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van Hugte TBR, Heeren WFL. Exploring Interspeaker Variation in Creaky Voice in Dutch. J Voice 2024:S0892-1997(24)00162-0. [PMID: 38902141 DOI: 10.1016/j.jvoice.2024.05.011] [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: 03/04/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVES This study explored the extent and discriminatory potential of interspeaker variation in creaky voice in Dutch men. METHODS Intervals of creaky voice for 30 speakers were manually segmented and annotated from a corpus of spontaneous speech data. For each speaker, at least 1500 syllables were analyzed. Total creakiness was calculated based on the proportion of creaky syllables. Creaky intervals were categorized into subtypes based on the degree of periodicity. Furthermore, acoustic measurements were taken from the intervals and tested for speaker-discriminating capacity by means of a linear discriminant analysis (LDA). RESULTS Speakers differed in what percentage of syllables they realized with creaky voice, with a range of roughly 0-5% of all syllables. They likewise differed in the proportion with which they used different subtypes of creaky voice, such that some speakers have very distinctive profiles. The LDA resulted in correct classifications of creaky intervals to speakers at a rate above chance level. CONCLUSIONS Interspeaker variation in creaky voice in Dutch male speech was confirmed and allowed for moderate speaker classification on the basis of speech acoustics.
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Affiliation(s)
- Thom B R van Hugte
- Institut für Linguistik, Leipzig University, Leipzig, Germany; Leiden University Centre for Linguistics, Leiden University, Leiden, The Netherlands.
| | - Willemijn F L Heeren
- Leiden University Centre for Linguistics, Leiden University, Leiden, The Netherlands
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Barsties V Latoszek B, Watts CR, Hetjens S. The Efficacy of the Manual Circumlaryngeal Therapy for Muscle Tension Dysphonia: A Systematic Review and Meta-analysis. Laryngoscope 2024; 134:18-26. [PMID: 37366280 DOI: 10.1002/lary.30850] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/09/2023] [Accepted: 06/11/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Muscle tension dysphonia (MTD) is the most common functional voice disorder. Behavioral voice therapy is the front-line treatment for MTD, and laryngeal manual therapy may be a part of this treatment. The objective of this study was to investigate the effect of manual circumlaryngeal therapy (MCT) on acoustic markers of voice quality (jitter, shimmer, and harmonics-to-noise ratio) and vocal function (fundamental frequency) through a systematic review with meta-analysis. DATA SOURCES Four databases were searched from inception to December 2022, and a manual search was performed. REVIEW METHODS The PRISMA extension statement for reporting systematic reviews incorporating a meta-analysis of health care interventions was applied, and a random effects model was used for the meta-analyses. RESULTS We identified 6 eligible studies from 30 studies (without duplicates). The MCT approach was highly effective on acoustics with large effect sizes (Cohen's d > 0.8). Significant improvements were obtained in jitter in percent (mean difference of -.58; 95% CI -1.00 to 0.16), shimmer in percent (mean difference of -5.66; 95% CI -8.16 to 3.17), and harmonics-to-noise ratio in dB (mean difference of 4.65; 95% CI 1.90-7.41), with the latter two measurements continuing to be significantly improved by MCT when measurement variability is considered. CONCLUSION The efficacy of MCT for MTD was confirmed in most clinical studies by assessing jitter, shimmer, and harmonics-to-noise ratio related to voice quality. The effects of MCT on the fundamental frequency changes could not be verified. Further contributions of high-quality randomized control trials are needed to support evidence-based practice in laryngology. Laryngoscope, 134:18-26, 2024.
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Affiliation(s)
| | - Christopher R Watts
- Harris College of Nursing & Health Sciences, Texas Christian University, Fort Worth, Texas, USA
| | - Svetlana Hetjens
- Department for Medical Statistics and Biomathematics, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Nayebian R, Darouie A, Hasanvand A, Vahedi M. Cepstral and Perceptual Investigations of Voice in Speech and Language Pathologists with Vocal Fatigue. Indian J Otolaryngol Head Neck Surg 2023; 75:3696-3702. [PMID: 37974796 PMCID: PMC10645846 DOI: 10.1007/s12070-023-04048-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/27/2023] [Indexed: 11/19/2023] Open
Abstract
Vocal fatigue is known as a hyperfunctional voice disorder that can lead to other conditions, such as muscle tension dysphonia (MTD). Speech and language pathologists (SLPs) are professional voice users who may suffer from vocal fatigue due to heavy vocal demands. This study aimed at investigating the cepstral and perceptual dimensions of voice and their correlation in the SLPs with vocal fatigue. Twenty-six SLPs and senior speech therapy students (mean age = 27.11 ± 6.8 yrs), including men (n = 5) and women (n = 21), participated in this descriptive cross-sectional study. They had vocal fatigue according to the Vocal Fatigue Index (VFI). In acoustic assessment, cepstral analysis (CPP and CPPS) was performed using Praat software. The Persian version of Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) was used to evaluate the overall severity of dysphonia. The correlation between these two evaluations was also investigated using IBM SPSS Statistics software version 23. Results revealed that the mean CPPS (13.716 ± 2.084) was lower than the cutoff point. Perceptual findings indicated that the mean overall severity (10.557 ± 11.210) fell in the normal variability of voice quality (NVVQ) range. In addition, cepstral and perceptual evaluations had no significant correlation (P > 0/05). The findings showed that auditory-perceptual evaluation considered the gold standard method of voice evaluation, cannot solely identify vocal fatigue. However, cepstral measures can help provide a more objective profile of vocal function in SLPs with vocal fatigue. Therefore, both of these evaluations are recommended for voice assessment of vocal fatigue.
