VOCAL QUALITY OF INDIVIDUALS UNDERGOING ESOPHAGECTOMY

Objective:: To describe the voice quality of individuals undergoing esophagectomy. Methods: This was a cross-sectional study, approved by the Ethics Committee of the institution (No. 4.229.741). 42 individuals undergoing esophagectomy with or without association with adjuvant treatment (radiotherapy and chemotherapy) linked to the department of abdominal surgery of an oncology center, without cognitive and/or neurological changes. Data collection occurred from January 2020 to May 2021, being suspended for three months due to the COVID-19 pandemic. Voice recording was performed on an iPhone 11 with the Voice Record application, requesting the emission of the vowel /a/ sustained in maximum phonation time (MPT) and in usual pitch and loudness. Three Speech and Language Pathologists (SLP) specialized in voice judged the samples using the GRBASI scale and analyzed pitch (adequate, low or high) and loudness (adequate, weak or strong).
Results: Thirty-three male and nine female subjects participated, with a mean age of 61 years (±7.2 years). Regarding the type of esophagectomy, thirty underwent transthoracic esophagectomy (71.4%) and twelve transhiatal esophagectomy (28.6%). All participants underwent adjuvant radiotherapy, and thirty-five (83.3%) chemotherapy concomitantly. The distribution of the GRBASI scale findings showed a predominance of discrete alterations in the general voice grade and in the breathiness, instability, roughness and asthenia parameters. There were significant positive correlations (p<0.01) between all the GRBASI parameters, except for the tension parameter. Between the overall grade and breathiness, a very strong correlation (r=1.000) was observed. As for pitch, 36 (85.7%) were identified as adequate, 4 (9.5%) low voice, and 2 (4.8%) high voice. Poor loudness was observed in 15 (35.7%) subjects. The MPT ranged from 7 to 22 seconds, with an average of 15.8 seconds. Conclusions: The overall voice grade was measured as mild, with a prevalence of impairment of the breathiness, instability, roughness and asthenia parameters, as well as poor loudness. The MPT was reduced in male participants and the pitch was considered adequate in most participants. Transthoracic esophagectomy was the one that caused the most vocal sequelae.