generalidades y fisiologÍa vocal en las disfonÍas de origen profesional

8/2/2019 GENERALIDADES Y FISIOLOGÍA VOCAL EN LAS DISFONÍAS DE ORIGEN PROFESIONAL

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¶USC C] JE YFW6

C} cj }fkhdf usc cj eh|c cr~cjhdf dc jf} ~sj`fkc} ~|fdsmcej }ejh| dc je je|hkac* bemhckdf usc yhl|ck je} msc|de}yfmejc}+

C} cj }fkhdf ~|fdsmhdf ~f| cj e~e|etf ifkedf| bs`ekf+ Bexdf} `cmekh}`f} lå}hmf} dc ~|fdsmmhýk dc yfw* je yhl|emhýkdc je} msc|de} yfmejc} usc de jsae| e }fkhdf} ,}fkf|f},

"yfmejc}* }c`hyfmejc}* ke}ejc}* ctm+(* x je} hktc||s~mhfkc}"tftejc} f ~e|mhejc}( ck cj ijsgf dc eh|c usc }ejc dc jf}~sj`fkc} usc de jsae| e jf} }fkhdf} ,}f|df}, "i|hmethye}*cr~jf}hye}* ctm+(* edhmhfkej`cktc bex mf`lhkemhfkc} dce`lf} `cmekh}`f}* mf`f je} fmjs}hye} }fkf|e} "ckc}~eõfj !l!* !d! x !a!(+ +++

Te`lhèk }c mfk}hdc|e usc je yfw c} cj }fkhdf ~|fdsmhdf ~f|cj e~e|etf ifkedf| bs`ekf+ Je c`h}hýk mfk}mhcktc dc}fkhdf} ~|fdsmhdf} sthjhwekdf cj e~e|etf ifkedf| c}mfkfmhde mf`f mektf+ Cj mektf thckc sk |fj h`~f|tektc ck cje|tc dc je `÷}hme* ~f|usc c} cj ÷khmf hk}t|s`cktf `s}hmej

me~ew dc hktca|e| ~ejel|e} e je jàkce `s}hmej+



EKETF@FIH]HFJFAÀE DC JE YFW Je Je|hkac* c} ske c}t|smts|e `ýyhj* usc if|è ~e|tc dc je yàe eè|ce*

emtsekdf kf|èj`cktc mf`f ske yåjysje usc h`~hdc cj ~e}f dc jf}

cjc`cktf} dcajsthdf} x msc|~f} crt|eõf} bemhe cj t|emtf |c}~h|etf|hfhkic|hf|+ Edc`å} ~c|`htc cj `cmekh}`f dc je ifkemhýk dh}cõedfc}~cmàihme`cktc ~e|e je ~|fdsmmhýk dc je yfw+ Je c`h}hýk dc }fkhdf}c}tå mfkdhmhfkede ej `fyh`hcktf dc je} msc|de} yfmejc}+ ]fk jf}`fyh`hcktf} dc jf} me|tàjeaf} dc je je|hkac jf} usc ~c|`htck ye|he| cja|edf dc e~c|ts|e ckt|c je} msc|de} x ske dc~|c}hýk f ske cjcyemhýk dc

je c}t|smts|e je|àkace* mfk jf usc ye|àe cj tfkf dc jf} }fkhdf}~|fdsmhdf} ~f| cj ~e}f dcj eh|c e t|eyè} dc cjjf}+ C}tf gsktf e jedh}~f}hmhýk dc jf} ft|f} cjc`cktf} dc je meyhded f|ej "jelhf}* jckase xlfme( ~c|`htc dctc|`hke| jf} dhic|cktc} }fkhdf} usc c`hth`f}+

]c ckmsckt|e }htsede ck je ~f|mhýk ektc|hf| dcj mscjjf x `hdce~|frhède`cktc 3 m` dc jfkahtsd* }hckdf `å} mf|te x mciåjhme ck je}

`sgc|c} x c}~cmhej`cktc ck jf} khõf}+ Cjje }c |cjemhfke mfk jf} msc|~f}yc|tcl|ejc} M=-M9+

]s c}t|smts|e c}tå mfk}thtshde ~f| sk c}uscjctf me|thjeahkf}f ej msej }cskck sk a|s~f h`~f|tektc dc c}t|smts|e} `s}msje|c} x ck dfkdc je`smf}e edushc|c me|emtc|à}thme} ~e|thmsje|c}+



EKETF@FIH]HFJFAÀE DC JE YFW

]s~|eajfth}7 }c cjelf|e je yfw+ Ajfth}7 c}~emhf ckt|c je} msc|de}

yfmejc}+ ]slajfth}7 slhmede ~f| dclegf dc je}

msc|de} yfmejc}+

Je yfw }c ~|fdsmc ~f| cj ijsgf dc eh|c usc}slc ~f| je t|åusce x ~e}e ~f| skc}t|cmbe`hcktf+ Ej ~e}e| cj eh|c ~|fdsmcje yhl|emhýk dc je} msc|de} yfmejc}+



EKETF@FIH]HFJFAÀE DC JE YFW

Cj e~e|etf ifkedf| bs`ekf c}tåmf`~sc}tf ~f| 7Ý|aekf} dc |c}~h|emhýk "Meyhdedc}

hki|eajýthme}7 ~sj`fkc}* l|fkushf} xt|åusce(+

Ý|aekf} dc ifkemhýk "Meyhdedc} ajýthme}7je|hkac* msc|de} yfmejc} x |c}fkedf|c}

ke}ej* lsmej x ie|àkacf(+Ý|aekf} dc e|thmsjemhýk "meyhded

}s~|eajýthme7 ~ejede|* jckase* dhcktc}*

jelhf} x ajfth}(+



EKETF@FIH]HFJFAÀE DC JE YFW CK CJ MEKTF7

Je `cdhe dcj tfkf ck cj mektf c} `å} easde usc ck cj belje+ê|e usc jf} }fkhdf} }cek `å} è|medf} }c dclc tckc| ck

msckte75+ ^f}hmhýk dcj ycjf dcj ~ejede| cjcyedf+

<+ ^f}hmhýk èkdhlsje| lege+=+ Je |eàw dc je jckase dclc ~c|`hth| cj ~e}f jhl|c dcj }fkhdf

~f| je ie|hkac+ 4+ \fj dc je meyhded lsmej7 e|thmsjedf|+

3+ Ycjf dcj ~ejede|7 mfk }s e}mck}f f dc}mck}f dctc|`hkeusc cj }fkhdf }ce ke}ej s f|ej+



ME]HIHMEMHÝK ]CRSEJ DC JE YFW

Yfw ck cj bf`l|c7

5+ Je} msc|de} yfmejc} }fk `å} je|ae} x }ýjhde}+<+ Dhic|cktc yfjs`ck dc meyhded dc |c}fkekmhe+

=+ Je|hkac è} a|ekdc ~f| jf usc cj }fkhdf c} è} a|eyc+

Yfw ck je `sgc|7

5+ Je yfw }c ejtc|e mfk je `ck}t|semhýk x je ac}temhýk+<+ Je|hkac x msc|de} yfmejc} è} |cdsmhde} usc ck cj bf`l|c

~f| jf usc je yfw dc je `sgc| edsjte c}tå e ske fmteye `å} ejteusc je dcj bf`l|c+

Yfw hkiekthj7 je je|hkac c} è} mf|te usc ck cj bf`l|c x je `sgc|

~f| jf tektf je yfw c} `sx easde+Yfw e}crsej7 yfw dcj khõf me}t|edf ektc} dc je ~slc|ted* ~f| jf

usc kf m|c}c x }c dc}e||fjje je je|hkac* dekdf èxf| ~ftckmhex crtck}hýk e je yfw+



Je mje}hihmemhýk yfmej sthjhwede ckmektektc} mjå}hmf} c} je }hashcktc7

Yfmc} `e}msjhke}7 Tckf| "yfw e easde(*Le|àtfkf "yfw `cdhe( x legf "yfw

a|eyc(+ Yfmc} ic`ckhke}7 ]f~|ekf "yfw

easde(* @cwwf}f~|ekf "yfw `cdhe( x

mfkt|ejtf f ejtf "yfw a|eyc(+



Mje}hihmemhýk }ca÷k tc}hts|eJe tc}hts|e* c} cj mfkgsktf dc tfkf} ck jf} msejc} }c

mekte mfk el}fjste mf`fdhded x c}tèthme+ Je|cejhwemhýk dc je mje}hihmemhýk yfmej }ca÷k tc}hts|e*mfk}thtsxc cj ~|fmcdh`hcktf `å} ekthasf x t|edhmhfkej+Mfk}h}tc ck bemc| mekte| ej mektektc x ekfte| je kfte`å} easde x je `å} a|eyc usc ~scdc ejmekwe| mfkmf`fdhded+ Kf|èj`cktc je tc}hts|e c}~c|ede ck skmektektc mjå}hmf mfk if|èmhýk ~|fic}hfkej c} dc ej`ckf} < fmteye}+ C}tf }scjc }c| dhic|cktc ck jf}mektektc} dc `s}hme ~f~sje|* dfkdc cj |ekaf ~scdc

