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Inicio Acta Otorrinolaringológica Española Nódulos de cuerdas vocales. factores de riesgo en los docentes. estudio de caso...
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Vol. 54. Issue 4.
Pages 253-260 (April 2003)
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Vol. 54. Issue 4.
Pages 253-260 (April 2003)
Nódulos de cuerdas vocales. factores de riesgo en los docentes. estudio de casos y controles
Vocal fold nodules. Risk factors in teachers. A case control study design
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C.A. Pérez FernÁndez1
Corresponding author
arapi61@hotmail.com

Correspondencia: C/ Avenida Principal 61. 24271 Llamas de la Ribera. León.
, J. Preciado lÓpez
Servicio orl. hospital san millán. logroño. la rioja
Article information
Resumen

Los nódulos de cuerdas vocales son lesiones frecuentes entre los profesionales de la voz, como son los docentes. Hemos realizado un estudio de los factores de riesgo que favorecen el desarrollo de la patología nodular en 240 docentes: 120 normales y 120 con nódulos. Se evaluaron los antecedentes profesionales y los personales, el ambiente del aula y se realizó una exploración completa de la voz: pruebas aerodinámicas, tono y extensión de voz, análisis acústico de la voz, evaluación perceptual de la voz y videolaringo-estroboscopia para realizar el diagnóstico. Los docentes más jóvenes y con menos años de ejercicio profesional presentaban una mayor tendencia a padecer nódulos que los docentes normales. El ambiente seco y la existencia de ruido y de eco en la clase eran más frecuentes en los docentes con nódulos. Los antecedentes con mayor influencia en el desarrollo de los nódulos fueron: la patología vocal previa, la microcirugía laríngea, la cirugía nasal y el reflujo gastro-esofágico. Los docentes con nódulos tenían el rango de intensidades y el rango de frecuencias acortado. Existía, además, un aumento de los parámetros de la perturbación de la frecuencia, de la amplitud y del ruido. Asimismo, existía una mayor ineficacia del soplo fonatorio en los docentes patológicos.

Palabras clave:
Docentes
Nódulos
Factores de riesgo
Análisis acústico
Abstract

Vocal nodules are structural lesions very common amongst professional voice users such as teachers. We have studied the risk factors that predispose the development of vocal nodules in teachers. Two hundred and forty-two teachers were selected: 120 with vocal nodules and 120 with normal vocal folds. Professional and personal factors as well as classroom environment were studied. A complete evaluation of the voice was performed, aerodynamic measures, tone and extension of the voice, acoustic analysis, perceptual evaluation of the voice as well as a videolaryngostroboscopy which was definitive in the diagnosis. Younger teachers with less years of teaching experience a greater have tendency to develop vocal nodules than the rest. Class-roo m ’s dryness, loudness and echo are correlated with the pathological group. The most relevant personal factors in the pathological group were previous vocal pathology, laryngeal surgery, nasal surgery and gastroesophageal reflux. Vocal intensity and vocal frequency ranks were shorter in the pathological group. We could also see that, fonatory flow was less effective in the pathological group.

Key words:
Teachers
Vocal fold nodules
Risk factors
Acoustic analysis

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