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Frosolini A, Fantin F, Tundo I, Pessot N, Badin G, Bartolotta P, Vedovelli L, Marioni G, de Filippis C. Voice Parameters in Children With Cochlear Implants: A Systematic Review and Meta-Analysis. J Voice 2023:S0892-1997(23)00021-8. [PMID: 36868956 DOI: 10.1016/j.jvoice.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 03/05/2023]
Abstract
INTRODUCTION An intact auditory system is essential for the development and maintenance of voice quality and speech prosody. On the contrary hearing loss affects the adjustments and appropriate use of organs involved in speech and voice production. Spectro-acoustic voice parameters have been evaluated in Cochlear Implant (CI) users, and the authors of previous systematic reviews on the topic concluded that fundamental frequency (F0) seemed preliminarily the most reliable parameter to evaluate voice alterations in adult CI users. The main aim of this systematic review and meta-analysis was to clarify the vocal parameters and prosodic alterations of speech in pediatric CI users. MATERIALS AND METHODS The protocol of the systematic review was registered on the PROSPERO database, International prospective register of systematic reviews. We conducted a search of the English literature published in the period between January 1, 2005 and April 1, 2022 on the Pubmed and Scopus databases. A meta-analysis was conducted to compare the values of voice acoustic parameters in CI users and non-hearing-impaired controls. The analysis was conducted using the standardized mean difference as the outcome measure. A random-effects model was fitted to the data. RESULTS A total of 1334 articles were initially evaluated using title and abstract screening. After applying inclusion/exclusion criteria, 20 articles were considered suitable for this review. The age of the cases ranged between 25 and 132 months at examination. The most studied parameters were F0, Jitter, Shimmer and Harmonics-to-Noise Ratio (HNR); other parameters were seldom reported. A total of 11 studies were included in the meta-analysis of F0, with the majority of estimates being positive (75%); the estimated average standardized mean difference based on the random-effects model was 0.3033 (95% CI: 0.0605 to 0.5462; P = 0.0144). For Jitter (0.2229; 95% CI: -0.1862 to 0.7986; P = 0.2229) and shimmer (0.2540; 95% CI: -0.1404 to 0.6485; P = 0.2068) there was a trend toward positive values without reaching statistical significance. DISCUSSION AND CONCLUSIONS This meta-analysis confirmed that higher F0 values have been observed in the pediatric population of CI users compared to age-matched normal hearing volunteers, whereas the parameters of voice noise were not significantly different between cases and controls. Prosodic aspects of language need further investigations. In longitudinal contexts, prolonged auditory experience with CI has brought voice parameters closer to the norm. Following the available evidence, we stress the utility of inclusion of vocal acoustic analysis in the clinical evaluation and follow-up of CI patients to optimize the rehabilitation process of pediatric patients with hearing loss.
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Affiliation(s)
- Andrea Frosolini
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy; Department of Maxillo-Facial Surgery, Policlinico Le Scotte, University of Siena, Siena, Italy.
| | - Francesco Fantin
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy
| | - Isabella Tundo
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy; Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", ENT Section, A.O.U. Policlinico "G.Rodolico-San Marco", University of Catania, Catania, Italy
| | - Nicholas Pessot
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy
| | - Giulio Badin
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy; Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Patrizia Bartolotta
- Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, Unit of Biostatistics, University of Padova, Padova, Italy
| | - Luca Vedovelli
- Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, Unit of Biostatistics, University of Padova, Padova, Italy
| | - Gino Marioni
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Cosimo de Filippis
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy
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Arias-Vergara T, Batliner A, Rader T, Polterauer D, Högerle C, Müller J, Orozco-Arroyave JR, Nöth E, Schuster M. Adult Cochlear Implant Users Versus Typical Hearing Persons: An Automatic Analysis of Acoustic-Prosodic Parameters. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4623-4636. [PMID: 36417788 DOI: 10.1044/2022_jslhr-21-00116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE The aim of this study was to investigate the speech prosody of postlingually deaf cochlear implant (CI) users compared with control speakers without hearing or speech impairment. METHOD Speech recordings of 74 CI users (37 males and 37 females) and 72 age-balanced control speakers (36 males and 36 females) are considered. All participants are German native speakers and read Der Nordwind und die Sonne (The North Wind and the Sun), a standard text in pathological speech analysis and phonetic transcriptions. Automatic acoustic analysis is performed considering pitch, loudness, and duration features, including speech rate and rhythm. RESULTS In general, duration and rhythm features differ between CI users and control speakers. CI users read slower and have a lower voiced segment ratio compared with control speakers. A lower voiced ratio goes along with a prolongation of the voiced segments' duration in male and with a prolongation of pauses in female CI users. Rhythm features in CI users have higher variability in the duration of vowels and consonants than in control speakers. The use of bilateral CIs showed no advantages concerning speech prosody features in comparison to unilateral use of CI. CONCLUSIONS Even after cochlear implantation and rehabilitation, the speech of postlingually deaf adults deviates from the speech of control speakers, which might be due to changed auditory feedback. We suggest considering changes in temporal aspects of speech in future rehabilitation strategies. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21579171.
