Kay Elemetrics Research Articles

How Early Can We Predict the Need for VPI Surgery?

This retrospective study reviewed documentation of children with moderate-to-severe VPI at age 3 years who did not undergo VPI surgery until age 5 years. Based on the national cleft register, 959 patients with syndromic and nonsyndromic CP were treated by the craniofacial team at Helsinki University Hospital, Finland between 2000 and 2014. Eighty-six patients fulfilled the study inclusion criteria. The speech pathologist evaluated velopharyngeal function at age 3, 5, and 8 years. Of the 86 children presenting with moderate-to-severe VPI at age 3 years, 94% still had moderate-to-severe VPI at age 5 years, even though speech therapy was offered to 77%. Of those whose velopharyngeal function improved by age 5 years, function regressed to incompetent over time. Overall, 93% underwent VPI surgery and 82% underwent VPI surgery between ages 5 and 8 years. Only 23% at age 8 years still had moderate-to-severe VPI. Speech therapy alone did not improve VPI speech characteristics. Moderate-to-severe VPI did not improve from 3 to 5 years or improved but subsequently relapsed. This suggests that the decision for VPI surgery can be made for children aged 3 years with moderate-to-severe VPI.

Increasing the speech intelligibility by the use of voice therapy in patients with profound hearing loss

Objective: The purpose of this study is to evaluate changes in the acoustic properties of voice in patients with profound sensorineural hearing loss to determine the effectiveness of voice therapy. Material-Method: Our study consisted of 15 individuals from the 20-25 years of age with bilateral symmetrical hearing loss (Group A), and 15 individuals in the 26-65 age group with post lingual cochlear implants (Group B). The control group (Group C) included 15 adults with the normal hearing range from the age group of 20-30. Prospective analysis methods was utilized for this research. In order to quantitatively measure the psychosocial consequences of voice-related disorders the Voice Handicap Index (VHI) was given, and, to determine the acoustic measures of the voice quality, the /ah/ sound was digitally recorded with the Multidimensional Voice Program (Kay Elemetrics) in all groups. Conclusion: Average Fundamental frequency (F0), jitter percentage (jitter), shimmer, noise-harmonic ratio (NHR), voice turbulence index (VTI), soft phonation index (SPI), PPQ and APQ parameters were analyzed through acoustic sound analysis program. When the data in Group A are compared with Group B, the acoustic parameters show a statistically significant higher value. Discussion: Speech intelligibility increased in individuals with profound hearing loss who received sound therapy and who used cochlear implants. According to the results of the VHI, individuals with cochlear implants benefit from voice therapy.

Searching for Best Predictors of Paralinguistic Comprehension and Production of Emotions in Communication in Adults With Moderate Intellectual Disability.

Paralinguistic comprehension and production of emotions in communication include the skills of recognizing and interpreting emotional states with the help of facial expressions, prosody and intonation. In the relevant scientific literature, the skills of paralinguistic comprehension and production of emotions in communication are related primarily to receptive language abilities, although some authors found also their correlations with intellectual abilities and acoustic features of the voice. Therefore, the aim of this study was to investigate which of the mentioned variables (receptive language ability, acoustic features of voice, intellectual ability, social-demographic), presents the most relevant predictor of paralinguistic comprehension and paralinguistic production of emotions in communication in adults with moderate intellectual disabilities (MID). The sample included 41 adults with MID, 20–49 years of age (M = 34.34, SD = 7.809), 29 of whom had MID of unknown etiology, while 12 had Down syndrome. All participants are native speakers of Serbian. Two subscales from The Assessment Battery for Communication – Paralinguistic comprehension of emotions in communication and Paralinguistic production of emotions in communication, were used to assess the examinees from the aspect of paralinguistic comprehension and production skills. For the graduation of examinees from the aspect of assumed predictor variables, the following instruments were used: Peabody Picture Vocabulary Test was used to assess receptive language abilities, Computerized Speech Lab (“Kay Elemetrics” Corp., model 4300) was used to assess acoustic features of voice, and Raven’s Progressive Matrices were used to assess intellectual ability. Hierarchical regression analysis was applied to investigate to which extent the proposed variables present an actual predictor variables for paralinguistic comprehension and production of emotions in communication as dependent variables. The results of this analysis showed that only receptive language skills had statistically significant predictive value for paralinguistic comprehension of emotions (β = 0.468, t = 2.236, p < 0.05), while the factor related to voice frequency and interruptions, form the domain of acoustic voice characteristics, displays predictive value for paralinguistic production of emotions (β = 0.280, t = 2.076, p < 0.05). Consequently, this study, in the adult population with MID, evidenced a greater importance of voice and language in relation to intellectual abilities in understanding and producing emotions.

