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Chadwick KA, Andreadis K, Sulica L. Prospective Outcomes of Microlaryngoscopy Versus Office Laser Photoangiolysis for Vocal Fold Polyps. Laryngoscope 2024; 134 Suppl 8:S1-S20. [PMID: 38742623 DOI: 10.1002/lary.31484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/02/2024] [Accepted: 04/17/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE(S) The objective of this study is to compare treatment outcomes for vocal fold polyps (VFPs) between operating room microlaryngoscopy and office-based photoangiolysis with the potassium titanyl phosphate (KTP) laser. METHODS Prospective nonrandomized cohort study of patients with VFPs undergoing microlaryngoscopy ("OR group") or KTP laser photoangiolysis ("KTP group"). Voice outcomes (patient-reported outcome measures [Voice Handicap Index-10 (VHI-10) and Singing VHI-10 (SVHI-10)], auditory-perceptual measures [Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V)], videostroboscopic characteristics [Voice-Vibratory Assessment of Laryngeal Imaging (VALI)], and acoustic and aerodynamic measures) were performed at baseline and regular intervals after intervention. RESULTS Forty-four subjects (17 OR group, 27 KTP group) with VFPs were enrolled. Mean VHI-10 significantly improved from baseline to each follow-up interval in both groups, except for the 1-2-week interval in the OR group. Mean SVHI-10 improved for both groups at some intervals. Growth curve models and time-to-event analyses for patient-reported outcomes did not differ between groups. There were significant improvements in all categories of auditory-perceptual voice quality and some categories of videostroboscopic characteristics in both groups. No significant trends were identified in acoustic and aerodynamic measures. Improvements in most outcomes did not significantly differ between groups or based on polyp size. There were no major complications. CONCLUSIONS Significant improvements in patient-reported voice outcomes measures, auditory-perceptual voice evaluation, and videostroboscopic characteristics occur following surgical treatment of vocal fold polyps with either microlaryngoscopy or office-based KTP laser. Long-term voice outcomes do not significantly differ between treatment modalities. LEVEL OF EVIDENCE 3 Laryngoscope, 134:S1-S20, 2024.
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Affiliation(s)
- Keith A Chadwick
- Division of Otolaryngology-Head & Neck Surgery, Stony Brook University, Stony Brook, New York, USA
| | | | - Lucian Sulica
- Department of Otolaryngology-Head and Neck Surgery, The Sean Parker Institute for the Voice, Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, New York, USA
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Bang JH, Lee SG, Kwon KJ, Lee SA, Eun YG, Lee YC. Effect of Proton Pump Inhibitor on the Outcome of Laryngeal Microsurgery in Patients With Vocal Fold Mucosal Disease With Reflux Symptoms. J Voice 2024; 38:931-935. [PMID: 35153121 DOI: 10.1016/j.jvoice.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To evaluate the effect of proton pump inhibitor (PPI) after laryngeal microsurgery (LMS) in patients with benign vocal fold (VF) mucosal disease and in patients with overt reflux symptom according to subjective and objective voice assessment. METHODS The improvement of voice handicap index-10 (VHI-10) score, reflux symptom index (RSI) score, grade, roughness, breathiness, asthenia, and strain (GRBAS) score, Jitter, Shimmer, noise to harmonics ratio (NHR), maximum phonation time of acoustic voice analysis RESULTS: A total of 47 patients (PPI group [n = 24] and non-PPI group [n = 23]) completed the study. The scores for VHI-10, RSI, GRBAS, and acoustic parameters significantly improved in both groups after surgery. In the subgroup analysis of patients with overt reflux symptoms (RSI ≥ 13; non-PPI group [n = 12], PPI group [n = 15]), significant between-group differences were observed in terms of the improvement in NHR and the strain factor. CONCLUSION Postoperative PPI administration in patients with VF benign mucosal disease with reflux symptoms might improve subjective and objective voice outcomes after LMS.
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Affiliation(s)
- Je Ho Bang
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sun Gyu Lee
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ki Jin Kwon
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seul Ah Lee
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Young-Gyu Eun
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Young Chan Lee
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Gojayev EK, Büyükatalay ZÇ, Akyüz T, Rehan M, Dursun G. The Effect of Masks and Respirators on Acoustic Voice Analysis During the COVID-19 Pandemic. J Voice 2024; 38:798.e1-798.e6. [PMID: 34961655 PMCID: PMC8627850 DOI: 10.1016/j.jvoice.2021.11.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/31/2021] [Accepted: 11/23/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES World Health Organization declared the coronavirus disease (COVID-19) as a global pandemic on March 11, 2020. The aim of this study was to determine the effectiveness and reliability of voice analysis performed with surgical masks and respirators during the pandemic and to discuss its routine applicability. METHODS This prospective study included 204 patients who applied to our clinic between the ages of 18 and 55, whose preoperative SARS-Cov-2 PCR tests were negative. Voice analyses were performed on each patient without a mask, with a surgical mask and with a valved face-filtering piece-3 (FFP3) respirator respectively. The F0, shimmer, jitter, s/z ratio, maximum phonation time and harmonic/noise ratio (HNR) values obtained from the voice analyses were compared with each other. RESULTS No significant difference was found in terms of F0, Jitter, Shimmer, HNR, s/z and maximum phonation time values in the voice analyses performed without a mask and with a surgical mask. With an FFP3, a significant difference was found in only the Shimmer and HNR values compared to the other analysis values. When we look at the data with sex distinction, in the group of female and male patients, when the data of voice analysis obtained in three situations were compared, different results were obtained from the female and male group. CONCLUSION In conclusion, it should be decided by the physician to perform the voice analysis with a surgical mask or with an FFP3, considering the clinically desired parameters.
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Affiliation(s)
- Ebru Karakaya Gojayev
- Department of Otorhinolaryngology, Ankara University, Medical School, Ankara, Turkey
| | | | - Tuğba Akyüz
- Department of Otorhinolaryngology, Ankara University, Medical School, Ankara, Turkey
| | - Mustafa Rehan
- Department of Otorhinolaryngology, Ankara University, Medical School, Ankara, Turkey
| | - Gürsel Dursun
- Department of Otorhinolaryngology, Ankara University, Medical School, Ankara, Turkey
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Martinez-Paredes JF, Menton SM, Thompson CC, Rutt AL. Evaluation of Size, Laterality, and Location of Unilateral Vocal Fold Lesions on Voice Quality. J Voice 2024; 38:472-478. [PMID: 34740499 DOI: 10.1016/j.jvoice.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/10/2021] [Accepted: 09/16/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The presence of a vocal fold mass implies high mechanical stress at the vocal fold base during vibration and an impaired glottic closure. However, evidence about its potential effects on diagnostic tools used in voice evaluation is lacking. We aimed to evaluate the impact of the location, laterality, and size of a unilateral unique vocal fold lesion on patient self-assessment questionnaires, acoustic-aerodynamic voice measures, and perceptual voice evaluation (GRBAS scale). METHODS A retrospective chart review involving patients with a diagnosis of a unique unilateral vocal fold lesion and a complete voice evaluation was performed. A total of 58 patients were enrolled and demographics, characteristics of the vocal fold lesion (size, laterality, and location), self-assessment questionnaires, acoustic-aerodynamic measures, and perceptual evaluation (GRBAS scale) were analyzed. Pearson correlation and ANOVA analysis were completed to evaluate the correlation between the clinical characteristics of the vocal fold mass and self-assessment questionnaires, and to compare the level of significance for the differences between the continuous variables between groups of patients once stratified according to the location or laterality of the vocal fold mass. RESULTS Glottal Function Index was found to correlate with the location of the vocal fold mass (P < 0.05), however, no correlation was found when evaluating the Reflux Symptom Index or the Voice Handicap Index (P > 0.05). Patients with a lesion located in the anterior-middle 2/3 of the vocal fold were found to have a higher mean Glottal Function Index and (G) component of the GRBAS scale (P < 0.05). No differences were observed when analyzing the remaining self-assessment questionnaires or the acoustic-aerodynamic voice measures according to size, location, or laterality of the vocal fold lesion (P > 0.05). CONCLUSION The size and location of unilateral vocal fold lesions were found to have no effect on the majority of measures analyzed in this study. This is the first study we know of to assess the effect that laterality of the vocal fold lesion may have on the self-assessment questionnaires, audio-perceptual, and acoustic-aerodynamic measures included in this study. Our study found no significant differences in regard to laterality. This may indicate that other factors (eg, stiffness of lesion, amount of extraneous muscle tension, etc) could have more of an impact on audio-perceptual, self-assessment questionnaires, and acoustic-aerodynamic measures. Further research with larger cohort sizes and possibly prospective analysis is needed.
