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At least 829 records · Page 46Linked to original sources
PubMed2006

Prevalence and relative risk of dysphonia in rheumatoid arthritis.

SUMMARY: Laryngeal involvement in rheumatoid arthritis is not uncommon and may include cricoarytenoid arthritis or vocal fold lesions such as vocal fold rheumatoid nodules or bamboo nodes. Dysphonia or voicing problems can be the result of such laryngeal involvement. This cohort study investigates the prevalence and the relative risk of dysphonia when suffering from rheumatoid arthritis compared to that of healthy subjects. One hundred and sixty-six subjects with rheumatic arthritis and 148 healthy control subjects completed two quality-of-life questionnaires: the Voice Handicap Index and a three-item outcome scale. Both instruments measure the quality of the voice itself and the extent of impairment resulting from dysphonia as experienced by the patient in social and occupational settings. Patients proved to have statistically significant higher prevalence and relative risk of dysphonia. Depending on the questionnaire being used, prevalence data of dysphonia in patients varied between 12% and 27%, whereas the healthy subjects showed prevalence data varying from about 3% to 8%. A patient's relative risk varied from about 3 to 4 when compared to healthy subjects. Patients suffering from rheumatoid arthritis have a clearly higher risk of dysphonia compared to healthy subjects.

Adolescent↗
PubMed2006

Voice therapy improves quality of life in age-related dysphonia: a case-control study.

The objective of the study is to determine the efficacy of voice therapy in the treatment of age-related dysphonia. The study was conducted using a retrospective case-control chart review. The medical records of 54 patients older than 60 years diagnosed with age-related dysphonia without complicating diagnoses were reviewed. Patients who chose to undergo voice therapy were grouped as cases. Patients who chose not to undergo voice therapy were grouped as controls. The voice-related quality of life (VRQOL) measure was used to measure outcomes before and after treatment in cases and at a minimum 2-month follow-up in controls. Of the 54 patients, 19 (10 female, 9 male; mean age 73 years) chose to undergo voice therapy and filled in >1 VRQOL questionnaire. Six patients (3 female, 3 male; mean age 66 years) chose not to undergo voice therapy and filled in >1 VRQOL questionnaire. The 19 cases experienced a mean improvement in VRQOL score of 19.21 (2-tailed matched pairs t test P=0.00038) after a mean of 4.1 voice therapy sessions and 5.1 months. The six controls experienced a mean change in VRQOL score of 0.42 (2-tailed matched pairs t test P=0.96) after a mean of 3.3 months. Voice therapy leads to statistically significant improvement in the VRQOL life in elderly patients with age-related dysphonia. It is an efficacious noninvasive therapy for this disease.

Aged↗
PubMed2006

Voice of postradiotherapy nasopharyngeal carcinoma patients: evidence of vocal tract effect.

This study was aimed at identifying acoustic and physiological measures useful for monitoring voice changes in postnasopharyngeal patients with nonlaryngeal malignancies, and providing evidences of vocal tract effect on voice through comparisons between individuals with and without intact vocal tract. Simultaneous acoustic-electroglottographic signals recorded during phonation of vowels /i/ and /a/ sustained at habitual, high, and low pitch levels were compared among 10 postradiotherapy patients with nasopharyngeal carcinoma (NPC), 10 voice patients (VPs) with intact vocal tract, and 10 healthy individuals with normal voice (NORM). Results from a series of discriminant analyses revealed that the NPC group generally exhibited lower signal-to-noise (SNR) and open quotient (OQ) and higher Formant 1 frequency (F(1)) and speed quotient (SQ) than the NORM group. Unlike both VP and NORM groups, the NPC group failed to show a pitch effect on all voice measures, including OQ, SQ, percent jitter, percent shimmer, and SNR, suggesting an effect of radiotherapy and/or vocal tract on laryngeal behaviors. For the vowel /i/, on the other hand, only the NPC and NORM groups showed a pattern of pitch-dependent F(1) raising, a reflection of increased pharyngeal narrowing. These findings suggested that the pitch effect on laryngeal behaviors differed not only between individuals with intact vocal tract and those without but also between those with structural and dynamic changes of vocal tract.

