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Iob NA, He L, Ternström S, Cai H, Brockmann-Bauser M. Effects of Speech Characteristics on Electroglottographic and Instrumental Acoustic Voice Analysis Metrics in Women With Structural Dysphonia Before and After Treatment. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1660-1681. [PMID: 38758676 DOI: 10.1044/2024_jslhr-23-00253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
PURPOSE Literature suggests a dependency of the acoustic metrics, smoothed cepstral peak prominence (CPPS) and harmonics-to-noise ratio (HNR), on human voice loudness and fundamental frequency (F0). Even though this has been explained with different oscillatory patterns of the vocal folds, so far, it has not been specifically investigated. In the present work, the influence of three elicitation levels, calibrated sound pressure level (SPL), F0 and vowel on the electroglottographic (EGG) and time-differentiated EGG (dEGG) metrics hybrid open quotient (OQ), dEGG OQ and peak dEGG, as well as on the acoustic metrics CPPS and HNR, was examined, and their suitability for voice assessment was evaluated. METHOD In a retrospective study, 29 women with a mean age of 25 years (± 8.9, range: 18-53) diagnosed with structural vocal fold pathologies were examined before and after voice therapy or phonosurgery. Both acoustic and EGG signals were recorded simultaneously during the phonation of the sustained vowels /ɑ/, /i/, and /u/ at three elicited levels of loudness (soft/comfortable/loud) and unconstrained F0 conditions. RESULTS A linear mixed-model analysis showed a significant effect of elicitation effort levels on peak dEGG, HNR, and CPPS (all p < .01). Calibrated SPL significantly influenced HNR and CPPS (both p < .01). Furthermore, F0 had a significant effect on peak dEGG and CPPS (p < .0001). All metrics showed significant changes with regard to vowel (all p < .05). However, the treatment had no effect on the examined metrics, regardless of the treatment type (surgery vs. voice therapy). CONCLUSIONS The value of the investigated metrics for voice assessment purposes when sampled without sufficient control of SPL and F0 is limited, in that they are significantly influenced by the phonatory context, be it speech or elicited sustained vowels. Future studies should explore the diagnostic value of new data collation approaches such as voice mapping, which take SPL and F0 effects into account.
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Affiliation(s)
- Naomi Anna Iob
- Division of Phoniatrics and Speech Pathology, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Switzerland
| | - Lei He
- Division of Phoniatrics and Speech Pathology, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Switzerland
- Department of Computational Linguistics, University of Zurich, Switzerland
| | - Sten Ternström
- Division of Speech, Music and Hearing, School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Huanchen Cai
- Division of Speech, Music and Hearing, School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Meike Brockmann-Bauser
- Division of Phoniatrics and Speech Pathology, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Switzerland
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Influence of Loudness on Vocal Stability in the Male Passaggio. J Voice 2023; 37:296.e1-296.e8. [PMID: 33455852 DOI: 10.1016/j.jvoice.2020.12.044] [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: 10/26/2020] [Revised: 12/11/2020] [Accepted: 12/15/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Vocal registers and the frequency region where registration events occur, the passaggio, have been in focus of scientific research for almost 200 years. In professional tenors, it has been shown before that singing across the passaggio avoiding a register shift and therefore using their stage voice above the passaggio (SVaP) is associated with greater vocal stability than a register change to the falsetto. However, it is unclarified how much different loudness conditions contribute to this vocal stability. MATERIAL AND METHODS Six professional tenors were asked to perform four pitch glides from A3 to A4 (220-440 Hz) on the vowel [i:]. These glides included (1) the passaggio from modal register to falsetto. The following glides into SVaP were performed under different loudness conditions, (2) mezzoforte (average loudness), (3) pianissimo (as quietly as possible), and (4) fortissimo (the loudest possible). During phonation, high speed videoendoscopy (HSV), electroglottography, and audio signals were recorded simultaneously. The glottal area waveform was derived based on the HSV material. RESULTS Modal to falsetto transitions were associated with relatively low sound pressure level and rise of open quotients (OQ) for the falsetto. Transitions to SVaP showed a clear dependence on the intended loudness. The OQs were lower the louder the task was. There was no clear evidence that transitions with softer voice showed greater stability of vocal fold oscillation patterns than louder tasks. CONCLUSIONS The vocal fold oscillation pattern show- differences among various loudness conditions within the tenors' passaggio but no clear differences with regard to oscillatory stability.