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Affiliation(s)
- Jhon F Martinez-Paredes
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Florida, Jacksonville, Florida
| | - Stacey M Menton
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Florida, Jacksonville, Florida
| | - Chandler C Thompson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Florida, Jacksonville, Florida
| | - Amy L Rutt
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Florida, Jacksonville, Florida.
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Yam C, Christianson J, Sataloff RT. Prevalence of Objective Voice Measurement Use in Laryngology Practices in the United States. J Voice 2023:S0892-1997(23)00356-9. [PMID: 37980207 DOI: 10.1016/j.jvoice.2023.10.035] [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: 09/06/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVES The aim of this study was to assess the prevalence of use of objective voice measurements (OVM), instrumentation, and factors that may impact OVM outcomes, such as setting and implementation to clarify current practice. Doing so should clarify the impact of OVM research on patient care. METHODS A 12-question, one-time anonymous survey using the Research Electronic Data Capture tool was distributed during January 2023 to laryngologists in the United States identified through membership in The Voice Foundation (TVF) or previous participation in a TVF symposium. RESULTS A total of 101 responses to 418 emails yielded a response rate of 24.2%. Seventeen point eight percentage (N = 18) were in private practice, 63.4% (N = 64) were in academic settings, and 18.8% (N = 19) were classified as mixed private and academic. Common OVMs used were fundamental frequency 95.12% (N = 78), maximum phonation time 90.24% (N = 74), noise-to-harmonic ratio 71.95% (N = 59), jitter 71.95% (N = 59), and shimmer 70.73% (N = 58). Common equipment and software used Pentax Multi-Dimensional Voice Program 42.68% (N = 35), Pentax Computerized Speech Lab Model 4500B 37.80% (N = 31), and Pentax Visi-Pitch, Model 3950C 23.17% (N = 19), PRAAT 21.95% (N = 18), OperaVOX 4.88% (N = 4), VoceVista 3.66% (N = 3). Fifty one point two percentage (N = 42) stated that they used OVMs with the majority of their patients, most commonly for the assessment of treatment effectiveness (84.1%, N = 69), documentation (78.0%, N = 64), research (70.7%, N = 58), and/or diagnosis (61.0%, N = 50). Ninety point two percentage (N = 74) stated that OVMs were used during initial evaluation of patients. CONCLUSION This study estimates of the prevalence of OVM use among laryngologists in the United States. There appears to be sufficient consistency among laryngology centers to permit comparison of results between centers, although additional research is needed. Future OVM research should compare measurements and equipment commonly used by laryngologists to define further the generalizability of results.
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Affiliation(s)
- Christopher Yam
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Joe Christianson
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Robert T Sataloff
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
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Barsties V Latoszek B, Watts CR, Hetjens S, Neumann K. The Efficacy of Different Voice Treatments for Vocal Fold Polyps: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12103451. [PMID: 37240557 DOI: 10.3390/jcm12103451] [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: 04/18/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Vocal fold polyps (VFP) are a common cause of voice disorders and laryngeal discomfort. They are usually treated by behavioral voice therapy (VT) or phonosurgery, or a combination (CT) of both. However, the superiority of either of these treatments has not been clearly established. METHODS Three databases were searched from inception to October 2022 and a manual search was performed. All clinical trials of VFP treatment were included that reported at least auditory-perceptual judgment, aerodynamics, acoustics, and the patient-perceived handicap. RESULTS We identified 31 eligible studies (VT: n = 47-194; phonosurgery: n = 404-1039; CT: n = 237-350). All treatment approaches were highly effective, with large effect sizes (d > 0.8) and significant improvements in almost all voice parameters (p-values < 0.05). Phonosurgery reduced roughness and NHR, and the emotional and functional subscales of the VHI-30 were the most compared to behavioral voice therapy and combined treatment (p-values < 0.001). Combined treatment improved hoarseness, jitter, shimmer, MPT, and the physical subscale of the VHI-30 more than phonosurgery and behavioral voice therapy (p-values < 0.001). CONCLUSIONS All three treatment approaches were effective in eliminating vocal fold polyps or their negative sequelae, with phonosurgery and combined treatment providing the greatest improvement. These results may inform future treatment decisions for patients with vocal fold polyps.
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Affiliation(s)
- Ben Barsties V Latoszek
- Speech-Language Pathology, SRH University of Applied Health Sciences, 40210 Düsseldorf, Germany
| | - Christopher R Watts
- Harris College of Nursing & Health Sciences, Texas Christian University, Fort Worth, TX 76109, USA
| | - Svetlana Hetjens
- Department for Medical Statistics and Biomathematics, Medical Faculty Mannheim, University of Heidelberg, 68165 Mannheim, Germany
| | - Katrin Neumann
- Department of Phoniatrics and Pediatric Audiology, University Hospital Münster, University of Münster, 48149 Münster, Germany
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Siqueira LTD, Vitor JDS, Brasolotto AG, de Andrade EC, Silverio KCA. Can Vocal Therapy With Transcutaneous Electrical Nerve Stimulation (TENS) Followed by Vocal Exercises Reduce Benign Laryngeal Lesions in Dysphonic Women?: Randomized, Blind Clinical Trial. J Voice 2022:S0892-1997(22)00238-7. [PMID: 36068131 DOI: 10.1016/j.jvoice.2022.08.006] [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: 05/24/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the effectiveness of vocal therapy with the use of low-frequency transcutaneous electrical nerve stimulation (TENS) followed by voice exercises on vocal fold lesion size, vocal quality and quality of life in dysphonic women. METHODS 27 women with vocal nodules participated, randomized into to: experimental group (EG)-13 women who received vocal therapy with 12 sessions of 20 min of TENS application (pulse:200μs, frequency:10Hz, motor threshold intensity, electrodes positioned in the trapezius muscle [descending fibers and submandibular region, bilaterally]). Each TENS session was followed by 30 min of vocal exercises; and the Control Group (CG)- 14 women who received 12 sessions with 20 min of application of placebo TENS (same conditions EG, but without receiving the stimulus electric), followed by 30 min of vocal exercise. Before, immediately after and one month after vocal therapy, participants underwent vocal recording for acoustic analysis, vocal self-assessment, laryngological examination and answered voice-related quality of life (V-RQOL) protocol. RESULTS There was reduction in the size of vocal fold lesions only in the EG, immediately after treatment and one month after treatment. Acoustic analysis showed decreases in SPI values immediately after and one month after treatment in both groups. There was improvement in voice self-perception in both groups after treatment and one month after, but no significant difference in V-RQOL values. CONCLUSION TENS followed by vocal exercises produced results similar to vocal therapy without TENS regarding voice quality, self-perception and quality of life in voice. However, vocal therapy with low-frequency TENS followed by vocal exercise was effective in reducing vocal fold lesion size in dysphonic women.
