The effects of humming and pitch on craniofacial and craniocervical morphology measured using MRI

Awake 160-Slice Computed Tomography for Upper Airway Evaluation in 17 Dogs

This study investigated using a 160-slice multidetector computed tomography (CT) scanner for conscious image acquisition in dogs with upper airway disease, and describes findings in dogs that had previously undergone soft palate surgery. Seventeen client-owned dogs with upper airway disease were retrospectively reviewed, and classified into three groups: group I, "untreated brachycephalic obstructive airway syndrome (BOAS) patients"; group II, "previously treated BOAS patients"; and group III, "patients with respiratory disease other than BOAS". Data included signalment, clinical history, direct laryngoscopy and endoscopy findings, previous surgeries and CT findings. CT scans in group I revealed overlong and thickened soft palates in all dogs, and signs of laryngeal collapse in four dogs. Patients in group II exhibited normal soft palate lengths, while patients in group III displayed various findings such as nasopharyngeal narrowing and tracheal collapse. Upper airway examinations under general anaesthesia confirmed most CT findings. This study demonstrates the feasibility and value of conscious CT scanning for assessing upper airway diseases in dogs, providing valuable diagnostic information while eliminating the need for chemical immobilisation, thus reducing patient stress and cost. These findings offer new insight into upper airway anatomy in awake patients, especially in brachycephalic breeds, and lay a foundation for future research.

The Impact of Vocal Task on Voice Acoustics, Effort and Discomfort Following Submandibular Neuromuscular Electrical Stimulation in Healthy Adults

BACKGROUND

Neuromuscular electrical stimulation (NMES) offers a potential adjuvant to traditional voice therapy for individuals with dysphonia. The type of vocal task to implement in conjunction with electrical stimulation to achieve maximal therapeutic benefit is unknown. The purpose of this study was to elucidate the impact of tasks on voice outcomes.

METHODS

Nineteen vocally-healthy adult females, between 23 and 27 years of age (Ave: 23.8, SD: 1.13), participated in the study. 15 participants completed all three 30-minute sessions, and four completed at least one session. NMES was paired with three different voice conditions: high-pitched hum, low-pitched hum, and comfortable-pitched hum. Acoustic (average fundamental frequency and loudness; perturbation (jitter, shimmer, noise to harmonic ratio); Cepstral Spectral Index of Dysphonia; pitch range), perceived phonatory effort, and discomfort (delayed onset muscle soreness) measures were compared across conditions.

RESULTS

Eight participants experienced discomfort following NMES. Three participants withdrew from the study due to discomfort, and one withdrew due to an unrelated oral surgery. NMES paired with high-pitch humming resulted in increased average fundamental frequency during sustained phonation and reading tasks, and increased Cepstral Spectral Index of Dysphonia during sustained phonation. Low-pitch humming resulted in a decreased noise to harmonic ratio. No statistically significant changes in perceived phonatory effort were noted.

CONCLUSION

Almost half of the participants reported temporary discomfort. Task-specific differences in some outcomes were noted indicating that the nature of voice task performed with NMES must be considered when examining the impact of NMES on voice. Vocal tasks can impact discomfort and acoustic vocal outcomes of NMES.

Origins Of Vocal-Entangled Gesture

Gestures during speaking are typically understood in a representational framework: they represent absent or distal states of affairs by means of pointing, resemblance, or symbolic replacement. However, humans also gesture along with the rhythm of speaking, which is amenable to a non-representational perspective. Such a perspective centers on the phenomenon of vocal-entangled gestures and builds on evidence showing that when an upper limb with a certain mass decelerates/accelerates sufficiently, it yields impulses on the body that cascade in various ways into the respiratory-vocal system. It entails a physical entanglement between body motions, respiration, and vocal activities. It is shown that vocal-entangled gestures are realized in infant vocal-motor babbling before any representational use of gesture develops. Similarly, an overview is given of vocal-entangled processes in non-human animals. They can frequently be found in rats, bats, birds, and a range of other species that developed even earlier in the phylogenetic tree. Thus, the origins of human gesture lie in biomechanics, emerging early in ontogeny and running deep in phylogeny.