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Affiliation(s)
- Tomás Arias-Vergara
- Department of Otorhinolaryngology and Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
- Faculty of Engineering, Universidad de Antioquia, Medellín, Colombia
- Pattern Recognition Lab, Friedrich-Alexander University, Erlangen-Nuremberg, Germany
| | - Anton Batliner
- Pattern Recognition Lab, Friedrich-Alexander University, Erlangen-Nuremberg, Germany
- Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Germany
| | - Tobias Rader
- Department of Otorhinolaryngology and Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
| | - Daniel Polterauer
- Department of Otorhinolaryngology and Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
| | - Catalina Högerle
- Department of Otorhinolaryngology and Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
| | - Joachim Müller
- Department of Otorhinolaryngology and Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
| | - Juan-Rafael Orozco-Arroyave
- Faculty of Engineering, Universidad de Antioquia, Medellín, Colombia
- Pattern Recognition Lab, Friedrich-Alexander University, Erlangen-Nuremberg, Germany
| | - Elmar Nöth
- Pattern Recognition Lab, Friedrich-Alexander University, Erlangen-Nuremberg, Germany
| | - Maria Schuster
- Department of Otorhinolaryngology and Head and Neck Surgery, Ludwig Maximilians University of Munich, Germany
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Myszel K, Szkiełkowska A. Quality of Voice in Patients With Partial Deafness Before and After Cochlear Implantation. J Voice 2022:S0892-1997(22)00138-2. [PMID: 35667987 DOI: 10.1016/j.jvoice.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022]
Abstract
Partial deafness is a condition characterised by normal hearing thresholds in low frequencies and increased hearing thresholds (nearly deafness) for high frequencies. Typical hearing aids are rather of a very limited use in this condition as they do not improve understanding of speech. Patients with partial deafness can be presently treated with cochlear implants, which had not been used before due to the risk of damage of hearing remains by electrode introduced into cochlea. The purpose of our study was an objective and subjective assessment of voice quality in partial deafness patients before and after cochlear implantation. The subjects in this study were 25 post-lingual, bilaterally partially deaf patients, 13 females and 12 males. The reference group composed of 55 normal hearing individuals (28 females and 27 males). The acoustic analysis was performed with a multidimensional voice analysis MDVP (Multi Dimension Voice Program), and the subjective assessment was done with GRBAS scale. Initial analysis of voice changes in partial deafness patients was performed versus normal hearing individuals, then voice parameters were measured and perceptual voice assessment was done before and 9 months after cochlear implantation. Measurements of acoustic voice parameters in partially deaf patients showed changes in most of frequency, amplitude, noise and subharmonic components versus normal hearing control group. The most significant, statistically important changes were observed in fundamental frequency variation (vF0), absolute jitter (Jita), jitter percent (Jitt), amplitude perturbation quotient (APQ), smoothed amplitude perturbation quotient (sAPQ), relative average perturbation (RAP), peak amplitude variation (vAm), relative amplitude modulation (Shim), percent shimmer (%Shim), pitch perturbation quotient (PPQ), smoothed pitched perturbation quotient (sPPQ), degree of subharmonics (DSH), degree of voiceless (DUV), number of subharmonic segments (NSH), noise-to-harmonic ratio (NHR), voice turbulence index (VTI). All patients in the study group were subjects to cochlear implantation. After 9 months objective and subjective assessment of patients` voices were performed again. Statistically important changes were identified in average fundamental frequency variability (vF0), relative amplitude modulation index (ShdB), noise-to-harmonic ratio (NHR), number of subharmonics NSH, degree of subharmonics (DSH) and the degree of voiceless (DUV). Comparison