1
|
Tsai MJ, Wang CT, Fu S, Lin FC. Effect of intensive water resistance phonation therapy for people with presbyphonia: A pilot study. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 26:728-736. [PMID: 37908078 DOI: 10.1080/17549507.2023.2261660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Purpose: The aim of this pilot study was to explore the efficacy of an intensive 3 week water resistance phonation (WRP) therapy program for people with presbyphonia.Method: Participants included 13 people with presbyphonia who received intensive WRP therapy. All participants completed eight sessions of therapy over 3 weeks. Auditory perceptual ratings, and acoustic and aerodynamic assessments were performed before and after treatment. Participants also completed the voice-related quality of life questionnaire before and after the treatment.Result: After 3 weeks of intensive voice therapy, significant improvements were demonstrated in acoustic, aerodynamic, and auditory perceptual parameters, as well as patient perceptions of voice-related quality of life. Acoustically, it was found there were significant decreases in shimmer (p = 0.019), noise-to-harmonic ratio (p = 0.016), and smoothed cepstral peak prominence (p = 0.001). Perceptually, the clients with presbyphonia showed significant reductions in the ratings of the overall grade, roughness, asthenia, and strain. Moreover, there was a significant increase in the total score of the Mandarin version of the Voice-Related Quality of Life measure post-therapy.Conclusion: The investigation provides preliminary evidence that people with presbyphonia can improve their vocal function and voice-related quality of life through intensive WRP therapy within a short period of time.
Collapse
Affiliation(s)
- Ming-Jhen Tsai
- Department of Otorhinolaryngology - Head & Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chi-Te Wang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Electric Engineering, Yuan-Ze University, Taoyuan, Taiwan
| | - Sherry Fu
- Department of Audiology and Speech Language Pathology, Mackay Medical College, New Taipei City, Taiwan
- Lower School, Taipei American School, Taipei, Taiwan
| | - Feng-Chuan Lin
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| |
Collapse
|
2
|
Schultz BG, Rojas S, St John M, Kefalianos E, Vogel AP. A Cross-sectional Study of Perceptual and Acoustic Voice Characteristics in Healthy Aging. J Voice 2023; 37:969.e23-969.e41. [PMID: 34272139 DOI: 10.1016/j.jvoice.2021.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/02/2021] [Accepted: 06/10/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE The human voice qualitatively changes across the lifespan. Although some of these vocal changes may be pathologic, other changes likely reflect natural physiological aging. Normative data for voice characteristics in healthy aging is limited and disparate studies have used a range of different acoustic features, some of which are implicated in pathologic voice changes. We examined the perceptual and acoustic features that predict healthy aging. METHOD Participants (N = 150) aged between 50 and 92 years performed a sustained vowel task. Acoustic features were measured using the Multi-Dimensional Voice Program and the Analysis of Dysphonia in Speech and Voice. We used forward and backward variable elimination techniques based on the Bayesian information criterion and linear regression to assess which of these acoustic features predict age and perceptual features. Hearing thresholds were determined using pure-tone audiometry tests at frequencies 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz. We further explored potential relationships between these acoustic features and clinical assessments of voice quality using the Consensus Auditory-Perceptual Evaluation of Voice. RESULTS Chronological age was significantly predicted by greater voice turbulence, variability of cepstral fundamental frequency, low relative to high spectral energy, and cepstral intensity. When controlling for hearing loss, age was significantly predicted by amplitude perturbations and cepstral intensity. Clinical assessments of voice indicated perceptual characteristics of speech were predicted by different acoustic features. For example, breathiness was predicted by the soft phonation index, mean cepstral peak prominence, mean low-high spectral ratio, and mean cepstral intensity. CONCLUSIONS Findings suggest that acoustic features that predict healthy aging are different than those previously reported for the pathologic voice. We propose a model of healthy and pathologic voice development in which voice characteristics are mediated by the inability to monitor vocal productions associated with age-related hearing loss. This normative data of healthy vocal aging may assist in separating voice pathologies from healthy aging.
