Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Voice Disorders”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 739 records · Page 41Linked to original sources
PubMed2004

Laser projection in high-speed glottography for high-precision measurements of laryngeal dimensions and dynamics.

The detection of metric dimensions of laryngeal structures yields valuable information for both clinical and research purposes. The use of a laser projection system combined with a high-speed camera system enables the derivation of absolute spatial dimensions of the larynx. Vocal fold length, vibratory amplitudes and velocity can be derived. This was shown on 13 female and 9 male larynges during phonation of a vowel at different pitches. The vocal fold length, the amplitude of oscillation and the velocity of vibration were analyzed in between pitches of 119 to 236 Hz in the male group and 181 to 555 Hz in the female group. The vocal folds' length ranged from 8.4 to 14.3 mm in the male group and from 7.7 to 15.6 mm in the female group. Corresponding amplitudes varied from 0.33 to 1.24 mm (male) and from 0.38 to 0.82 mm (female). The maximal velocity of vibration was between 0.48 and 0.85 m/s in males and between 0.47 and 1.3 m/s in females without showing significant correlation between each parameter. The described technique enables the detection of absolute spatial laryngeal dimensions of female and male subjects at different pitches. Dynamic processes such as velocity of vibration can be quantified. The detection of metric data serves to optimize biomechanical model computations and provides valuable information in diagnostics and interpretation of organic and non-organic voice disorders.

Adult↗
PubMed2005

Perceptual evaluation of substitution voices: development and evaluation of the (I)INFVo rating scale.

Substitution voicing cannot be evaluated accurately by the GRBAS perceptual rating scale, and there is a need for a valuable alternative. Therefore, we developed and tried out a perceptual rating scale, consisting of five new parameters: impression, intelligibility, noise, fluency and voicing, each to be scored between 0 (very bad score) to 10 (very good score for a substitution voice). In analogy to the GRBAS scale, they are then converted to deviance scores ranging from 0 (similar to good substitution voicing) to 3 (very deviant from good substitution voicing). Inter-individual agreement measured in a set of 24 semi-professional jury members seemed to be moderate for all parameters. Mean figures of 0.52, 0.51, 0.46, 0.53 and 0.46 are obtained for the parameters impression, intelligibility, noise, fluency and voicing, respectively. Because a high correlation exists between the first two parameters (0.917) and relying on the correlation figures between the two "I"s and the other parameters (correlation values for "impression" vary from 0.79-0.86; values for "intelligibility" range from 0.74-0.83), we suggest to discard the parameter impression, which turns the actual IINFVo scale into INFVo. The proposed (I)INFVo perceptual rating scale seems promising for the assessment of substitution voicing. Eventual improvements and practical proposals are discussed.

Humans↗
PubMed2006

The INFVo perceptual rating scale for substitution voicing: development and reliability.

In this paper, an experimental study of inter-judge consistency for the different dimensions of a recently proposed new scale for the rating of substitution voices is presented. The IINFVo rating scale tries to score five parameters, namely impression, intelligibility, noise, fluency and voicing. Each parameter is scored between 0 (very good substitution voicing) and 10 (very deviant substitution voicing) on a visual analogue scale. Inter-judge consistencies were measured among semi-professional as well as among professional jury members. The consistencies among semi-professionals, expressed as Pearson correlation coefficients, ranged from moderate to good (0.57-0.68), whereas those among professionals were good to excellent (0.82-0.87) and compared favourably to consistency figures published for traditional perceptual evaluation scales such as the GRBAS scale for laryngeal dysphonia. Since there is a strong correlation between the scores of impression and intelligibility, and since intelligibility is hard to score by non-native listeners, we suggest taking the mean of the two scores as the "impression" of a modified dimensional INFVo rating scale. Our experiments demonstrate that the INFVo rating scale has good potential to become a routine perceptual evaluation method in a multidimensional assessment protocol for substitution voicing.

Humans↗
PubMed2006

Voice quality improvement after management of unilateral vocal cord paralysis with different techniques.