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Affiliation(s)
- Larissa Thaís Donalonso Siqueira
- Speech-Language Pathology and Audiology Department, Universidade Federal do Rio Grande do Norte, Rua General Cordeiro de Faria, s/n - Petrópolis, Natal, Rio Grande do Norte 59012-570, Brazil.
| | - Jhonatan da Silva Vitor
- Speech Language-Pathologist, Bauru School of Dentistry, São Paulo College, São Paulo, Brazil
| | - Alcione Ghedini Brasolotto
- Speech-Language Pathology and Audiology Department, Bauru School of Dentistry, São Paulo College, Bauru, São Paulo, Brazil
| | | | - Kelly Cristina Alves Silverio
- Speech-Language Pathology and Audiology Department, Bauru School of Dentistry, São Paulo College, Bauru, São Paulo, Brazil
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Ren Z, Chang Y, Bartl-Pokorny KD, Pokorny FB, Schuller BW. The Acoustic Dissection of Cough: Diving Into Machine Listening-based COVID-19 Analysis and Detection. J Voice 2022:S0892-1997(22)00166-7. [PMID: 35835648 PMCID: PMC9197794 DOI: 10.1016/j.jvoice.2022.06.011] [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] [Received: 03/14/2022] [Revised: 05/25/2022] [Accepted: 06/09/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) has caused a crisis worldwide. Amounts of efforts have been made to prevent and control COVID-19's transmission, from early screenings to vaccinations and treatments. Recently, due to the spring up of many automatic disease recognition applications based on machine listening techniques, it would be fast and cheap to detect COVID-19 from recordings of cough, a key symptom of COVID-19. To date, knowledge of the acoustic characteristics of COVID-19 cough sounds is limited but would be essential for structuring effective and robust machine learning models. The present study aims to explore acoustic features for distinguishing COVID-19 positive individuals from COVID-19 negative ones based on their cough sounds. METHODS By applying conventional inferential statistics, we analyze the acoustic correlates of COVID-19 cough sounds based on the ComParE feature set, i.e., a standardized set of 6,373 acoustic higher-level features. Furthermore, we train automatic COVID-19 detection models with machine learning methods and explore the latent features by evaluating the contribution of all features to the COVID-19 status predictions. RESULTS The experimental results demonstrate that a set of acoustic parameters of cough sounds, e.g., statistical functionals of the root mean square energy and Mel-frequency cepstral coefficients, bear essential acoustic information in terms of effect sizes for the differentiation between COVID-19 positive and COVID-19 negative cough samples. Our general automatic COVID-19 detection model performs significantly above chance level, i.e., at an unweighted average recall (UAR) of 0.632, on a data set consisting of 1,411 cough samples (COVID-19 positive/negative: 210/1,201). CONCLUSIONS Based on the acoustic correlates analysis on the ComParE feature set and the feature analysis in the effective COVID-19 detection approach, we find that several acoustic features that show higher effects in conventional group difference testing are also higher weighted in the machine learning models.
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Affiliation(s)
- Zhao Ren
- EIHW - Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Augsburg, Germany; L3S Research Center, Hannover, Germany.
| | - Yi Chang
- GLAM - Group on Language, Audio, & Music, Imperial College London, London, United Kingdom
| | - Katrin D Bartl-Pokorny
- EIHW - Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Augsburg, Germany; Division of Phoniatrics, Medical University of Graz, Graz, Austria; Division of Physiology, Medical University of Graz, Graz, Austria.
| | - Florian B Pokorny
- EIHW - Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Augsburg, Germany; Division of Phoniatrics, Medical University of Graz, Graz, Austria; Division of Physiology, Medical University of Graz, Graz, Austria
| | - Björn W Schuller
- EIHW - Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Augsburg, Germany; GLAM - Group on Language, Audio, & Music, Imperial College London, London, United Kingdom
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Voice processing for COVID-19 scanning and prognostic indicator. Heliyon 2021; 7:e08134. [PMID: 34632133 PMCID: PMC8491927 DOI: 10.1016/j.heliyon.2021.e08134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/25/2021] [Accepted: 10/01/2021] [Indexed: 12/24/2022] Open
Abstract
COVID-19 pandemic has posed serious risk of contagion to humans. There is a need to find reliable non-contact tests like vocal correlates of COVID-19 infection. Thirty-six Asian ethnic volunteers 16 (8M & 8F) infected subjects and 20 (10M &10F) non-infected controls participated in this study by vocalizing vowels /a/, /e/, /i/, /o/, /u/. Voice correlates of 16 COVID-19 positive patients were compared during infection and after recovery with 20 non-infected controls. Compared to non-infected controls, significantly higher values of energy intensity for /o/ (p = 0.048); formant F1 for /o/ (p = 0.014); and formant F3 for /u/ (p = 0.032) were observed in male patients, while higher values of Jitter (local, abs) for /o/ (p = 0.021) and Jitter (ppq5) for /a/ (p = 0.014) were observed in female patients. However, formant F2 for /u/ (p = 0.018), mean pitch F0 for /e/, /i/ and /o/ (p = 0.033; 0.036; 0.047) decreased for female patients under infection. Compared to recovered conditions, HNR for /e/ (p = 0.014) was higher in male patients under infection, while Jitter (rap) for /a/ (p = 0.041); Jitter (ppq5) for /a/ (p = 0.032); Shimmer (local, dB) for /i/ (p = 0.024); Shimmer (apq5) for /u/ (p = 0.019); and formant F4 for vowel /o/ (p = 0.022) were higher in female patients under infection. However, HNR for /e/ (p = 0.041); and formant F1 for /o/ (p = 0.002) were lower in female patients compared to their recovered conditions. Obtained results support the hypothesis since changes in voice parameters were observed in the infected patients which can be correlated to a combination of acoustic measures like fundamental frequency, formant characteristics, HNR, and voice perturbations like jitter and shimmer for different vowels. Thus, voice analysis can be used for scanning and prognosis of COVID-19 infection. Based on the findings of this study, a mobile application can be developed to analyze human voice in real-time to detect COVID-19 symptoms for remedial measures and necessary action.
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Bartl-Pokorny KD, Pokorny FB, Batliner A, Amiriparian S, Semertzidou A, Eyben F, Kramer E, Schmidt F, Schönweiler R, Wehler M, Schuller BW. The voice of COVID-19: Acoustic correlates of infection in sustained vowels. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 149:4377. [PMID: 34241490 PMCID: PMC8269757 DOI: 10.1121/10.0005194] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
COVID-19 is a global health crisis that has been affecting our daily lives throughout the past year. The symptomatology of COVID-19 is heterogeneous with a severity continuum. Many symptoms are related to pathological changes in the vocal system, leading to the assumption that COVID-19 may also affect voice production. For the first time, the present study investigates voice acoustic correlates of a COVID-19 infection based on a comprehensive acoustic parameter set. We compare 88 acoustic features extracted from recordings of the vowels /i:/, /e:/, /u:/, /o:/, and /a:/ produced by 11 symptomatic COVID-19 positive and 11 COVID-19 negative German-speaking participants. We employ the Mann-Whitney U test and calculate effect sizes to identify features with prominent group differences. The mean voiced segment length and the number of voiced segments per second yield the most important differences across all vowels indicating discontinuities in the pulmonic airstream during phonation in COVID-19 positive participants. Group differences in front vowels are additionally reflected in fundamental frequency variation and the harmonics-to-noise ratio, group differences in back vowels in statistics of the Mel-frequency cepstral coefficients and the spectral slope. Our findings represent an important proof-of-concept contribution for a potential voice-based identification of individuals infected with COVID-19.
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Affiliation(s)
- Katrin D Bartl-Pokorny
- EIHW-Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Eichleitnerstrasse 30, 86159 Augsburg, Germany
| | - Florian B Pokorny
- EIHW-Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Eichleitnerstrasse 30, 86159 Augsburg, Germany
| | - Anton Batliner
- EIHW-Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Eichleitnerstrasse 30, 86159 Augsburg, Germany
| | - Shahin Amiriparian
- EIHW-Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Eichleitnerstrasse 30, 86159 Augsburg, Germany
| | - Anastasia Semertzidou
- EIHW-Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Eichleitnerstrasse 30, 86159 Augsburg, Germany
| | - Florian Eyben
- audEERING GmbH, Friedrichshafener Strasse 1, 82205 Gilching, Germany
| | - Elena Kramer
- Department of Otorhinolaryngology, Phoniatrics and Paediatric Audiology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Florian Schmidt
- Department of Otorhinolaryngology, Phoniatrics and Paediatric Audiology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Rainer Schönweiler
- Department of Otorhinolaryngology, Phoniatrics and Paediatric Audiology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Markus Wehler
- Department of Emergency Medicine and Medicine IV, University Medical Center Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Björn W Schuller
- EIHW-Chair of Embedded Intelligence for Health Care and Wellbeing, University of Augsburg, Eichleitnerstrasse 30, 86159 Augsburg, Germany
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Fiorella ML, Cavallaro G, Di Nicola V, Quaranta N. Voice Differences When Wearing and Not Wearing a Surgical Mask. J Voice 2021; 37:467.e1-467.e7. [PMID: 33712355 DOI: 10.1016/j.jvoice.2021.01.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of our study was to investigate the impact of surgical mask on some vocal parameters such as F0, vocal intensity, jitter, shimmer and harmonics-to-noise ratio in order to understand how surgical mask can affect voice and verbal communication in adults. METHODS The study was carried out on a selected group of 60 healthy subjects. All subjects were trained to voice a vocal sample of a sustained /a/, at a conversational voice intensity for the Maximum Phonation Time (MPT), wearing the surgical mask and then without wearing the surgical mask. Voice samples were recorded directly in Praat. RESULTS There were no statistically significant differences in any acoustic parameter between the masked and unmasked condition. There was a non-significant decrease in vocal intensity in 65% of the subjects while wearing a surgical mask. CONCLUSIONS The statistical comparison carried out between all the acoustic voice parameters observed, extracted wearing and not wearing a surgical mask did not reveal any significant statistical difference. Most of the subjects, after wearing the surgical mask, presented a decrease in vocal intensity measured. Our conclusion was that wearing a mask is likely to induce the unconscious need to increase the vocal effort, resulting over time in a greater risk of developing functional dysphonia. The reduction of intensity can affect also social interaction and speech audibility, especially for individuals with hearing loss.
