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Diniz ML, Penido FA, Gama ACC. Cepstral Measurements: A Comparison of Results Between Singing and Non-Singing Individuals. J Voice 2023; 37:851-856. [PMID: 34281752 DOI: 10.1016/j.jvoice.2021.06.010] [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: 03/20/2021] [Revised: 06/07/2021] [Accepted: 06/15/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To analyze and compare cepstral measurements in singing and non-singing men and women to understand if vocal adaptations of singers reflect greater cepstral measurement results. METHOD The study included 91 vocally healthy individuals, consisting of 60 erudite or popular singers (30 males, 30 females) and 31 non-singers (16 males, 15 females). The Cepstral Peak Prominence (CPP) and Cepstral Peak Prominence-Smoothed (CPPS) measures were carried out using the sustained /a/ vowel recorded with a unidirectional condenser microphone associated with a sound card on the computer. The Praat software (version 6.1.16) was used to extract the CPP and CPPS measurements. The intra and intergroup values obtained for each sex were compared using the t-test with a 5% significance level. RESULTS There was a CPP (P = 0,000) and CPPS (P = 0,000 and P = 0,001) value difference between the sexes in both groups. Cepstral measurements showed no statistically significant difference between singing and non-singing participants (male: P = 0,778 and P = 0,622; female: P = 0,622 and P = 0,460). CONCLUSION Men presented higher CPP and CPPS values than women, which may be related to the presence of the physiological posterior glottic cleft in women. The knowledge of the cepstral values of singers shows that singing specificities may not reflect in all vocal evaluations.
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Affiliation(s)
- Maria Luiza Diniz
- Department of Speech-language Pathology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Fabiana Andrade Penido
- Speech-language Pathology Expert at the Central Superintendence of the Server's Health and Medical Expertise of the State of Minas Gerais. Belo Horizonte, Minas Gerais, Brazil
| | - Ana Cristina Côrtes Gama
- Department of Speech-language Pathology, Federal University of Minas Gerais. Belo Horizonte, Minas Gerais, Brazil; Researcher of Productivity at National Council of Scientific Researches - Brazil (CNPq) (n° 309108/2019-5); Study conducted at the Department of Speech-language Pathology, Faculty of Medicine, Universidade Federal de Minas Gerais - UFMG - Minas Gerais (MG)
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Yılmaz T. Voice After Cordectomy Type I or Type II or Radiation Therapy for Large T 1a Glottic Cancer. Otolaryngol Head Neck Surg 2023; 168:798-804. [PMID: 35943800 DOI: 10.1177/01945998221117453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE T1a glottic cancer can be treated with transoral laser microsurgery (TLM) or radiation therapy (RT). Dysphonia is the major disadvantage of TLM, and preservation of voice appears to be the best advantage of RT compared to TLM. Studies on voice outcomes of both options gave conflicting results, but there is a tendency toward better voice outcome after TLM compared to the past. STUDY DESIGN Nonrandomized retrospective cohort study. SETTING Tertiary referral center. METHODS In total, 172 patients with a cancer lesion involving more than two-thirds of 1 membranous vocal fold underwent cordectomy type I (n = 56) (C1 group) or type II (n = 59) (C2 group) or RT (n = 57) (RT group). GRBASI (grade, roughness, breathiness, asthenia, strain, instability), videolaryngostroboscopy, Voice Handicap Index-30, acoustic analysis including F0, jitter, shimmer, noise to harmonic ratio, cepstral peak prominence, and cepstral spectral index of dysphonia using running speech, and aerodynamic analysis were performed before treatment and 6 and 24 months after treatment. RESULTS Study groups did not differ significantly on pretreatment voice outcomes (P > .05). The RT group had significantly better voice outcomes at 6 months posttreatment compared to the C1 and C2 groups (P < .05). The C1 group had significantly better voice outcomes at 6 months posttreatment compared to the C2 group (P < .05). The C1 group had significantly better voice outcomes at 24 months posttreatment compared to the RT and C2 groups (P < .05). The RT and C2 groups did not differ significantly at 24 months posttreatment (P > .05). CONCLUSION Voice outcomes after C2 are equal to RT. C1 has better voice outcomes than RT. C1 and C2 can be the treatment of choice for large T1a glottic cancers.