Akustičke karakteristike glasa kod odraslih osoba sa depresivnim poremećajem

In order to examine the differences in people suffering from depression (EG, N=18) compared to the healthy controls (CG1, N=24) and people with the diagnosed psychogenic voice disorder (CG2, N=9), nine acoustic features of voice were assessed among the total of 51 participants using the MDVP software programme ("Kay Elemetrics" Corp., model 4300). Nine acoustic parameters were analysed on the basis of the sustained phonation of the vowel /a/. The results revealed that the mean values of all acoustic parameters differed in the EG compared to both the CG1 and CG2 as follows: the parameters which indicate frequency variability (Jitt, PPQ), amplitude variability (Shim, vAm, APQ) and noise and tremor parameters (NHR, VTI) were higher; only the parameters of fundamental frequency (F0) and soft index phonation (SPI) were lower (F0 compared to CG1, and SPI compared to CG1 and CG2). Only the PPQ parameter was not significant. vAm and APQ had the highest discriminant value for depression. The acoustic features of voice, analysed in this study with regard to the sustained phonation of a vowel, were different and discriminant in the EG compared to CG1 and CG2. In voice analysis, the parameters vAm and APQ could potentially be the markers indicative of depression. The results of this research point to the importance of the voice, that is, its acoustic indicators, in recognizing depression. Important parameters that could help create a programme for the automatic recognition of depression are those from the domain of voice intensity variation.

Impact of pregnancy on voice: a prospective observational study

Purpose We aimed to assess if there is a significant change in voice of pregnant women by the end of third trimester. Materials and methods Forty-nine pregnant women were enrolled in this study between April 2019 and March 2020. Subjective and objective voice evaluation was conducted in the third trimester and three months after delivery. The Turkish version of the VHI-10 questionnaire was filled out by every participant. GRBAS scale was used for perceptual voice evaluation. Acoustic analyses were conducted by Multi-Dimensional Voice Program (MDVP) (Computerized Speech Lab, Kay Elemetrics Corporation, Lincoln Park, NJ). Fundamental frequency (fo), Jitter percent (Jitt), Shimmer percent (Shim), noise to harmonic ratio (NHR), maximum phonation time (MPT), voice turbulence index (VTI), vocal intensity, and scale parameters were categorized as predelivery (a) and postdelivery (b). Results Comparison of acoustic parameters of the third trimester with the third month postpartum revealed statistically significant increases for fo (p = .013), MPT (p = .008), and vocal intensity (p≤.001) as well as a significant decrease for VTI (p≤ .001). No statistically significant difference was found for NHR, Jitt, and Shim. Comparison of both VHI-10 and GRBAS scores revealed statistically significant decreases. Conclusions Disturbances in certain vocal parameters suggest that vocal abnormalities observed during pregnancy are mainly due to anatomical alterations of the lower respiratory system. It would be appropriate to warn pregnant women about bad vocal habits and vocal hygiene. In addition, it would be appropriate to recommend professional voice support to pregnant women who use their voices intensively due to their profession.

