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At least 685 records · Page 38Linked to original sources
PubMed1996

Aerodynamic measurements of voice production.

This article reviews measurement techniques, normative results and clinical uses of the aerodynamic voice measures maximum phonation time (MPT), vital capacity (VC) and phonation quotient (PQ). Variations in measurement procedures have proven to yield different results. Simple test techniques have resulted in the following normative data: 22.2 sec for MPT, 4800 ml for VC, 269 ml/sec for PQ in adult men, and 18.4 sec for MPT, 3500 ml for VC and 233 ml/sec for PQ in adult women. None of the three parameters can be used to diagnose voice disorders, but each of them is useful for evaluating their degree and for monitoring their evolution. MPT appears to be the most sensitive measure of the three.

Adolescent↗
PubMed1991

[Mucosal bridge of the vocal fold].

Mucosal bridge of the vocal fold is a newly recognized laryngeal disease need to be differentiated from the functional voice disorder. A 16-year-old woman with deteriorating hoarseness presented for indirect laryngoscopy and laryngofiberoscopy of just slight swelling of the bilateral vocal folds. Since the laryngeal stroboscopy revealed the decrease of wave formation at the swelling portion, we performed an endolaryngeal microsurgery and discovered a sulcus in a side of the vocal fold and a mucosal bridge in the other side. Resection of the bridge followed by the voice therapy increased the voice range and decreased the hoarseness. This case suggests that the laryngeal stroboscopy and microscopic examination with direct laryngoscopy are the most important for diagnosing the mucosal bridge of the vocal fold.

Adolescent↗
PubMed1990

[Pharmacotherapy of voice and articulation disorders in aphasia].

The phonation and articulation disorders in a group of aphasics with aphonia/dysarthrophonia could be considerably reduced by the use of medication. The group consisted of 10 apoplectic patients whose resulting aphasia could not be classified because of the vocal impairment. Extrapyramidal motion disorders were proved by laryngoscopy and stroboscopy. A definite improvement of phonation and articulation was observed after L-dopa medication.

Aphasia↗
PubMed2000

Study of the elderly females' voice by phonetography.

This study was carried out to investigate the voice characteristics of 40 healthy females with no voice disorders, ranging in age from 60 to 84 years (X = 68.2+/-5.74 years). Measurements over all the entire phonational range were obtained by phonetography. The subjects were asked to sustain the vowel /a/ in modal register for a minimum of 5 seconds in the highest and lowest intensities after hearing the semitones C, E, G, and A, over all phonational ranges. The results indicated expansion of the low and reduction of high ends of the pitch range, decrease of the pitch numbers of the vocal range, restriction of the lowest and highest limits of the intensity, and reduction of either the maximum phonational range and the phonetogram area. The phonetography technique has shown efficacy to investigate the voice characteristics of elderly females.

Age Factors↗
PubMed2004

[Vocal function of benign vocal fold lesions and outcomes assessment after CO2 phonomicrosurgery].

OBJECTIVE: To investigate the nature of benign vocal fold lesions and its outcomes assessment after CO2 phonomicrosurgery. METHOD: Vocal function of 292 cases of benign vocal fold lesions (vocal nodules, Reinke's edema, vocal fold cyst, vocal fold polyp and chronic laryngitis) and their outcomes assessment after CO2 phonomicrosurgery were evaluated. Vocal function was examined by acoustic analysis, aerodynamic analysis and videostroboscopic examination. RESULT: Young women with professional occupation were predominant in vocal nodules and the higher age showered in Reinke's edema. Vocal function of vocal nodules and vocal fold polyps had improved distinctly only one month after operation. For Reinke's edema, vocal function can recover three months after operation steadily. Although vocal function of vocal cyst also had improved distinctly only one month after operation, there was depression instead of cyst, the outcome of vocal quality would be affected by that. Vocal function of chronic laryngitis did not change so much after operation. However, ventricular dysphonia did not changed any more. CONCLUSION: Benign vocal fold lesion was located in the cover layer of the vocal fold. According to different lesions, the degree of voice disorder were differently. CO2 phonomicrosurgery can control the range of the operation and protect the cover layers delicately. Vocal function can recover three months after operation steadily. The localized lesions recovered only one month after operation. As the supraglottal hyperfunction remained post-operation, it is regarded as incorrect vocalization and effect on the prognosis.

Female↗
PubMed1994

[Synchronous analysis of multi-channel spectrum for human resonance cavity].