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Affiliation(s)
- Taner Yılmaz
- Hacettepe University Faculty of Medicine, Department of Otolaryngology-Head & Neck Surgery, Ankara, Turkey
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Zhang Y, Li S. Transcutaneous injection of triamcinolone acetonide for persistent glottic granulation after laser microsurgery. Braz J Otorhinolaryngol 2023; 89:359-365. [PMID: 36805348 PMCID: PMC10164776 DOI: 10.1016/j.bjorl.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/28/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE The aim of study was to demonstrate that transcutaneous intralesional injection of Triamcinolone Acetonide (TA) under fibrolaryngoscopy could be an option for persistent granulation after Transoral Laser Microsurgery (TLM) in glottic cancer patients. METHODS We recruited 32 patients, who had conservative treatment but failed. 20 patients accepted TA injection monthly until the granulation disappeared or did not shrink further. 12 patients chose to closely monitor. RESULTS For the 20 patients, 17 (85.0%) patients' granulations completely disappeared. 3 (15.0%) patients' granulations had reduced 80%. For the 12 patients, 3 (25.0%) patients' granulations disappeared but 9 (75%) patients' granulations did not have an obvious change. Recurrence was not observed. CONCLUSION Our experience showed that transcutaneous intralesional TA injection for persistent granulation after TLM through cricothyroid membrane is an efficient, security, harmless and low recurrence method. Especially suitable for huge granulation which blocks the glottis and recur after a second operation.
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Affiliation(s)
- Ying Zhang
- Central South University, The Second Xiangya Hospital, Department of Otolaryngology, Head and Neck Surgery, Hunan, China
| | - Shisheng Li
- Central South University, The Second Xiangya Hospital, Department of Otolaryngology, Head and Neck Surgery, Hunan, China.
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Printz T, Mehlum CS, Godballe C, Iwarsson J, Pedersen SG, Christensen JH, Jørkov AS, Grøntved ÅM. Vocal Outcome After Cordectomy by Transoral CO 2 Laser Microsurgery in Patients With Laryngeal Intraepithelial Neoplasia and Non-neoplastic Lesions. J Voice 2022:S0892-1997(22)00129-1. [PMID: 35732537 DOI: 10.1016/j.jvoice.2022.04.018] [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: 12/09/2021] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study investigates vocal outcome after cordectomy by transoral CO2 laser microsurgery (TLM-cordectomy) in patients with laryngeal intra-epithelial neoplasia (LIN) or non-neoplastic lesions (NNL), for improved individual patient advice and potential adjustment of national treatment strategy by which patients suspected to have glottic LIN or T1a cancer are offered TLM-cordectomy, without prior biopsy. STUDY DESIGN Prospective, longitudinal, quasi-experimental time series. METHODS Consecutively included patients (n = 155) with LIN (n = 84) or NNL (n = 71) who underwent voice assessments before and after TLM-cordectomy. The multi-dimensional voice assessment protocol comprised voice and speech range profiles, aerodynamics, acoustic analysis, self-evaluated voice handicap, and perceptual auditory voice ratings. RESULTS Median follow-up time was 195 (range 50-1121) days for patients with LIN and 193 (range 69-1294) days for patients with NNL. Statistically significant changes, LIN: in voice handicap index (VHI) and breathiness after TLM-cordectomy. Statistically significant changes, NNL: voice range profile (voice range area, intensity range, and frequency range) and VHI after TLM-cordectomy. All group-wise changes were to less disordered voices. Previous smokers had the largest decreases in VHI and breathiness. Patients with baseline VHI scores >65 had smaller increases in VHI, however 13-19% of the patients had increases in VHI above the clinically relevant threshold after TLM-cordectomy. CONCLUSION Overall, TLM-cordectomy in patients with LIN and NNL improved vocal outcome and our study thus supports the current Danish treatment strategy and improves the basis for proper patient advice. Multi-dimensional voice assessment is suggested preoperatively and six-nine months postoperatively, with focus on individual vocal differences and voice demands.