Is the Cepstral Analysis Sensitive Enough to Detect Untrained/Trained Resonant Voice in Healthy Subjects? A Preliminary Study

Objectives: In training resonant voice, clinicians rely on listening and feeling sensations that are subjective in nature. In the present study, the aim was to find out if cepstral analysis was sensitive enough to distinguish a resonant voice from an unresonant voice in healthy subjects. It was suggested that the immediate effect of humming exercise could be shown by accompanying higher Cepstral Peak Promince (CPP) and lower CPP standard deviation (CPP SD). Materials and Methods: Study included 20 vocally healty subjects aged between 20-30 years. All the participants were trained Humming exercise by teaching airflow technique. The recording protocol was repeated before and after resonant voice training. The recordings were gathered for the three samples of a) Humming b) A sentence weighted with nasal phonemes and c) A sentence weighted with all- voiced phonemes. Cepstral analysis recordings were gathered by the ‘Kay Elemetrics Group CSL Model 4300B’ equipment via the Analysis of Dysphonia in Speech and Voice software. Results: In both sentences, CPP values were found numerically higher and CPP SD values were found to be numerically lower after training. The difference was found statistically significant for the post-training value of voiced- weighted sentence (p=0.004). Conclusion: The higher numerical CPP values and lower CPP SD values for both sentences after resonant voice training indicated that cepstral measures were sensitive to detect trained/untrained resonant voice. However, these preliminary findings should be investigated in a larger sample size in order to achieve more reliable data.

Application of a Landmark-Based Method for Acoustic Analysis of Dysphonic Speech

Speakers with dysphonia often report difficulty with maintaining intelligibility in noisy environments; however, there is no objective method for characterizing this difficulty. Landmark-based analysis is a linguistically-motived, knowledge-based speech analysis technique, which may serve as the basis of acoustic tool for describing the intelligibility deficit. As the first step toward development of such a tool, this study examined whether Landmark-based analysis could describe acoustic differences between normal and dysphonic speech. The recordings subjected to the Landmark-based analysis were the first sentence of the Rainbow Passage from 33 speakers with normal voice and 36 speakers with dysphonia. These recordings were selected from the Kay Elemetrics Database of Disordered Voice. The between-group difference was evaluated based on counts of certain Landmarks (LM). The average counts of all LMs were significantly greater in normal speech, t(66.85) = 2.36, P = 0.02. When the group-difference was examined for each LM, dysphonic speech had more [g] and [b] LMs and fewer [s] LMs than normal speech (P < 0.01 for all cases). A classification tree model identified [+s] and [+b] LMs are the primary predictors for the dysphonic speech. The model's misclassification rate was 7.24%. This preliminary investigation demonstrates that LM-based analysis is capable of differentiating dysphonic speech from normal speech. This encouraging result rationalizes future examinations of LM analysis in other areas of interest. For example, LM-based measures could conceivably be used as to quantify general intelligibility, and/or provide insight into underlying mechanisms of intelligibility deficits.

Use of cepstral analysis for differentiating dysphonic from normal voices in children

ObjectivesCepstral measures have mainly been evaluated by studies conducted on dysphonic and healthy adults, and many of these studies have reported the advantages of using cepstral measures for the evaluation of dysphonia however there is a paucity regarding to the cepstral analyses' results in dysphonic children. In this present study, it is hypothesized that cepstral peak prominence (CPP) and some other parameters of cepstral analysis would differ in children with vocal nodules when compared with the same parameters of cepstral analysis of healthy children. MethodsIn this present study, totally 54 children aged between 5 years old to 12 years and 7 months participated. The study group consisted of 20 males and 7 females diagnosed with vocal nodules. The control group consisted of an equal number of age- and gender-matched healthy peers. Analysis of Dysphonia in Speech and Voice software (CSL Model 4500 equipment, Kay Elemetrics Group) was used to gather speech sample recordings according to the Consensus Auditory-Perceptual Evaluation of Voice/Turkish protocol. Cepstral measures of all the six CAPE-V sentences and sustained/a/sample were calculated. CPP, CPP fundamental frequency, CPP standard deviation (CPP SD), Low_high spectral ratio (L/H ratio), L/H ratio standard deviation parameters were taken into account when statistical analyses were completed. In addition to the descriptive statistics of ceptral measures for both groups, the differences between the study and control groups according to the gender were documented. ResultsIt was found that for both genders CPP and CPP SD values were significantly higher for the control group for vowel-weighted sample, all voiced-weighted sample, glottal attack-weighted sample, nasal weighted sample, and voiceless-weighted sample. In the vowel-weighted sample, CPP and CPP SD were significantly higher for the control group in males. In females, a difference was only observed on the CPP parameter for the same sentence. In terms of the CPP value of the sustained phonation sample, a significant difference was only detected for males, whereas no difference was detected for females. ConclusionsIn conclusion, present study found that cepstral analysis can be used to determine the difference between dysphonic and healthy voices of children and indicated that cepstral analysis should be a compulsory component of routine clinical voice evaluation of children. In addition, this present study indicates that of the cepstral analysis of sentences appear to be more sensitive to dysphonia than the analysis of vowel samples. In future studies, normative values of the CAPE-V/Turkish sentences and cutoff values for differentiating dysphonia from normal voice should be evaluated using a larger sample size.

