Harmonics-to-noise Ratio Research Articles

The Outcomes of the Voice Use Reduction Program on Voice Quality and Vocal Fatigue in Occupational Voice Users

The study aimed to describe the outcomes of the voice use reduction (VUR) program on voice quality and vocal fatigue (VF) in occupational voice users (OVUs). A within-subject, quasi-experimental, pre-test, post-test research design was performed on 30 OVUs. Perceptual and acoustic outcome measures were employed pre-and post-implementation of the VUR, including the GRBASI 4-point rating scale, jitter, shimmer, fundamental frequency ( F0), harmonic-to-noise ratio (HNR), maximum phonation time (MPT), frequency min and max, intensity min and max, the dysphonia severity index (DSI), and the vocal fatigue index (VFI). The pre-and post-test outcomes revealed significant ( p < .001) decreases in perceptual G (Grade of hoarseness), R (Roughness), A (Asthenia), S (Strain), and I (Instability). Perceptual normality in these areas increased significantly ( p < .001). Acoustic measures revealed significant ( p < .05) decreases in Jitter%, Intensity (dB) Min, and DSI scores as well as significant ( p < .05) increases in MPT /a/, /s/, and /z/, Frequency (Hz) Max, and F0 (Hz) Max, indicating improved voice quality at post-test. The VUR program positively affected and improved OVUs’ perception of VF in the areas of tiredness of voice and physical discomfort. OVUs strongly perceive improvement of VF symptoms with rest regardless of the current level of VF they are experiencing. When approaching OVUs, clinicians are encouraged to use a combination of direct voice therapy and vocal hygiene accompanied by VUR to help develop healthier use of the voice, facilitate healing, and prevent further/future injury or disorder.

A meta-analysis on the improvement of vocal function in unilateral vocal cord paralysis by reinnervation of the recurrent laryngeal nerve

Objective:To conduct a systematic description and meta-analysis of the treatment of unilateral vocal cord paralysis（UVCP） with recurrent laryngeal nerve reinnervation through literature search, and to analyze the therapeutic effect of recurrent laryngeal nerve reinnervation on improving vocal function in UVCP. Methods:Electronic databases Pubmed, Web of Science, EMBASE, Cochrane Library, CNKI, and Wanfang databases were searched using relevant keywords and screened in strict accordance with the inclusion and exclusion criteria, and quality evaluations were conducted. Reported treatment outcomes were measured by relevant data extracted from literature, such as auditory perception assessment（GRBAS）, voice handicap index（VHI）, maximal phonation time（MPT）, jitter, shimmer, and noise harmonic ratio（NHR）, etc. Meta-analysis was performed by Revman5.3 and heterogeneity was analyzed using fixed effects or random effects models. Results:Eight articles were included in this study, all of which showed that the postoperative maximum phonation time of patients was significantly prolonged compared to preoperative, while the postoperative GRBAS score, Jitter, Shimmer, and NHR decreased compared to preoperative with statistical significance. Conclusion:The innervation of the internal laryngeal muscle was obtained through the reinnervation of the recurrent laryngeal nerve, which effectively improved the patient's vocal function and had a good long-term therapeutic effect. Although there was no difference in the efficacy of surgical methods for reconstructing the recurrent laryngeal nerve, the anastomosis between ansa cervicalis nerve and the recurrent laryngeal nerve is more ideal. Further randomized controlled studies with longer follow-up periods and larger samples will increase the credibility of their effectiveness.

Acoustic, aerodynamic, and vibrational effects of ventricular folds adduction in an ex vivo experiment.