Adult↗
PubMed2006

Acoustic measures and self-reports of vocal fatigue by female teachers.

This study investigated the relation of symptoms of vocal fatigue to acoustic variables reflecting type of voice production and the effects of vocal loading. Seventy-nine female primary school teachers volunteered as subjects. Before and after a working day, (1) a 1-minute text reading sample was recorded at habitual loudness and loudly (as in large classroom), (2) a prolonged phonation on [a:] was recorded at habitual speaking pitch and loudness, and (3) a questionnaire about voice quality, ease, or difficulty of phonation and tiredness of throat was completed. The samples were analyzed for average fundamental frequency (F0), sound pressure level (SPL), and phonation type reflecting alpha ratio (SPL [1-5 kHz]-SPL [50 Hz-1 kHz]). The vowel samples were additionally analyzed for perturbation (jitter and shimmer). After a working day, F0, SPL, and alpha ratio were higher, jitter and shimmer values were lower, and more tiredness of throat was reported. The average levels of the acoustic parameters did not correlate with the symptoms. Increase in jitter and mean F0 in loud reading correlated with tiredness of throat. The results seem to suggest that, at least among experienced vocal professionals, voice production type had little relevance from the point of view of vocal fatigue reported. Differences in the acoustic parameters after a vocally loading working day mainly seem to reflect increased muscle activity as a consequence of vocal loading.

Adult↗
PubMed2005

Vocal fold augmentation by autologous fat injection with lipostructure procedure.

BACKGROUND: Fat is theoretically the ideal implant for vocal fold augmentation because it is soft, easily available and biocompatible. However, reabsorption is a frequent cause of long-term failure. OBJECTIVE: We prospectively tested Coleman's "lipostructure" technique used for facial recontouring in the treatment of glottic incompetence. STUDY DESIGN AND SETTING: Fourteen patients (aged 18-74 years, mean 48) with breathy dysphonia secondary to laryngeal hemiplegia (7) or anatomical defects (7) underwent vocal fold lipoinjection. Fat harvested by liposuction was centrifuged, and the fat cell layer injected into the vocalis muscle. The patients underwent pre- and postoperative videolaryngostroboscopy, maximum phonation time (MPT) measurements, GRBAS perceptual evaluations, and Voice Handicap Index (VHI) self-assessments. RESULTS: Voice quality improved soon after surgery and remained stable over 3-26 months (mean 10.6), being confirmed by the GRBAS, MPT and VHI evaluations ( P < 0.005). The results were best in the seven patients with paralytic dysphonia. CONCLUSION: Lipostructure is a valuable technique for voice rehabilitation in glottic incompetence.

Adipocytes↗
PubMed2005

Effects of tracheostomy on well-being and body-image perceptions.

OBJECTIVE: Quality of life after tracheostomy was addressed by measuring its impact on well being and body image perceptions. STUDY DESIGN AND SETTING: A controlled study in a laryngotracheal clinic of a tertiary referral center. Three groups were studied: 24 cannulated, 19 decannulated, and 20 noncannulated patients. They filled up 3 conventional questionnaires. RESULTS: (1) Satisfaction-with-life scale: reduced scores were detected between cannulated and noncannulated patients. (2) Personality traits: neuroticism and extroversion: no differences were noted. (3) Body cathexis scale: both cannulated and decannulated patients scored less than noncannulated. In tracheostomy-specific issues, decannulated patients scored better than cannulated patients. CONCLUSIONS: Reduced scores after tracheostomy indicate an overall diminished quality of life. These changes correlate with personality traits. Decannulated patients exhibited only slight improvement indicating an incomplete psychosocial recovery. SIGNIFICANCE: This is the first report on tracheostomy related quality of life in noncancer patients conducted with specific psychological questionnaires.

Body Image↗
PubMed2006

Perceptual voice analysis of patients with subglottic stenosis.

