Multi-Dimensional Voice Program Research Articles

Cepstral, Spectral and Time-Based Analysis of Voices of Esophageal Speakers

Objective: To evaluate esophageal speech quality in patients after total laryngectomy using cepstral, spectral and time-based measures. Patients and Methods: The subjects were all males and included 20 total laryngectomy patients and 20 age-matched normal controls. The sustained vowel /a/ was measured using the tools of MDVP (Multi-Dimensional Voice Program) and ADSV (Analysis of Dysphonia in Speech and Voice). Results: Compared to normal controls, esophageal speakers showed significantly lower values for cepstral peak prominence (CPP) and a low- to high-frequency spectral energy (L/H) ratio, but their mean CPP fundamental frequency (CPP F0) was higher. Highly negative correlations were found between CPP and jitter (percent jitter), shimmer (percent shimmer) and noise-to-harmonics ratio (NHR). Positive correlations were also found between L/H ratio and CPP. CPP F0 showed a positive correlation with F0, shimmer and NHR. In addition, CPP and L/H ratio parameters indicated an area under the curve of 0.93 or higher compared to that for time-based measures. Conclusion: This study showed that cepstral and spectral analyses are more effective than time-based analysis in examining the voice quality of alaryngeal speakers. The present findings are expected to contribute to establishing the baseline for voice quality characteristics in total laryngectomy patients.

Detection of Voice Pathology using Fractal Dimension in a Multiresolution Analysis of Normal and Disordered Speech Signals.

Voice disorders are associated with irregular vibrations of vocal folds. Based on the source filter theory of speech production, these irregular vibrations can be detected in a non-invasive way by analyzing the speech signal. In this paper we present a multiband approach for the detection of voice disorders given that the voice source generally interacts with the vocal tract in a non-linear way. In normal phonation, and assuming sustained phonation of a vowel, the lower frequencies of speech are heavily source dependent due to the low frequency glottal formant, while the higher frequencies are less dependent on the source signal. During abnormal phonation, this is still a valid, but turbulent noise of source, because of the irregular vibration, affects also higher frequencies. Motivated by such a model, we suggest a multiband approach based on a three-level discrete wavelet transformation (DWT) and in each band the fractal dimension (FD) of the estimated power spectrum is estimated. The experiments suggest that frequency band 1-1562 Hz, lower frequencies after level 3, exhibits a significant difference in the spectrum of a normal and pathological subject. With this band, a detection rate of 91.28 % is obtained with one feature, and the obtained result is higher than all other frequency bands. Moreover, an accuracy of 92.45 % and an area under receiver operating characteristic curve (AUC) of 95.06 % is acquired when the FD of all levels is fused. Likewise, when the FD of all levels is combined with 22 Multi-Dimensional Voice Program (MDVP) parameters, an improvement of 2.26 % in accuracy and 1.45 % in AUC is observed.

Normative Values and Interrelationship of MDVP Voice Analysis Parameters Before and After Endotracheal Intubation

The Multi-Dimensional Voice Program (MDVP) is used for assessment of voice quality. A simple procedure for MDVP recordings was used in a randomized clinical trial (RCT) on induced vocal fold trauma due to intubation. This secondary study compares the common MDVP parameters with other normative values for adults and investigates the correlation between these MDVP parameters in relation to the "standardized" trauma of endotracheal intubation. Preoperative and postoperative assessments of vocal fold pathology with flexible videolaryngoscopy and voice analysis with MDVP using the best-of-three standardized recording were performed in 121 patients with normal voices included consecutively in the RCT. The procedures of anesthesia were standardized. The normative MDVP values of this study are consistently lower compared with most normative values presented in other studies. The preoperative to postoperative differences in jitter values (jitter and relative average perturbation) were closely correlated to the shimmer values for patients with postoperative vocal fold edemas. In the patients with edema, the preoperative to postoperative differences in jitter had a correlation coefficient of 0.95 (P<0.0001) to the difference in shimmer, compared with a correlation coefficient of 0.39 (P<0.0001) in the patients without edema. This study supports the use of the "Best-of-Three" procedures for precise and relevant MDVP parameter calculations. The MDVP parameters, with closely correlated changes in jitter and shimmer values, accurately reflect the induced vocal fold edema when using the preoperative to postoperative changes.

