ADRIANA HACHIYA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
27 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 27
- Perturbation Measurements on the Degree of Naturalness of Synthesized Vowels(2017) YAMASAKI, Rosiane; MONTAGNOLI, Arlindo; MURANO, Emi Z.; GEBRIM, Eloisa; HACHIYA, Adriana; SILVA, Jorge Vicente Lopes da; BEHLAU, Mara; TSUJI, DomingosObjective. To determine the impact of jitter and shimmer on the degree of naturalness perception of synthesized vowels produced by acoustical simulation with glottal pulses (GP) and with solid model of the vocal tract (SMVT). Study Design. Prospective study. Methods. Synthesized vowels were produced in three steps: 1. Eighty GP were developed (20 with jitter, 20 with shimmer, 20 with jitter+shimmer, 20 without perturbation); 2. A SMVT was produced based on magnetic resonance imaging (MRI) from a woman during phonation-/epsilon/ and using rapid prototyping technology; 3. Acoustic simulations were performed to obtain eighty synthesized vowels-/epsilon/. Two experiments were performed. First Experiment: three judges rated 120 vowels (20 humans+80 synthesized+20% repetition) as ""human"" or ""synthesized"". Second Experiment: twenty PowerPoint slide sequences were created. Each slide had 4 synthesized vowels produced with the four perturbation condition. Evaluators were asked to rate the vowels from the most natural to the most artificial. Results. First Experiment: all the human vowels were classified as human; 27 out of eighty synthesized vowels were rated as human, 15 of those were produced with jitter+shimmer, 10 with jitter, 2 without perturbation and none with shimmer. Second Experiment: Vowels produced with jitter+shimmer were considered as the most natural. Vowels with shimmer and without perturbation were considered as the most artificial. Conclusions. The association of jitter and shimmer increased the degree of naturalness of synthesized vowels. Acoustic simulations performed with GP and using SMVT demonstrated a possible method to test the effect of the perturbation measurements on synthesized voices.
bookPart Avaliação endoscópica faringolaríngea(2022) KINCHOKU, Vanessa Mika; HACHIYA, Adriana; TSUJI, Domingos Hiroshi- Impact of Cricothyroid Muscle Contraction on Vocal Fold Vibration: Experimental Study with High-Speed Videoendoscopy(2017) ISHIKAWA, Camila Cristina; PINHEIRO, Thais Goncalves; HACHIYA, Adriana; MONTAGNOLI, Arlindo Neto; TSUJI, Domingos HiroshiObjectives. The aim of this study was to evaluate the effects of cricothyroid muscle contraction on vocal fold vibration, as evaluated with high-speed videoendoscopy, and to identify one or more aspects of vocal fold vibration that could be used as an irrefutable indicator of unilateral cricothyroid muscle paralysis. Study Design. This was an experimental study employing excised human larynges. Methods. Twenty freshly excised human larynges were evaluated during artificially produced vibration. Each larynx was assessed in three situations: bilateral cricothyroid muscle contraction, unilateral cricothyroid muscle contraction, and no contraction of either cricothyroid muscle. The following parameters were evaluated by high-speed videoendoscopy: fundamental frequency, periodicity, amplitude of vocal fold vibration, and phase symmetry between the vocal folds. Results. Although neither unilateral nor bilateral cricothyroid muscle contraction altered the periodicity of vibration or the occurrence of phase asymmetry, there was a significant decrease in fundamental frequency in parallel with decreasing longitudinal tension. We also found an increase in vibration amplitude of right and left vocal folds, which were similar in terms of their behavior for this parameter in the various situations studied. Conclusion. Our results suggest that differences in vibration amplitude and phase symmetry between vocal folds are not reliable indicators of unilateral cricothyroid muscle paralysis.