The aim of this study was to objectively evaluate the voices of patients suffering from unilateral vocal cord paralysis, before and after endoscopic augmentation and thyroplasty. In the past, we used injectable Teflon to treat this condition; later techniques included collagen injection and Isshiki thyroplasty. In the last 7 years, preferred treatment methods have included Bioplastique injection and lipoaugmentation of the vocal cords as well as medialization thyroplasty using a titanium implant according to Friedrich. Pre- and postoperative data was evaluated and compared to 25 patients. Appropriate glottic closure of the vocal cords was achieved in every case, in most cases after the first intervention. We used voice range profile measurements to evaluate the results. An objective evaluation was performed using the Friedrich dysphonia index. Significant improvements were found: the dysphonia index decreased in every case, from an average of 2.47, preoperatively, to an average of 1.18 postoperatively. In agreement with earlier studies, voice pitch range was the only parameter that not significantly improved. There was no statistical difference between the lipoaugmentation and thyroplasty according to Friedrich. We concluded that both endoscopic methods and thyroplasty can be used to achieve an optimal result. Cases must be evaluated individually so that the best technique, or combination of methods can be determined.

Adipose Tissue↗
PubMed2006

Effects of unilateral vocal cord paralysis on objective voice measures obtained by Praat.

Unilateral vocal cord paralysis (VCP) affects the objective properties of voice by diminished neurologic control and degenerative changes in laryngeal tissue. The goal of this study was to compare the acoustic parameters of VCP patients with control volunteers using the software Praat. Acoustic analysis results of 18 unilateral VCP patients were compared with age and sex matched 72 normal adult volunteers. Comparison of acoustic analysis results of male and female VCP patients with their age and sex matched control groups revealed statistically significant difference in jitter, shimmer, and noise-to-harmonics ratio values (P < 0.01) in both groups. There were no differences in mean fundamental frequency and intensity values. We conclude that these differences were in accordance with the results obtained by commercially available voice analysis programs. This study reflects the first results obtained with Praat software in VCP patients. Using the software Praat, is free and easy, that supports the clinician to rely on objective scientific data.

Adult↗
PubMed2006

Relevance of subglottic pressure in normal and dysphonic subjects.

The purpose of this study was to determine the clinical value of subglottic pressure (SGP) in normal and dysphonic subjects. "The airway interrupted method" was used to measure the intra-oral pressure. Voice samples from 60 healthy subjects and 79 dysphonic patients were recorded under normal conditions of pitch and intensity. In normal subjects, age and gender have no significant impact on mean and peak SGP. The peak SGP measurements are significantly higher in dysphonic patients and could be included in the basic clinical set of objective voice parameters. No differences could be shown between pre- and postoperative assessments or between groups of dysphonic patients.

Adolescent↗
PubMed2001

A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques. Guideline elaborated by the Committee on Phoniatrics of the European Laryngological Society (ELS).

The proposal of this basic protocol is an attempt to reach better agreement and uniformity concerning the methodology for functional assessment of pathologic voices. The purpose is to allow relevant comparisons with the literature when presenting/publishing the results of voice treatment, e.g. a phonosurgical technique, or a new/improved instrument or procedure for investigating the pathological voice. Meta-analyses of the results of voice treatments are generally limited and may even be impossible owing to the major diversity in the ways functional outcomes are assessed. A multidimensional set of minimal basic measurements suitable for all "common" dysphonias is proposed. It includes five different approaches: perception (grade, roughness, breathiness), videostroboscopy (closure, regularity, mucosal wave and symmetry), acoustics (jitter, shimmer, Fo-range and softest intensity), aerodynamics (phonation quotient), and subjective rating by the patient. The protocol is elaborated on the basis of an exhaustive review of the literature, of the experience of the Committee members, and of plenary discussions within the European Laryngological Society. Instrumentation is kept to a minimum, but it is considered essential for professionals performing phonosurgery.

Clinical Protocols↗
PubMed1999

Neoglottic vibration in tracheoesophageal shunt phonation.