Acoustic Analysis of Madhya and Taar Saptak/Sthayi in Indian Classical Singers

Objectives: We aimed to compare the acoustic parameters of voice between Madhya Saptak/Sthayi (MS) and Taar Saptak/Sthayi (TS) in trained Indian classical singers and between males and females. Participants and Method: Sixty-five adult trained Indian classical singers were instructed to produce MS and TS; the acoustic parameters were analyzed with the Multidimensional Voice Program. Descriptive statistics were used for analysis across tasks and gender. Two-way random-effects ANOVA was used to test the effect of gender and task. Results: Male participants had a restricted range of fundamental frequency (F0), especially at high pitches. The acoustic analysis showed a statistically significant difference for F0 measures, range of F0, jitter and pitch perturbation quotient between males and females during MS and TS. Conclusion: The use of TS, that is, high-pitch phonation, during the clinical evaluation of singers enables an understanding of their vocal behavior in the higher scales of singing.

Late oropharyngeal functional outcomes of suicidal maxillofacial gunshot wounds.

The aim of this study was to evaluate the long-term aesthetic and functional results of suicidal gunshot injuries using objective methods to identify the residual problems after one-stage reconstruction. Twenty male patients with gunshot injuries resulting from suicide attempts who were treated in the Department of Plastic and Reconstructive Surgery at Gulhane Military Medical Academy were included in the study. The control group was composed of 10 male volunteers. The reconstructions of all involved structures were performed within 1-3 days of the injury. The patients were evaluated both aesthetically and functionally. The Body Satisfaction Scale was used for evaluation of aesthetic appearances of the facial structures. To evaluate swallowing, videofluoroscopy, cine-magnetic resonance imaging, submental electromyography, Functional Endoscopic Evaluation of Swallowing, and submental ultrasound were performed. Perceptual speech analysis was used for speech evaluation. The Body Satisfaction Scale score was statistically higher in the control group than in patients with both ongoing and completed reconstructions (P < 0.05). Swallowing disturbances and their frequencies were higher in the study group than in the control group. The most frequently observed swallowing disturbance was stasis in the sinuses. The laryngeal elevation and geometric angle of the epiglottis in the study group were statistically lower than in the control group (P < 0.05). The mean amplitude of contraction of submental muscles was lower in the study group than in the control group (P < 0.05). The Multidimensional Voice Program showed statistically significant differences between the treatment and control groups (P < 0.01). Objective assessment methods enabled us to retrospectively evaluate the treatment and identify the specific problem underlying functional and aesthetic morbidities.

Vocal Characteristics of Elderly Women Engaged in Aerobics in Private Institutions of Salvador, Bahia

To characterize the voice of elderly people engaged in aerobics. Collection of phonation /a:/ from 58 elderly people engaged in aerobics for perceptual voice analysis (RASATI scale) and computed acoustics (Multi Dimensional Voice Program Advanced, software of Kay Pentax®, that analyzes up to 33 measures, proposing normal ranges according to sex). The Spearman correlation test was used, with significance level of 5%. The association between auditory-perceptual assessment of voice and acoustic parameters was not statistically significant but showed less vocal quality deviations. The association between acoustic measures and age was only statistically significant result for the measurement of fundamental frequency (f0) and maximum f0 (fhi). There was no correlation between time of aerobics and acoustic measures, but there was correlation of those measurements with age. There was a statistically significant positive correlation between f0 and fhi with minimal roughness and standard deviation of f0 with hoarseness, breathiness, and asthenia; jitter and shimmer measures with hoarseness, breathiness, and asthenia; noise measurements with hoarseness, breathiness, and harshness; measures of breaking voice hoarseness and breathiness; measures of voiceless segments with hoarseness and asthenia; measures of subharmonic with hoarseness; and measures of vocal tremor with breathiness, asthenia, and instability. There was a significant negative correlation between minimum f0 with breathiness; jitter measures with tension; and soft phonation index with roughness and instability. Elderly women engaged in aerobics showed mostly normal voice, with most values of acoustic measures within normal and positive correlations between perceptual and auditory vocals and acoustic aspects that suggest instability, noise, and vocal tremor.