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Affiliation(s)
- Rezvane Nayebian
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Akbar Darouie
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Arezoo Hasanvand
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohsen Vahedi
- Department of Biostatistics and Epidemiology, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Barsties v. Latoszek B, Jansen V, Watts CR, Hetjens S. The Impact of Protective Face Coverings on Acoustic Markers in Voice: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:5922. [PMID: 37762863 PMCID: PMC10531748 DOI: 10.3390/jcm12185922] [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: 08/14/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Wearing respiratory protective masks (RPMs) has become common worldwide, especially in healthcare settings, since the onset of the COVID-19 pandemic. Hypotheses have suggested that sound transmission could be limited by RPMs, which possibly affects the characteristics of acoustic energy and speech intelligibility. The objective of this study was to investigate the effect of RPMs on acoustic measurements through a systematic review with meta-analysis. METHODS Five database searches were conducted, ranging from their inception to August 2023, as well as a manual search. Cross-sectional studies were included that provided data on widely used gender-independent clinical acoustic voice quality measures (jitter, shimmer, HNR, CPPS, and AVQI) and habitual sound pressure level (SPL). RESULTS We found nine eligible research studies with a total of 422 participants who were compared both without masks and with different types of masks. All included studies focused on individuals with vocally healthy voices, while two of the studies also included those with voice disorders. The results from the meta-analysis were related to medical/surgical and FFP2/(K)N95 masks. None of the acoustic measurements showed significant differences between the absence and presence of masks (p > 0.05). When indirectly comparing both mask types, statistical significance was identified for parameters of jitter, HNR, CPPS and SPL (p < 0.001). CONCLUSIONS The present meta-analysis indicates that certain types of RPMs have no significant influence on common voice quality parameters and SPL compared to recordings without masks. Nevertheless, it is plausible that significant differences in acoustic parameters might exist between different mask types. Consequently, it is advisable for the clinical practice to always use the same mask type when using RPMs to ensure high comparability and accuracy of measurement results.
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Affiliation(s)
| | - Viktoria Jansen
- 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
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Yildiz MG, Sagiroglu S, Bilal N, Kara I, Orhan I, Doganer A. Assessment of Subjective and Objective Voice Analysis According to Types of Sulcus Vocalis. J Voice 2023; 37:729-736. [PMID: 34112548 DOI: 10.1016/j.jvoice.2021.04.018] [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: 02/08/2021] [Revised: 03/30/2021] [Accepted: 04/08/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Sulcus vocalis (SV) subtypes are difficult to diagnose. Non-invasive techniques are sometimes not feasible in the diagnosis. The study aims to demonstrate the effectiveness and applicability of objective and subjective voice analysis combined with videolaryngostroboscopic examination (VLS) in the diagnosis of SV types. MATERIAL AND METHODS This is a retrospective study that includes patients who presented to Phoniatric outpatient clinic with complaints related to voice and diagnosed with SV on VLS examination between 2017-2020. The SV type was determined based on VLS findings and the patients were categorized into respective groups. Between- and within-group assessment of objective and subjective voice analysis of SV types was conducted. RESULTS 47 patients were included in the study; Type I, Type II, Type III SV patients were 16, 17, and 14 in number, respectively. Fundamental frequency (F0) and Shimmer (%) values were significantly high in Type II and III SV cases, whereas the Maximum Phonation Time (MPT) was significantly low. GRBAS, Voice Handicap Index -10 (VHI-10), Reflux Symptom Index (RSI) scores were statistically significantly high in pathological SV and Voice Related Quality of Life (V-RQOL) scores were low. A moderate correlation between VHI-10 and V-RQOL and between RSI and V-RQOL was detected. CONCLUSIONS Objective and subjective voice analysis in Type II and III SV show a significant difference compared to Type I SV. The use of objective and subjective voice analysis combined with VLS examination can be helpful in the diagnosis of SV types.
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Affiliation(s)
- Muhammed Gazi Yildiz
- The department of ENT, Kahramanmaraş Sütcü Imam university faculty of medicine, TURKEY.
| | - Saime Sagiroglu
- The department of ENT, Kahramanmaraş Sütcü Imam university faculty of medicine, TURKEY
| | - Nagihan Bilal
- The department of ENT, Kahramanmaraş Sütcü Imam university faculty of medicine, TURKEY
| | - Irfan Kara
- The department of ENT, Kahramanmaraş Sütcü Imam university faculty of medicine, TURKEY
| | - Israfil Orhan
- The department of ENT, Kahramanmaraş Sütcü Imam university faculty of medicine, TURKEY
| | - Adem Doganer
- The department of biostatistics, Kahramanmaraş Sütcü Imam university faculty of medicine, TURKEY
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Dwyer CD, Gochman GE, Rosen CA, Young VN, Schneider SL. Comparison of Outcome Measures (Subjective, Objective, and Patient-Based) in Laryngeal Dystonia Treatment With Botulinum Toxin A Injection. J Voice 2023:S0892-1997(23)00122-4. [PMID: 37121839 DOI: 10.1016/j.jvoice.2023.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Outcome assessment in laryngeal dystonia is hindered by lack of consensus on a core set of outcome measures to quantify treatment effect and disease severity on quality of life. Potential outcome measure domains include objective voice, clinician reported, and patient reported outcome measures (PROMs) for determining treatment success and longitudinal disease tracking. We aim to determine correlations between a selections of outcome measure tools following Botulinum toxin injection. METHODS A selection of instruments were administered to assess adductor laryngeal dystonia patient outcomes before and after Botulinum toxin injection. Voice samples recorded using a cellular telephone application were used for objective acoustic measures (CPPS, acoustic voice quality index) and speech language pathologist perceptual analysis (CAPE-V). Additionally, patients completed a PROMs battery consisting of the Voice Handicap Index-10, Communicative Participation Item Bank-10, OMNI-Vocal Effort Scale, 3 visual analog scale (VAS) questions. Changes in these outcome measures pre-post treatment were compared between each other and with a global rating of change questionnaire (GRCQ) using Spearman's rank correlation coefficients. RESULTS Twenty six patients (20 female, mean age 57.7 years) participated. Using an anchor based GRCQ, patients reported Botox efficacy was the only outcome measure found to have significant correlation (r = 0.54, P = 0.022); all other outcome measures did not meet statistically significant correlation. Amongst the selected outcome tools, several moderate-strong correlations were identified, largely for outcome measures within the same domain. Most notable were correlations between the patient reported OMNI-VES and VAS questions (r > 0.68, P < 0.05), clinician CAPE-V strain and overall severity (r = 0.900, P < 0.001), and acoustic voice quality index with sustained vowel CPPs (r = -0.797, P = 0.002). CONCLUSION Correlation between outcome measures instruments used for patients with adductor laryngeal dystonia requires further attention. Weak correlations with an anchor based GRCQ were found for this study's selected outcome instruments. A select number of correlations were found between outcome instruments within each of the individual outcome measure domains (patient perception, clinical perception, objective acoustics), but there was largely a lack of correlation found for instruments between these three separate domains.
