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.     

Immediate effects of the phonation into a straw exercise

Immediate effects of an exercise with the vocal tract semi-closed.ObjectiveTo investigate the immediate effects of the phonation exercise in a straw in individuals with and without vocal fold lesions.Materials and MethodsProspective study. 48 individuals, aged between 18 and 55 years participated in the study, and they were distributed into two groups: GL- with a benign vocal fold lesion; GSL-without a lesion. The following analyses were carried out before and after the straw phonation exercises: voice self-analysis, [ε] vowel auditory-perception analysis, selected parameters acoustics (VoxMetria 2.6) and videolaryngoscopy.ResultsThe vocal self assessment indicated a statistically significant improvement on voice emission in GL individuals (p=0.015). There were no statistically significant differences before and after the exercise and between the groups, in the videolaryngoscopy, acoustic and auditory-perception assessments.ConclusionThe straw phonation exercise caused positive effects, seen upon voice self-assessment, indicating an easier and better voice upon phonation.     

History of voice rehabilitation following laryngectomy

INTRODUCTION: The history of voice rehabilitation following laryngectomy is as long as the history of laryngectomy itself. The multitude of methods which have been employed to reduce the disability associated with the loss of the larynx, illustrate the difficulty of finding an optimal method of reestablishing verbal communication while preserving the ability to breathe and swallow. MATERIAL AND METHODS: The world literature was reviewed using various Internet and medical search engines and library facilities. Landmark articles were identified and summarized. RESULTS: A coherent history of voice rehabilitation following laryngectomy was constructed. DISCUSSION: The methods employed to reestablish voice after extirpation of the larynx may be grouped into the categories of: esophageal speech, surgical methods of creating competent tracheo-pharyngeal shunts to create lung powered voice with and without the use of prosthetic devices to prevent aspiration, "near-total" resection of the larynx with dynamic phonatory shunt, and the use of external pneumatic or electrical devices to create sound which is then transmitted through the oral cavity and pharynx. CONCLUSION: For the past two decades, simple shunt devices inserted either primarily, at the time of laryngectomy, or later as a secondary procedure, have mainly supplanted the other methods of voice rehabilitation, with the exception of an occasional patient who has acquired good esophageal speech, or for whom external devices may be the only practical method of voice production.     

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.     

Acoustic analysis of voice using WPCVox: a comparative study with Multi Dimensional Voice Program

In this study, two different tools developed for the parametric extraction and acoustic analysis of voice samples are compared. The main goal of the paper is to contrast the results obtained using the classical Multi Dimensional Voice Program (MDVP), with the results obtained with the novel WPCVox. The aim of this comparison was to find differences and similarities in the parameters extracted with both systems in order to make comparison of measurements and data transfer among both equipments. The study was carried out in two stages: in the first, a wide sample of healthy voices belonging to Spanish-speaking adults from both genders were used to carry out a direct comparison between the results given by MDVP and those obtained with WPCVox. In the second stage, a sample of 200 speakers (53 normal and 173 pathological) taken from a commercially available database of voice disorders were used to demonstrate the usefulness of WPCVox for the acoustic analysis and the characterization of normal and pathological voices. The results conclude that WPCVox provides very reliable measurements which are very similar to those obtained using MDVP, and very similar capabilities to discriminate among normal and pathological voices.     

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.     

嗓音客观评估的研究进展

嗓音是一个复杂的多维现象,它是通过肺气流驱动声带振动继而被听者感知到的声音。嗓音疾病最早依靠富有经验的喉科医生的主观判断,由于受临床经验、个人习惯等一些主观因素的影响,难免出现误诊、漏诊。后来出现了嗓音的客观检测方法,随着现代计算机技术、电子技术的飞速发展,催生了一系列新的嗓音检测手段,计算机仿生功能检     

CO2 laser in the diagnosis and treatment of early cancer of the vocal fold

A total of 74 patients underwent cordectomy using CO₂ laser for either diagnosis or treatment of an early cancer of the vocal fold. Type I cordectomy consisted in the resection of the entire epithelium, while leaving the vocal ligament intact. Type II cordectomy involved removal of the vocal fold from the vocal process to the anterior commissure and passing through the inferior thyroarytenoid muscle. Type IIIA required vocal fold resection along the internal side of the thyroid ala, while type IIIB included removal of the anterior commissure. Type I cordectomies were carried out with an Acuspot micromanipulator, which provided a 250-m-diameter beam for a working distance of 400 mm, and in the shot-by-shot cutting mode with 3 W power superpulse. This cordectomy was carried out in 39 patients and a dysplasia or an early carcinoma were detected in 45.9% of cases. Type II and type III procedures were performed with the Microslad micromanipulator having a 700-m-diameter beam in the continuous cutting mode, 7 W power superpulse. Fifteen cases were treated by type II cordectomy, of which 3 T1aN0M0 cases underwent postoperative radiotherapy due to insufficient resections and 2 cases with T1bN0M0 tumors later underwent reconstructive laryngectomy. A type III cordectomy was used for 14 cases of TlaNOMO carcinomas and 3 cases of severe dysplasia. The margins of resection were found to be positive histologically in 23.5% of these cases, making frozen section examinations mandatory at time of surgery. Results of all procedures showed that voice was best after a type I cordectomy where only the epithelium was resected. In the type II and type III cordectomies, the quality of voice depended on the development of a fibrous fold and the absence of anterior synechia in the healed larynx.Presented in part during the First European Laryngological Society Conference, Marburg, 26–29 September 1996