Abstract
Many common voice disorders are chronic or recurring conditions that are likely to result from inefficient and/or abusive patterns of vocal behavior, referred to as vocal hyperfunction. The clinical management of hyperfunctional voice disorders would be greatly enhanced by the ability to monitor and quantify detrimental vocal behaviors during an individual’s activities of daily life. This paper provides an update on ongoing work that uses a miniature accelerometer on the neck surface below the larynx to collect a large set of ambulatory data on patients with hyperfunctional voice disorders (before and after treatment) and matched-control subjects. Three types of analysis approaches are being employed in an effort to identify the best set of measures for differentiating among hyperfunctional and normal patterns of vocal behavior: (1) ambulatory measures of voice use that include vocal dose and voice quality correlates, (2) aerodynamic measures based on glottal airflow estimates extracted from the accelerometer signal using subject-specific vocal system models, and (3) classification based on machine learning and pattern recognition approaches that have been used successfully in analyzing long-term recordings of other physiological signals. Preliminary results demonstrate the potential for ambulatory voice monitoring to improve the diagnosis and treatment of common hyperfunctional voice disorders.
Highlights
Voice disorders have been estimated to affect approximately 30% of the adult population in the United States at some point in their lives, with 6.6–7.6% of individuals affected at any given point in time (Roy et al, 2005; Bhattacharyya, 2014)
This means that a subject is predicted to be a patient with phonotraumatic vocal hyperfunction if more than 68% of their windows were classified to those from the other patients the LASSO model was trained on
We could interpret the right-shifting of Normalized features in subjects with vocal fold nodules to mean that they tended to deviate from their baseline f0 and SPL as their days progressed, possibly reflecting increased difficulty in producing phonation
Summary
Voice disorders have been estimated to affect approximately 30% of the adult population in the United States at some point in their lives, with 6.6–7.6% of individuals affected at any given point in time (Roy et al, 2005; Bhattacharyya, 2014). While many vocally healthy speakers take verbal communication for granted, individuals suffering from voice disorders experience significant communication disabilities with far-reaching social, professional, and personal consequences (NIDCD, 2012). The most frequently occurring subset of voice disorders is associated with vocal hyperfunction, which refers to chronic “conditions of abuse and/or misuse of the vocal mechanism due to excessive and/or ‘imbalanced’ [uncoordinated] muscular forces” Our group has begun to provide evidence for the concept that there are two types of vocal hyperfunction that can be quantitatively described and differentiated from each other and normal voice production using a combination of acoustic and aerodynamic measures (Hillman et al, 1989, 1990)
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