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At least 1,045 records · Page 58Linked to original sources
PubMed2004

Cross-linked hyaluronan versus collagen for injection treatment of glottal insufficiency: 2-year follow-up.

OBJECTIVES: To evaluate the long-term (24 months) clinical performance (vocal fold function) and safety of hylan B gel as compared with bovine cross-linked collagen in the treatment of patients with glottal insufficiency. MATERIAL AND METHODS: In a prospective trial, 70 patients with glottal insufficiency due to unilateral vocal fold paresis (n =35) or atrophy (n =35) were randomized to received either hylan B gel (n =47) or collagen (n =23) injections into 1 vocal fold. Forty-two of the patients were examined 24 months after treatment. Evaluations were made based on patients' subjective ratings, digitized videostroboscopic measurements, maximum phonation time and phonation quotient. RESULTS: The patients' self-ratings were significantly improved in both the hylan B gel and collagen groups. Videostroboscopic measurements of glottal closure were significantly improved for both groups. The hylan B gel group showed a trend towards less resorption at the injected vocal fold edge in comparison with the collagen group (p =0.05). No serious adverse events were observed. Twenty-eight patients dropped out of the study after 12 months: 18 had been re-injected or operated on with medialization laryngoplasty due to insufficient voice and 10 had either died of causes unrelated to the study or refused to attend follow-up. CONCLUSIONS: No long-term side-effects were found for either the hylan B gel or collagen groups after injection treatment. Both treatments resulted in significantly improved voice as rated by the patients and significantly improved glottal closure. Some resorption was noted for both substances, and approximately 25%, of the patients chose re-treatment 2 years after the initial treatment.

Adult↗
PubMed2006

Voice analysis of patients with diverse types of Reinke's edema and clinical use of electroglottographic measurements.

CONCLUSIONS: Reinke's edema shows a variety of clinical patterns and differences in voice analysis depending on its type. Electroglottographic measurements help to objectively assess the severity of edema and voice quality before and after surgery. OBJECTIVES: Reinke's edema manifests various clinical findings and different voice characteristics depending on the degree of swelling and the severity of voice impairment. The aim of this study was to compare the aerodynamic, acoustic and electroglottographic parameters for the different types of Reinke's edema according to its morphological, perceptual and histopathological classifications, and to assess voice quality in patients with Reinke's edema before and after laryngomicrosurgery. We also aimed to determine which parameter was most associated with the improvement in postoperative voice quality and to investigate the clinical usefulness of electroglottographic analysis in Reinke's edema. MATERIAL AND METHODS: The clinical and voice records of 61 patients with Reinke's edema were reviewed. All the patients were classified according to stroboscopic findings (Yonekawa's classification), perceptual grade and histopathological findings. Voice analysis of the perceptual, acoustic, aerodynamic and electroglottographic measurements was carried out using various classifications, and the voices of 23 patients who underwent laryngomicrosurgery were evaluated 2 months after surgery. Furthermore, the voices of 30 normal speakers (controls) were recorded and analyzed. RESULTS: The fundamental frequency (FxM) of Yonekawa Type III was significantly lower than those of the other types of Reinke's edema, and the SD of the FxM, the percentage irregularity of the FxM (CFx) and the percentage irregularity of the amplitude were larger than those of the other types of Reinke's edema. The closed quotient was significantly higher in Yonekawa Type III. In addition, the mean flow rate (MFR), maximum phonation time and harmonics:noise ratio (HNR) differed significantly among the different types of Reinke's edema. The postoperative results showed an increase in the FxM and an improvement in the MFR, subglottic pressure, shimmer and HNR. Correlation analysis showed that jitter, the HNR, the mean closed quotient and the irregularity of the frequency were the parameters that had the best correlation with improvement in postoperative voice quality.

Adolescent↗
PubMed1998

Comparison and evolution of perceptual and acoustic characteristics of voice after supracricoid partial laryngectomy with cricohyoidoepiglottopexy.

The present prospective study, based on a series of 12 male patients managed with supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL-CHEP), was designed i) to compare the perceptual and acoustic parameters before surgery and at 6 months after sugery, ii) to evaluate the evolution of the perceptual and acoustic parameters between 6 and 18 months postoperatively, and iii) to determine the correlations between the perceptual and acoustic parameters preoperatively and at 18 months postoperatively. The roughness was found to be significantly worsened after SCPL-CHEP. The jitter, shimmer, noise-to-harmonic ratio, and degree of voiceless increased significantly after SCPL-CHEP. Neither acoustic nor perceptual parameters varied significantly between 6 and 18 months postoperatively. Preoperatively, a strong statistical correlation was found between grade, roughness and strain and all acoustic parameters but F0. Breathiness was statistically correlated with all acoustic parameters but jitter. Postoperatively the only statistical correlation noted was between roughness and F0.

