Brazil
Paulo
Pontes (Sao Paulo) - IFOS Regional Secretariat for South and
Central America
FAX #(+5511) 539.5013 / e-mail:
ppontes@mandic.com.br
In 1964, during the first most important meeting on phoniatry
and basic logopedy in Rio de Janeiro, a group of doctors organized
by Dr. Pedro Bloch has defined the statements to create a Specialty
of Phoniatry in Brazil. Resulting from the work of this group,
in November, 1973, the Medical Brazilian Association (Associaco
Medica Brasileira - AMB) approved the inclusion of phoniatry
as a medical specialty.
In 1974, it was created the Brazilian Association of Phoniatry
and Audiology (Associacao Brasileira de Foniatria e Audiologia
- ABRAFA) associated to the Latin American Federation of Phoniatry
Logopedy and Audiology Societies. (Federacao Latino-Americana
das Sociedades de Foniatria Logopedia e Audiologia - FLASFLA),
which has actuated until 1983. Mauro Spinelli, Paulo Pontes,
Irene Abramovich and Alfredo Tabith were the presidents of this
association. In 1996, the AMB has unfortunately decided not
continue conferring the title of phoniatrician specialist due
to the lacking number of physicians involved. However, with
the developing interest in the field of communication disorders,
the physicians who has focused their work in this area, are
now trying to reorganize the Brazilian Society of Phoniatry
with a scientific purpose, yet not having the authority to confer
the specialist degree. Nowadays, the field of communication
disorders and the specific area of voice and speech problems,
have being assessed by both otolaryngologists (ORL) and speech-language
pathologists (SLP). The responsibilities of the formers are
the medical diagnosis and treatment, including surgical procedures,
while the lasts are responsible for functional diagnosis and
rehabilitation treatment.
Besides the otolaryngologists, a few number of neurologists
has being working with speech and language disorders, as phoniatricians.
The national society that assumes the nearest role of phoniatry
is the Brazilian Otolaryngology Society (Sociedade Brasileira
de Otorrinolaringologia - SBORL) through the Brazilian Society
of Laryngology and Voice (Sociedade Brasileira de Laringologia
e Voz - SBLV), that results from the intersection with Brazilian
Society of Speech-Language Pathology (Sociedade Brasileira de
Fonoaudiologia - SBFa). These institutions has their own websites
and each one of them includes many indications of interesting
links (attached).
Today, we count on approximately 78 medical universities and
60 speech-language pathology bachelor courses. Even without
specific departments for phoniatry, some medical universities
count on departments for communication disorders. Some courses
for speech-language pathology are independent and characterize
a college, while others belong to public and private universities.
The minimum program for graduation on medicine is 6 years of
undergraduate program plus 3 years of medical residence. The
SBORL have one ORL department for each Brazilian State and annually
applies a theoretical and a practical examinations for physicians
who have concluded the 3 years of medical residence, in order
to confer the ORL specialist degree. The SLP bachelor course
requires a minimum of 4 years of undergraduate program. The
Federal Council of Speech-Language Pathology (Concelho Federal
de Fonoaudiologia - CFFa) has implemented the specialty degree
in the voice field in 1995, for which it is required 2 years
of a specialization course, in any institution recognized by
the Council.
