Padrão visual da dinâmica vocal como instrumento para o diagnóstico da disfagia em pacientes com alterações neurológicas / Vocal Dynamic Visual Patterns (VDVP) for swallowing dysfunctions analysis in patients with neurological diseases

AUTOR(ES)

Jamille Lays Marrara

DATA DE PUBLICAÇÃO

2010

RESUMO

Swallowing dysfunction (dysphagia) is very common in individuals with neurological impairment. Most studies examining the presence of coughing after swallowing, and/or disorders of phonation such as hoarseness have shown that a variety of voice and laryngeal disorders can be positively related to penetration or aspiration. Although, acoustic analysis has been used to assess pathologic voices, it may be unsuitable for severely disordered voices. Over the last years, nonlinear dynamic techniques have shown to be a valuable way to analyze signals with aperiodic segments. The objective of this study is to characterize dysphagic patient voice samples, before and after swallowing solutions with different consistencies, with traditional acoustic analysis, perceptual analysis and Vocal Dynamic Visual Patterns (VDVP). Five volunteer without neurological disorders and twenty six patients, with neurological disorders of different etiologies, were subjected to a video-fluoroscopic swallowing study (VFSS), in the Speech Pathology Service at Clinics Hospital of Ribeirão Preto USP (HCFMRP). Five voice samples of each patient were recorded, one sample before the videofluoroscopic, and the other four during the procedure. The last four acquisitions were performed immediately after the first pasty (3ml and 7ml) and liquid solutions swallowing, respectively. Patients were asked to produce a sustained vowel /a/, which were characterized using traditional acoustic analysis, perceptual analysis and Vocal Dynamic Visual Patterns. For perceptual analysis, strained and instability qualities were more susceptible to residue and laryngeal penetration; roughness quality was more susceptible to aspiration. Acoustic Analysis showed none significance differences for mean values of the acoustic parameters among the five groups. For VDVP, all samples presented irregular trajectories, different numbers of loops, and divergent trajectory lines. Results demonstrate that PVDV seems to be a suitable technique for characterizing voice signals with neurological disturbance.

ASSUNTO(S)

acoustic analysis transtorno da deglutição vocal dynamic visual patterns (vdvp) dysphagia and voice padrão visual da dinâmica vocal análise acústica voz

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