- Bipedicled Vocal Fold Mucosal Flap Use in Phonomicrosurgery: Case Series(2021) TSUJI, Domingos Hiroshi; KINCHOKU, Vanessa Mika; IMAMURA, Rui; HACHIYA, Adriana; YAMASAKI, Rosiane; MARINHO, Guilherme Rodrigues; SENNES, Luiz UbirajaraObjectives. The objective of this study was to present a novel surgical technique involving the use of a ""bipedicled vocal fold mucosal flap"" to repair a mucosal defect and to evaluate the outcomes of patients in whom it was used. Material and methods. This was a retrospective study of 6 clinical cases. All patients underwent surgery between November 2000 and July 2018, and all procedures were performed by the same surgeon. For the auditory-perceptual assessment, the Grade-Roughness-Breathiness-Asthenia-Strain hoarseness scale was used. We based the stroboscopic evaluation on the European Laryngological Society protocol, analyzing the parameters glottal closure, mucosal wave, and phase symmetry. Results. Ages at the time of surgery ranged from 10 to 52 years, and all of the patients were male. Preexisting vocal fold lesions included polyps, cysts, a sulcus, and mucosal bridges. Among the stroboscopic parameters, only the mucosal wave differed significantly between the preoperative and postoperative periods (P = 0.046). There were also significant postoperative improvements in the overall grade of dysphonia (P = 0.025) and in the degree of breathiness (P = 0.025). Conclusions. The use of a bipedicled vocal fold mucosal flap appears to promote significant improvements in the mucosal wave and in voice quality. In the patients evaluated here, the technique was used without preoperative planning. However, it proved to be a safe and appropriate means of repairing mucosal defects in the vocal folds, with the potential to preserve rheological properties and promote healing with less chance of fibrosis.
- Correlation of the Dysphonia Severity Index (DSI), Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), and Gender in Brazilians With and Without Voice Disorders(2016) NEMR, Katia; SIMOES-ZENARI, Marcia; SOUZA, Glaucia S. de; HACHIYA, Adriana; TSUJI, Domingos H.Objectives. This study aims to analyze the Dysphonia Severity Index (DSI) in Brazilians with or without voice disorders and investigate DSI's correlation with gender and auditory-perceptual evaluation data obtained via the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) protocol. Study Design. A total of 66 Brazilian adults from both genders participated in the study, including 24 patients with dysphonia confirmed on laryngeal examination (dysphonic group [DG]) and 42 volunteers without voice or hearing complaints and without auditory-perceptual voice disorders (nondysphonic group [NDG]). Methods. The vocal tasks included in CAPE-V and DSI were performed and recorded. Data were analyzed by means of the independent t test, the Mann-Whitney U test, and Pearson correlation at the 5% significance level. Results. Differences were found in the mean DSI values between the DG and the NDG. Differences were also found in all DSI items between the groups, except for the highest frequency parameter. In the DG, a moderate negative correlation was detected between overall dysphonia severity (CAPE-V) and DSI value, and between breathiness and DSI value, and a weak negative correlation was detected between DSI value and roughness. In the NDG, the maximum phonation time was higher among males. In both groups, the highest frequency parameter was higher among females. Conclusions. The DSI discriminated among Brazilians with or without voice disorders. A correlation was found between some aspects of the DSI and the CAPE-V but not between DSI and gender.
bookPart Tosse(2018) OGAWA, Allex Itar; HACHIYA, AdrianabookPart Injeção intralaríngea de substâncias para medialização de prega vocal(2022) HACHIYA, Adriana; TSUJI, Domingos Hiroshi; SENNES, Luiz Ubirajara- Comparative Analysis of Vocal Fold Vibration Using High-Speed Videoendoscopy and Digital Kymography(2014) BARAVIEIRA, Paula Belini; BRASOLOTTO, Alcione Ghedini; HACHIYA, Adriana; TAKAHASHI-RAMOS, Marystella Tomoe; TSUJI, Domingos Hiroshi; MONTAGNOLI, Arlindo NetoObjectives. To compare high-speed videoendoscopy (HSV) and digital kymography (DKG) in the vocal fold vibration analysis of normophonic women with no vocal fold abnormalities. Study Design. Prospective study comparing quantitative parameters extracted by HSV and DKG. Methods. Eighteen normophonic women whose age ranged from 18 to 45 years participated in the study. The procedures comprised HSV and DKG of the medial line of the vocal folds. The parameters evaluated were fundamental frequency (F-0), open quotient (OQ), and duration of vibration cycle phases (open phase, closed phase, opening phase, and closing phase). Results. The F-0 results of HSV and DKG were similar. However, significant differences were found in both duration of vibration cycle phases and OQ, indicating a longer open phase in the vocal fold vibration when this phase was measured by HSV. Conclusions. The results emphasize the need to set up different normative threshold values for both HSV and DKG.