Research has being performed mostly in the governmental education
institutions. However, there are many non governmental centers,
which has decisively contributed to this area. The most representative
governmental institutions for research in voice speech and language
field in Brazil are:
* Universidade Federal de Sao Paulo (UNIFESP- EPM), Sao Paulo
- SP
* Faculdade de Medicina da Universidade de Sao Paulo (FMUSP),
Sao Paulo - SP
* Universidade Estadual de Campinas (UNICAMP), Campinas - SP
* Universidade Federal de Santa Maria (UFSM), Santa Maria -
RS
* Universidade Federal do Rio de Janeiro (UFRJ), Rio de janeiro
- RJ
Some of the most important non-governmental centers that has
contributed in education and research and directors are:
* Instituto da Laringe (INLAR), Sao Paulo - SP: Paulo Pontes,
MD
* Centro de Estudos da Voz (CEV), Sao Paulo - SP: Mara Behlau,
PhD
* Instituto de Foniatria e Fonoaudiologia (IFF), Campinas -
SP: Evaldo Rodrigues, MD
* Pontificia Universidade Catolica (PUC), Depto. de Educacao
e Reabilitacao em Disturbios da Comunicacao (DERDIC), Sao Paulo
- SP: Mauro Spinelli, MD
Instituto de Voz e Fala, Belo Horizonte - MG: Elisio Nascimento
Batista, MD
* Centro de Especializacao em Fonoaudiologia Clinica (CEFAC),
Sao Paulo - SP: Irene Marchesan, PhD
In Brazil, there are around 15000 Speech Language Pathologists,
with more than 600 working in the field of voice and approximately
5000 ORLs, being 400 laryngologists in voice field. The most
important personalities in Brazil are certainly Dr. Pedro Bloch,
who was the first phoniatrician of the country, Dr. Mauro Spinelli
, who has developed an important work, promoting the school
for Phoniatry of PUC-SP, Dr. Elisio Nascimento Batista, who
has organized the first governmental clinic center for phoniatry
not associated with any university and Dr. Paulo Pontes who
has implemented and developed the school for phonosurgical procedures
in the last decades. Their inestimable contribution has empowered
and strengthened the field, being widely recognized.
Dr. Pedro Bloch who has intensively actuated at IALP, founded
the Department of Phoniatry at the Otolaryngology Society of
Rio de Janeiro (Sociedade de Otorrinolaringologia do Rio de
Janeiro - SORJ) in the end of the 50's. He has ministered courses
of phoniatry and logopedy in the 60's, at the School of Rehabilitation
of Rio de Janeiro (Escola de Reabilitacao do Rio de Janeiro),
from where many physicians got their specialist degree.
Since this time we have experienced a large period of gradual
progress and many realizations. The main contribution of Dr.
Bloch and his group is the holistic analysis of the human's
voice problems, considering the progresses of the anatomo-physiologic
studies applied to the methods of evaluation, diagnosis and
treatment.
Dr. Mauro Spinelli is the full professor of PUC-SP, actuating
mostly at the post-graduation programs. He has developed basic
studies and research systems in post-graduation and specialization
programs specifically related to voice, hearing, language and
speech pathology. He has studied with Professor Julio Bernaldo
Quiros, in Buenos Aires in 1964, as well as Paulo Americo Morganti,
who was the first phoniatrician in Sao Paulo. Mauro Spinelli
has contributed to the specialization of many eminent Brazilians
phoniatricians as: Alfredo Tabith Jr., Fernando Carvalho Silva,
Evaldo Rodrigues, Maria Helena Ermel, Maria Estala Figueiredo,
Sulene Pirana e Heloisa de Nubia.
Dr. Elisio Nascimento Batista was full professor of the Department
for Phoniatry of the Speech-Language Pathology course at the
Isabela Hendrix Institute (Instituto Metodista Isabella Hendrix).
He has created the Minas Rehabilitation Association (Associacao
Mineira de Reabilitacao), a non profit organization that provides
free assistance to children with communication disorders. In
1969, he founded the Institute for Voice and Speech (Instituto
da Voz e da Fala), a private center in the area of phoniatry.
Dr. Paulo Pontes studied with Professor Hans Von Leden in Los
Angeles, 1970. He introduced and standardized the laryngeal
microsurgical procedures, as well as the basis for the post
phonosurgery rehabilitation process, including the implementation
of the voice laboratory in Brazil. Is full professor at the
Department of Otolaryngology and Communication Disorders at
the UNIFESP-PM. At this institution, he has decisively actuated
in the development of the post graduation programs in the field
of laryngology and voice. Arnaldo Guilherme and Orlando Armelin
are phoniatricians specialized at this school. He is the director
of the INLAR, being responsible for many international scientific
publications.
