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Portalete CR, Moraes DADO, Pagliarin KC, Keske-Soares M, Cielo CA. Acoustic and Physiological Voice Assessment And Maximum Phonation Time In Patients With Different Types Of Dysarthria. J Voice 2024; 38:540.e1-540.e11. [PMID: 34895782 DOI: 10.1016/j.jvoice.2021.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/09/2021] [Accepted: 09/16/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To compare the maximum phonation time of /a/, acoustic glottal source parameters, and physiological measures in patients with dysarthria. METHOD Thirteen patients were classified according to dysarthria type and divided into functional profiles (hypofunctional, hyperfunctional, and mixed). Assessments of maximum phonation time of /a/, glottal source parameters, electroglottography, and nasometry were performed. Results were compared between groups using ANOVA and Tukey posthoc tests. RESULTS The highest fundamental frequency differed significantly between groups, with the hyperfunctional profile showing higher values than the other participant groups. Reductions in the maximum phonation time of /a/ and alterations in acoustic glottal source parameters and electroglottography measures were observed in all groups, with no significant differences between them. The remaining measures did not differ between groups. CONCLUSION The maximum phonation times for /a/ were reduced in all participant groups, suggesting air escape during phonation. The presence of alterations in several glottal source parameters in all participant groups is indicative of noise, tremor, and vocal instability. Lastly, the high fundamental frequency in patients with a hyperfunctional profile reinforces the presence of vocal instability. These findings suggest that, although the characteristics observed in the assessments were consistent with expectations of patients with dysarthria, it is difficult to perform a differential diagnosis of this condition based on acoustic and physiological parameters alone.
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Gama ACC, da Mata SM, Martins Dos Santos PC, Vieira MN, Sansão JPH, Quinino RDC. Auditory Training With Synthesized Voice Anchors: Effects on Rater Agreement. J Voice 2024; 38:366-375. [PMID: 34702611 DOI: 10.1016/j.jvoice.2021.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the effects of auditory training with synthesized voices on intra- and inter-rater agreement of the auditory-perceptual voice analysis of roughness and breathiness. METHODS This was an experimental study consisting of four auditory training sessions. The sample consisted of twenty raters, students from a Speech-Language Pathology course, who had previous experience with auditory-perceptual assessment. The raters participated in the four training sessions with a seven-day break in between sessions. Each training consisted of three tasks: 1) Pre-training activity: Participants were asked to rate 20 natural voices, normal and dysphonic, from zero to three, according to the parameters of roughness and breathiness; 2) Training activity: Synthesized voice anchor stimuli were presented, and participants were asked to rate them from zero to three. Four stimuli were related to roughness and four to breathiness. Participants heard 20 voice stimuli and were instructed to pair the natural voice with the synthesized anchor stimulus that most resembled it; and 3) Post-training activity: the 20 voices from the pre-training activity were randomized and participants rated the same voices, without prior knowledge that these were repeated. Statistical analysis of data was performed using the AC2 test, to assess the extent of agreement between raters, and the Friedman test to compare the training sessions. A 5% significance level was considered. RESULTS For the auditory-perceptual voice analysis of roughness, intra-rater agreement results ranged from 79% to 86% between the first and fourth auditory training session, with improvement in intra-rater agreement from the fourth session forward (P = 0.005). For the analysis of breathiness, results ranged from 88% to 92% between the first and fourth auditory training sessions, with improvement from the fourth session forward (P = 0.036). Inter-rater agreement results for the auditory-perceptual analysis of roughness ranged from 23% to 34%, and from 48% to 61% for breathiness, with no differences regarding training (P = 0.855). CONCLUSION The auditory-perceptual breathiness parameter had a higher AC2 indicator compared to the roughness parameter, suggesting better agreement. The intra-rater agreement showed improvement starting from the fourth auditory training session for the assessment of roughness and breathiness. The auditory training program did not show a positive inter-rater agreement impact.
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Affiliation(s)
- 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 Research, Brazil.
| | - Sabrina Martins da Mata
- Speech-language Pathology, Department of Speech-language Pathology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Priscila Campos Martins Dos Santos
- Speech-language Pathology, Post-graduate program (MSc) in speech therapy Sciences; Department of Speech-language Pathology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maurílio Nunes Vieira
- Department of Electronic Engineering, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - João Pedro Hallack Sansão
- Department of Technology in Civil Engineering, Computing, Automation, Telematics and Humanities, Federal University of São João Del Rei - UFSJ - Ouro Branco, Minas Gerais, Brazil
| | - Roberto da Costa Quinino
- Department of Statistics of the Institute of Exact Sciences, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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.
