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At least 757 records · Page 42Linked to original sources
PubMed1988

Spectral noise level measurements used to track voice improvement in one patient.

In this report we present one example of the utilization of an acoustic measurement to aid in describing voice roughness objectively in a clinical context. Vowel spectral noise level (SNL) and fundamental voice frequency (F0) measurements were acquired for five sustained vowels produced by one patient having bilateral vocal fold nodules. The measurements were obtained at specific time intervals while the patient underwent voice therapy. Clinically observed changes over the course of therapy included an improvement in perceived voice quality, a general reduction in vowel SNL, and an increase in vowel F0. These observations were accompanied by visually detected laryngeal tissue changes. The results suggest that acoustic SNL measurements can be employed clinically to verify and support perceptual judgments of voice quality.

Adult↗
PubMed1991

Phonatory function of neurologically impaired patients.

Previous studies investigated the use of acoustic perturbation measures as a screening tool for neuropathologies with conflicting results. In the present study, five parameters of phonatory function (jitter, shimmer, signal-to-noise ratio, fundamental frequency, and standard deviation of fundamental frequency) were obtained from samples of sustained phonation in three neuropathological groups (Parkinson, Huntington, cerebellar ataxia) and a normal control group to assess the use of acoustic measures in differential diagnosis. In addition, perceptual judgements of the severity of dysphonia for each patient were obtained. The results indicated that perturbation measures of the neuropathological groups showed a higher degree of variability compared to normals. From the five parameters studied, only the standard deviation of fundamental frequency differentiated among neuropathological subgroups. The acoustic parameters studied did not clearly reflect the perceived dysphonia for all subgroups.

Adult↗
PubMed1991

The use of an autochromatic tuner for the measurement of vocal fundamental frequency.

Comparative measures of vocal fundamental frequency were made with three different instruments, the Visi-Pitch. FLORIDA 1, and a Korg Autochromatic Tuner. The purpose of these measures was to determine whether an autochromatic tuner, a relatively inexpensive device designed to assist musicians in fast-tuning their instruments, would provide a valid and reliable measure of vocal fundamental frequency. Subjects for this study included 15 males and 15 females. They were recorded while sustaining vowels, reading a phonetically balanced passage, and singing to their lowest and highest pitch levels. Spearman's Rho correlations indicated that measures taken with the autochromatic tuner significantly correlated with measures taken with the other instruments. Results indicate that the use of an autochromatic tuner to measure vocal fundamental frequency is an effective and inexpensive alternative to other methods for clinical purposes.

Adult↗
PubMed1987

Hand-held text-to-speech device for the non-vocal disabled.

A hand-held, battery-powered synthetic speech aid for the non-vocally disabled has been constructed. The device accepts as its input, largely unrestricted text keyed by the user. This is converted by text-to-speech software, based on 349 letter-to-sound rules and some simple rules of continuity, intonation and stress, to appropriate control signals which drive a single-chip (series formant) speech synthesizer. A number of implementation constraints are imposed by portability; the system has, as far as possible, been designed using CMOS components. To extend the time for which the system will operate between battery charges, power saving facilities are incorporated. Hand-held use implies the need for a one-handed keyboard: a unique integral keyboard is used, designed to minimize the visual search time to locate a letter key. Considerable attention has been paid to rule-search strategies, the handling of 'exceptions' which violate the letter-to-sound principle and the resolution of conflicts when more than one rule might apply. The quality and intelligibility of speech from a rule-based system is typically poor, and every effort has been made to improve it. Limits on possible improvement are, however, set by the use of a proprietary single chip synthesizer and by the minimal nature of a portable system. To facilitate the task of composing messages, a two-line liquid crystal display is provided together with a range of editing functions. The display can also be shown to the message receiver should he/she be deaf, or used for silent communication as an analogue to 'whispering'.(ABSTRACT TRUNCATED AT 250 WORDS)

Communication Devices for People with Disabilities↗
PubMed1993

The use of midazolam for hypnosedative interviews.

The authors describe three cases in which midazolam was successfully used in diagnostic hypnosedative interviews. A discussion comparing and contrasting midazolam to other intravenous hypnosedatives is presented. The authors suggest that midazolam is an effective agent for diagnostic hypnosedative interviews and may be preferable to other agents when posthypnotic recollection of interview content is undesirable.