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Patel RR, Ternström S. Quantitative and Qualitative Electroglottographic Wave Shape Differences in Children and Adults Using Voice Map-Based Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2977-2995. [PMID: 34319772 DOI: 10.1044/2021_jslhr-20-00717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Purpose The purpose of this study is to identify the extent to which various measurements of contacting parameters differ between children and adults during habitual range and overlap vocal frequency/intensity, using voice map-based assessment of noninvasive electroglottography (EGG). Method EGG voice maps were analyzed from 26 adults (22-45 years) and 22 children (4-8 years) during connected speech and vowel /a/ over the habitual range and the overlap vocal frequency/intensity from the voice range profile task on the vowel /a/. Mean and standard deviations of contact quotient by integration, normalized contacting speed, quotient of speed by integration, and cycle-rate sample entropy were obtained. Group differences were evaluated using the linear mixed model analysis for the habitual range connected speech and the vowel, whereas analysis of covariance was conducted for the overlap vocal frequency/intensity from the voice range profile task. Presence of a "knee" on the EGG wave shape was determined by visual inspection of the presence of convexity along the decontacting slope of the EGG pulse and the presence of the second derivative zero-crossing. Results The contact quotient by integration, normalized contacting speed, quotient of speed by integration, and cycle-rate sample entropy were significantly different in children compared to (a) adult males for habitual range and (b) adult males and adult females for the overlap vocal frequency/intensity. None of the children had a "knee" on the decontacting slope of the EGG slope. Conclusion EGG parameters of contact quotient by integration, normalized contacting speed, quotient of speed by integration, cycle-rate sample entropy, and absence of a "knee" on the decontacting slope characterize the wave shape differences between children and adults, whereas the normalized contacting speed, quotient of speed by integration, cycle-rate sample entropy, and presence of a "knee" on the downward pulse slope characterize the wave shape differences between adult males and adult females. Supplemental Material https://doi.org/10.23641/asha.15057345.
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Affiliation(s)
- Rita R Patel
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Sten Ternström
- Division of Speech, Music, and Hearing, School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, Stockholm, Sweden
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Echternach M, Herbst CT, Köberlein M, Story B, Döllinger M, Gellrich D. Are source-filter interactions detectable in classical singing during vowel glides? THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 149:4565. [PMID: 34241428 DOI: 10.1121/10.0005432] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 06/03/2021] [Indexed: 06/13/2023]
Abstract
In recent studies, it has been assumed that vocal tract formants (Fn) and the voice source could interact. However, there are only few studies analyzing this assumption in vivo. Here, the vowel transition /i/-/a/-/u/-/i/ of 12 professional classical singers (6 females, 6 males) when phonating on the pitch D4 [fundamental frequency (ƒo) ca. 294 Hz] were analyzed using transnasal high speed videoendoscopy (20.000 fps), electroglottography (EGG), and audio recordings. Fn data were calculated using a cepstral method. Source-filter interaction candidates (SFICs) were determined by (a) algorithmic detection of major intersections of Fn/nƒo and (b) perceptual assessment of the EGG signal. Although the open quotient showed some increase for the /i-a/ and /u-i/ transitions, there were no clear effects at the expected Fn/nƒo intersections. In contrast, ƒo adjustments and changes in the phonovibrogram occurred at perceptually derived SFICs, suggesting level-two interactions. In some cases, these were constituted by intersections between higher nƒo and Fn. The presented data partially corroborates that vowel transitions may result in level-two interactions also in professional singers. However, the lack of systematically detectable effects suggests either the absence of a strong interaction or existence of confounding factors, which may potentially counterbalance the level-two-interactions.