The synchronous analysis of multichannel spectrum were used to determine the regulars, conditions and characters of the resonance when subjects pronounced. 140 subjects were selected for test and 1040 pieces of sound sample were collected, then the analysis of different parts (mouth, throat, head and chest) was done. The results of the analysis of variance showed that there was much difference among the various professional workers, different places of articulation, and patients with voice disorders in spectrum analysis (P < 0.001). Each part of resonance frequencies was put forward of pronouncing system. High frequency resonance comes from head and pharynx (above 2000 Hz high resonance cavity), and low frequency resonance comes from chest and larynx (less than 2000 Hz resonance cavity). We suggest that there are six degrees of clinical objective classification of the pathologic hoarseness.

Female↗
PubMed2000

Effects of head extension and tongue protrusion on voice perturbation measures.

Head extension with protruded tongue is the position for videolaryngoscopy and simultaneous glottographic recordings including photoglottographic signals. This study investigated the effect of head extension and tongue protrusion on the measures of fundamental frequency, frequency perturbation (jitter), and amplitude perturbation (shimmer). Acoustic signals recorded during sustained vowels were obtained from 49 women and 66 men with no speech or voice disorders in different head-tongue positions. Head extension was associated with increased fundamental frequency and decreased shimmer. In men, head extension did not appear to affect jitter. When the tongue was protruded, head extension tended to lower jitter. For both genders, tongue protrusion was associated with decreased fundamental frequency with head extension. In the men, tongue protrusion tended to increase shimmer when the head was in the neutral position. In the women, tongue protrusion was associated with increased jitter and increased shimmer and was most evident in the head-neutral position. These findings supported a physical linkage hypothesis of the relationship between vocal tract configuration and vocal fold vibration, suggesting that head-tongue position must be taken into account when comparing voice measures.

Adult↗
PubMed1986

Identification of Down's syndrome adults from prolonged vowel samples.

Special educators and speech pathologists were both able to distinguish adults with Down's syndrome from nonretarded adults with voice disorders based only on prolonged vowel samples. Listeners indicated that resonance differences may have helped them to identify Down's syndrome speakers. Differences in formant frequencies and perceived hypernasality between Down's syndrome and nonretarded speakers, however, were nonsignificant. Formant frequency measures and perceived nasality ratings obtained from Down's syndrome adults in the present study are in contrast to such measures obtained from Down's syndrome children in previously reported studies.

Adult↗
PubMed2006

Reliability of speech-language pathologist and otolaryngologist ratings of laryngeal signs of reflux in an asymptomatic population using the reflux finding score.

OBJECTIVE: To determine inter- and intrajudge agreement in rating signs of laryngopharyngeal reflux (LPR) under "ideal" conditions: Experienced coworkers in a practice devoted to voice-disordered patients, raters trained in the items on a standardized scale, raters from both speech-language pathology (SLP) and otolaryngology, and raters of asymptomatic participants. STUDY DESIGN: Prospective study using a scale to rate videolaryngoscopic examinations. METHODS: Two SLPs and two otolaryngologists used the Reflux Finding Scale (RFS) to independently rate videotapes of endoscopic examinations for 30 participants asymptomatic of reflux. RESULTS: Thirteen (43%) were assigned a total score >7, indicative of LPR, by at least one rater. Intraclass correlation coefficients showed a significant lack of agreement in total scores provided by the otolaryngologists and by all raters combined. One otolaryngologist and the two SLPs demonstrated good interrater agreement in total scores. McNamar's statistic and Poisson regression modeling showed differences in rater agreement for many individual items. Repeated ratings of four participants showed no significant differences, indicating good intrarater reliability. CONCLUSIONS: Level of rater agreement regarding the presence and the severity of physical findings attributed to LPR within and between otolaryngologists and SLPs differed. Given the role each profession plays in the diagnosis and treatment of LPR and related voice disturbances, higher levels of interprofessional agreement are desired. Results support the need for greater consensus among professionals regarding the discreet features of physical findings associated with LPR, a fuller understanding of normal variants, and greater emphasis on interrater reliability when rating physical findings.

Adult↗
PubMed2006

The pitch rise paradigm: a new task for real-time endoscopy of non-stationary phonation.

