences found can be related to the physiology of birth.

Acoustics↗

Voice-over: perceptual and acoustic analysis of vocal features.

Voice-overs are professional voice users who use their voices to market products in the electronic media. The purposes of this study were to (1) analyze voice-overed and non-overed productions of an advertising text in two groups consisting of 10 male professional voice-overs and 10 male non-voice-overs; and (2) determine specific acoustic features of voice-over productions in both groups. A naïve group of listeners were engaged for the perceptual analysis of the recorded advertising text. The voice-overed production samples from both groups were submitted for analysis of acoustic and temporal features. The following parameters were analyzed: (1) the total text length, (2) the length of the three emphatic pauses, (3) values of the mean, (4) minimum, (5) maximum fundamental frequency, and (6) the semitone range. The majority of voice-overs and non-voice-overs were correctly identified by the listeners in both productions. However voice-overs were more consistently correctly identified than non-voice-overs. The total text length was greater for voice-overs. The pause time distribution was statistically more homogeneous for the voice-overs. The acoustic analysis indicated that the voice-overs had lower values of mean, minimum, and maximum fundamental frequency and a greater range of semitones. The voice-overs carry the voice-overed production features to their non-voice-overed production.

Adult↗

Glottic characteristics and voice complaint in the elderly.

This study evaluated the relationship between voice complaint and deviant vocal fold status with special regard to presbylarynx, in patients aged more than 60 years, with pharyngeal-laryngeal complaint. The material consisted of clinical histories and images obtained by laryngoscopies from protocols from the Larynx Institute-INLAR, Sao Paulo, Brazil, of 210 patients, 88 men and 122 women, aged more than 60 years, who had sought otorhinolaryngologic treatment. Indicative glottic characteristics of the presbylarynx, such as vocal fold bowing, prominence of vocal processes, and spindle-shaped glottic chink, were analyzed. The increase in mass, leukoplakia, and other vocal fold alterations, distinct from these two, grouped as miscellaneous, as well as the presence or absence of voice complaint were also analyzed. Vocal fold bowing, prominence of vocal processes, and spindle-shaped glottic chink showed a strong correlation among each other. The presence of presbylarynx was accompanied by less voice complaint than the presence of vocal fold mucosa alterations, which in turn are more common where an absence of presbylarynx exists.

Aged↗

Acoustic analysis of voice in multiple sclerosis patients.

The objective is to investigate the presence of dysphonic symptoms in multiple sclerosis (MS) patients and to compare quantitative acoustic parameters in multiple sclerosis patients and normal individuals. The method of study was an 8-month controlled cross-sectional that was carried out with 106 individuals (30 MS, 76 controls). Both groups included males and females from 20 to 55 years. Exclusion criteria were prior vocal disorder, laryngeal microsurgery, recent endotracheal intubation, tumors, laryngeal, lung or mediastinal metastases, respiratory disease, and other associated neurological diagnoses. For dysphonic symptoms (qualitative variables), associations were assessed using Mantel-Haenszel's chi2 test, with Yates correction or the Fisher exact test when necessary. Statistical significance was set at p< or =0.05. Dysphonia was observed in 70% of MS individuals versus 33% of controls (p=0.01). Association was found between MS and dysphonia (OR: 2.2, CI 95%: 1.13-4.25). Fundamental frequency was higher among MS patients (p=0.01). Fundamental frequency deviation was significantly higher in MS women (but not men) than controls (p=0.00). Jitter was higher in MS men than in all other groups (p=0.00). Results suggest that evaluation and treatment of MS patients should be revised, evaluating voice alterations in relation to other signs. MS seems to intensify gender effect on fundamental frequency deviation, noise, and jitter, with MS women presenting fewer voice variations than men.

Adult↗

Nasalance changes after functional endoscopic sinus surgery.

Forty adult patients diagnosed with chronic rhinosinusitis who underwent functional endoscopic sinus surgery (FESS), were analyzed with respect to postoperative resonatory voice changes. For evaluation the patients were asked about their subjective impression of voice changes using a questionnaire. An objective assessment was performed by determining the so-called nasalance using the Nasometer (Kay Elemetrics), preoperatively, on the immediate postoperative follow-up (2 days after surgery), and approximately 1 month after surgery. The mean nasalance values increased significantly one month after FESS whereas the immediate postoperative control (2 days after surgery) showed a decrease of nasalance. Although FESS is a minimally invasive procedure, it can change the acoustic characteristics of the vocal tract in the long term and produce a significant increase in nasality. The authors strongly recommend that clinicians inform all patients, in particular voice professionals, about the possible effects of endonasal sinus surgery on voice quality.

Adolescent↗

Vocal nodules and laryngeal morphology.

Our purpose was to study the occurrence of vocal fold nodules under conditions of habitual vocal abuse associated with increased laryngeal muscle tension, to identify the existence of a relationship between vocal nodules and laryngeal morphology. We studied one group of 30 subjects with vocal nodules, 18 to 50 years old, who were compared with two control groups, one of females and one of males, consisting of 30 subjects each. The parameters evaluated were: type of vocal folds coaptation, glottic proportion (GP) and abduction angle (AA), obtained by videotelelaryngoscopy. In the nodules group, the larynges presented a mean value of GP similar to that of the female group, both of which were lower than the mean GP value of the male group. On the other hand, the mean AA was lower than the one in the female group, and closer to the one in the male group. We concluded that vocal nodules were present only in larynges with a predominantly young female morphology, with functional limitations of abduction.

Adolescent↗

The influence of the position of the laryngeal endoscope on videokymography.

Videokymography is a new high-speed imaging technique to investigate vocal fold vibration. The system has been considered useful in the analysis of irregular signals, making it possible to observe left-right asymmetries, open quotient, propagation of mucosal waves, and movement of the upper and lower margins. The aim of the present study was to verify the correspondence of the videokymographic images with larynx exposition angle variation. Three Brazilian adult female subjects, with no vocal complains, were evaluated. Videokymographic images were obtained with the laryngeal endoscope 90 degrees positioned on the measuring line, perpendicular to the glottal axis-zero degree, during a sustained "ae" vowel, using habitual frequency and intensity. The procedure was repeated twice and adjusted by rotating the camera in fifteen degrees from the perpendicular line to the right and to the left. The results showed clear differences depending on the position of the endoscope, suggesting the standardization of laryngeal exposition to interpret videokymographic images correctly.

Adult↗