Voice features of Parkinson's disease patients with subthalamic nucleus deep brain stimulation.

Voice and speech disorders are one of the most important issues after subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease patients; however, their characteristics remain unclear. We performed a comprehensive voice evaluation including the multi-dimensional voice program for acoustic analysis, the GRBAS scale for perceptual analysis, and the evaluation of the voice handicap index (VHI) for psychosocial analysis. In total, 68 patients who had undergone STN-DBS (37 assessed in the on- and off-stimulation conditions) and 40 who had been treated with medical therapy alone were evaluated. Further, we performed laryngoscopic examinations in 13 STN-DBS and 19 medical-therapy-alone patients. The STN-DBS group, especially females, showed widespread impairment of voice parameters and significantly poorer VHI scores than the medical-therapy-alone group. The degree of voiceless (DUV) and strained voice were the most impaired factors in the STN-DBS group; and DUV significantly improved after stopping stimulation. Furthermore strained voice, breathiness, and asthenia improved after stopping stimulation. Laryngoscopic examination showed that abnormal laryngeal muscle contraction and incomplete glottal closure were more prominent in the STN-DBS group than in the medical-therapy-alone group. We demonstrated that (1) more widespread voice impairment in females, (2) poorer voice-related QOL, (3) worse DUV and strained voice, and (4) abnormal laryngeal muscle contraction were the characteristic voice and laryngeal findings in the STN-DBS group compared with those in the medical-therapy-alone group.

Voice Assessment After Treatment of Subacute and Chronic Cough With Inhaled Steroids

Inhaled steroids are widely used for persistent cough treatment. Although the side effects of long-term inhaled steroids have been well described in the literature, their laryngeal side effects after short-term use have not yet been defined. The aim of this study was to evaluate the effect of 1 month application of inhaled steroid treatment on voice parameters in patients with subacute or chronic cough. Furthermore, the efficacy of inhaled steroids on cough was investigated, as well. This study included 46 patients (27 females and 19 males) with a persistent cough lasting at least 3 weeks and treated with inhaled steroids. All patients were examined by a pulmonologist and lung auscultation where a posteroanterior chest X-ray and spirometry were performed. The patients were also examined by an otolaryngologist. Anterior rhinoscopy, flexible fiberoptic nasopharyngoscopy, and laryngostroboscopy were performed. Also, the patients' acoustic voice analyses were performed and recorded using a multidimensional voice program. Cough symptom index (CSI) scores were used to evaluate the response to treatment. Patients with an underlying disease that was unresponsive to inhaled steroids were excluded from study. The 46 patients were administered inhaled budesonide 400 mcg twice a day, for 1 month, and their acoustic voice analyses were performed again at the end of the treatment. In addition, CSI scores were determined after stopping medication. When pretreatment and posttreatment acoustic voice analysis parameters (Fo, Jita, Jitt, Shim, APQ, vAm, and NHR) were compared, statistically significant differences were detected for vAm (P = 0.001) and F0 (P0.003). After treatment with inhaled steroids, the CSI score reduced from 3 to 1 (median), and the difference was statistically significant. Inhaled budesonide treatment in the proper dose seems to be an effective treatment for persistent cough, in the selected patient group. In addition, short-term budesonide application did not cause any negative effects on the voice parameters in these patients. These findings may be related to the steroid formulation used, the application method, and the duration of treatment. Further studies are needed on a larger group of patients with different formulations of inhaled steroids to clarify aforementioned issues.