Collapse
Affiliation(s)
- Benjamin G Schultz
- Centre for Neuroscience of Speech, The University of Melbourne, Melbourne, Australia; Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
| | - Sandra Rojas
- Centre for Neuroscience of Speech, The University of Melbourne, Melbourne, Australia; Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
| | - Miya St John
- Speech and Language, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Elaina Kefalianos
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
| | - Adam P Vogel
- Centre for Neuroscience of Speech, The University of Melbourne, Melbourne, Australia; Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia; Redenlab, Australia.
| |
Collapse
|
3
|
Santos M, Freitas SV, Sousa CAE, da Silva ÁM. Stratifying Presbylarynx: Characterization of its Three Types. J Voice 2022:S0892-1997(22)00289-2. [PMID: 36266223 DOI: 10.1016/j.jvoice.2022.09.019] [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: 08/15/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 03/07/2023]
Abstract
OBJECTIVES To describe the clinical characteristics of each type of glottal configuration proposed in a classification that allows stratifying presbylarynx into three types: Type 0: there is no significant morphological alteration in glottal configuration. Type 1: two or more of the following endoscopic signs are present: atrophic vocal folds, vocal fold bowing, prominence of vocal processes, supraglottal hyperactivity, decreased amplitude (vocal fold edge stiffness without evidence of vocal post-traumatic scar), and tremor of laryngeal structures. Type 2: elderly patients with type 1 plus glottal insufficiency. METHODS Prospective, observational, and cross-sectional study. Data regarding age, gender, type of glottal configuration, self-assessment regarding vocal complaints, as well as acoustic and audio-perceptive examination were collected. RESULTS The study population included 306 subjects (180 females), and the mean age was 73.85. Type 0 was the most frequent (61%). A statistically significant association was found between type 0 and female subjects, as well as type 2 and male subjects. The mean age of the patients with type 0 was statistically lower than the mean age of the patients with type 1 or type 2. The mean score of self-assessment questionnaires of patients with type 2 was statistically higher than the mean score registered for patients with type 0 and type 1. The mean score of Jitter, Shimmer, and HNR in type 2 were statistically higher than in type 0 or type 1 (P < 0.05). The mean score of Maximum Phonation Time in type 2 was statistically lower than in type 0 or 1 (P < 0.001). Based on vocal complaints, 115 subjects (38%) had presbyphonia (46 males; 69 females), and the mean age was 75.97 years (SD = 6.98; range 65 - 97). Among subjects without presbyphonia (n = 191), type 0 was the most frequent (84%), followed by type 1 (15%) and type 2 (1%). Among subjects with presbyphonia (n = 115), type 1 was the most frequent (58%), followed by type 0 (23%) and type 2 (19%). CONCLUSIONS This study presented the clinical characterization of a classification that allows stratifying endoscopic laryngeal signs in elderly patients with presbyphonia. We believe this classification will enrich the diagnostic protocol of the aging voice and will improve the documentation of treatment outcomes.
Collapse
Affiliation(s)
- Mariline Santos
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Porto, Portugal.
| | - Susana Vaz Freitas
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Porto, Portugal; Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Porto, Portugal
| | - Cecília Almeida E Sousa
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Porto, Portugal
| | - Álvaro Moreira da Silva
- Serviço de Cuidados Intensivos do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Porto, Portugal
| |
Collapse
|
4
|
Tuomainen O, Taschenberger L, Rosen S, Hazan V. Speech modifications in interactive speech: effects of age, sex and noise type. Philos Trans R Soc Lond B Biol Sci 2022; 377:20200398. [PMID: 34775827 PMCID: PMC8591383 DOI: 10.1098/rstb.2020.0398] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
When attempting to maintain conversations in noisy communicative settings, talkers typically modify their speech to make themselves understood by the listener. In this study, we investigated the impact of background interference type and talker age on speech adaptations, vocal effort and communicative success. We measured speech acoustics (articulation rate, mid-frequency energy, fundamental frequency), vocal effort (correlation between mid-frequency energy and fundamental frequency) and task completion time in 114 participants aged 8-80 years carrying out an interactive problem-solving task in good and noisy listening conditions (quiet, non-speech noise, background speech). We found greater changes in fundamental frequency and mid-frequency energy in non-speech noise than in background speech and similar reductions in articulation rate in both. However, older participants (50+ years) increased vocal effort in both background interference types, whereas younger children (less than 13 years) increased vocal effort only in background speech. The presence of background interference did not lead to longer task completion times. These results suggest that when the background interference involves a higher cognitive load, as in the case of other speech of other talkers, children and older talkers need to exert more vocal effort to ensure successful communication. We discuss these findings within the communication effort framework. This article is part of the theme issue 'Voice modulation: from origin and mechanism to social impact (Part II)'.
