Abstract Objective Frozen biopsy may guide surgical intraoperative decisions. We evaluated the accuracy of frozen biopsy for diagnosing benign, dysplastic and malignant laryngeal lesions, compared to paraffin section (gold standard). Methods Retrospective review of the charts of all patients presenting with laryngeal lesions suspicious of malignancy, who underwent laryngeal microsurgery with frozen biopsy in our institution, between 2015 and 2020. Results of frozen biopsy and paraffin section examinations were compared. Results Among 113 samples of 89 patients, paraffin section diagnosed 23 benign, 31 dysplastic and 59 malignant lesions. The accuracy of the frozen biopsy in identifying dysplasia or malignancy was 80.5% (91/113), and greater for lesions >5 mm (78.8% × 51.5%; p= 0.009). The positive and negative predictive values, sensitivity and specificity were 95.9%, 51.3%, 78.9% and 86.9%, respectively. Conclusions Frozen section is a reliable tool when malignancy is detected, but almost half of benign results exhibit dysplasia or malignancy in paraffin section. Other clinical parameters should be considered in intraoperative decisions to prevent undertreatment. Level of evidence 4. gold standard. standard . standard) institution 201 2020 11 8 2 3 5 805 80 80.5 91/113, 91113 91/113 , 91 (91/113) > 78.8% 788 78 (78.8 51.5% 515 51 p 0.009. 0009 0.009 0 009 0.009) values 959 95 9 95.9% 513 51.3% 789 78.9 869 86 86.9% respectively detected undertreatment 4 20 202 1 80. 9111 91/11 (91/113 78.8 7 (78. 51.5 000 0.00 00 95.9 51.3 78. 86.9 911 91/1 (91/11 (78 51. 0.0 95. 86. 91/ (91/1 (7 0. (91/ ( (91 (9

Abstract Objective: To describe the process of translation into Brazilian Portuguese and cross-cultural adaptation of the French Reflux Symptom Score-12 questionnaire used for the diagnosis of laryngopharyngeal reflux. Methods: This was across-cultural translation and adaptation study of a health instrument, with a cross-sectional design. It was carried out in eight stages: translation from French into Brazilian Portuguese, cultural adaptation by a panel of experts, application of the first version (pilot test 1), adaptation by a panel of experts, application of the second version (pilot test 2), back translation, reviewing by a committee in conjunction with the author of the original instrument and, application of the final version. The Brazilian Portuguese versions of the questionnaire were applied to individuals with symptoms and signs of laryngopharyngeal reflux who underwent pHmetry and esophageal manometry at the study site. Results: In pilot test 1, the first version of the RSS-12 in Brazilian Portuguese was applied to 30 patients. The patients had no difficulty to understand any of the 12 symptom items, but 15 patients (50%) had difficulty interpreting the symptom frequency score. After adapting the format of the frequency score, a version 2 of the RSS-12 in Brazilian Portuguese was applied to another 23 patients, who completed the questionnaire in full without any difficulty. Along with the review committee, the author of the original RSS-12 considered the version 2 to be adequate and did not propose any changes, so it was approved as the final version of the Brazilian Portuguese RSS-12. Conclusion: The Brazilian Portuguese version of the instrument, called Reflux Symptom Score-12 PT-BR, shows good understanding and linguistic, conceptual and content equivalence, in relation to the original Reflux Symptom Score-12. Objective crosscultural cross Score12 Score Score-1 Methods acrosscultural across crosssectional sectional design stages experts 1 , 1) 2, 2) site Results RSS12 RSS RSS-1 3 items 50% 50 (50% score changes RSS12. 12. Conclusion PTBR, PTBR PT BR, BR PT-BR linguistic equivalence Score12. Score1 Score- RSS1 RSS- 5 (50 (5 (

