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At least 649 records · Page 36Linked to original sources
PubMedDate not supplied

Glottic configuration in wind instrument players.

INTRODUCTION: Knowledge of occupational voice disorders has gained increased importance as more individuals rely on their voices for their work. Wind instrument players are a specific group of individuals that present intensive use of the vocal tract associated with blowing their instrument. Interestingly, only a small number of reports focus on the laryngeal function of such professionals. AIM: The current study evaluated the laryngeal and vocal tract movement of wind instrument players. MATERIAL AND METHODS: Ten adult wind instrument players were studied with flexible videolaryngoscopy while playing their instrument, in order to observe the movements of the glottis, the vocal tract and the base of the tongue. RESULTS: In all the participants it was observed that musical tones were played with adducted vocal folds and that the greater the technical difficulty reported by the player, the more it was associated with increased lateral tension in the larynx, as well as constriction in the vocal tract. CONCLUSIONS: The larynx controls the airflow that will reach the mouthpiece of the instrument, directly interfering in blowing. Therefore, wind instrument players should also be considered professional voice users.

Adult↗
PubMed2001

Diagnostic laryngeal electromyography: The Wake Forest experience 1995-1999.

BACKGROUND: Laryngeal electromyography (LEMG) is a valuable diagnostic/prognostic test for patients with suspected laryngeal neuromuscular disorders. OBJECTIVE: To report our experience with diagnostic LEMG at the Center for Voice Disorders of Wake Forest University and to evaluate the impact of LEMG on clinical management. METHODS: Retrospective chart review of 415 patients who underwent diagnostic LEMG over a 5-year period (1995-1999). RESULTS: Of 415 studies, 83% (346 of 415) were abnormal, indicating a neuropathic process. LEMG results altered the diagnostic evaluation (eg, the type of radiographic imaging) in 11% (46 of 415) of the patients. Unexpected LEMG findings (eg, contralateral neuropathy) were found in 26% (107 of 415) of the patients, and LEMG results differentiated vocal fold paralysis from fixation in 12% (49 of 415). Finally, LEMG results altered the clinical management (eg, changed the timing and/or type of surgical procedure) in 40% (166 of 415) of the patients. CONCLUSIONS: LEMG is a valuable diagnostic test that aids the clinician in the diagnosis and management of laryngeal neuromuscular disorders.

Adult↗
PubMed1980

A survey of speech pathologists: current trends in the diagnosis and management of velopharyngeal insufficiency.

A questionnaire designed to survey methods of diagnosis and management of velopharyngeal insufficiency associated with cleft palate was distributed to over 1,000 speech pathologists in the United States and Canada. There was a 60% response, and 65% of those responding were associated with cleft palate teams. Findings included: (1) 90% of responding cleft palate team members primarily rely on listener judgment, oral examination, and articulation testing in the diagnosis of velopharyngeal insufficiency (VPI) and for the recommendation of pharyngoplasty. (2) Only 11% indicated that their team had a radiologist. (3) More than half of those responding said that they would prefer palatal repair to be completed after the age of two. (4) 60% of those responding regarded VPI as a voice disorder, yet 84% treated the symptoms of VPI with articulation therapy rather than voice therapy.

Age Factors↗
PubMed1977

[Observations on the accent-method of Smith in the management of speech and voice disturbances. Part I (author's transl)].

One of the best known methods in northern Europe for the treatment of voice disorders is the "accent-method", which was devised by Svend Smith in Denmark. The method is based on the use of the stressed ("accentuated") syllable as a therapeutic tool to develop pronunciation and a natural attractive voice. Present theories of the physics and the physiology of voice function form the basis for the method, in addition to concepts from modern psychology and pedagogics. By using the technique, it is possible to develop a therapeutic field between patient and therapist within which voice and speech behavior can be treated as a whole. The method is described in detail in the present paper. In a forthcoming paper, the method will be discussed from the viewpoints of the physics and physiology of phonation as well as from pedagogical and psychological aspects,

Breathing Exercises↗
PubMed1999

[Comparative voice quality evaluation after laser surgical versus fronto-lateral partial laryngectomy in T1b and T2 vocal cord carcinoma].

BACKGROUND: We conducted a study to compare the voice quality after transoral endolaryngeal laser surgery versus anterolateral partial laryngectomy in terms of ability to communicate effectively. MATERIAL AND METHODS: Two groups each of 8 patients were reexamined at least 6 months after either a laser surgical or a partial anterolateral laryngectomy for a T1b or T2 vocal chord carcinoma was performed by the same surgeon. The following examinations were conducted: video-laryngoscopy, video-stroboscopy, phonetogram when reading a standard text or when speaking and shouting, voice load test, respiratory flow measurement, auditive voice rating following the RBH model, and auditive rating of the voice by the patients according to a questionnaire. RESULTS: A voice disorder with a medium-grade dysphony and an essential limitation of the speaking and shouting voice function and voice quality was detected in both groups of patients. No significant differences were observed in any of the parameters evaluation in both groups of patients. CONCLUSIONS: Both surgical techniques appear to be equivalent in terms of postoperative voice function. However, the tracheotomy was avoided in the patients undergoing laser surgery.