of the objective voice parameters changes after cochlear implantation with subjective, perceptual voice quality assessments leads to observation, that improvement of subjective voice quality after cochlear implantation takes place parallelly with improvement of certain objective acoustic voice parameters and some correlations exist. We found, that G correlates with vF0 and Shim, R correlates with DSH and NSH, B correlates with NSH and NHR, A correlates with DUV. We did not prove correlation of S with any of the objective parameters in our research group. Our study proved, that acoustic and perceptual features of voice in partially deaf adults are different than in normally hearing people and cochlear implantation in partial deafness patients is an effective tool to improve hearing and leads to improvement of the acoustic structure of the voice.Partial deafness is a condition characterised by normal hearing thresholds in low frequencies and increased hearing thresholds (nearly deafness) for high frequencies. Typical hearing aids are rather of a very limited use in this condition as they do not improve understanding of speech. Patients with partial deafness can be presently treated with cochlear implants, which had not been used before due to the risk of damage of hearing remains by electrode introduced into cochlea. The purpose of our study was an objective and subjective assessment of voice quality in partial deafness patients before and after cochlear implantation. The subjects in this study were 25 post-lingual, bilaterally partially deaf patients, 13 females and 12 males. The reference group composed of 55 normal hearing individuals (28 females and 27 males). The acoustic analysis was performed with a multidimensional voice analysis MDVP (Multi Dimension Voice Program), and the subjective assessment was done with GRBAS scale. Initial analysis of voice changes in partial deafness patients was performed versus normal hearing individuals, then voice parameters were measured and perceptual voice assessment was done before and 9 months after cochlear implantation. Measurements of acoustic voice parameters in partially deaf patients showed changes in most of frequency, amplitude, noise and subharmonic components versus normal hearing control group. The most significant, statistically important changes were observed in fundamental frequency variation (vF0), absolute jitter (Jita), jitter percent (Jitt), amplitude perturbation quotient (APQ), smoothed amplitude perturbation quotient (sAPQ), relative average perturbation (RAP), peak amplitude variation (vAm), relative amplitude modulation (Shim), percent shimmer (%Shim), pitch perturbation quotient (PPQ), smoothed pitched perturbation quotient (sPPQ), degree of subharmonics (DSH), degree of voiceless (DUV), number of subharmonic segments (NSH), noise-to-harmonic ratio (NHR), voice turbulence index (VTI). All patients in the study group were subjects to cochlear implantation. After 9 months objective and subjective assessment of patients` voices were performed again. Statistically important changes were identified in average fundamental frequency variability (vF0), relative amplitude modulation index (ShdB), noise-to-harmonic ratio (NHR), number of subharmonics NSH, degree of subharmonics (DSH) and the degree of voiceless (DUV). Comparison of the objective voice parameters changes after cochlear implantation with subjective, perceptual voice quality assessments leads to observation, that improvement of subjective voice quality after cochlear implantation takes place parallelly with improvement of certain objective acoustic voice parameters and some correlations exist. We found, that G correlates with vF0 and Shim, R correlates with DSH and NSH, B correlates with NSH and NHR, A correlates with DUV. We did not prove correlation of S with any of the objective parameters in our research group. Our study proved, that acoustic and perceptual features of voice in partially deaf adults are different than in normally hearing people and cochlear implantation in partial deafness patients is an effective tool to improve hearing and leads to improvement of the acoustic structure of the voice.
