Quality analysis of laryngography in a busy hospital ENT voice clinic

Stimulated production of vowel-like LX-waveforms and spectral damping in the absence of phonation

Electrical impedance 'LX' waveforms measured across the neck at the thyroid level during phonation are known to be correlated with vocal fold movement. Changes in vocal fold contact are thought to be the cause of this phenomenon though emerging applications in radiotherapy indicate that changes in the configuration of both fold and neck tissues are correlated with LX waveform shape. In this paper it is shown that a two-stage tissue damping model with controlled bandpass and passive low pass components is consistent with evidence from gradually degraded, controlled phonation. In particular it is shown that an externally applied stimulus to the vertebral processes of the neck can produce similar impedance waveforms in the absence of phonation and hence no controlled fold contact. It is postulated that this is initial evidence suggesting that both pressure waves and vocal fold contact components contribute to the production of the classical 'LX' waveform.

On the influence of laryngeal pathologies on acoustic and electroglottographic jitter measures

This study compared acoustic and electroglottographic (EGG) jitter from [a] vowels of 103 dysphonic speakers. The EGG recordings were chosen according to their intensity, signal-to-noise ratio, and percentage of unvoiced intervals, while acoustic signals were selected based on voicing detection and the reliability of jitter extraction. The agreement between jitter measures was expressed numerically as a normalized difference. In 63.1% (65/103) of the cases the differences fell within +/-22.5%. Positive differences above +22.5% were associated with increased acoustic jitter and occurred in 12.6% (13/103) of the speakers. These were, typically, cases of small nodular lesions without problems in the posterior larynx. On the other hand, substantial rises in EGG jitter leading to differences below -22.5% took place in 24.3% (25/103) of the speakers and were related to hyperfunctional voices, creaky-like voices, small laryngeal asymmetries affecting the arytenoids, or small-to-moderate glottal chinks. A clinically relevant outcome of the study was the possibility of detecting gentle laryngeal asymmetries among cases of large unilateral increase in EGG jitter. These asymmetries can be linked with vocal problems that are often overlooked in endoscopic examinations.