Collapse
Affiliation(s)
- Outi Tuomainen
- Speech Hearing and Phonetic Sciences, University College London, 2 Wakefield Street, London WC1N 1PF, UK,Department of Linguistics, University of Potsdam, Haus 14, Karl-Liebknecht-Straße 24-25, 14476 Potsdam, Germany
| | - Linda Taschenberger
- Speech Hearing and Phonetic Sciences, University College London, 2 Wakefield Street, London WC1N 1PF, UK
| | - Stuart Rosen
- Speech Hearing and Phonetic Sciences, University College London, 2 Wakefield Street, London WC1N 1PF, UK
| | - Valerie Hazan
- Speech Hearing and Phonetic Sciences, University College London, 2 Wakefield Street, London WC1N 1PF, UK
| |
Collapse
|
5
|
D'haeseleer E, Huvenne W, Vermeersch H, Meerschman I, Imke K, Servayge L, Versavel O, Van Lierde K. Long-term voice quality outcome after thyroidectomy without laryngeal nerve injury: a prospective 10 year follow up study. JOURNAL OF COMMUNICATION DISORDERS 2021; 91:106109. [PMID: 34034037 DOI: 10.1016/j.jcomdis.2021.106109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/16/2021] [Accepted: 04/10/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE This study investigates the long-term voice outcome of thyroidectomy up to 10 years after the surgery using a longitudinal prospective study design. METHODS Eighteen participants (6 men and 12 women, mean age: 54 years) who underwent a thyroidectomy between September 2006 and May 2007 were included in this study. A voice assessment protocol consisting of subjective (videolaryngostroboscopic evaluation, auditory- perceptual evaluation, patients' self-report) and objective voice assessments (maximum performance task, acoustic analysis, voice range profile and Dysphonia Severity Index) was used to evaluate the participants' pre- and postoperative voice. Voice measurements were compared before and one week, six weeks, three months and 10 years after the surgery. RESULTS No significant differences over time in auditory-perceptual and objective voice parameters were found, except for shimmer. Only in the first postoperative condition, significantly more patients reported vocal complaints. A progressive amelioration of the vocal folds' movement patterns was observed in the postoperative conditions. CONCLUSION The findings of this small longitudinal prospective study suggest that thyroidectomy without laryngeal nerve injury does not cause a permanent deterioration of the laryngeal aspect or function, vocal fold behavior and the self-perceived, perceptual and objective vocal quality. The increase of the shimmer 10 years post-thyroidectomy may be related to vocal aging.
Collapse
Affiliation(s)
- Evelien D'haeseleer
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, Belgium.
| | - Wouter Huvenne
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium.
| | - Hubert Vermeersch
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium.
| | - Iris Meerschman
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Kissel Imke
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Lena Servayge
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Orphee Versavel
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Kristiane Van Lierde
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South-Africa.
| |
Collapse
|
6
|
Kent RD, Eichhorn JT, Vorperian HK. Acoustic parameters of voice in typically developing children ages 4-19 years. Int J Pediatr Otorhinolaryngol 2021; 142:110614. [PMID: 33450527 PMCID: PMC7902385 DOI: 10.1016/j.ijporl.2021.110614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/31/2020] [Accepted: 12/31/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Report data on acoustic measures of voice in sustained vowels produced by typically developing children, aged 4-19 years, to add to the cross-sectional reference values in a pediatric database. METHODS Recordings of sustained vowel/ɑ/phonation were obtained from 158 children (80 males, 78 females) aged 4-19 years who were judged to be typically developing with respect to speech and voice. Acoustic analyses were performed with the Multidimensional Voice Program (MDVP™) and the Analysis of Dysphonia in Speech and Voice (ADSV™), both from Pentax Medical. RESULTS Values from both MDVP and ADSV are reported for children in the following age cohorts: 4-6 years, 7-9 years, 10-12 years, 13-15 years, and 16-19 years. CONCLUSION The data in this study complement previously published data and contribute to a pediatric reference database useful for research and for clinical practice related to children's voice. Acoustic parameters most sensitive to age and sex are identified.