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Affiliation(s)
| | - Agata Szkiełkowska
- Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
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Zamani P, Bayat A, Saki N, Ataee E, Bagheripour H. Post-lingual deaf adult cochlear implant users' speech and voice characteristics: cochlear implant turned-on versus turned-off. Acta Otolaryngol 2021; 141:367-373. [PMID: 33461389 DOI: 10.1080/00016489.2020.1866778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND A time-period of turning off cochlear implant (CI) might affect the speech and voice features of the CI users due to loss of auditory feedback monitoring. OBJECTIVES To evaluate Persian-speaking CI users' speech and voice parameters in a device-on/off experiment. MATERIAL AND METHODS Forty-eight Persian-speaking adults with post-linguistic deafness who had received a unilateral CI and 50 normally-hearing counterparts were recruited. All CI users had to fulfill three phases of speech sampling, including the device-on, device-off (a 5-hourly period), and once again device-on phase. Their Fundamental frequency, Jitter, Shimmer, Harmonics-to-noise ratio, hyper-nasality score, and the percentage of speech intelligibility were assessed for both groups. RESULTS The findings revealed that the CI-on/off conditions significantly changed cochlear implanted participants' F0, Shimmer, HNR, and hyper-nasality values. However, no statistical differences were observed in Jitter and the percentage of speech intelligibility between the CI and control groups. CONCLUSIONS A short-term auditory deprivation in CI recipients could degrade the speech and voice quality in CI users, so that could change the quality of their speech resonance into hyper-nasality. However, when the CIs were turned on again, the quality of their speech and voice returned to normal-sounding.
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Affiliation(s)
- Peyman Zamani
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Speech Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arash Bayat
- Department of Audiology, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nader Saki
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elahe Ataee
- Department of Speech Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Bagheripour
- Department of Speech Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Graf S, Bungenstock A, Richter L, Unterhofer C, Gruner M, Hartmann P, Hoyer P. Acoustically Induced Vocal Training for Individuals With Impaired Hearing. J Voice 2021; 37:374-381. [PMID: 33632556 DOI: 10.1016/j.jvoice.2021.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/24/2021] [Accepted: 01/26/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES/HYPOTHESIS Articulation, phonation, and resonance disorders in the speech of hearing-impaired-speakers reduces intelligibility. The study focusses on (1) whether nonacoustic feedback may facilitate the adjustment of the vocal tract, leading to increased vocal tract resonance, and (2) whether training with the feedback would be helpful for the subsequent formation of vowels. STUDY DESIGN Prospective. METHODS Seven profoundly hearing-impaired participants used acoustic sound waves in the frequency range of the first two vocal tract resonances applied in front of the open mouth at intensities above 1 Pa. They were asked to amplify the sound via adjusting the vocal tract. The sound waves corresponded to the first and second resonance frequencies of the vowels [u], [o], and [a]. The self-assessment of the participants and a software-based/auditory analysis was reported. RESULTS The participants were able to enhance the acoustic signal by adjusting the vocal tract shape. The self-perception of the participants, the auditory voice analysis, and the acoustic analysis of vowels were consistent with each other. While the maximum sound pressure levels were constant, the mean sound pressure levels increased. Breathiness and hoarseness declined during the exercises. Resonance/harmonic-to-noise ratio increased, especially for the vowels [u], [o], [a]. Furthermore, the positively connoted feedback from the participants indicated easier sound production. CONCLUSION Nonauditory feedback, based on acoustic waves, could be suitable for improving the formation of vowels. The findings are in accordance with a reduction of acoustic losses within the vocal tract.