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Affiliation(s)
- Maria Luisa Fiorella
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Giada Cavallaro
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Bari, Italy.
| | - Vincenzo Di Nicola
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Nicola Quaranta
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Bari, Italy
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Cavallaro G, Di Nicola V, Quaranta N, Fiorella ML. Acoustic voice analysis in the COVID-19 era. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2021; 41:1-5. [PMID: 33231205 PMCID: PMC7982755 DOI: 10.14639/0392-100x-n1002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 08/12/2020] [Indexed: 01/22/2023]
Abstract
Objective Among the different procedures used by the ENT, acoustic analysis of voice has become widely used for correct diagnosis of dysphonia. The instrumental measurements of acoustic parameters were limited during the COVID-19 pandemic by the common belief that a face mask affects the results of the analysis. The purpose of our study was to investigate the impact of surgical masks on F0, jitter, shimmer and harmonics-to-noise ratio (HNR) in adults. Methods The study was carried out on a selected group of 50 healthy subjects. Voice samples were recorded directly in Praat. All subjects were trained to voice a vocal sample of a sustained /a/, at a conversational voice intensity, with no intensity or frequency variation, for the Maximum Phonation Time (MPT), wearing the surgical mask and then without wearing the surgical mask. Results None of the variations in acoustic voice analysis detected wearing a surgical mask and not wearing a surgical mask were statistically significant. Conclusions Our study demonstrates that the acoustic voice analysis procedure can continue to be performed with the use of a surgical mask for the patient, even during the COVID-19 pandemic.
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Affiliation(s)
- Giada Cavallaro
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Italy
| | - Vincenzo Di Nicola
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Italy
| | - Nicola Quaranta
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Italy
| | - Maria Luisa Fiorella
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Italy
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van der Woerd B, Wu M, Parsa V, Doyle PC, Fung K. Evaluation of Acoustic Analyses of Voice in Nonoptimized Conditions. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:3991-3999. [PMID: 33186510 DOI: 10.1044/2020_jslhr-20-00212] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Objectives This study aimed to evaluate the fidelity and accuracy of a smartphone microphone and recording environment on acoustic measurements of voice. Method A prospective cohort proof-of-concept study. Two sets of prerecorded samples (a) sustained vowels (/a/) and (b) Rainbow Passage sentence were played for recording via the internal iPhone microphone and the Blue Yeti USB microphone in two recording environments: a sound-treated booth and quiet office setting. Recordings were presented using a calibrated mannequin speaker with a fixed signal intensity (69 dBA), at a fixed distance (15 in.). Each set of recordings (iPhone-audio booth, Blue Yeti-audio booth, iPhone-office, and Blue Yeti-office), was time-windowed to ensure the same signal was evaluated for each condition. Acoustic measures of voice including fundamental frequency (fo), jitter, shimmer, harmonic-to-noise ratio (HNR), and cepstral peak prominence (CPP), were generated using a widely used analysis program (Praat Version 6.0.50). The data gathered were compared using a repeated measures analysis of variance. Two separate data sets were used. The set of vowel samples included both pathologic (n = 10) and normal (n = 10), male (n = 5) and female (n = 15) speakers. The set of sentence stimuli ranged in perceived voice quality from normal to severely disordered with an equal number of male (n = 12) and female (n = 12) speakers evaluated. Results The vowel analyses indicated that the jitter, shimmer, HNR, and CPP were significantly different based on microphone choice and shimmer, HNR, and CPP were significantly different based on the recording environment. Analysis of sentences revealed a statistically significant impact of recording environment and microphone type on HNR and CPP. While statistically significant, the differences across the experimental conditions for a subset of the acoustic measures (viz., jitter and CPP) have shown differences that fell within their respective normative ranges. Conclusions Both microphone and recording setting resulted in significant differences across several acoustic measurements. However, a subset of the acoustic measures that were statistically significant across the recording conditions showed small overall differences that are unlikely to have clinical significance in interpretation. For these acoustic measures, the present data suggest that, although a sound-treated setting is ideal for voice sample collection, a smartphone microphone can capture acceptable recordings for acoustic signal analysis.
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Affiliation(s)
- Benjamin van der Woerd
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - Min Wu
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
| | - Vijay Parsa
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
- Department of Electrical and Computer Engineering, Western University, London, Ontario, Canada
| | - Philip C Doyle
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, CA
| | - Kevin Fung
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
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Zhao EE, Nguyen SA, Salvador CD, O'Rourke AK. A Meta-Analysis of the Association Between the Voice Handicap Index and Objective Voice Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:3461-3471. [PMID: 32955998 DOI: 10.1044/2020_jslhr-20-00209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Dysphonia can be evaluated by both patient-reported quality of life instruments and objective acoustic and aerodynamic analyses. However, less is known about the association between the two metrics. The goal of this study was to perform a meta-analysis of the correlation of the Voice Handicap Index (VHI-30) with the following objective parameters: fundamental frequency, jitter, shimmer, harmonics to noise ratio, noise to harmonic ratio, maximum phonation time, and the Dysphonia Severity Index. Method A literature search was performed in the PubMed, Scopus, and Cumulative Index of Nursing and Allied Health Literature databases. Inclusion criteria were subjects age 18 years and older with voice complaints and assessed by both VHI-30 and objective voice analysis. Results A literature search resulted in 1,297 unique articles, of which 310 underwent full-text review and 17 studies were included in quantitative analysis. Significant pooled correlation was observed for VHI-30 total with jitter (.301 [.177; .416]), shimmer (.255 [.162; .344]), noise to harmonic ratio (.200 [.111; .285]), maximum phonation time (-.227 [-.352; -.094]), and Dysphonia Severity Index (-.254[-.455; -.0286]). Significant correlations were observed in 4/7 objective parameters with the Physical subscale, 3/7 with the Functional subscale, and 2/7 with the Emotional subscale. All significant correlations were negligible (0-.3) or low (.3-.5). Conclusions Results from meta-analysis showed that correlations between objective voice parameters and the VHI-30 were negligible or low. Further study is needed to determine if correlations vary by patient demographics or specific pathology.
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Affiliation(s)
- Elise E Zhao
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Craig D Salvador
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Ashli K O'Rourke
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston
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Hasukawa A, Mochizuki R, Sakamoto H, Shibano A, Kitahara T. Surgical effects of type-I thyroplasty and fat injection laryngoplasty on voice recovery. Auris Nasus Larynx 2020; 48:302-309. [PMID: 32958328 DOI: 10.1016/j.anl.2020.08.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/18/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Type-I thryroplasty, also known as medialization thyroplasty (MT) and autologous fat injection laryngoplasty (FIL) are one of the main surgical treatments for unilateral vocal fold paralysis (UVFP). Both procedures have the same concept of completing the glottal closure by medializing the vocal fold, although the surgical approaches are quite different. In order to assess these surgical effects, we examined the treatment outcomes and benefits of the two surgeries. METHODS We collected data from the 135 phonosurgeries that we performed out of 375 patients with UVFP at Osaka Voice Center, Osaka Kaisei Hospital from January 2009 to February 2013. After excluding cases with glottal level differences on phonation, either MT or FIL were performed on 80 cases. The inclusion criteria for the present study were: (1) patients had no history of previous phonosurgery, and (2) functional evaluations were available before/after surgery. Consequently, 43 participants (12 for MT and 31 for FIL) were enrolled in this study. Surgical effects were evaluated by means of the maximum phonation time (MPT), pitch period perturbation quotient (PPQ), amplitude perturbation quotient (APQ), and harmonic to noise ratio (HNR) just before, one month, and 6 months after surgery. RESULTS Both MT and FIL showed significant improvement in MPT (MT, p = 0.005; FIL, p < 0.001) and PPQ (MT, p = 0.047; FIL, p = 0.041) at 1 month postoperation. We also compared the variation of each variable between the two procedures, but there were no significant differences in these parameters. However, MPT, APQ, and HNR at the post-MT after 6 months worsened compared to those at 1 month posttreatment, whereas MPT showed only a slight decrease from the 1st month to the 6th month in those with FIL. CONCLUSION Both MT and FIL were effective for the voice recovery in patients with UVFP. Our findings suggest that surgical results in FIL might be better than those in MT 6 months after surgery, although there were no significant differences between these two procedures 1 month postoperation.
