Evaluation Of Vocal Function Research Articles

喉頭全摘出後のvoice prosthesisを使用した症例の音声機能評価

喉頭全摘出後のvoice prosthesisを使用した症例の音声機能評価

Autologous fat injection therapy including a high concentration of adipose-derived regenerative cells in a vocal fold paralysis model: animal pilot study.

To verify the effectiveness and safety of the addition of adipose-derived regenerative cells to autologous fat injection therapy. Unilateral vocal fold paralysis models were made by cutting the right recurrent laryngeal nerve in two pigs. At day 30, 0.5 ml adipose-derived regenerative cells mixed with 1 ml autologous fat was injected into the right vocal fold of one pig, with the other receiving 0.5 ml Ringer's solution mixed with 1 ml autologous fat. At day 120, fibrescopy, laser Doppler flowmeter, computed tomography, vocal function evaluation and histological assessment were conducted. Although histological assessment revealed atrophy of the thyroarytenoid muscle fibre in both pigs, there was remarkable hypertrophy of the thyroarytenoid muscle fibre in the area surrounding the adipose-derived regenerative cells injection site. The addition of a high concentration of adipose-derived regenerative cells to autologous fat injection therapy has the potential to improve the treatment outcome for unilateral vocal fold paralysis.

A Review of Voice Therapy Techniques Employed in Treatment of Dysphonia with and Without Vocal Fold Lesions

The purpose of the review is to provide otolaryngologists a framework for understanding voice evaluation by speech-language pathologists and the voice therapy techniques they employ. Recent reports have demonstrated the efficacy of behavioral voice therapy in the management of a variety of types of dysphonia, including those associated with vocal fold lesions and those without. Otolaryngologists can be experts in managing specific laryngeal lesions to improve voice. However, not all voice problems have lesions amenable to surgical or medical therapies. Many are associated with maladaptive voicing behaviors. Speech-language pathologists can be experts in both the evaluation of vocal function and technique. They may employ a variety of techniques to improve vocal quality and function in patients with and without structural or neurologic laryngeal pathology. Otolaryngologists can partner to manage a constellation of voice problems with directed voice evaluation and therapy. A basic review of these techniques and this partnership with voice therapists is presented.

Veränderung der stimmlichen Leistungsfähigkeit durch verschiedene Stimmbelastungstests

Vocal loading tests are an important element in the evaluation of vocal function. In Germany mostly tests with changes of loading intensity between 75 and 80 dB(A) or tests with continuous intensity of 80 dB(C) are used. 17 subjects with healthy vocal function were analyzed in 3 test conditions (1. continuous loading of 80 dB(A), 2. loading with changes of intensity between 75 and 80 dB(A) and 3. without loading for 10 min) concerning DSI and visual analog scale in their time course. The measurements were performed pre, directly after and 20, 40 and 60 min after the loading. The loading test was performed using the German text “Das tapfere Schneiderlein”. The data show that the deviation and percentages of lower values of the intended dB loading were much greater for the test with changes of intensity compared to the test with continuous loading. There were no significant differences of the DSI between both loading conditions. After the loading there was a drop of the DSI followed by a short recovery and a drop after 60 min. The loading test with continuous intensity appears more stable for healthy subjects and can be fulfilled more easily. Both tests show comparable courses concerning the DSI after the loading tests.

Multidimensional Evaluation of Vocal Function after Supracricoid Laryngectomy with Cricohyoidopexy

The aim of this study was to assess the vocal outcome and the impact of arytenoid resection on vocal function following supracricoid laryngectomy with cricohyoidopexy. Twenty-eight male patients who had undergone supracricoid laryngectomy with cricohyoidopexy were included in the study. In 7 patients, one arytenoid cartilage had been totally resected; in 11, both arytenoid cartilages had been preserved; and in 10, one arytenoid cartilage had been partially resected. The maximum phonation time, fundamental frequency, jitter, shimmer, and noise-to-harmonics ratio were assessed and analyzed. Perceptual analysis was performed with the grade, roughness, breathiness, asthenia, and strain (GRBAS) scale. Abduction-adduction and anteroposterior squeezing actions were analyzed from videoendoscopic records. The Voice Handicap Index-10 (VHI-10) was used for self-assessment. The acoustic and aerodynamic parameters and GRBAS score showed severe impairment. The self-assessment revealed that patients were relatively satisfied with their voice quality. There were no statistically significant differences in the acoustic and aerodynamic parameters, the GRBAS score, or the VHI-10 score according to the level of arytenoid resection. Supracricoid laryngectomy with cricohyoidopexy caused deterioration of acoustic and aerodynamic voice parameters and the GRBAS score. Statistically, the level of arytenoid resection had no apparent effect on the objective, perceptual, or subjective voice parameters.

発声状態を評価する2種類のボイスマップの考案と声帯メスを用いたファイバースコープでの声帯手術

発声状態を評価する2種類のボイスマップの考案と声帯メスを用いたファイバースコープでの声帯手術

Development of a minimum protocol for assessment in the paediatric voice clinic. Part 2: Subjective measurement of symptoms of voice disorder

The European Laryngological Society (ELS) recommend that functional assessment of voice disorder in adults requires evaluation of a number of different parameters. These include perceptual evaluation of voice, videostroboscopic imaging of vocal fold movement, acoustic analysis of specific voicing aspects, aerodynamic support for voicing, and a subjective rating of voice impact. No specific guidelines are available for children, but a similar range of parameters is needed to guide intervention and measure outcomes. The development of subjective voice measures for adults and their adaptations for the paediatric population are reviewed and compared to the research comparing these to evaluation of vocal function. The need for further refinement of child assessment measures, and a proposal of how these might be developed, is discussed.

Differentiated Vocal Tract Control and the Reliability of Interpretations of Nasendoscopic Assessment

Training specific vocal techniques can be effective in treating nonorganic dysphonias. Evaluation of vocal function in these studies has included auditory-perceptual assessment, aerodynamic measurement, acoustic analysis, self-report, and visual inspection of the larynx. Reliability of judgments made using visual rating tools for nasendoscopic and videostroboscopic visualization of the larynx when diagnosing vocal function and disorder has been the focus of previous research. However, detailed analysis of factors that affect reliability and consistency of perceptual ratings of laryngoscopic footage has not been investigated in voice therapy outcome studies. This study evaluated clinicians' judgments of the effectiveness of training differentiated vocal tract control of false vocal fold activity (FVFA), true vocal fold mass (TVFM) and larynx height (LH). A within-subject, experimental design was used to assess participants' mastery in manipulating FVFA, TVFM, and LH assessed via laryngoscopic visualization of the larynx. Three experienced speech pathologists rated the nasendoscopy footage with accompanying acoustic recordings of 12 speakers. Intrajudge consistency, interjudge reliability, and interjudge agreement of perceptual ratings were investigated. Twelve vocally trained unimpaired speakers used differentiated biomechanical manipulation of various laryngeal muscles to produce eight specific vocal qualities each. These manipulated vocal qualities were rated by three experienced voice clinicians who demonstrated higher levels of intrajudge consistency and interjudge agreement when identifying rather than quantifying the degree of a voice quality based on their visual and auditory perceptions of the different vocal features. The findings suggest that unimpaired speakers can be trained successfully to manipulate and change individual biomechanical aspects of their vocal functions as demonstrated by the visual- and auditory-perceptual judgments of expert voice clinicians. These judgments are vulnerable to issues of reliability and suggests that judges used auditory-perceptual judgments when interpreting laryngoscopic footage, particularly when the view of laryngeal features is compromised.

喉頭全摘後の音声機能評価

喉頭全摘後の音声機能評価