Abstract Objective: To investigate the effect of Wendler glottoplasty on voice feminization, voice quality and voice-related quality of life. Methods: Prospective interventional cohort of transgender women submitted to Wendler glottoplasty. Acoustic analysis of the voice included assessment of fundamental frequency, maximum phonation time formant frequencies (F1 and F2), frequency range, jitter and shimmer. Voice quality was blindly assessed through GRBAS scale. Voice-related quality of life was measured using the Trans Woman Voice Questionnaire and the self-perceived femininity of the voice. Results: A total of 7 patients were included. The mean age was 35.4 years, and the mean postoperative follow-up time was 13.7 months. There was a mean increase of 47.9 ± 46.6 Hz (p = 0.023) in sustained/e/F0 and a mean increase of 24.6 ± 27.5 Hz (p = 0.029) in speaking F0 after glottoplasty. There was no statistical significance in the pre- and postoperative comparison of maximum phonation time, formant frequencies, frequency range, jitter, shimmer, and grade, roughness, breathiness, asthenia, and strain scale. Trans Woman Voice Questionnaire decreased following surgery from 98.3 ± 9.2 to 54.1 ± 25.0 (p = 0.007) and mean self-perceived femininity of the voice increased from 2.8 ± 1.8 to 7.7 ± 2.4 (p = 0.008). One patient (14%) presented a postoperative granuloma and there was 1 (14%) premature suture dehiscence. Conclusion: Glottoplasty is safe and effective for feminizing the voice of transgender women. There was an increase in fundamental frequency, without aggravating other acoustic parameters or voice quality. Voice-related quality of life improved after surgery. Objective feminization voicerelated related Methods F1 F (F F2, F2 , F2) range shimmer scale Voicerelated selfperceived self perceived Results 354 35 4 35. years followup follow up 137 13 13. months 479 47 9 47. 466 46 6 46. p 0.023 0023 0 023 sustainedeF0 sustainedeF sustained e sustained/e/F 246 24 24. 275 27 5 27. 0.029 0029 029 pre grade roughness breathiness asthenia 983 98 3 98. 92 2 9. 541 54 54. 250 25 25. 0.007 0007 007 28 8 2. 18 1. 77 7. 0.008. 0008 0.008 . 008 0.008) 14% 14 (14% dehiscence Conclusion 0.02 002 02 0.00 000 00 (14 0.0 (1 0. (

RESUMO Osteofitose cervical anterior é uma condição não inflamatória caracterizada por calcificação ou ossificação dos ligamentos paravertebrais anterolaterais da coluna cervical. Acomete 20 a 30% dos idosos, sendo responsável por 1,6% das etiologias identificáveis da disfagia na população senil. Em estados avançados, a disfagia por osteofitose cervical pode levar a complicações como desnutrição, perda de peso e pneumonia aspirativa. Este estudo visa alertar para a suspeição desse diagnóstico à equipe multidisciplinar que cuida do idoso disfágico, possibilitando tratamento oportuno e precoce da condição. É relatado o caso de um paciente masculino de 66 anos com disfagia tipo engasgo para sólidos e refluxo nasal de alimentos há 1 ano. Videoendoscopia da deglutição evidenciou abaulamento da parede posterior da faringe e, à oferta de alimento sólido, restrição à retroflexão da epiglote, refluxo nasal do alimento e grande quantidade de resíduo alimentar sobre a lesão. Tomografia computadorizada de coluna cervical identificou a presença de osteófitos cervicais anteriores entre as vértebras C3 e C6, o maior com comprimento anteroposterior de 12 milímetros, estreitando a coluna aérea ao nível da oro- e hipofaringe. O paciente foi adequadamente tratado com fonoterapia da deglutição. A estratégia inicial de tratamento para a osteofitose sintomática deve ser conservadora, geralmente com boa resposta à fonoterapia da deglutição. Apesar de raramente estarem implicados na etiologia da disfagia, considerando sua alta prevalência, é importante que otorrinolaringologistas e fonoaudiólogos estejam atentos a esse diagnóstico, permitindo tratamento precoce e efetivo para o paciente assistido, melhor prognóstico e menos complicações da disfagia orofaríngea no idoso.