As standard stroboscopy is restricted to the recording of periodic vocal fold vibrations, observations of non-stationary laryngeal mechanisms demand real-time recording systems, the most advanced being the high-speed video technique. It allows the registration of laryngeal parameters during a variation of the fundamental frequency. The aim of this study was to compare amplitude and frequency parameters of vocal fold vibration during stationary and non-stationary phonation, i.e. a monotonous pitch rise. Twenty-nine young female adults with no incidence of voice disorders were examined while performing two different phonation tasks: sustained phonation with a constant frequency and a monotonous pitch rise. Endoscopic recordings and the acoustic signals were acquired simultaneously. Both acoustic and laryngeal parameters were derived for short time intervals of 17.8 ms for the constant pitch and pitch rise conditions. Instantaneous frequency, sound pressure level, vibratory amplitudes of the vocal folds and the type of glottal closure were compared. At the beginning of the pitch rise, the acoustic and laryngeal parameters were similar to the parameters that occurred within the sustained phonation conditions. In contrast, the laryngeal parameters at the middle and at the end of the pitch rise differed substantially from those during sustained phonation. For the first time, quantitative measures of the growing glottal chink and the vibration amplitude decrease during pitch increase could be taken. In general, the image evaluation of the pitch rise paradigm can be subdivided into the starting, the raising and the final phase. As each phase can be considered as quasi-stationary, existing software modules are capable of analysing the process by treating each phase separately. Hence, the pitch rise condition may be suitable for clinical examination to detect information of voice disturbances that cannot be visualized during sustained phonation.

Adolescent↗
PubMed2005

Aerodynamics of the human larynx during vocal fold vibration.

OBJECTIVES: : The goal of this study was to comprehensively analyze the influence of aerodynamics on laryngeal function. Three specific aspects were considered: 1) a multidimensional comparison of the interaction of subglottic pressure, sound intensity, and fundamental frequency; 2) examination of instantaneous changes in subglottic pressure during each glottic cycle; and 3) determination of the threshold subglottic pressure for vocal fold vibration and its dependence on other aerodynamic factors. STUDY DESIGN: : Prospective study with six healthy individuals without history of voice disorders. METHODS: : The subjects vocalized the vowel sound /i/ with a variety of different intensities, pitch, and sound intensity. Subglottic air pressure, fundamental frequency, sound intensity, and the electroglottography signal were simultaneously measured. RESULTS: : Linear relationships were seen in all subjects between subglottic air pressure and sound intensity, although there were large variations in the slopes of these relationships. Rapid variations in subglottic pressure during each glottic cycle were detected, corresponding to the opening of the vocal folds with each individual vibration. Threshold pressures for vocal fold vibration were dependent primarily on sound intensity and fundamental frequency and tended to be higher at vibration onset than at offset. CONCLUSION: : The larynx responded in a predictable pattern to general aerodynamic forces, but there was tremendous variability in its specific behavior. Fundamental frequency and sound intensity tended to increase with subglottic air pressure, but that relationship was not seen consistently in all subjects. The relationship between subglottic air pressure and sound intensity was usually linear, unlike the exponential relationship seen in previous studies. Subglottic pressure was noted to undergo rapid change with each glottic cycle in some, but not all, subjects and was most strongly affected by average subglottic pressure. Phonation threshold air pressure was influenced by the sound intensity and, to a smaller extent, by the fundamental frequency of the voiced sound.

Adult↗
PubMed2005

Histopathological changes of vocal folds induced by chronic pollutant exposure: an experimental study.

UNLABELLED: Calcium carbonate (CaCO(3)) particles, the main component of chalk, are an important pollutant in the Brazilian school environment. However, there are few reports of the effect of this pollutant in the vocal folds and its influence in voice disorder in the literature. METHODS: Thirty rats (Wistar), randomly divided into two groups, the control group and the experimental group, were submitted to air or to CaCO(3) inhalation, respectively, during 15, 30, and 90 days. Then, the larynx region was dissected and embedded in paraffin, and 5-mum sections were obtained for microscopic analysis. RESULTS: No histopathological alteration was found on the vocal folds in the control group. In the experimental group, a moderate chronic inflammatory infiltrate, characterized by macrophage cells, was found in the vocal folds after 30 and 90 days of the CaCO(3) inhalation. CONCLUSIONS: This study suggests that the inhalation of pollutant particles, such as CaCO(3), induces inflammatory alterations in the larynx; this can affect the vibration of the vocal folds, which influence vocal function.

Air Pollutants↗
PubMedDate not supplied

Recurrent laryngeal nerve histopathology in spastic dysphonia: a preliminary study.

Spastic dysphonia is a severe voice disorder ordinarily described as psychogenic. Organic-neurologic changes secondary to central or peripheral nervous system involvement have also been postulated and led recently to the surgical treatment of spastic dysphonia by unilateral section of the recurrent laryngeal nerve (RLN). This study reports the histologic findings from these resections of the RLN from patients with an average 9.5 years duration of spastic dysphonia. Thirty percent of the RLNs examined demonstrated significant abnormalities as compared to age-matched controls. Although no reactive changes were noted by light microscopy, groups of fibers which did not stain for myelin or axons were found in RLNs from patients with spastic dysphonia. A preliminary ultrastructural study of these areas in one RLN revealed sheets of unmyelinated axons. These findings suggest an organic basis for spastic dysphonia at least in some patients.