The purpose of the present study was to examine vibratory patterns of the neoglottis and to ascertain the neoglottic conditions that could cause failure in tracheoesophageal shunt phonation. We studied 30 tracheoesophageal shunt speakers while using "trap-door" type voice prostheses. Videostroboscopy was undertaken to investigate vibratory patterns of the neoglottis during phonation of the sustained vowel sound /e/ in these patients. The voice qualities of the patients were judged perceptually. A regular neoglottic vibration was observed in 21 patients. Nine patients had irregular neoglottic vibrations. In this latter group, two patients had incomplete neoglottic closures with breathy voices, four patients had multiple contacts of several mucosal walls with rough voices, and three patients had tight neoglottic closures with strained voices. During stroboscopic evaluation of tracheoesophageal shunt phonation, regularity of the neoglottic vibration may be the most significant finding. These findings show that it is as important to evaluate neoglottic vibration in alaryngeal voicing as it is to study glottic vibration in laryngeal voicing. Stroboscopic examination may be a help to elucidate a cause of failure in cases of poor tracheoesophageal shunt speech.

Aged↗
PubMed1999

Effects on voice by endolaryngeal microsurgery.

Endolaryngeal microsurgery (EM) is functionally oriented. Therefore, assessment of vocal function is important to evaluate the effect of the surgery on voice. In all, 58 patients, including 26 patients with vocal cord nodules and 32 patients with vocal cord polyps, underwent EM. The patients' voices were recorded and analyzed before EM and 2 weeks after. Analysis of voice quality included perceptual assessment and each patient's own subjective evaluation of social acceptability of voice according to the 10.0 cm visual analogue scale (VAS) scale. Acoustic voice signal data were measured for fundamental frequency (Fo), jitter, shimmer and normalized noise energy (NNE) using Tiger Electronics Dr. Speech software. Statistically significant (P < 0.001) improvement was achieved in both perceptual and acoustic analysis and in both patient groups. According to the VAS scale, a high degree of satisfaction with the surgery was achieved. The grade of hoarseness (G) as well as roughness (R) and breathiness (B) decreased significantly after the operation. EM resulted in a statistically significant decrease in the mean jitter, shimmer and NNE postoperatively. There were no significant changes in the Fo after EM. These results confirm a high degree of effectiveness of EM on vocal rehabilitation and meet the expectations regarding the assessment and documentation of postsurgical voice changes.

Adult↗
PubMed2001

Medialization framework surgery for voice improvement after endoscopic cordectomy.

Seven dysphonic patients who had previously undergone total or extended cordectomy underwent laryngeal framework medialization. A minimum 6-month period between cordectomy and framework surgery was enforced to allow the vocal cord to scar and form a fibrous "neocord", to evaluate the voice recovery achieved by speech therapy alone and avoid the risk of operating on a patient with undiagnosed early recurrence. The operation is performed with fiberscopic control under general anesthesia. These operating conditions are required because undermining the fibrous tissue at the inner side of the thyroid ala is a lengthy and laborious procedure. This step is necessary to ensure easy placement of the implant. Caution must be taken to avoid tearing the fibrous tissue, with consequent risk of prosthesis extrusion. The cartilage window is left intact. Whereas cartilage implants remain indicated for minor gaps, we advocate Friedrich's implant for wider gaps. The vocal outcome revealed an increased median maximum phonation time from 5 s (range 2-12 s) to 7.5 s (range 3-23 s); a reduced phonation quotient from 516.5 ml/s (range 235-1000 ml/s) to 222 ml/s (range 146-595 ml/s); a slightly increased modal intensity from 61.5 dB (range 57-75 dB) to 67 dB (range 46-68 dB); an improved intensity range from 24.5 dB (range 16-36 dB) to 30 dB (range 16-62 dB); a steady fundamental frequency from 150 Hz (range 132-290) to 152 Hz (range 125-200); and an increased median spectral analysis class from 2 (range 1-3) to 3 (range 2-4). Subjectively, the patients noted that, throughout the day, phonation required less effort and induced less vocal fatigue.

Durapatite↗
PubMed2001

Female-pitched sound-producing voice prostheses--initial experimental and clinical results.

