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Objective: The aim of this study was to evaluate the functioning and associated factors in children and adolescents with osteogenesis imperfecta (OI)., Methods: This is a cross-sectional study conducted on 30 children and adolescents with OI. Medical records, use of bisphosphonates, socioeconomic status, handgrip strength, balance, joint hypermobility, ambulatory level, and the Pediatric Evaluation of Disability Inventory-Computer Adaptative Test (PEDI-CAT) scores were assessed. Data is presented as mean and standard deviation and Student's t-test or Mann-Whitney U test. Categorical data is presented as frequency and analyzed using Fisher's exact test. Within-group analyses were conducted using ANCOVA or Wilcoxon signed-rank test. Correlations used Kendall's Tau-b test., Results: The participants involved in this study were 6-18 years old. The sample was separated into two groups according to disease severity. The moderate/severe OI group (n=10) presented a lower height and muscular strength than the mild group (n=20). Muscle weakness was observed in all participants with OI when compared with the normal population. No differences were observed between the groups in the PEDI-CAT scores except for the mobility domain. There were correlations between the PEDI-CAT mobility domain and the number of fractures, OI type, weight, and balance; there was also a correlation between the PEDI-CAT daily activities, mobility, responsibility, and social/cognitive domains., Conclusions: The findings suggest that children with moderate/severe forms of OI can achieve the same function levels as children with mild OI. Fractures can have a major influence on the functional level, and treatment should focus on the prevention and rehabilitation of these events when they occur.

Objectives: Early identification of vocal fold leukoplakia (VFL), which has a risk of progressing to malignant transformation, remains a controversial topic. The identification of biological markers for diagnosing these lesions would lead to a more effective treatment. We aimed to analyze the immunoexpression of cathepsin B and E-cadherin in VFL and correlate it with clinical and epidemiological data and disease prognosis., Methods: Thirty-two patients with VFL treated with microsurgery were retrospectively evaluated. The patients were distributed according to the histological results into Group A (low grade) and Group B (high grade). The expression of markers was quantitatively determined as per their staining intensity and tissue distribution using ImageLab. The index of expression (IE) of each marker was correlated with tobacco and alcohol consumption, signs of laryngopharyngeal reflux, and local recurrence of the lesion., Results: The correlation between the IE of markers and variables within the two groups (A and B) demonstrated that patients in Group B with local recurrence had a higher IE of cathepsin B. When all patients (A + B) were included, the same analysis demonstrated that the IE of cathepsin B was higher among smokers and patients who did not show signs of reflux and that the IE of E-cadherin was higher only in patients with recurrence., Conclusion: Patients with moderate to severe dysplasia and carcinoma in situ who smoked as well as had a high IE of cathepsin B were more prone to local recurrence. Regardless of the type of histological lesion, patients with signs of laryngopharyngeal reflux had a lower IE of cathepsin B. The IE of E-cadherin was higher among patients with VFL who relapsed after initial treatment., (Copyright © 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: The aim of this study was to describe the methodological approaches adopted in experimental researches in laryngology intervention studies., Methods: The study was performed as a scoping review using the electronic databases Medline (PubMed), Web of Science, Embase, BioMed Central and SCOPUS. These databases were manually searched from 1995 (or its inception) until the most recently published articles in June 2022. The inclusion criteria were as follows: a) studies performed with animal models in voice and/or larynx therapy, intervention and/or surgery; b) studies with participant populations composed with animals; c) studies containing original research; d) studies performed with at least one objective measurement for treatment and or intervention; e) studies reporting at least one method of larynx intervention; and f) publications written in English, Spanish or Portuguese. The exclusion criteria were as follows: a) studies considering without any objective intervention and or treatment; b) studies without animal models; and c) studies that reviewed articles or books. These criteria were set to increase inter-study comparability., Results: There were found 26 studies that showed that in experimental laryngology. There were retrieved four main characteristics in the retrieved studies. It was observed five major groups of experimental models used for assessing vocal folds: dog (38.5%), rat/mouse (23,1%), pig (23.1%), rabbit (19.2%), human (11.5%), and sheep (3.8%). In addition, three characteristics were observed: sample (up to 20 subjects 88.5%), type of surgery/intervention (100%) and duration (up to 30 days 61.5%)., Conclusion: In experimental laryngology, the state of the art is grounded on mainly in dog, rat and pig in vocal folds assessment. Up to 20 subjects, surgery/intervention and experimental trial lasting no more than 30 days are frequent methodological approaches in this research field., Competing Interests: Declaration Competing of Interest All the authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported., (Copyright © 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: What are the normative data available on the perceptual and acoustic characteristics of the voice of adults of both sexes who have hearing-impairment and who use cochlear implants?, Purpose: To identify in the literature, normative data about the perceptual auditory and acoustic characteristics of the voice of hearing-impaired cochlear implant adult users., Search Strategy: A systematic search was carried out in the Virtual Health Library, Web of Science, Science Direct, SciELO, and SCOPUS databases with no temporal restriction., Selection Criteria: The articles were selected if they led with citation to normative data of the acoustic analysis of the voice of deaf cochlear implant users. And duplicate articles, case