Avaliação vocal e atividade eletrica dos musculos supra-hioideos e esternocleidomastoideo em individuos com desordem temporomandibular miogenica em situações de repouso e fonação

AUTOR(ES)
DATA DE PUBLICAÇÃO

2002

RESUMO

The aim of this study was to evaluate the voice and mesure the electrical activity of suprahyoid (SH) and esternocleidomastoid (SCM) muscles in subjects with temporomandibular joint disorder, in rest and speaking situations. By means of surface eletromyographic, were assessed the SCM left and right muscles, as well as the SH muscles of 20 female individuais, divided into two groups: one group formed by 10 subjects carrying temporomandibular joint disorder - TMJ group on average of 18 to 33 years old (X=22,1; DP ?+ or ?? 4,3) and 10 clinically normal subjects -Control Group - without complaints related to temporomandibular joint disorder as well to voice problems, with normal voice in the ages of 18 to 30 years old (X=22,5; DP ?+ or ?? 4,0). Every subjects were evaluate by perceptual and acoustical analysis of voice and otorhinolaryngologic exams. The situations analyzed were rest, production of vowel Ia/, spontaneous sequenced speech and counting. The electric activity was measured by an Analogic/Digital Converter AlD (LYNX,), a Software for Data Acquisition and simpie differential active electrodes. The electric sign was calculated by the root mean square (RMS) in ?mu?V, processed by Matlab (version 5.0) routine and normalized by Envoltory. The voices were registers in minidiscs for perceptual and acoustical analysis. The perceptual analysis was evaluated by three speech pathologists and the acoustical analysis was measured by Multi Speech model 3700 - Kay Elemetrics software. The data were statistically analyzed by variance analysis (ANOVA) and Tukey s test, with significance levei of 0.05. The results of this study showed that, in relation to the perceptual analysis, the TMJ group presented a slight dysphonia degree, roughness, beathness and instability, yet significantly greater than the Control group. Likewise, the TMJ group showed a prevalence of 51.7% of ressonant alteration as well the articulatory pattern. In the meanwhile, the Control group showed 21% of ressonance alteration and 30% of articulation alteration. The vocal register acoustics analysis revealed that the TMJ group presented bigger significantly values in the Peak-to-peak Amplitude Variation (vAm) and Noise to Harmonic Ratio (NHR) in relation to the Control group. As for the electrical activity, the results showed that the SH muscles of the Control group presented a significantly bigger electrical activity than the TMJ group while there was a significant difference between the right and left SCM muscles, when comparing both groups. In the Control group, the SH muscles presented significantly increased electrical activity in relation to the two-sided SCM muscles (p=0.0014 and p=0.0023, respectively), as for in the TMJ group the same only occurred in relation to the right SCM muscle (p=0.0022).There just was a statistically significant difference between the pho nation and rest activities regarding the electrical activity of the SH muscles in both groups (p=0.0001).The data of this study allow us to conclude that in spite of the lack of differences in both groups with the electromyograph, individuais carrying myogenic TMJ, present some kind of vocal complaint and, besides the normal glottal pattern, they presented vocal alterations of light degree in relation to the individuais that don t carry this kind of alteration. The electrical activity of the left SCM muscle was verified to be raised in the TMJ subjects which suggests cervical problems in agreement with the literature. As for the SH muscles, other studies need to be carried out for better comprehension of these muscles in relation to the phonation

ASSUNTO(S)

voz voice acustica fala eletromiografia temporomandibular joint disorders articulação temporomandibular phonation

ACESSO AO ARTIGO

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