In order to improve voice quality in female laryngectomees and/or laryngectomees with a hypotonic pharyngo-oesophageal segment, a sound-producing voice prosthesis was designed. The new source of voice consists of either one or two bent silicone lips which perform an oscillatory movement driven by the expired pulmonary air that flows along the outward-striking lips through the tracheo-oesophageal shunt valve. Four different prototypes of this pneumatic sound source were evaluated in vitro and in two female laryngectomees, testing the feasibility and characteristics of this new mechanism for alternative alaryngeal voice production. In vivo evaluation included acoustic analyses of both sustained vowels and read-aloud prose, videofluoroscopy, speech rate, and registration of tracheal phonatory pressure and vocal intensity. The mechanism proved feasible and did not result in unacceptable airflow resistance. The average pitch of voice increased and clarity improved in female laryngectomees. Pitch regulation of this prosthetic voice is possible with sufficient modulation to avoid monotony. The quality of voice attained through the sound-producing voice prostheses depends on a patient's ability to let pulmonary air flow easily through the pharyngo-oesophageal segment without evoking the low-frequency mucosal vibrations that form the regular tracheo-oesophageal shunt voice. These initial experimental and clinical results provide directions for the future development of sound-producing voice prostheses. A single relatively long lip in a container with a rectangular lumen that hardly protrudes from the voice prosthesis may have the most promising characteristics.

Aged↗
PubMed2003

New surgical technique for primary and secondary voice restoration using a free ileocecal patch graft after total laryngectomy.

PURPOSE: We devised a new surgical technique to restore the voice after laryngectomy. This procedure is designed to repair the hypopharyngeal defect by using a free ileocecal patch for voice rehabilitation. METHODS: We performed this procedure in seven patients; for primary voice restoration in six and for secondary voice restoration in one. The technique involved resecting an ileocecal segment containing the ileocecal valve and cutting a patch from the cecum, the size of which was equalized with the hypopharyngeal defect. After patch repair of the defect, the tracheopharyngeal shunt was completed by an anastomosis between the ileum and trachea. RESULTS: One patient died from sudden rupture of the carotid artery, but all six survivors were able to speak and swallow without aspiration, achieving fair to good articulation. CONCLUSIONS: The advantages of our method are as follows. (1) The operative procedure is simple and does not require complicated remodeling of the intestinal graft for voice production. (2) The ileocecal valve can prevent aspiration. (3) The patch expands the pharynx and prevents narrowing. (4) Using this procedure, it is possible to achieve voice restoration even in patients who have undergone total laryngectomy in the past.

Adult↗
PubMed1979

Prevalence of voice quality deviations in the normal adult population.

The purpose of this study was to determine the prevalence of voice quality deviations in a normal adult population. One-hundred twelve subjects, aged 17 to 80, read a short paragraph aloud into a high-fidelity tape recorder and completed a case history questionnaire. A group of 11 pretrained judges rated overall performance of each taped sample on a seven-point equal-appearing intervals scale, then designated those quality components which contributed toward deviant ratings. Eighty-two percent of the group received a mean severity rating lower than 1.99; 16% had a rating between 2.00 and 2.99; and 2% was assigned a mean rating higher than 3.00.

Adolescent↗
PubMed1984

Acoustic measurement of voice quality in central dysphonia.

Speech samples of 14 male and 10 female patients with central dysphonia were examined. Eighteen patients had suffered a severe closed head trauma and the remaining six patients had experienced cerebrovascular accident (CVA). Several parameters were developed in order to find acoustic correlates for three major pathologic voice qualities in central dysphonia. The well know jitter parameter, fundamental period perturbation (PP), was adapted for our purposes and proved to be a good measure for rough voices, though the patients revealed less jitter than in peripheral dysphonia. The vocal onset parameter, time lag of preexhalation (Tb), and the spectral parameter, spectral energy above 5 KHz (A5), classified the breathy voices. Most of the tense voices could be detected by the spectral parameters, spectral energy in the 1-5 KHz range (A1), and variance of spectral energy above 5 KHz (V5). The successful classification of these voice qualities allowed the description of compound pathologic voice types in central dysphonia.

Adolescent↗
PubMed1986

The vocal tract model of placement: II. Acoustic aspects.

The technique of "placing" the voice in the throat, head, or elsewhere is used in training singers of operatic quality and in vocal rehabilitation. A vocal tract model of placement has been shown to have perceptual validity (Nichols and Shellenberger, 1985). This study tested its acoustic validity. Line spectra of vowels at different vocal placements were analyzed. We found that Formant 2 reflected changes in vocal placement for both male and female speakers.

Humans↗