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Affiliation(s)
- Christopher D Dwyer
- Division of Otolaryngology, Department of Surgery, Harvard University, Brigham & Women's Hospital, Boston, Massachusetts.
| | - Grant E Gochman
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California
| | - Clark A Rosen
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California
| | - VyVy N Young
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California
| | - Sarah L Schneider
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California
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Fujiki RB, Braden M, Thibeault SL. Voice Therapy Improves Acoustic and Auditory-Perceptual Outcomes in Children. Laryngoscope 2023; 133:977-983. [PMID: 35754165 PMCID: PMC9790974 DOI: 10.1002/lary.30263] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/02/2022] [Accepted: 06/14/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE This study employed acoustic measures as well as auditory-perceptual assessments to examine the effects of voice therapy in children presenting with benign vocal fold lesions. METHODS A retrospective, observational cohort design was employed. Sustained vowels produced by 129 children diagnosed with benign vocal fold lesions were analyzed, as well as connected speech samples produced by 47 children. Treatment outcome measures included Consensus of Auditory-Perceptual Evaluation of Voice (CAPE-V), jitter, shimmer, Noise-to-Harmonic Ratio (NHR), cepstral peak prominence (CPP), and Low-to-High Ratio (LHR) on sustained vowels, and CPP and LHR on connected speech. RESULTS Following voice therapy, significant improvements in CAPE-V ratings (p < 0.001) were observed. Additionally, jitter (p = 0.041), NHR (p = 0.019), and CPP (p < 0.01) on sustained vowels, and CPP (p = 0.002), and LHR (p = 0.008) on connected speech significantly improved following voice therapy. CPP increased with age in males but did not change in females. CAPE-V ratings and perturbation measures indicated that dysphonia was more severe in younger children pre and post-therapy. CONCLUSIONS Auditory-perceptual and acoustic measures demonstrated improved voice quality following voice therapy in children with dysphonia. CPP effectively quantified voice therapy gains and allowed for analysis of connected speech, in addition to sustained vowels. These findings demonstrate the value of CPP as a tool in assessing therapy outcomes and support the efficacy of voice therapy for children presenting with vocal fold lesions. LEVEL OF EVIDENCE 4 Laryngoscope, 133:977-983, 2023.
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Affiliation(s)
| | - Maia Braden
- Department of Communication Sciences and Disorders, University of Wisconsin Madison, Madison, Wisconsin, U.S.A
| | - Susan L Thibeault
- Department of Surgery, University of Wisconsin Madison, Madison, Wisconsin, U.S.A
- Department of Communication Sciences and Disorders, University of Wisconsin Madison, Madison, Wisconsin, U.S.A
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Voice Disorders in Lower Primary School Teachers: An Observational Study. J Voice 2023; 37:141.e1-141.e8. [PMID: 33349479 DOI: 10.1016/j.jvoice.2020.12.001] [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: 09/16/2020] [Revised: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Voice problems are very common among teachers, and etiology-based methods are used in the diagnosis and treatment process. Our study aims to reveal the changes in subjective voice analysis during the diagnosis and treatment process of dysphonia in lower primary school teachers. METHODS The nature of the study is a prospective observational one designed for lower primary school teachers in Kahramanmaraş conducted between the year 2015 and 2019 and evaluations for parameters including sociodemographic characteristics, laryngeal lesions and pre- and post-treatment scales such as Voice Handicap Index-10 (VHI-10), Reflux Symptom Index (RSI) and Hospital-Anxiety Depression Scale (HADS) for treatment subgroups were made. Statistical analysis was analyzed using SPSS. RESULTS Three hundred and fifty-one lower primary school teachers were included in the study. A statistically significant difference was found for the development of dysphonia in terms of sociodemographic features such as smoking, professional experience and crowdedness of classroom. Changes in RSI, VHI-10 and HADS values after treatment were clinically significant in all treatment groups. While there was a significant post-treatment improvement in terms of RSI in patients with granuloma and laryngopharyngeal reflux disorders, the VHI-10, and HADS assessments revealed a significant difference in clinical recovery compared to laryngeal lesions. CONCLUSION The RSI, VHI-10 and HADS values for various laryngeal pathologies were found to be high in dysphonic teachers. An improvement was observed in the scale scores upon the application of treatment modalities. This situation emphasizes the importance of questionnaire survey in the diagnosis, treatment, and follow-up process of dysphonia.
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Afacan NN, Özergin Coşkun Z, Çeliker M, Erdivanlı ÖÇ, Terzi S, Dursun E. Test-Retest Reliability and Discriminatory Power of Multi-Dimensional Voice Analysis Program (MDVP). Clin Otolaryngol 2022; 47:628-633. [PMID: 35833689 DOI: 10.1111/coa.13958] [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: 10/16/2021] [Revised: 05/18/2022] [Accepted: 06/26/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objectives of this study were to evaluate and compare the test-retest reliability of acoustic parameters (jitter [%], shimmer [%], noise-to-harmonic ratio (NHR), and voice turbulence index (VTI)) by using multidimensional voice program (MDVP), and to detect the discriminatory power of the acoustic measures with respect to dysphonic voices and normal voices. DESIGN, SETTING, PARTICIPANTS, AND METHODS Fifty-four (25 male and 29 female) participants with voice disorders and fifty-one (27 male and 24 female) participants with normal voices were enrolled in this study. They were assessed by anamnesis, visual examination, auditory perceptual assessment (GRBAS), and acoustic measurements. The intraclass correlation coefficient was used to determine the test-retest reliability. The effect size (d value) and p value obtained from the t-test were used to determine the discriminatory power. RESULTS In the normal group, good reliability was observed for jitter, shimmer, and NHR, and moderate reliability was observed for VTI. With regard to the dysphonic group, jitter, shimmer, and VTI were moderately reliable, and the NHR had good reliability. Meanwhile, the discriminatory powers of jitter and shimmer were evaluated as 'medium', and those of NHR and VTI as 'small'. CONCLUSIONS The reliability and discriminatory powers of our acoustic measures were high compared with most other studies. Their level of reliability and discriminatory power can be maximised by using stringent rules. However, attaining an excellent level of reliability and discriminatory seems infeasible power owing to the variable characteristic of voice. Therefore, acoustic measures should be adopted as a complementary tool.