Surgical Treatment Modalities for Iatrogenic Anterior Glottic Stenosis.

The aim of this study was to describe common iatrogenic causes of anterior glottic stenosis and to investigate the surgical treatment outcomes of 3 different techniques aimed at repairing stenoses and preventing web reformation. Clinical information regarding patient demographics, presentation, etiology, treatment, and follow-up outcomes was obtained retrospectively through a review of patients' records between April 2010 and April 2017. Voice quality was evaluated using grade, roughness, breathiness, asthenia, and strain scale and Voice Handicap Index scores. Objective acoustic parameters were collected using the Kay Elemetrics Multi-Speech program. Twenty patients were included in the study. Causes of glottic web formation included chemoradiation therapy and previous laryngeal surgery for polyps or malignant tumors at the anterior commissure. Web lysis with a CO2 laser, intralaryngeal suturing, and keel placement were used in surgical treatment. Satisfactory results were achieved in 19 patients, and 1 recurrence was observed. Grade, roughness, breathiness, asthenia, and strain scale and Voice Handicap Index scores and objective voice variables for patients with Cohen type I or II webs improved significantly after the surgery. Treatment modalities for anterior glottic stenosis should be carefully chosen according to the etiology of the web, as well as the length and depth of the glottis involved.

Koklear implantlı çocuklarda sesin artikülasyon özelliklerinin değerlendirilmesi

Objective: To investigate the effect of cochlear implantation on articulation by using voice- onset time (VOT). Methods: At the first phase of this study, a total of 25 children without hearing loss were examined. VOT values of Turkish plosive consonants of /p/, /b/, /t/, /d/, /k/, /g/ specific to this age group were estimated, and their standardization was achieved. To this end, Kay Elemetrics CSL 4400 software (Key Elemetrics Ltd, Lincoln Park, NJ, USA) was used. Referencing these VOT values, 40 children ages ranging between 4 and 11 years who underwent cochlear implantation in our clinic were divided into six groups based on the duration of cochlear implantation, and VOT values were determined in these groups. These groups were compared within themselves, and with healthy children. Results: VOT values of consonants increased as the duration of cochlear implantation increased and approached to those of the children with normal hearing, and at the end of four years of cochlear implant use, they caught up with those of the normal hearing group. Conclusion: Our results have shown that early stage implantation, and use of implant for an adequate time period have a favorable impact on articulation in other words on comprehensibility of speech. We thought that VOT can be use in the evaluation of the effect of cochlear implant on the development of speech.

Voice Profile Recovery and Quality of Life Changes After Microdirect Laryngoscopy in Three Categories of Glottis Lesions: Benign, Precancerous, and Malignant

The aim of the study was comparison of voice and life quality after microdirect laryngoscopy in three patient histopathological categories: benign, precancerous, and malignant glottic lesions. A totalnof 137 patients treated with microdirect laryngoscopy were included in the study. Each patient was evaluated with a multidimensional protocol before and 3, 6, and 12 months after treatment. Final 1-year evaluations were achieved in 74.5% (102). The assessment included laryngovideostroboscopy (LVS), perceptual (GRBAS) grading, aerodynamic measures including maximum phonation time and phonation quotient and acoustic measurements (Kay Elemetrics Multi-Speech program), Voice Handicap Index (VHI), Voice-Related Quality of Life questionnaire; and World Health Organization Quality of Life Scale-Brief Version (WHOQoL-BREF). An improvement in mean value of LVS ratings was obtained in all three groups; however, only in benign lesion group was it consistently statistically significant for each time period (P < 0.001). Perceptual evaluation revealed significant improvement of G, R, and B parameters in benign lesions for each time period. In malignant neoplasms R and B parameters improved 3 and 6 months post microsurgery. In patients with benign lesions the maximum phonation time increased, but the improvement was significant only after 3 months. The acoustic parameters improved in all three groups. VHI significantly improved in patients with benign lesions after 3 and 12 months. VHI in the malignant neoplasm group significantly worsened on the first follow-up visit. Considering quality of life (QoL) results, only in patients with benign lesions was there a significant improvement in overall assessment of their QoL and general health.