OBJECTIVES: To characterize the perceptual assessment of vocal quality in subglottic stenosis (SGS) patients and to identify risk factors for dysphonia. STUDY DESIGN AND SETTING: Retrospective review, academic center. METHODS: Perceptual voice assessment using GRBAS scale (Grade, Roughness, Breathiness, Asthenia, Strain); patient characteristics determined for 31 SGS cases. RESULTS: The mean GRBAS (0 to 3 scale, 0 = normal quality) for SGS patients at their initial visit was G(1.4)R(1.2)B(0.5)A(0.5)S(1.1). For males vs females: G(2.1 vs 1.1)R(2.0 vs 0.8)B(1.0 vs 0.4)A(1.0 vs 0.3)S(1.7 vs 0.9). The Grade (P < 0.03), Breathiness (P < 0.04), and Asthenia (P < 0.02) assessments were significantly more dysphonic in patients with multilevel stenosis; vocal fold motion impairment (VFMI) also impacted overall Grade (P < 0.01). Overall Grade (P < 0.002), Roughness (P < 0.007), and Breathiness (P < 0.006) were significantly worse in patients with prior airway surgery. CONCLUSION: SGS patients demonstrate a mild to moderate change in perceptual voice characteristics with males in this series being more affected than females. Negative risk factors include multiple stenoses, VFMI, and previous airway surgery. SIGNIFICANCE: This is the first systematic report of perceptual voice assessment in subglottic stenosis. SGS patients have notable degrees of dysphonia with identifiable risk factors.

Auditory Perception↗
PubMed2006

Changes of the speaking and singing voice after thyroid or parathyroid surgery.

BACKGROUND: While permanent dysphonia is a rare complication of thyroid or parathyroid surgery, postoperative changes of the speaking and/or singing voice often remain unrecognized. METHODS: In a prospective 4-arm study, vocal fold videolaryngostroboscopy and functional assessment of pre- and postoperative vocal performance was used to evaluate voice disturbances in 120 patients undergoing extended cervical surgery and in 19 patients with limited interventions for thyroid and/or parathyroid pathology. RESULTS: Impairments, especially of the singing voice, were predominantly observed after extended endocrine neck surgery. In women, the highest pitch of the singing voice (HPS) dropped from 651 Hz to 563 Hz (E5 to Csharp5, P < .001). In men, the HPS decreased to a lesser extent (423 Hz to 374 Hz, (Gsharp4 to Fsharp4, P = .009). Covariant analysis of influencing factors revealed the preoperative maximum frequency range and the HPS as predictors of the postoperative voice outcome. CONCLUSIONS: While alterations of the speaking voice after thyroid and parathyroid surgery usually remain subclinical, transient changes of the singing voice will matter to voice professionals.

Data Interpretation, Statistical↗
PubMed2002

[Acoustic voice analysis: reliability of a set of multi-dimensional parameters].

A correlational study of the reliability of acoustic voice parameters was made of 148 healthy adults. Acoustic analysis was performed with MDVP-Multi-Dimensional Voice Program implemented in a CSL-Computerized Speech Lab of Kay Elemetrics. A set of 29 voice parameters were obtained from two samples of sustained vowel /a/ recorded from each subject. General results separated by sex are showed and the test-retest reliability in each pair of measures was calculated. Data show a high intra-subject stability of Frequency Fundamental parameters; acceptable stability in parameters of Frequency and Amplitude Perturbation, Noise, Subharmonics and Voice irregularities; and a very low consistency in Tremor parameters. Parameters related with shimmer were more reliable than parameters related with jitter. According to results several conclusions are reported.

Adult↗
PubMedDate not supplied

[Perceptual evaluation of dysphonia: correlation with acoustic parameters and reliability].

The perceptual GRBAS scale for analysis of voice quality is quite important clinically in voices that cannot be effectively analyzed with a voicing parameter method like vocalizations with strong subharmonics and modulations and in chaotic or random voices. In the present study, two experiments were performed: Firstly, GRBAS/acoustical correlations were investigated in 107 pathological voices. Secondly, the GRBAS interrater and intrarater agreement. The severity of dysphonia was assesed better by breath related parameters and low fundamental frequencies. The presence of subharmonics in the power spectrum had not a significant relationship with the degree of roughness. A (asthenic) and S (strain) scales. The results of this study show that GRBAS test-retest reliability and intrerrater agreement is high.