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Affiliation(s)
| | | | | | | | - Suat Terzi
- Recep Tayyip Erdoğan University, Turkey, Rize
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Rechenberg L, Meurer EM, Melos M, Nienov OH, Corleta HVE, Capp E. Voice, Speech, and Clinical Aspects During Pregnancy: A Longitudinal Study. J Voice 2022:S0892-1997(22)00133-3. [PMID: 35662512 DOI: 10.1016/j.jvoice.2022.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Pregnancy involves anatomical, physiological, and metabolic changes in a woman's body. However, the effects of these changes on the voice remains unclear, particularly regarding the clinical characteristics. OBJECTIVES We aimed to evaluate changes in vocal and speech acoustic measures and the relationship between them and clinical aspects in women during pregnancy. METHOD A prospective, longitudinal study was carried out with 41 low risk, adult, pregnant women, followed for prenatal care. Demographic and anthropometric data as well as lifestyle habits and health conditions were collected. Voice recordings of sustained vowels, and automatic and spontaneous speech were held over each trimester and analyzed by PRAAT®to evaluate acoustic, aerodynamic, and articulatory measures. RESULTS There were no changes in fundamental frequency, jitter, shimmer, and harmony to noise ratio during pregnancy. Maximum phonation time (MPT), pause rate, and pause duration reduced at the end of pregnancy. MPT was lower in sedentary pregnant women. The fundamental frequency peak rate was higher in eutrophic participants and lower in the third trimester in women with BMI ≥25 kg/m2. Pause rate was higher in pregnant women with BMI ≥25 kg/m2. There was no relationship between sleep quality, reflux, and vocal symptoms and acoustic and aerodynamic measures. CONCLUSIONS Differences were shown in MPT and temporal pause measurements during pregnancy. Acoustic measurements did not change. There was a relationship between acoustic and aerodynamic measures and clinical variables (BMI, physical activity, and body mass gain).
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Affiliation(s)
- Leila Rechenberg
- Graduate Program of Health Science: Obstetrics and Gynecology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Undergraduate Program of Speech and Language Therapy, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Department of Social and Preventive Dentistry, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Eliséa Maria Meurer
- Graduate Program of Health Science: Obstetrics and Gynecology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Monica Melos
- Graduate Program of Health Science: Obstetrics and Gynecology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Undergraduate Program of Speech and Language Therapy, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Otto Henrique Nienov
- Graduate Program of Health Science: Obstetrics and Gynecology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Helena von Eye Corleta
- Graduate Program of Health Science: Obstetrics and Gynecology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Department of Obstetrics and Gynecology, Hospital de Clínicas de Porto Alegre, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Edison Capp
- Graduate Program of Health Science: Obstetrics and Gynecology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Department of Obstetrics and Gynecology, Hospital de Clínicas de Porto Alegre, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Yamauchi A, Imagawa H, Yokonishi H, Sakakibara KI, Tayama N. Sex and Age Stratified Voice Data in Japanese Vocally Healthy Individuals: Vocal Capacity. J Voice 2022:S0892-1997(22)00103-5. [PMID: 35513937 DOI: 10.1016/j.jvoice.2022.03.027] [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: 01/20/2022] [Revised: 03/30/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE There is no normative voice dataset regarding the vocal capacity of Japanese speakers in the English literature. We collected age- and sex-stratified data on the vocal capacity of vocally healthy Japanese speakers. METHODS In total, 111 vocally healthy Japanese speakers (42 men and 69 women) were divided into the young (13 men and 30 women), middle-aged (18 men and 27 women), and elderly (11 men and 12 women) groups. Participants underwent duration-, intensity-, and pitch-related vocal capacity tests using either a conventional method or an aerodynamic method or both. The data obtained were statistically analyzed in terms of age and sex. RESULTS Overall, the duration- and pitch-related parameters measured by the conventional method were generally comparable to the previous results in the literature, while duration-, pitch-, and intensity-related parameters measured by the aerodynamic method differed significantly from them. Significant sex differences were noted in all parameters in the duration-, intensity-, and pitch-related vocal capacity tests. Furthermore, significant age-related changes were observed in all parameters, except for the mean flow rate and highest pitch measured by the aerodynamic method. CONCLUSION This study is the first to provide a sex- and age-stratified database of the normative vocal capacity data of Japanese speakers. However, further improvements will be needed in the assessment protocols, conditions, or devices used for the duration-, intensity-, and pitch-related vocal capacity tests in the aerodynamic method.
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Affiliation(s)
- Akihito Yamauchi
- Department of Otolaryngology, The University of Tokyo Hospital, Tokyo, Japan.
| | - Hiroshi Imagawa
- Department of Otolaryngology, The University of Tokyo Hospital, Tokyo, Japan
| | - Hisayuki Yokonishi
- Department of Otolaryngology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Ken-Ichi Sakakibara
- Department of Communication Disorders, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Niro Tayama
- Department of Otolaryngology and Tracheo-Esophagology, National Center for Global Health and Medicine, Tokyo, Japan
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Pierce JL, Tanner K, Merrill RM, Shnowske L, Roy N. Acoustic Variability in the Healthy Female Voice Within and Across Days: How Much and Why? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3015-3031. [PMID: 34269598 DOI: 10.1044/2021_jslhr-21-00018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose The aims of this study were (1) to quantify variability in voice production (as measured acoustically) within and across consecutive days in vocally healthy female speakers, (2) to identify which acoustic measures are sensitive to this variability, and (3) to identify participant characteristics related to such voice variability. Method Participants included 45 young women with normal voices who were stratified by age, specifically 18-23, 24-29, and 30-35 years. Following an initial acoustic and auditory-perceptual voice assessment, participants performed standardized field voice recordings 3 times daily across a 7-day period. Acoustic analyses involved 32 cepstral-, spectral-, and time-based measures of connected speech and sustained vowels. Relationships among acoustic data and select demographic, health, and lifestyle (i.e., participant-based) factors were also examined. Results Significant time-of-day effects were observed for acoustic analyses within speakers (p < .05), with voices generally being worse in the morning. No significant differences were observed across consecutive days. Variations in voice production were associated with several participant factors, including improved voice with increased voice use; self-perceived poor voice function, minimal or no alcohol consumption, and extroverted personality; and worse voice with regular or current menstruation, depression, and anxiety. Conclusions This acoustic study provides essential information regarding the nature and extent to which healthy voices vary throughout the day and week. Participant-based factors that were associated with improved voice over time included increased voice use, self-perceived poor voice function, minimal or no alcohol consumption, and extroverted personality. Factors associated with worse voice production over time included regular or current menstruation, and depression and anxiety.