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Affiliation(s)
- Simone Graf
- Department of Otorhinolaryngology/Phoniatrics, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - Anna Bungenstock
- Department of Otorhinolaryngology/Phoniatrics, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - Lena Richter
- Department of Otorhinolaryngology/Phoniatrics, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - Carmen Unterhofer
- Department of Otorhinolaryngology/Phoniatrics, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - Michael Gruner
- Fraunhofer Application Center for Optical Metrology and Surface Technologies (AZOM), Zwickau, Germany and West Saxon University of Applied Sciences, Zwickau, Germany
| | - Peter Hartmann
- Fraunhofer Application Center for Optical Metrology and Surface Technologies (AZOM), Zwickau, Germany and West Saxon University of Applied Sciences, Zwickau, Germany
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Coprevalence of Presbycusis and Its Effect on Outcome of Voice Therapy in Patients With Presbyphonia. J Voice 2020; 36:877.e9-877.e14. [PMID: 33067119 DOI: 10.1016/j.jvoice.2020.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/28/2020] [Accepted: 09/30/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To identify the coprevalence of presbycusis and presbycusis and analyze the effect of presbycusis on compliance and result of voice therapy in presbycusis patients. METHODS This cross-sectional, prospective cohort study initially screened patients aged ≥65 years who visited our hospital from February 2019 to January 2020. Unaided pure tone audiometry was performed in these subjects to determine the presence of presbycusis. Perceptual voice assessment by an examiner was conducted for screening of presbycusis, and its diagnosis was confirmed through the voice handicap index-10 (VHI-10) questionnaire and a laryngoscopic exam. Patients with presbycusis underwent voice therapy and were assessed for their compliance and outcomes of the treatment according to the coexistence of presbycusis. RESULTS Among the 221 patients, presbycusis and presbycusis were diagnosed in 125 (56.6%) and 110 (49.8%) patients, respectively. The copresence of these two disorders were identified in 87 (39.4%) patients, and there was a significant correlation between presbycusis and presbycusis. The effects of voice therapy were examined in the consecutive 40 patients who were diagnosed with presbycusis. There were 21 patients without presbycusis and 19 patients with presbycusis. The average pretreatment voice handicap index-10 score was significantly higher in presbycusis patients; there was no significant difference in the incidence of dropout from voice therapy between the groups. The patients without presbycusis showed a significant improvement in the functional communication measurement (FCM) level and maximum phonation time (MPT) compared with those of patients with presbycusis after voice therapy. CONCLUSIONS Presbyphonia and presbycusis coexisted in many elderly people. The improvement in the FCM level and MPT after voice therapy was relatively low if patients with presbycusis accompanied by presbycusis. The copresence of presbycusis did not significantly affect compliance with voice therapy in the patients.
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Moradi V, Farahani S, Fatahi F, Mohebbi S, Emamdjomeh H. Can Pitch Mismatch Be Diagnosed in Children Who Use Electric-Acoustic Stimulation? Cureus 2020; 12:e10338. [PMID: 33052297 PMCID: PMC7546602 DOI: 10.7759/cureus.10338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Pitch mismatch is one of the most important problems of users of bimodal cochlear implants, which affects their life satisfaction. Children with acquired hearing loss cannot explain their pitch mismatch problems, as they have had no auditory experience. This study tries to diagnose pitch mismatch in these children through the sound-induced flash illusion test. Materials and methods In this study, 20 children with a bimodal cochlear implant and 20 children with normal hearing, within the age range of 8 to 13 years old, were examined using the sound-induced flash illusion test. In this test, participants received one flash with one to four beep sounds, and they were asked to indicate the number of perceived flashes. Results The results revealed that in the bimodal implantation group, when the flash was provided with one beep, at certain frequencies, children expressed that they saw two flashes. However, the results were not the same in children with normal hearing. Conclusion The results indicated that at frequencies where the auditory information of the hearing aids and those of the cochlear implants overlap, pitch mismatch develops, which can significantly affect the auditory performance of bimodal users.
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Affiliation(s)
- Vahid Moradi
- Department of Audiology, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Tehran, IRN
| | - Saeid Farahani
- Department of Audiology, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Tehran, IRN
| | - Farzaneh Fatahi
- Department of Audiology, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Tehran, IRN
| | - Saleh Mohebbi
- Skull Base Research Center, the Five Senses Institute, Iran University of Medical Sciences, Tehran, IRN.,ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, IRN
| | - Hessam Emamdjomeh
- ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, IRN
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Saki N, Bayat A, Nikakhlagh S, Zamani P, Khaleghi A, Karimi M, Dastoorpoor M. Acoustic Voice Analysis in Postlingual Deaf Adult Cochlear Implant Users: A Within-Group Comparison Study. J Voice 2020; 36:439.e1-439.e8. [DOI: 10.1016/j.jvoice.2020.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/10/2020] [Accepted: 06/10/2020] [Indexed: 10/23/2022]
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van de Velde DJ, Frijns JHM, Beers M, van Heuven VJ, Levelt CC, Briaire J, Schiller NO. Basic Measures of Prosody in Spontaneous Speech of Children With Early and Late Cochlear Implantation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:3075-3094. [PMID: 30515513 DOI: 10.1044/2018_jslhr-h-17-0233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 07/05/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE Relative to normally hearing (NH) peers, the speech of children with cochlear implants (CIs) has been found to have deviations such as a high fundamental frequency, elevated jitter and shimmer, and inadequate intonation. However, two important dimensions of prosody (temporal and spectral) have not been systematically investigated. Given that, in general, the resolution in CI hearing is best for the temporal dimension and worst for the spectral dimension, we expected this hierarchy to be reflected in the amount of CI speech's deviation from NH speech. Deviations, however, were expected to diminish with increasing device experience. METHOD Of 9 Dutch early- and late-implanted (division at 2 years of age) children and 12 hearing age-matched NH controls, spontaneous speech was recorded at 18, 24, and 30 months after implantation (CI) or birth (NH). Six spectral and temporal outcome measures were compared between groups, sessions, and genders. RESULTS On most measures, interactions of Group and/or Gender with Session were significant. For CI recipients as compared with controls, performance on temporal measures was not in general more deviant than spectral measures, although differences were found for individual measures. The late-implanted group had a tendency to be closer to the NH group than the early-implanted group. Groups converged over time. CONCLUSIONS Results did not support the phonetic dimension hierarchy hypothesis, suggesting that the appropriateness of the production of basic prosodic measures does not depend on auditory resolution. Rather, it seems to depend on the amount of control necessary for speech production.