The Impact of Tonsillectomy With or Without Adenoidectomy on Voice: Acoustic and Aerodynamic Assessments

To study the objective acoustic assessment and aerodynamic assessment of pediatric patients after tonsillectomy with or without adenoidectomy. Prospective cohort study. Pediatric patients who had received tonsillectomy in our department since 2011 October to 2012 September were selected as study objects. The acoustic analysis was performed by the Multi-Dimensional Voice Program and aerodynamic examination was performed by Phonatory Aerodynamic System. The preoperative and postoperative (1month after surgery) data were compared. The postoperative acoustic index had no obvious change compared with the preoperative data. Among the aerodynamic index, postoperative maximum phonation time prolonged and postoperative subglottal pressure decreased comparing with preoperative index. From the aerodynamic point of view, tonsillectomy with or without adenoidectomy plays a positive role in the improvement of voice production.

Multidimensional Voice Data on Participants With Perceptually Normal Voices From Ages 60 to 80: A Preliminary Acoustic Reference for the Elderly Population

The purpose of this study was to provide a preliminary acoustic reference for an elderly population (aged 60-80) with perceptually normal voices to determine the degree of noise in the vocal signal ofthis population; a younger population (aged 20-30) with perceptually normal voices participated for comparison. The participants were tested on the MultidimensionalVoice Program (model 5105, KayPENTAX, Lincoln Park, NJ), and the following acoustic parameters were evaluated: relative average perturbation (cycle-to-cycle frequency perturbations), shimmer (cycle-to-cycle amplitude perturbations), and noise-to-harmonic ratio (degree of noise in the vocal signal). Fifty participants between the ages of 60 and 80 (mean age, 69.5) and 50 participants between the ages of 20 and 30 (mean age, 23.23) were tested by sustaining the vowel /a/ on the Multidimensional Voice Program. Voice and/or speech samples were also recorded for each participant to reveal perceptually normal voices. The older group had significantly higher levels of relative average perturbation, shimmer, and noise-to-harmonic ratio than the younger group, and males had significantly higher levels of shimmer than females. The acoustic values obtained for the older group with perceptually normal voices resembled data in the literature, particularly when the ages of the participants in the studies were similar. The present findings may possibly be used as a preliminary reference against which to compare clinical acoustic data to older clients with dysphonic voices.

Vocal effectiveness of speech-language pathology students: Before and after voice use during service delivery.

BackgroundAs a professional voice user, it is imperative that a speech-language pathologist's (SLP) vocal effectiveness remain consistent throughout the day. Many factors may contribute to reduced vocal effectiveness, including prolonged voice use, vocally abusive behaviours, poor vocal hygiene and environmental factors.ObjectivesTo determine the effect of service delivery on the perceptual and acoustic features of voice.MethodA quasi-experimental., pre-test–post-test research design was used. Participants included third- and final-year speech-language pathology students at the University of Pretoria (South Africa). Voice parameters were evaluated in a pre-test measurement, after which the participants provided two consecutive hours of therapy. A post-test measurement was then completed. Data analysis consisted of an instrumental analysis in which the multidimensional voice programme (MDVP) and the voice range profile (VRP) were used to measure vocal parameters and then calculate the dysphonia severity index (DSI). The GRBASI scale was used to conduct a perceptual analysis of voice quality. Data were processed using descriptive statistics to determine change in each measured parameter after service delivery.ResultsA change of clinical significance was observed in the acoustic and perceptual parameters of voice.ConclusionGuidelines for SLPs in order to maintain optimal vocal effectiveness were suggested.

