This study examined the differences between normal vocal fold vibration and the movement patterns of vocal folds with mass lesions by means of a synthetic model. The experimenter molded and cast three sets of vocal folds, representing normal structure, small nodules, and larger nodules. Acoustic, aerodynamic, and digital video signals were recorded and analyzed in order to quantify air flow and pressure, measure vibratory stability, and visually assess closure patterns across the three structural conditions. Statistical analysis revealed that the presence of vocal nodules resulted in a significantly higher onset pressure, fundamental frequency, airflow at onset, and offset pressure. However, the results were inconclusive with regard to vocal stability, and it remains unclear whether the current models of nodules are sufficiently similar to the human system to adequately model the type of mass lesions typically seen in a clinical context.

Orientador: Regina Helena Garcia Martins / Resumo: Objetivo: Estudar a evolução dos nódulos vocais em crianças nas diversas modalidades de tratamentos: fonoterapia, expectante e cirurgia. Casuística e métodos: Coorte longitudinal prospectivo. Foram incluídas 30 crianças (7a 12 anos) com nódulos vocais atendidas entre 2013 a 2018, avaliadas nos momentos: M1 (caso novo), M2 (retorno um ano), M3 (retorno dois anos). Parâmetros estudados: questionário de qualidade de vida em voz pediátrico (QVV-Pediátrico); videolaringoscopia; análise vocal perceptivo-auditiva (escala GRBASI), análise vocal acústica (software MDVP), cálculo do tempo máximo de fonação (TMF) e da relação s/z. Em M1, todas as crianças foram encaminhadas à fonoterapia após o diagnóstico; em M2, casos de insucesso após um ano de fonoterapia ou piora dos sintomas foram encaminhados à microcirurgia. Em M3 (após dois anos), todas as crianças foram convocadas para as reavaliações. Ao final da coleta, as crianças foram inseridas em três tipos de tratamentos: G1-fonoterapia (n-15); G2- expectante (n-7); G3-cirurgia (n-8). Resultados: houve predomínio dos meninos. Os escores QVVP, GRBASI e análise acústica apresentaram melhora nos momentos finais (M3), especialmente no grupo fonoterapia, seguido pelo grupo cirurgia. Videolaringoscopias: houve melhora completa e parcial das lesões, respectivamente, no grupo fonoterapia (86,6% e 13,3%), cirurgia (62,5% e 37,5%) e expectante (42,8% e 33%). Apenas uma criança do grupo expectante não apresentou melhora das lesões (14,28%). Conclu... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Objective: To study the evolution of vocal nodules in children in the many modalities of treatment: voice therapy, expectant and surgery. Casuistry and methods: Longitudinal prospective cohort. Were included 30 children (7 to 12 years) with vocal nodules attended between 2013 to 2018, evaluated in the moments: M1 (first evaluation), M2 (follow up of one year), M3 (follow up of two years). Studied parameters: Pediatric Voice-Related Quality-of-Life (VR-QOL-P); videolaryngoscopy; perceptive-auditory vocal analysis (GRBASI scale), acoustic vocal analysis (software MDVP), maximum phonation time calculation (TMF) and of the s/z ratio. In M1, all were forwarded to voice therapy after diagnosis; in M2, unsuccessful cases after one year of voice therapy were forwarded to microsurgery. Cases of worsening of the voice or doubts in the diagnosis were forwarded to direct laryngoscopy. In M3 (after two years), all children were invited for re-evaluation and were distributed in three conduct groups: the voice therapy group (n=15); expectant group (n=7); and surgery group (n=8). Results: There has been a predominance of boys. The VR-QOL-P, GRBASI and acoustic analysis scores showed improvement in the final moments (M3), being more evident in the voice therapy group, followed by the surgery group. Videolaryngoscopy showed complete and partial improvement of the lesions, respectively, in the voice therapy group (86,6% and 13,3%), surgery (62,5% and 37,5%) and expectant (42,8% and 33%). Only t... (Complete abstract click electronic access below) / Doutor