Phonetic convergence is the process by which a speaker adapts his/her speech to sound more similar to his/her interlocutor. While most studies analysing this process have been conducted amongst speakers sharing the same language or variety, this experiment focuses on imitation between non-native and native speakers in a repetition task. The data is a fragment from the ANGLISH corpus designed by Anne Tortel (Tortel, 2008). 40 French speakers (10 male intermediate, 10 male advanced, 10 female intermediate and 10 female advanced learners) were asked to repeat a set of 20 sentences produced by British native speakers. Segmental (vowel quality), suprasegmental (vowel duration) and voice quality were analysed. Level of proficiency, gender and model talker were taken as independent variables. Level appeared not to be a relevant parameter due to a high amount of inter-individual variability amongst groups. Somewhat contradictory results were observed for vowel duration and F1-F2 distance for male learners converged more than female learners. Our hypothesis that low vowels display a higher degree of imitation, and especially within the F1 dimension (Babel, 2012), was partially validated. Convergence in vowel duration in order to sound more native-like was also observed (Zając, 2013). Regarding the analysis of voice quality, and more particularly of creaky voice, observations suggest that some advanced female learners creaked more than the native speakers and more in the reading task, which indicate, both linguistic idiosyncrasy and accommodation towards the native speakers. Low vowels seem also to be more likely to be produced with a creaky voice, especially at the end of prosodic constituents.

Extramedullary plasmacytoma (EMP) is a rare form of plasma cell neoplasm that originates from B lymphocytes. It accounts for only 4% of all plasma cell disorders. We present two cases of EMP that were diagnosed in two different locations. The first case is a 55-year-old presented with epistaxis and sinusoidal polyps. Histologic examination disclosed plasmacytoma. The second case is a 69-year-old patient presented with upper airway obstruction caused by laryngeal mass and histologic examination revealed plasmacytoma of the larynx. Our cases are unique in their presentation and anatomic locations. To our knowledge, sinusoidal and laryngeal occurrences of the disease are only reported in a handful of cases. Both cases were treated mainly with radiotherapy. The postoperative phase was uneventful. J Med Cases. 2018;9(11):371-374 doi: https://doi.org/10.14740/jmc3179

Objectives: Describe surgical results of transoral CO2 LASER Microsurgery for laryngeal cancer.\nMaterial and methods: Retrospective analysis of 29 patients with oropharyngeal and laryngeal cancer submitted to transoral LASER microsurgery between 2009 and 2015 in the Hospital de Egas Moniz.\nResults: Two patients had oropharyngeal cancer and 29 laryngeal cancer. The tumors were classified in Tis (2 cases), T1 (17 cases) and T2 (10 cases). Twenty-eight cordectomies (26 patients) were performed, 3 for tumor removal in supraglottis. Recession was performed always with negative margins. Three patients died during follow up (2 were not related with laryngeal tumor and 1 because of pulmonary mestastasis). One patient had ganglionar metastasis. In the postoperative period 3 patients developed synechias of the anterior comissure (assintomatic) and 2 developed dysphagia (1 temporary and 1 definitive).\nConclusion: Transoral CO2 LASER Microsurgery allows the removal of tumors of the larynx with good results and low morbidity.

Objective To evaluate the efficacy of airway topical anesthesia with combination of superior laryngeal nerve block (SLNB) and thyrocricoid membrane puncture for tracheal intubation in the pediatric patients with Pierre Robin Sequence. Methods Thirty-two American Society of Anesthesiologist physical status Ⅰ or Ⅱ pediatric patients with Pierre Robin Sequence, aged 5-12 months, weighing 5-13 kg, scheduled for elective cleft palate repair under general anesthesia, were divided into 2 groups (n=16 each) using a random number table method: control group (group C) and airway topical anesthesia with SLNB-thyrocricoid membrane puncture group (group ST). After anesthesia was induced by inhaling sevoflurane by mask on admission to the operating room, 2% lidocaine 0.5 ml was injected around the bilateral superior laryngeal nerve under ultrasound guidance, and then 2% lidocaine 1 ml was injected via the thyrocricoid membrane in group ST, and the root of tongue, pharynx and larynx were sprayed with 2% lidocaine by using a laryngotracheal mucosal atomization device in group C. The pediatric patients were tracheally intubated guided by a video laryngoscope 3 min later.The development of cardiovascular responses, vocal cord activity and body movement was recorded during intubation.The intubation time, success rate of intubation at first attempt and patient′s tolerance to tube were recorded.The occurrence of postoperative hoarseness was also recorded. Results Compared with group C, the incidence of cardiovascular responses, vocal cord activity and body movement was significantly decreased, the intubation time was shortened, the success rate of intubation at first attempt was increased, and the patient′s tolerance to tube score was decreased in group ST (P<0.05). Conclusion Airway topical anesthesia with combination of SLNB and thyrocricoid membrane puncture can provide better intubation conditions when used for the pediatric patients with Pierre Robin Sequence. Key words: Nerve block; Anesthesia, local; Intubation, intratracheal; Pierre Robin Syndrome