ABSTRACT Anterior cervical osteophytosis is a noninflammatory condition characterized by calcification or ossification of the anterolateral paravertebral ligaments of the cervical spine. It affects 20 to 30% of the elderly, being responsible for 1.6% of the identifiable etiologies of dysphagia in the senile population. In advanced states, dysphagia due to cervical osteophytosis can lead to complications such as malnutrition, weight loss and aspiration pneumonia. This study aims to alert to this diagnosis, enabling early treatment of the condition. The case of a 66-year-old male patient with choking dysphagia for solids and nasal food reflux for 1 year is reported. Fiberoptic Endoscopic Evaluation of Swallowing showed bulging of the posterior pharyngeal wall and, with solid food supply, restriction to the retroflexion of the epiglottis, nasal reflux of the food and a large amount of food residue on the lesion. Cervical spine Computed Tomography identified the presence of anterior cervical osteophytes between the C3 and C6 vertebrae, the largest with anteroposterior length of 12 millimeters, narrowing the air column at the level of the oro- and hypopharynx. The patient was adequately treated with swallowing therapy by speech-language pathologist. The initial treatment strategy for symptomatic osteophytosis should be conservative, usually with a good response to swallowing therapy. Although they are rarely implicated in the etiology of dysphagia, considering its high prevalence, it is important that otolaryngologists and speech-language pathologists are attentive to this diagnosis, allowing early and effective treatment for the assisted patient, better prognosis and fewer complications of oropharyngeal dysphagia in the elderly.

RESUMO Objetivo Avaliar frequência da desnutrição e consumo alimentar de crianças com paralisia cerebral de acordo com a idade do início do tratamento de reabilitação fonoaudiológica e nutricional. Métodos Foram incluídas crianças de 2 a 11 anos com diagnóstico de paralisia cerebral e que tinham até três meses de reabilitação fonoaudiológica e nutricional em dois centros de referência em Recife, Pernambuco. Submetidas a medidas de peso, altura do joelho, circunferência do braço e dobra cutânea tricipital. Peso, estatura estimada e índice de massa corporal foram classificados em escore-Z pelas curvas da Organização Mundial da Saúde. Circunferência braquial, dobra cutânea tricipital e circunferência muscular do braço foram classificados segundo Frisancho. Utilizou-se o recordatório das 24 horas para calcular consumo de calorias, proteínas, cálcio, ferro, vitamina A e zinco, pelo software NutriWin®. Resultados Foram avaliados 68 pacientes. Crianças maiores que cinco anos tiveram maior frequência de desnutrição quando se considerava peso (p=0,02) e ou circunferência muscular do braço (p<0,001) apesar de menor desnutrição pela dobra tricipital (p=0,002). Estas também tinham menor consumo de calorias/kg/dia, proteína/kg/dia e cálcio do que os menores. Conclusão O maior comprometimento nutricional a partir de cinco anos sugere que intervenções nutricionais e fonoaudioló-gicas poderiam ter maior efeito caso fossem realizadas antes dessa idade.

ABSTRACT Objective To evaluate the frequency of malnutrition and food consumption of children with cerebral palsy according to the age at the beginning of speech and hearing rehabilitation treatment. Methods Two to eleven-year-old children diagnosed with cerebral palsy who had up to three months of speech-language and nutritional rehabilitation were included in two reference centers in Recife, Pernambuco, Brazil. The following measurement of the children were taken: weight, knee height, arm circumference and triceps skinfold. Weight, estimated height and body mass index were classified into Z-scores according to the World Health Organization curves. Brachial circumference, triceps skinfold and arm circumference were classified according to Frisancho. The 24-hour recall was used to calculate intake of calories, proteins, calcium, iron, vitamin A, and zinc using the NutriWin software. Results A total of 68 patients were evaluated. Children older than five had a higher frequency of malnutrition when weight (.=0.02) and arm circumference (.<0.001) were considered, although there was less triceps malnutrition (.=0.002). These also had lower calorie consumption per kg/day, protein/kg/day and calcium than the younger children. Conclusion The greatest nutritional impairment after the age of five suggests that nutritional and speech therapy interventions could have a greater effect if they were performed before that age.