studies, letters to the editor, reviews, and studies that were not directly related to the topic were excluded., Data Extraction: The data from each article were extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist: title, abstract, year of publication, journal, authors and country of origin, identification of background, purpose, study design, participants, variables, and data measurement., Data Synthesis: There were 1,052 publications that met the search criteria. After applying the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist, excluding duplicates, and reading of the full text, 10 papers were selected for further analysis. Although several voice parameters have been studied, there is a great variation in study designs, sample sizes, age of participants, voice samples analyzed, and cochlear implant specifications., Conclusion: The normative data available in the literature concerning the voice of cochlear implant users are consistent only in terms of fundamental frequency., (Copyright © 2020 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Purpose: To verify the auditory-perceptual and acoustic effects of the semioccluded vocal tract exercise with Finnish tube on the vocal quality of a deaf musician., Methods: A seven-day protocol with Finnish tube was performed with guidance for its home replication twice a day. A 46-years-old man with profound bilateral sensorineural hearing loss, musician and composer participated. Before and after the application of the protocol had undergone tonal audiometry, nasofibrolaryngoscopy, acoustic analysis with Praat and auditory-perceptual evaluation of the voice with Voice Profile Analysis Scheme for Brazilian Portuguese., Results: The postintervention auditory-perceptual analysis identified reduction of the deviation in lip spreading, extensive labial range, raised tongue body, pharyngeal expansion, nasal resonance, larynx height, larynx and vocal tract tension and irregularity, pitch, speech rate, and a better respiratory support. The maximum phonation time reduced, probably because of elimination of the abrupt vocal attack and tension, articulatory deviations, improvement in voicing and the absence of the use of expiratory reserve air. The fundamental frequency became lower, and the first, second, third, and fourth formants became higher. The jitter increased, and the shimmer reduced., Conclusion: The use of the Finnish tube might have facilitated the voicing sensations in the deaf musician, by enhancing the tactile-kinesthetic perception of the vocal tract and brought a greater source-filter interaction., (Copyright © 2019 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Background: Breast reconstruction with a latissimus dorsi myocutaneous flap associated with a breast implant is a well-established procedure. However, there are few published articles regarding latissimus association with expanders and radiotherapy. This study assess data of breast reconstructions using a latissimus dorsi myocutaneous flap associated with Becker expander implant (TLDMF/E) in patients submitted to radiotherapy., Methods: This is a descriptive study consisting of a series of cases. Inclusion criteria were patients who underwent mastectomy, radiotherapy, and delayed LDMF/E breast reconstruction. A minimum 6-month follow-up period was established, and descriptive variables were analyzed., Results: One hundred twenty-three patients were selected. The mean age of the patients was 45.1 years. Contralateral breast procedures were performed in 68 patients to achieve symmetry with substitution of the expander for an implant, with the majority of patients with an implant larger than the expander (74.0%) The nipple-areola complex was reconstructed in 77 patients (62.6%). In the donor site area, 116 patients (94.3%) had no complications. Minor complications were seroma in one patient and partial dehiscence in another patient. In the reconstructed breast, 11 patients (8.9%) had minor complications such as hematomas, partial necrosis of the native irradiated breast skin (3 cm or smaller), local infections, and partial exposition of the injection port. Major complications in the reconstructed breast were necrosis (larger than 3-5 cm) of the native irradiated breast skin in 5 patients (4.0%) who needed repair to avoid exposure of the expander. One patient needed expander removal due to a larger exposition., Conclusions: Delayed breast reconstruction with TLDMF/E is a reliable option to selected patients with mastectomy and radiotherapy sequel., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: This study aimed to present an experience in rating voices of adults with normal hearing and adults with cochlear implants and critically examine the outcomes, discussing pros and cons of the methodology used., Study Design: This is a cross-sectional, prospective study., Methods: One hundred and fifty voice samples, consisting of 50 sustained vowels, 50 samples of connected speech, and 50 samples of conversational speech, belonging to 25 adults with hearing impairment with cochlear implants and 25 adults with normal hearing, were perceptually analyzed for inter-rater agreement and intra-rater reliability. Three experienced judges rated the voice samples using visual analog scales of parameters considered relevant for cochlear-implanted population such as articulation, intonation, and resonance. The raters participated in three training sessions for calibration and had 1 month to complete the ratings individually. Twenty percent of the samples were repeated randomly to verify intra-rater reliability. The levels of agreement and reliability were verified using the interclass correlation coefficient., Results: The inter-rater agreement varied widely across the parameters and speech tasks, from poor to excellent agreement. The only parameter for which the raters maintained consistently good or excellent agreement for all groups and emissions was the pitch. For intra-rater reliability, two of the raters presented excellent reliability for most parameters across all of the speech tasks, whereas one rater presented more inconsistencies., Conclusions: In this reliability study, factors such as extensive deadline for the auditory perceptual evaluation, lack of periodic recalibration, speech tasks, and familiarity with the population studied were identified as factors that contributed to inconsistent reliability results., (Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)