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J Voice. 2019 Feb 19. pii: S0892-1997(18)30432-6. doi: 10.1016/j.jvoice.2018.12.015. [Epub ahead of print]

Phonotherapeutic Intervention in Patients With Mucosal Leishmaniasis Sequelae.

Author information

1
Graduate Program in Health Science, Federal University of Bahia-UFBA, Salvador, Bahia, Brazil. Electronic address: famycolman@yahoo.com.br.
2
Immunology Department, Edgard Santos University Hospital of the Federal University of Bahia-UFBA, Salvador, Bahia, Brazil.
3
Department of Speech-Language Pathology and Post-Graduation Program in Human Communication Disorders, Federal University of Santa Maria-UFSM, Santa Maria, Rio Grande do Sul, Brazil.
4
Health Sciences, Federal University of Bahia-UFBA, Salvador, Bahia, Brazil.
5
Gonçalo Muniz Institute (Fiocruz-Bahia), Immunology Service at the Edgard Santos University Hospital, Federal University of Bahia-UFBA, Salvador, Bahia, Brazil.
6
Immunology Service, Edgard Santos University Hospital of the Federal University of Bahia-UFBA, Salvador, Bahia, Brazil.
7
Speech Therapist, Federal University of Santa Maria-UFSM, Santa Maria, Rio Grande do Sul.
8
Degree in Speech Therapy, Federal University of Bahia-UFBA, Salvador, Brazil.
9
Speech Therapist, Federal University of Bahia-UFBA, Salvador, Brazil.

Abstract

PURPOSE:

To characterize the voice before and after speech-language intervention, with Humming nasal sound in patients with sequelae Mucosal Leishmaniasis (ML) and Cutaneous Leishmaniasis (CL).

METHODS:

Collection of phonation /a:/ from 44 patients with ML and CL for perceptual voice analysis and computed acoustic. The Wilcoxon nonparametric test and Fisher's exact test were used, with significance level of 5%.

RESULTS:

It was observed, prespeech therapy, that 27.7% of participants with ML presented asthenic vocal quality, and for the acoustics characteristics there was a statistically significant result for measures of frequency, frequency disturbance, noise, and subharmonic measurements, indicating phonatory instability, weakness, and noise emission giving the emission a feeling of vocal weakness. After therapy, the subharmonic segment measurements for the group with ML, showing reduction noise emission. Patients with CL had more grade 1 instability (36.4%), indicating tremor in vocal tract structures. After speech therapy, this group presented a reduction in the degree of roughness and reduction of the frequency disturbance measures, indicating a decrease in tension in the larynx and pharynx.

CONCLUSION:

Even after completing treatment for LM, patients may experience vocal changes due to the sequelae of the disease, like vocal alterations due to nasal lesions or in other locations that interfere in the correct vocal emission. As for participants with CL, no vocal changes would be expected, since these patients present thorax, leg and arm lesions that would not cause problems for the voice. Nevertheless, the two groups of participants presented vocal changes to different degrees before vocal therapy. However, it was observed that patients with ML present vocal alterations with more severe degrees. After the speech-language intervention, the participants of both groups showed vocal improvement, but the group with CL presented more vocal benefits, possibly due to the previous vocal alterations not being so severe.

KEYWORDS:

Cutaneous Leishmaniasis; Mucosal Leishmaniasis; Voice; Voice disorders

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