Gesture-speech physics in fluent speech and rhythmic upper limb movements

It is commonly understood that hand gesture and speech coordination in humans is culturally and cognitively acquired, rather than having a biological basis. Recently, however, the biomechanical physical coupling of arm movements to speech vocalization has been studied in steady-state vocalization and monosyllabic utterances, where forces produced during gesturing are transferred onto the tensioned body, leading to changes in respiratory-related activity and thereby affecting vocalization F0 and intensity. In the current experiment (n = 37), we extend this previous line of work to show that gesture-speech physics also impacts fluent speech. Compared with nonmovement, participants who are producing fluent self-formulated speech while rhythmically moving their limbs demonstrate heightened F0 and amplitude envelope, and such effects are more pronounced for higher-impulse arm versus lower-impulse wrist movement. We replicate that acoustic peaks arise especially during moments of peak impulse (i.e., the beat) of the movement, namely around deceleration phases of the movement. Finally, higher deceleration rates of higher-mass arm movements were related to higher peaks in acoustics. These results confirm a role for physical impulses of gesture affecting the speech system. We discuss the implications of gesture-speech physics for understanding of the emergence of communicative gesture, both ontogenetically and phylogenetically.

The pitch glide speech task lacks clinical utility to infer laryngeal lift during swallowing†

Purpose: To investigate the amount of laryngeal lift during the pitch glide speech task and during a bolus swallow.Method: Modified Barium Swallows (MBS) videos captured speech tasks and bolus trials. Using SwallowTail®, laryngeal elevation was measured by the amount of laryngeal lift from rest to its maximum excursion during each subject's pitch glide and 5 mL thin liquid, 20 mL thin liquid, and 15 mL puree trials. Paired t-tests, with Bonferroni correction, determined if there was a difference in laryngeal lift between the pitch glide and the bolus trials. Two methods were used to compare the methodology of measuring laryngeal lift.Result: Each subject's pitch glide was compared to their swallows. Laryngeal lift during the bolus swallow was greater than the lift during the pitch glide by an average of 1.10 cm, 1.38 cm, and 1.34 cm for 5 mL thin liquid, 20 mL thin liquid, and 15 mL puree, respectively. There was a significant difference in laryngeal lift between the pitch glide task and the 20 mL thin liquid, 5 mL thin liquid, and 15 mL puree swallows. Measurement tracking the posterior cricoid detected greater differences than the previous methodology using the hyoid.Conclusion: In this group of dysphagic patients, the larynx lifted significantly less during a pitch glide than during bolus swallows.

The Diagnostic Accuracy of the Pitch Glide to Identify Aspiration in Patients with Respiratory Diseases: A Pilot Study

INTRODUCTION

Initial research has been conducted to determine the diagnostic accuracy of the pitch glide during the clinical swallow evaluation to identify aspiration in adults after stroke. Findings suggest that reduced pitch glide can predict aspiration in patients with dysphagia after stroke. This study aimed to identify the diagnostic accuracy of the pitch glide in detecting aspiration, pharyngeal residue and hyo-laryngeal excursion during swallowing in adults with respiratory diseases.

MATERIAL AND METHODS

17 adults (9 males and 8 females) with dysphagia who had a background of respiratory diseases (chronic obstructive pulmonary disease = 11; lower respiratory tract infection = 6) were consecutively recruited in an acute hospital setting. Participants completed two pitch glide tasks (/a/ and /i/) immediately before a videofluoroscopic swallowing study (VFSS). Pitch glide recordings were analysed by blinded researchers both acoustically (Praat software) to obtain maximum F0, pitch range and auditory-perceptually using a binary scale ("normal" or "abnormal"). Clinicians blinded to pitch glide ratings rated 5 mL, 10 mL and a sip of liquid swallows during VFSS using the Penetration-Aspiration Scale, Bolus Residue Scale and hyolaryngeal component of the MBS Measurement Tool for Swallow Impairment. Receiver operating characteristic curve, Pearson correlations and independent sample t tests were used to address the research questions.

RESULTS

Maximum F0 of sound /a/ had high sensitivity and specificity in identifying aspiration on 10 mL of liquids during VFSS. Both pitch glides (/a/ and /i/) had moderate sensitivity and specificity in predicting aspiration on a sip of liquids. However, auditory-perceptual measures of pitch glide had weak accuracy in identifying people who were aspirating during VFSS. Finally, all pitch glide measures (acoustic and auditory-perceptual) had low accuracy in predicting pharyngeal residue and hyolaryngeal excursion.

CONCLUSION

Based on this initial pilot study, acoustic pitch glide of sound /a/ is an accurate way to predict aspiration on 10 mL of liquids in patients with respiratory diseases. Based on findings from this study, both auditory-perceptual and acoustic analyses of pitch glide could not identify residue and hyolaryngeal excursion.