From the Neurology, there are some important phoniatrics that
are contribution to the language disorders as: Irene Abramovich,
from Sao Paulo University (Universidade de Sao Paulo - USP)
was assistant of the Antonio B. Lefevre.
Other phoniatricians who has developed an expressive work, are:
Gisela de Almeida Batista, José Carlos Lassi Caldeira,
Ismael Gomes, Evaldo J. B. Rodrigues, Ariovaldo Silva.
Otolaryngologists that has given an important contribution to
the phoniatry are: OsÌris CamponÍs do Brasil,
Henrique O. Costa, Agricio Crespo, Claudia Eckley, Ivo Khul,
Marcos Nemetz, Geraldo Druck Sant'Anna, Marcos Sarvat, Nedio
Steffen and Domingos Tsuji.
General contribution from Brazil to the voice field may be found
in several articles in international publications such as:
-de ANGELIS EC; MOURAO LF; FERRAZ HB; BEHLAU MS; PONTES PA;
ANDRADE LA - Effect of voice rehabilitation on oral communication
of Parkinson's disease patients. Acta Neurol Scand 1997 Oct;96(4):199-205
- CAMPONES DO BRASIL OO; PONTES PA; SPECK FILHO J; COSTA HO
- Partial vertical laryngectomies and reconstruction with plathysma
myocutaneous flap. Rev Laryngol Otol Rhinol (Bord) 1991;112(1):45-53
[Article in French]
- CERNEA CR; FERRAZ AR; FURLANI J; MONTEIRO S; NISHIO S; HOJAIJ
FC; DUTRA JUNIOR A; MARQUES LA; PONTES PA; BEVILACQUA RG - Identification
of the external branch of the superior laryngeal nerve during
thyroidectomy. Am J Surg 1992 Dec;164(6):634-9
- KOWALSKI LP; FRANCO EL; DE ANDRADE SOBRINHO J; OLIVEIRA BV;
PONTES PL - Prognostic factors in laryngeal cancer patients
submitted to surgical treatment. J Surg Oncol 1991 Oct;48(2):87-95
- PINHO SM; PONTES PA; GADELHA ME; BIASI N - Vestibular vocal
fold behavior during phonation in unilateral vocal fold paralysis.
J Voice 1999 Mar;13(1):36-42
- PINHO SM; TSUJI DH; SENNES L; MENEZES M - Paradoxical vocal
fold movement: a case report. J Voice; 11(3):368-72, 1997 Sep.
-PONTES P & BEHLAU M - Treatment of sulcus vocalis: auditory
perceptual and acoustical analysis of the slicing mucosa surgical
technique. J Voice 1993 Dec;7(4):365-76
- PONTES PAL; BIASE NG; BEHLAU, M - Vascular characteristics
of the vocal fold cover in control larynges and larynges with
benign lesions. Phonoscope 1999, 2(3):129-35
- PONTES PAL; BIASE N; GADELHA ME - Clinical evolution of laryngeal
granulomas treatment and prognosis. Laryngoscope 1999, 109(2):289-94
- PONTES PA; GADELHA ME; GREGORIO LC - Pathologic quiz case
2. Laryngeal syngamosis. Arch Otolaryngol Head Neck Surg 1993
May;119(5):570-1, 573-4
- VASSALLO J; ALTEMANI AM; CARDINALLI IA; CRESPO AN; LIMA CS;
EID KA; SOUZA CA - Granulocytic sarcoma of the larynx preceding
chronic myeloid leukemia. Pathol Res Pract; 189(9):1084-6; discussion
1086-9, 1993 Nov.
Interesting
links may be found at:
English version available
- EPM-UNIFESP -
http://www.epm.br
- PUC - http://www.pucsp.br
- SBORL and SBLV - http://www.sborl.com.br
Portuguese
version only
- FMUSP -
http://www.usp.br/medicina
- IFF - http://www.bestway.com.br/foniatria
- UFRJ - http://www.ufrj.br
- UFSM- http://www.ufsm.br
- UNICAMP -
http://www.unicamp.br