Adult↗
PubMed2006

Mucosal wave: a normophonic study across visualization techniques.

Visualization of vocal fold vibration is essential for accurate diagnoses and optimal treatment of persons with voice disorders. Recently, scientific and anecdotal reports have evidenced an increased amount of variation in the diagnostically relevant features of extent and symmetry of mucosal wave magnitude in normophonic speakers. The objectives of this study were to preliminarily ascertain the variation in mucosal wave magnitude and symmetry for normophonic speakers as assessed via standard and novel techniques, and compare findings across modal and pressed phonations. A correlational design with a multiple baseline across visualization methods approach was used. Mucosal wave presence, magnitude, and symmetry from 52 normophonic speakers were judged via stroboscopy, high-speed videoendoscopy (HSV) playback, mucosal wave playback, and mucosal wave kymography playback. Results demonstrate a prevalence of atypical magnitude and symmetry of mucosal wave during modal and pressed phonations by normophonic persons, differences across techniques, and a relationship between judgments and habitual fundamental frequency. Given the prevalence of mucosal wave magnitude and symmetry variations in the normophonic population, overdiagnosis may be possible without caution. The various visualization techniques provided unique information suggesting that it may be beneficial to use both full view and kymographic visualization techniques in combination. A major restriction of the current commercial HSV systems is the frame rate, typically limited to 2000 frames per second, which appears insufficient for most female habitual phonations.

Adolescent↗
PubMed2003

An evaluation of the effects of three laryngeal lubricants on phonation threshold pressure (PTP).

Clinicians frequently offer advice to performers and voice-disordered patients aimed ostensibly to manipulate the water content and/or viscosity of the mucus blanket covering the vocal folds. To evaluate the relative effects of three potential laryngeal lubricants on phonatory function (ie, water, Mannitol--an osmotic agent, and Entertainer's Secret Throat Relief (Kli Corp., Carmel, IN)--a glycerin-based product), phonation threshold pressure (PTP) was measured in 18 healthy, vocally normal female participants twice before (baseline) and then four times after 2 ml of each substance were nebulized. PTP is the minimum subglottal pressure required to initiate vocal fold oscillation, and the lowering of PTP is assumed to correspond to physiologically more efficient phonation and reduced phonatory effort. Over a 3-week period, participants were tested on three separate occasions (at 1-week intervals). On each occasion, a different nebulized treatment was administered. PTP for both comfortable and high fundamental frequency productions was measured using an oral pressure-flow system (Perci-Sars, MicroTronics Corp., Chapel Hill, NC). Analysis of the results revealed that Mannitol, an agent that encourages osmotic water flux to the luminal airway surface, lowered PTP immediately after its administration (ie, p = 0.071, for high-pitched productions only). However, the duration of its PTP lowering effect was less than 20 minutes. The other two substances did not demonstrate any significant postadministration effect on PTP.

Adult↗
PubMed1998

Outcomes analysis of voice and quality of life in patients with laryngeal cancer.

OBJECTIVE: To assess relationships between voice satisfaction and global quality of life in patients who have been treated for laryngeal cancer. DESIGN: Cross-sectional survey study. SETTING: Veterans Affairs Medical Center. PATIENTS: Eighty patients who had completed treatment for laryngeal cancer with either total laryngectomy (n=17), radiotherapy (n=24), or both (n=39). MAIN OUTCOME MEASURES: Subscale scores on a general health status instrument (the Medical Outcomes Study 36-item short-form health survey), and a validated voice-specific functional status instrument (the Voice Handicap Index). RESULTS: Self-rated global health did not correlate significantly with emotional, functional, or physical voice handicap, although some subscales on the 36-item short-form health survey correlated with voice handicap scores. Global health status scores did not differ between patients who had undergone laryngectomy with a tracheoesophageal puncture and patients treated with radiotherapy only. Physical voice handicap scores did not differ significantly between those who underwent tracheoesophageal puncture and those who had radiotherapy, but emotional (P=.07) and functional (P=.01) handicap scores were lower in patients treated with radiotherapy. However, there was considerable overlap in voice handicap scores, with many patients who had had tracheoesophageal puncture showing less voice handicap than patients treated with radiotherapy. CONCLUSIONS: These data demonstrate that health status is affected by other factors than voice handicap in patients with laryngeal cancer. In addition, there is a large amount of individual variation in voice handicap after treatment. These findings illustrate the need for prospective studies assessing voice handicap and quality of life after treatment for laryngeal cancer.

Activities of Daily Living↗