Recurrent respiratory papilloma is a common benign tumor in the larynx, infected by human papillomavirus. Clinically, it is mainly characterized by recurrence of the disease, and repeated surgical resection is the main treatment method. The risk of cancer is significantly different between the two types of juvenile and adult patients, the latter is more susceptible to cancer. Therefore, to grasp the expression of cancer-associated genes for the further understanding of the disease is privotal to its treatment. This paper will review the current situation of cancer-related genes. Key words: Respiratory Tract Diseases; Papilloma; Genes

Background/Aims: Creaky voice in American English plays both a prosodic role, as a phrase-final marker, and a sociolinguistic one, but it is unclear how accurately naïve listeners can identify creak, and what factors facilitate or hinder ist identification. Methods: In this study, American listeners are presented with 2 experiments containing stimuli from both high- and low-pitched male and female speakers. Other manipulations include whether the auditory stimulus is a full sentence or a sentence fragment, and whether it is completely modally voiced, completely creaky, or partially creaky (final 40-50% of the utterance). Results: Accuracy is lowest on partial creak, suggesting that creaky voice is least salient when it serves as an utterance-final marker. There are no strong gender effects aside from a weak tendency to identify creak more often in females than males in the whole creak condition in one experiment. In contrast, when no creak is present, listeners false alarm on the low-pitched males. Conclusion: Rates of identifying creak in male and female speakers are similar, suggesting that listeners have a comparable ability to hear creaky voice in all speakers.

Abstract Mock white girl(MWG) performances parody a linguistic and embodied style associated with contemporary middle class white girls in the United States. The article identifies bundles of semiotic resources in the stylization of the white girl persona—for example, creaky voice, uptalk, blondeness, and Starbucks—in three genres of MWG:Savior,Shit white girls say, andTeenage girl problems. While semiotic variables used to index the white girl persona are consistent across performances, there is significant variation in performers’ ideological stances relative to the mocked figure of personhood: white girls in the US are not ‘heard’ in any one way by all social actors. Contextualizing MWG performances through analysis of stance reveals critical variation in how the white girl is interpreted, evaluated, and produced as a meaningful social entity by diverse segments of the population. (Gender, mock, race, parody, persona, stance, style)*

Objective To analyze the clinical features and prognosis of extra-nodal nasal NK/T cell lymphoma originated from the larynx. Methods Clinical data of 15 cases of extra-nodal nasal NK/T-cell lymphoma originated from the larynx were retrospectively analyzed. The overall survival (OS) and progression-free survival (PFS) were calculated by Kaplan-Meier survival analysis. The effect of different clinical factors on the clinical prognosis was assessed by univariate analysis. Results Among 15 patients, 13 cases were male and 2 female. The median age of onset was 40 years. In 8 cases, the lesions were confined to the larynx, and only 4 cases suffered from cervical lymph node involvement. According to Ann Abor staging, 11 cases were classified as grade I, 3 as grade Ⅱ and 1 as grade Ⅲ.The median OS was 28.0 months and the 5-year OS was 32.0%.The median PFS was 24.7 months and the 5-year PFS was 33.3%.Among 14 patients with stage Ⅰ/Ⅱ, the clinical prognosis of patients receiving combined chemo-radiotherapy was significantly better than those of their counterparts undergoing radiotherapy or chemotherapy alone (median OS: 37.2 vs.11.2 vs.3.7 months, P=0.004). Conclusion Extra-nodal nasal NK/T cell lymphoma originated from the larynx is extremely rare, predominantly in middle-aged male patients. The general condition is relatively favorable. Patients present with multiple lesions in the early stage and relatively poor prognosis. The clinical efficacy of chemotherapy combined with radiotherapy is probably higher compared with that of radiotherapy or chemotherapy alone. Key words: Extra-nodal natural killer/T-cell lymphoma, nasal type; Larynx; Prognosis

