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At least 667 records · Page 37Linked to original sources
PubMedDate not supplied

A new clinical measure of external laryngeal size which predicts the fundamental frequency of the larynx.

A method for accurately predicting the average fundamental frequency of the larynx from an external measurement of laryngeal size has been developed. In 21 human cadaveric dissections we have demonstrated that the external height of the larynx (measured from the lower border of the cricoid cartilage to the upper border of the thyroid notch) was significantly correlated to the length of the membranous vocal fold (r = 0.94, p less than 0.001). This same external measure of laryngeal size in 115 healthy volunteers was found to be related to their voice fundamental frequency. Significant differences were found between males and females with respect to both laryngeal size (p less than 0.001) and voice fundamental frequency (p less than 0.001). A strong correlation between the external laryngeal measurement and speaking fundamental frequency was found with an overall correlation coefficient for both sexes of 0.8 (p less than 0.001). Using this external measurement, it may be possible to accurately predict the fundamental frequency in males and females. It is proposed that such a measurement could be used to identify various laryngeal diseases and also serve as a basis for corrective treatment in various voice disorders.

Aged↗
PubMed2003

[Laryngeal symptoms in patients with gastroesophageal reflux diseases].

Gastroesophageal reflux disease (GERD) is considered an important etiological factor of numerous larynx dysfunctions. The goal of our study was to describe larynx status of patients with GERD before and after treatment. Forty-five patients with GERD symptoms entered our study. GERD was confirmed in 24-hours pH-metric examination. Patients were treated with proton pump inhibitors in doses chosen accordingly to GERD severity. All patients underwent endoscopic evaluation of the larynx and acoustic voice analysis before and after the treatment. GERD was diagnosed in 35 out of 45 patients. Acoustic voice analysis revealed that voice disorders appeared more often in patients with severe than moderate or mild refluxes (p = 0.023). Laryngeal changes found in endoscopic evaluation also depended on reflux severity (p = 0.05). The voice quality improved (p = 0.031) and the changes in larynx diminished after anti-reflux treatment (p = 0.016).

Female↗
PubMed2004

Nonlinear dynamic analysis of voices before and after surgical excision of vocal polyps.

Phase space reconstruction, correlation dimension, and second-order entropy, methods from nonlinear dynamics, are used to analyze sustained vowels generated by patients before and after surgical excision of vocal polyps. Two conventional acoustic perturbation parameters, jitter and shimmer, are also employed to analyze voices before and after surgery. Presurgical and postsurgical analyses of jitter, shimmer, correlation dimension, and second-order entropy are statistically compared. Correlation dimension and second-order entropy show a statistically significant decrease after surgery, indicating reduced complexity and higher predictability of postsurgical voice dynamics. There is not a significant postsurgical difference in shimmer, although jitter shows a significant postsurgical decrease. The results suggest that jitter and shimmer should be applied to analyze disordered voices with caution; however, nonlinear dynamic methods may be useful for analyzing abnormal vocal function and quantitatively evaluating the effects of surgical excision of vocal polyps.

Adult↗
PubMed1995

Bifurcations in an asymmetric vocal-fold model.

A two-mass model of vocal-fold vibrations is analyzed with methods from nonlinear dynamics. Bifurcations are located in parameter planes of physiological interest (subglottal pressure, stiffness of the folds). It is shown that a sufficiently large tension imbalance of the left and right vocal fold induces bifurcations to subharmonic regimes, toroidal oscillations, and chaos. The corresponding attractors are characterized by phase portraits, spectra, and next-maximum maps. The relevance of these simulations for voice disorders such as laryngeal paralysis is discussed.

Humans↗
PubMed1994

Effect of hydration treatments on laryngeal nodules and polyps and related voice measures.

In this study, a double-blind, placebo-controlled approach was used in assessing the effectiveness of hydration treatments in the clinical management of selected voice disorders. Six adult female patients with laryngeal nodules or polyps each received 5 consecutive days of hydration treatment and 5 consecutive days of placebo/control treatment. The combined results indicated improvements in voice and in laryngeal appearance following both placebo/control and hydration treatments as compared with baseline. However, the greatest improvements were obtained following the hydration treatment. Although caution about generalization of the effects to the typical clinical situation is emphasized, the study provides preliminary evidence of a therapeutic benefit from hydration treatments in patients with nodules or polyps. Based on previous theoretical work, hydration effects may be related to reductions in the viscosity of vocal fold tissue, although other explanations are also possible.

Adolescent↗
PubMed1994

Aerodynamic and electroglottographic measures of normal voice production: intrasubject variability within and across sessions.