Collapse
Affiliation(s)
- Raymond D. Kent
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI 53705
| | - Julie T. Eichhorn
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI 53705
| | - Houri K. Vorperian
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI 53705
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Stager SV, Sparks AD, Bielamowicz SA, Edgar JD. The Role of Choral Singing in Speaking Voice Preservation of Aging Adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2099-2114. [PMID: 32569498 DOI: 10.1044/2020_jslhr-19-00347] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This descriptive cohort pilot study, using a convenience sample, examined whether evidence from vocal function measures, auditory-perceptual ratings, and/or endoscopic signs of aging supported singing in senior chorales as a possible intervention to preserve the speaking voice in aging adults. Method Thirteen singers and five nonsinging controls, all over 65 years of age, participated. They were assessed at two visits, 15-20 months apart. Vocal function measures and auditory-perceptual ratings of estimated age and the presence of voice disorders were compared across singing status and visit. Changes in the presence and degree of laryngeal signs of aging between visits were compared across singing status. Results Using an alpha of .2, deemed acceptable for pilot studies, vocal function measures supported choral singing as an intervention to preserve the speaking voice as less noise energy between 2 and 3 kHz (p = .01) and lower phonation threshold pressures (PTPs) were present (p = .09) for singers compared to nonsinging controls. Greater flows at comfortable pitch (p = .04) and high pitch (p = .06) as well as lower cepstral peak prominence smoothed (CPPS) for the vowel /a/ (p < .01) were found at Visit 2 for both groups, but singers demonstrated lower flows at Visit 2 than nonsinging controls at comfortable pitch (p = .06). Auditory-perceptual ratings did not support preservation of speaking voice, although a larger percentage of listeners rated nonsinging controls as voice disordered at Visit 2. Endoscopic ratings supported preservation, as singers were more likely than nonsinging controls to be rated as having laryngeal signs of aging absent at both visits (p = .02). Conclusion The findings from this pilot study provide evidence that regular singing in senior chorales may assist in preserving older adults' speaking voices.
Collapse
Affiliation(s)
- Sheila V Stager
- Medical Faculty Associates Voice Treatment Center, Department of Surgery, Division of Otolaryngology, The George Washington University School of Medicine, Washington, DC
| | - Andrew D Sparks
- Department of Surgery, The George Washington University School of Medicine, Washington, DC
| | - Steven A Bielamowicz
- Medical Faculty Associates Voice Treatment Center, Department of Surgery, Division of Otolaryngology, The George Washington University School of Medicine, Washington, DC
| | - Julia D Edgar
- Department of Communication Disorders, Truman State University, Kirksville, MO
| |
Collapse
|
9
|
Jayakumar T, Benoy JJ, Yasin HM. Effect of Age and Gender on Acoustic Voice Quality Index Across Lifespan: A Cross-sectional Study in Indian Population. J Voice 2020; 36:436.e1-436.e8. [DOI: 10.1016/j.jvoice.2020.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
|
10
|
Rojas S, Kefalianos E, Vogel A. How Does Our Voice Change as We Age? A Systematic Review and Meta-Analysis of Acoustic and Perceptual Voice Data From Healthy Adults Over 50 Years of Age. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:533-551. [PMID: 32083980 DOI: 10.1044/2019_jslhr-19-00099] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Approximately 30% of adults over the age of 50 years present with altered vocal function. Our understanding of how these changes manifest acoustically and perceptually is derived from relatively modest-sized studies using a diversity of tools. Voice changes can arise from the onset of disease or disorder, but also age-related physiological changes, which may not reflect pathology as such. Here, we bring together data on acoustic, perceptual, and instrumental assessments (electroglottography), with the aim of gaining a better understanding of the changes occurring across these measurement domains. We consider these changes in the context of different acoustic features, software programs, and perceptual protocols. Method Studies of voice function in healthy older adults over the age of 50 years were sought. Literature was systematically searched with 746 abstracts reviewed. Forty-seven studies were included in the review. A meta-analysis of included studies compared voice acoustic parameters between sex and age. Sixteen acoustic parameters collected from 1,475 participants were analyzed in the meta-analysis. These included some previously unpublished analyses using data provided by authors of included studies. Results Data from the systematic review suggest that older individuals are perceived to present with higher overall scores of dysphonia and roughness, breathiness, strain, and instability. Acoustically, males have significantly higher scores on measures of perturbation, including noise-to-harmonic ratio and absolute jitter. The meta-analysis outcomes suggest that participants aged 80-89 years produce significantly higher fundamental frequency, jitter percent, shimmer percent, and shimmer in decibels compared to participants aged 60-69 years and a significant increase in relative average perturbation, jitter percent, and shimmer in decibels compared to participants aged 70-79 years. Limited data were available comparing acoustic measures using the same acoustic software. Conclusions Variations in fundamental frequency and frequency and amplitude perturbation increase as healthy adults age. It was difficult to draw definitive conclusions based on existing literature due to variability in hardware used, limited descriptions of study cohorts, or missing data from statistical analysis. Supplemental Material https://doi.org/10.23641/asha.11868663.