Adult↗
PubMed1975

The psychosomatic aspects of children with vocal nodules.

Psychological and emotional aspects of voice disorders have long received attention from otolaryngologits and speech clinicians. The literature contains frequent reports of such problems, but there are few studies on the full importance of these aspects. The cause of vocal nodules in children has been attributed to vocal abuse, and therapy has consisted of the elimination of this abuse. Reports of long-term follow-up are few, lending suspicion to both the proposed causes and the therapeutic approaches. Seventy-seven prepuberal children with vocal nodules are studies from the social, medical, and physical aspects. The incidence of vocal nodules approaches 1% of all children. Boys predominate this amount by ratios greater than 3:1, with incidence peaks between ages 5 and 10. Conventional modes of therapy have been unsuccessful because of the lack of recognition of psychosomatic factors. New approaches for therapy are suggested including parental involvement, counseling, group therapy, and drug therapy. Though emotional problems may persist, the somatic aspect of this disease disappears at puberty.

Child↗
PubMed2003

Normal voice production: computation of driving parameters from endoscopic digital high speed images.

OBJECTIVES: A central point for quantitative evaluation of pathological and healthy voices is the analysis of vocal fold oscillations. By means of digital High Speed Glottography (HGG), vocal fold oscillations can be recorded in real time. Recently, a numerical inversion procedure was developed that allows the extraction of physiological parameters from digital high speed videos and a classification of voice disorders. The aim of this work was to validate the inversion procedure and to investigate the applicability to normal voices. METHODS: High speed recordings were performed during phonation within a group of five female and five male persons with normal voices. By using knowledge based image processing algorithms, motion curves of the vocal folds were extracted at three different positions (dorsal, medial, ventral). These curves were used to obtain physiological voice parameters, and in particular the degree of symmetry of the vocal folds based upon a biomechanical model of the vocal folds. RESULTS: The highest degree of symmetry was observed for the medial motion curves. While the dorsally and ventrally extracted motion curves exhibited similar results concerning the degree of symmetry the performance of the algorithm was less stable. CONCLUSIONS: The inversion algorithm provides reasonable results for all subjects when applied to the medial motion curves. However, for dorsal and ventral motion curves, correct performance is reduced to 85%.

Algorithms↗
PubMed2000

Novel approach to acoustical voice analysis using artificial neural networks.

Perceptual rating scales are widely used for the assessment of voice quality. These ratings may be influenced by the individual experience of the listener. Thus, researchers have turned to acoustical measures which may eventually correlate with voice quality. In this study we tested whether multivariate statistics, combined with artificial neural networks, could identify patterns of acoustic voice parameters corresponding to a widely used perceptual rating scale. In a multicenter study with 31 raters, voice samples of 117 individuals with or without voice disorders were perceptually rated. The RBH index, consisting of a 4-point scale of roughness, breathiness, and hoarseness, was used. Voice samples were then analyzed with an acoustical feature extraction and classified using amultivariate regression tree analysis with the perceptual ratings as a priori information. Artificial neural networks were trained to selected acoustic parameters having high "relative importance" in the regression trees. Mean classification accuracies were around 30% with topographic feature maps (trained with Learning Vector Quantization algorithm) and 65-85% with feedforward networks (trained with RProp algorithm). Based on the best-fitting results with feedforward networks, a classification system (computer program) consisting of 50 simultaneous working networks was developed. Using this program, the classification matched 40% of the a prori values in both R and B domains. In 65% they matched at least in one domain. These accuracies are within the range reported by other authors using artificial neural networks in biology and clinical medicine. Thus, the results encourage further research of feedforward networks for acoustic voice analysis.

Humans↗
PubMed1999

[Dysphagia and speech disorders].

Swallowing disorders in oral and pharyngeal phase after surgery of mouth, pharynx or larynx are very often interrelated with speech and voice disorders. The results of diagnostic methods of dysphagia and voice/speech disorders based on own material of patients after total laryngectomy, partial tongue resection and cleft palate surgery were presented. Attention was also paid to other etiological factors of swallowing disorders observed in phoniatric practice.

Adult↗
PubMed2003

Influence of glottal closure configuration on vocal efficacy in young normal-speaking women.