Acoustic analysis of voice signal: Comparison of four applications software

Abstract Objectives To describe the results of the acoustic analysis of a database of 90 voice samples with distinct dysphonia levels, using four different – commercial and open source – software programs. Study design Exploratory, transversal. Methods The samples were analyzed by four different types of software programs that perform acoustical evaluation – one open source software (Praat) and three commercial ones (Multi Dimensional Voice Program – MDVP by Kay Elemetrics; VoiceStudio by Seegnal; and Dr. Speech by Tiger Electronics) – for comparison among the most commonly used acoustic measures (frequency, perturbation and noise measures). Results There is a moderate to strong correlation, positive and statistically significant among the software programs. The mean F0 is not statistically different among the used applications. The other acoustic measures revealed statistically significant differences. Conclusion Even though it is easier to access software programs and there are numerous proposals for acoustic measures, not all of them are statistically representative nor have numeric semblance among the different applications.

A Review of the Effect of Age and Speech Stimulus on Nasalance Scores in Healthy Participants

Introduction: Instrumental assessments can provide numerical values in nasality assessment. One of these instruments is the nasometer (Kay Elemetrics, Lincoln Park, NJ, USA). The nasometer measures the oral and nasal acoustic energy during speech and the resultant signal is expressed as a nasalance score. The aim of the current review was to study the impact of age and speech stimulus on nasalance score through a systematic review of studies on nasalance. Materials and Methods: The ASHA publication, PubMed, ScienceDirect, Google Scholar, Cochrane, Wiley, ProQuest, IranDoc, and SID databases were searched using the keywords “nasalance”, “nasometer”, “normative nasalance score”, and “instrumental assessment of resonance disorders” for related articles published between 1990 and 2016. Results: Based on the inclusion and exclusion criteria, 38 of the 67 published documents were selected to be reviewed. The review showed that different studies had obtained different results regarding the effect of age and speech stimulus on nasalance scores. Conclusion: As, in addition to age and speech stimulus, many factors (like language, accent, and gender) affect nasalance scores, a meta-analysis study seems to be necessary on this topic.

Akustička i perceptivna analiza ezofagealnog i traheoezofagealnog glasa

Total laryngectomy is a radical surgery where the larynx is completely removed. Each type of surgical treatment has an impact on voice quality and speech intelligibility. However, it is important to know that the methods of speech adoption, esophageal speech and speech with use of tracheoesophageal prosthesis, are available and applicable methods for establishing functional communication between laryngectomy patients. The main objective of this research is to ascertain whether there is a correlation between the acoustic and perceptual characteristics of voice and speech intelligibility observed among persons with use of esophageal speech and persons with tracheoesophageal prosthesis, as well as to examine which of the following characteristics have the greatest impact on speech intelligibility among these two groups of respondents. The research was conducted on a sample of 85 laryngectomy patients, of both genders, 48 to 85 years old. Acoustic vocal characteristics were examined with a computer program for multidimensional analysis of vocals, model 4300 of 'Kay Elemetrics' corporation. Perceptual vocal characteristics were analyzed on GRBAS scale. Phonetically balanced text was used for the subjective assessment of speech intelligibility. For statistical analysis of the obtained data we used: arithmetic mean, standard deviation, frequencies, percentages, ANOVA, Pearson correlation coefficient, linear regression analysis and the multiple correlation coefficient. Study results have shown that the contribution on explaining the assessment of speech intelligibility are provided by parameters of speech perceptual analysis. The highest degree of variance in the speech intelligibility assessment is explained with the model composed of scores on the GRBAS scale, R parameters (F=26.1; p=0.000) (roughness of the voice), A (F=26.1; p=0.001) (asthenia) and S (F=18.33; p=0.000) (strain).