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Affiliation(s)
- Jenny L Pierce
- Department of Surgery, The University of Utah, Salt Lake City
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City
| | - Kristine Tanner
- Department of Communication Disorders, Brigham Young University, Provo, UT
| | - Ray M Merrill
- Department of Public Health, Brigham Young University, Provo, UT
| | - Lauren Shnowske
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City
- Department of Communication Sciences and Disorders, University of Kentucky, Lexington
| | - Nelson Roy
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City
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Villas-Bôas AP, Schwarz K, Fontanari AMV, Costa AB, Cardoso da Silva D, Schneider MA, Cielo CA, Spritzer PM, Rodrigues Lobato MI. Acoustic Measures of Brazilian Transgender Women's Voices: A Case-Control Study. Front Psychol 2021; 12:622526. [PMID: 34135803 PMCID: PMC8203313 DOI: 10.3389/fpsyg.2021.622526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/09/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: This study aims to compare the acoustic vocal analysis results of a group of transgender women relative to those of cisgender women. Methods: Thirty transgender women between the ages of 19 and 52 years old participated in the study. The control group was composed of 31 cisgender women between the ages of 20 and 48 years old. A standardized questionnaire was administered to collect general patient data to better characterize the participants. The vowel /a/ sounds of all participants were collected and analyzed by the Multi-Dimensional Voice Program advanced system. Results: Statistically significant differences between cisgender and transgender women were found on 14 measures: fundamental frequency, maximum fundamental frequency, minimum fundamental frequency, standard deviation of fundamental frequency, absolute jitter, percentage or relative jitter, fundamental frequency relative average perturbation, fundamental frequency perturbation quotient, smoothed fundamental frequency perturbation quotient, fundamental frequency variation, absolute shimmer, relative shimmer, voice turbulence index (lower values in the cases), and soft phonation index (higher values in the cases). The mean fundamental frequency value was 159.046 Hz for the cases and 192.435 Hz for the controls. Conclusion: Through glottal adaptations, the group of transgender women managed to feminize their voices, presenting voices that were less aperiodic and softer than those of cisgender women.
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Affiliation(s)
- Anna Paula Villas-Bôas
- Gender Identity Program, Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Porto Alegre, Brazil
| | - Karine Schwarz
- Identity Program, Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, Brazil
| | - Anna Martha Vaitses Fontanari
- Gender Identity Program, Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Porto Alegre, Brazil
| | - Angelo Brandelli Costa
- Pontifícia Universidade Católica do Rio Grande do Sul, Programa de Pós-Graduação em Psicologia e do Programa de Pós-Graduação em Ciências Sociais, Porto Alegre, Brazil
| | - Dhiordan Cardoso da Silva
- Gender Identity Program, Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Porto Alegre, Brazil
| | - Maiko Abel Schneider
- Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Carla Aparecida Cielo
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Speech Therapy Department, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Poli Mara Spritzer
- Identity Program, Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, Brazil
| | - Maria Inês Rodrigues Lobato
- Gender Identity Program, Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Porto Alegre, Brazil
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Hall A, Kawai K, Graber K, Spencer G, Roussin C, Weinstock P, Volk MS. Acoustic analysis of surgeons’ voices to assess change in the stress response during surgical in situ simulation. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2021; 7:471-477. [DOI: 10.1136/bmjstel-2020-000727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 11/04/2022]
Abstract
IntroductionStress may serve as an adjunct (challenge) or hindrance (threat) to the learning process. Determining the effect of an individual’s response to situational demands in either a real or simulated situation may enable optimisation of the learning environment. Studies of acoustic analysis suggest that mean fundamental frequency and formant frequencies of voice vary with an individual’s response during stressful events. This hypothesis is reviewed within the otolaryngology (ORL) simulation environment to assess whether acoustic analysis could be used as a tool to determine participants’ stress response and cognitive load in medical simulation. Such an assessment could lead to optimisation of the learning environment.MethodologyORL simulation scenarios were performed to teach the participants teamwork and refine clinical skills. Each was performed in an actual operating room (OR) environment (in situ) with a multidisciplinary team consisting of ORL surgeons, OR nurses and anaesthesiologists. Ten of the scenarios were led by an ORL attending and ten were led by an ORL fellow. The vocal communication of each of the 20 individual leaders was analysed using a long-term pitch analysis PRAAT software (autocorrelation method) to obtain mean fundamental frequency (F0) and first four formant frequencies (F1, F2, F3 and F4). In reviewing individual scenarios, each leader’s voice was analysed during a non-stressful environment (WHO sign-out procedure) and compared with their voice during a stressful portion of the scenario (responding to deteriorating oxygen saturations in the manikin).ResultsThe mean unstressed F0 for the male voice was 161.4 Hz and for the female voice was 217.9 Hz. The mean fundamental frequency of speech in the ORL fellow (lead surgeon) group increased by 34.5 Hz between the scenario’s baseline and stressful portions. This was significantly different to the mean change of −0.5 Hz noted in the attending group (p=0.01). No changes were seen in F1, F2, F3 or F4.ConclusionsThis study demonstrates a method of acoustic analysis of the voices of participants taking part in medical simulations. It suggests acoustic analysis of participants may offer a simple, non-invasive, non-intrusive adjunct in evaluating and titrating the stress response during simulation.
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Pierce JL, Tanner K, Merrill RM, Shnowske L, Roy N. A Field-Based Approach to Establish Normative Acoustic Data for Healthy Female Voices. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:691-706. [PMID: 33561361 DOI: 10.1044/2020_jslhr-20-00490] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The primary aim of this study was to obtain high-quality acoustic normative data in natural field environments for female voices. A secondary aim was to examine acoustic measurement variability in field environments. Method This study employed a within-subject repeated-measures experimental design that included 45 young female adults with normal voices. Participants were stratified by age (18-23, 24-29, and 30-35 years). After initial evaluation and instruction, participants completed voice recordings during seven consecutive days using a standard protocol, including both connected speech and sustained vowels. Thirty-two cepstral-, spectral-, and time-based acoustic measures were acquired using Praat and the Analysis of Dysphonia in Speech and Voice. Results Among the 958 total recordings, greater than 90% satisfied inclusion criteria based on protocol compliance, peak clipping, and signal-to-noise ratio. Significant differences were observed for age (p < .05). For 19 acoustic measures, values improved significantly as signal-to-noise ratio increased. Cepstral- and spectral-based measures demonstrated less measurement variability as compared with time-based measures. Conclusions With adequate training, field audio recordings represent a viable option for clinical voice management. The significant age effects observed in this study support the need for more specific criteria when collecting and applying normative data. Cepstral- and spectral-based measures demonstrated the least measurement variability. This study provides additional evidence for multiparameter acoustic voice measurement, specifically toward ecologically valid sampling in natural environments. Future studies should expand on these findings in other populations with normal and disordered voices.