}c| èxf| f `ckf|* dc~ckdhckdf dc je tèmkhme yfmej*if|è ck usc sthjhwe jf} |cah}t|f} yfmejc}"`cmekh}`f} yfmejc}( x cj c}thjf `s}hmej usc cjjf}sthjhmck++ "@e|mf Asw`åk ” qqq+yfw~|fic}hfkej+mj(



Mje}hihmemhýk ~f| cj mfjf| dc je yfw

C}tc `ètfdf mfk}h}tc ck mje}hihme| je yfw }ýjfc}msmbekdf je mejhded dc }s mfjf|+ C} hkdsdeljc uscc}tc `ètfdf* c} `å} }slgcthyf usc cj ektc|hf|+ ê|edctc|`hke| cj mfjf| dc ske yfw* c} kcmc}e|hf tckc| ska|ek ckt|cke`hcktf esdhthyf+ @hckt|e} `å}cr~c|hckmhe }c tckae* dh}`hksh|å ck ~e|tc cj a|edf dc}slgcthyhded+

Cj mfjf| c} skf dc jf} cjc`cktf} usc mfkif|èk cjth`l|c dc je yfw+ Em÷}thme`cktc beljekdf* cj mfjf|c}tå dctc|`hkedf ~f| jf} e|`ýkhmf} dc je yfw usc

c}tèk `å} e`~jhihmedf} ~f| jf} |c}fkedf|c}"slhmemhýk dc jf} if|èktc}(+ Ske yfw mje|e tckd|å jf}e|`ýkhmf} ejtf} `å} e`~jhihmedf}* `hckt|e} usc ckske yfw f}ms|e bex èxf| e`~jhihmemhý dc jf}

e|`ýkhmf} legf}+ C}tf c} ck tè|`hkf} ackc|ejc}+ "@e|mf

Asw`åk ” qqq+yfw~|fic}hfkej+mj(



Mje}hihmemhýk ~f| cjc`cktf} dc je eketý`hme7 Crh}tck ejaskf} m|htc|hf} eketý`hmf} c}teljcmhdf} ~e|e mje}hihme| je

yfw* tejc} mf`f* je jfkahtsd dc je} msc|de} yfmejc}* jfkahtsd dcjt|emtf yfmej x teèõf dc je je|hkac+ C}tf} cjc`cktf} c}tåk

dctc|`hkedf} ~|hkmh~ej`cktc ~f| t|c} iemtf|c}7 je cded* cj }crf xje tejje+ Ck cj me}f dc jf} bf`l|c} ~f| cgc`~jf* jf} }sgctf}edsjtf}* ejtf} x dcjaedf}* mfk msc|de} yfmejc} `å} je|ae} xt|emtf yfmej dc èxf| jfkahtsd* tckd|åk yfmc} `å} f}ms|e}*tc}hts|e `å} a|eyc x ~f| jf tektf c} è} ~|fleljc usc tckaek yfwdc legf f le|àtfkf+ ^f| ft|f jedf* jf} }sgctf} ~cuscõf}* mfk

msc|de} yfmejc} `å} mf|te} x t|emtf yfmej dc `ckf| jfkahtsd*tckd|åk yfmc} `å} mje|e}* tc}hts|e `å} easde x ~f| jf tektf c}è} ~|fleljc usc tckaek yfw dc tckf|+ C}te hkif|èmhýk }ýjfthckc sk yejf| |cic|ckmhej* ck khka÷k me}f c} dcmh}hye kh el}fjste+

Kf|èj`cktc jf} |e}af} |cjemhfkedf} mfk je eketf`àe* kf }fk

mfk}hdc|edf} ck if|è dh|cmte ~f| sk c}~cmhejh}te ej `f`cktf dcmje}hihme| ske yfw+ ]hk c`le|af* ck if|è }cmskde|he f hkdh|cmte*c}tf} cjc`cktf} eketý`hmf} dctc|`hke|ek me`lhf} ck jeih}hfjfaàe dc je yfw x ~f| jf tektf ck ~e|å`ct|f} em÷}thmf} dc jeyfw* tejc} mf`f je tc}hts|e* mfjf| dc je yfw* ~e}egc yfmej* ctm+ "@e|mf Asw`åk ” qqq+yfw~|fic}hfkej+mj(



Mje}hihmemhýk ~f| cj tfkf `cdhf beljedf

Cj tfkf `cdhf beljedf c} cj tfkf usc }c |c~htc `å}

ycmc} msekdf }c belje f* dhmbf dc ft|e if|è* c} cjtfkf ~|f`cdhf ck usc belje sk }sgctf+ Dhmbf tfkf }cckmsckt|e slhmedf ck mfkdhmhfkc} kf|èjc}* mc|me dcjjà`htc hkic|hf| dc je tc}hts|e+ Ck je èxf|àe dc je}~c|}fke}* tektf bf`l|c} mf`f `sgc|c}* cj tfkf `cdhf

beljedf thckc |cjemhýk mfk je tc}hts|e+ Dc c}te èkc|e*sk mektektc tckf| dclc|àe tckc| cj tfkf `cdhf beljedf`å} easdf usc sk le|àtfkf x è}tc* e }s ycw* sk tfkf`cdhf `å} easdf usc cj dc sk legf+ C}te }htsemhýk kffms||c }hc`~|c* ~f| jf usc dclc`f} mfk}hdc|e| e c}tc

`ètfdf dc mje}hihmemhýk* mf`f sk cjc`cktf usc e~f|teyejhf}e hkif|èmhýk ~c|f usc ~f| }h }ýjf* kf c}dctc|`hkektc ck je mje}hihmemhýk yfmej+ "@e|mf Asw`åk ” qqq+yfw~|fic}hfkej+mj(



Mje}hihmemhýk ~f| cj ~e}egc7

Ck tè|`hkf} `sx ackc|ejc}* cj ~e}egc dc je yfw c} sketèmkhme ck je c`h}hýk yfmej* usc ~c|`htc ~f| `cdhf dcmhc|tf} `fyh`hcktf} dc jf} `÷}msjf} dcj e~e|etf

ifketf|hf x&f |c}fkekmhej* jfa|e| je c`h}hýk dc jf}easdf} ck yfw mektede+ Cj ~e}f f ~e}egc dc je yfw* c}sk cjc`cktf `sx h`~f|tektc dc mfk}hdc|e| msekdf }cdc}ce mje}hihme| je yfw dc sk mektektc* dclhdf e usccrh}tc ske |cjemhýk me}h el}fjste ckt|c je} kfte} dc

~e}f x je mje}hihmemhýk yfmej }ca÷k tc}hts|e+ C} e}àmf`f sk tckf|* thckc je wfke dc ~e}f ck kfte} `å}easde} usc sk le|àtfkf+ Fms||c jf `h}`f ck cj me}fdc je} `sgc|c}+ "@e|mf Asw`åk ” qqq+yfw~|fic}hfkej+mj(



Mje}hihmemhýk dc jf} }fkhdf} dc je yfw

Jf} }fkhdf} c`hthdf} ~f| cj e~e|etf ifketf|hf ~scdckmje}hihme|}c dc emsc|df mfk dhyc|}f} m|htc|hf} uscthckck ck msckte jf} dhic|cktc} e}~cmtf} dcjický`ckf dc c`h}hýk+ C}tf} m|htc|hf} }fk7

e( ]ca÷k }s me|åmtc| yfmåjhmf f mfk}fkåkthmf+

l( ]ca÷k }s f|ejhded f ke}ejhdedm( ]ca÷k }s me|åmtc| tfkej "}fkf|f( f kf tfkej

"}f|df(d( ]ca÷k cj jsae| dc e|thmsjemhýk

c( ]ca÷k cj `fdf dc e|thmsjemhýki( ]ca÷k je ~f}hmhýk dc jf} ý|aekf} e|thmsjetf|hf}a( ]ca÷k je ds|emhýk



Yfmejc}

Dc}dc sk ~sktf dc yh}te `cmekfem÷}thmf* je}yfmejc} }fk jf} }fkhdf} c`hthdf} ~f| je }fjeyhl|emhýk dc je} msc|de} yfmejc} }hk khka÷kfl}tåmsjf f mfk}t|hmmhýk ckt|c je je|hkac x je}

elc|ts|e} f|ej x ke}ej+ Dhmbe yhl|emhýk }cackc|e ~f| cj ~|hkmh~hf dcj f}mhjedf| dc|cjegemhýk* dfkdc hktc|yhckc ske iscktc dcckc|aàe mfk}tektc ck je if|`e dc sk ijsgf dc

eh|c ~|fyckhcktc dc jf} ~sj`fkc}+ ]fk}hc`~|c }fkhdf} dc me|åmtc| tfkej"mse}h~c|hýdhmf}(* x ~f| mfk}hashcktc dcc}~cmt|f dh}m|ctf+