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Affiliation(s)
- Akihito Hasukawa
- Department of Otolaryngology and Head & Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-city, Nara 634-8522, Japan; Department of Otolaryngology and Osaka Voice Center, Osaka Kaisei Hospital, Japan.
| | - Ryuichi Mochizuki
- Department of Otolaryngology and Head & Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-city, Nara 634-8522, Japan; Department of Otolaryngology and Osaka Voice Center, Osaka Kaisei Hospital, Japan; Sakamoto ENT clinic, Japan
| | | | - Akira Shibano
- Department of Otolaryngology and Osaka Voice Center, Osaka Kaisei Hospital, Japan
| | - Tadashi Kitahara
- Department of Otolaryngology and Head & Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-city, Nara 634-8522, Japan
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Öcal B, Tatar EÇ, Toptaş G, Barmak E, Saylam G, Korkmaz MH. Evaluation of Voice Quality in Patients With Vocal Fold Polyps: The Size of a Polyp Matters or Does it? J Voice 2019; 34:294-299. [PMID: 31060763 DOI: 10.1016/j.jvoice.2019.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/12/2019] [Accepted: 04/16/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to investigate the correlation between morphological features of vocal fold polyps (VFPs) and subjective/objective voice parameters. METHODS Perceptual evaluations, aerodynamic and acoustic tests were performed on 47 patients with VFPs. Still images were captured from video and the morphological features associated with the size of VFP were quantified. To reveal the correlation between size-related morphological features (length of polyp base, the ratio of polyp base to vocal fold length, glottal gap area) and objective/subjective parameters of voice, Pearson's and Spearman's tests were carried out. RESULTS This cohort was composed of 30 (63.8 %) male and 17 (36.2%) female patients with the mean age of 45.2 years and 41.3 years, respectively. No correlation was found between the morphological features of VFPs and any of perceptual, aerodynamic and acoustic voice parameters. CONCLUSIONS Our findings indicated that controversies still exist regarding the role of vocal fold polyp morphology in clinical decision making.
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Affiliation(s)
- Bülent Öcal
- Department of Otolaryngology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
| | - Emel Ç Tatar
- Department of Otolaryngology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Gökhan Toptaş
- Department of Otolaryngology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Elife Barmak
- Hearing-Speech-Balance Unit, Department of Otolaryngology and Head and Neck Surgery, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ministry of Health, Ankara, Turkey
| | - Güleser Saylam
- Department of Otolaryngology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet H Korkmaz
- Department of Otolaryngology, Yıldırım Beyazıt University Medical School, Ankara, Turkey
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On the design of automatic voice condition analysis systems. Part I: Review of concepts and an insight to the state of the art. Biomed Signal Process Control 2019. [DOI: 10.1016/j.bspc.2018.12.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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18
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Ankışhan H. Classification of acoustic signals with new feature: Fibonacci space (FSp). Biomed Signal Process Control 2019. [DOI: 10.1016/j.bspc.2018.08.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Vasconcelos DD, Gomes ADOC, Araújo CMTD. Vocal Fold Polyps: Literature Review. Int Arch Otorhinolaryngol 2019; 23:116-124. [PMID: 30647795 PMCID: PMC6331298 DOI: 10.1055/s-0038-1675391] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 09/02/2018] [Indexed: 10/27/2022] Open
Abstract
Introduction Vocal fold polyps are one of the most frequent benign laryngeal lesions, impacting the quality of life of those affected by them, primarily the vocal production. Despite being a well-established therapy in conjunction with surgery, speech therapy alone may also be effective in treating these lesions. As such, otolaryngologists and speech therapists need updated bibliographic knowledge on the issue. Objective To describe the literature findings on vocal fold polyps that discuss prevalence, etiology, histology, physiopathology, vocal characteristics or treatment. Data Synthesis The present study is a review article based on a bibliographic search using platforms, databases and search engines, with no restrictions on means of publication, methodological quality or language. All the articles on vocal fold polyps pertaining to the object of study published in the past 15 years were included. Among the characteristics investigated, the most discussed were prevalence of men, smoking as an etiological cofactor, the possibility of histological differentiation from vocal nodules, the relationship with cover minor structural alterations, and the indication and effectiveness of different treatment options. Conclusion Despite the discrepancies found in the present literature review on vocal fold polyps, there has been a notable scientific progress in the otolaryngologic techniques and in the effectiveness of speech therapy as initial treatment, with direct and indirect techniques, corroborating the need for scientific investigation of the issue.
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Affiliation(s)
- Daniela de Vasconcelos
- Speech Therapy Service, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, PE, Brazil
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Chitguppi C, Raj A, Meher R, Rathore P. Is the Voice of Professional Voice Users With no Vocal Cord Lesions Similar to That of Non Professional Voice Users? J Voice 2019; 33:66-72. [DOI: 10.1016/j.jvoice.2017.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/04/2017] [Accepted: 09/06/2017] [Indexed: 10/18/2022]
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Ropero Rendón MDM, Ermakova T, Freymann ML, Ruschin A, Nawka T, Caffier PP. Efficacy of Phonosurgery, Logopedic Voice Treatment and Vocal Pedagogy in Common Voice Problems of Singers. Adv Ther 2018; 35:1069-1086. [PMID: 29949040 PMCID: PMC11343907 DOI: 10.1007/s12325-018-0725-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Functional and organic impairments of the singing voice are common career-threatening problems of singers presenting in phoniatric and laryngological departments. The objective was to evaluate the efficacy of phonosurgery, logopedic voice treatment and vocal pedagogy in common organic and functional voice problems of singers, including investigation of the recently introduced parameter vocal extent measure (VEM). METHODS In a prospective clinical study, the analysis of treatment outcome in 76 singers [57 female, 19 male; 38 ± 11 years (mean ± SD)] was based on pre- and post-therapeutic voice function diagnostics and videolaryngostroboscopy. Examination instruments included auditory-perceptual voice assessment, voice range profile (VRP), the VEM calculated from area and shape of the VRP, acoustic-aerodynamic analysis, and patients' self-assessment (e.g., Singing Voice Handicap Index). RESULTS While 28% of all singers (21/76) presented with functional dysphonia, 72% (55/76) were diagnosed with organic vocal fold changes, of which marginal edema (n = 25), nodules (n = 9), and polyps (n = 8) were the most common pathologic changes. Of the 76 singers, 57% (43) received phonosurgery, 43% (33) had conservative pedagogic (14) and logopedic (19) treatment. Three months post-therapeutically, most parameters had significantly improved. The dysphonia severity index (DSI) increased on average from 6.1 ± 2.0 to 7.4 ± 1.8 (p < 0.001), and the VEM from 113 ± 20 to 124 ± 14 (p < 0.001). Both parameters correlated significantly with each other (rs = 0.41). Phonosurgery had the largest impact on the improvement of vocal function. Conservative therapies provided smaller quantitative enhancements but also qualitative vocal restoration with recovered artistic capabilities. CONCLUSIONS Depending on individual medical indication, phonosurgery, logopedic treatment and voice teaching are all effective, objectively and subjectively satisfactory therapies to improve the impaired singing voice. The use of VEM in singers with functional and organic dysphonia objectifies and quantifies their vocal capacity as documented in the VRP. Complementing the established DSI, VEM introduction into practical objective voice diagnostics is appropriate and desirable especially for the treatment of singers.