Adult↗
PubMed1980

Otorhinolaryngologic screening of children with vocal quality disturbances.

Voice evaluations of 1481 children were conducted in a rural community school system. One hundred and four children were identified as having vocal qualities that differed perceptually from normal upon initial evaluation by two speech pathologists. From a rescreening several months later, 65 children were presented to an ENT specialist for examination. Eighty-eight percent of these children had their larynx examined by the physician. Of this group, 82% were male, with 35% of all the cases showing bilateral vocal nodules and 28% with bilateral vocal fold thickening. Only a small percentage of children displayed mucoid nasal secretion, redness of arytenoids or granulation of the pharyngeal wall. The results suggest that a team approach including medical and behavioral management is most beneficial for children with voice deviations.

Arytenoid Cartilage↗
PubMed1987

Hypernasal speech caused by tonsillar hypertrophy.

Twenty patients with hypernasal speech were studied with both flexible fiber optic nasopharyngoscopy and multi-view videofluoroscopy, as well as behavioral speech assessment. Characteristic diagnostic findings showed the hypernasality to be caused by hypertrophic tonsils with posterior placement of the upper poles of the tonsils into the oropharyngeal and nasopharyngeal airway. In 16 of the 20 cases, there was a complete resolution of hypernasal speech following only tonsillectomy with no other treatments. Three patients required a brief period of speech therapy and one additional patient required both speech therapy and temporary prosthetic treatment (speech bulb reduction).

Adolescent↗
PubMed1993

Voice problems after pediatric laryngotracheal reconstruction: videolaryngostroboscopic, acoustic, and perceptual assessment.

Children with laryngotracheal stenosis undergo laryngotracheal reconstruction (LTR) to permit tracheostomy decannulation. We conducted voice assessments of 8 pediatric LTR patients with voice problems. Perceptual ratings and acoustic measures were taken in 5 patients and videolaryngoscopy/laryngostroboscopy was conducted in all 8. Results of perceptual evaluation were abnormal for hoarseness, breathiness and pitch. Acoustic analysis revealed a markedly decreased fundamental frequency of phonation, diminished frequency range, decreased vocal intensity, and shortened maximum phonation time. Videolaryngostroboscopic findings are summarized as follows: 2 patients had severe glottal insufficiency, 3 patients had vocal fold asymmetry in stiffness and position, and 3 patients demonstrated phonation using supraglottal structures. Use of the stroboscope contributed to diagnosis in 3 of 8 patients. Reverse (inhalatory) phonation was observed in three patients. Concomitant articulation problems were exhibited frequently. Sentence production was shortened by the decreased phonatory duration. When coupled with the abnormal voice quality, speech intelligibility was significantly affected. Voice problems following decannulation were observed to persist as a long-term difficulty in some LTR patients.

Adolescent↗
PubMed1993

Diplophonia in a neonate.

Diplophonia has never been described in a neonate. An unusual case, then, of diplophonia in a neonate is described here. There is a description of the acoustic characteristics of this infant's cry and a discussion of their significance. This contributes to a review of the differential diagnosis of diplophonia. Moreover, this case further shows the essential relation between laryngoscopic findings and acoustical data.

Crying↗
PubMedDate not supplied

Semi-automated voice evaluation.

This report describes a voice evaluation procedure that in some way parallels the audiologic tests used for hearing and has multiple uses both clinically and in research. It uses a simultaneous eight-channel input, is not difficult to use, requiring between 12 and 25 minutes to administer, and provides the physician with a printout in standardized form before the patient leaves the room. This three-page report includes 15 abstracted or calculated values, normal ranges by sex for each value, notes that draw attention to deviations from the normal, a summary profile, a graphic representation of the evaluation, and raw data waveforms.

Aphonia↗
PubMedDate not supplied

Effects of voice therapy on vocal process granuloma: a phonoscopic approach.