The Effects of Heel Height on Head Position, Long-Term Average Spectra, and Perceptions of Female Singers

Female singers often wear high heels for auditions and performances. Heel height research in non-singing contexts indicates that wearing heels can affect body alignment and head position. Studies in orthodontics, sleep apnea, and voice science suggest that head and neck positioning can alter the vocal tract. The purpose of this study was to assess the effects, if any, of heel height (barefoot, 10.16-cm stilettos) on three angles of singer head position (calculated from C7-tragus-nasion), long-term average spectra data, and perceptual data (questionnaire) acquired from female (N = 30) soloists during alternating periods of silence and singing. Results indicated that all participants (100%) significantly decreased head position angle measurements (inferior and posterior head and neck movement) when singing in high heels compared with singing barefoot. Participants, on average, significantly increased head position angle measurements (superior and anterior head and neck movement) when singing compared with standing silently, and did so to a greater degree when transitioning from silent heels to singing heels compared with transitioning from silent barefoot to singing barefoot. Long-term average spectra data indicated significant spectral energy differences between barefoot and high heel singing conditions across participants. Most participants (n= 21, 70.00%) indicated they felt comfortable and sang their best while barefoot. Results of this study, the second in a series of experiments addressing the effects of shoe heel height on female singers' vocal production, were discussed in terms of application to vocal pedagogy and directions for future research.

Asociación entre el patrón postural cefálico y la inteligibilidad articulatoria del habla

RESUMEN Objetivo: el propósito de este estudio fue establecer un factor asociativo que relacione la morfología del sistema cráneo - cervical con el nivel de inteligibilidad articulatoria del habla en sujetos jóvenes. Métodos: estudio transversal, consideró una muestra de 42 jóvenes universitarios de un universo de 140, ambos sexos, sin antecedentes mórbidos y con un rango de edad entre 18 y 21 años. Se evalúo: a) inteligibilidad articulatoria mediante el coeficiente de variación periódica diadococinética, b) parámetros posturales estáticos tradicionales mediante método fotogramétrico y c) patrón postural cefálico mediante radiografía cefalométrica lateral. Resultados: se encontraron 36 sujetos con inteligibilidad adecuada y 6 alterada, donde la variable rotación cráneo cervical antero-posterior presentó diferencias estadísticamente significativas (p= 0,009) entre el grupo con inteligibilidad normal respecto al grupo con inteligibilidad alterada. El análisis de regresión lineal evidenció que sujetos que presentan rotación posterior de cabeza sobre cuello presentan mayor variabilidad en la emisión silábica del rendimiento diadocinético del habla (Sq r lineal = 0,128). Conclusión: se establece que la postura cefálica con presencia de rotación posterior de la cabeza sobre el cuello se asocia a la pérdida de inteligibilidad del habla en la muestra estudiada.

Occupational markers and pathology of the castrato singer Gaspare Pacchierotti (1740-1821)

Following the birth of modern opera in Italy in 1600, the demand for soprano voices grew up and the prepuberal castration was carried out to preserve the young male voice into adult life. Among the castrati, Gaspare Pacchierotti was probably one of the most famous. The remains of Pacchierotti were exhumed for the first time in 2013, for a research in the reconstruction of his biological profile, to understand the secrets behind his sublime voice and how the castration influenced the body. All the findings discovered, through anthropological and Computed Tomography analyses, are consistent both with the occupational markers of a singer and with the hormonal effects of castration. The erosion of cervical vertebrae, the insertion of respiratory muscles and muscles of the arms can be an effect of the bodily position and exercise during singing. The hormonal effect of castration were related to osteoporosis and to the disorders of spine.

The Effect of Head Position and/or Stance on the Self-perception of Phonatory Effort

BACKGROUND

Vocal fatigue is a common but poorly defined complaint of patients presenting with voice disorders. Definitions of vocal fatigue generally include increased self-perceived phonatory effort resulting from references to vocal loading or prolonged voice use resulting in deterioration of function. The present study looks at the role of posture, specifically head position and stance, in self-perceived phonatory effort.

METHODS

Forty-six healthy adults, 13 males and 33 females (mean age was 27.5), with no history of vocal problems/disorders within the past year were recruited. Subjects were asked to sustain the vowel /a/ at a comfortable pitch and loudness for 5-10 seconds in each of six positions: sitting and standing in the manner habitual for each subject, two exaggerated positions of the head (head back and head forward), and two exaggerated positions in standing (standing with knees locked and with knees soft). Each position was repeated three times in randomized order, resulting in 18 trials for each subject. After each repetition of the sustained /a/, subjects were asked to rate their experience of vocal effort using a 100-mm visual analog scale (0-40 least effort, 40-60 habitual effort, and 60-100 increased effort).