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Affiliation(s)
- Maria Del Mar Ropero Rendón
- Department of Audiology and Phoniatrics, Charité, University Medicine Berlin, Campus Charité Mitte, Berlin, Germany
| | - Tatiana Ermakova
- Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | - Marie-Louise Freymann
- Department of Audiology and Phoniatrics, Charité, University Medicine Berlin, Campus Charité Mitte, Berlin, Germany
| | - Alina Ruschin
- Department of Audiology and Phoniatrics, Charité, University Medicine Berlin, Campus Charité Mitte, Berlin, Germany
| | - Tadeus Nawka
- Department of Audiology and Phoniatrics, Charité, University Medicine Berlin, Campus Charité Mitte, Berlin, Germany
| | - Philipp P Caffier
- Department of Audiology and Phoniatrics, Charité, University Medicine Berlin, Campus Charité Mitte, Berlin, Germany.
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Wang H, Zhuge P, You H, Zhang Y, Zhang Z. Comparison of the efficacy of vocal training and vocal microsurgery in patients with early vocal fold polyp. Braz J Otorhinolaryngol 2018; 85:678-684. [PMID: 29784620 PMCID: PMC9443021 DOI: 10.1016/j.bjorl.2018.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 03/13/2018] [Accepted: 03/29/2018] [Indexed: 02/03/2023] Open
Abstract
Introduction Vocal fold polyp is a benign proliferative disease in the superficial lamina propria of the vocal fold, and vocal microsurgery can improve the voice quality of patients with vocal fold polyp. In preliminary studies, we found that vocal training could improve the vocal quality of patients with early vocal fold polyp. Objective This study aimed to compare the efficacies of vocal training and vocal microsurgery in patients with early vocal fold polyp. Methods A total of 38 patients with early vocal fold polyp underwent 3 months of vocal training (VT group); another 31 patients with early vocal fold polyp underwent vocal microsurgery (VM group). All subjects were assessed using laryngostroboscopy, voice handicap index, and dysphonia severity index, and the efficacies of vocal training and vocal microsurgery were compared. Results The cure rates of vocal training and vocal microsurgery were 31.6% (12/38) and 100% (31/31), respectively. The intragroup paired-sample t-test showed that the post treatment vocal handicap index, maximum phonation time, highest frequency (F0-high), lowest intensity (I-low), and dysphonia severity index in both the VT and VM groups were better than those before treatment, except for the jitter value. The intergroup independent-sample t-test revealed that the emotional values of vocal handicap index (t = − 2.22, p = 0.03), maximum phonation time (t = 2.54, p = 0.013), jitter (t = − 2.11, p = 0.03), and dysphonia severity index (t = 3.24, p = 0.002) in the VT group were better than those in the VM group. Conclusions Both, vocal training and vocal microsurgery could improve the voice quality of patients with early vocal fold polyp, and these methods present different advantages.
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Affiliation(s)
- Hanqing Wang
- Jinhua Central Hospital, Department of Otolaryngology, Jinhua, China
| | - Pan Zhuge
- Jinhua Central Hospital, Department of Otolaryngology, Jinhua, China.
| | - Huihua You
- Jinhua Central Hospital, Department of Otolaryngology, Jinhua, China
| | - Yulan Zhang
- Jinhua Central Hospital, Department of Otolaryngology, Jinhua, China
| | - Zhifeng Zhang
- Jinhua Central Hospital, Department of Otolaryngology, Jinhua, China
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Lu D, Chen F, Yang H, Yu R, Zhou Q, Zhang X, Ren J, Zheng Y, Zhang X, Zou J, Wang H, Liu J. Changes After Voice Therapy in Acoustic Voice Analysis of Chinese Patients With Voice Disorders. J Voice 2018; 32:386.e1-386.e9. [DOI: 10.1016/j.jvoice.2017.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 05/04/2017] [Accepted: 05/04/2017] [Indexed: 11/25/2022]
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Akbari E, Seifpanahi S, Ghorbani A, Izadi F, Torabinezhad F. The Effects of Size and Type of Vocal Fold Polyp on Some Acoustic Voice Parameters. IRANIAN JOURNAL OF MEDICAL SCIENCES 2018; 43:158-163. [PMID: 29749984 PMCID: PMC5936847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Vocal abuse and misuse would result in vocal fold polyp. Certain features define the extent of vocal folds polyp effects on voice acoustic parameters. The present study aimed to define the effects of polyp size on acoustic voice parameters, and compare these parameters in hemorrhagic and non-hemorrhagic polyps. METHODS In the present retrospective study, 28 individuals with hemorrhagic or non-hemorrhagic polyps of the true vocal folds were recruited to investigate acoustic voice parameters of vowel/ æ/ computed by the Praat software. The data were analyzed using the SPSS software, version 17.0. According to the type and size of polyps, mean acoustic differences and correlations were analyzed by the statistical t test and Pearson correlation test, respectively; with significance level below 0.05. RESULTS The results indicated that jitter and the harmonics-to-noise ratio had a significant positive and negative correlation with the polyp size (P=0.01), respectively. In addition, both mentioned parameters were significantly different between the two types of the investigated polyps. CONCLUSION Both the type and size of polyps have effects on acoustic voice characteristics. In the present study, a novel method to measure polyp size was introduced. Further confirmation of this method as a tool to compare polyp sizes requires additional investigations.
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Affiliation(s)
- Elaheh Akbari
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sadegh Seifpanahi
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Ghorbani
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Izadi
- ENT-Head and Neck Research Center, Hazrat Rasoul AKram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Torabinezhad
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Hamdan AL, Tabet G, Saadeddin Z, Btaiche R, Khalifeh I. Apoptosis in Vocal Fold Polyps. J Voice 2018; 32:104-108. [DOI: 10.1016/j.jvoice.2017.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/30/2017] [Accepted: 03/31/2017] [Indexed: 11/26/2022]
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Pei YC, Chuang HF, Chang CF, Chang TL, Chiang HC, Fang TJ. Voice Range Change After Injection Laryngoplasty for Unilateral Vocal Fold Paralysis. J Voice 2017; 32:625-632. [PMID: 29248388 DOI: 10.1016/j.jvoice.2017.07.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 07/23/2017] [Accepted: 07/25/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Patients with unilateral vocal fold paralysis (UVFP) caused by nerve injury manifest with voice changes. This study investigated vocal performance measured by voice range profile (VRP) in patients with UVFP and changes in VRP in response to intracordal hyaluronate injection. METHODS Eighty-five patients with UVFP were enrolled prospectively, among whom 68 received intracordal hyaluronate injections. The outcome measurements included VRP, acoustic and aerodynamic analyses, peak turn frequency of thyroarytenoid-lateral cricoarytenoid muscle complex (TA-LCA) measured by laryngeal electromyography, and normalized glottal gap area by videolaryngostroboscopy. RESULTS The peak turn frequency of the paralyzed TA-LCA showed a modest correlation with max fundamental frequency (F0) and F0 range. Closed-phase normalized glottal gap area showed modest negative correlations with max F0 and F0 semitone range. Regarding conventional acoustic and aerodynamic analyses, the paralyzed TA-LCA peak turn frequency was only correlated with maximal phonation time. Intracordal hyaluronate injection improved VRP performance by increasing max F0, decreasing min F0, increasing F0 range, and increasing semitone range (all P <0.01) with small or medium strength of effect size (Cohen d, 0.39-0.76). CONCLUSIONS Change in voice pitch in patients with UVFP can partly predict impairment of neuromuscular functions and glottal gap. VRP provides a more sensitive reflection of the severity of neuromuscular impairment, compared with conventional voice analysis. The validity of VRP is further supported by a robust response to voice improvements following injection laryngoplasty.
