Idosos usuários de implante coclear: dados perceptivo-auditivos de qualidade vocal e dinâmica vocal

Abstract

Introduction: Speech and language are distinct and inseparable elements, and their manifestations occur in a cooperative way, for their understanding, perceptions are attributed by the interlocutors, who make them under the influence of several factors, from contextual, sociocultural clues, as well as the adjustments of vocal quality and dynamics produced by the individual. Brazilian projections suggest a tendency to increase in the elderly adult population in the coming years, population share this to the aging show a gradual decrease in their abilities, like, hearing that may require the use of devices such as the cochlear implant, depending factors such as: degree of deafness, pathologies and residual hearing. The CI is an auditory device capable of promoting an auditory sensation for speakers of different age groups and allows a resumption of auditory feedback, in which different effects on users' communication are described. Objective: To characterize the vocal quality and vocal dynamics adjustments of elderly adult speakers using cochlear implants. Methodology: Three volunteers aged between 76 and 78 years participated in the study, two users of unilateral cochlear implants and one bilateral, in addition to all living in João Pessoa (PB). The instruments for data collection were a sociodemographic questionnaire and the script of auditory-perceptual analysis Vocal Profile Analysis Scheme (VPA). The corpus was constituted with the task of reading nine VPA sentences-vehicle, in which all speech samples were submitted to auditory-perceptual analysis of three judges with training and experience in the script. The data obtained from the evaluations were subjected to clustering analysis, in which a dissimilarity matrix with the Euclidean metric was calculated. Results: The evaluations were described in two dendrograms, in which the first revealed the grouping of three clusters: 1) neutral adjustments; 2) adjustments in muscle tension, laryngeal and vocal tract hyperfunction, as well as raised tongue body and decreased tongue extension; and finally 3) non-neutral vocal quality adjustments: decreased lip extension, recessed and lowered tongue body, recessed and advanced tongue tip, high laryngeal height, pharyngeal constriction and nasality and phonatory elements were perceived: crackling voice, rough voice and vocal fry. Regarding the vocal dynamics elements, adjustments of lowered usual pitch, decreased pitch extension, sometimes decreased and sometimes increased pitch variability, sometimes decreased and sometimes increased habitual loudness, slow and fast speech rate and interrupted continuity were observed. While in the second dendrogram, analyzes of the sentences were obtained, so that the speaker P3 who used a bilateral implant showed a tendency to move away from the speakers (P1 and P2) with unilateral CI. Conclusions: By analyzing the adjustments identified among the three speakers who use cochlear implants, it is possible to verify that their phonatory mobilizations are compatible with those of their peers without hearing problems, in addition to pointing to different positions of the articulators of the body and tip of the tongue. Such findings can support the recommendations for the application of CI among elderly adults, and it is suggested that acoustic analyzes be carried out to deepen the perceptual correlates.