Mfk}fkektc}

Je} mfk}fkektc}* ~f| cj mfkt|e|hf* }cc`htck hktc|~fkhckdf eja÷k fl}tåmsjfif|`edf ~f| jf} cjc`cktf} e|thmsjetf|hf}+

Jf} }fkhdf} mf||c}~fkdhcktc} e je}mfk}fkektc} ~scdck }c| tfkejc} f kfdc~ckdhckdf dc }h je} msc|de} yfmejc}c}tåk yhl|ekdf f kf+ Iskmhfkej`cktc*

ck cj me}tcjjekf je} yfmejc} ~scdckmfk}thtsh| ~ejel|e} mf`~jcte}* kf e}à je}mfk}fkektc}+



F|ejhded x ke}ejhded

Jf} ifkc`e} ck jf} usc cj eh|c ~e}e ~f|je meyhded ke}ej }c dckf`hkekke}ejc}* ck tektf usc eusèjjf} ck jf}

usc }ejc ~f| je lfme }c dckf`hkekf|ejc}+ Je dhic|ckmhe ~|hkmh~ej c}tå ckcj th~f dc |c}fkedf| ~|hkmh~ej ~f|ckmh`e dc je je|hkac "meyhded ke}ej x

f|ej* |c}~cmthye`cktc(+ Ck me}tcjjekf}fk ke}ejc} }ýjf je} mfk}fkektc} ‚`‐* ‚k‐* ‚õ‐



Tfkejhded Jf} ifkc`e} ck jf} usc ~e|thmh~e je yhl|emhýk

dc je} msc|de} yfmejc} }c dckf`hkek tfkejc} f* te`lhèk* }fkf|f}+ Je tfkejhded jjcye h`~jàmhtf sk c}~cmt|f mse}h ~c|hýdhmf+ Tfde}je} yfmejc} }fk tfkejc}* ~c|f crh}tck ye|he}

mfk}fkektc} usc te`lhèk jf }fk7 ‚l‐* ‚d‐* ‚`‐* ctm+ Euscjjf} ifkc`e} ~|fdsmhdf} }hkyhl|emhfkc} ajftejc} }c dckf`hkek }f|df}+Ye|hf} dc cjjf} }fk cj |c}sjtedf dc je ts|lsjckmhe mes}ede ~f| cj eh|c ~e}ekdf ea|ek ycjfmhded ~f| sk c}~emhf |cdsmhdf* mf`fje} mfk}fkektc} ‚}‐* ‚w‐* ‚g‐* ‚i‐+



^sktf x `fdf e|thmsjetf|hf



Ds|emhýk



^\FIC]HFKEJ DC JE YFW

Tfdf t|elegedf| usc fltckae ske|c`skc|emhýk ~f| sthjhwe| }s yfwmf`f hk}t|s`cktf f bc||e`hcktedc t|elegf+



^\FIC]HFKEJC] DC JE YFW

^\FIC]HFKEJC] DC JE YFW BELJEDE7 Dfmcktc}+ Jfmstf|c} x t|elegedf|c} dc `å|uscthk+

Ske cr~c|hckmhe dc hkyc}thaemhýk jjcyede e melf ~f|ifkfesdhýjfaf} dc je skhyc|}hded dcj \f}e|hf ck Lfaftåckmfkt|ý ~f| `cdhf dc ske ckmsc}te usc }c |cejhwý dcif|è ~|c}ckmhej x yh|tsej ck je msej }c ~|casktele e<48 ~|fic}f|c} |f}e|h}te} }fl|c }s ~c|mc~mhýk ektc jf}|hc}af} dc dc}e||fjje| ske ~etfjfaàe yfmej ~f| msj~e dc

}s cgc|mhmhf ~|fic}hfkej+ Sk =9# dc jf} dfmcktc}èkhic}tý tckc| sk |hc}af yfmej jcyc* `hckt|e} usc sk9<# hdckthihmý ejaske dhihmsjted ck cj s}f dc je yfw x tek}ýjf sk 5# mfk}hdc|ý usc cicmthye`cktc xe tckàe~|fljcè} dc yfw+ "btt~7&&qqq+cjc}~cmtedf|+mf`&h`~|c}f&e|thmsjfh`~|c}f812<8-yfw-sk-|hc}af-~|fic}hfkej(




^\FIC]HFKEJC] DC JE YFW MEKTEDEMektektc c} msejushc| ~c|}fke msxe me||c|e

f ~|fic}hýk }c le}e ck je sthjhwemhýk dc jeyfw ck sk mfktcrtf `s}hmej usc kf c} dcjdh}ms|}f f|dhke|hf "Ckmhmjf~cdhe dc ]ejsd x]cas|hded ck cj T|elegf-Eke Ochdc|(




YFW MEKTEDE @E]MSJHKE Tckf| Le|àtfkf

Legf

YFW MEKTEDE IC@CKHKE

]f~|ekf7 `å} easde @cwwf}f~|ekf Mfkt|ejtf



@cdhmhke dcj t|elegf

Bhahckc x }cas|hded hkds}t|hej

C|afkf`àe

]EJSD FMS^EMHFKEJ X ]SL^\FA\E@E]MFK \CJEMHÝK EJ S]F DC JE YFW MF@F

BC\\E@HCKTE DC T\ELEGF





@CDHMHKE DCJ T\ELEGF

Cj Cre`ck ^|c-fms~emhfkej





@CDHMHKE DCJ T\ELEGFCJ CRE@CK ^\CFMS^EMHFKEJ

Eke`kc}h} Ifkfesdhfjýahme+ Yejf|emhýk Ifkfesdhfjýahme mjàkhme dc je yfw+ Yejf|emhýk Esdhfjýahme Lå}hme7 Esdhf`ct|àe x

}h c} kcmc}e|hf jfafesdhf`ct|àe c

h`~cdekmhf`ct|àe+ Cyejsemhýk F\J7 Yejf|emhýk f|aåkhme dc je}

MY+ Je|hkaf}mf~àe hkdh|cmte fihl|fje|hkaf}mf~àe+





CJ CRE@CK ^\CFMS^EMHFKEJ "B+M IFKFESDHFJFAHME7EKE@KC]H] IFKFESDHFJFAHME DC HKA\C]F(

Bålhtf} týrhmf} x dcj cktf|kf jelf|ej "bemc| bhkme~hè ck `cdhde}bhahèkhme}(+

Ektcmcdcktc} ie`hjhe|c} ck |cjemhýk e je dh}ifkàe "bex ~etfjfaàe}mfkaèkhte} usc }c ~|c}cktek ck ye|hf} `hc`l|f} dc ie`hjhe(+

]ck}emhfkc} }slgcthye} dcj ~emhcktc7 dfjf|* ~hmf|* msc|~f crt|eõf*ifke}tckhe* f~|c}hýk* ctm+ ^e|e cjelf|e|je} x t|elege|je} ck je |ccdsmemhýk+

Dhihmsjtedc} e je dcajsmhýk? }c |ccdsme|åk ~e|ejcje`cktc e je yfw+

\cijsgf ae}t|fc}fiåahmf7 mfkt|ehkdhme dctc|`hkede} ~f}hmhfkc} dc t|elegf+ Emthyhded yfmej7 `fthye `å} e }cash| je |ccdsmemhýk msekdf

hkdc~ckdhcktc`cktc dc je ~|fic}hýk }c mekte ck ske mf|ej* }c bemc tcet|f*ctm+

Ckic|`cdedc} h`~f|tektc} f hktc|yckmhfkc} usc bexek dcgedf }cmscje}7e ycmc} mfkt|ehkdhmek dctc|`hkedf} cgc|mhmhf} dc je |ccdsmemhýk+

Ý À



YEJF\EMHÝK MJÀKHME IFKFESDHFJFAHME7Me|emtc|à}thme} Ekåtf`fiskmhfkejc} dc jf}

FIE7

5+ @÷}msjf} ~c|hje|hkacf}+<+ @erhje| }s~c|hf|+=+ Ke|hke}+4+ \sae}+3+ Ycjf+9+ Fmjs}hýk+1+ @erhje| hkic|hf|+2+ Jelhf}+8+ ^ejede|+

5>+ I|ckhjjf+55+ Dckthmhýk+

Fl}c|yemhfkc}7



YEJF\EMHÝK MJÀKHME IFKFESDHFJFAHME7

Dcajsmhýk7

5+ ]ejhye+<+ Jàushdf}+=+ ]c`h}ýjhdf}+

4+ ]ýjhdf}+

C d j t à th



Cre`ck dc je} me|emtc|à}thme}em÷}thmf-~c|mc~tsejc} dc je yfw

C} `sx h`~f|tektc a|ele| je yfw dcj~emhcktc cj ~|h`c| dàe dc mfk}sjte+Mfk}thtsxc sk tc}t }c`h-flgcthyf usc kf}~c|`htc jscaf mf`~e|e| je cyfjsmhýk+

