ABSTRACT Purpose: the aim of this study was to analyze the relationship between patient-reported swallowing disorders and common mental disorders after total laryngectomy. Methods: fourteen patients of both genders and aged 66 ± 8.63 years were assessed after total laryngectomy. They were all asked about the perception of swallowing disorders and answered the Self-Reporting Questionnaire. Patients with swallowing complaints also answered the MD Anderson Dysphagia Inventory. The mean difference between groups was evaluated using the Mann-Whitney test, with a significance level of 5%. Results: the median of Self-Reporting Questionnaire total score was 3.00 [interquartile range: 0.00-5.00] and did not reflect the presence of common mental disorders. Five volunteers (35.7%) self-reported swallowing disorders and had a worse, although not significant (p = 0.15), performance on the Self-Reporting Questionnaire. The MD Anderson Dysphagia Inventory indicated a limitation in the quality of life, with a greater impact of swallowing disorders in the emotional domain [median = 53.30; interquartile range: 33.30-74.95]. Conclusion: common mental disorders are not related to patient-reported swallowing disorders following total laryngectomy. However, patients with swallowing complaints had a negative impact on their quality of life, especially in the emotional domain.

RESUMO Objetivos: analisar se existem alterações miofuncionais orofaciais clínicas e autorreferidas em trombonistas, assim como comparar a atividade elétrica do músculo orbicular da boca antes e após o uso do trombone. Métodos: estudo transversal e observacional, cuja amostra foi composta por 20 universitários trombonistas. Foi utilizado um questionário que investiga algumas particularidades sobre o instrumentista, da Avaliação Miofuncional Orofacial Com Escores Ampliados - AMIOFE-A e análise eletromiográfica do músculo orbicular da boca antes e após execução de uma tarefa com o trombone. Foram calculadas: média, desvio padrão, frequência e porcentagem e utilizou-se o teste t-Student pareado na comparação das médias dos registros eletromiográficos pré e pós-execução do trombone, significância=5%. Resultados: setenta por centro dos trombonistas relataram algum sintoma de alteração miofuncional orofacial, sendo compensações musculares, tensão e dor. Na avaliação miofuncional encontrou-se alteração leve no volume de bochechas (90%) e comissuras labiais com assimetria (60%). Houve redução significante da atividade elétrica do músculo orbicular inferior após a execução de tarefa com trombone (p=0,04), enquanto a do superior permaneceu inalterada. Conclusão: trombonistas apresentam alterações oromiofuncionais clínicas e autorreferidas e diminuição da atividade elétrica do músculo orbicular inferior da boca após uso do trombone.

ABSTRACT Objective: to analyze whether trombonists present orofacial myofunctional changes and compare the electrical activity of the orbicularis oris muscle before and after playing their instrument. Methods: an observational, descriptive, and cross-sectional study. The sample consisted of 20 university trombonists. Data collection involved three steps: application of a questionnaire investigating some peculiarities of trombonists (Orofacial Myofunctional Evaluation with Expanded Scores - OMES-E), and electromyographic analysis of the orbicularis oris muscle before and after performing a piece with the trombone. The mean, standard deviation, frequency, and percentage were calculated, and the paired Student’s t test was used to compare the means of the electromyographic records before and after playing the trombone, at a 5% significance. Results: seventy per cent of trombonists reported some symptom of orofacial myofunctional alteration, namely, muscle compensations, tension, and pain. The myofunctional evaluation showed a mild change in cheek volume (90%) and labial commissure asymmetry (60%). The electrical activity of the lower orbicularis oris muscle decreased significantly after the trombone practice (p = 0.04), while that of the superior orbicularis oris muscle remained unchanged. Conclusion:trombonists show clinical and self-reported oromyofunctional changes as well as decreased electrical activity of the lower orbicularis oris muscle, after playing the trombone.