The purpose of this investigation was to quantify the normal intrasubject performance variability of four measures of phonatory function within and across sessions. Two different speaking tasks, syllable series and sentence production, were used to determine if more natural speaking tasks resulted in greater intrasubject variability. Vowel type ([i] versus [a]) also was varied. Estimated subglottal air pressure, mean phonatory air flow, abduction quotient, and fundamental frequency were derived from aerodynamic and electroglottographic signals obtained from 11 normally speaking men and 10 normally speaking women on four different days. Relative intrasubject variability was compared across speaking task, gender, and vowel type. Average across-session intrasubject variability was 5% for fundamental frequency and abduction quotient, 8% for estimated subglottal air pressure, and 15% for mean phonatory air flow during syllable repetition. There was significantly greater intrasubject variability for mean phonatory air flow and abduction quotient for the sentence repetition task. There were no significant differences in intrasubject variability across gender and vowel type. The data were used to compute cutoff values that represent the amount of variability that would be considered within normal limits. These normal data can be used for comparison when assessing and monitoring the phonatory abilities of individuals with voice disorders.

Adult↗
PubMed2005

Comparison of nonlinear dynamic methods and perturbation methods for voice analysis.

Nonlinear dynamic methods and perturbation methods are compared in terms of the effects of signal length, sampling rate, and noise. Results of theoretical and experimental studies quantitatively show that measurements representing frequency and amplitude perturbations are not applicable to chaotic signals because of difficulties in pitch tracking and sensitivity to initial state differences. Perturbation analyses are only reliable when applied to nearly periodic voice samples of sufficiently long signal lengths that were obtained at high sampling rates and low noise levels. In contrast, nonlinear dynamic methods, such as correlation dimension, allow the quantification of chaotic time series. Additionally, the correlation dimension method presents a more stable analysis of nearly periodic voice samples for shorter signal lengths, lower sampling rates, and higher noise levels. The correlation dimension method avoids some of the methodological issues associated with perturbation methods, and may potentially improve the ability for real time analysis as well as reduce costs in experimental designs for objectively assessing voice disorders.

Adult↗
PubMed1996

Respiratory function during speaking and singing in professional country singers.

Respiratory function during speaking and singing was investigated in six male professional country singers. Function was studied using magnetometers to transduce anteroposterior diameter changes of the rib cage and abdomen while subjects performed various respiratory maneuvers, speaking activities, and singing activities. Results indicated that respiratory behavior during speaking was generally the same as that of other normal subjects. Respiratory behavior during singing resembled that of speaking. Discussion includes comparison of respiratory performance of present singers with untrained singers and classically trained singers. Implications are offered regarding how the results might be applied to the prevention of voice disorders by education and training of country singers.

Adult↗
PubMed2003

Nonlinear dynamics of phonations in excised larynx experiments.

Nonlinear dynamic methods including correlation dimension and Lyapunov exponents are applied to quantitatively analyze phonations in excised larynx experiments. Irregular phonations are typically characterized by aperiodic waveforms and broadband spectra. Finite correlation dimensions and positive Lyapunov exponents of irregular phonations demonstrate the existence of chaos in excised larynx phonations. Furthermore, the correlation dimension, maximal Lyapunov exponent, jitter, shimmer, and peak prominence ratio are used to statistically distinguish irregular phonations from normal phonations. The correlation dimension and maximal Lyapunov exponent indicate a significant difference between irregular and normal phonations; however, jitter, shimmer, and peak prominence ratio do not reveal such a significant difference and thus are unsuitable to differentiate between irregular phonations and normal phonations. These findings might potentially assist investigators in understanding rough phonations and developing clinically valuable methodologies for the diagnosis of voice disorders.

Animals↗
PubMed1994

Relationships between intra-speaker variation in aerodynamic measures of voice production and variation in SPL across repeated recordings.

Intra-speaker variation in aerodynamic and acoustic measures of voice production across repeated recordings was studied in relation to cross-recording variation in SPL for three normal female and three normal male speakers. Group data for 15 females and 15 males served as the statistical reference. The speech material consisted of syllable strings in soft, normal, and loud voice. Measures were made of (a) parameters characterizing the inverse filtered oral airflow waveform, (b) the inferred average transglottal air pressure and glottal airflow, and (c) SPL. The results showed that intra-speaker parameter variation across recordings was generally less than 2 standard deviations relative to group mean values. In terms of relation to variation in SPL, the measures could be divided into two main groups: (a) For air pressure, AC flow, and maximum flow declination rate, both intra-speaker variation across recordings and inter-speaker (group) variation was related systematically to variation of SPL. For these measures, it is suggested that variation across recordings was due in part to SPL differences, which can be adjusted for statistically, thus facilitating comparisons between absolute values. (b) For other measures, neither intra-speaker variation across recordings nor inter-speaker group variation was systematically related to SPL. However, some of these latter measures changed with SPL in an orderly fashion across soft, normal, and loud voice for individual speakers. The results are discussed in terms of the clinical use of these measures in studies of voice disorders.

Adult↗
PubMed1993

Current topics in voice production mechanisms.

A brief overview of current research in voice production mechanisms is given. The self-oscillatory behavior of the vocal folds is clarified, along with the identification of preferred tissue modes. Fundamental frequency control is reviewed as a coordinated activity between cricothyroid and thyroarytenoid muscles and lung pressure. Lung pressure is shown to be the primary regulator of vocal intensity. For eventual application to the study of voice disorders, a method of measurement of contact stress on a hemilarynx preparation is described.