E}à `h}`f e~|fycmbe`f} ds|ektc jea|elemhýk ~e|e yejf|e| je hktck}hded* cjtfkf x cj th`l|c dc je yfw+

Cre`ck dc je} me|emtc|à}thme}




Mfkyhckc bemc|jf }hashckdf ske }cmsckmhe }hc`~|c ihge* usc ~scdc

}c| je }hashcktc7 Yfw c}~fktåkce7 detf} ~c|}fkejc}* dc}m|h~mhýk dc }s}

dhihmsjtedc}* dc ske jå`hke* ctm+

Yfmejc} }f}tckhde} hkdhyhdsej`cktc ds|ektc mset|f f mhkmf}caskdf} mede ske+

I|e}c ck je usc ckt|ck mhkmf yfmejc}* dcmh|je t|c} ycmc}+ Dcmh| }c|hc} estf`åthme} "dàe}* `c}c}* k÷`c|f} dc 5 e <3(+

Mfkte| dc skf e dhcw ck yfw ~|fxcmtede+

^cdh| }fkhdf e `ckf| hktck}hded usc ~scde c`hth| }fl|c ske

yfmej* }f}tckc|jf mhkmf }caskdf}+ ]fjhmhte| cj }fkhdf `å} isc|tc usc ~scde bemc|* jje`ekdf e

ejashck jf `å} isc|tc`cktc ~f}hljc+

Jcmts|e dc sk tcrtf c}tåkde|* e tfkf c hktck}hded kf|`ej+

^cdh| usc mektc ske mekmhýk `àkh`f dc mhkmf kfte}+




]c dclc ekfte| }h je yfw mektede c} `cgf| f ~cf| usc je yfwbeljede ~sc} f|hckte bemhe dhic|cktc ~etfjfaàe+ @hckt|e} ye`f}|cejhwekdf cj |cah}t|f dc je yfw mfjfme`f} cj }fký`ct|f e => m`dc je lfme dcj ~emhcktc x ye`f} ekftekdf je hktck}hded ck medeàtc`+

Hktck}hded7 c} je isc|we* je ~ftckmhe dc je yfw* c}tå |casjede ~f|je ~|c}hýk dcj }f~jf c}~h|etf|hf x cj tfkh}`f ajýthmf+ Jf} yejf|c}kf|èjc} ~e|e yfw beljede kf|èj }fk dc 9>-1> dL* ~e|e yfw~|fxcmtede ckt|c 2>-8> dL x ~e|e yfw dc a|htf f dc jjeède ckt|c8>-5>> dL+ Je `àkhè hktck}hded }scjc c}te| ckt|c jf} 33-9> dL+

Tfkf7 ds|ektc je yfw beljede* je ejts|e tfkej f}mhje ej|cdcdf| dc

ske i|cmsckmhe `cdhe e je usc Te|kcesd dhf cj kf`l|c dc tfkfiskde`cktej+ Ck cj bf`l|c }scjc c}te| ej|cdcdf| dc 5>>-54> Bw"ckt|c ]fj5 x @h<(+ Ck je `sgc| ej|cdcdf| dc <<>-<9> Bw "ckt|cJe< x Df=(+ Ck cj khõf ye|àe `smbf }ca÷k je cded ~c|fkf|èj`cktc ckt|c <9> e =4> Bw "dc Df= e Ie=(+

C d j t à th




Crtck}hýk dc je yfw7 c} cj mfkgsktf dc i|cmsckmhe} usc

je ~c|}fke ~scdc c`hth| dc}dc je kfte `å} a|eycbe}te je `å} easde+ Dclc }c| mf`f `àkh`f dc skefmteye "ck yfmc} kf|èjc} }scjc }c| dc df} fmteye}(+Gsktf mfk jf} yejf|c} dc je hktck}hded hkif|è }fl|c jedhkå`hme yfmej+

@cjfdàe x cktfkemhýk dc je ~ejel|e7 ds|ektc je ~ejel|ec}~fktåkce bex ye|hemhfkc} dc tfkf f dc i|cmsckmhe+C}te} ye|hemhfkc} mfk}thtsxck jf usc }c jjeè je`cjfdàe f cktfkemhýk dc je yfw beljede+ Je e`~jhtsddc c}te} ye|hemhfkc} dc i|cmsckmhe hkdhmek ijcrhlhjhdedx egs}tc dc je `s}msjets|e hkt|àk}cme je|àkace* x dc je`smf}e mf|dej* mf`f dc je lscke sthjhwemhýk dc jf}|c}fkedf|c}+ C}te `cjfdàe x cktfkemhýk je me~te`f}~c|mc~tsej`cktc e t|eyè} dcj fàdf+

Cre`ck dc je} me|emtc|à}thme}




Ck je mjàkhme }c ~scdc flgcthye| cj tfkf iskde`cktej x jecrtck}hýk yfmej dc ye|he} èkc|e}+

e( Mfjfmekdf }fl|c je je|hkac dcj ~emhcktc dcj ifkckdf}mf~hf x~hdhèkdfjc7

Usc tf}e* x usc dc je tf} }eusc ske yfmej x je èktckae+ Usc dhae ske ~cuscõe cr~|c}hýk x usc eje|asc je ÷jthè }àjele+

Cg7 usè teeeejjjj…

Jscaf }c ~e}e e kfte} `s}hmejc}7 ]c ~hdc ej ~emhcktc jf `h}`f ~c|f hdckthihme`f} ej fàdf je kfte

`s}hmej usc mf||c}~fkde* jscaf }c ls}me ck cj ~hekf x }c bemcje t|ek}if|èmhýk ck Bc|tw+ ê|e je crtck}hýk dc je yfw* ~cdh`f}

bemc| je kfte `å} a|eyc x `å} easde usc ~scde*|c}~cmthye`cktc* dc if|è mý`fde* }hk if|we|* ls}me`f} je}kfte} ck cj ~hekf+ Hkdc~ckdhcktc`cktc dc c}te} ekftemhfkc}flgcthye} |cah}t|e`f} ck tè|`hkf} }slgcthyf} cj tfkf* je crtck}hýkx je `cjfdàe+



Cre`ck dc je} me|emtc|à}thme}em÷}thmf-~c|mc~tsejc} dc je yfw Th`l|c7 c} e t|eyè} dcj fàdf usc dclc`f} |cejhwe| cj ekåjh}h} dcj th`l|c dc je yfw* ck je

mjàkhme dhe|he+ Cj ~|fljc`e dcj ekåjh}h}~c|mc~tsej c} usc c} }slgcthyf x ~jektce

dhihmsjtedc} ck msektf e je dc}m|h~mhýk*hktc|~|ctemhýk x yejf|emhýk dc mhc|tf}~e|å`ct|f}+

^f| cjjf }c bek bcmbf hktcktf} dc skhihme|*

c}tekde|hwe| c}tf} ~e|å`ct|f} x msekthihme|jf}~e|e cktckdc|kf} tfdf} `cgf| ej dc}m|hlh| je}me|emtc|à}thme} tà`l|hme} dc ske yfw+



Je Skhýk Cs|f~ce dc Ifkhet|e} be ~|f~sc}tf skec}meje le}ede ck je D|+ Bh|ekf "5825( "A+\+L+E+]+(+

A "A|edc( 0 a|edf dc dh}ifkàe+ \ "\fsab( 0 |e}~f}hded* e}~c|cwe+ L "L|cetbx( 0 }f~jedf* c}me~c dc eh|c+ E "E}tbckhm( 0 dèlhj* yfw mfk ~fme hktck}hded* ~fmf ejmekmc+ ] "]t|ehkcd( 0 mfk}t|cõhde* if|wede+

Ck je ede~temhýk ej me}tcjjekf* bcmbe ~f| cj Ifkhet|e D|+ M+ E|he}@e|mhej* ck dfkdc }c jc be eõedhdf t|c} ~e|å`ct|f} `å}7

F 0 f~emf* yfw `etc* iejte dc l|hjjf* dhiàmhj dc ~|fxcmte|+ C 0 c}t|hdcktc* `ctåjhme e ycmc} `sx easde+ ]fk ~emhcktc} usc

sthjhwek hktck}hded es`cktede+ Y 0 yhl|ektc 0 yfw bfkde* ~c|mhlhde mf`f a|eyc x mfk e~fxf

~cmtf|ej+ ]ck}emhýk dc iejte dc tck}hýk dc je} M+Y+



\C]FKEKMHE7

]c dclc ekfte| }h cj ~emhcktc c}tå c`~jcekdfedcmsede`cktc }s} |c}fkedf|c} f c}tå }fl|cme|aekdfsk |c}fkedf| x f`hthckdf jf} dc`å}+