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Affiliation(s)
- Matthias Echternach
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Munich University Hospital (LMU), Marchioninistrasse 15, Munich, 81377, Germany
| | - Christian T Herbst
- Antonio Salieri Department of Vocal Studies and Vocal Research in Music Education, University of Music and Performing Arts Vienna, Vienna, Austria
| | - Marie Köberlein
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Munich University Hospital (LMU), Marchioninistrasse 15, Munich, 81377, Germany
| | - Brad Story
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, Arizona 85718, USA
| | - Michael Döllinger
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Erlangen, Medical School Waldstrasse 1, Erlangen, 91054, Germany
| | - Donata Gellrich
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Munich University Hospital (LMU), Marchioninistrasse 15, Munich, 81377, Germany
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Echternach M, Döllinger M, Köberlein M, Kuranova L, Gellrich D, Kainz MA. Vocal fold oscillation pattern changes related to loudness in patients with vocal fold mass lesions. J Otolaryngol Head Neck Surg 2020; 49:80. [PMID: 33228812 PMCID: PMC7686765 DOI: 10.1186/s40463-020-00481-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 11/17/2020] [Indexed: 11/10/2022] Open
Abstract
Introduction Vocal fold mass lesions can affect vocal fold oscillation patterns and therefore voice production. It has been previously observed that perturbation values from audio signals were lower with increased loudness. However, how much the oscillation patterns change with gradual alteration of loudness is not yet fully understood. Material and methods Eight patients with vocal fold mass lesions were asked to perform a glide from minimum to maximum loudness on the vowel /i/, ƒo of 125 Hz for male or 250 Hz for female voices. During phonation the subjects were simultaneously recorded with transnasal high speed videoendoscopy (HSV, 20,000 fps), electroglottography (EGG), and an audio recording. Based on the HSV material the Glottal Area Waveform (GAW) was segmented and GAW parameters were computed. Results The greatest vocal fold irregularities were observed at different values between minimum and maximum sound pressure level. There was a relevant discrepancy between the HSV and EGG derived open quotients. Furthermore, the EGG derived sample entropy and GAW values also evidenced different behavior. Conclusions The amount of vocal fold irregularity changes with varying loudness. Therefore, any evaluation of the voice should be performed under different loudness conditions. The discrepancy between EGG and GAW values appears to be much stronger in patients with vocal fold mass lesions than those with normal physiological conditions. Level of evidence 4.
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Affiliation(s)
- Matthias Echternach
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology Head & Neck Surgery, Munich University Hospital (LMU), Marchioninistr. 15, 81377, Munich, Germany.
| | - Michael Döllinger
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery, University Hospital Erlangen, Medical School, Bohlenplatz 21, 91054, Erlangen, Germany
| | - Marie Köberlein
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology Head & Neck Surgery, Munich University Hospital (LMU), Marchioninistr. 15, 81377, Munich, Germany.,Institute of Musicians' Medicine, Freiburg University Hospital and Faculty of Medicine Freiburg University, Elsässerstr 2m, Freiburg, Germany
| | - Liudmila Kuranova
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology Head & Neck Surgery, Munich University Hospital (LMU), Marchioninistr. 15, 81377, Munich, Germany
| | - Donata Gellrich
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology Head & Neck Surgery, Munich University Hospital (LMU), Marchioninistr. 15, 81377, Munich, Germany
| | - Marie-Anne Kainz
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology Head & Neck Surgery, Munich University Hospital (LMU), Marchioninistr. 15, 81377, Munich, Germany
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Hsu CM, Yang MY, Fang TJ, Wu CY, Tsai YT, Chang GH, Tsai MS. Maximum and Minimum Phonatory Glottal Area before and after Treatment for Vocal Nodules. Healthcare (Basel) 2020; 8:healthcare8030326. [PMID: 32906704 PMCID: PMC7551475 DOI: 10.3390/healthcare8030326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/29/2020] [Accepted: 09/04/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Vocal fold nodules (VFNs) are a challenge for otolaryngologists. Glottal area (GA) waveform analysis is an examination method used for assessing vocal fold vibration and function. However, GA in patients with VFNs has rarely been studied. This study investigated the maximum and minimum GA in VFN patients using modern waveform analysis combining ImageJ software and videostroboscopy. Methods: This study enrolled 42 patients newly diagnosed with VFN, 15 of whom received voice therapy and 27 of whom underwent surgery. Acoustic parameters and maximum phonation time (MPT) were recorded, and patients completed the Chinese Voice Handicap Index-10 (VHI-C10) before and after treatment. After videostroboscopy examination, the maximum and minimum GAs were calculated using ImageJ software. The GAs of patients with VFNs before and after surgery or voice therapy were analyzed. Results: The MPTs of the patients before and after voice therapy or surgery did not change significantly. VHI-C10 scores decreased after voice therapy but the decrease was nonsignificant (14.0 ± 8.44 vs. 9.40 ± 10.24, p = 0.222); VHI-C10 scores were significantly decreased after surgery (22.53 ± 7.17 vs. 12.75 ± 9.84, p = 0.038). Voice therapy significantly increased the maximum GA (5.58 ± 2.41 vs. 8.65 ± 3.17, p = 0.012) and nonsignificantly decreased the minimum GA (0.60 ± 0.73 vs. 0.21 ± 0.46, p = 0.098). Surgery nonsignificantly increased the maximum GA (6.34 ± 3.82 vs. 8.73 ± 5.57, p = 0.118) and significantly decreased the minimum GA (0.30 ± 0.59 vs. 0.00 ± 0.00, p = 0.036). Conclusion: This study investigated the GA of patients with VFNs who received voice therapy or surgery. The findings indicated that voice therapy significantly increased maximum GA and surgery significantly decreased minimum GA. GA analysis could be applied to evaluate the efficacy of voice therapy, and it may help physicians to develop precise treatment for VFN patients (either by optimizing voice therapy or by performing surgery directly).