Vocal Range in the Speech of Users of Low-Dose Oral Contraceptives

The study aimed to investigate the vocal range of oral contraceptive (OC) users aged between 20 and 30 years. This is a cross-sectional study. Forty-eight women aged 20-30 years who used low-dose OCs and 24 age-matched women who did not use oral monophasic contraceptives (w/oOC) were enrolled. Acoustic analysis was performed using the Motor Speech Profile program, Model 4341 (Kay Elemetrics Corp). Data were analyzed using generalized estimating equation. In the w/oOC group, the highest vocal tones in the sentence uttered using exclamatory intonation were similar in the follicular phases of two cycles (F1: 289 ± 46 Hz; F2: 284 ± 61 Hz). In the luteal phase of the first cycle, the vocal tones were lower, whereas in the second cycle they were higher than the tones in both follicular phases (L1: 274 ± 42 Hz; L2: 291 ± 62 Hz) (P = 0.056). In the highest vocal tones of the same sentence uttered using exclamatory intonation, the OC group showed lower tones (284 ± 53 Hz) than the w/oOC group (298 ± 44 Hz) (P = 0.048). In the lowest vocal tones of utterances of joy, the OC group showed higher values (180 ± 39 Hz) than the w/oOC group (169 ± 44 Hz) (P = 0.024). The close proximity of the highest to the lowest values of utterances of joy in the OC group (321 ± 59 Hz and 180 ± 39 Hz), when related to the w/oOC group (338 ± 65 Hz and 169 ± 44 Hz), suggests a reduced vocal modulation. The present findings demonstrate that the use of low-dose OCs influences the vocal range of women during menacme.

THE EFFECT OF SINGING TRAINING ON ACOUSTIC PARAMETERS OF VOICE

The aim of the present study is to analyze the impact of singing training on the acoustic properties of students’ voices. The participants of the stuy were 20 students between 19 and 32 without absenteeism ranging from the 1st to the 4th grade. The voices of 12 female and 8 male students, enrolled at Selcuk University Dilek Sabanci State Conservatory Opera Maindepartment, Sub-department of Vocal Arts were recorded throughout 2014-2015 academic year using Shure Sm 48 model microphone in order to determine their acoustic properties using CSL (Computerized Speech Laboratory) 4500 to the computer with Kay Elemetrics MDVP (Multi Dimensional Voice Program). In order to determine changes in the acoustic parameters and evaluate the effectiveness of the singing training given, a single sample -pre and post-test research design was used. Hence, among the acoustic properties, F0, (Fundamental Frequency) F1, F2, F3, F4, F5, formant frequencies, jitter (%), shimmer (%), NHR (Ratio of harmonic noise) parameters were evaluated. The statistical analyses made for the comparison of MDVP parameters before and after the vocal training revealed no statistically significant difference in the students’ F0, Jitter, Shimmer, NHR, F1, F2, F3, and F4 acoustic parameters. However, the F5 formant value revealed statistically significant differences in all the students and a statistically significant difference was seen in the F0 parameter and F5 formant values of female students. Fundamental frequency (F0) is an important parameter changing throughout the singing training process among the female students’ acoustic characteristics. The increase in the F5 formant values of female students and the acoustic properties of all students within normal ranges could be considered as an indicator of the positive impact of the singing training received.

The ageing voice and voice therapy in geriatrics.