Carcinoma, Squamous Cell↗
PubMed1984

Vocal abnormalities. What listening can tell you.

"The human voice is the organ of the soul," said Longfellow. It can also serve as a mirror of the physical and mental problems that affect not only the vocal mechanism but the rest of the body. We should strive to become more aware of this--and that our ears can be, at times, as important a diagnostic tool as our eyes. Mastery of the art of listening to vocal abnormalities will enable the clinician to determine which patients he or she can treat at the outset and which require immediate referral to a laryngologist or other specialist. An experienced listener often is able to diagnose vocal problems prior to a laryngeal examination.

Aphonia↗
PubMedDate not supplied

The influence of oral cavity tumour treatment on the voice quality and on fundamental frequency.

This study aimed to discover whether the surgical treatment of oral cavity tumours only affects on articulation or whether it also leads to a change in voice quality and fundamental frequency. Twelve participants were examined pre- and postoperatively for mean speaking fundamental frequency, standard deviation of the mean fundamental frequency, harmonic-to-noise-ratio and intrinsic pitch. All the parameters showed a substantial postoperative change in some patients.

Adult↗
PubMedDate not supplied

Acoustic correlates of hypernasality.

The aim of this study was to apply one-third-octave analysis for measuring an acoustic correlate of hypernasality in the speech of adults with a range of aetiologies (dysarthria, maxillectomy and cleft palate). Subjects included 12 speakers with hypernasality and 12 normal controls. The speech material was the vowel /i/ segmented from two Cantonese single words produced by each speaker. The results showed that speakers with hypernasality had significantly higher energy level for the one-third-octave bands centred at 630, 800 and 1000 Hz, and significantly lower amplitude for the band centred at 2500 Hz than speakers with normal resonance. These results are in general agreement with past findings about nasalization of vowels. This study showed that one-third-octave analysis has high intrajudge reliability and is applicable to the speech of adults with hypernasality due to different etiologies.

Acoustics↗
PubMed2006

Acoustic and perceptual analysis of modal and falsetto registers in females with dysphonia.

Modal and falsetto registers are the basic vocal qualities used in female speaking voices. The purpose of this study was to identify the frequency at which modal register changed to falsetto register and the frequency range of each modal and falsetto register produced under three loudness levels: soft, comfortable and loud phonations in normal and dysphonic speakers. These data provide information on the relationship between vocal registers. It is hypothesized that vocal pathologies affect the frequency at which register change from one mode to another mode. Fifteen dysphonic and 15 non-dysphonic females were assessed on their ability to produce tone series from the lowest to the highest frequency at soft, comfortable and loud phonations. Fourteen listeners served as judges to identify the first production of falsetto voice in each tone series. The first falsetto tone perceived was considered to represent the frequency at which the modal-falsetto register change occurred perceptually. The change from modal to falsetto register in the tone series occurred between G4 (360.74 Hz) and B4 (485.23 Hz) in the dysphonic group and between A4 (421.00 Hz) and B4 (476.13 Hz) in the non-dysphonic group among the three loudness levels. The results showed that the presence of dysphonia affected the production of vocal registers The dysphonic group demonstrated the modal-falsetto register change at a significantly lower frequency and reduced frequency range in the modal register than those of the non-dysphonic group in the soft and comfortable phonations. In producing falsetto register, the dysphonic group demonstrated reduced ability in producing falsetto register in soft and loud phonations when compared to the non-dysphonic group. Physiological explanations are used to account for the observations.

Adult↗
PubMedDate not supplied

Voice characteristics in the progression of Parkinson's disease.

This study examined the acoustic and perceptual voice characteristics of patients with Parkinson's disease according to disease severity. The perceptual and acoustic voice characteristics of 30 patients with early stage PD and 30 patients with later stage PD were compared with data from 30 normal control subjects. Voice recordings consisted of prolongation of the vowel /a/, scale singing, and a 1-min monologue. In comparison with controls and previously published normative data, both early and later stage PD patients' voices were characterized perceptually by limited pitch and loudness variability, breathiness, harshness and reduced loudness. High modal pitch levels also characterized the voices of males in both early and later stages of PD. Acoustically, the voices of both groups of PD patients demonstrated lower mean intensity levels and reduced maximum phonational frequency ranges in comparison with normative data. Although less clear, the present data also suggested that the PD patients' voices were characterized by excess jitter, a high-speaking fundamental frequency for males and a reduced fundamental frequency variability for females. While several of these voice features did not appear to deteriorate with disease progression (i.e. harshness, high modal pitch and speaking fundamental frequency in males, fundamental frequency variability in females, low intensity and jitter), breathiness, monopitch and monoloudness, low loudness and reduced maximum phonational frequency range were all worse in the later stages of PD. Tremor was the sole voice feature which was associated only with later stage PD.

Aged↗
PubMedDate not supplied

The effects of age and gender on laryngeal aerodynamics.

A computerized airflow/air pressure analysis system, the Aerophone II Model 6800 (Kay Elemetrics Corp.), was used to assess the effects of age and gender on laryngeal aerodynamics. A sample of 56 male and 53 female normal speaking subjects was divided into six age groups (20-30; 31-40; 41-50; 51-60; 61-70 and 71-80 years). The laryngeal aerodynamic parameters measured included phonatory (mean) flow rate, estimated subglottal pressure, laryngeal airway resistance, phonatory sound pressure level, phonatory power, and phonatory efficiency. Most comfortable phonation, vocal efficiency, and running speech tasks were used to collect the aerodynamic data. Comfortable pitch and loudness levels were used for each of these tasks. Age and gender effects were found for a number of the phonatory (mean) flow rate and phonatory sound pressure level values. Results failed, however, to indicate age or gender effects for the estimated subglottal pressure, laryngeal airway resistance, phonatory power and phonatory efficiency parameters. High intersubject variability was found for the phonatory flow rate, laryngeal airway resistance, phonatory power and phonatory efficiency values. Estimated subglottal pressure values, however, appeared to vary the least among subjects. The results are discussed with respect to factors that might influence laryngeal aerodynamics, such as underlying laryngeal anatomical and physiological age-related changes and gender-related differences. The clinical implications of the findings for the assessment and treatment of individuals with voice disorders using the Aerophone II are also discussed.

Adult↗
PubMed2001

A simple subspace approach for speech denoising.

For pathological voices, hoarseness is mainly due to airflow turbulence in the vocal tract and is often referred to as noise. This paper focuses on the enhancement of speech signals that are supposedly degraded by additive white noise. Speech enhancement is performed in the time-domain, by means of a fast and reliable subspace approach. A low-order singular value decomposition (SVD) allows separating the signal and the noise contribution in subsequent data frames of the analysed speech signal. The noise component is thus removed from the signal and the filtered signal is reconstructed along the directions spanned by the eigenvectors associated with the signal subspace eigenvalues only, thus giving enhanced voice quality. This approach was tested on synthetic data, showing higher performance in terms of increased SNR when compared with linear prediction (LP) filtering. It was also successfully applied to real data, from hoarse voices of patients that had undergone partial cordectomisation. The simple structure of the proposed technique allows a real-time implementation, suitable for portable device realisation, as an aid to dysphonic speakers. It could be useful for reducing the effort in speaking, which is closely related to social problems due to awkwardness of voice.

Humans↗
PubMed2002

Vibratory capacity and voice outcome in patients with scarred vocal folds treated with collagen injections--case studies.

This prospective case study evaluates the effect of collagen injections on vibratory capacity and voice outcome in four patients with vocal fold scarring. The minimum follow-up time was 6 months. We studied the effect of the injections on the vibratory capacity in a multidimensional way, using computerized image analysis of videostroboscopy, acoustic and perceptual analysis of voice recordings, as well as patients' self-evaluations. Subjective voice ratings from the patients showed improvement in two patients, while two patients had no change in voice function. None of the patients experienced any side effects from the treatment. The documented acoustic and perceptual changes were marginal, but the videostroboscopic findings suggest some improvement in vibratory capacity.

Aged↗
PubMed2002

Cordless amplifying system in classrooms. A descriptive study of teachers' and students' opinions.

This study investigated one possible method to diminish teachers' vocal loading and, consequently, voice problems. Thirty-three teachers used electric sound amplification in teaching for at least 1 week. Both the teachers (33) and the students (791) reported their opinions of the amplification in a questionnaire. Ninety-seven percent of the teachers reported easier voice production, 82% found improved vocal endurance. The need for repetition also diminished. Eighty-four percent of the students found listening easier and 63% concentration better when amplification was used. The negative points reported both by teachers and students were technical problems (e.g. incorrect sound level or placement of the amplifier). Electrical amplification, thus, can be recommended in classroom use provided that the technical problems have been solved.

Amplifiers, Electronic↗
PubMed2002

Clinical pilot study assessment of a portable real-time voice analyser.

The use of computer-based real-time visual displays is now well established in voice clinics. A number of situations exist, however, where a computer-based system is inconvenient and a battery-powered hand-held version would be preferred. This would, for example, enable voice monitoring to be carried out at any time and place, including during home visits. This paper describes a purpose-built device that provides real-time displays of fundamental frequency and larynx closed quotient (CQ) derived from the electrolaryngograph output. The fundamental frequency data can in addition, be acquired from a microphone. The system has been in use recently in a speech and language therapy clinic in Sheffield, UK and the advantages and disadvantages noted during that trial are discussed.