An initial study of voice characteristics of children using two different sound coding strategies in comparison to normal hearing children

Objective: To compare some perceptual and acoustic characteristics of the voices of children who use the advanced combination encoder (ACE) or fine structure processing (FSP) speech coding strategies, and to investigate whether these characteristics differ from children with normal hearing. Design: Acoustic analysis of the sustained vowel /a/ was performed using the multi-dimensional voice program (MDVP). Analyses of sequential and spontaneous speech were performed using the real time pitch. Perceptual analyses of these samples were performed using visual-analogic scales of pre-selected parameters. Study sample: Seventy-six children from three years to five years and 11 months of age participated. Twenty-eight were users of ACE, 23 were users of FSP, and 25 were children with normal hearing. Results: Although both groups with CI presented with some deviated vocal features, the users of ACE presented with voice quality more like children with normal hearing than the users of FSP. Conclusions: Sound processing of ACE appeared to provide better conditions for auditory monitoring of the voice, and consequently, for better control of the voice production. However, these findings need to be further investigated due to the lack of comparative studies published to understand exactly which attributes of sound processing are responsible for differences in performance.

Integrating Voice Evaluation: Correlation Between Acoustic and Audio-Perceptual Measures

This article aims to establish correlations between acoustic and audio-perceptual measures using the GRBAS scale with respect to four different voice analysis software programs. Exploratory, transversal. A total of 90 voice records were collected and analyzed with the Dr. Speech (Tiger Electronics, Seattle, WA), Multidimensional Voice Program (Kay Elemetrics, NJ, USA), PRAAT (University of Amsterdam, The Netherlands), and Voice Studio (Seegnal, Oporto, Portugal) software programs. The acoustic measures were correlated to the audio-perceptual parameters of the GRBAS and rated by 10 experts. The predictive value of the acoustic measurements related to the audio-perceptual parameters exhibited magnitudes ranging from weak (R(2)a=0.17) to moderate (R(2)a=0.71). The parameter exhibiting the highest correlation magnitude is B (Breathiness), whereas the weaker correlation magnitudes were found to be for A (Asthenia) and S (Strain). The acoustic measures with stronger predictive values were local Shimmer, harmonics-to-noise ratio, APQ5 shimmer, and PPQ5 jitter, with different magnitudes for each one of the studied software programs. Some acoustic measures are pointed as significant predictors of GRBAS parameters, but they differ among software programs. B (Breathiness) was the parameter exhibiting the highest correlation magnitude.

Laryngopharyngeal reflux, a randomized controlled trial of voice changes after treatment in Scandinavian adults.

A randomized prospective controlled study was made in order to find out if voice related acoustical measures show usable predictive pathologies in patients with laryngo-pharyngeal reflux (LPR), based on high speed films with 4000 pictures of the larynx per second. The main results of this study were that lifestyle changes (according to the standard literature) did optimize the voice in patients with LPR. The used acoustical program was an advanced MDVP (multi-dimensional voice program) by Laryngograph Ltd. which routinely adjusts to well-defined sustained tones measures as well as reading of a standard text and electroglottography. Three treatment groups for LPR with each 78, 70 and 89 patients respectively were treated with standard advice of lifestyle changes, combined with proton pump inhibitors, and a third group with lifestyle changes, proton pump inhibitors and alginate. The mean age was 42, 42 and 41 years, all three groups with a standard deviation of 15 years. There was no difference of treatments effect between the groups; they were therefore added to each other. A comparison between the first and second consultation after two weeks did show shimmer change from 9.35% to 7.76% after two weeks to 7.96% follow up after three months, comparing the first to the third measurement. In reading of a standard text the frequency and intensity variations were also reduced from 10.73% and 16.23% at the first consultation to 9.43% and 15.26% at the second consultation and after three months the frequency variation was 9.51% and 15.77%. So it can be concluded that especially reading of a standard text is changed after treatment of LPR. No change was found of electroglottography. The acoustical findings were not related to the oedema of the arytenoid region based on high speed films with 4000 pictures per second. The acoustical measures should be refined in the future with online measures on high speed films.