Objective To evaluate the safety, feasibility and operational effectiveness of master-slave system controlled Robot-assisted flexible endoscopy 'YunSRobot’ in upper gastrointestinal endoscopy examination in living pigs. Methods Seven Guangxi BA-MA Mini-pigs underwent upper gastrointestinal endoscopy examination with master-slave system controlled Robot-assisted flexible endoscopy 'YunSRobot’ and Olympus GIF-Q260J gastroendoscope (Japan). The experiment divided into manual operation group and robot operation group. Nine gastroenterologists skilled with endoscopy operation handled the robot once in vitro to familiar with the mechanism and method of robot operation. And then performed manual operation and robot operation four times each. Endoscopy pictures and operation time were recorded. T test and one-way analysis of variance were performed for statistical analysis. Results Both manual operation and robot operation could successfully finish standard esophagus and stomach endoscopic examination. There were no complications such as hemorrhage, perforation, mistaken insertion into of trachea, injures of pharynx and larynx and inhalation pneumonia. Esophagus, gastric cardia, gastric fundus, gastric body, gastric angle, gastric antrum and gastric pylorus could be clearly observed in both groups. The manual operating time of nine gastroenterologists was (3.67±1.95) minutes, which was shorter than that of robot operating time ((7.60±2.00) minutes), and the difference was statistically significant (t=8.445, P<0.01). The time of first in vitro operation performed by nine gastroenterologist was (13.10±6.32) minutes. The operation times of each case of nine gastrienterologist were (8.49±0.90) minutes, (7.50±1.19) minutes, (7.30±1.33) minutes and (7.12±1.61) minutes. The difference was statistically significant (F=7.901, P<0.01). Operation time gradually shortened and operation proficiency significantly improved. Conclusion Master-slave system controlled Robot-assisted flexible endoscopy 'YunSRobot’ which provides a clear observation of esophagus and stomach is safe in endoscopic examination of living animal. Key words: Esophagoscopy; Gastroscopy; Animal experimentation; Flexible endoscope robotic system; YunSRobot; Digestive endoscope robot

The History of the Thirty Years in the Basic Laryngological Research

Introduction: Head and neck cancer (HNC) is a vast group of oncological conditions, which have as an origin various tissue types and organ localizations, situated in the topographical regions of the head and neck (H&N). This single institution retrospective study aims to establish the HNC patient demographics and categorize the separate instances of H&N malignancies, in regards to their organ of origin and main histopathological type and depict the demographics and incidence of the individ­ual entries. Materials and methods: All histologically verified cases of HNC from the St. Marina University Hos­pital, Varna, Bulgaria - a tertiary referral center, were retrospectively reviewed in a descriptive man­ner. Data sampling period was 47 months, from September 2012 to July 2016. Results: HNC Male to female ratio was 3.24:1. The mean age of diagnosis was 63.84 ± 12.65 years, me­dian 65 years. Common HNC locations are the larynx 30.37% (n = 188), lips and oral cavity 29.08% (n = 180), pharynx 20.03% (n = 124) and salivary glands 10.94% (n = 68), with the external nose, na­sal cavity and sinuses and auricle and external ear canal presenting a minority of the cases. The main histopathological groups include squamous cell carcinoma 76.74% (n = 475) and adenocarcinoma 6.14% (n = 38), other malignancies such as other epithelial malignancies, primary tonsillar, muco­sa-associated lymphoid tissue or parenchymal lymphomas, connective tissue neoplasias, neuroendo­crine and vascular malignancies make up a minority of the cases. Based on the collected data the an­nual incidence of HNC in the region is 17.16 per 100.000 capita. Conclusion: Deemed to be of relatively low frequency (worldwide 3%- 5%, Bulgaria 4.41%), HNC rep­resents a varied group of oncological entities with individual and specific demographic characteris­tics.