Adult↗
PubMed2005

[Acoustic and aerodynamic characteristics of the oesophageal voice].

OBJECTIVE: The aim of the study is to determine the physiology and pathophisiology of esophageal voice according to objective aerodynamic and acoustic parameters (quantitative and qualitative parameters). MATERIAL AND METHODS: Our subjects were comprised of 33 laryngectomized patients (all male) that underwent aerodynamic, acoustic and perceptual protocol. RESULTS: There is a statistical association between acoustic and aerodynamic qualitative parameters (phonation flow chart type, sound spectrum, perceptual analysis) among quantitative parameters (neoglotic pressure, phonation flow, phonation time, fundamental frequency, maximum intensity sound level, speech rate). CONCLUSION: Nevertheles, not always such observations bring practical resources to clinical practice. We consider that the facts studied may enable us to add, pragmatically, new resources to the more effective vocal rehabilitation to these patients. The physiology of esophageal voice is well understood by the method we have applied, also seeking for rehabilitation, improving oral communication skills in the laryngectomee population.

Aged↗
PubMed2005

[Dysphonia: current methods of evaluation].

OBJECTIVES: The aim of this review article was to provide an update on current techniques for evaluation of dysphonia in routine clinical practice. MATERIALS AND METHODS: Recent medical and other scientific literature was reviewed and pertinent current theories concerning the physiology of laryngeal function described. RESULTS: Perceptual voice quality evaluation by a professional jury of listeners is still considered to be the most reliable and complete means of evaluating pathologic voice, even though it is difficult to perform in routine and the results lack reproducibility. The objective evaluation of the vocal fundamental frequency and its variations and the spectral characteristics of voice has the advantage of being simple to perform, reproducible and quantifiable. However, automatic measurements need to be analyzed with precaution for severe dysphonia, the computer algorithms being designed for voices retaining a certain periodicity. Aerodynamic measurements are quantifiable and reproducible and provide information as to the quality of laryngeal function as a transducer of aerodynamic energy into acoustic energy. Videostroboscopy and electroglottography provide information as to the quality of the laryngeal vibrations, the source of sound production. CONCLUSIONS: All of these types of analysis are complementary, informing as to different aspects of vocal quality and laryngeal function. No one measurement alone can diagnose or characterize dysphonia.

Electrodiagnosis↗
PubMedDate not supplied

Acoustic correlates of dysphonia: type and severity.

The purpose of this study was to explore the acoustic discrimination and graded severity of three clinical voice types. Listeners classified 102 samples of dysphonic vowels /a/ and /i/ on the basis of voice types: breathy, hoarse, and strained. The vowels were analyzed acoustically with two measures of perturbation and 2 measures of spectral noise. Discriminant analysis showed that apriori, acoustic classifications of voice type were made with 92% accuracy using four acoustic parameters: (a) cepstral peak prominence (CPP), (b) jitter standard deviation (SD-J), (c) fundamental frequency (F0), and (d) standard deviation of signal-to-noise ratio (SD-SNR). Findings suggest that voice type is associated with the interaction of spectral noise, fundamental frequency, and signal irregularity, and that dysphonic severity is associated with similar parameters, regardless of voice type.

Adolescent↗
PubMed1996

Assessment in the treatment of hypernasal speech with motor neuron disease: a clinical report.

The application of nasal anemometry in this patient's treatment proved to be of value in obtaining an objective assessment of this intervention. Nasal anemometry may be of use in other situations, for example, (1) in preassessment and postassessment of cleft palate surgery and surgical interventions to improve the velopharyngeal seal (such as pharyngoplasty), (2) in the evaluation of nasalized speech with conventional speech therapy, (3) in the evaluation of nasalized speech by use of a palatal training appliance, and (4) in the investigation of snoring.

Denture, Partial↗