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Lou Z, Lou Z, Lv T, Chen Z. A comparison of radiofrequency Coblation and cold steel excision in the treatment of idiopathic vocal process granulomas. J Laryngol Otol 2023; 137:1003-1009. [PMID: 37403597 DOI: 10.1017/s0022215122001906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To compare the effectiveness of radiofrequency Coblation assisted excision and cold steel excision in the treatment of idiopathic vocal process granulomas. METHODS A retrospective study was performed of patients with idiopathic vocal process granulomas who underwent radiofrequency Coblation excision or cold steel excision between January 2013 and January 2020. The recurrence rate was compared among the two groups at six months post-operatively. RESULTS Of the 47 patients with vocal process granulomas, 28 were in the cold steel excision (control) group and 19 were in the Coblation-assisted group. The recurrence rate in the control group was significantly higher than that in the Coblation-assisted group (60.7 per cent vs 5.3 per cent; p < 0.001). In addition, the voice recovery of the Coblation-assisted group was significantly better than that of the control group; vocal quality recovered one month after surgery in the Coblation-assisted group. CONCLUSION Radiofrequency Coblation should be considered the optimal method when approaching idiopathic vocal process granulomas surgically.
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Affiliation(s)
- Z Lou
- Department of Otorhinolaryngology, Yiwu Central Hospital, Yiwu City, China
| | - Z Lou
- Department of Otolaryngology - Head and Neck Surgery, Shanghai Jiao Tong University affiliated with Sixth People's Hospital, Shanghai City, China
- Center of Sleep Medicine, Shanghai Jiao Tong University affiliated with Sixth People's Hospital, Shanghai City, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai City, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai City, China
| | - T Lv
- Department of Otorhinolaryngology, Yiwu Central Hospital, Yiwu City, China
| | - Z Chen
- Department of Otolaryngology - Head and Neck Surgery, Shanghai Jiao Tong University affiliated with Sixth People's Hospital, Shanghai City, China
- Center of Sleep Medicine, Shanghai Jiao Tong University affiliated with Sixth People's Hospital, Shanghai City, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai City, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai City, China
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Bal KK, Alagoz S, Delibas V, Ortoglu F, Ceylan B, Ozdas T, Kuran G, Gorgulu O. Effects of Infertility on Voice in male patients. Indian J Otolaryngol Head Neck Surg 2022; 74:5199-5206. [PMID: 36742516 PMCID: PMC9895568 DOI: 10.1007/s12070-022-03130-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 07/10/2022] [Indexed: 02/07/2023] Open
Abstract
Purpose In this study, we aimed to determine the differences in normospermic, oligospermic and azoospermic infertile men by performing voice analysis and to discuss this in the light of the literature. Methods 71 male patients who applied to the urology clinic due to infertility and were then referred to us were included in the study. Hormone analysis and spermiogram were requested from the patients for routine infertility tests. Testosterone, Follicle stimulating hormone (FSH), Luteinizing hormone (LH), Prolactin levels of the patients were recorded. Age and spermiogram results were recorded. According to the spermiogram results, the patients were categorized as Group 1 (azoospermic), Group 2 (oligospermic), Group 3 (normospermic). Voice Handicap Index-10 Turkish version (VHI-10) was applied to the patients and the results were recorded. Results The age of the infertile patients ranged from 20 to 37. The mean age was 28.23. The distribution of the patients was 21 patients in Group 1, 40 patients in Group 2, and 10 patients in Group 3. The mean Testosterone level of the patients was 2.78; mean FSH level 12.14; mean LH level 7.26; mean Prolactin level was 8.1. The mean VHI-10 scores of the patients were 10.52. The fundamental frequency F0 Hz (mean pitch) values of the patients were 176,468; jitter % (frequency perturbation jitter) values average 0.25; shimmer % (amplitude perturbation shimmer) values average 2,322; HNR dB values averaged 24,862. Conclusions Testosterone is more effective on the voice, especially in male individuals.It would be more logical to think that many hormones, growth factors and local factors are effective instead of a single hormone.
