Vocal Fold Self-Disruption After Phonotrauma On A Lead Actor: A Case Presentation

Performance of the phonatory deviation diagram in the evaluation of rough and breathy synthesized voices

INTRODUCTION

Voice disorders alter the sound signal in several ways, combining several types of vocal emission disturbances and noise. The phonatory deviation diagram is a two-dimensional chart that allows the evaluation of the vocal signal based on the combination of periodicity (jitter, shimmer, and correlation coefficient) and noise (Glottal to Noise Excitation) measurements. The use of synthesized signals, where one has a greater control and knowledge of the production conditions, may allow a better understanding of the physiological and acoustic mechanisms underlying the vocal emission and its main perceptual-auditory correlates regarding the intensity of the deviation and types of vocal quality.

OBJECTIVE

To analyze the performance of the phonatory deviation diagram in the discrimination of the presence and degree of roughness and breathiness in synthesized voices.

METHODS

871 synthesized vocal signals were used corresponding to the vowel /ɛ/. The perceptual-auditory analysis of the degree of roughness and breathiness of the synthesized signals was performed using visual analogue scale. Subsequently, the signals were categorized regarding the presence/absence of these parameters based on the visual analogue scale cutoff values. Acoustic analysis was performed by assessing the distribution of vocal signals according to the phonatory deviation diagram area, quadrant, shape, and density. The equality of proportions and the chi-square tests were performed to compare the variables.

RESULTS

Rough and breathy vocal signals were located predominantly outside the normal range and in the lower right quadrant of the phonatory deviation diagram. Voices with higher degrees of roughness and breathiness were located outside the area of normality in the lower right quadrant and had concentrated density.

CONCLUSION

The normality area and the phonatory deviation diagram quadrant can discriminate healthy voices from rough and breathy ones. Voices with higher degrees of roughness and breathiness are proportionally located outside the area of normality, in the lower right quadrant and with concentrated density.

Voice care knowledge by dysphonic and healthy individuals of different generations

The purpose of this study was to identify the opinions of both dysphonic and vocally healthy individuals regarding the factors that affect their voices positively and negatively, analyzing them according to the generation to which the participants belong. Eight hundred sixty-six individuals (304 dysphonic and 562 vocally healthy; 196 men and 670 women) categorized by generation: 22 individuals in Silent Generation (1926/-/1945), 180 in Baby Boomers (1946/-/1964), 285 in Generation X (1965/-/1981), and 379 in Generation Y (1982/-/2003) responded to two open questions: "Cite five things that you believe are good/bad to your voice". Five thousand, two hundred sixty answers were identified (2478 positive and 2782 negative) and organized in 365 factors related to voice care. The three most prevalent positive and negative factors for each generation were as follows: Silent Generation - positive factors: 1 - water, honey and pomegranate, 2 - apple, and 3 - ginger tea, voice exercises and gargling; negative factors: 1 - cold drinks, 2 - excessive speaking, and 3 - alcoholic drinks, smoking and screaming; Baby Boomers - positive factors: 1 - water, 2 - apple, and 3 - sleeping well; negative factors: 1 - cold drinks, 2 - screaming, and 3 - smoking; Generation X - positive factors: 1 - water, 2 - apple, and 3 - vocal warm-up; negative factors: 1 - screaming, 2 - smoking, and 3 - alcoholic drinks; and Generation Y - positive factors: 1 - water, 2 - apple, and 3 - vocal warm-up; negative factors: 1 - screaming, 2 - smoking, and 3 - alcoholic drinks. The impact of generation was greater on the frequency of the responses than on their type. Water and apple were the most frequently cited positive factors for all the generations investigated, whereas screaming and smoking were the most frequently mentioned negative factors. Behavioral aspects related to popular beliefs were reported more frequently by the older generations.

Vocal fold paralysis secondary to phonotrauma

A unique case of acute onset vocal fold paralysis secondary to phonotrauma is presented. The cause was forceful vocalization by a drill instructor on a firearm range. Imaging studies revealed extensive intralaryngeal and retropharyngeal hemorrhage. Laryngoscopy showed a complete left vocal fold paralysis. Relative voice rest was recommended, and the patient regained normal vocal fold mobility and function after approximately 12 weeks.