Acoustical Voice Measurements did Change after Treatment in Patients with Laryngo-Pharyngeal Reflux: A Prospective Randomized Study Including MDVP (Laryngograph Ltd.)

A randomized prospective controlled study was made in order to find out if voice related acoustical measures show usable predictive pathologies in patients with laryngo-pharyngeal reflux (LPR). The used acoustical program was an advanced MDVP (multi-dimensional voice program) by Laryngograph Ltd. which routinely adjusts to well defined sustained tones measures as well as reading of a standard text and electroglottography. Three treatment groups for LPR were: Life style changes (avoid acid provoking food), and combined with proton pump inhibitors, and the third group also combined with alginate. There was no acoustical difference between the groups; they were therefore added to each other. A comparison between the first and second consultation after two weeks as well as follow up after three months did show significant jitter reduction of the measures of MDVP, and in reading of a standard text the frequency and intensity variations were also reduced. No change was found of electroglottography. The acoustical findings were not related to the oedema of the arytenoid region. The acoustical measures should be refined in the future with online measures on high speed films.

Vocal acoustic and auditory-perceptual measures, vocal complaints and professional characteristics of teachers from the city of Santa Maria (Rio Grande do Sul), Brazil

Purpose Describe and correlate acoustic and auditory-perceptual vocal measures, vocal complaints and professional characteristics of a group of teachers. Methods Ninety-nine female primary school teachers, aged 20 to 66 years, underwent auditory-perceptual (CAPE-V) and acoustic (Multi-Dimensional Voice Program Advanced) vocal assessments, and answered a questionnaire with questions about personal identification, overall health, occupational activities and vocal complaints. The ANOVA and Pearson’s correlation statistical tests have been applied. Results The teachers worked 6.98 hours a day, on average, and had been working as teachers for 12.91 years, approximately. Most of them reported vocal complaints and were employed in private schools. Auditory perceptual parameters were normal. All measures of jitter, shimmer, voiceless or unvoiced and subharmonic segments were above the normal range, as well as the standard deviation for fundamental frequency and soft phonation index. Perturbation frequency and age, roughness, breathiness and overall degree of voice were positively correlated with age and length of professional practice. There was also a negative correlation between amplitude perturbation and daily use of voice. Conclusion The teachers’ voices were considered as normal by the auditory-perceptual assessment, but noise and instability were detected in the acoustic analysis; there were, particularly, vocal complaints, and alteration of vocal acoustic and auditory-perceptual measures with increasing age and length of professional practice.

Assessment of Voice Quality After Carbon Dioxide Laser and Microdebrider Surgery for Reinke Edema

Surgery of Reinke edema requires reduction of the degenerated superficial lamina propria and preservation of the vibratory epithelium. Sixteen patients were included for microdebrider and 10 patients for carbon dioxide (CO2) laser surgery. Vocal analysis was performed before and at 1 and 3months after surgery. Subjective rating of voice quality was completed by the grade, roughness, breathiness, asthenia, and strain scale. The objective assessment was conducted by Multi-Dimensional Voice Program software. We found consistent improvement in all parameters both in CO2 laser and microdebrider group. The normalization of all parameters were statistically better after microdebrider surgery. The most statistically significant improvements were accounted in reduction in grade of hoarseness, roughness, and asthenia and acoustic analysis. Microdebrider is a useful and safe tool for Reinke edema treatment. The oscillatory cutting knife and low suction protect lamina propria resulting in better vibratory function.

Changes in Acoustic Parameters of Voice After Endoscopic Sinus Surgery in Patients with Nasal Polyposis.

