Normative study of vocal acoustic parameters from children from 4 to 12 years of age without vocal symptoms. A pilot study

Acoustic vocal analysis is a simple and fast method that allows to differentiate normal from changed voices. There are few studies that analyze normal acoustic vocal parameters at different age ranges in children.AimsTo establish normative acoustic parameters of children's voice aged 4 to 12 years.MethodsTwo hundred and forty children were divided into four sub-groups by age: G1 (n-60; 4-5 years), G2 (n-60; 6-7 years), G3 (n-60; 8-9 years) and G4 (n-60; 10-12 years). The children's parents answered a questionnaire and the children were submitted to auditory acuity evaluation (Assessment of Transient Otoacoustic Emissions), acoustic vocal analyses, otorhinolaryngological and videolaryngoscopy exams.ResultsThe normal values for the acoustic vocal parameters studied were established according to age range and gender. As age increased, there was a decrease of f0 and APQ and an increased in SPI with statistical difference of these parameters. The vocal parameters did not differ between genders until the age of 12.Conclusionsthe characterization of the normative vocal patterns of children is an important reference for future studies. Some of the changes showed a direct relationship between age and a reduction of f0 and of APQ, and increase in SPI, with no difference between genders.     

Laryngeal and vocal analysis in bulimic patients

Bulimia is an eating disorder classified as a mental disorder according to DSM-IV.AimsThe aim of the study was to evaluate vocal and laryngeal abnormalities in patients with bulimia compared to a control group.Materials & methodsStudy control group. Twenty-two women were evaluated, with an age range of 18 to 34 years old. Eleven diagnosed with purging bulimia and 11 in the control group. Both groups underwent an otolaryngological, perception and acoustic evaluation. The statistic analysis was done through a chi-square test and a Kruskall-Wallis non-parametric test, considering 5% as significance level.ResultsThe bulimic group presented a higher prevalence of laryngeal abnormalities compared to the control group (p=0.000). The group with bulimia had higher GRBSI values (p=0.000) and A (p=0.022) of the GRBASI scale. The results of vocal acoustics analysis of the jitter, shimmer, PPQ and APQ were higher in the bulimic group (p=0.033). No statistical significance difference in the fundamental frequency and NHR were found between both groups.Conclusionthe bulimic patients in this study presented more laryngeal, acoustics and perception evaluation disorders when compared to a control group.     

Voice and vocal fold position in men with unilateral vocal fold paralysis

The paralyzed vocal fold positioning and the degree of dysphonia are important inputs when one is deciding upon treatment options for unilateral vocal fold paralysis (UVFP).ObjectiveTo check voice characteristics and paralyzed vocal fold position in men with UVFP.Materials and MethodsThis is a retrospective historical cross-sectional cohort study, with data from 24 men with UVFP with mean age of 60.7 years, submitted to voice assessment by three speech therapists and three ENT physicians used laryngeal images to classify the position of the paralyzed vocal fold.ResultsThe paralyzed vocal fold was found in the paramedian position in 45.83% of the cases; in the intermediary position in 25%; lateral in 20.83%, and it was in the median position in 4.16%; the dysphonia resulting from the UVFP was characterized by moderate hoarseness, roughness and stress in the voice; breathiness (most had severe breathiness); weakness and instability(mostly mild); the position of the paralyzed vocal fold had a significant influence on the general degree of vocal deviation.ConclusionThe general degree of dysphonia is associated with the paralyzed vocal fold position; dysphonia is characterized by hoarseness, breathiness, roughness and stress of moderate to severe levels.     

Sulcus configurations of vocal folds during phonation

Conclusion: A detailed understanding of clinical and voice characteristics will help to differentiate sulcus configuration and plan rational management strategies for each type. Objectives: To investigate the clinical and voice characteristics of patients with sulcus configuration of vocal folds during phonation. Patients and methods: A total of 146 patients with bilateral sulcus configuration of vocal folds were enrolled in this study. Based on videostroboscopic findings, patients were classified into three groups: physiologic sulcus configuration group (type I), pathologic sulcus configuration group, including sulcus vergeture (type II), and sulcus vocalis (type III). Voice analyses were obtained from a recorded speech sample. Results: Thirty-two patients (21.9%) were type I, 61 (41.8%) were type II, and 53 (36.3%) were type III. Different sulcus configuration groups had significantly different roughness and mean fundamental frequency. Type III was significantly different from type I and type II in grade, breathiness, mean flow rate, subglottic pressure, maximum phonation time, Jitter%, and harmonics to noise ratio. The pathologic sulcus showed distinctive features in electroglottograph waveform.     

Clinical diagnosis and histological analysis of vocal nodules and polyps

Recent studies emphasize the importance of the clinical-histology correlation in laryngeal pathologies.ObjectiveTo compare the ENT diagnosis with the pathology diagnosis one of 132 surgical specimens, from 119 patients with vocal nodules and polyps.MethodRetrospective study. We investigated the paraffin blocks corresponding to the lesions of the operated patients. We made new histology cross-sections, totaling 396 new slides, divided into three groups: hematoxylin and eosin, Gomori trichrome and PAS. We analyzed the following histological parameters: epithelium, lamina propria, basement membrane, vascular changes. We compared the laryngological and pathological diagnoses, and we did the statistical analysis, checking the predominant histological aspects in each lesion.ResultsThere was an agreement between the clinical and pathological diagnoses in 123 (93.18%) of 132 lesions analyzed (42.42% nodules and 50.76% polyps). In the histological parameters we found: epithelial changes such as nodules hyperplasia (82.14%) and polyp atrophy (31.34%). Lamina propria: edema in polyps (71.43%), fibrosis in the nodules (57.14%). Basement membrane: thickened nodules (100%), thin/no change in polyps (100%). There was a predominance of vascular changes in the polyps.ConclusionWe found a high correlation between the ENT diagnosis and the pathology report. Histopathologically, the nodules presented with predominantly epithelial changes, lamina propria and basement membrane fibrosis, while the polyps by changes strictly on the lamina propria and vascular aspects.     

Effects of vocal fatigue on voice parameters of Indian Teachers

Vocal fatigue is a frequently reported voicec symptom among professional voice users. Indian School teachers teach lontinuously for many hours in advene acoustical environments and are highly susceptible to vocal fatigue. The present study is the first to examine acoustic voice measures in teacher, reporting naturally induced vocal fatigue. 40 female primary school teachers (mean age =36 yearn) with varying severity of vocal fatigue participated in this studr. Voice measures of minimum and maximum fundametal frequency were obtained before and after one and a half hours of continuous teaching at the workplace. Maximum fundamental frequent was an important acoustic parameter in determining presence of weal fatigue. Most cummin perceptual sympioms include throat dryneis, discomfort and loss of voit e. The rule of vocal hygiene and warm-up in reducing vocal fatigue are considered.