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Affiliation(s)
- Kemal Koray Bal
- Otorhinolaryngology Department,Lecturer Otorhinolaryngology Specialist, University of Mersin, Mersin, Turkey
| | - Sedat Alagoz
- Otorhinolaryngology Department, Specialist Doctor, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Vedat Delibas
- Otorhinolaryngology Department,Research Assistant Doctor, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Ferhat Ortoglu
- Urology Department, Specialist Doctor, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Betul Ceylan
- Speech and Language Therapist, Otorhinolaryngology Department, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Talih Ozdas
- Otorhinolaryngology Department,Associate Professor, University of Health Sciences Adana City Training and Research Hospital, Yuregir, Adana, Turkey
| | - Gokhan Kuran
- Otorhinolaryngology Department,Associate Professor, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Orhan Gorgulu
- Otorhinolaryngology Department,Professor , Ozel Adana Ortadogu Hospital, Adana, Turkey
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Lima MMDS, Vasconcelos DD, Reis SCSD, Cardoso NSV, Souza MKD, Lucena JA, Araújo ANBD, Gomes ADOC. Effects of the Voiced Tongue Trill Technique in Glissandos on the Voice Range Profile of Choir Members: A Preliminary Study. J Voice 2022:S0892-1997(22)00148-5. [PMID: 35760631 DOI: 10.1016/j.jvoice.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/22/2022] [Accepted: 05/23/2022] [Indexed: 10/17/2022]
Abstract
The objective of this study was to verify the immediate effect of the voiced tongue trill technique in ascending and descending glissandos on the voice range profile of choir members. A total of 25 sopranos, mezzo-sopranos, contraltos, tenors, and baritones participated in the study. They were choir members, aged 20 to 45 years, with no voice symptoms, and able to perform the voiced tongue trill technique. Their voice range profile was analyzed before and after performing the ascending and descending technique for 2 and 5 minutes. The maximum fundamental frequency values in the study groups increased after performing the ascending and descending technique for 2 minutes (P = 0.001) and 5 minutes (P = 0.003). The range in Hz increased after 2 minutes (P = 0.010) and 5 minutes (P = 0.050) of the ascending technique and after 2 minutes (P = 0.001) of the descending technique, and the minimum fundamental frequency mean value suffered interference from the type of technique (ascending/descending). The immediate effects of VTTT in glissandos on the VRP of choir members' considering the two factors: condition and time, in ascending and descending glissandos for 2 and 5 minutes increased the maximum frequency and the range in Hz of choristers. Regarding volume levels results, no difference was found in intensity after applying the technique.
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Affiliation(s)
- Mykaella Monyque da Silva Lima
- Speech-Languague Pathology and Audiology Departament, Departamento de Fonoaudiologia, Universidade Federal de Pernambuco - Centro de Ciências da Saúde, Recife, Pernambuco, Brazil
| | - Daniela de Vasconcelos
- Speech-Language Pathology Outpatient Clinic, Clinical Hospital of Pernambuco, Recife, Pernambuco Brazil
| | - Suelene Cibelle Silva Dos Reis
- Speech-Languague Pathology and Audiology Departament, Departamento de Fonoaudiologia, Universidade Federal de Pernambuco - Centro de Ciências da Saúde, Recife, Pernambuco, Brazil
| | - Nathália Suellen Valeriano Cardoso
- Health Sciences Center. Speech-Languague Pathology and Audiology Departament, Departamento de Fonoaudiologia, Graduate Program in Human Communication Health at the Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Mayara Kerolyn de Souza
- Health Sciences Center. Speech-Languague Pathology and Audiology Departament, Departamento de Fonoaudiologia, Graduate Program in Human Communication Health at the Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Jonia Alves Lucena
- Speech-Languague Pathology and Audiology Departament, Departamento de Fonoaudiologia, Universidade Federal de Pernambuco - Centro de Ciências da Saúde, Recife, Pernambuco, Brazil; Health Sciences Center. Speech-Languague Pathology and Audiology Departament, Departamento de Fonoaudiologia, Graduate Program in Human Communication Health at the Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Ana Nery Barbosa de Araújo
- Speech-Languague Pathology and Audiology Departament, Departamento de Fonoaudiologia, Universidade Federal de Pernambuco - Centro de Ciências da Saúde, Recife, Pernambuco, Brazil
| | - Adriana de Oliveira Camargo Gomes
- Speech-Languague Pathology and Audiology Departament, Departamento de Fonoaudiologia, Universidade Federal de Pernambuco - Centro de Ciências da Saúde, Recife, Pernambuco, Brazil; Health Sciences Center. Speech-Languague Pathology and Audiology Departament, Departamento de Fonoaudiologia, Graduate Program in Human Communication Health at the Federal University of Pernambuco, Recife, Pernambuco, Brazil.