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Affiliation(s)
- Yu-Cheng Pei
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Feng Chuang
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chia-Fen Chang
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Tzu-Ling Chang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hui-Chen Chiang
- Graduate School of Management, Ming Chung University, Taipei, Taiwan
| | - Tuan-Jen Fang
- School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
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Lopes LW, Batista Simões L, Delfino da Silva J, da Silva Evangelista D, da Nóbrega e Ugulino AC, Oliveira Costa Silva P, Jefferson Dias Vieira V. Accuracy of Acoustic Analysis Measurements in the Evaluation of Patients With Different Laryngeal Diagnoses. J Voice 2017; 31:382.e15-382.e26. [DOI: 10.1016/j.jvoice.2016.08.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 08/20/2016] [Accepted: 08/23/2016] [Indexed: 11/29/2022]
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Treatment for Vocal Polyps: Lips and Tongue Trill. J Voice 2017; 31:252.e27-252.e36. [DOI: 10.1016/j.jvoice.2016.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/05/2016] [Accepted: 07/07/2016] [Indexed: 11/22/2022]
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Salmen T, Ermakova T, Möller A, Seipelt M, Weikert S, Rummich J, Gross M, Nawka T, Caffier PP. The Value of Vocal Extent Measure (VEM) Assessing Phonomicrosurgical Outcomes in Vocal Fold Polyps. J Voice 2017; 31:114.e7-114.e15. [DOI: 10.1016/j.jvoice.2016.03.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 03/30/2016] [Indexed: 11/29/2022]
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Gulec S, Kulahli I, Sahin MI, Kokoğlu K, Gunes MS, Avci D, Arli T. Effect of Septoplasty on Voice Quality: A Prospective-Controlled Trial. Clin Exp Otorhinolaryngol 2016; 9:238-43. [PMID: 27230274 PMCID: PMC4996097 DOI: 10.21053/ceo.2015.01354] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/17/2015] [Accepted: 11/17/2015] [Indexed: 12/02/2022] Open
Abstract
Objectives. The purpose is to investigate effect of septoplasty and widened nasal patency on voice quality. Methods. Fifty patients who undergone septoplasty were included in the study. Thirty-three people who had similar age and distribution were enrolled as control group. Before and 1 and 3 months after surgery, anterior rhinomanometry, voice analysis by Multi-Dimensional Voice Program, and spectrographic analysis were performed to patients. The recordings of /a/ vowel were used to evaluate average fundamental frequency (F0), jitter percent, and shimmer percent. In spectrographic analyses, F3–F4 values for the vowels /i, e, a, o, and u/, nasal formant frequencies of the consonants /m/ and /n/ in the word /mini/, and 4 formant frequencies (F1, F2, F3, and F4) for nasalized /i/ vowel following a nasal consonant /n/ in the word /mini/ were compared. The differences in nasal resonance were evaluated. All patients were asked whether change in their voices after the surgery. Preoperative and postoperative voice parameters and anterior rhinomanometry results were compared separately with the control group as well as in the patient group itself. Results. Preoperative total nasal resistance (TNR) values of patients were higher than the control group (P=0.001). TNR values of patients measured one day before surgery and after surgery in the 1st and 3rd months were different and these differences were significant statistically (P=0.001). There was no significant difference between the voice analysis parameters in preoperative, postoperative 1st, and 3rd months. As a result of their subjective reviews, 12 patients (36%) noted their voices were better than before surgery and 20 patients (61%) noted no change before and after surgery. Conclusion. Providing widened nasal cavity has no effect on voice quality.
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Affiliation(s)
- Safak Gulec
- Department of Otolaryngology, Private Neon Hospital, Erzincan, Turkey
| | - Ismail Kulahli
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Ilhan Sahin
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Kerem Kokoğlu
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Murat Salih Gunes
- Department of Otolaryngology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Deniz Avci
- Department of Otolaryngology, Patnos State Hospital, Agri, Turkey
| | - Turan Arli
- Deprtment of Otolaryngology, Kasımpasa Military Hospital, Istanbul, Turkey
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Lee Y, Na S, Kim H, Yang C, Kim S, Byun Y, Jung A, Ryu I, Eun Y. Effect of postoperative proton pump inhibitor therapy on voice outcomes following phonomicrosurgery for vocal fold polyp: a randomized controlled study. Clin Otolaryngol 2016; 41:730-736. [DOI: 10.1111/coa.12611] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2015] [Indexed: 02/04/2023]
Affiliation(s)
- Y.C. Lee
- Department of Otolaryngology-Head & Neck Surgery; School of Medicine; Kyung Hee University; Seoul Korea
| | - S.Y. Na
- Department of Otolaryngology-Head & Neck Surgery; School of Medicine; Kyung Hee University; Seoul Korea
| | - H.J. Kim
- Department of Otolaryngology-Head & Neck Surgery; School of Medicine; Kyung Hee University; Seoul Korea
| | - C.W. Yang
- Department of Otolaryngology-Head & Neck Surgery; School of Medicine; Kyung Hee University; Seoul Korea
| | - S.I. Kim
- Department of Otolaryngology-Head & Neck Surgery; School of Medicine; Kyung Hee University; Seoul Korea
| | - Y.S. Byun
- Department of Otolaryngology-Head & Neck Surgery; School of Medicine; Kyung Hee University; Seoul Korea
| | - A.R. Jung
- Department of Otolaryngology-Head & Neck Surgery; School of Medicine; Kyung Hee University; Seoul Korea
| | - I.Y. Ryu
- Department of Otolaryngology-Head & Neck Surgery; School of Medicine; Kyung Hee University; Seoul Korea
| | - Y.G. Eun
- Department of Otolaryngology-Head & Neck Surgery; School of Medicine; Kyung Hee University; Seoul Korea
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Voice data mining for laryngeal pathology assessment. Comput Biol Med 2016; 69:270-6. [DOI: 10.1016/j.compbiomed.2015.07.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 07/24/2015] [Accepted: 07/29/2015] [Indexed: 11/18/2022]
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Mohseni R, Sandoughdar N. Survey of Voice Acoustic Parameters in Iranian Female Teachers. J Voice 2015; 30:507.e1-5. [PMID: 26275636 PMCID: PMC4943854 DOI: 10.1016/j.jvoice.2015.05.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 05/29/2015] [Indexed: 11/15/2022]
Abstract
Objectives Teachers are one of the professional voice users. Voice problems are common among them. Female teachers are known to have more voice problems than male ones. Furthermore, there are only few studies on the voice of Iranian female teachers. The present study investigated the acoustic parameters of voice in Iranian female teachers and compares them with nonteachers. Methods In this cross-sectional study, 90 Iranian female elementary teachers, 30–50 years old, and 90 Iranian female nonteachers in the same age were assessed between May 2010 and October 2011. Data collection was carried out, using the Dr. Speech software (subprogram: vocal assessment Version 4.0 from Tiger Electronics) at the speech therapy clinic under a comfortable phonation. Normal voice in practitioners was judged by the perceptual evaluation by a voice therapist and indirect laryngoscopy examination by an otorhinolaryngologist. Voice characteristics were assessed with GRBAS scale. The speech sample was sustained /â/ using habitual and constant vocal for 10 seconds. Three tokens from each subject were obtained. Then, each subject was asked to read a standard passage in Farsi. Eventually, the difference measures of F0, jitter, shimmer, harmonic to noise ratio (HNR), and maximum of phonation time (MPT) between two groups were investigated by statistics software SPSS 19.0 (IBM corp.2010). Results Results showed that the values of F0 were higher in teachers (210.03 Hz) than in nonteachers (194.11 Hz; P < 0.001). In addition, the values of perturbation measures were greater in teachers (jitter 0.32% and shimmer 4.63%) than those in the control group (jitter 0.22% and shimmer 3.15%; P < 0.001), but in HNR and MPT values, nonteachers showed higher levels (P < 0.001). The value of HNR in teachers was (18.84±1.56) but it was (21.3±1.73) in non-teachers and MPT value in teachers was (16.83±3.65) and in non-teachers was (22.5±5.2). Conclusions It can be concluded that vocal overuse, abuse, or misuse during teaching over a period of time result in achievement of inadequate phonatory pattern with excessive musculoskeletal tension, and the possible result is tissue changes in teacher's voice. In addition, acoustic analysis of voice parameters for teachers may significantly contribute to the objective voice examination of this group.