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Affiliation(s)
- Cheng-Ming Hsu
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (C.-M.H.); (Y.-T.T.); (G.-H.C.)
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Ming-Yu Yang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Tuan-Jen Fang
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Otolaryngology–Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Ching-Yuan Wu
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (C.-M.H.); (Y.-T.T.); (G.-H.C.)
| | - Geng-He Chang
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (C.-M.H.); (Y.-T.T.); (G.-H.C.)
| | - Ming-Shao Tsai
- Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (C.-M.H.); (Y.-T.T.); (G.-H.C.)
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Correspondence: ; Tel.: +886-53621000 (ext. 2076); Fax: +886-53623002
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Echternach M, Högerle C, Köberlein M, Schlegel P, Döllinger M, Richter B, Kainz MA. The Effect of Nasalance on Vocal Fold Oscillation Patterns During the Male Passaggio. J Voice 2019; 35:500.e9-500.e16. [PMID: 31668917 DOI: 10.1016/j.jvoice.2019.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/23/2019] [Accepted: 09/23/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION It is generally assumed that when singing across the region where registration events for untrained voices occur (the passaggio), singers modify the voice production system in order to avoid changes of voice quality. In this context, it has been postulated that nasalance could be used to stabilize vocal function throughout the passaggio. However, whether nasalance is frequently used by professional singers and if so, if it has a stabilizing effect on vocal fold oscillation patterns, is not yet fully understood. MATERIAL AND METHODS Eight western classically trained professional male singers (6 tenors and 2 baritones) were asked to perform transitions (1) from modal to falsetto register and (2) from modal to stage voice above the passaggio (SVaP) during ascending pitch glides from A3 (ƒo approx. 220 Hz) to A4 (ƒo approx. 440 Hz) on the vowel /i/. Transnasal high-speed videoendoscopy at 20.000 fps was captured simultaneously with electroglottographic, nasal and oral flow, and audio signals, recorded using the same frame rate. The nasalance was calculated from both oral and nasal DC-flow signals. RESULTS Transitions to SVaP showed greater periodicity and regularity than transitions to falsetto. For 5 subjects, nasalance was increased during the passaggio for the transition to SVaP. For 4 subjects the increase of nasalance for the SVaP was associated with a stabilization of the open quotient and occurred at a comparable fundamental frequency as the increase of the open quotient for the transition to falsetto. CONCLUSIONS Nasalance can be used in order to stabilize oscillatory regularity and open quotient in male singers for singing across the passaggio.
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Affiliation(s)
- Matthias Echternach
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Munich University Hospital (LMU), Munich, Germany
| | - Catalina Högerle
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Munich University Hospital (LMU), Munich, Germany
| | - Marie Köberlein
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Munich University Hospital (LMU), Munich, Germany; Institute of Musicians' Medicine, Freiburg University Medical Center and Medical Faculty, Freiburg University, Freiburg, Germany
| | - Patrick Schlegel
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Döllinger
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Bernhard Richter
- Institute of Musicians' Medicine, Freiburg University Medical Center and Medical Faculty, Freiburg University, Freiburg, Germany
| | - Marie-Anne Kainz
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Munich University Hospital (LMU), Munich, Germany
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