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Jayakumar T, Rajasudhakar R, Benoy JJ. Comparison and Validation of Acoustic Voice Quality Index Version 2 and Version 3 among South Indian Population. J Voice 2022:S0892-1997(22)00058-3. [PMID: 35337701 DOI: 10.1016/j.jvoice.2022.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/17/2022] [Accepted: 02/20/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Acoustic Voice Quality Index (AVQI) has emerged in the recent past as a robust multiparametric voice quality evaluation tool. Two versions of AVQI derived using the program PRAAT have found extensive clinical and research applications. These versions have been validated in several languages around the world. However, no research reports are available on validation of AVQI in the South Indian population. Further, studies comparing the performance of the two versions of AVQI are limited in the literature. OBJECTIVES This study was designed to validate and compare the two versions of AVQI (AVQIv02.02 and AVQIv03.01) in South Indian languages (Malayalam and Kannada). METHODS A retrospective analysis of previously recorded voice samples was carried out on a total of 160 (91 normophonic and 69 dysphonic) voice samples. These samples were perceptually rated on a GRBAS scale by five experienced speech-language pathologists. Standardized Syllable Number (SSN) necessary to derive AVQIv03.01 was computed. Following this, these samples were analyzed to obtain the AVQIv02.02 and AVQIv03.01. The concurrent validity and diagnostic accuracy of these measures were then examined and compared. RESULTS A moderate agreement was obtained across the judges on perceptual evaluation of voice quality. SSN in Malayalam and Kannada languages were identified to be 29 and 25 syllables respectively. Language differences were not observed on both versions of AVQI. The concurrent validity of AVQIv03.01 (r = 0.788) was superior to that of AVQIv02.02 (r = 0.655). Further, the threshold of differentiating normophonic and dysphonic samples were determined to be >3.45 for AVQIv02.02 and >2.45 for AVQIv03.01. CONCLUSIONS AVQIv03.01 is superior to AVQIv02.02 in terms of its diagnostic accuracy and concurrent validity. Current findings also extend the application of AVQI as a robust tool for the evaluation of voice characteristics to the South Indian population.
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Affiliation(s)
- T Jayakumar
- Associate Professor of Speech Sciences, Department of Speech-Language Sciences, All India Institute of Speech and Hearing, University of Mysore, Mysuru, Karnataka, India.
| | - R Rajasudhakar
- Associate Professor of Speech Sciences, Department of Speech-Language Sciences, All India Institute of Speech and Hearing, University of Mysore, Mysuru, Karnataka, India
| | - Jesnu Jose Benoy
- Junior Research Fellow, Department of Speech-Language Sciences, All India Institute of Speech and Hearing, University of Mysore, Mysuru, Karnataka, India
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Mateos-Serrano B, García-López I, Toledano A, Gavilán J. Subjective voice analysis in patients with muscular tension dysphonia: comparison between clinician and patient evaluation. J Laryngol Otol 2021; 135:458-63. [PMID: 33906703 DOI: 10.1017/S0022215121001067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study evaluated the correlation between patient and clinician subjective voice analysis in a group of patients suffering from muscular tension dysphonia. This disease does not usually present with organic lesions, and voice analysis is crucial to evaluate it. METHODS A retrospective study with 75 patients was performed. Correlation between grade, roughness, breathiness, asthenia and strain scale and voice handicap index-10 was analysed. Any possible influence of the type of muscular tension dysphonia on these two scales was studied. RESULTS There are only a few studies that correlate voice handicap index-10 and the grade, roughness, breathiness, asthenia and strain scale; however, none of them are specific for patients suffering from muscular tension dysphonia. A moderate correlation (r = 0.56) was found. No influence of muscular tension dysphonia type on voice handicap index-10 score was found, but muscular tension dysphonia type 4 had worse grade, roughness, breathiness, asthenia and strain scale scores than other muscular tension dysphonia types. This could be explained if muscular tension dysphonia type 4 is considered to be the most severe form of this disease. CONCLUSION The use of assessment scales based on the opinion of both the clinician and patient must be considered as complementary clinical tools in order to perform a complete assessment of dysphonia.