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Affiliation(s)
- Trine Printz
- Department of Oto-Rhino-Laryngology - Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Camilla Slot Mehlum
- Department of Oto-Rhino-Laryngology - Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark.
| | - Christian Godballe
- Department of Oto-Rhino-Laryngology - Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Jenny Iwarsson
- Department of Scandinavian Studies and Linguistics, University of Copenhagen, Copenhagen, Denmark
| | - Solveig Gunvor Pedersen
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | | | - Andreas Schellerup Jørkov
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - Ågot Møller Grøntved
- Department of Oto-Rhino-Laryngology - Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
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Lee SJ, Choi HS, Kim H. Acoustic Psychometric Severity Index of Dysphonia (APSID): Development and Clinical Application. J Voice 2021; 35:660.e19-660.e25. [DOI: 10.1016/j.jvoice.2019.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 10/25/2022]
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Using Pitch Height and Pitch Strength to Characterize Type 1, 2, and 3 Voice Signals. J Voice 2021; 35:181-193. [DOI: 10.1016/j.jvoice.2019.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/05/2019] [Accepted: 08/08/2019] [Indexed: 11/19/2022]
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Miramont JM, Restrepo JF, Codino J, Jackson-Menaldi C, Schlotthauer G. Voice Signal Typing Using a Pattern Recognition Approach. J Voice 2020; 36:34-42. [PMID: 32376059 DOI: 10.1016/j.jvoice.2020.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/24/2020] [Accepted: 03/26/2020] [Indexed: 11/29/2022]
Abstract
Voice signal classification in three types according to their degree of periodicity, a task known as signal typing, is a relevant preprocessing step before computing any perturbation measures. However, it is a time consuming and subjective activity. This has given rise to interest in automatic systems that use objective measures to distinguish among the different signal types. The purpose of this paper is twofold. First, to propose a pattern recognition approach for automatic voice signal typing based on a multi-class linear Support Vector Machine, and using rather well-known parameters like Jitter, Shimmer, Harmonic-to-Noise Ratio, and Cepstral Prominence Peak in combination with nonlinear dynamics measures. Two novel features are also proposed as objective parameters. Second, to validate this approach using a large amount of signals coming from two well-known corpora using cross-dataset experiments to assess the generalizability of the system. A total amount of 1262 signals labeled by professional voice pathologists were used with this purpose. Statistically significant differences between all types were found for all features. Accuracies over 82.71% were estimated in all intra-datasets and inter-datasets using cross-validation. Finally, the use of posterior probabilities is proposed as a measure of the reliability of the assigned type. This could help clinicians to make a more informed decision about the type assigned to a voice. These outcomes suggest that the proposed approach can successfully discriminate among the three voice types, paving the way to a fully automatic tool for voice signal typing in the future.
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Affiliation(s)
- J M Miramont
- Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática, UNER-CONICET, Oro Verde, Entre Ríos, Argentina.