RESUMO Objetivo: averiguar a perspectiva da população sobre trauma de face, de acordo com nível de escolaridade. Métodos: estudo observacional, transversal, documental, quantitativo, oriundo de 852 entrevistas, em duas capitais brasileiras. Investigou-se associação entre nível de escolaridade e demais conhecimentos sobre trauma de face. Dados foram analisados com testes Qui-quadrado de Pearson ou Exato de Fisher, erro de 5%. Resultados: houve associação estatisticamente significante da escolaridade e entendimento das consequências do trauma em: funções (p=0,001), mobilidade da boca (p=0,005) e questões dentárias (p=0,003). Na população mais acometida, escolaridade também se associou a jovens (p=0,001) e adultos (p=0,044). Sobre causas, houve associação com quedas (p=0,034) e acidentes de trânsito (p=0,034). Houve associação de ciclistas (p=0,016) e motociclistas (p=0,001) como população mais propensa. Escolaridade foi associada a todos profissionais. Com relação às consequências para a vida, houve também associação com saúde geral (p=0,049), atividades domésticas (p=0,001) e vida social (p=0,001). Imprudência foi a única causa com associação (p=0,004). Escolaridade foi associada ao conhecimento prévio sobre trauma (p=0,001). Conclusão: entendimento sobre consequências do trauma, população mais acometida, principais causas, profissionais envolvidos no tratamento, repercussão para a vida das pessoas e conhecimento prévio sobre o assunto aumentaram de acordo com os níveis de escolaridade.

ABSTRACT Purpose: to verify the population’s understanding on facial trauma, according to their level of schooling. Methods: an observational, cross-sectional, quantitative, documentary study conducted, based on 852 interviews carried out in two Brazilian state capitals. The association between the levels of schooling and varied knowledge of facial trauma was investigated. The data were analyzed with Pearson’s chi-square test or Fisher’s exact test, with a margin of error of 5%. Results: there was a statistically significant association between the participants’ schooling and their understanding on the consequences of trauma in: functions (p = 0.001), mouth mobility (p = 0.005), and dental issues (p = 0.003). In the most affected population, schooling was also associated with youth (p = 0.001) and adults (p = 0.044). Regarding causes, there was association with falls (p = 0.034) and traffic accidents (p = 0.034). There was association with bikers (p = 0.016) and motorcyclists (p = 0.001) as the population with greater propensity. Schooling was associated with all the professionals. Concerning the consequences to the victim’s life, there was association also with general health (p = 0.049), household chores (p = 0.001), and social life (p = 0.001). Recklessness was the only cause with an association (p = 0.004). Schooling was associated with previous knowledge of trauma (p = 0.001). Conclusion: their understanding on the consequences of trauma, most affected population, main causes, professionals involved in the treatment, repercussion for people’s lives, and previous knowledge of the subject increased along with the levels of background.

RESUMO Objetivo: comparar a atividade elétrica dos músculos masseteres bilateralmente de acordo com a presença ou ausência de Disfunção Temporomandibular (TMD) em estudantes universitários com alto grau de ansiedade. Métodos: o estudo foi realizado com 31 acadêmicos de Fonoaudiologia, selecionados aleatoriamente, com idades entre 17 e 32 anos, sendo 61,3% (n=19) do sexo feminino e 38,7% (n=12) do sexo masculino, divididos em dois grupos, sendo o Grupo 1 (G1) composto por 11 estudantes com DTM e o Grupo 2 (G2) formado por 20 estudantes sem DTM. Para investigação da ansiedade os estudantes universitários responderam o Inventário de Ansiedade Traço-Estado (IDATE), e para o diagnóstico de DTM, foram avaliados por meio do protocolo Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). A avaliação da atividade elétrica muscular considerou os registros nas condições de repouso, Máxima Atividade Voluntária Sustentada (MAVS) e mastigação habitual (MH). Os dados foram analisados por meio do software IBM Statistical Package for Social Sciences (SPSS), versão 22. A estatística analítica foi realizada por meio do teste T de Student para comparação das médias entre os grupos. Os dados foram considerados significantes, quando o p-valor fosse inferior a 5%. Resultados: os graduandos, de ambos os grupos, apresentaram alto nível de ansiedade traço. Foram verificadas diferenças estatisticamente significantes para a porcentagem da atividade elétrica do músculo masseter direito na mastigação, bem como no recrutamento de fibras musculares na mastigação, as quais foram superiores no grupo sem DTM. Conclusões: universitários com DTM e alto grau de ansiedade apresentaram médias de atividade eletromiográfica do músculo masseter inferiores as do grupo sem DTM, na maioria das condições avaliadas, exceto para o masseter esquerdo em repouso e na mastigação.