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de Oliveira KGSC, de Lira ZS, da Silva HJ, Lucena JA, Gomes AOC. Oropharyngeal Geometry and the Singing Voice: Immediate Effect of Two Semi-Occluded Vocal Tract Exercises. J Voice 2020:S0892-1997(20)30244-7. [PMID: 32712077 DOI: 10.1016/j.jvoice.2020.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE The aim of this study was to verify the immediate effect of a flexible resonance tube in water and of lip trill on oropharyngeal geometry and vocal acoustic parameters of singers without vocal symptoms. METHODS Twenty-two adult singers participated in the study. They had an average age of 27 (±4.8) years. Participants were split into two groups: a group composed of 12 singers who performed the flexible resonance tube (FRT) exercise and a group of 10 singers who performed the Lip Trill technique (LTT). Acoustic pharyngometry and acoustic analysis of the voice were used to assess oropharyngeal geometry before and after the exercises. RESULTS After performing the techniques, the vocal tract length was longer in the group that performed the FRT, compared to the one that performed the LTT. In the acoustic evaluation, there was an improvement in the glottal to noise excitation ratio and a decrease in noise in the group of singers who performed the LTT. In the analysis by sex men had a longer oral cavity compared to women and after application of the techniques greater volume of the vocal tract. CONCLUSION There was variation in the oropharyngeal geometry with the FRT, while the LTT had a positive effect on the vocal acoustic parameters related to glottal noise.
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10
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Forner D, Rigby MH, Corsten M, Trites JR, Pyne J, Taylor SM. Oncological and functional outcomes after repeat transoral laser microsurgery for the treatment of recurrent early glottic cancer. J Laryngol Otol 2020; 134:1-5. [PMID: 32079549 DOI: 10.1017/s0022215120000407] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Transoral laser microsurgery for glottic squamous cell carcinoma is the standard of care at many institutions. Repeat transoral laser microsurgery for recurrence may avoid the need for radiotherapy and total laryngectomy. This study aimed to identify oncological and functional outcomes in a cohort of patients who had undergone repeat transoral laser microsurgery procedures. METHOD A retrospective review of prospectively collected data of patients treated with transoral laser microsurgery for carcinoma in situ or tumour stages T1 or T2 glottic cancer, from 2003 to 2018. RESULTS Twenty patients were identified. Additional treatment was not needed in 45 per cent of patients. The five-year overall survival rate was 90 per cent. The disease-specific survival rate was 100 per cent. The laryngeal preservation rate was 85 per cent. There was improvement in mean Voice Handicap Index-10 scores following repeat transoral laser microsurgery treatment, when comparing the pre- and post-operative periods (mean scores = 15.5 vs 11.5, p = 0.373). CONCLUSION Repeat transoral laser microsurgery can be an oncologically safe alternative to other salvage therapies for glottic squamous cell carcinoma recurrence, without sacrificing functional outcomes.
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Affiliation(s)
- D Forner
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada
| | - M H Rigby
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada
| | - M Corsten
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada
| | - J R Trites
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada
| | - J Pyne
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Canada
| | - S M Taylor
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada
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Lee SH, Hong KH, Kim JS, Hong YT. Perceptual and Acoustic Outcomes of Early-Stage Glottic Cancer After Laser Surgery or Radiotherapy: A Meta-Analysis. Clin Exp Otorhinolaryngol 2019; 12:241-248. [PMID: 30959580 PMCID: PMC6635706 DOI: 10.21053/ceo.2018.00990] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 12/16/2018] [Indexed: 02/08/2023] Open
Abstract
Laser surgery (LS) or radiotherapy (RT) is normally recommended in early glottic cancer. The objective of this study was to perform a comprehensive meta-analysis of acoustic and perceptual outcomes to compare voice quality of LS or RT in early-stage glottic cancer. Data sources were obtained after searching PubMed, Google Scholar, EBSCO, and RISS using the following search terms: glottic cancer, glottic carcinoma, endoscopic surgery, laser surgery, radiotherapy, radiation, voice, voice quality, and grade, roughness, breathiness, asthenia, and strain (GRBAS) scale. Articles that compared voice outcomes between LS and RT were identified. This meta-analysis included 15 articles with 744 patients, including 400 in the LS group and 344 in the RT group. Random effects models were selected. Forest plots included standardized mean differences, standard errors, variance, 95% confidence intervals (lower limit to upper limit), z-values, and P-values. In perceptual analysis, grade (G) and asthenia (A) of RT were significantly better than LS. There was no statistically significant difference in roughness (R), breath (B), or strain (S) between LS and RT groups. Jitter, shimmer, and noise to harmonic ratio measurements showed significant differences, resulting in enhanced posttreatment effect of RT compared to LS. Results of our meta-analysis suggested that RT might lead to superior voice quality than LS in early glottic cancer.