Mje}hihme|c`f} je |c}fkekmhe mf`f7

•Kf|èj* ~cmtf|ej* je|àkace* ie|àkace* bh~f-ke}ej"dcicimtf dc |c}fkekmhe ke}ej(+•Bh~c|-ke}ej "crmc}f dc |c}fkekmhe ke}ej(* dc melcwe+

Kfte7 ê|e ihkejhwe| cj c}tsdhf ~c|mc~tsej dc je yfw }c ekfte|å }h bex~|fljcè} dc e|thmsjemhýk f dc |ht`f dcj belje+]c ekfte|å te`lhèk ck cj e~e|tedf ¯ft|f}¿ msejushc| ekfèjàe usc bexe`f}fl}c|yedf x usc usc|e`f} Dc}teme|+



Cre`ck dcj mf`~f|te`hcktf yfmej

Cj cre`ck dcj mf`~f|te`hcktf yfmej thckc tekteh`~f|tekmhe mf`f cj dc je je|hkac x cj dc je}me|emtc|à}thme} em÷}thmf-~c|mc~tsejc} dc jeyfw+ C} a|emhe} e c}tc cre`ck usc cj ~emhcktc

dc}msl|c x }c de msckte dc je `cmåkhmeifketf|he* dc je cthfjfaàe dc `smbe} dc }s}dhihmsjtedc} x dc jf usc bex usc mf||cah|`cdhektc je |ccdsmemhýk yfmej "jc ~|f~f|mhfkesk `cgf| mfkfmh`hcktf dc }s ~|fljc`e x dc jfusc bex usc bemc| ~e|e mf||cah|jf(+



Cre`ck dcj mf`~f|te`hcktf yfmej ackc|ej ^f}ts|e* yc|thmejhded* cushjhl|hf

Je mfjs`ke yc|tcl|ej mc|yhmej7 ]f~f|te je melcwe* dc }s cushjhl|hfc}tåthmf dc~ckdc je mf||cmte ~f}hmhýk dc je mhkts|e c}me~sje|7bf`l|f}* ksme* mscjjf* ~e|tc c}tc|kf-mjeyhmsje|* `÷}msjf} dc je~e|tc ektc|hf| x jetc|ej dcj mscjjf+ E }s ycw dc tfdf c}tf dc~ckdcje mf||cmte ~f}hmhýk x `fyhjhded dc je je|hkac ck cj mscjjf+

Je mfjs`ke yc|tcl|ej df|}ej7 Ck cjje }c e|thmsjek je} mf}thjje} x

gsktf mfk cj c}c}tc|kýk x je mjeyàmsje if|`ek je mege tf|åmhme+È}te ejlc|ae e jf} ~sj`fkc}* jf} msejc} c}tåk edbc|hdf} e jemege tf|åmhme e t|eyè} dc je ~jcs|e ~e|hctej+ ^f| cjjf jf} ~sj`fkc}}hasck e je mege tf|åmhme ck }s} dc}~jewe`hcktf} ck je|c}~h|emhýk+ Te`lhèk ck je mege tf|åmhme }c hk}c|tek jf} `÷}msjf}dc je |c}~h|emhýk7 dhei|ea`e* hktc|mf}tejc}* ctm+

Ske lscke c}tåthme dc je mfjs`ke yc|tcl|ej df|}ej ~c|`htc skelscke e~c|ts|e dc je mege tf|åmhme x ~f| tektf iemhjhte ske|c}~h|emhýk mf||cmte x mf`~jcte+ Edc`å} e}cas|e je mf||cmte~f}hmhýk dc je mhkts|e c}me~sje|+

Mhkts|e c}me~sje| s bf`l|f7 Mfk}thtshde ~f| je mjeyàmsje x cj



Mhkts|e c}me~sje| s bf`l|f7 Mfk}thtshde ~f| je mjeyàmsje x cjf`f~jetf* ~c|f e }s ycw if|`ekdf ~e|tc dc je mege tf|åmhme ~f| jee|thmsjemhýk dc je mjeyàmsje mfk cj c}tc|kýk x je ~|h`c|e mf}thjje+

Tektf je mfjs`ke yc|tcl|ej mc|yhmej mf`f je mfjs`ke yc|tcl|ej df|}ej gscaek sk ~e~cj `sx h`~f|tektc ck je c}tåthme x dhkå`hme dc jemhkts|e c}me~sje|+ ^hcwe mjeyc c} cj `÷}msjf t|e~cmhf usc }chk}c|te ck cj bsc}f fmmh~htej* ck je mjeyàmsje* ck cj f`f~jetf x ckje} yè|tcl|e} df|}ejc}+

Je mfkt|emmhýk creac|ede x ~c|`ekcktc dcj t|e~cmhf ~|fyfme skemhif}h} df|}ej* ske bh~c|jf|df}h} mc|yhmej usc ~|fxcmte cj `cktýkbemhe edcjektc* ske cjcyemhýk dc jf} bf`l|f} usc ~|fyfme skedc~|c}hýk dc je wfke c}tc|kfmjeyhmsje| mfk je mfk}hashcktc

hkbhlhmhýk dc je e`~jhtsd dc je mege tf|åmhme+

Edc`å} }c dh}`hksxck jf} c}~emhf} hktc|mf}tejc} jh`htekdf cjdc}~jewe`hcktf dc je mege tf|åmhme ck hk}~h|emhýk "Ies|c* 5821(+

J j l j j l ^ h hý j dh i



Je mfjs`ke yc|tcl|ej js`le|7 ^|c}te hk}c|mhýk ej dhei|eaè"<+e* =+e* 4+e yè|tcl|e( x e ft|f} `÷}msjf} usc gsktf mfk jf}eldf`hkejc} gscaek sk ~e~cj `sx h`~f|tektc ck èktckc| jee~c|ts|e dc mf}thjje} hkic|hf|c} x |ct|e}e| cj e}mck}f dcj

dhei|eaè ck je c}~h|emhýk "e~fxf(+ Msejushc| ejtc|emhýk e khycjdcj cgc yc|tcl|ej mf`f jf|df}h} creac|ede f c}mfjhf}h} ye ehkijsh| kcaethye`cktc ck je mf||cmte dh}~f}hmhýk dc tfdf} c}tf}cjc`cktf} ~e|e je ifkemhýk* ~sc}tf usc h`~cdh|å ske mf||cmte|c~e|thmhýk dc isc|we}+

]h bex ske jf|df}h} creac|ede* jf} `÷}msjf} dc je c}~ejde }cmfkt|eck emf|tåkdf}c x jf} eldf`hkejc} }c dh}thckdck }hk ~fdc|~|c}te| }sgcmhýk ck cj e~fxf dhei|ea`åthmf ds|ektc je c}~h|emhýk+

Ske dh}`hksmhýk ekf|èj dc je ms|yets|e js`le| }c }scjc e}fmhe|mfk meàde dc bf`l|f} mhif}h}* bskdh`hcktf dc je wfke c}tc|kf-mjeyhmsje|+ C}te emthtsd }c t|edsmc ck jh`htemhýk dc jf}`fyh`hcktf} tf|åmhmf} mf||cmtf} ck je |c}~h|emhýk+

Ý|aekf} dc |c}fkekmhe7 Cj dc}egs}tc ~|fyfmedf ck je



Ý|aekf} dc |c}fkekmhe7 Cj dc}egs}tc ~|fyfmedf ck jemfjs`ke mc|yhmej "bh~c|jf|df}h} mc|yhmej( x ck je ~e|tc}s~c|hf| dc je mege tf|åmhme kf} hkijsh|å dc if|èkcie}te }fl|c je ~f}hmhýk x `fyhjhded dcj èrhje|hkic|hf| x ~f| ckdc }fl|c je e|thmsjemhýktc`~f|fèkdhlsje|+

@÷}msjf} iemhejc}7 usc hktc|yhckck ck je `à`hè xedcmsek jf} ý|aekf} dc |c}fkekmhe x e|thmsjemhýk+

@÷}msjf} dc je è}thmemhýk x dcajsmhýk "è}ctc|f*~tc|hafhdcf hktc|kf x tc`~f|ej(+ ]h c}tåk mfkt|eàdf}isc|e dc je dcajsmhýk* tckd|c`f} ske èkdàlsjemc||ede* mfkt|eàde x |àahde+ Ck mfk}cmsckmhe je meyhded

lsmej mc||ede+@÷}msjf} }s~|e-bhfhdcf}7 }fk cjcyedf|c} dc je je|hkac* }h

c}tåk mfkt|eàdf} bex e}mck}f je|àkacf* mfk cjmfk}hashcktc mhc||c dcj yc}tàlsjf je|àkacf+