ABSTRACT Objective: to compare the electrical activity of masseter muscles, bilaterally, according to the presence or absence of Temporomandibular Disorder (TMD) in college students with a high degree of anxiety. Methods: the study was conducted with a randomized sample of 31 Speech Therapy students aged between 17 and 32 years; 61.3% (n = 19) were females and 38.7% (n = 12) were males. They were divided into two groups, Group 1 (G1), comprising 11 students with TMD, and Group 2 (G2), composed of 20 students without TMD. The college students answered the State-Trait Anxiety Inventory (STAI) for anxiety investigation, and were evaluated by the protocol Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for TMD diagnosis. The evaluation of muscular electrical activity took into account the records in the conditions of rest, Sustained Maximum Voluntary Activity (SMVA) and habitual chewing (HC). The data were analyzed using the version 22 IBM Statistical Package for Social Sciences (SPSS) software. The statistical analysis was performed using Student t test to compare means between groups, considering < 0,05 as the significant p-value. Results: college students, of both groups, presented high levels of anxiety traits. Significant statistical differences were observed on the percentage of electrical activity of right masseter muscle in chewing function, as well as muscle fibers recruitment during chewing, which were higher on the group without TMD. Conclusion: college students with TMD and a high degree of anxiety presented lower means of masseter muscle electromyografic activity during chewing, in most conditions assessed, as compared to volunteers without TMD, except for the left masseter muscle in rest and chewing.

RESUMO Objetivo Investigar e mensurar os efeitos da eletroestimulação na musculatura orofacial e nas funções de mastigação, respiração e deglutição dos indivíduos com síndrome de Down. Método Participaram da pesquisa 16 indivíduos com Síndrome de Down, sendo seis do gênero masculino e dez do gênero feminino com idade entre 9 e 25 anos, participantes de um projeto de extensão institucional. Foram realizadas avaliações fonoaudiológicas com uso do protocolo AMIOFE antes e após a intervenção, que consistiu em oito sessões de eletroestimulação semanais. A corrente utilizada foi a Functional Electrical Estimulation (FES), com uma frequência de 10Hz no aquecimento e 30 Hz na aplicação, em um tempo ON de 5s e OFF de 10s comuns nas duas etapas, e com a largura de pulso de 200(µs) no aquecimento e 250(µs) na aplicação. Resultados Observaram-se diferenças significativas após aplicação da eletroestimulação (FES) em relação ao aspecto das bochechas quando comparadas flacidez/arqueamento pré e pós o estímulo elétrico, diferenças na mobilidade de língua (lateralidade direita e esquerda), no comportamento da musculatura na execução das funções estomatognáticas de respiração, melhoria no comportamento dos lábios durante a deglutição e mudanças expressivas no processo de mastigação (mordida e trituração). Conclusão Foi identificado estatisticamente que houve efeito após a eletroestimulação associada ao treino mastigatório nos músculos masseteres, com ganhos funcionais na execução da mastigação, respiração e deglutição, em pessoas com Síndrome de Down.

ABSTRACT Purpose Investigate and measure the effects of electrostimulation on the orofacial musculature and on the chewing, breathing and swallowing functions of individuals with Down syndrome. Methods Study participants were 16 individuals with Down syndrome (six males and 10 females) from an institutional extension project aged nine to 25 years. Speech-language pathology assessment was performed using the protocol of Orofacial Myofunctional Evaluation with Scores (OMES) pre- and post-intervention. This protocol comprised eight weekly electrostimulation sessions. Functional Electrical Stimulation (FES) current was used at a frequency of 10Hz in warm-up and 30Hz in application, intermittent stimulation (cycling pulses) with ON-time of 5s and OFF-time of 10s common to both stages, and pulse width of 200μs in warm-up and 250μs in application. Results Significant differences were observed between pre- and post-application of FES regarding cheek appearance (flaccidity and arching), tongue mobility (right and left laterality), and musculature behavior during performance of functions of the stomatognathic system: respiration, deglutition (lip behavior), and mastication (bite and trituration). Conclusion Effects of electrostimulation associated with masticatory training of the masseter muscles were statistically identified, with functional gains in chewing, breathing and swallowing performance in individuals with Down syndrome.