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Affiliation(s)
- Daan J van de Velde
- Leiden University Centre for Linguistics, the Netherlands
- Leiden Institute for Brain and Cognition, the Netherlands
| | - Johan H M Frijns
- Leiden Institute for Brain and Cognition, the Netherlands
- Leiden University Medical Center, the Netherlands
| | - Mieke Beers
- Leiden University Medical Center, the Netherlands
| | - Vincent J van Heuven
- Department of Hungarian and Applied Linguistics, Pannon Egyetem, Veszprém, Hungary
| | - Claartje C Levelt
- Leiden University Centre for Linguistics, the Netherlands
- Leiden Institute for Brain and Cognition, the Netherlands
| | | | - Niels O Schiller
- Leiden University Centre for Linguistics, the Netherlands
- Leiden Institute for Brain and Cognition, the Netherlands
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Tejeda-Franco CD, Valadez-Jimenez VM, Hernandez-Lopez X, Ysunza PA, Mena-Ramirez ME, Garcia-Zalapa RA, Miranda-Duarte A. Hearing Aid Use and Auditory Verbal Therapy Improve Voice Quality of Deaf Children. J Voice 2018; 34:301.e7-301.e11. [PMID: 30224309 DOI: 10.1016/j.jvoice.2018.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Adequate phonation is self-regulated by auditory feedback. Children with bilateral profound hearing loss (PHL) lack this feedback resulting in abnormal voice. Adequate hearing aid use and auditory-verbal therapy (AVT) may improve voice quality in deaf children. OBJECTIVE To study whether hearing aid use and AVT approach improve acoustic parameters of voice of children with bilateral PHL. MATERIALS AND METHODS Nineteen children with bilateral PHL were studied. Age range 2-5 years (X = 53.04 months; SD = 9.54). All children were fitted with hearing aids according to auditory testing and they underwent a 1-year auditory habilitation period using the AVT approach. Acoustic analysis of voice including F0, shimmer, and jitter was performed at the onset and at the end of the auditory habilitation period. Final acoustic data were compared to a matched control group of 19 children, age range 2-5 years (X = 52.85; SD = 9.74) with normal hearing. RESULTS Mean fundamental frequency (F0) was significantly increased after AVT intervention. Shimmer and jitter significantly (P < 0.05) improved after the intervention period. However, despite the improvements, mean F0 at the end of the intervention period was still significantly (P < 0.05) decreased as compared to controls. Also, mean shimmer and jitter at the end of the habilitation period were still significantly (P < 0.05) higher as compared to controls. CONCLUSIONS The results of this preliminary study suggest that hearing aid use and auditory habilitation with AVT approach improved acoustic voice parameters of children with PHL. However, acoustic parameters persisted abnormal as compared to matched normal hearing controls. AVT approach and regular hearing aid use seem to be safe and reliable clinical tools for improving voice quality of children with PFL.