PURPOSE: This study reviewed the effects of a voice therapy program in patients who had failed other treatments for vocal process granuloma related to laryngopharyngeal reflux. The program was offered to 16 patients, all of whom demonstrated contact of the vocal processes at the site of pathology on voicing. During an initial evaluation, each patient was counseled regarding the need for voice conservation and improved vocal hygiene. Of the 16 patients, 10 agreed to undergo voice therapy and were subsequently enrolled in the treatment program. METHODS: The primary therapy objective was to modify each patient's vocal fold contact pattern so that a small gap remained between the vocal processes during voicing. A "phonoscopic" approach to therapy was used. That is, the clinician and the patient were able to observe the larynx endoscopically while also listening to the voice. This combined aural and visual approach enabled the clinician to guide the patient toward the treatment objective with precision and provided patients with immediate feedback regarding their progress. RESULTS: Of the 10 patients who underwent therapy, 8 were able to achieve the treatment objective, and all 8 experienced resolution of pathology or a marked reduction in its extent. Six patients who did not undergo treatment, and the 2 who were unable to achieve the treatment objective, demonstrated minimal or no improvement, or worsening of their pathology, over the same period. CONCLUSIONS: The treatment program described may be of value to similar patients with resistant granuloma related to extraesophageal reflux.

Adult↗
PubMed2006

Voice rehabilitation with Provox2 voice prosthesis following total laryngectomy for laryngeal and hypopharyngeal carcinoma.

OBJECTIVE: To analyze the effectiveness of the Provox2 voice prosthesis for voice rehabilitation following total laryngectomy. METHODS: From September 2000 to December 2004, the Provox2 voice prosthesis was used for voice rehabilitation in 32 patients following total laryngectomy. The quality of speech with the Provox2 voice prosthesis was analyzed using the HRS rating scale, the maximum phonation time (MPT), incidence of complications and the in situ lifetime. The rate of speech restoration was further analyzed in 129 patients with total laryngectomy from 1996 to 2004. RESULT: Twenty-nine of 32 patients were able to restore speech using the Provox2 voice prosthesis, a speech restoration rate of 90.6%. The maximum phonation time (MPT) was measured in 18 patients using the Provox2 voice prosthesis. The mean MPT was 15.1 s, with a range of 8-28 s. MPT was not influenced by age, concurrent radiotherapy treatment, the location of the primary tumor or use of reconstructive surgery. The average lifetime of the Provox2 in patients with laryngeal carcinoma (12 patients) and hypopharyngeal carcinoma (17 patients) was 27.2 and 16.6 weeks, respectively, which was significantly different (P=0.024, non-parametric Mann-Whitney's U-test). The rate of speech restoration by the use of esophageal speech, and insertion of an artificial larynx was 62.7% for laryngeal carcinoma (59 cases) and 38.6% for hypopharyngeal carcinoma (70 cases), which was also significantly different (P<0.01, chi-square test). CONCLUSION: Provox2 voice prosthesis speech was very useful due to the higher rate of speech restoration, longer phonatory time, and better intelligibility. It was also thought that voice prosthesis speech was useful in conjunction with esophageal speech and an artificial larynx depending on the patient's condition or wishes.

Aged↗
PubMed2005

Pediatric vocal nodules: correlation with perceptual voice analysis.

OBJECTIVE: To present the epidemiology and correlation with perceptual analysis of vocal nodules in pediatric patients. METHODS: Retrospective review of patients seen in a tertiary care pediatric hospital's voice center from 1996 to 2003. Six hundred and forty-six patients were evaluated with videostroboscopic examinations and perceptual analysis of voice characteristics by speech pathologists. Appropriate treatment was based on the pathology identified. RESULTS: Two hundred and fifty-four patients (40%) with an average age of 7.7 years (range 0.1-19.3 years) were identified as having vocal nodules. Of these, 72% were male. Six patients (2%) were under the age of 7 months. Nodules were most commonly found in males, aged 3-10 years old. Evidence of gastro-esophageal reflux disease was found in one-quarter of patients; hyperfunction of the larynx was seen in three-fourths. Hyperfunction of the larynx correlates with the size of vocal nodules. Distortion of the vocal fold mucosal wave was not present. Perceptual analysis revealed positive correlation of the severity of hoarseness, breathiness, straining and aphonia with the size of vocal nodules. CONCLUSION: The epidemiology and correlation with perceptual voice analysis in pediatric patients with vocal nodules is presented. Hyperfunction of the larynx correlates with nodule size, while the presence of reflux disease does not. The severity of hoarseness, breathiness, straining and aphonia correlates with the size of vocal nodules.