Abstract Introduction The hormonal changes that occur during the menstrual cycle and their relationship with hearing problems have been studied. However, they have not been well explained. Objective The objective of our study is to investigate the variation in hearing thresholds in women during the menstrual cycle. Method We conducted a cohort and longitudinal study. It was composed of 30 volunteers, aged 18-39 years old, of which 20 were women during the phases of the menstrual cycle and 10 were men (control group) who underwent audiometry and impedance exams, to correlate the possible audiological changes in each phase of the menstrual cycle. Results There were significant changes in hearing thresholds observed during the menstrual cycle phases in the group of women who used hormonal contraceptives and the group who did not use such contraceptives. Improved hearing thresholds were observed in the late follicular phase in the group who did not use hormonal contraceptives and the hearing thresholds at high frequencies were better. Throughout the menstrual cycle phases, the mean variation was 3.6 db HL between weeks in the group who used hormonal contraceptives and 4.09 db HL in the group who did not use them. Conclusions The present study found that there may be a relationship between hearing changes and hormonal fluctuations during the menstrual cycle based on changes in the hearing thresholds of women. In addition, this study suggests that estrogen has an otoprotective effect on hearing, since the best hearing thresholds were found when estrogen was at its maximum peak.

Resumo: O tema proposto é Intervenção Fonoaudiológica pré e pós Cirurgia Ortognática. Foi realizada avaliação (por meio do Protocolo de Avaliação Miofuncional Orofacial MBGR com escores) e intervenção fonoaudiológica em período pré-operatório (por três meses) e pós-operatório iniciado no 20º dia (por três meses), após a liberação do cirurgião. Além disso, investigou-se o impacto da deformidade dentofacial na qualidade de vida do paciente, por meio do Oral Health Impact Profile - versão reduzida. Na avaliação pré-operatória, foram encontradas mastigação bilateral simultânea, presença de ruídos na Articulação Temporomandibular e fechamento labial assistemático durante a realização da função. Durante a deglutição houve contração da musculatura perioral e presença de resíduos após essa função. Encontrou-se na fala distorção no fonema /r/. Houve dor à palpação nos músculos mastigatórios e diminuição da tonicidade na musculatura perioral e mastigatória. Encontrou-se alto impacto na qualidade de vida, totalizando em 32 pontos. Na avaliação após a intervenção fonoaudiológica, observou-se melhora nas funções de mastigação (pré: 4 pontos, pós: 1 ponto), deglutição (pré:14, pós :5), respiração (pré: 3, pós: 1) e fala (pré: 7, pós: 1), na mobilidade muscular (pré: 8, pós 1), na tonicidade da musculatura (pré 5, pós: 0) e na dor à palpação (pré: 10, pós: 2). Houve melhora na postura dos lábios e melhora significante na qualidade de vida, passando de 32 para 8 pontos. Constatou-se melhora na fisiologia das funções estomatognáticas, diminuição da dor à palpação, equilíbrio no tônus, na mobilidade muscular e melhora na qualidade de vida.

Abstract: The proposed theme is Speech Therapy Intervention before and after orthognathic surgery. Evaluation (through MBGR Protocol of Orofacial Myofunctional Evaluation with scores) and speech therapy intervention were performed in the preoperative (three months) and postoperative periods, started on the 20th day (for three months) after the surgeon's liberation. In addition, it was investigated the impact of dentofacial deformity in the patient's life quality through the Oral Health Impact Profile - reduced version. In the preoperative evaluation, Simultaneous bilateral chewing, presence of noise in the temporomandibular joint and unsystematic lip closure were found while performing the function. During swallowing, there was contraction of the perioral muscles and presence of residues after this function. It was found, in speech, distortion in the /r/ sound. There was pain on palpation in the masticatory muscles and decreased tone in the perioral and masticatory muscles. It was found high impact on quality of life, totaling 32 points. In the evaluation after speech therapy intervention, improvement was observed in the chewing functions (pre: 4 points, post: 1 point), swallowing (pre: 14, post: 5), breathing (pre: 3, post: 1) and speech (pre: 7, post: 1), muscle mobility (pre: 8, post: 1), tonicity of the muscles (pre: 5, post: 0) and pain on palpation (pre: 10, post: 2). There was improvement in the posture of the lips and significant improvement in quality of life, from 32 to 8 points. It was found an improvement in the physiology of the stomatognathic functions, decreased pain on palpation, balance in tone, muscle mobility and improved quality of life.