- Endoscopic Laser Thyroarytenoid Myoneurectomy in Patients with Adductor Spasmodic Dysphonia: A Pilot Study on Long-Term Outcome on Voice Quality(2012) TSUJI, Domingos Hiroshi; TAKAHASHI, Marystella Tomoe; IMAMURA, Rui; HACHIYA, Adriana; SENNES, Luiz UbirajaraObjectives. Adductor spasmodic dysphonia (ADSD) is a focal laryngeal dystonia, which compromises greatly the quality of life of the patients involved. It is a severe vocal disorder characterized by spasms of laryngeal muscles during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms result from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold to strain, pressing each vocal fold against the other and increasing glottic resistance. Botulinum toxin injection remains the gold-standard treatment. However, as injections should be repeated periodically leading to voice quality instability, a more definitive procedure would be desirable. In this pilot study we report the long-term vocal quality results of endoscopic laser thyroarytenoid myoneurectomy. Study Design. Prospective study. Methods. Surgery was performed in 15 patients (11 females and four males), aged between 29 and 73 years, diagnosed with ADSD. Voice Handicap Index (VHI) was obtained before and after surgery (median 31 months postoperatively). Results. A significant improvement in VHI was observed after surgery, as compared with baseline values (P = 0.001). The median and interquartile range for preoperative VHI was 99 and 13, respectively and 24 and 42, for postoperative VHI. Subjective improvement of voice as assessed by the patients showed median improvement of 80%. Conclusions. Because long-term follow-up showed significant improvement of voice quality, this innovative surgical technique seems a satisfactory alternative treatment of ADSD patients who seek a definite improvement of their condition.
- Diffusion of aniline blue injected into the thyroarytenoid muscle as a proxy for botulinum toxin injection: an experimental study in cadaver larynges(2013) ALONSO, Valéria Maria de Oliveira; CHAGURY, Azis Arruda; HACHIYA, Adriana; IMAMURA, Rui; TSUJI, Domingos Hiroshi; SENNES, Luiz UbirajaraINTRODUCTION: Endolaryngeal injection of botulinum toxin into the thyroarytenoid (TA) muscle is one of the methods for treatment of focal laryngeal dystonia. However, after treatment, there is variation in laryngeal configuration as well as the side effects reported by patients. As a consequence of the functional variability of results, it was hypothesized that botulinum toxin diffuses beyond the limits of the muscle into which it is injected. OBJECTIVES: After injection of botulinum toxin into the TA muscle for the treatment of focal laryngeal dystonia, patients differ in terms of laryngeal configuration and side effects. We hypothesized that this toxin diffuses from the target muscle to adjacent muscles. METHOD: The TA muscles of 18 cadaver larynges were injected with aniline blue (0.2 mL). After fixation in formaldehyde and nitric acid decalcification, the larynges were sectioned in the coronal plane and the intrinsic muscles were analyzed. RESULTS: We found diffusion of aniline blue to the lateral cricoarytenoid muscle, cricothyroid muscle, and posterior cricoarytenoid muscle in 94.3%, 42.9%, and 8.6% of the cases, respectively. In terms of the degree of diffusion to adjacent muscles, we found no differences related to the size (height and width) of the TA muscle or to gender. CONCLUSIONS: Our findings suggest that diffusion of botulinum toxin from its injection site in the TA muscle to the lateral cricoarytenoid muscle is likely in most cases. On the other hand, diffusion to the cricothyroid muscle occurs in approximately half of cases and diffusion to the posterior cricoarytenoid muscle occurs in very few cases.
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