Lengthening and creaky voice are associated with prosodic finality in English. Listeners can use lengthening to identify both utterance-internal and final prosodic phrase boundaries and can use creak to locate utterance endings. Less is known about listeners' use of creak to locate internal prosodic boundaries and the relative importance assigned to duration and creak when both are present. Participants in two experiments segmented structurally ambiguous sentences in which duration and creak were manipulated to signal prosodic boundaries. When duration- and creak-based cues provided redundant information, their effects were additive. When these cues conflicted, the effect of creak was subtractive.

White Hmong contrasts two high-falling tones (one breathy, the other modal) and two low tones (one modal level-tone, the other creaky low-falling). Perceptual studies [Garellek et al. (2013)] have shown that listeners rely on breathy voice to distinguish between the high-falling tones, but ignore creaky voice when distinguishing between the low tones. We test whether such differences stem from prosodic variation, by examining tokens from stories read by native speakers. Vowels were annotated for phrasal position and neighbouring tones. We obtained f0 and voice quality measures. Results support and help elucidate previous perceptual research: (1) the breathy high-falling tone is breathy in all prosodic positions, (2) the breathy high-falling tone has a prosodically-variable f0, (3) the creaky low-falling tone has a prosodically-stable f0. The creaky low-falling tone is creakier than the modal low tone in all positions. Therefore, listeners may ignore f0 in the identification of the breathy high-falling ton...

Irregular pitch periods (IPPs) occur in a wide variety of speech contexts and can support automatic speech recognition systems by signaling word boundaries, phrase endings, and certain prosodic contours. IPPs can also provide information about emotional content, dialect, and speaker identity. The ability to automatically detect IPPs is particularly useful because accurately identifying IPPs by hand is time-consuming and requires expertise. In this project, we use an algorithm developed for creaky voice analysis by Kane et al. (2013) incorporating features from Ishi et al. (2008) to automatically identify IPPs in recordings of speech from the American English Map Task database. Short-term power, intra-frame periodicity, inter-pulse similarity, subharmonic energy, and glottal pulse peakiness measures are input into an artificial neural network to generate frame-by-frame creak probabilities. To determine a perceptually relevant threshold probability, the creak probabilities are compared to IPPs hand-labeled by experienced raters. Preliminary results yielded an area under the receiver operating characteristic curve of 0.82. Thresholds above 0.1 produced very high specificity, but even lower thresholds yielded fairly high sensitivity and specificity. These results indicate generally good agreement between hand-labeled IPPs and automatic detection, calling for future work investigating effects of linguistic and prosodic context.

In American English, voiceless codas /t/ and /p/ are often glottalized: They have glottal constriction that results in creaky voice on the preceding vowel. Previous claims suggest that such glottalization can serve to enhance /t/ or, more generally, voicelessness of coda stops. In this study, we examine the timecourse of word recognition to test whether glottalization facilitates the perception of words ending in voiceless /t/ and /p/, which is expected if glottalization is in fact enhancing. Sixty American English listeners participated in an eye-tracking study, where they heard resynthesized glottalized and non-glottalized versions of CVC English words ending in /p, t, b, d/ while looking at a display with two words presented orthographically. Target words were presented with a minimal pair differing in place of articulation (e.g., cop-cot), or voicing, (e.g., bat-bad, cap-cab). Although there is little evidence that glottalization facilitates recognition of words ending in /t/ or /p/, there is a strong inhibitory effect: Words ending in voiced stops are recognized more slowly and poorly when the preceding vowel was glottalized. These findings lend little support to a listener-driven, enhancement-based explanation for the occurrence of coda glottalization in American English. On the other hand, they suggest that glottalized instances of coda /t/ and /p/, but not of coda /d/ and /b/, are perceived as equally good variants of these sounds.

Primary solitary extramedullary plasmacytoma of the larynx involving the true vocal cords is an extremely rare entity. Extramedullary plasmacytoma has the potential to transform into multiple myeloma and mandates strict vigilance and routine follow-up. We describe such a case in a 29-year-old pregnant woman who presented with progressive hoarseness, dysphagia and intermittent respiratory difficulty. Fiberoptic laryngoscopy revealed a fleshy mass involving the posterior third of the true vocal cords, encroaching on the ventricle and false cords. Histopathology and immunohistochemistry revealed extramedullary plasmacytoma of a monoclonal nature. In spite of Bence Jones proteinuria and a rising serum β 2-microglobulin level, a thorough search for metastasis and subsequent treatment with radiotherapy were delayed due to the patient's pregnancy. She is the youngest adult ever reported with primary solitary extramedullary plasmacytoma involving the true cords. Described for the first time in pregnancy, the relevant issues in management are highlighted.