Our aim was to evaluate acoustic voice analysis of patients diagnosed with nasal polyps before and after endoscopic sinus surgery. Forty-three patients diagnosed with nasal polyposis who had undergone endoscopic sinus surgery were included in this prospective study. Patients were divided into three groups according to the stage of nasal obstruction before the surgery. Acoustic voice analyses were performed on each patient before the endoscopic sinus surgery and six weeks following the surgery with the multi-dimensional voice program. Jitter, shimmer, F0 frequency, and noise to harmonic ratio (NHR) parameters were obtained for acoustic analysis. Our investigation showed thatJitter, shimmer and NHR values decreased, and F0 value increased in the postoperative period in patients that had a partial nasal obstruction before the surgery. Non-significant increases were also observed in these four parameters after the surgery in cases with total or near-total nasal obstruction. We also found that the postoperative changes in shimmer values between the Stage III patients and the patients in other stages were statistically significant (P=0.027). Voice changes that became more marked with increasing stages of the nasal polyposis. According to our results, patients should be informed of the possible alterations in speech following major surgical interventions on the paranasal sinuses.

Voice acoustic profile of males exposed to occupational infrasound and low-frequency noise

Background: Vibroacoustic disease (VAD) is a systematic pathology characterized by the abnormal growth of extra-cellular matrices in the absence of inflammatory processes, namely collagen and elastin, both of which are abundant in the basement membrane zone of the vocal folds. VAD can develop due to long-term exposure to infrasound and low-frequency noise (ILFN, < 500 Hz). Mendes et al. (2006, 2008 and 2012) revealed that ILFN-exposed males and females presented an increased fundamental frequency (F 0 ), decreased jitter %, and reduced maximum phonation frequency range, when compared with normative data. Temporal measures of maximum phonation time and S/Z ratio were generally reduced. Study Aims: Herein, the same voice acoustic parameters of 48 males, 36 airline pilots and 12 cabin crewmembers (age range 25-60 years) were studied, and the effects and interaction of age and years of ILFN exposure were investigated within those parameters. ILFN-exposure time (i.e. years of professional activity) ranged from 3.5 to 36 years. Materials and Methods: Spoken and sung phonatory tasks were recorded with a DA-P1 Tascam DAT and a C420III PP AKG head-worn microphone, positioned at 3 cm from the mouth. Acoustic analyses were performed using KayPENTAX Computer Speech Lab and Multi-Dimensional Voice Program. Results: Results revealed that even though pilots and cabin crewmembers were exposed to occupational environments with distinct (ILFN-rich) acoustical frequency distributions and sound pressure levels, differences in the vocal acoustic parameters were not evident. Analyzing data from both professional groups (N = 48) revealed that F 0 increased significantly with the number of years of professional activity. Conclusion: These results strongly suggest that the number of years of professional activity (i.e. total ILFN exposure time) had a significant effect on F 0 . Furthermore, they may reflect the histological changes specifically observed on the vocal folds of ILFN-exposed professionals.

Noonan Sendromu Olan Çocuklarda Ses Özellikleri

Objective: Noonan syndrome (NS) is characterized by multiple physical and cardiac anomalies. Voice characteristics in NS are not well characterized in the available literature. The aim of this study was to examine voice properties of patients with NS. Material and Methods: This study included 11 children with NS with a mean age of 11.96±3.47 years (age range: 6.3-17.7). The control group consisted of 11 healthy children with a mean age of 11.96±3.34 years (age range: 6.0-17.1). In all subjects (n=22), 11 parameters out of 33 acoustic parameters of the Multi-Dimensional Voice Program, related to fundamental frequency, frequency variations, amplitude variations, and noise measurements were analyzed. Results: In the acoustic analysis of children with NS, soft phonation index (SPI) was found to be lower than that in the control group (p<0.05). Fundamental frequency of children with NS was higher than that in the control group; but the difference was not statistically significant (p>0.05). Conclusion: This study adds knowledge about the clinical symptoms of children with NS. The findings of this study indicate that children with NS mostly share similar voice properties with healthy children.