Posterior closure insufficiency of the glottis is often mentioned in connection with permanent voice disorders. Recently published studies have revealed that an incomplete closure of the glottis can be found also in normal-speaking voices, especially in women. However, the effect of glottal closure configuration on vocal efficacy is not sufficiently clarified. The purpose of this study was to determine the effect of glottal closure configuration on singing and speaking voice characteristics. Overall, 520 young female normal-speaking subjects were examined by videostroboscopy for different phonation conditions in the combination of soft, loud, low, and/or high phonation and by voice range profile measurements. According to the videostroboscopic analysis, the subjects were subdivided into four groups: complete closure of the vocal folds already in soft phonation (group 1), closure of the vocal fold with increasing intensity (group 2), persistent closure insufficiencies despite increasing intensity (group 3), and hourglass-shaped closure in subjects with vocal nodules (group 4). Subjects in which the glottal closure could not be evaluated sufficiently were subclassified into group 5 (missing values). Selected criteria of the singing and speaking voice were evaluated and statistically processed according to the mentioned subclassification. Group 1 reached significantly the highest sound pressure levels (SPLmax) for the singing voice as well as for the shouting voice. Group 3 showed a limited capacity to increase the intensity of the singing and speaking voice. The results gathered in this study objectify the relationship of insufficient glottal closure and reduced vocal capabilities. As long as no conclusive data on long-term consequences of insufficient glottal closure are available, a prophylactic improvement of the laryngeal situation especially in female professional voice users by voice therapy should be recommended.

Adolescent↗
PubMed2007

The prevalence of stuttering, voice, and speech-sound disorders in primary school students in Australia.

PURPOSE: The aims of this study were threefold: to report teachers' estimates of the prevalence of speech disorders (specifically, stuttering, voice, and speech-sound disorders); to consider correspondence between the prevalence of speech disorders and gender, grade level, and socioeconomic status; and to describe the level of support provided to schoolchildren with speech disorders. METHOD: Students with speech disorders were identified from 10,425 students in Australia using a 4-stage process: training in the data collection process, teacher identification, confirmation by a speech-language pathologist, and consultation with district special needs advisors. RESULTS: The prevalence of students with speech disorders was estimated; specifically, 0.33% of students were identified as stuttering, 0.12% as having a voice disorder, and 1.06% as having a speech-sound disorder. There was a higher prevalence of speech disorders in males than in females. As grade level increased, the prevalence of speech disorders decreased. There was no significant difference in the pattern of prevalence across the three speech disorders and four socioeconomic groups; however, students who were identified with a speech disorder were more likely to be in the higher socioeconomic groups. Finally, there was a difference between the perceived and actual level of support that was provided to these students. CONCLUSION: These prevalence figures are lower than those using initial identification by speech-language pathologists and similar to those using parent report.

Articulation Disorders↗
PubMedDate not supplied

School employees: the forgotten municipal workers.

The occupational health and safety issues of public school employees in large urban areas are many and complex. Crumbling school infrastructure and crowded classrooms are associated with inadequate indoor air quality, asbestos exposure, noisy environments, and enhanced transmission of communicable and infectious diseases. Poor ventilation in vocational education classrooms, duplicator rooms, kitchens, and science laboratories may also contribute to hazardous exposures. Ergonomic hazards may be responsible for increasing rates of musculoskeletal disorders. Other work-related illnesses and injuries now documented among school employees include asthma, mesothelioma, asbestos-related lung cancer, violent assault, voice disorders, and depression. Such a diverse industry with many potentially hazardous activities and conditions calls for a comprehensive research and intervention agenda.

Accidents, Occupational↗
PubMed1994

[Laryngeal contact granuloma--a psychosomatic disorder?].

In a multidimensional design using the hypothesis of a psychosomatic genesis, 28 patients (1 female, 27 male) showed, in their personality profile, increased scores in 'impulsiveness', 'emotionality (neuroticism)', 'strain' and 'inhibition'. In addition to the voice disorders other somatic symptoms were observed, especially general symptoms as dysthymia, depression and excessive vegetative stimulation. Their social competence was reduced by the fear of making contacts and the inability 'to say no'. Also psychosocial stress factors were registered due to loss of a loved one with feelings of an existential danger. Thus, contact granuloma can be considered as a secondary reaction to a specific combination of personal disposition and social life situation. Lastly a causal model is presented, which can be used as a diagnostic criterion.

Adult↗
PubMed2004

[Communication disorders in the practice of Department of Phoniatrics ad Audiology in Poznań].

The relations between audiology and phoniatrics which formed the base for the present name of Poznań Department of Phoniatrics and Audiology are presented. It is specific for this Department to include the olfacto-gustometry into clinical evaluation of sensory organs. The periodic "Informacje Foniatryczne" which were published in 1966-1972 in our Department were exception in the history of Polish phoniatrics. The communications disorders should be inspected by rehabilitation team: phoniatrician, psychologist and logopedist, but the leading role is left for the physician. The prevention, prophylaxis and rehabilitation of professional voice disorders is one of the main social goals for audiology and phoniatrics.

Academic Medical Centers↗
PubMedDate not supplied

Superior laryngeal nerve paralysis an often overlooked entity.

The anatomy and physiology of the larynx are discussed. The larynx is a dynamic structure, and motion pictures are helping to document and to clarify its dynamic behavior in the presence of diseases such as paresis and paralysis. The recognizable distinguishing features of unilateral and bilateral superior nerve paralysis are discussed in detail. These lesions often have gone unrecognized in the past and the patients mistakenly have been referred to the speech therapist with an incorrect diagnosis of "functional voice disorder."

Humans↗