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Affiliation(s)
- Jenny L Pierce
- Department of Surgery, The University of Utah, Salt Lake City
- Department of Communication Sciences & Disorders, The University of Utah, Salt Lake City
| | - Kristine Tanner
- Department of Communication Disorders, Brigham Young University, Provo, UT
| | - Ray M Merrill
- Department of Public Health, Brigham Young University, Provo, UT
| | - Lauren Shnowske
- Department of Communication Sciences & Disorders, The University of Utah, Salt Lake City
- Department of Communication Sciences and Disorders, University of Kentucky, Lexington
| | - Nelson Roy
- Department of Communication Sciences & Disorders, The University of Utah, Salt Lake City
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Saggio G, Costantini G. Worldwide Healthy Adult Voice Baseline Parameters: A Comprehensive Review. J Voice 2020; 36:637-649. [PMID: 33039203 DOI: 10.1016/j.jvoice.2020.08.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 12/17/2022]
Abstract
The voice results in acoustic signals analyzed and synthetized at first for telecommunication matters, and more recently investigated for medical purposes. In particular, voice signal characteristics can evidence individual health conditions useful for screening, diagnostic and remote monitoring aims. Within this frame, the knowledge of baseline features of healthy voice is mandatory, in order to balance a comparison with their unhealthy counterpart. However, the baseline features of the human voice depend on gender, age-range and ethnicity and, as far as we know, no work reports as those features spread worldwide. This paper intends to cover this lack. Our database research yielded 179 relevant published studies, retrieved using digital libraries of IEEE Xplore, Scopus, Web of Science, Iop Science, Taylor and Francis Online, and Scitepress. These relevant studies report different features, among which here we consider the most investigated ones, within the most investigated age-range. In particular, the features are the fundamental frequency, the jitter, the shimmer, the harmonic-to-noise ratio, and the cepstral peak prominence, the most investigated age-range is within 20-40 years and, related to the ethnicity, 20 countries are considered.
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Affiliation(s)
- Giovanni Saggio
- Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy.
| | - Giovanni Costantini
- Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy
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Young VN, Jordan KM, Schneider SL, Lazar A, Dwyer CD, Rosen CA. Laryngology Quality of Life Questionnaire Associations: Towards Reducing Survey Burden. Laryngoscope 2020; 131:1561-1565. [PMID: 32901941 DOI: 10.1002/lary.29019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/06/2020] [Accepted: 07/24/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Outcomes in laryngology focus primarily on patient reported outcome measures (PROMs). The increasing number of questionnaires may lead to survey fatigue. We sought to determine the relationship between the newest questionnaire, Laryngopharyngeal Universal Measure of Perceived Sensation (LUMP), and other laryngology PROMs. STUDY DESIGN Cross-sectional study. METHODS Patients undergoing laryngology multidisciplinary evaluation prospectively completed laryngology questionnaires. Average summed scores between standard laryngology PROMs (ie, VHI-10, RSI, DI, CSI, EAT-10) and LUMP were compared. Expert consensus panel identified the most clinically relevant statements which were then compared to LUMP summed scores, in increasingly additive fashion. RESULTS Four hundred eighty patients (259 female) were assessed. Average age was 57.1 ± 17.7 years. Intraclass correlation coefficient (ICC) for each PROM in comparison to LUMP ranged from moderate to poor correlation: 0.64 (RSI), 0.55 (EAT-10), 0.50 (DI), 0.48 (CSI), and 0.34 (VHI-10). ICC for combinations of the five most clinically relevant individual items ranged from 0.29-0.53. CONCLUSIONS Patients with self-reported globus had statistically significantly higher scores across all PROMs. RSI had moderate correlation with LUMP, and the five selected expert consensus items demonstrated weaker correlation. While RSI may serve as a moderately selective clinical proxy for the LUMP questionnaire, LUMP remains a validated tool with increased specificity for quantification of globus which may be especially important in the research setting. There is continued question about the need for multiple laryngologic PROMs to evaluate patient complaints, and survey reduction remains an area of interest to decrease respondent fatigue, optimize patient care, and quantify interventional success. LEVEL OF EVIDENCE 4 Laryngoscope, 131:1561-1565, 2021.
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Affiliation(s)
- VyVy N Young
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
| | - Kristiana M Jordan
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
| | - Sarah L Schneider
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
| | - Ann Lazar
- Division of Biostatistics, Clinical and Translational Science Institute, University of California - San Francisco, San Francisco, California, U.S.A
| | - Christopher D Dwyer
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
| | - Clark A Rosen
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, California, U.S.A
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Young VN, Yousef A, Zhao NW, Schneider SL. Voice and Stroboscopic Characteristics in Transgender Patients Seeking Gender-Affirming Voice Care. Laryngoscope 2020; 131:1071-1077. [PMID: 32750170 DOI: 10.1002/lary.28932] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/09/2020] [Accepted: 06/20/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Understanding transgender voice is in nascent stages. This study describes voice characteristics in treatment-seeking trans women by comparing two validated questionnaires-Voice Handicap Index-10 (VHI-10) and Transsexual Voice Questionnaire (TVQMtF )-and reports incidence of abnormal stroboscopy findings and acoustic characteristics. METHODS Retrospective review of transgender patients presenting to tertiary-care laryngology center between February 2018-February 2019. Mean VHI-10, TVQ, and Singing VHI-10 (SVHI-10) scores; audio-perceptual grade; acoustic measures; and stroboscopy findings were analyzed. VHI-10 and SVHI-10 vs TVQMtF were compared. RESULTS Sixty-one trans female patients (mean age: 32 ± 11 years) were analyzed. Mean duration since start of transition was 41.5 ± 61 months. Sixty-nine percent presented full-time female in all contexts. Pathologic stroboscopy findings were found in 5%. Mean questionnaire scores were 16 ± 10 (VHI-10), 19 ± 13 (SVHI-10), and 81 ± 22 (TVQMtF ). Correlation between VHI-10 and SVHI-10 versus TVQMtF was weak, R = 0.47 (P = .053) and R = 0.35 (P = .17), respectively. Mean audio-perceptual grade was 0.27 ± 0.15. Mean Cepstral Spectral Index of Dysphonia (CSID, sustained vowel) was 8.5 ± 21.9. Mean Cepstral Peak Prominence (CPP) Fo and CPP Fo SD in rainbow passage were 157.3 ± 16 and 59.4 ± 15.9, respectively. CONCLUSION Trans women report perceived voice handicap in speaking and singing, which appears separate from gender-related voice/communication concerns. This study is the first to report stroboscopy findings in transgender individuals, with 5% being abnormal. Stroboscopy is encouraged before initiating voice intervention in transgender patients. Preliminary evaluation suggests weak correlation between VHI-10 or SVHI-10 and TVQMtF but requires further investigation. TVQMtF may provide information which more specifically reflects voice concerns of trans women as compared to VHI-10 and SVHI-10. LEVEL OF EVIDENCE 4 Laryngoscope, 131:1071-1077, 2021.