RESULTS

Repeated measures analysis of variance revealed significant difference in the self-perceived phonatory effort levels across positions (P value < 0.001). The exaggerated forward and back head positions in both sitting and standing positions showed the greatest significance on the Tukey post hoc tests (P < 0.000).

CONCLUSIONS

Based on the findings, posture may play a more important role in vocal fatigue than previously thought.

Correlation Between the Position of the Hyoid Bone on Lateral Cephalographs and Formant Frequencies

OBJECTIVES

The objective of this study is to examine the F1, F2, F3, and F4 during sustained vowels /ɑ/, /i/, /o/, /u/.

STUDY DESIGN

Prospective cross-sectional study.

METHODS

Fifty-two consecutive patients aged between 9 years and 38 years were invited to participate in this study. Linear measurements included linear vertical distance from the hyoid bone to the sella turcica (H-S); linear vertical distance from the hyoid bone to the posterior nasal spine (H-PNS); linear measure from the hyoid bone to the most anterior point of the cervical vertebra C3 (H-C3); and linear vertical distance from the hyoid bone to the mandibular plane (H-MP).

RESULTS

The results showed a moderate and statistically significant correlation between the average fundamental frequency for the vowel /ɑ/ and H-C3, H-S, and H-PNS and another moderate negative correlation between F3 and F4, and the vertical position of the hyoid bone H-C3 and H-S. For the vowel /i/, there was a moderate negative correlation between F1, F3, and F4 and H-S and also a moderate negative correlation between F3 and F4 and H-C3. For the vowel /o/, there was a moderate negative correlation between F4 and H-S and H-PNS. For the vowel /u/, only F4 correlated significantly with H-S.

CONCLUSION

There is a moderate correlation between the high formants, mostly F4, and the cephalo-caudal position of the hyoid bone.

Effortful pitch glide: a potential new exercise evaluated by dynamic MRI

PURPOSE

The purpose of this study was to compare the biomechanics of the effortful pitch glide (EPG) with swallowing using dynamic MRI. The EPG is a combination of a pitch glide and a pharyngeal squeeze maneuver for targeting laryngeal and pharyngeal muscles. The authors hypothesized that the EPG would elicit significantly greater structural excursions of anterior hyoid, superior hyoid, hyolaryngeal approximation, laryngeal elevation, and lateral pharyngeal wall medialization compared with swallowing.

METHOD

Eleven healthy, young subjects with a mean age of 25 were recruited. The EPG was first taught and verified via laryngoscopy. Then 2-planar (coronal and sagittal) dynamic MRI acquisitions captured 10 repeated swallows and 3 EPGs. Kinematic analyses of minimum and maximum excursion of anatomical landmarks were calculated.

RESULTS

Results showed a nonsignificant difference between the 2 tasks for range of excursion with all measured biomechanics except for superior hyoid, where the swallow showed significantly greater excursion. This indicated that swallowing and EPG biomechanics were comparable, lending support for the potential use of the EPG as another nonswallowing exercise.

CONCLUSION

Findings suggest EPG may be an effective exercise to target several important swallowing muscles, especially the long pharyngeal muscles that elevate the larynx and shorten the pharynx in swallowing.

Autonomic responses to correct outcomes and interaction errors during single-switch scanning among children with severe spastic quadriplegic cerebral palsy

BACKGROUND

The combination of single-switch access technology and scanning is the most promising means of augmentative and alternative communication for many children with severe physical disabilities. However, the physical impairment of the child and the technology's limited ability to interpret the child's intentions often lead to false positives and negatives (corresponding to accidental and missed selections, respectively) occurring at rates that frustrate the user and preclude functional communication. Multiple psychophysiological studies have associated cardiac deceleration and increased phasic electrodermal activity with self-realization of errors among able-bodied individuals. Thus, physiological measurements have potential utility at enhancing single-switch access, provided that such prototypical autonomic responses exist in persons with profound disabilities.

METHODS

The present case series investigated the autonomic responses of three pediatric single-switch users with severe spastic quadriplegic cerebral palsy, in the context of a single-switch letter matching activity. Each participant exhibited distinct autonomic responses to activity engagement.

RESULTS

Our analysis confirmed the presence of the autonomic response pattern of cardiac deceleration and increased phasic electrodermal activity following true positives, false positives and false negatives errors, but not subsequent to true negative outcomes.

CONCLUSIONS

These findings suggest that there may be merit in complementing single-switch input with autonomic measurements to improve augmentative and alternative communications for pediatric access technology users.