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Affiliation(s)
- So Hyun Lee
- Department of Speech Pathology, Chonbuk National University-Chonbuk National University Hospital, Jeonju, Korea
| | - Ki Hwan Hong
- Department of Otolaryngology-Head and Neck Surgery, Chonbuk National University-Chonbuk National University Hospital, Jeonju, Korea.,Department of Research Institute of Clinical Medicine, Chonbuk National University-Chonbuk National University Hospital, Jeonju, Korea
| | - Jong Seung Kim
- Department of Otolaryngology-Head and Neck Surgery, Chonbuk National University-Chonbuk National University Hospital, Jeonju, Korea.,Department of Research Institute of Clinical Medicine, Chonbuk National University-Chonbuk National University Hospital, Jeonju, Korea
| | - Yong Tae Hong
- Department of Otolaryngology-Head and Neck Surgery, Chonbuk National University-Chonbuk National University Hospital, Jeonju, Korea.,Department of Research Institute of Clinical Medicine, Chonbuk National University-Chonbuk National University Hospital, Jeonju, Korea
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12
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Xu J, Kang YA, Park SK, Yoon YH, Bai SJ, Jin YD, Kim YM, Rha KS. Nasality Changes With Age in Normal Korean-Speaking Adults. Clin Exp Otorhinolaryngol 2018; 12:95-99. [PMID: 30257547 PMCID: PMC6315219 DOI: 10.21053/ceo.2018.00717] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 08/03/2018] [Indexed: 11/24/2022] Open
Abstract
Objectives This study was performed to investigate the effects of aging on nasality and the influence of age-related changes in nasal cavity volume and nasal patency on nasality. Methods A total of 180 healthy Korean-speaking adult volunteers, who had no nasal or voice-related complaints, were enrolled in this study. Nasometry, acoustic rhinometry, and rhinomanometry were performed to obtain the nasalance score, nasal cavity volume, and nasal resistance, respectively. Changes in these parameters with age were analyzed. Results Nasal cavity volume increased significantly, and nasal resistance decreased significantly, with age. The nasalance scores for the nasal passage and oronasal passage decreased significantly with age, while there were no age-related changes in nasalance scores for the oral passage. Conclusion Nasalance scores for the passages containing nasal consonants decreased with age although significant increases were observed in nasal cavity volume and nasal patency with age. Therefore, the age-related decreases in nasalance scores may result from factors other than changes in the nasal cavity.
