Resumen Introducción: Los trastornos laríngeos se caracterizan por un cambio en el patrón vibratorio de los pliegues vocales. Este trastorno puede tener un origen orgánico, descrito como la modificación anatómica de los pliegues vocales, o de origen funcional, provocado por abuso o mal uso de la voz. Los métodos de diagnóstico más comunes se realizan mediante procedimientos invasivos que causan malestar al paciente. Además, los desvíos vocales de grado leve no impiden que el individuo utilice la voz, lo que dificulta la identificación del problema y aumenta la posibilidad de complicaciones futuras. Objetivo: Por esas razones, el objetivo de esta investigación es desarrollar una herramienta alternativa, no invasiva para la identificación de voces con grado leve de desvío vocal aplicando Transformada Wavelet Packet (WPT) y la red neuronal artificial del tipo Perceptrón Mutlicapa (PMC). Métodos: Fue utilizado un banco de datos con 78 voces. Fueron extraídas las medidas de energía y entropía de Shannon usando las familias Daubechies 2 y Symlet 2 para después aplicar la red neuronal PMC. Resultados: La familia Symlet 2 fue más eficiente en su generalización, obteniendo un 99.75% y un 99.56% de precisión mediante el uso de medidas de energía y entropía de Shannon, respectivamente. La familia Daubechies 2, sin embargo, obtuvo menores índices de precisión: 91.17% y 70.01%, respectivamente. Conclusión: La combinación de WPT y PMC presentó alta precisión para la identificación de voces con grado leve de desvío vocal.

Abstract Introduction: Laryngeal disorders are characterized by a change in the vibratory pattern of the vocal folds. This disorder may have an organic origin described by anatomical fold modification, or a functional origin caused by vocal abuse or misuse. The most common diagnostic methods are performed by invasive imaging features that cause patient discomfort. In addition, mild voice deviations do not stop the individual from using their voices, which makes it difficult to identify the problem and increases the possibility of complications. Aim: For those reasons, the goal of the present paper was to develop a noninvasive alternative for the identification of voices with a mild degree of vocal deviation applying the Wavelet Packet Transform (WPT) and Multilayer Perceptron (MLP), an Artificial Neural Network (ANN). Methods: A dataset of 74 audio files were used. Shannon energy and entropy measures were extracted using the Daubechies 2 and Symlet 2 families and then the processing step was performed with the MLP ANN. Results: The Symlet 2 family was more efficient in its generalization, obtaining 99.75% and 99.56% accuracy by using Shannon energy and entropy measures, respectively. The Daubechies 2 family, however, obtained lower accuracy rates: 91.17% and 70.01%, respectively. Conclusion: The combination of WPT and MLP presented high accuracy for the identification of voices with a mild degree of vocal deviation.

OBJETIVO: Propor e verificar a exequibilidade de programa de intervenção fonoaudiológica para indivíduos com sinais de presbilaringe com ou sem queixa vocal. MÉTODO: Dentre 20 idosos integrantes da pesquisa, participaram deste piloto três idosas com média de 67 anos. Antes e após o programa, realizaram exame laringológico, gravação da voz com protocolo CAPE-V, responderam ao Protocolo de Rastreio de Risco de Disfonia (PRRD) e participaram do Programa Vocal Cognitivo para presbifonia elaborado com fundamentação teórica na epistemologia genética de Jean Piaget associado a técnicas vocais baseadas na literatura. É composto por seis sessões, cada uma com ênfase em diferentes aspectos da produção vocal. RESULTADOS: Após o programa, loudness, coordenação pneumofonoarticulatória, clareza articulatória, jitter e proporção harmônico-ruído melhoraram, ficando dentro do esperado para a faixa etária. Nas três participantes observou-se melhora da qualidade vocal, aumento da frequência fundamental e melhora dos tempos máximos de fonação. Em duas observou-se tensão associada à elevação da loudness e melhora no escore PRRD. Observou-se nas participantes redução dos sinais de presbilaringe observados ao exame de laringoscopia, com melhora da coaptação glótica e movimentação da onda mucosa. CONCLUSÃO: Os resultados preliminares apontam perspectivas animadoras em relação à proposta com melhora dos aspectos analisados. O programa proposto mostrou-se exequível e bem delineado, não sendo necessários ajustes para continuidade do projeto.

PURPOSE: To propose and verify the feasibility of a vocal program intervention in patients with presbylarynx signs with or without vocal complaints. METHOD: Among 20 elder participants of the current research, 3 female patients with median age of 67 years were chosen for the pilot study. Laryngological examination, vocal recording with CAPE-V (Consensus Auditory-Perceptual Evaluation of Voice) protocol, and Screening Protocol of Risk of Dysphonia (SPRD) were conducted before and after the program intervention. They joined the Cognitive Vocal Program for presbyphonia based on the genetic epistemology by Jean Piaget associated with vocal techniques based on scientific literature. This program is structured with six sessions and each one of them is focused in different aspects of vocal production. RESULTS: After the program intervention, some aspects such as loudness, coordination between breathing and speaking, accuracy in articulatory movements, jitter, and harmonics-to-noise ratio improved with parameters within the expected range for the age group. Three female participants were observed for better vocal quality, higher fundamental frequency, and better maximum phonation time. In two cases, tension related to loudness elevation and better scores on SPRD was observed. Using by high-speed laryngeal image, we also observed reduction of presbylarynx signs, and remarkable improvement in glottis closure competence and mucosal wave movement of the patients with and without vocal complaints. CONCLUSION: The preliminary results suggest encouraging prospects for the proposal with improvement in the aspects analyzed. This program was well designed and did not require any further adjustments.

Introduction  The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV) has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution. Objective  To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies. Methods  We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia). The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases) were assessed. Results  Differences in the vocal vibration parameters were observed and correlated with the pathophysiology. Conclusion  HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation.