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At least 19 recordsLinked to original sources
PubMed2001

[Voice restoration with voice prosthesis after total laryngectomy. Assessment of survival time of 378 Provox-1, Provox-2 and Blom-Singer voice prosthesis].

UNLABELLED: Voice Restoration with Voice Prosthesis after Total Laryngectomy. Assessment of Survival Time of 378 Provox-1, Provox-2 and Blom-Singer Voice Prosthesis. BACKGROUND: Indwelling voice prosthesis are used in Trier for voice restoration after total laryngectomy since 1991. OBJECTIVE AND METHOD: To assess the voice prosthesis survival times the patients of the years 1993-1999 are assessed retrospectively. PARTICIPANTS: 58 patients provided with indwelling voice prosthesis were seen regularly at follow-up. 378 prosthesis were changed. Provox 1, Provox 2 and Blom-Singer-Prostheses were used. RESULTS: The average survival lifetime of the prosthesis was 224 days for Provox-1, 96 days for Provox-2 and 107 days for Blom-Singer respectively. There is no significant difference found between Provox-2 and Blom-Singer Prosthesis. The survival times of the Provox-1 Prosthesis is significant longer. CONCLUSION: Using indwelling voice prosthesis for voice restoration after total laryngectomy an average survival time of the prosthesis of three months can be expected. There are relevant individual differences. Provox-1 Prosthesis have a significantly longer survival time, but as they are more difficult to handle they are not suitable for routine use. The indication for the choice between Blom-Singer or Provox-2 Prosthesis should be influenced by the surgeons' experience.

Adult↗
PubMed2003

Voice quality change in future professional voice users after 9 months of voice training.

Sixty-eight students of a school for audiovisual communication participated in this study. A part of them, 49 students, received voice training for 9 months (the trained group); 19 subjects received no specific voice training (the untrained group). A multidimensional test battery containing the GRBAS scale, videolaryngostroboscopy, Maximum Phonation Time (MPT), jitter, lowest intensity (IL), highest frequency (FoH), Dysphonia Severity Index (DSI) and Voice Handicap Index (VHI) was applied before and after training to evaluate training outcome. The voice training is made up of technical workshops in small groups (five to eight subjects) and vocal coaching in the ateliers. In the technical workshops, basic skills are trained (posture, breathing technique, articulation and diction), and in the ateliers, the speech and language pathologist assists the subjects in the practice of their voice work. This study revealed a significant amelioration over time for the objective measurements [Dysphonia Severity Index: from 2.3 to 4.5 ( P<0.001)] and the self-evaluation [Voice Handicap Index, from 23 to 18.4 ( P=0.016)] for the trained group only. This outcome favors the systematic introduction of voice training during the schooling of professional voice users.

Adult↗
PubMed1986

[Average spectral analysis of the voice. A comparison between the normal voice and the voice altered by various categories of laryngeal pathology].

Long-time spectral analysis shows a highly significant difference between a sample of normal voices, a sample of voices of nodule- and polyp-carriers, and a sample of voices of small malignant lesion-carriers. Schematically, pathologic voices due to lesions of the vocal folds have a relative excess of noise in the high part of the spectrum (6-10 kHz), but, in cases of small malignancy, this high-frequency noise also extends to the region 4-6 kHz. No clear difference appears between spectra of voices from nodule-carriers and voices of polyp-carriers. A standardized, phonetically selected text, seems to improve the discrimination power.

Adult↗
PubMedDate not supplied

[The measurement of voice quality and voice capacity to penetrate background noise and multidimensional voice program].

The paper presents a method of measuring the vocal penetrating capacity under conditions of masking voice. The noise consists of a frequency mixture of vowels in combination with voiced and unvoiced consonants. The comprehensibility of the test matrix is measured with respect to the capacity of the voice to penetrate background noise. The results of the measurement, which are based on more than 1,000 patients, show a significant correlation between the vocal inset phase of the voice status and the patient's subjective assessment of his ability to increase loudness of the duration of vocal use and vocal well-being. This method is therefore suitable for vocal diagnostic purposes, for evaluating the success of therapy, and testing the aptitude for voice-related professions.

Humans↗
PubMed1993

Voice research: so what? A clearer view of voice production, 25 years of progress; the speaking voice.

The past 25 years has yielded an impressive growth in our knowledge of vocal function. Interdisciplinary research cooperation in areas of laryngeal histology, vocal aerodynamics and acoustics, vocal fold vibratory characteristics, neurolaryngology, and phonatory models has led to a clearer view of voice production. This article offers a brief review of the progress that has been made in our understanding of the speaking voice and relates this knowledge to clinical practice. The importance of utilizing voice research to confirm traditional management techniques and to develop new physiologically based management approaches is also stressed.

Female↗
PubMed1998

[Voice rehabilitation after total laryngectomy. Voice prostheses or esophageal replacement voice?].

BACKGROUND: During the last years tracheoesophageal fistula has a well established role and in several units is now the principal means of speech rehabilitation following laryngectomy. The purpose of this study is to present the long term results after using the Provox voice prosthesis and to compare the phonetic results obtained with this means of speech rehabilitation with esophageal speech. PATIENTS, METHODS, AND RESULTS: During the last 7 years, 265 laryngectomy patients were trained in our Department in an effort to develop esophageal speech. One hundred and twelve of them developed comprehensive speech of various quality. In another group consisting of 35 patients, a Provox low-resistance, self-retaining prosthesis was fitted. Twenty-nine of them developed a very good voice. Ten patients of each group were tested in order to estimate the quality of voice of the two methods. Three measurements were obtained from each patient: the maximal intensity, the maximal phonation time, and the number of syllables with one breath. CONCLUSION: All the results confirmed the better quality of the tracheo-esophageal speech. The main two advantages of the prosthesis are the effortless speech due to the low resistance of the valve and the simple maintenance by the patient. The most important disadvantage is the cost and the need to occlude the stoma during phonation. Conclusively each method of speech rehabilitation should be selected individually according to the needs, desire, and abilities of every patient.

Adult↗
PubMed1998

Cognitive assessment of voices: further developments in understanding the emotional impact of voices.

OBJECTIVES: This study examines cognitive behavioural assessment of auditory hallucinations ('voices') in people with psychoses. It aims to compare findings with previous work and validate the Assessment of Voices Schedule (Chadwick & Birchwood, 1994). Data were collected on appraisals of voices in relation to the self. It was hypothesized that self-appraisals may be a further factor in understanding the emotional impact of voices. DESIGN: A replication study where data were collected from a new sample of participants and compared with a previous independent sample. METHOD: Voices of 30 patients with a diagnosis of schizophrenia were assessed using a semi-structured interview and questionnaires. Thought-chaining was used to assess appraisals of the voice in relation to the self. RESULTS: Compared to the previous study, current participants were significantly less likely to believe in the omnipotence of their voices, to view their voices as omniscient and to have a positive affective response to benevolent voices. Similar numbers in this study construed their voices as malevolent, but fewer participants in this sample had benevolent voices. There were no significant differences between samples in behavioural responses to voices or in the affective responses to malevolent voices. The Assessment of Voices Schedule was found to have generally good test-retest and inter-rater reliability. Extremely negative self-appraisals were common, as were negative affective responses to the voice experience and low self-esteem. CONCLUSION: The implications of these findings for both cognitive behavioural models and therapy are discussed.

Adult↗
PubMed2001

Human brain potential correlates of voice priming and voice recognition.

This study investigated repetition priming in the recognition of famous voices, recording reaction times (RTs) and event-related brain potentials (ERPs). In Experiment 1, a facilitation was found in RTs to famous but not to unfamiliar voices when these had been primed by a different voice sample of the same speaker earlier in the experiment. However, ERPs to both famous and unfamiliar voices showed repetition priming in terms of an increased P2 component, which is thought to be generated in the auditory cortex. When the likelihood of conscious retrieval of primes was reduced in Experiment 2, facilitatory priming in RTs was again observed for famous voices, but inhibitory priming was now observed for unfamiliar voices. This is consistent with predictions of a bias model of priming. Moreover, substantial priming was observed even when voice primes were backward speech samples, which were recognised at chance levels. The results suggests that (a) voice priming is mediated to a large extent by frequency characteristics of a particular voice, rather than by articulatory and other 'sequential' features that are eliminated in backward speech; (b) priming affects the processing of voices in auditory cortical areas within 200 ms after voice onset; and (c) explicit recognition of a voice in the priming phase is not a necessary condition for priming to occur.

Adult↗
PubMed2001

Voice activity and participation profile: assessing the impact of voice disorders on daily activities.

Traditional clinical voice evaluation focuses primarily on the severity of voice impairment, with little emphasis on the impact of voice disorders on the individual's quality of life. This study reports the development of a 28-item assessment tool that evaluates the perception of voice problem, activity limitation, and participation restriction using the International Classification of Impairments, Disabilities and Handicaps-2 Beta-1 concept (World Health Organization, 1997). The questionnaire was administered to 40 subjects with dysphonia and 40 control subjects with normal voices. Results showed that the dysphonic group reported significantly more severe voice problems, limitation in daily voice activities, and restricted participation in these activities than the control group. The study also showed that the perception of a voice problem by the dysphonic subjects correlated positively with the perception of limitation in voice activities and restricted participation. However, the self-perceived voice problem had little correlation with the degree of voice-quality impairment measured acoustically and perceptually by speech pathologists. The data also showed that the aggregate scores of activity limitation and participation restriction were positively correlated, and the extent of activity limitation and participation restriction was similar in all except the job area. These findings highlight the importance of identifying and quantifying the impact of dysphonia on the individual's quality of life in the clinical management of voice disorders.

Activities of Daily Living↗
PubMed2002

Voice amplification versus vocal hygiene instruction for teachers with voice disorders: a treatment outcomes study.

Voice problems are common among schoolteachers. This prospective, randomized clinical trial used patient-based treatment outcomes measures combined with acoustic analysis to evaluate the effectiveness of two treatment programs. Forty-four voice-disordered teachers were randomly assigned to one of three groups: voice amplification using the ChatterVox portable amplifier (VA, n = 15), vocal hygiene (VH, n = 15), and a nontreatment control group (n = 14). Before and after a 6-week treatment phase, all teachers completed: (a) the Voice Handicap Index (VHI), an instrument designed to appraise the self-perceived psychosocial consequences of voice disorders; (b) a voice severity self-rating scale; and (c) an audiorecording for later acoustic analysis. Based on pre- and posttreatment comparisons, only the amplification group experienced significant reductions on mean VHI scores (p = .045), voice severity self-ratings (p = .012), and the acoustic measures of percent jitter (p = .031) and shimmer (p = .008). The nontreatment control group reported a significant increase in level of vocal handicap as assessed by the VHI (p = .012). Although most pre- to posttreatment changes were in the desired direction, no significant improvements were observed within the VH group on any of the dependent measures. Between-group comparisons involving the three possible pairings of the groups revealed a pattern of results to suggest that: (a) compared to the control group, both treatment groups (i.e., VA and VH) experienced significantly more improvement on specific outcomes measures and (b) there were no significant differences between the VA and VH groups to indicate superiority of one treatment over another. Results, however, from a posttreatment questionnaire regarding the perceived benefits of treatment revealed that, compared to the VH group, the VA group reported more clarity of their speaking and singing voice (p = .061), greater ease of voice production (p = .001), and greater compliance with the treatment program (p = .045). These findings clearly support the clinical utility of voice amplification as an alternative for the treatment of voice problems in teachers.

Adult↗
PubMed2000

The power and omnipotence of voices: subordination and entrapment by voices and significant others.

BACKGROUND: Cognitive therapy for psychotic symptoms often embraces self-evaluative beliefs (e.g. self-worth) but whether and how such beliefs are related to delusions remains uncertain. In previous research we demonstrated that distress arising from voices was linked to beliefs about voices and not voice content alone. In this study we examine whether the relationship with the voice is a paradigm of social relationships in general, using a new framework of social cognition, 'ranking' theory. METHOD: In a sample of 59 voice hearers, measures of power and social rank difference between voice and voice hearer are taken in addition to parallel measures of power and rank in wider social relationships. RESULTS: As predicted, subordination to voices was closely linked to subordination and marginalization in other social relationships. This was not the result of a mood-linked appraisal. Distress arising from voices was linked not to voice characteristics but social and interpersonal cognition. CONCLUSION: This study suggests that the power imbalance between the individual and his persecutor(s) may have origins in an appraisal by the individual of his social rank and sense of group identification and belonging. The results also raise the possibility that the appraisal of voice frequency and volume are the result of the appraisal of voices' rank and power. Theoretical and novel treatment implications are discussed.

Adult↗
PubMed1990

[Voice rehabilitation following total laryngectomy: microvascular laryngeal replacement-plasty (laryngoplasty) instead of voice prosthesis].

Since the introduction of the so-called voice prostheses tracheoesophageal puncture is currently the most widely used surgical procedure for vocal rehabilitation after total laryngectomy. The voice prosthesis renders possible a reliably reproducible voice, which is superior (period of uninterrupted sound production, basal frequency, voice intensity) to the other techniques (esophageal speech, external vibrators, other surgical reconstructive measures), but has the following disadvantages: high initial phonation pressure, formation of granulation tissue around the voice shunt, blockage or leakage of the prosthesis or the voice shunt, displacement of the prosthesis, spontaneous occlusion when the prosthesis is accidentally removed, overtaxing the patients who have difficulties in replacing and cleaning the prosthesis. As an alternative new surgical technique a substitute larynx tube (laryngoplasty) was formed by a microvascular anastomotic forearm flap and connected to the trachea and pharynx in ten patients with extensive (T3-T4) laryngohypopharyngeal carcinoma. All ten patients developed a voice comparable with those of patients who have a voice prosthesis (frequency, voice intensity, period of uninterrupted sound production). An advantage of this graft over the voice prosthesis is that the phonation pressure required is low. While they were still in hospital eight patients learned to speak without using their hands by means of a tracheostomal valve. So far (six months postoperative) this surgical procedure has proved to be a practicable surgical alternative to a voice prosthesis.

Animals↗
PubMed2001

Plasticity of voice quality: a prognostic factor for outcome of voice therapy?

Plasticity of voice quality is defined here as the degree of improvement in deviant voice quality that can be achieved immediately or quasi-immediately by changing basic voicing conditions, posture, articulation or resonance, breathing mechanics, laryngeal position, or auditory feedback. Thirty-two adult patients with various benign organic voice pathologies, and who had a (preoperative) functional voice therapy, were scored before therapy using a weighted multidimensional Index of Voice Plasticity (IVP). The hypothesis is that IVP could be a predictor of the final outcome of functional voice therapy, and therefore a correlation with a comparable quantification of the actual results of the therapy was investigated. The IVP shows a satisfactory correlation (Spearman's rho = 0.68) with the efficacy of (preoperative) voice therapy. The IVP also significantly differs between diagnostic categories. Although its predictive value remains limited, the Index of Voice Plasticity seems helpful in decision making for indication of (presurgical) voice therapy.

Humans↗
PubMed1999

Quantitative evaluation of the voice range profile in patients with voice disorder.

In 1953, Calvet first displayed the fundamental frequency (pitch) and sound pressure level (intensity) of a voice on a two-dimensional plane and created a voice range profile. This profile has been used to evaluate clinically various vocal disorders, although such evaluations to date have been subjective without quantitative assessment. In the present study, a quantitative system was developed to evaluate the voice range profile utilizing a personal computer. The area of the voice range profile was defined as the voice volume. This volume was analyzed in 137 males and 175 females who were treated for various dysphonias at Kyushu University between 1984 and 1990. Ten normal subjects served as controls. The voice volume in cases with voice disorders significantly decreased irrespective of the disease and sex. Furthermore, cases having better improvement after treatment showed a tendency for the voice volume to increase. These findings illustrated the voice volume as a useful clinical test for evaluating voice control in cases with vocal disorders.

Adult↗
PubMedDate not supplied

Voice dysfunction in dysarthria: application of the Multi-Dimensional Voice Program.

Phonatory dysfunction is a frequent component of dysarthria and often is a primary feature noted in clinical assessment. But the vocal impairment can be difficult to assess because (a). the analysis of voice disorder of any kind can be challenging, and (b). the voice disorder in dysarthria often occurs along with other impairments affecting articulation, resonance, and respiration. A promising assessment tool is multi-parameter acoustic analysis, such as the Multi-Dimensional Voice Program (MDVP). Part 1 of this paper recommends procedures and standards for the acoustic analysis of voice, including (1). selection of the sample to be analyzed, (2). signal quality requirements, (3). availability of normative data for both genders and different ages of speakers, (4). reliability of analysis, and (5). correlation of acoustic results with results from other methods of analysis. In Part 2, acoustic data are reviewed for the dysarthria associated with Parkinson disease (PD), cerebellar disease, amyotrophic lateral sclerosis (ALS), traumatic brain injury (TBI), unilateral hemispheric stroke, and essential tremor. Tentative profiles of voice disorder are described for these conditions. These profiles may serve as hypotheses for future research. Although several issues remain to be resolved in the acoustic analysis of voice disorder in dysarthria, steps can be taken now to promote the reliability, validity, and clinical utility of such analyses. (1). As a result of this activity, the participant will be able to describe ways in which an optimal multi-dimensional analysis of voice can be performed with modern acoustic analysis systems. (2). As a result of this activity, the participant will be able to apply multi-dimensional acoustic analysis of voice to individuals who have a dysarthria-related voice disorder. (3). As a result of this activity, the participant will be able to identify major sources of normative data on the Multi-Dimensional Voice Program.

Amyotrophic Lateral Sclerosis↗
PubMed2001

Alternative voice after laryngectomy using a sound-producing voice prosthesis.

OBJECTIVE: To improve the voice quality of female laryngectomees and/or laryngectomees with a hypotonic pharyngoesophageal (PE) segment by means of a pneumatic artificial source of voice incorporated in a regular tracheoesophageal (TE) shunt valve. STUDY DESIGN: Experimental, randomized, crossover trial. METHODS: The new sound source consists of a single silicone lip, which performs an oscillatory movement driven by expired pulmonary air flowing along the outward-striking lip through the TE shunt valve. A prototype of this pneumatic sound source is evaluated in vitro and in six laryngectomees. In vivo evaluation includes speech rate, maximal phonation time, perceptual voice evaluation of read-aloud prose by an expert listener, speech intelligibility measurements with 12 listeners, and self-assessment by the patients. Moreover, extensive acoustical and aerodynamic in vivo registrations are performed using a newly developed data acquisition system. RESULTS: The current prototype seems beneficial in female laryngectomees with a hypotonic PE segment only. For them the sound-producing voice prosthesis improves voice quality and increases the average pitch of voice, without decreasing intelligibility or necessitating other pressure and airflow rates than regular TE shunt speech. Pitch regulation of this prosthetic voice is possible, yet limited. CONCLUSIONS: The mechanism is feasible and does not result in unacceptable airflow resistance. For this new mechanism of alaryngeal voice to become an established technique for postlaryngectomy voice restoration, a voice suitably pitched for male laryngectomees has to be generated and a large part of the melodic and dynamic range of the sound source has to be attainable within physiological airflow rates.

Aged↗
PubMed2003

Measurement and validation of the voice handicap index in voice-disordered patients in Taiwan.

Voice disorders can cause problems for patients emotionally, physically, economically and functionally. Neither subjective nor objective voice examinations are able to evaluate such factors adequately. For this study, a retrospective analysis of 79 dysphonic cases was conducted using the voice handicap index (VHI) to gather comprehensive data across a variety of voice disorders. Of the 79 cases, 41 involved glottic insufficiency, 26 involved vocal polyps or mass, and 12 involved functional voice disorders. Cases were assessed with the VHI using physical (P), functional (F), emotional (E) parameters and a total (T) of the three. P, F, E and T variables were entered into a statistical programme and analysed using one-way analysis of variance (ANOVA). Mean +/-SE values for P, F, E and T, respectively, in glottic insufficiency cases were 31.61 +/- 1.10, 26.49 +/- 1.43, 26.06 +/- 1.54, and 84.20 +/- 4.21. Mean +/-SE values for P, F, E and T, respectively, in vocal mass cases were 30.69 +/- 1.73, 25.23 +/- 1.90, 23.96 +/- 1.82, and 79.88 +/- 5.08. The mean +/-SE values of P, F, E and T, respectively, in functional voice disorders were 20.92 +/- 2.06, 18.33 +/- 1.82, 16.83 +/- 1.86, and 56.08 +/- 5.23. We found the mean glottic insufficiency was significantly greater than functional voice disorders for each measure. There were significant differences between vocal mass and functional voice disorders means for P and T. Glottic insufficiency and vocal mass means were not significantly different for any measure. Problems in the physical realm were identified as the most severe amongst all patients. Glottic insufficiency patients were found to suffer the most in every VHI value. Although VHI is a relatively new method by which to measure discomfort in voice-disordered patients, it provides a mechanism for patients to define their discomfort and for therapists to better target recovery programmes to patient's needs.

Adolescent↗