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Affiliation(s)
- Jun Xu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Yanbian University Hospital, Yanji, China
| | - Young-Ae Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Soo-Kyoung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Young Hoon Yoon
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Shang Jie Bai
- Department of Otorhinolaryngology-Head and Neck Surgery, Yanbian University Hospital, Yanji, China
| | - Yong De Jin
- Department of Otorhinolaryngology-Head and Neck Surgery, Yanbian University Hospital, Yanji, China
| | - Yong Min Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Ki-Sang Rha
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
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13
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Schwarz K, Fontanari AMV, Costa AB, Soll BMB, da Silva DC, de Sá Villas-Bôas AP, Cielo CA, Bastilha GR, Ribeiro VV, Dorfman MEKY, Lobato MIR. Perceptual-Auditory and Acoustical Analysis of the Voices of Transgender Women. J Voice 2017; 32:602-608. [PMID: 28965663 DOI: 10.1016/j.jvoice.2017.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/04/2017] [Accepted: 07/05/2017] [Indexed: 10/18/2022]
Abstract
Voice is an important gender marker in the transition process as a transgender individual accepts a new gender identity. The objectives of this study were to describe and relate aspects of a perceptual-auditory analysis and the fundamental frequency (F0) of male-to-female (MtF) transsexual individuals. A case-control study was carried out with individuals aged 19-52 years who attended the Gender Identity Program of the Hospital de Clínicas of Porto Alegre. Vocal recordings from the MtF transgender and cisgender individuals (vowel /a:/ and six phrases of Consensus Auditory Perceptual Evaluation Voice [CAPE-V]) were edited and randomly coded before storage in a Dropbox folder. The voices (vowel /a:/) were analyzed by consensus on the same day by two judge speech therapists who had more than 10 years of experience in the voice area using the GRBASI perceptual-auditory vocal evaluation scale. Acoustic analysis of the voices was performed using the advanced Multi-Dimensional Voice Program software. The resonance focus and the degrees of masculinity and femininity for each voice recording were determined by listening to the CAPE-V phrases, for the same judges. There were significant differences between the groups regarding a greater frequency of subjects with F0 between 80 and 150 Hz (P = 0.003), and a greater frequency of hypernasal resonant focus (P < 0.001) in the MtF cases and greater frequency of subjects with absence of roughness (P = 0.031) in the control group. The MtF group of individuals showed altered vertical resonant focus, more masculine voices, and lower fundamental frequencies. The control group showed a significant absence of roughness.
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Affiliation(s)
- Karine Schwarz
- Gender Identity Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Centro Universitário Metodista do Sul, Faculdade de Fonoaudiologia, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Anna Martha Vaitses Fontanari
- Gender Identity Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Bianca Machado Borba Soll
- Gender Identity Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Dhiordan Cardoso da Silva
- Gender Identity Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Carla Aparecida Cielo
- Departamento de Fonoaudiologia, Universidade Federal de Santa Maria-UFSM, Santa Maria, Rio Grande do Sul, Brazil
| | - Gabriele Rodrigues Bastilha
- Departamento de Fonoaudiologia, Universidade Federal de Santa Maria-UFSM, Santa Maria, Rio Grande do Sul, Brazil
| | | | | | - Maria Inês Rodrigues Lobato
- Gender Identity Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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14
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Gulec S, Kulahli I, Sahin MI, Kokoğlu K, Gunes MS, Avci D, Arli T. Effect of Septoplasty on Voice Quality: A Prospective-Controlled Trial. Clin Exp Otorhinolaryngol 2016; 9:238-43. [PMID: 27230274 PMCID: PMC4996097 DOI: 10.21053/ceo.2015.01354] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/17/2015] [Accepted: 11/17/2015] [Indexed: 12/02/2022] Open
Abstract
Objectives. The purpose is to investigate effect of septoplasty and widened nasal patency on voice quality. Methods. Fifty patients who undergone septoplasty were included in the study. Thirty-three people who had similar age and distribution were enrolled as control group. Before and 1 and 3 months after surgery, anterior rhinomanometry, voice analysis by Multi-Dimensional Voice Program, and spectrographic analysis were performed to patients. The recordings of /a/ vowel were used to evaluate average fundamental frequency (F0), jitter percent, and shimmer percent. In spectrographic analyses, F3–F4 values for the vowels /i, e, a, o, and u/, nasal formant frequencies of the consonants /m/ and /n/ in the word /mini/, and 4 formant frequencies (F1, F2, F3, and F4) for nasalized /i/ vowel following a nasal consonant /n/ in the word /mini/ were compared. The differences in nasal resonance were evaluated. All patients were asked whether change in their voices after the surgery. Preoperative and postoperative voice parameters and anterior rhinomanometry results were compared separately with the control group as well as in the patient group itself. Results. Preoperative total nasal resistance (TNR) values of patients were higher than the control group (P=0.001). TNR values of patients measured one day before surgery and after surgery in the 1st and 3rd months were different and these differences were significant statistically (P=0.001). There was no significant difference between the voice analysis parameters in preoperative, postoperative 1st, and 3rd months. As a result of their subjective reviews, 12 patients (36%) noted their voices were better than before surgery and 20 patients (61%) noted no change before and after surgery. Conclusion. Providing widened nasal cavity has no effect on voice quality.