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Affiliation(s)
| | - Victor M Valadez-Jimenez
- Department of Phoniatrics, National Institute of Rehabilitation (INR) "Luis Guillermo Ibarra", Mexico City, Mexico
| | - Xochiquetzal Hernandez-Lopez
- Department of Phoniatrics, National Institute of Rehabilitation (INR) "Luis Guillermo Ibarra", Mexico City, Mexico
| | - Pablo Antonio Ysunza
- Department of Phoniatrics, National Institute of Rehabilitation (INR) "Luis Guillermo Ibarra", Mexico City, Mexico; Department of Speech and Language Pathology, Beaumont Hospital, Royal Oak, MI.
| | - Maria E Mena-Ramirez
- Department of Audiology, National Institute of Rehabilitation (INR), "Luis Guillermo Ibarra", Mexico City, Mexico
| | - Ricardo A Garcia-Zalapa
- Department of Phoniatrics, National Institute of Rehabilitation (INR) "Luis Guillermo Ibarra", Mexico City, Mexico
| | - Antonio Miranda-Duarte
- Department of Research, National Institute of Rehabilitation (INR), "Luis Guilermo Ibarra", Mexico City, Mexico
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Yüksel M, Gündüz B. Long-term Average Speech Spectra of Postlingual Cochlear Implant Users. J Voice 2018; 33:255.e19-255.e25. [PMID: 29329722 DOI: 10.1016/j.jvoice.2017.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022]
Abstract
Long term average speech spectra (LTASS) is a commonly used voice analysis method for different purposes. This method offers an acoustic representation of the language in daily conservations. Results of that method can be altered by the deteriorations in the auditory feedback loop. Hearing losses occurred in the post lingual stage of life have some serious negative effects on the auditory feedback loop. Cochlear implantation may help these patients with regards to auditory feedback loop. Therefore, we aimed to evaluate the LTASS of cochlear implant users whose have a post lingual hearing loss. We assessed the LTASS of 24 cochlear implant users and compared our findings with normal hearing subjects. Our findings revealed that cochlear implant users have similar LTASS findings with normal hearing subjects. We conclude that cochlear implantation helps to the recovery of auditory feedback loop in patients with post lingual hearing losses.
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Affiliation(s)
- Mustafa Yüksel
- Audiology, Marmara University, Fevzi Cakmak Mah., Pendik, Turkey.
| | - Bülent Gündüz
- Audiology, Marmara University, Fevzi Cakmak Mah., Pendik, Turkey
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Preoperative voice parameters affect the postoperative speech intelligibility in patients with cochlear implantation. Clin Exp Otorhinolaryngol 2012; 5 Suppl 1:S69-72. [PMID: 22701152 PMCID: PMC3369987 DOI: 10.3342/ceo.2012.5.s1.s69] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 12/06/2011] [Accepted: 01/19/2012] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Verbal communication depends on a good function of voice and speech organs. Some of the voice characteristics of deaf people differ considerably from those of speakers with normal hearing. After cochlear implantation (CI), auditory control of voice production is possible and the quality of the voice is improved. CI improves quality of voice, speech and hearing with deafness. The aim of our study was to investigate the relationship between acoustic analysis before CI and the speech intelligibility before and after CI. METHODS Twelve prelingually deafened children implanted unilaterally at the age of 3.4-9 years were included in the study. For all of the children an acoustic analysis of the Slovene vowel 'a' was performed before CI. The fundamental frequency (F0), jitter, shimmer and noise-to-harmonic ratio (NHR) were studied before the implantation. For all of the children the speech intelligibility was performed before and 12 months after CI. Preoperative hearing was divided on existing residual hearing. The results of the acoustic analyses and speech intelligibility before and after CI were compared for preoperative hearing. The results of the speech intelligibility were compared for the age of operation and preoperative acoustic analysis (F0, jitter, shimmer, NHR). RESULTS Preoperative hearing had no influence on preoperative voice analysis. The children with residual hearing had a high grade of speech intelligibility before and after CI. The preoperative shimmer had positive correlation with postoperative 12 month speech intelligibility (r=0.618, P=0.032). The preoperative jitter had positive correlation with postoperative 12 month speech intelligibility, but was not statistically significant (r=0.479, P=0.116). CONCLUSION Shimmer on preoperative voice analyses had influence on speech intelligibility after CI.
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