Collapse
Affiliation(s)
- Sandra Rojas
- Department of Audiology and Speech Pathology, The University of Melbourne, Victoria, Australia
| | - Elaina Kefalianos
- Department of Audiology and Speech Pathology, The University of Melbourne, Victoria, Australia
- Centre for Neuroscience of Speech, The University of Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria,Australia
| | - Adam Vogel
- Department of Audiology and Speech Pathology, The University of Melbourne, Victoria, Australia
- Redenlab, Melbourne, Victoria, Australia
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| |
Collapse
|
11
|
Crawley BK, Dehom S, Thiel C, Yang J, Cragoe A, Mousselli I, Krishna P, Murry T. Assessment of Clinical and Social Characteristics That Distinguish Presbylaryngis From Pathologic Presbyphonia in Elderly Individuals. JAMA Otolaryngol Head Neck Surg 2019; 144:566-571. [PMID: 29799925 DOI: 10.1001/jamaoto.2018.0409] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Importance An aging population experiences an increase in age-related problems, such as presbyphonia. The causes of pathologic presbyphonia are incompletely understood. Objective To determine what distinguishes pathologic presbyphonia from presbylaryngis. Design, Setting, and Participants This was a cohort study at an outpatient otolaryngology subspecialty clinic of a tertiary academic referral center. Participants were consecutive consenting adults older than 74 years without laryngeal pathologic abnormalities who visited the clinic as participants or companions. Patient questionnaires, otolaryngologic, video stroboscopic, and voice examinations were compiled. Patients were divided into groups based on whether they endorsed a voice complaint. Three blinded authors graded stroboscopic examinations for findings consistent with presbylaryngis (vocal fold bowing, vocal process prominence, glottic insufficiency). Main Outcomes and Measures Voice Handicap Index-10, Reflux Symptom Index, Cough Severity Index, Dyspnea Index, Singing Voice Handicap Index-10 , Eating Assessment Tool -10, Voice-Related Quality of Life (VRQOL), and Short-Form Health Survey; face-sheet addressing social situation, work, marital status, education, voice use, transportation; acoustic and aerodynamic measures; and a full otolaryngologic examination, including videostroboscopic imaging. Results A total of 31 participants with dysphonia (21 were female; their mean age was 83 years [range, 75-97 years]) and 26 control participants (16 were female; their mean age was 81 years [range, 75-103 years]) completed the study. Presbylaryngis was visible in 27 patients with dysphonia (87%) and 22 controls (85%). VHI-10 and VRQOL scores were worse in patients with pathologic presbyphonia (median [range] VHI-10 scores, 15 (0-40) vs 0 (0-16) and median VRQOL score, 19 [0-43] vs 10 [10-23]). All other survey results were indistinguishable, and no social differences were elucidated. Acoustic measures revealed that both groups averaged lower than normal speaking fundamental frequency (mean [SD], 150.01 [36.23] vs 150.85 [38.00]). Jitter was 3.44% (95% CI, 2.46%-4.61%) for pathologic presbyphonia and 1.74% (95% CI, 1.35%-2.14%) for controls (d = 0.75). Shimmer means (95% CI) were 7.8 2 (6.08-10.06) for the pathologic presbyphonia group and 4.84 (3.94-5.72) for controls (d = 0.69). Aerodynamic measures revealed an odds ratio of 3.03 (95% CI, 0.83-11.04) for patients with a maximum phonation time of less than 12 seconds who had complaints about dysphonia. Conclusions and Relevance Presbylaryngis is present in most ambulatory people older than 74 years. Some will endorse pathologic presbyphonia that has a negative effect on their voice and quality of life. Pathologic presbyphonia seems to be influenced by respiratory capacity and sex. Further study is required to isolate other social, physiologic, and general health characteristics that contribute to pathologic presbyphonia.