Although voice therapy is commonly used as an initial treatment for geriatric dysphonia, its role in the treatment for different organic voice disorder is less defined. The goal of this study was to investigate dysphonia and therapy modalities in this cohort. This study analyzes the demographics, Voice Handicap Index questionnaires, and acoustic voice measures including fundamental frequency, jitter and shimmer by using Kay Elemetrics Computerized Speech Lab Multidimensional voice program which were obtained in all patients before and after treatment. A total of 91 (55 men and 36 women) patients with voice complaints, age ranging from 50 to 91years (mean 64.11±7.2) diagnosed of any vocal fold pathology were made via strobovideolaryngoscopy. Vocal nodules in 23.9% (N=22) was the most common diagnosis associated with the voice complaints, followed by laryngopharyngeal reflux in 10.8% (N=10) and paresis in 9.78% (N=9). VHI scores varied greatly, ranging from 4 to 92, with an average score of 42.7. Multidimensional voice program scores showed that fundamental frequency (F0) tends to rise as a function of age in men (mean 283.66±23.7). Fundamental frequency perturbation may be affected in ageing, both genders same values detected. Of these patients, 80% received hygienic voice therapy and % 20 symptomatic voice therapies. This study identified fundamental frequency alteration for ageing voice and dysphonia in all elderly patients presenting with voice complaints. Additional research is needed to determine normative values for multidimensional voice program scores and other assessments in the elderly population.

장애 음성 판별을 위한 의료/전자 융복합 소프트웨어 개발

If the software is developed to analyze the speech disorder, the application of various converged areas will be very high. This paper implements the user-friendly program based on CART(Classification and regression trees) analysis to distinguish between normal and pathological voices utilizing combination of the acoustical and HOS(Higher-order statistics) parameters. It means convergence between medical information and signal processing. Then the acoustical parameters are Jitter(%) and Shimmer(%). The proposed HOS parameters are means and variances of skewness(MOS and VOS) and kurtosis(MOK and VOK). Database consist of 53 normal and 173 pathological voices distributed by Kay Elemetrics. When the acoustical and proposed parameters together are used to generate the decision tree, the average accuracy is 83.11%. Finally, we developed a program with more user-friendly interface and frameworks.

Do Pharyngeal Surgeries for Snoring and Obstructive Sleep Apnea Have an Impact on Nasalance Scores?

Most of the surgeries which are used in the treatment of habitual snoring and obstructive sleep apnea (OSA) mainly target velopharyngeal structures, which play an important role in voice characteristics such as nasalance. The aim of this study is to assess the effect of different types of such surgical procedures including expansion sphincter pharyngoplasty (ESP), lateral pharyngoplasty (LP), and anterior palatoplasty (AP) on nasalance scores. Forty-nine consecutive patients with primary snoring or OSA who underwent AP, LP, and ESP procedures were included in this study. All patients underwent a fully attended overnight polysomnography and detailed otolaryngologic examination. Nasalance studies were performed with Nasometer II instrument (model 6400; Kay Elemetrics, Lincoln Park, NJ) by reading 3 passages that were categorized according to the amount of nasal consonants (oral, oro-nasal, and nasal passages), preoperatively, and 3 months after surgery. There was no statistically significant difference in either group between preoperative and postoperative assessments of nasalance scores for all 3 passages. Seven patients experienced nasal regurgitation symptoms for fluids for a short time after LP, 2 patients after AP, and 7 patients after ESP. None of these symptoms showed persistence and diminished approximately at 1-month follow-up. Anterior palatoplasty, LP, and ESP seem not to have any impact on nasalance scores of males.

Employing linear prediction residual signal of wavelet sub-bands in automatic detection of laryngeal pathology

An automatic voice pathology detection scheme based on the processing of speech signal is introduced that is highly reliable in detecting various vocal folds impairments. Using linear prediction (LP) analysis to accurately keep track the variations of glottal signal from speech signal is the key element of our proposed method. The linear prediction-based residual signal estimation is employed to monitor the irregularity of glottal signal with the aim of providing information about vocal folds status. The procedure is done by decomposing a voiced signal (/a/) selected from Kay Elemetrics databases using 1-D discrete wavelet decomposition in four levels, and then applying linear prediction (LP) analysis on achieved coefficients of wavelet sub-band to capture a time-frequency representation of vocal folds vibrations. Support vector machine is finally used to make a decision about the existence of any abnormality in the vocal folds of the analyzed sample. Experimental results indicate that the extracted residual signals from wavelet sub-bands provide highly reliable features especially where there are a variety of abnormal voices that are applicable for assessing voice quality and the effectiveness of the prescribed rehabilitation medicine.