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Affiliation(s)
- R Mohseni
- Department of Speech and Language Pathology, Hazrat-e-Rasoul Hospital, Tehran, Iran
| | - N Sandoughdar
- Department of Speech and Language Pathology, Taleghani General Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Christmann MK, Brancalioni AR, Freitas CRD, Vargas DZ, Keske-Soares M, Mezzomo CL, Mota HB. Uso do programa MDVP em diferentes contextos: revisão de literatura. REVISTA CEFAC 2015. [DOI: 10.1590/1982-021620151742914] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo:Este estudo tem como objetivo descrever, a partir de revisão de literatura, a confiabilidade da análise acústica utilizando o Multi Dimensional Voice Program,comparação de suas medidas com outros programas de análise acústica; caracterização de vozes de diferentes grupos; e sua utilização para verificar os efeitos e eficácia de diferentes procedimentos terapêuticos. Realizou-se levantamento bibliográfico que priorizaram estudos dos últimos cinco anos, incluindo-se artigos cujo objetivo estivesse de acordo com o interesse da presente revisão. A pesquisa foi realizada nos bancos de dados das bases Lilacs, BIREME, PubMed, MedLine, Scielo e Google Schoolar, por meio dos descritores acoustic, speech acoustics e voice. As medidas mais utilizadas são frequência fundamental, jitter, shimmer e proporção harmônico-ruído. As medidas de tremor não apresentam boa confiabilidade. As medidas mais consistentes que apresentam alta concordância com outros programas de análise acústica são as relacionadas com a frequência fundamental. Diversos estudos buscam caracterizar diferentes tipos de vozes tais como as de sujeitos sem alterações vocais de ambos os sexos, buscando estabelecer parâmetro de normalidade para diferentes grupos populacionais. Além disso, alguns estudos caracterizam vozes com diferentes distúrbios. A análise acústica é um recurso objetivo e necessário na avaliação de pacientes com distúrbio vocal e, principalmente, na comparação de diversos tipos de tratamento.
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Park YJ, Park YB. Relationships between pathological patterns and vocal qualities estimated by acoustic parameters. Chin J Integr Med 2015; 21:346-54. [DOI: 10.1007/s11655-015-2171-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Indexed: 11/29/2022]
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Hosokawa K, Ogawa M, Iwahashi T, Hashimoto M, Inohara H. Does Cervical Muscular Contraction Affect the Measurement for Electroglottographic Perturbation Parameters? J Voice 2015; 29:660-9. [PMID: 25873542 DOI: 10.1016/j.jvoice.2014.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 11/04/2014] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The purpose was to assess whether cervical muscular contraction during phonation influences the period and amplitude perturbation quotients (PPQ and APQ, respectively) of electroglottographic (EGG) signals, and whether high-pass filtering can attenuate these effects. STUDY DESIGN Prospective. METHODS We included 19 nondysphonic speakers and 21 patients with muscle tension dysphonia. During the recording of acoustic and EGG signals, each participant was instructed to naturally phonate sustained vowels /i:/ and /a:/ (NP tasks), and additionally, each nondysphonic participant was asked to phonate the same vowels in a nondysphonic voice quality while contracting the cervical muscles (muscular contracted phonation [MCP] tasks). To confirm the contraction, surface and needle electromyography (EMG) was performed. The EGG signals were high-pass filtered at different cutoff frequencies from 0 to 90 Hz and were subsequently analyzed for the PPQ and APQ. RESULTS Compared with the NP tasks, the MCP tasks enhanced the cervical EMG activities ranging from 0 to more than 1000 Hz, but conferred only low-frequency noise to the EGG signals under 50 Hz and increased the values for EGG-APQ, but not EGG-PPQ. These EGG-APQ values exhibited gradual decreases after high-pass filtering with an increase in the cutoff frequency ranging from 0 to 50 Hz in both groups, followed by plateaus during the MCP tasks in the nondysphonic group. CONCLUSIONS The present results demonstrate that cervical muscular contraction seriously affects the EGG-APQ values for unfiltered EGG signals independent of the EMG activities and that appropriate high-pass filtering over 50 Hz can attenuate these effects.
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Affiliation(s)
- Kiyohito Hosokawa
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Makoto Ogawa
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Toshihiko Iwahashi
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Michiko Hashimoto
- Department of Otorhinolaryngology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Hyogo, Japan
| | - Hidenori Inohara
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan
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Petrovic-Lazic M, Jovanovic N, Kulic M, Babac S, Jurisic V. Acoustic and Perceptual Characteristics of the Voice in Patients With Vocal Polyps After Surgery and Voice Therapy. J Voice 2015; 29:241-6. [DOI: 10.1016/j.jvoice.2014.07.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 07/17/2014] [Indexed: 11/30/2022]
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Comparison of Effects on Voice of Diode Laser and Cold Knife Microlaryngology Techniques for Vocal Fold Polyps. J Voice 2014; 28:387-92. [DOI: 10.1016/j.jvoice.2013.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 10/23/2013] [Indexed: 11/24/2022]
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Statistical Analysis of the Reliability of Acoustic and Electroglottographic Perturbation Parameters for the Detection of Vocal Roughness. J Voice 2014; 28:263.e9-263.e16. [DOI: 10.1016/j.jvoice.2013.07.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 07/15/2013] [Indexed: 11/22/2022]
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Persistent dysphonia after laryngomicrosurgery for benign vocal fold disease. Clin Exp Otorhinolaryngol 2013; 6:166-70. [PMID: 24069520 PMCID: PMC3781230 DOI: 10.3342/ceo.2013.6.3.166] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 08/13/2012] [Accepted: 08/17/2012] [Indexed: 12/03/2022] Open
Abstract
Objectives Laryngomicrosurgery (LMS) is used to manage most vocal fold lesions. However, the functional voice outcome of the LMS might be diverse due to the influence of various factors. We intend to evaluate the incidence and etiologic factors of persistent dysphonia after LMS for benign vocal fold disease (BVFD). Methods We performed a retrospective review of 755 patients who underwent LMS for BVFD. We analyzed the clinical characteristics, preoperative and postoperative two onths voice studies. Postsurgical dysphonia was defined as grade 1 or above in GRBAS (grade, roughness, breathiness, asthenia, and strain) scale. Thirty nine patients (5.2%; 25 males and 14 females; average, 42.9 years; range, 21 to 70 years) were diagnosed with postsurgical dysphonia. Results There was no correlation between the diagnosis, coexistence with laryngopharyngeal reflux disease, habit of smoking, or occupational voice abuse and voice outcome. The patients with a worse preoperative acoustic parameter had aworse voice outcome. Stroboscopic findings showed excessive scarring or bowing in 21 cases, presence of lesion remnant in eight cases, prolonged laryngeal edema in five and no abnormal findings in three. Conclusion Great care should be taken in patients with worse preoperative jitter. With a few exceptions, postoperative dysphonia can be avoided by the use of an ppropriate surgical technique.
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Goy H, Fernandes DN, Pichora-Fuller MK, van Lieshout P. Normative Voice Data for Younger and Older Adults. J Voice 2013; 27:545-55. [DOI: 10.1016/j.jvoice.2013.03.002] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 03/07/2013] [Indexed: 11/17/2022]
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Uloza V, Vegienė A, Pribuišienė R, Šaferis V. Quantitative Evaluation of Video Laryngostroboscopy: Reliability of the Basic Parameters. J Voice 2013; 27:361-8. [DOI: 10.1016/j.jvoice.2012.12.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 12/17/2012] [Indexed: 10/27/2022]
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Olszewski AE, Shen L, Jiang JJ. Objective methods of sample selection in acoustic analysis of voice. Ann Otol Rhinol Laryngol 2011; 120:155-61. [PMID: 21510140 DOI: 10.1177/000348941112000303] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES In acoustic voice analysis, the fact that reproducible methods of sample selection have not been defined impedes research study generalizability and clinical assessment of treatment efficacy. Because perturbation results differ along a single signal, this study sought to establish objective methods of sample selection by use of a moving window to determine the most stable regions of phonation. METHODS Voice signals obtained from 21 patients affected by laryngeal conditions associated with Parkinson's disease were analyzed to study jitter, shimmer, signal-to-noise ratio, and correlation dimension parameters when various sample selection procedures were used. Objectively selected voice samples were chosen based upon 5%, 10%, and 20% variance from a signal's minimum perturbation value. The stability of these samples, defined by the standard deviations of the acoustic measurements, was compared to the stability of unselected samples and subjectively selected samples. RESULTS A significant decrease in standard deviation values of acoustic parameters was found in comparing the objectively selected samples (particularly those selected with 5% and 10% variance) to the subjectively selected and unselected samples. CONCLUSIONS These results suggest that the development of an objective sample selection method may have significant effects on the stability and reliability of acoustic voice measurements.
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Affiliation(s)
- Aleksandra E Olszewski
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53706-1532, USA
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Analysis of factors influencing voice quality and therapeutic approaches in vocal polyp patients. Eur Arch Otorhinolaryngol 2011; 268:1321-7. [DOI: 10.1007/s00405-011-1618-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Accepted: 04/19/2011] [Indexed: 10/18/2022]
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