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Affiliation(s)
- VyVy N Young
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Andrew Yousef
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Nina W Zhao
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, U.S.A
| | - Sarah L Schneider
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, U.S.A
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Kitayama I, Hosokawa K, Iwahashi T, Iwahashi M, Iwaki S, Kato C, Yoshida M, Umatani M, Matsushiro N, Ogawa M, Inohara H. Intertext Variability of Smoothed Cepstral Peak Prominence, Methods to Control It, and Its Diagnostic Properties. J Voice 2020; 34:305-319. [DOI: 10.1016/j.jvoice.2018.09.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 11/30/2022]
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Cepstral and Perceptual Investigations in Female Teachers With Functionally Healthy Voice. J Voice 2020; 34:485.e33-485.e43. [DOI: 10.1016/j.jvoice.2018.09.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/11/2018] [Accepted: 09/11/2018] [Indexed: 11/23/2022]
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P S S, Pebbili GK. Cepstral Analysis of Voice in Young Adults. J Voice 2020; 36:43-49. [PMID: 32336570 DOI: 10.1016/j.jvoice.2020.03.010] [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: 11/29/2019] [Revised: 03/09/2020] [Accepted: 03/13/2020] [Indexed: 11/25/2022]
Abstract
The fundamental frequency and harmonic organization of voice can be quantified using cepstral measure. The two commonly studied cepstral measures are Cepstral Peak Prominence (CPP) and smoothened Cepstral peak prominence (sCPP). CPP is determined by measuring the amplitude difference from the highest peak of the cepstrum to the corresponding regression line, drawn directly below the cepstral peaks and when a smoothening factor is applied, sCPP is obtained. Cepstral analysis has been reported to be a reliable and valid measure for voice evaluation even for signals with high level of aperiodicity, which the time based measures fails to evaluate. Thus, the present study aimed to investigate the reference values for CPP and sCPP in young adults with normal voice in the age range of 20-40 years. Hundred adults in the age range of 20-40 years with equal number of males and females were considered and the task includes to phonate vowels /a/, /i/ and /u/ for five seconds each and to read "300 word Kannada reading passage" (Savithri & Jayaram, 2005) and the Bengaluru passage. The cepstral analysis was done using speech tool software (version 1.65). The data was subjected to statistical analysis using SPSS (version 21). The present study provides the reference values for CPP and sCPP across various stimuli.
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Affiliation(s)
- Sujitha P S
- CDMRP, Speech Language Pathology and Audiology Unit, Department of Psychology, University of Calicut, Kerala, India.
| | - Gopi Kishore Pebbili
- Department of speech language pathology, All India Institute of Speech and Hearing, Mysore, India
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Park Y, Stepp CE. Test-Retest Reliability of Relative Fundamental Frequency and Conventional Acoustic, Aerodynamic, and Perceptual Measures in Individuals With Healthy Voices. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:1707-1718. [PMID: 31181173 PMCID: PMC6808369 DOI: 10.1044/2019_jslhr-s-18-0507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/14/2019] [Accepted: 02/18/2019] [Indexed: 05/31/2023]
Abstract
Purpose Recent studies have shown that an acoustic measure, relative fundamental frequency (RFF), has potential for the assessment of excessive laryngeal tension and vocal effort associated with functional and neurological voice disorders. This study presents an analysis of the test-retest reliability of RFF in individuals with healthy voices and a comparison of reliability between RFF and conventional measures of voice. Method Acoustic and aerodynamic measurements and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) were performed on 28 individuals with healthy voices on 5 consecutive days. Participants produced RFF stimuli, a sustained /ɑ/, and a reading passage to allow for extraction of acoustic measures and CAPE-V ratings; /pa/ trains were produced to allow for extraction of aerodynamic measures. Results Moderate reliabilities (intraclass correlation coefficient [ICC] = .64-.71) were found for RFF values. Mean vocal fundamental frequency, smoothed cepstral peak prominence, shimmer, harmonics-to-noise ratio, and mean airflow rate exhibited good-to-excellent reliabilities (ICC = .76-.99). ICCs for jitter and phonation threshold pressure were moderately reliable (ICC = .67-.74). ICCs for subglottal pressure estimates and all CAPE-V parameters showed poor reliabilities (ICC = .31-.58). Conclusion RFF has comparable reliability to conventional measures of voice. This expands the potential for clinical application of RFF. Supplemental Material https://doi.org/10.23641/asha.8233376.
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Affiliation(s)
- Yeonggwang Park
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
| | - Cara E. Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
- Department of Biomedical Engineering, Boston University, MA
- Department of Otolaryngology–Head and Neck Surgery, Boston University School of Medicine, MA
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Andrea M, Andrea M, Figueira ML. Self-perception of quality of life in patients with functional voice disorders: the effects of psychological and vocal acoustic variables. Eur Arch Otorhinolaryngol 2018; 275:2745-2754. [PMID: 30116878 DOI: 10.1007/s00405-018-5090-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 07/31/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE Functional voice disorders (FVD) are multifactorial and may have a significant impact on the patients' quality of life (QOL). The aim of this study was to explore and analyze the relationship between the VHI scores, psychological variables, and objective voice measurements, and to develop a psychological and/or vocal acoustic model for the overall self-perceived evaluation of quality of life for three different types of FVD. METHODS After ENT examination, 83 women were classified into three groups: psychogenic voice disorder (PVD = 39), primary muscle tension voice disorder (MTVD1 = 16), and secondary muscle tension voice disorder (MTVD2 = 28). All patients were evaluated according to a multidisciplinary assessment protocol, which included the self-evaluation of quality of life (Voice Handicap Index, VHI), psychological evaluation (Hamilton Rating Scales for Depression (HAM-D) and for Anxiety (HARS), and Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Auto questionnaire (TEMPS-A)), and vocal acoustic analysis [mean fundamental frequency (F0, Hz), jitter (local, %), shimmer (local, %), and harmonic-to-noise ratio (HNR, dB)]. RESULTS Our findings revealed a moderate impact on QOL, regardless of the type of FVD. There were significant correlations between VHI scores, psychological variables, and voice perturbation parameters, with the exception of the MTVD1 and MTVD2 groups. The stepwise multiple linear regression analysis suggested that QOL could be explained by: anxious temperament together with shimmer in PVD group, jitter in the MTVD1 group, and depressive temperament in the MTVD2 group. CONCLUSIONS Affective temperaments and/or voice perturbation parameters were meaningful predictors of self-evaluation of quality of life in patients with different types of FVD.
