Dissertação de Mestrado
Contribuição ao estudo da análise acústica e perceptivo-auditiva da voz dos pacientes com paracoccidioidomicose em mucosas nasal, oral e/ou faríngea em acompanhamento no Centro de Treinamento e Referência em Doenças Infecciosas e Parasitárias da Secretaria Municipal de Saúde da Prefeitura Municipal de Belo Horizonte, e do Serviço de Doenças Infecciosas e Parasitárias do Hospital das Clínicas da Universidade Federal de Minas Gerais.
Maria Carolina de Lima Faria
This study was conducted with 31 patients of the Center of Training and Reference in Infectious and Parasitic Diseases of the University Hospital of the Minas Gerais Federal University (UFMG) to evaluate the oral aspects of the paracoccidioidomycosis (PCM) disorder. Other 20 patients were excluded after the oral evaluation due to the following reasons: 60 years old or more, hearing disorder, aphasia or confirmed diagnosis of laryngeal PCM. The remaining 31 patients were classified in groups according to the lesion location: Group 1 with lesions in nose, mouth and/or pharynx and Group 2 without lesions in nose, mouth and/or pharynx. In addition, specific reports have been developed to identify the individual characteristics: gender; age; smoking habit, use of medicines, location and type of lesions caused by the fungus P. brasiliensis, fundamental frequency parameter, jitter, noise-to-harmonic-ratio, vocal quality, vocal type, pitch, loudness, resonance, articulation and dysphonia index expressed in GRBASI. An acoustic analysis and a perceptual- auditory evaluation of voice were performed. The Fisher test and the multiway analysis were used for the comparison between groups.The results indicated the following predominant factors: majority patients of group 1, male, smokers, regular users of antifungal medicines and mean age of 49 years. The lesions, mainly vegetations, were mostly located in the gum predominant in group 1. The lymphadenopathy was predominant in group 2. The majority of the patients presentedfundamental frequency within the normal standards as well as alterations of the acoustic parameters jitter and noise-to-harmonic-ratio. Changes of the vocal quality were observed in 48.38% of the patients with PCM, being hoarseness the main vocal feature. The majority of the patients presented adequate pitch and loudness. The laryngeal-pharyngeal resonance and a precise articulation were detected in most of the patients. The parameters of grade and roughness have shown the most significant variations in the GRBASI scale. The predominant factorsidentified in group 1 were: up to 54 years of age, smoking habit, use of medicines, imprecise articulation and higher indexes in the GRBASI scale.