Collapse
Affiliation(s)
- Brianna K Crawley
- Department of Otolaryngology-Head and Neck Surgery, Voice and Swallowing Center, Loma Linda University Health, Loma Linda, California
| | - Salem Dehom
- School of Nursing, Loma Linda University Health, Loma Linda, California
| | - Cedric Thiel
- School of Medicine, Loma Linda University Health, Loma Linda, California
| | - Jin Yang
- School of Medicine, Loma Linda University Health, Loma Linda, California
| | - Andrea Cragoe
- School of Medicine, Loma Linda University Health, Loma Linda, California
| | | | - Priya Krishna
- Department of Otolaryngology-Head and Neck Surgery, Voice and Swallowing Center, Loma Linda University Health, Loma Linda, California
| | - Thomas Murry
- Department of Otolaryngology-Head and Neck Surgery, Voice and Swallowing Center, Loma Linda University Health, Loma Linda, California
| |
Collapse
|
12
|
Spazzapan EA, Marino VCDC, Cardoso VM, Berti LC, Fabron EMG. Acoustic characteristics of voice in different cycles of life: an integrative literature review. REVISTA CEFAC 2019. [DOI: 10.1590/1982-0216/201921315018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to carry out an integrative literature review about the acoustic characteristics of healthy voice production, from childhood to old age. Methods: a bibliographic survey was conducted on the databases PubMed, SciELO, MEDLINE and LILACS, covering the last 10 years. Nineteen studies were found, meeting the proposed criteria, on acoustic measurements: F0 (fundamental frequency), jitter, shimmer and/or noise measurements, in males and females, with normal voices in their different stages of life. Results: the analysis showed that F0 is the most changing acoustic parameter as people grow up and grow old. Its values present gradual fall from childhood to old age in the female population, whereas among men such decrease lasts until adulthood. Jitter, shimmer and noise remain stable throughout childhood and adulthood, while shimmer and noise measurements increase in old age. In the literature, there is no consensus regarding increase of jitter measurements in the elderly. Conclusion: from childhood to old age, in both genders, vocal changes take place which are reflected, especially by F0. There is a scarcity of information on acoustics related to specific populations with ample age range, using the same methodology. The information in this study may guide future investigations aiming to understand natural changes occurring in the human voice, in addition to guiding in the clinical practice.
Collapse
|
13
|
Effect of Bhramari Pranayama on the Acoustic and Aerodynamic Parameters of Voice in Normophonic Females. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:4176803. [PMID: 30174704 PMCID: PMC6106724 DOI: 10.1155/2018/4176803] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/29/2018] [Accepted: 07/25/2018] [Indexed: 11/30/2022]
Abstract
Summary. Objective Pranayama is known for improving various health conditions. The present study is aimed at investigating the effects of bhramari pranayama on aerodynamic and acoustic parameters of voice in healthy individuals. Study Design This is a pretest-posttest design study. Methods A total of 24 participants in the age range of 20 to 25 years completed the bhramari pranayama regimen for 30 sessions. Aerodynamic and acoustic assessments were done before and after pranayama sessions. Maximum phonation duration, pitch, loudness, subglottal pressure, glottal airflow, laryngeal resistance and conductance along with acoustical parameters such as average F0, jitter, and shimmer, soft phonation index, noise to harmonic ratio, cepstral peak prominence, and smoothened cepstral peak prominence were analysed. Results The results revealed significant improvement in the maximum phonation duration, glottal airflow and pressure, average fundamental frequency, and cepstral peak prominence after practice suggesting that it has an effect on voice parameters. Conclusion Bhramari pranayama is effective in improving the acoustic and aerodynamic parameters of voice. The same needs to be investigated in hyper- and hypofunctional voice disorders in the future studies.