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Affiliation(s)
- Mafalda Andrea
- Department of Psychiatry, Santa Maria Hospital, Lisbon, Portugal.
| | - Mario Andrea
- University Clinic of Otolaryngology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Maria Luísa Figueira
- University Clinic of Psychiatric and Medical Psychology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Jeffery T, Cunningham S, Whiteside SP. Analyses of Sustained Vowels in Down Syndrome (DS): A Case Study Using Spectrograms and Perturbation Data to Investigate Voice Quality in Four Adults With DS. J Voice 2018; 32:644.e11-644.e24. [DOI: 10.1016/j.jvoice.2017.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 11/16/2022]
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Young VN, Jeong K, Rothenberger SD, Gillespie AI, Smith LJ, Gartner‐Schmidt JL, Rosen CA. Minimal clinically important difference of voice handicap index‐10 in vocal fold paralysis. Laryngoscope 2017; 128:1419-1424. [DOI: 10.1002/lary.27001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 09/13/2017] [Accepted: 10/16/2017] [Indexed: 01/14/2023]
Affiliation(s)
- VyVy N. Young
- Department of Otolaryngology, University of Pittsburgh Voice CenterUniversity of Pittsburgh School of MedicinePittsburgh Pennsylvania U.S.A
| | - Kwonho Jeong
- Department of MedicineCenter for Research on Health Care Data CenterUniversity of Pittsburgh School of MedicinePittsburgh Pennsylvania U.S.A
| | - Scott D. Rothenberger
- Department of MedicineCenter for Research on Health Care Data CenterUniversity of Pittsburgh School of MedicinePittsburgh Pennsylvania U.S.A
| | - Amanda I. Gillespie
- Department of Otolaryngology, University of Pittsburgh Voice CenterUniversity of Pittsburgh School of MedicinePittsburgh Pennsylvania U.S.A
| | - Libby J. Smith
- Department of Otolaryngology, University of Pittsburgh Voice CenterUniversity of Pittsburgh School of MedicinePittsburgh Pennsylvania U.S.A
| | - Jackie L. Gartner‐Schmidt
- Department of Otolaryngology, University of Pittsburgh Voice CenterUniversity of Pittsburgh School of MedicinePittsburgh Pennsylvania U.S.A
| | - Clark A. Rosen
- Department of Otolaryngology, University of Pittsburgh Voice CenterUniversity of Pittsburgh School of MedicinePittsburgh Pennsylvania U.S.A
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Meurer EM, Moura AD, Rechenberg L, von Eye Corleta H, Capp E. Vocal Range in the Speech of Users of Low-Dose Oral Contraceptives. J Voice 2017; 31:390.e17-390.e21. [DOI: 10.1016/j.jvoice.2016.09.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 09/22/2016] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
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Johnson AM, Goldfine A. Intrasubject Reliability of Maximum Phonation Time. J Voice 2016; 30:775.e1-775.e4. [DOI: 10.1016/j.jvoice.2015.11.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 11/23/2015] [Indexed: 11/15/2022]
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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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State-Space Approach to Structural Representation of Perturbed Pitch Period Sequences in Voice Signals. J Voice 2015; 29:682-92. [PMID: 25944289 DOI: 10.1016/j.jvoice.2014.11.007] [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: 08/15/2014] [Accepted: 11/20/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to propose a state space-based approach to model perturbed pitch period sequences (PPSs), extracted from real sustained vowels, combining the principal features of disturbed real PPSs with structural analysis of stochastic time series and state space methods. METHODS The PPSs were obtained from a database composed of 53 healthy subjects. State space models were developed taking into account different structures and complexity levels. PPS features such as trend, cycle, and irregular structures were considered. Model parameters were calculated using optimization procedures. For each PPS, state estimates were obtained combining the developed models and diffuse initialization with filtering and smoothing methods. Statistical tests were applied to objectively evaluate the performance of this method. RESULTS Statistical tests demonstrated that the proposed approach correctly represented more than the 75% of the database with a significance value of 0.05. In the analysis, structural estimates suitably characterized the dynamics of the PPSs. Trend estimates proved to properly represent slow long-term dynamics, whereas cycle estimates captured short-term autoregressive dependencies. CONCLUSIONS The present study demonstrated that the proposed approach is suitable for representing and analyzing real perturbed PPSs, also allowing to extract further information related to the phonation process.
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Fraile R, Godino-Llorente JI. Cepstral peak prominence: A comprehensive analysis. Biomed Signal Process Control 2014. [DOI: 10.1016/j.bspc.2014.07.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gillespie AI, Dastolfo C, Magid N, Gartner-Schmidt J. Acoustic Analysis of Four Common Voice Diagnoses: Moving Toward Disorder-Specific Assessment. J Voice 2014; 28:582-8. [DOI: 10.1016/j.jvoice.2014.02.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 02/05/2014] [Indexed: 10/25/2022]
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The effect of oral topical anesthesia on the characteristics of voice. J Voice 2013; 28:92-7. [PMID: 24050820 DOI: 10.1016/j.jvoice.2013.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 07/29/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVES/HYPOTHESIS Although oral topical anesthesia is used routinely before rigid laryngeal endoscopy, no study has determined whether oral topical anesthesia changes voice quality. Our goal was to determine the effects of topical anesthesia on voice. STUDY DESIGN Prospective cohort study. METHODS Adult patients presenting to a laryngology practice who required rigid laryngeal endoscopy as part of the routine clinical visit were eligible for the study. Voices were recorded before and after oral topical benzocaine (14%)/butamben (2%)/tetracaine (2%) (ie, cetacaine) spray. Consensus auditory perceptual evaluation of voice (CAPE-V) protocol was used for the voice recordings and was the primary outcome measure. Recordings were presented randomly to two blinded speech-language pathologists specialized in voice. Secondary outcome measures were fundamental frequency (F0), jitter, shimmer, and noise-to-harmonics ratio (N/H) on sustained /i/ and speaking F0. RESULTS One hundred two patients participated in the study. There was no significant difference in CAPE-V measurements before and after topical anesthesia for all six attributes: overall severity (P = 0.145), roughness (P = 0.214), breathiness (P = 0.761), strain (P = 0.053), pitch (P = 0.301), and loudness (P = 0.320). There was no significant difference in jitter (P = 0.315), shimmer (P = 0.942), N/H (P = 0.128), and speaking F0 (P = 0.320). F0 /i/ decreased by a mean of 4.8Hz, which was statistically significant (P = 0.003), but probably not clinically significant. CONCLUSION There was no clinically significant voice change after oral topical anesthesia.
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