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Affiliation(s)
- Safak Gulec
- Department of Otolaryngology, Private Neon Hospital, Erzincan, Turkey
| | - Ismail Kulahli
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Ilhan Sahin
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Kerem Kokoğlu
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Murat Salih Gunes
- Department of Otolaryngology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Deniz Avci
- Department of Otolaryngology, Patnos State Hospital, Agri, Turkey
| | - Turan Arli
- Deprtment of Otolaryngology, Kasımpasa Military Hospital, Istanbul, Turkey
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15
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Park KN, Mok JO, Chung CH, Lee SW. Does Postthyroidectomy Syndrome Really Exist Following Thyroidectomy? Prospective Comparative Analysis of Open vs. Endoscopic Thyroidectomy. Clin Exp Otorhinolaryngol 2015; 8:76-80. [PMID: 25729500 DOI: 10.3342/ceo.2015.8.1.76] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 11/01/2013] [Accepted: 11/09/2013] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES This study prospectively evaluated postthyroidectomy syndrome (PTS) through objective and subjective voice changes following thyroidectomy of open vs. endoscopic thyroidectomy. METHODS A prospective clinical trial (SCHBC IRB 09 26) was performed from Jan 2008 to Aug 2010 to compare the open thyroidectomy (OPEN group) and endoscopic thyroidectomy (ENDO group). Of the 110 patients, 75 completed the evaluation before and 1 and 6 months after surgery. Subjective parameters included perceptual analysis (GRBAS [grade, roughness, breathiness, asthenia, and strain] scale), stroboscopic or flexible fiberscopic analysis, voice handicap index, and 5-point visual analog scales for vocal fatigue, singing difficulty, difficulty with high-pitch phonation, and neck discomfort. Objective parameters included acoustic, aerodynamic analysis and the electroglottograph. RESULTS For the ENDO group (n=36), the operation time was longer than in the OPEN group (n=39; P<0.01). For the OPEN group, two objective and five subjective parameters were worse 1 month postoperatively; of these, two subjective parameters persisted for 6 months (P<0.05). For the ENDO group, three objective and six subjective parameters were worse 1 month postoperatively, and three of the subjective parameters persisted 6 months postoperatively (P<0.05). CONCLUSION PTS really exists following simple thyroidectomy and are very common for both OPEN and ENDO groups. Most of the parameters improved gradually over time, but some subjective changes persisted 6 months postoperatively.
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16
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Scherer S, Hammal Z, Yang Y, Morency LP, Cohn JF. Dyadic Behavior Analysis in Depression Severity Assessment Interviews. Proc ACM Int Conf Multimodal Interact 2014; 2014:112-119. [PMID: 28345076 PMCID: PMC5365085 DOI: 10.1145/2663204.2663238] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Previous literature suggests that depression impacts vocal timing of both participants and clinical interviewers but is mixed with respect to acoustic features. To investigate further, 57 middle-aged adults (men and women) with Major Depression Disorder and their clinical interviewers (all women) were studied. Participants were interviewed for depression severity on up to four occasions over a 21 week period using the Hamilton Rating Scale for Depression (HRSD), which is a criterion measure for depression severity in clinical trials. Acoustic features were extracted for both participants and interviewers using COVAREP Toolbox. Missing data occurred due to missed appointments, technical problems, or insufficient vocal samples. Data from 36 participants and their interviewers met criteria and were included for analysis to compare between high and low depression severity. Acoustic features for participants varied between men and women as expected, and failed to vary with depression severity for participants. For interviewers, acoustic characteristics strongly varied with severity of the interviewee's depression. Accommodation - the tendency of interactants to adapt their communicative behavior to each other - between interviewers and interviewees was inversely related to depression severity. These findings suggest that interviewers modify their acoustic features in response to depression severity, and depression severity strongly impacts interpersonal accommodation.
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Affiliation(s)
- Stefan Scherer
- USC Institute for Creative Technologies, 12015 Waterfront Dr. Playa Vista, CA
| | - Zakia Hammal
- Carnegie Mellon University, 5000 Fifth Avenue, Pittsburgh, PA
| | - Ying Yang
- University of Pittsburgh, Biomedical Science Tower, Pittsburgh, PA 15213
| | | | - Jeffrey F Cohn
- University of Pittsburgh, 210 S. Bouquet St. Pittsburgh, PA 15260
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