Collapse
|
14
|
Brockmann-Bauser M, Bohlender JE, Mehta DD. Acoustic Perturbation Measures Improve with Increasing Vocal Intensity in Individuals With and Without Voice Disorders. J Voice 2018; 32:162-168. [PMID: 28528786 PMCID: PMC7053781 DOI: 10.1016/j.jvoice.2017.04.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 04/13/2017] [Accepted: 04/17/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE In vocally healthy children and adults, speaking voice loudness differences can significantly confound acoustic perturbation measurements. This study examines the effects of voice sound pressure level (SPL) on jitter, shimmer, and harmonics-to-noise ratio (HNR) in adults with voice disorders and a control group with normal vocal status. STUDY DESIGN This is a matched case-control study. METHODS We assessed 58 adult female voice patients matched according to approximate age and occupation with 58 vocally healthy women. Diagnoses included vocal fold nodules (n = 39, 67.2%), polyps (n = 5, 8.6%), and muscle tension dysphonia (n = 14, 24.1%). All participants sustained the vowel /a/ at soft, comfortable, and loud phonation levels. Acoustic voice SPL, jitter, shimmer, and HNR were computed using Praat. The effects of loudness condition, voice SPL, pathology, differential diagnosis, age, and professional voice use level on acoustic perturbation measures were assessed using linear mixed models and Wilcoxon signed rank tests. RESULTS In both patient and normative control groups, increasing voice SPL correlated significantly (P < 0.001) with decreased jitter and shimmer, and increased HNR. Voice pathology and differential diagnosis were not linked to systematically higher jitter and shimmer. HNR levels, however, were statistically higher in the patient group than in the control group at comfortable phonation levels. Professional voice use level had a significant effect (P < 0.05) on jitter, shimmer, and HNR. CONCLUSIONS The clinical value of acoustic jitter, shimmer, and HNR may be limited if speaking voice SPL and professional voice use level effects are not controlled for. Future studies are warranted to investigate whether perturbation measures are useful clinical outcome metrics when controlling for these effects.
Collapse
Affiliation(s)
- M Brockmann-Bauser
- Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland.
| | - J E Bohlender
- Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - D D Mehta
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, One Bowdoin Square, 11th Floor, Boston, Massachusetts; Department of Surgery, Harvard Medical School, Boston, Massachusetts; MGH Institute of Health Professions, Boston, Massachusetts
| |
Collapse
|
15
|
Abstract
Adult sex ratios in a local environment are linked to a wide variety of reproductive behaviors in humans and other animals. When sex ratios are biased, the more numerous sex faces increased competition for mates and is more likely to yield to the sociosexual preferences of the less numerous sex. Despite widespread evidence of the relationship between sex ratios and behavior, we know little about whether or how sex ratios are encoded and perceived. In two experiments men and women showed perceived sex ratios that correlated with actual sex ratios after 1500 ms exposures to groups of simultaneous voices. However, men perceived more female voices than women did, and women perceived more male voices than men did. Women showed better accuracy than men, but only when sex ratios departed markedly from 50%. Increasing the number of simultaneous voices reduced accuracy, but only at extreme sex ratios. Talker age also significantly affected perceived sex ratios, suggesting that perceived operational sex ratios are adaptively linked to the reproductive viability of the local population. The results suggest that listeners automatically encode vocal sex ratio information and that perceived sex ratios are influenced by characteristics of the local population and characteristics of the listener.
Collapse
Affiliation(s)
- John G Neuhoff
- The College of Wooster, 1189 Beall Ave, Wooster, OH 44691, USA.
| |
Collapse
|
16
|
Schaeffer N. Pre- and Poststimulation Study on the Phonatory Aerodynamic System on Participants with Dysphonia. J Voice 2017; 31:254.e1-254.e9. [DOI: 10.1016/j.jvoice.2016.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/28/2016] [Accepted: 06/29/2016] [Indexed: 10/21/2022]
|
17
|
Dacakis G, Oates JM, Douglas JM. Exploring the validity of the Transsexual Voice Questionnaire (male-to-female): Do TVQMtF scores differentiate between MtF women who have had gender reassignment surgery and those who have not? Int J Transgend 2016. [DOI: 10.1080/15532739.2016.1222922] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
|