Jf} `fyh`hcktf} dc tfdf} c}tf} `÷}msjf} usc }chk}c|tek dh|cmte`cktc ck cj èrhje| hkic|hf| c}tåk}hkm|fkhwedf} mfk jf} `fyh`hcktf} dc je jckase* jeie|hkac x jf} dcj ycjf dcj ~ejede|* ý|aekf}dcmh}hyf} ck je |c}fkekmhe+ ^f| cjjf c} `sxh`~f|tektc cre`hke| tfdf} c}tf} ý|aekf} x

`÷}msjf} ~e|e hdckthihme| }s} ekfèjàe} xmf||cah|je} jscaf ck je |ccdsmemhýk yfmej+

5+ M+ E|he} @e|}e+ Cre`ck Iskmhfkej Dc Je Ifkemhýk Dc Je Cr~jf|emhýk Ifkhåt|hme+ Le}c} ê|e Je E~jhmemhýk Ck Jfaf~cdhe




Cre`ck Iskmhfkej dc je \c}~h|emhýk

Th~f @fdf I|cmsckmhe

\ht`f Mff|dhkemhýk |c}~h|etf|he

Ds|emhýk dcj }f~jf &}& &}& }fkf|e




Ajetwc|7 Kf} yejd|c`f} dcj c}~cgf dc Ajetwcj~e|e mf`~|fle| x mf||flf|e| }h bex f kfhk}sihmhckmhe |c}~h|etf|he* ck me}f dc usc cj`fdf isc}c f|ej* ck }hjckmhf* ~f|usc bslhc|e

eja÷k fl}tåmsjf ck if}e} ke}ejc} f ck|hkfie|hkac+Cyejse|c`f} jf} dhic|cktc} àtc`} dc je

dhkå`hme |c}~h|etf|he ck7 |c~f}f* yfw

beljede* yfw ~|fxcmtede x yfw mektede+




Cj `fdf ke}ej hk}~h|etf|hf }c dclc ~ftckmhe|mf`f crmjs}hyf* ÷khme`cktc ck je |c}~h|emhýk ck }hjckmhf+ Msekdf belje`f} f mekte`f} c}~c|icmte`cktc kf|`ej usc hk}~h|c`f} ~f| je

lfme x je ke|hw hkdh}thkte`cktc x kf }c be dcmf||cah| je hk}~h|emhýk lsmej+ Te`lhèkmf`~|fle|c`f} mfk cj c}~cgf dc Ajetwcj* }hbex c}me~c ke}ej* bemhckdf dcmh| ej ~emhcktc~ejel|e} x i|e}c} usc kf mfktckaek ifkc`e}ke}ejc}+ ]h bslhc}c c}me~c* bel|àe cktfkmc}crmc}f dc |c}fkekmhe ke}ej+




\F]CKTBEJ

^f}hmhýk E`le} Ke|hke}

Ke|hkeDc|cmbe

Ke|hkeHwushc|de

]cktedf

Emf}tedf

F M Ý M À M F F F FA M 7



YEJF\EMHÝK MJÀKHME IFKFESDHFJFAHME7 Th~f |c}~h|etf|hf "mf}tej }s~c|hf|*

dhei|ea`åthmf* eldf`hkej(+ ê|e yc|hihme|c}te e~|cmhemhýk c} `sx ÷thj tfè| jf}~c|à`ct|f} erhje|* rhifhdcf* dhei|ea`åthmfx eldf`hkej+ ]c tfèk mfk ske mhkte

`èt|hme* x }c ekftek jf} mckt|à`ct|f} ckhk}~h|emhýk x c}~h|emhýk+ Jf kf|èj c}usc cj dc}~jewe`hcktf e khycj erhje| }ce`àkh`f+ E khycj rhifhdcf dclc }c| èxf|x dclc belc| dc}~jewe`hcktf e khycjdhei|ea`åthmf x eldf`hkej+



YEJF\EMHÝK MJÀKHME IFKFESDHFJFAHME7 Ck je hk}~h|emhýk c} h`~f|tektc cre`hke| kf }fje`cktc }h cj th~f c}

tf|åmhmf }s~c|hf| mfk e}mck}f mjeyhmsje| x dc bf`l|f}* }hkfte`lhèk }h bex dhjetemhýk dhei|ea`åthme x yc|hihme| }h c}tecr~ek}hýk c} }fje`cktc ektc|hf| f te`lhèk c} jetc|ej x ~f}tc|hf|+^sc} }h kf je thckc }c dclc hk}tes|e|+

Ekfte|c`f} te`lhèk }h bex jf|df}h} mc|yhmej* th|egc mc|yhmej* usc}scjc yc|}c `sx i|cmscktc`cktc ck jf} khõf} mfk mf`~fkcktcbh~c|ushkèthmf+ Ackc|ej`cktc msekdf c}tå ~|c}cktc* c}tc th|egc}s~|emjeyhmsje| }c emf`~eõe dc tck}hýk dc `÷}msjf}c}tc|kfmjchdf`e}tfhdcf* dc c}mejckf}* ektc|hf|c} dcj mscjjf x

iemhejc}* usc kf }fk `å} usc cj cicmtf dc je tck}hýk creac|ede}fl|c tfde c}te `s}msjets|e x dcj cushjhl|hf ~f}ts|ej+



YEJF\EMHÝK MJÀKHME IFKFESDHFJFAHME7 Ck cj thc`~f c}~h|etf|hf yc|hihme|c`f} }h èkthckc je e~c|ts|e

c}tc|kf-mf}tej ej ihkej dc je c}~h|emhýk+ ]h bex `fyh`hcktf l|s}mfdcj dhei|eaè f dc jf} eldf`hkejc} ej hkhmhf dc je ifkemhýk* f }hbex }sgcmmhýk dc jf} `h}`f} ds|ektc cj thc`~f c}~h|etf|hf* c}dcmh| }h bex e~fxf+ Ekfte|c`f} }h c}tc e~fxf }c bemc ektc} dchkhmhe| je ifkemhýk jf msej c} mf||cmtf+ F ~f| cj mfkt|e|hf* cj~emhcktc jf bemc dc}~sè} dc belc| hkhmhedf je ifkemhýk* jf msej`å} usc e~fxf c} sk ljfuscf dc `s}msjets|e dhei|ea`åthmfeldf`hkej mfk je mfk}cmscktc e~e|hmhýk dc mfkt|emts|e} te`lhèke khycj dc je le}c dc mscjjf+

Ck yfw ~|fxcmtede }c dclc|å yhahje| mfk dctejjc }h bex |c}~h|emhýkhkyc|thde* c}tf c}* }h cj dhei|eaè c} c`~sgedf bemhe eisc|e ck

ycw dc h| bemhe edckt|f emf`~eõekdf je mfjs`ke dc eh|c+E~|cmhe|c`f} mý`f c} cj |ht`f x je i|cmsckmhe dc je |c}~h|emhýk+

I|cmsckmhe kf|èj7 5>-5< |c}~+&`hkstf+

Ej ih j d j d j h hý



Ej ihkej dcj cre`ck dc je |c}~h|emhýk|cah}t|e|c`f} skf} ~e|å`ct|f}

ec|fdhkå`hmf} usc kf} yek e }c|÷thjc} ~f|usc ~f| sk jedf* kf} dekhkif|`emhýk dc mý`f }c mfkgsaek je|c}~h|emhýk x je ifkemhýk* dýkdc c}tåcj iejjf ~|hkmh~ej`cktc x ~f| ft|f kf}}h|yck dc yejf| hkhmhej ~e|e mf`~e|e|jf} ~|fa|c}f} jfa|edf}* ck je dhkå`hme

|c}~h|etf|he+

C}te} `cdhde} ec|fdhkå`hme} }fk7



C}te} `cdhde} ec|fdhkå`hme} }fk7

@årh`f thc`~f dc c}~h|emhýk7 c} je ds|emhýk `århè ck}caskdf} "}c `hdc mfk m|fký`ct|f( usc cj ~emhcktc ~scdc h|

df}hihmekdf }s eh|c dh}~fkhljc ck ske c}~h|emhýk+ Jf} yejf|c}kf|èjc} }fk dc <>-=> }caskdf}+ Yejf|c} hkic|hf|c} hkdhmek iejtedc e~fxf x dc df`hkhf dcj }f~jf c}~h|etf|hf+

@årh`f thc`~f ifkemhýk7 c} cj èxf| thc`~f ~f}hljc* ck}caskdf}* usc cj ~emhcktc ~scdc }f}tckc| ske yfmej mfk yfw

mfk ske }fje c}~h|emhýk+ Jf} yejf|c} kf|èjc} dclck emc|me|}cej thc`~f dc c}~h|emhýk* ej|cdcdf| dc <> }caskdf}+

Mff|dhkemhýk ifkf-|c}~h|etf|he7 c} ske mf||cjemhýk usc kf} dhmcmý`f df}hihme cj ~emhcktc cj ijsgf eè|cf msekdf belje+