| | - Juan F Restrepo
- Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática, UNER-CONICET, Oro Verde, Entre Ríos, Argentina
| | - J Codino
- Lakeshore Professional Voice Center, Lakeshore Ear, Nose and Throat Center, St. Clair Shores, Michigan
| | - C Jackson-Menaldi
- Lakeshore Professional Voice Center, Lakeshore Ear, Nose and Throat Center, St. Clair Shores, Michigan; Department of Otolaryngology, School of Medicine, Wayne State University, Detroit, Michigan
| | - G Schlotthauer
- Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática, UNER-CONICET, Oro Verde, Entre Ríos, Argentina
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Madill C, Nguyen DD, Yick-Ning Cham K, Novakovic D, McCabe P. The Impact of Nasalance on Cepstral Peak Prominence and Harmonics-to-Noise Ratio. Laryngoscope 2018; 129:E299-E304. [PMID: 30585334 PMCID: PMC6767134 DOI: 10.1002/lary.27685] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2018] [Indexed: 11/10/2022]
Abstract
Objectives/Hypothesis Cepstral peak prominence (CPP) has been reported as a reliable measure of dysphonia and a preferred alternative to harmonics‐to‐noise ratio (HNR). However, CPP has been observed to be sensitive to articulatory variation and vocal intensity. The aim of this study was to examine the impact of nasalance on CPP and HNR of voice signals. It was hypothesized that increased nasalance would be associated with decreased CPP. Study Design Within‐subject correlation design. Methods Thirty vocally healthy female participants were recorded reading and producing a vowel in alternation with a nasal consonant while wearing a nasometer for calculation of nasalance. Recorded vowel, nasalized, and nasal segments of speech were used to calculate CPP using Analysis of Dysphonia in Speech and Voice software, and HNR and vocal intensity using Praat software. Results Significant main effects of conditions were observed for CPP. CPP values decreased significantly when phonation changed from vowel to nasalized vowel and to nasal. There was correlation between CPP and nasalance and between CPP and intensity. HNR was slightly higher in the nasal condition than in vowel. There was a weak correlation between HNR and nasalance. No correlation was found between HNR and intensity. Conclusions CPP is sensitive to changes in vocal tract configuration caused by nasalization as well as intensity, whereas HNR is not. Therefore, CPP may reflect the periodicity in source signal or the filtering effects of vocal tract. Further research is needed to clarify the application and interpretation of CPP in clinical practice. Level of Evidence 4 Laryngoscope, 129:E299–E304, 2019
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Affiliation(s)
- Catherine Madill
- Voice Research Laboratory, The University of Sydney, Sydney, New South Wales, Australia
| | - Duong Duy Nguyen
- Voice Research Laboratory, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Daniel Novakovic
- Faculty of Health Sciences and the Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Patricia McCabe
- Voice Research Laboratory, The University of Sydney, Sydney, New South Wales, Australia
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Millgård M, Tuomi L. Voice Quality in Laryngeal Cancer Patients: A Randomized Controlled Study of the Effect of Voice Rehabilitation. J Voice 2018; 34:486.e13-486.e22. [PMID: 32389236 DOI: 10.1016/j.jvoice.2018.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/12/2018] [Accepted: 09/13/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The study aimed to investigate the short-term and long-term effects of voice rehabilitation in patients treated with radiotherapy for laryngeal cancer as measured by both the acoustic measure smoothed cepstral peak prominence (CPPS) and perceptual measures. A secondary aim was to investigate the relationship between acoustic and perceptual measures. METHODS In total, 37 patients received voice rehabilitation post-radiotherapy and 37 patients constituted the irradiated control group. Outcome measures were mean CPPS for connected speech and ratings with the auditory-perceptual Grade, Roughness, Breathiness, Asthenia and Strain (GRBAS) scale. Outcome measures were analyzed 1 (baseline), 6, 12, and 24 months post-radiotherapy, where voice rehabilitation was conducted between the first two time-points. Additional recordings were acquired from vocally healthy participants for comparison. RESULTS CPPS values of the voice rehabilitation group and vocally healthy group were not significantly different at 24 months post-radiotherapy. Ten out of 19 patients who received voice rehabilitation yielded a CPPS value above the threshold for normal voice 24 months post-radiotherapy, compared to 11 out of 26 in the irradiated control group. No statistically significant correlations were found between CPPS and perceptual parameters of GRBAS. CONCLUSION Voice rehabilitation for irradiated laryngeal cancer patients may have positive effects on voice quality up to 24 months post-radiotherapy. The relationship between CPPS and GRBAS as well as the applicability of CPPS for evaluation over several points of measurement needs to be studied further.
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Affiliation(s)
- Moa Millgård
- Sahlgrenska University Hospital, Department of Otorhinolaryngology, Gothenburg, Sweden.
| | - Lisa Tuomi
- Sahlgrenska University Hospital, Department of Otorhinolaryngology, Gothenburg, Sweden; Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Lee SJ, Lim SE, Choi HS. A Comparison of Cepstral and Spectral Measures according to Measurement Position in a Reading Passage. COMMUNICATION SCIENCES AND DISORDERS-CSD 2017. [DOI: 10.12963/csd.17433] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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