Humans↗
PubMed1976

Identification, evaluation, therapy, and follow-up for children with vocal nodules in a public school setting.

This paper describes procedures used by speech and otorhinolaryngology specialists in the Independent School District of Carrollton and Farmers Branch, Texas, to identify, evaluate, treat, and follow up children with voice disorders and presents some initial findings resulting from the use of these procedures. In the identification process, 34 children were found to have vocal nodules, of which 31 children received treatment and underwent appropriate follow-up. After two months of voice therapy, 21 (68%) of the children exhibited reduced nodule size and seven (23%) exhibited normal larynges. Following six months of therapy, 26 (84%) children exhibited reduced nodule size, and 20 (65%) had normal larynges.

Child↗
PubMed1998

Integrated analyzer and classifier of glottographic signals.

Electroglottography (EGG) and photoglottography (PGG) are two plausible methods to study voice production for monitoring the patterns of laryngeal vibrations. It has been suggested that measures such as open quotient and speed quotient calculated from glottographic signals can provide useful information regarding pathological phonation. In this paper, an integrated analyzer and classifier of glottographic signals was implemented. The system makes it possible to calculate the measures from digitized EGG and PGG signals automatically in order to examine vocal fold abnormality. The system developed several techniques to extract features from glottographic signals and proposed a statistical classification method that can possibly aid the diagnosis process. To check the reliability of the system, a training set and a test set of glottographic signals from normal people and patients with recurrent/superior laryngeal paralysis were analyzed and classified by the system. The results showed that the system is a useful tool for quantitative study of phonatory pathophysiology and can be used by the examiner who is interested in the clinical examination of glottographic signals. Moreover, glottographic techniques may have some clinical applications in the quantitative documentation of phonatory function in patients with voice disorders but requires further evaluation before clinical application.

Electrodiagnosis↗
PubMedDate not supplied

Epidemiologic principles in studies of infectious disease outcomes: pediatric HIV as a model.

Epidemiologic principles have been employed in the investigation of AIDS since the early 1980s. Although such principles have demonstrated the difficulties in reporting the everchanging rates of incidence and prevalence, in addition to distributions of children with HIV, they have also established specific pieces of a multifaceted puzzle. Professionals interested in examining only a piece of the puzzle, such as a particular communication disorder, often are unable to see how it fits into the complete puzzle. This article presents several epidemiologic findings of pediatric HIV, including population distributions, a summary of modes of transmission, occurrence of opportunistic infections, and manifestations of the disease in child populations. It also discusses HIV-related speech, language, swallowing, and voice disorders, examining the complexities of quantification of risk for each piece within the pediatric HIV puzzle. The purpose is to broaden the perspective of professionals concerned with how these disorders fit within the overall puzzle of immunocompromised populations of children.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Communication problems in Turner syndrome: a sample survey.

Turner syndrome is a condition first recognized in 1938 with an incidence estimated at 1/2500 female births. It is known to result from a missing X chromosome and has as its main features a short stature, ovarian dysgenesis, neck webbing, congenital peripheral lymphedema, coarctation of the aorta, cubitus valgus, dysplastic nails, and pigmented nevi. In addition, psychosocial difficulties including communication disorders may occur. While the physical characteristics of Turner syndrome have been well documented, information on the communication problems in Turner syndrome is scarce. This study reports the results of a sample survey in 128 girls with Turner syndrome ranging in age from 2.4 to 58.8 years. Results are presented on the occurrence and nature of speech and language problems (voice disorders, articulation problems, stuttering, and delayed language development), on the presence of learning disabilities, and on educational history.

Adolescent↗
PubMed2006

Considerations for maintenance of postural alignment for voice production.

There is general agreement that postural alignment is important in optimizing voice function. A number of articles have illuminated the way in which posture, particularly of the cervical spine, is directly related to vocal resonance and pitch control. Despite frequent involvement in muscle training, few speech pathologists have the background in exercise physiology necessary to appreciate the contribution of muscular length-tension relationships to postural alignment. The purpose of this article is to provide voice therapists with information to help them formulate appropriate recommendations for improving postural alignment. This article synthesizes information from the literature regarding the role of muscular length-tension balance in the attainment and maintenance of postural alignment. Important considerations in the assessment of muscle tension and weakness are presented along with advice regarding application to the treatment of voice-disordered patients. Concepts detailed include agonist/antagonist relationships, the biomechanics of stretching, postural assessment, and the relationship between muscle tension and muscle weakness. The role of both stretching and strength-based training is discussed. Specific exercises with emphasis on altering the alignment of the cervical and thoracic spine are presented with suggestions for their use in the clinic. There is growing understanding of the physiology behind recommendations of voice teachers and therapists to maintain optimal alignment. To effectively mediate postural misalignment, clinicians must have knowledge of the length-tension relationships between muscles. This understanding will lead to better interventions for postural alignment.

Biomechanical Phenomena↗