]c flthckc dhyhdhckdf cj thc`~f `årh`f dc c}~h|emhýk }fl|c cjthc`~f `årh`f dc ifkemhýk+ Cj mfmhcktc kf|èj dclc }c| hasej e5+ C}te|å `å} ~c|ts|lede ck tektf c}tc mfmhcktc }ce èxf| usc5+



M+ E|he} @e|}e+ Cre`ck Iskmhfkej Dc Je Ifkemhýk Dc Je Cr~jf|emhýk Ifkhåt|hme+ Le}c} ^e|e Je E~jhmemhýk Ck Jfaf~cde



btt~7&&qqq+}mhcjf+f|a+yc&}mhcjf+~b~6~hd0]5=53->5=2<>>9>>>5>>>>4)}m|h~t0}mhVe|ttcrt

http://www.scielo.org.ve/scielo.php?pid=S1315-01382006000100004&script=sci_arttext






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Cre`ck ~c|hýdhmf ifkfesdhfjýahmf dc je yfwmede 9 f 5< ` }ca÷k m|htc|hf dc cr~f}hmhýk+

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]H]TC@E DC ]CAS\HDED ]FMHEJ



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Jcah}jemhýk hktc|kemhfkej mfk



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<+ E+@+@ckdcw x G+]tf|khkh Mf`h}hýk Hkyc}thaem+Mhcktàihme L}+E}+




a ~C|afkf`àe

C\AFKF@HE7@hm|fc|afkf`àe

Cj ~sc}tf dc t|elegf

Je ekt|f~f`ct|àe x cj `flhjhe|hf7




a ~C|afkf`àe

C\AFKF@HESke ~|f~sc}te ~e|e cyejse| cj |hc}af dc

}fl|cme|ae dc je yfw ck cj dfmcktc7

‚^|f~sc}te dc sk `ètfdf dc cyejsemhýkdcj s}f dc je yfw ck je} esje}‐7 @ètfdf dccyejsemhýk dc je emthyhded yfmej-@ètfdf dcjKEY "Khycj dc Emthyhded Yfmej(+

Me|jf} ]jc`ck}fk+ \cyh}te ]ejsd Fms~emhfkej Eõf <=* K÷`c|f 84* Gsjhf- }cthc`l|c <>>3+




a ~C|afkf`àe

^\CYCKMHFK X ^\F@FMHFK DC JE]EJSD JELF\EJC] DC JF] ^\FIC]HFKEJC] DC JE YFW

CJ MSHDEDF DC JE YFW

5+ MSHDEDF DC JE YFW CK DFMCKTC]+

<+ MSHDEDF DC JE YFW CK MEKTEKTC]+=+ MSHDEDF DC JE YFW CK JFMSTF\C]+4+ MSHDEDF DC JE YFW CK TCJC@E\OCT]+

¶Usè }c ckthckdc ~f| bhahckc



yfmej6

Cktckdc|c`f} ~f| bhahckc yfmej tfdf}euscjjf} ~|fmcdh`hcktf} dh|hahdf} e~c|`hth| cj estfmshdedf dc je yfw*c}~cmhej`cktc ck euscjje} ~c|}fke} usc

bemck sk s}f ~|fic}hfkej dc je `h}è+ê|e jjcye| e melf ske edcmsede bhahckcyfmej c} kcmc}e|hf tckc| ck msckte ske}c|hc dc ~|cmesmhfkc} ~e|e cyhte| je

h||htemhýk x dc}ae}tc hk÷thj dc je} msc|de}yfmejc}* e÷k ck }htsemhfkc} ck usc kf }cbeae s}f dc je yfw+ "@e|mf Asw`åk ” qqq+yfw~|fic}hfkej+mj(

Dh}thkte} }htsemhfkc} dc èjmshdedf dc je yfw



mshdedf dc je yfw

Ske dc je} }htsemhfkc} `å} me|emtc|à}thme} usc`c|cmck ske edcmsede bhahckc yfmej jemfk}thtsxc je bh~c|iskmhýk yfmej f je|àkace"a|hte|* belje| e ejte hktck}hdedc}* ctm+(+ Jebh~c|iskmhýk je|àkace e}fmhede e sk els}f f èj

s}f yfmej de ~f| |c}sjtedf tà~hmf ejtc|emhfkc}~etfjýahme} je|àkace} "~f| cg+7 je|hkahth} m|ýkhme}*kýdsjf} x ~ýjh~f} yfmejc} x ÷jmc|e} dcmfktemtf(* ackc|ej`cktc dc th~f |cyc|}hljc}*msekdf mc}e je bh~c|iskmhýk je|àkace+ Cj èj s}f

dc je yfw* }sahc|c ske mfkdsmte dc ~|fdsmmhýkyfmej usc dh}tf|}hfke je ~|f~ck}hýk kf|èj dcj`cmekh}`f ifketf|hf ~e|e t|elege| cicmthye xcihmhcktc`cktc+ "@e|mf Asw`åk ” qqq+yfw~|fic}hfkej+mj(

Cihmhckmhe ifketf|he



Cihmhckmhe ifketf|he

Sk }h}tcè cihmhcktc* ~|fdsmc }s} `cgf|c}|c}sjtedf} mfk sk `àkh`f dc c}isc|wf+ E}à* sk}h}tcè ifketf|hf mfk mf`~fkcktc} hkdhyhdsejc}}ekf}* mff|dhkedf c hktc|emtsekdf mfk tfdf} jf}}h}tcè} dc e~fxf* ~|fdsmc je yfw ck if|ècihmhcktc+ Crh}tc sk k÷`c|f dc if|è} ck je} msejc}je }seyc f~c|emhýk dc je yfw ~scdc }c| ejtc|ede+ Jehktc|yckmhýk ck yfw dclc* ~sc}* hkmf|~f|e|~|fa|eè} usc exsdck ej ~emhcktc e hdckthihme| xcjh`hke| c}te} emthyhdedc} yfmejc}* me|emtc|hwede}~f| je bh~c|iskmhýk je|àkace+ ^f| jf tektf* }c bemc

kcmc}e|hf elf|de| ck je} ~c|}fke} mfk bh~c|iskmhýkyfmej* ~|fmcdh`hcktf} dc}thkedf} e dc}e||fjje| cjestfmshdedf yfmej* c} dcmh|* e ieyf|cmc| je bhahckcyfmej+ "@e|mf Asw`åk ” qqq+yfw~|fic}hfkej+mj(

@ejf} bålhtf}



Ft|e dc je} }htsemhfkc} me|emtc|à}thme} usc dc}ieyf|cmck je bhahckcyfmej* je mfk}thtsxck ejaskf} bålhtf} dc hkac}te dc ~|fdsmtf}h||htektc} x }cmektc} dc je `smf}e je|àkace* tejc} mf`f jf}mfkdh`cktf}* je} lclhde} ejmfbýjhme}* ejh`cktf} `sx mejhcktc} f`sx i|àf}* cj bålhtf dc isè|* me`lhf} l|s}mf} dc tc`~c|ets|e*a|hte| ej eh|c jhl|c* hkac}te dc ejh`cktf} usc ~|f`scyek jemfk}th~emhýk ckt|c ft|f}+

^f| ft|e ~e|tc* c} |cmf`ckdeljc fl}c|ye| je} }htsemhfkc} dceafte`hcktf kc|yhf}f* je iejte dc }scõf* cj dc}mfkt|fj c`fthyf* jeyhde eahtede* cj }t|c}}* ~sc}tf usc tfde} c}te} }htsemhfkc} ~scdck|cdskde| ihkej`cktc ck èjf} bålhtf} yfmejc}* sk èj mshdedfyfmej x* ~f| jf tektf* ske hkedcmsede bhahckc yfmej+

Sk |cush}htf yhtej* tektf ~e|e ske lscke `cdhde ~|cyckthye mf`f~e|e ske edcmsede |cbelhjhtemhýk yfmej ck ~emhcktc} eicmtedf} dcels}f f èj s}f yfmej* c} sk ~|fa|eè dc bhahckc yfmej+ Cj ~|h`c|flgcthyf dc c}tc ~|fa|eè c} ektc tfdf* hdckthihme| x jscaf cjh`hke|jf} iemtf|c} mes}ektc} dcj els}f f èj s}f yfmej+ "@e|mf Asw`åk

” qqq+yfw~|fic}hfkej+mj(

Kf|è} Ackc|ejc} dc Bhahckc yfmej Jh ht j thd d d th d b lj B lj j g t



Jh`hte| je mekthded dc thc`~f dc belje+ Beljc jf gs}tf xkcmc}e|hf* }fl|c tfdf }h }hcktc usc }s yfw }c mek}e mfk iemhjhded+