Electric Stimulation↗
PubMed2002

The use of electroglottography in the treatment of deaf adolescents with puberphonia.

Electroglottography (EGG) was used as a visual feedback tool in the treatment of four male profoundly deaf adolescents of 15 years of age with puberphonia. A laryngograph, oscilloscope, computer, and laryngostroboscope were used for this research. The EGG was used during phonopedic exercises, which consisted of the patient producing voiced coughing in modal register and extended these into prolonged vowels. The investigation showed that EGG facilitated the production of vocal fold vibration in the modal register. It was concluded that EGG was highly effective in changing the production of vocal register and could be recommended in the treatment of puberphonia in the deaf.

Adolescent↗
PubMed2002

Hidden respiratory allergies in voice users: treatment strategies.

The treatment of the allergic voice patient may be somewhat different than other voice patients. Antihistamines are generally avoided, though decongestants with Guaifenesin may be useful. Steroids are more useful in perennial allergic systems. Steroids may be inhaled nasally, inhaled orally, or given systemically. Systemic steroids are especially useful for a performer who needs quick relief. We strongly feel that vocalists with chronic laryngitis and dysphonia should be allergy tested. A hidden dust mite or cat dander allergy is often found. A clean indoor environment can then be established. Immunotherapy injections can also be initiated. Both of these treatments, desensitization injections and environmental control, are especially useful in vocalists. These treatments are helpful in keeping a vocalist's trachea, larynx, and nasal cavity healthy. A careful search for mild asthma should be considered. Establishing good vocal hygiene and voice training may also be necessary.

Combined Modality Therapy↗
PubMed2002

Some objective measures indicative of perceived voice robustness in student teachers.

One of the problems confronted in the teaching profession is the maintenance of a healthy voice. This basic pedagogical tool is subjected to extensive use, and frequently suffers from overload, with some teachers having to give up their profession altogether. In some teacher training schools, it is the current practice to examine the student's voice, and to refer any perceived susceptibility to strain to voice specialists. For this study, a group of vocally healthy students were examined first at the teacher training schools, and then at the ENT clinic at the University Hospital of Nijmegen. The aim was to predict whether the subject's voice might be at risk for occupational dysphonia as a result of the vocal load of the teaching profession. We tried to find objective measures of voice quality in student teachers, used in current clinical practice, which reflect the judgements of the therapists and phoniatricians. We tried to explain such measures physiologically in terms of robustness of, and control over voicing. Objective measures used included video-laryngostroboscopy, phonetography and spectrography. Maximum phonation time, melodic range in conjunction with maximum intensity range, and the production of soft voice are suggested as possible predictive parameters for the risk of occupational voice strain.

Adolescent↗
PubMed2002

Persistent dysphonia in two performers affecting the singing and projected speaking voice: a report on a collaborative approach to management.

The projected speaking voice and the singing voice are highly sensitive to external and internal influences, and teachers of spoken voice and singing are in a unique position to identify subtle and more serious vocal difficulties in their students. Persistent anomalies may herald early onset of changes in vocal fold structure, neurophysiological control, or emotional stability. Two cases are presented to illustrate the benefits of a collaborative approach to diagnosis and management. The first, a 21-year-old male drama and singing student with an abnormally high speaking voice and falsetto singing voice was found to have a psychogenic dysphonia referred to as "puberphonia" or "mutational falsetto". The second, a 34-year-old female alto with strained phonation and perceived stutter of the vocal folds was diagnosed with "adductor spasmodic dysphonia" or "focal laryngeal dystonia" of neurological origin.

Adult↗
PubMed2003

Vocal hygiene in radio students and in radio professionals.

In this study 27 future professional voice users (i.e., radio students) and 53 professional voice users (i.e., radio professionals) were questioned on their vocal hygiene. Both groups differed clearly in age and in radio experience. The mean age of the radio students was 22 years, whereas the mean age of the radio professionals was 41 years; radio students had no radio experience and radio professionals' experience ranged from 2 to 32 years. This study shows that the vocal hygiene of radio professionals is not superior to the vocal hygiene of radio students. On the contrary, every group has a distinctive vocal hygiene profile. The intake of coffee was significantly higher in radio professionals (p < 0.001) and they indicated significantly more vocal fatigue (p = 0.028). The radio students, on the other hand, experienced more acid reflux problems (p < 0.001) and signalled significantly more hoarseness (p = 0.012). Next to this, both groups smoked more than one could expect from (future) professional voice users (radio students: 33%; radio professionals: 28%). This study demonstrates the necessity of an adapted vocal hygiene education programme for both future and professional voice users, as they seem to underestimate the negative implications of bad vocal hygiene.

Adult↗