Adolescent↗
PubMed2005

Muscle tension dysphonia in children: Voice characteristics and outcome of voice therapy.

OBJECTIVE: The main object of this study is to elucidate the voice characteristics and the efficacy of voice therapy in children with muscle tension dysphonia (MTD). METHODS: A retrospective file review was undertaken of eight Korean male children diagnosed as having MTD. All subjects received perceptual, acoustical and laryngoscopic evaluation before and after the treatment. RESULTS: Markedly strained and breathy voices were detected in all patients. Pitch breaks and/or inadequately high or low speaking fundamental frequencies were noticed in five subjects. Laryngoscopic evaluation revealed anteroposterior contraction, false vocal fold approximation, decreased vibration of true vocal folds and incomplete glottal closure. Notably, seven out of eight subjects had bilateral vocal nodules. Voice therapy was focused on the awareness, relaxation, respiration and easy-onset phonation to reduce the tension around the laryngeal muscles. A few sessions of voice therapy resulted in dramatic improvement of their voice quality and pitch adjustment. Hyper-contraction of the supraglottic structures was also relieved. CONCLUSIONS: These findings suggest that the proper diagnosis of MTD in children warrants prompt and favorable responses to voice therapy regardless of coexistence of vocal nodules.

Child↗
PubMed2005

Acoustic estimation of voice when incorrect resonance function of the nose takes place.

Phonation is a sensitive indicator of palatopharyngeal obstruction and its physiological force. The aim of the study was to evaluate the influence of nasality on the voice quality. The study was carried out on 125 patients divided into three subgroups. The first was created of the patients treated due to allergic rhinitis, the second was composed of patients with adenoids, the third one consisted of patients with cleft palate. The following acoustic parameters were assessed: Fo, Jitter, Shimmer, Fo-tremor, NNE, HNR, SNR. The results of the experimental and control groups were analysed statistically with Student's t-test. The performed acoustic tests of voice confirmed statistically significant elevation of Fo, HNR and SNR frequency in the studied group as compared with the control group.

Adenoids↗
PubMed2006

Voice therapy in pediatric functional dysphonia: a prospective study.

OBJECTIVE: We evaluated the efficacy of voice therapy according to Borragan's method associated to S. Magnani's vocal counselling in functional dysphonia in children. PATIENTS AND METHODS: We prospectively treated 16 patients with vocal fold nodules (10 males, 6 females). Age ranged from 6 to 11 years with a mean age of 9 years. We performed a full screening phoniatric evaluation. In addition psychological tests were carried out to investigate psychological background. RESULTS: We lost three patients at follow-up; one patient received surgery, eight patients healed (43.75%), four improved (25%). There was no statistical difference in the analysis of electroacoustical parameters while MPT significatively raised after therapy. CONCLUSION: If patients have motivation voice therapy could improve functional dysphonia in children. It is also important psychological background. Further studies on bigger populations with long-term follow-up are needed.

Child↗
PubMed2006

Influence of treatment concept, velopharyngoplasty, gender and age on hypernasality in patients with cleft lip, alveolus and palate.

OBJECTIVES: The aim of this study was to analyse cleft patients for hypernasality following velopharyngoplasty. PATIENTS AND METHODS: 95 subjects (43 females, 52 males) with cleft lip, alveolus and palate (4 - 25 years old) were analysed. Forty-three patients were treated according to the current protocol of the Cleft Palate/Craniofacial Malformations Centre of the Department of Cranio-Maxillofacial Surgery in Muenster ('MS+' group) and 52 patients were treated elsewhere according to different protocols. In 19 of the 95 patients a velopharyngoplasty had been performed. Hypernasality was judged perceptually and nasalance data was measured objectively using the NasalView system. RESULTS: Patients of the 'MS+' group showed significantly better results concerning hypernasality and nasalance data. Assessment of hypernasality and nasalance measurement showed no significant differences between subjects following velopharyngoplasty and those who had not had this operation. Gender and age did not correlate with hypernasality either. CONCLUSION: A functionally orientated treatment with early closure of lip and palate ensures optimal velopharyngeal function, optimal oro-nasal balance of resonance, low hypernasality and excellent nasalance data.

Adolescent↗