title: Vocal Tract Adjustments of Dysphonic and Non-Dysphonic Women Pre- and Post-Flexible Resonance Tube in Water Exercise: A Quantitative MRI Study.
abstract: OBJECTIVE
  To compare vocal tract (VT) adjustments of dysphonic and non-dysphonic women before and after flexible resonance tube in water exercise (FRTWE) at rest and during phonation using magnetic resonance imaging.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Twenty women, aged 20-40 years, 10 dysphonic with vocal nodules (VNG) and 10 controls (CG), underwent four sets of sagittal VT MRI: two pre-FRTWE, at rest and during phonation, and two post-FRTWE, during phonation and at rest. The subjects performed 3 minutes of exercise. Nine parameters at rest and 21 during phonation were performed.
  
  
  RESULTS
  Pre-FRTWE, eight significant differences were found, three at rest and five during phonation: at rest - laryngeal vestibule area, distance from epiglottis to pharyngeal posterior wall (PPW) and interarytenoid complex length were smaller in the VNG; during phonation - laryngeal vestibule area, angle between PPW and vocal fold (VF), epiglottis to PPW, and anterior commissure of the larynx to laryngeal posterior wall were smaller in the VNG; tongue area was larger in the VNG. Post-FRTWE, only three significant differences were found, two during phonation and one at rest: during phonation - angle between PPW and VF and the membranous portion of the VF length were smaller in the VNG; at rest - distance from epiglottis to PPW was smaller in the VNG.
  
  
  CONCLUSIONS
  Results suggest that the habitual VT adjustments of dysphonic and non-dysphonic women are different at rest and during phonation. The FRTWE promoted positive VT changes in the VNG, reducing the intergroup differences.
authors.affiliation: Department of Otorhinolaryngology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. Electronic address: r.yamasaki@uol.com.br.
authors.forename: Rosiane
authors.initials: R
authors.lastname: Yamasaki
authors.affiliation: Department of Otorhinolaryngology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.
authors.forename: Emi Z
authors.initials: EZ
authors.lastname: Murano
authors.affiliation: Department of Radiology, InRad, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.
authors.forename: Eloisa
authors.initials: E
authors.lastname: Gebrim
authors.affiliation: Department of Otorhinolaryngology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Hachiya
authors.affiliation: Department of Electrical Engineering, Universidade de São Paulo-São Carlos, Brazil.
authors.forename: Arlindo
authors.initials: A
authors.lastname: Montagnoli
authors.affiliation: Department of Speech-Language Pathology and Audiology, Universidade Federal de São Paulo-UNIFESP, Brazil; Centro de Estudos da Voz-CEV, São Paulo, Brazil.
authors.forename: Mara
authors.initials: M
authors.lastname: Behlau
authors.affiliation: Department of Otorhinolaryngology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.
authors.forename: Domingos
authors.initials: D
authors.lastname: Tsuji
mesh_terms: D000328:Adult; D055154:Dysphonia / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011446:Prospective Studies; D012137:Respiratory System / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014834:Voice Training; D055815:Young Adult
keywords: Dysphonia; Flexible resonance tube in water exercise; MRI measurements; Vocal nodules; Vocal tract