Recurrent Respiratory Papilloma is a common benign tumor of the respiratory tract. Adult laryngea papilloma is a common precancerous lesion of the larynx, prone to relapse and malignant tendency, and is a common precancerous lesion of the larynx. The serious lesion can endanger the patient's life, greatly reduce the quality of life of the patients, and bring a heavy psychological and financial burden to the patient and family. Reducing the recurrence time and the malignant transformation rate and improving the therapeutic effect is still a difficult problem to be solved in clinical practice, which challenges the establishment of precise medical and translational medical model. This article reviews the current treatment of adult recurrent respiratory papillomatosis. Key words: Papilloma; Adult; Surgical Procedures, Operative

Accurate knowledge of the dimension, shape, and morphology of larynx and its complex anatomy is a prerequisite for performing surgery of the larynx. Population differences are important not only for planning surgical interventions but also for performing an operation. Previous morphometrical studies on the larynx had shown variable results obtained from different populations, including Western and Eastern ones, yet information about larynx morphometry in Anatolian population is limited. The purpose of this study is to make more statistical data available for Anatolian population and help clinicians for surgical approaches related to this area. Ten parameters from anterior and lateral views were measured on 50 thyroid cartilages taken from autopsy specimens (28 male, 22 female). Specimens were removed and dissected under stereomicroscope after routine fixation procedure. Those with visible deformations were eliminated during dissections. Statistical evaluations and comparisons were done for a comprehensive description. Significant sexual differences were observed. Mean values for all parameters were higher in males than in females. These results were compared with already existing anatomical data of other populations. This study on larynx specimens from different regions of Anatolia provides a general knowledge of thyroid cartilage dimensions. The obtained results can have great clinical influence on surgical approaches to the related area and give information for anthropomorphic studies.

Abstract Stimuli produced by a female speaker with four different voice qualities - modal, girlish, breathy and creaky - were manipulated to have more or less formant dispersion and were rated on four scales (dominance, attractiveness, sexiness and youthfulness) by men and women. Stimuli with less formant dispersion were rated more dominant and those with more dispersed formants were rated as less dominant. Breathy voice and girlish voice were rated more attractive and sexy. Stimuli with a creaky voice were rated less attractive and sexy, as were stimuli with less formant dispersion. Girlish voices and those with greater formant dispersion were rated as more youthful; creaky voices and those with less formant dispersion were rated as less youthful. There were also gender differences in ratings of attractiveness and youthfulness. Our results suggest that women’s voice qualities can affect perceptions of their attractiveness, sexiness and youthfulness. We discuss the implications of these findings in the context of social signaling.

Our understanding of the evolution of human speech has been expanded by an increased knowledge of vocal anatomy and physiology in non-human primates. Comparative approaches provide evidence supporting the primate origins of many speech faculties. The descent of the larynx enables the two-tube configuration of the supralaryngeal vocal tract (SVT) in humans; however, this configuration is also found in chimpanzees and macaques. The acoustic properties of voices produced in helium gas support the view that vocalizations are usually produced through SVT resonance, with the sound source generated by vibration of the vocal folds in gibbons and marmosets, as seen in human speech. Nonhuman primates produce a wider range of vocal repertoire than previously thought, reflecting their varied manipulations of the vocal apparatus to modify SVT topology. These species often actively descend the hyoid and larynx to produce calls. This ‘active’ descent is one of the options for SVT modification in non-human primates. However, this is distinct from human speech, where a ‘static’ descended larynx moves in a restricted range during speech. Instead, humans modify SVT configuration by combinations of contraction and relaxation of the tongue muscles, to produce their vocal acoustics. The components of the vocal apparatus act under the constraint of anatomy, and various associations of anatomy and vocal actions are expected to be found in a variety of types of vocalization in non-human primates. Increasing knowledge of their anatomy and physiology promises better understanding of primate origins and of the evolutionary history of physical faculties in human speech.