Kf if|we| je yfw ck }htsemhfkc} dc `smbf |shdf e`lhcktej+ Cyhte| a|htf} c h`htemhýk dc }fkhdf} fkfètf~èxhmf}+ Msàdc}c dc jf} msed|f} mete||ejc} x cj |cijsgf ae}t|fc}fiåahmf+ Cj |cijsgf ~scdc deõe| a|eyc`cktc }s je|hkac x eicmte| je

~|fdsmmhýk dc je yfw+ Cyhtc belje| dc èkc|e ~|fjfkaede e je|ae dh}tekmhe x ck cj

crtc|hf|+ Kf mektc `å} ejjå dc je aeè ck usc }c ckmsckt|c mý`fdf+ Cyhte| tf}c| f emje|e| je yfw "me||e}~ce|( crmc}hye`cktc+ C}tc

emtf ~scdc deõe| jf} ~jhcasc} yfmejc}* ck jsae| dc cjjf tfè|ease+

Kf beljc `smbf ds|ektc sk cgc|mhmhf ià}hmf eaftedf|+ Cyhtc mf`hde} ~hmektc} "Egh* `f}tewe* ~h`hckte* ctm+( }fl|c tfdf

}h thckc |cijsgf ae}t|fc}fiåahmf+

Kf|è} Ackc|ejc} dc Bhahckc yfmej \cejhmc |c~f}f yfmej dc}~sè} dc ske gf|kede dc a|ek s}f dc }s



\cejhmc |c~f}f yfmej dc}~sè} dc ske gf|kede dc a|ek s}f dc }syfw+

Beae cgc|mhmhf mfk |casje|hded+ Mfè ske dhcte lejekmcede* hkmjsxckdf ycactejc}* i|ste} x a|ekf}

cktc|f}+ @ektckae ske ~f}ts|e mf|~f|ej edcmsede `hckt|e} bemc s}f dc }s

yfw+ ^f}ts|e} hkedcmsede} ~|fdsmck mf`~ck}emhfkc} `s}msje|c}usc ~scdck eicmte| e je wfke mc|yhmej x je|àkace+

Kf ~fkae ck tck}hýk je ~e|tc ejte dc }s tý|er+ Kf e~|hctc jf} dhcktc} kh tck}c je èkdàlsje f je jckase+

Kf isè| "isè| c} skf dc jf} iemtf|c} ~|hkmh~ejc} ck je if|èmhýkdc måkmc| je|àkacf* edc`å} h||hte je} msc|de} yfmejc} x je} |c}cme( \ht`f |casje| x c}teljc dc }scõf+ Kf s}e| ekc}tè}hmf} jfmejc}* kh e}~h|hke ~|cyhf e emtsemhýk+ Yfmejhmc ~|cyhf e je emtsemhýk* kf mektc kh beljc ,ck i|hf,+ \cejhwe|

cgc|mhmhf} dc mejckte`hcktf yfmej ektc} dc mekte| f dc belje|+ Cyhtc e`lhcktc} `sx }cmf}* mfk crmc}hye mejciemmhýk f eh|c

emfkdhmhfkedf+ C}tf dh}`hksxc je bhd|etemhýk dc je} msc|de}yfmejc} Tfè| ej `ckf} < jht|f} dc ease ~f| dàe "ckt|c 2 x 5> ye}f} ~f|

dàe(+ Jf} ~jhcasc} yfmejc} kcmc}htek c}te| jsl|hmedf} mfk ske me~edcjaede dc `fmf ~e|e ~fdc| yhl|e| cihmhcktc`cktc+ Je `cgf|jsl|hmemhýk ~scdc jfa|e|}c tfèkdf le}tektc ease+

Cyhte| belje| dcè}hedf |å~hdf+

Kf|è} Ackc|ejc} dc Bhahckc yfmej Cyhte| |cà| e me|megede}+



Kf mekte| }fl|c a|elemhfkc} dc mektektc}+ Bemc| c}tf thckdc ebemc| usc h`htc`f} je if|è dc c`hth| dc ft|f} mektektc}+

Cyhte| tfè| ejmfbfj kh meiè xe usc cj ejmfbfj x je meicàkedc}bhd|etek je} msc|de} yfmejc}+

Cyhte| belje| dcè}hedf isc|tc xe usc ~scdc t|esèthwe| je}msc|de} yfmejc}+ Ck cj me}f dc tckc| usc sthjhwe| je yfw beljedemfk khycjc} ejtf} dc hktck}hded |cejhwe| ckt|cke`hcktf

ifkfesdhfjýahmf+ Kf }s}s||e|+ ^|fyfme tck}hýk ck je je|hkac+

Ektc cj `ckf| }àktfè dc me`lhf dc }s mejhded yfmej "CG7 yfwf~eme* ~è|dhde dc kfte} easde} x&f a|eyc}* ushcl|c} dc yfw*~|fljcè} mfk cj yhl|etf* e~e|hmhýk dc |shdf ck je c`h}hýk*

~è|dhde dc yfjs`ck* mek}ekmhf yfmej* dfjf|* h||htemhýk* ctm(mfk}sjte| hk`cdhete`cktc e sk F+\+J+ x ifkfesdhýjfaf+

Kf h`hte| yfmc}* c}tf ~scdc ~|fdsmh| bh~c|iskmhýk f bh~fiskmhýkx ~f}tc|hf|`cktc jc}hýk f|aåkhme ck je} msc|de} yfmejc}+ ]h }cdclc h`hte| yfmc} ~|fic}hfkej`cktc mf`f ~f| cgc`~jf ck

dfljegc} |cejhwe| ckt|cke`hcktf yfmej+

Kf|è} Ackc|ejc} dc Bhahckc yfmej Cyhte| å|ce} ~fjyf|hckte} x mfk `smbf bs`f



Cyhte| å|ce} ~fjyf|hckte} x mfk `smbf bs`f+C}tf h||hte x dc}bhd|ete }s} msc|de} yfmejc}+

Cyhte| c}tedf} dc kc|yhf}h}`f+ Je yfw c}tådh|cmte`cktc |cjemhfkede mfk je} c`fmhfkc}+

Kf sthjhwe| dc}mfkac}thfkektc}* ekthbh}te`àkhmf}f iå|èmf} kf ~|c}m|h~tf} ~f| cj `èdhmf+Ejaskf} `cdhme`cktf} ~scdck ~|fdsmh|

dc}bhd|etemhýk ck je} msc|de} yfmejc}+ ]h sthjhwe }s yfw ck cj t|elegf f ck ft|e}emthyhdedc} |cejhwe| ckt|cke`hcktf mfkifkfesdhýjfaf+

Ektc ske dh}ifkàe dc `å} dc ske }cèke dcds|emhýk mfk}sjtc hk`cdhete`cktc ej F+\+J+

Cyhtc tc`~c|ets|e} crt|cè}7 eh|c `sx i|àf ý`sx mejhcktc+ Sthjhmc sk bs`cdhihmedf| ck je}kfmbc}+

Kf|è} Ackc|ejc} dc Bhahckc yfmej ]h belje ektc sk esdhtf|hf a|ekdc sthjhmc sk `hm|ýifkf



]h belje ektc sk esdhtf|hf a|ekdc sthjhmc sk `hm|ýifkf*beljc dc}~emhf x e|thmsjekdf lhck je} ~ejel|e}+

Je} `sgc|c} dclck jh`hte| ck jf ~f}hljc cj s}f dc jeyfw ektc} x ds|ektc }s mhmjf `ck}t|sej+

Cyhtc jf} usà`hmf}* ~hkts|e} x e|tàmsjf} dc jh`~hcwe+ ]hdclc s}e|jf} mfjýusc}c sk te~elfme} usc msl|e jeke|hw x je lfme+

]h kcmc}hte jje`e|jc je etckmhýk e ejashck* s}c }fkhdf}kf yfmejc} tejc} mf`f e~jesdh|* me`~eke}* mbhije|+

Emè|usc}c `å} bemhe je ~c|}fke mfk ushck c}tåbeljekdf+

@h|c me|e e me|e bemhe je ~c|}fke"}( mfk ushck c}tåbeljekdf+

Mfkt|fj ~c|hýdhmf mfk Ifkfesdhýjfaf+

\cmhle ckt|cke`hcktf yfmej mfk Ifkfesdhýjfaf+





@smbe} a|emhe}…

Kede c} `å} kcmc}e|hf usc je yc|ded x* mfk|cjemhýk e cjje* tfdf jf dc`å} kf thckc `å}usc sk yejf| dc }caskdf f|dck+ - Khctwmbc

D|+ GSEK GF]È YC\AE\E ]C\ÊIFKFESDHÝJFAF SKHYC\]HDED DC ]SM\C

]CAS\HDED HKDS]T\HEJ X ]EJSD FMSÊMHFKEJ S^L

C- gsekyc|ae|e}c|~eNbftèhj+mf`

Mcjsje|7 =5><3>53=3

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generalidades y fisiologÍa vocal en las disfonÍas de origen profesional

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