The excessive adduction of ventricular folds has been observed in patients with dysphonia and professional singers. Whether these changes in the ventricular folds are the cause or just a result of disease progression remains unclear, and their potential pathological and physiological implications are yet to be determined. This study aimed to examine the impact of different degrees of ventricular adduction on acoustics, aerodynamics, and vocal fold vibration. The excised models of mild and severe ventricular adduction were established. We recorded the vibration pattern of vocal folds and ventricular folds and measured acoustic metrics, including fundamental frequency (F0), Jitter, Shimmer, harmonic-to-noise ratio (HNR), and sound pressure level (SPL). Furthermore, we evaluated the aerodynamics index through phonation threshold pressure (PTP), phonation instability pressure (PIP), mean flow rate (MFR), phonation threshold flow (PTF), and phonation instability flow (PIF). Irregular vibrations of the ventricular fold were observed during ventricular adduction. Notably, mild and severe ventricular adduction conditions showed a significant increase in PTP, Shimmer, and Jitter, whereas MFR, PIF, and HNR decreased compared with the control condition. Ventricular adduction leads to the deterioration of acoustic and aerodynamic parameters. The aperiodic and irregular vibration of the ventricular folds may be responsible for this phenomenon, although further experiments are warranted. Understanding the functioning of ventricular folds can be beneficial in directing the treatment of muscle tension dysphonia and improving voice training techniques.Level of evidence: level 4.

Acoustic Analysis of Mandarin-Speaking Transgender Women

ObjectiveThis study aims to investigate the speech characteristics and assess the potential risk of voice fatigue and voice disorders in Chinese transgender women. MethodsA case-control study was conducted involving transgender women recruited in Shanghai, China, from 2022 to 2024. The participants included 15 transgender women (TW), 20 cisgender men (CISM), and 20 cisgender women (CISW). Acoustic parameters, including formants (F1, F2, F3, F4), cepstral peak prominence (CPP), jitter, shimmer, harmonic-to-noise ratio (HNR), noise-to-harmonics (NHR), fundamental frequency (fo), and intensity, were analyzed across vowels, passages, and free speech. Additionally, the Voice Handicap Index-10 (VHI-10) and the Voice Fatigue Index (VFI) were administered to evaluate voice-related concerns. Results(1) The F1 of TW was significantly higher than that of CISW for the vowels /i/ and /u/, and significantly higher than that of CISM for the vowels /a/, /i/, and /u/; The F2 was significantly lower in TW compared to CISW for the vowels /i/ and /u/, and significantly higher than CISM for the vowels /a/ and /u/. F3 was significantly lower in TW than in CISW for the vowels /a/ and /i/. The F4 formant was significantly lower in TW than in CISW for the vowels /a/ and /i/, but significantly higher than in CISM for the vowel /u/. (2) The fo of TW was significantly lower than that of CISW for the vowels /a/, /i/, /u/, during passage reading, and in free speech, but was significantly higher than CISM during passage reading and free speech. Additionally, TW exhibited significantly higher intensity compared to CISW for the vowel /a/ and during passage reading. (3) Jitter in TW was significantly higher than in CISW for the vowels /i/ and /u/, and significantly lower than in CISM during passage reading and free speech. Shimmer was significantly higher in TW compared to both CISW and CISM across the vowels /a/, /i/, during passage reading, and in free speech. The harmonic-to-noise ratio (HNR) in TW was significantly lower than in both CISW and CISM across all vowels, during passage reading, and in free speech. The NHR was significantly higher in TW than in CISW across the vowels /a/, /i/, /u/, during passage reading, and in free speech, and significantly higher than in CISM for the vowels /a/, /i/, during passage reading, and in free speech. The CPP in TW was significantly lower than in CISW during passage reading and free speech, and significantly lower than in CISM across all vowels, during passage reading, and in free speech. (4) The VHI-10 scores were significantly higher in TW compared to both CISM and CISW. ConclusionsTransgender women exhibit certain acoustic parameters, such as fo and some of the formants, that fall between those of CISW and CISM without undergoing phonosurgery or voice training. The findings suggest a potential risk for voice fatigue and the development of voice disorders as transgender women try to modify their vocal characteristics to align with their gender identity.

Comparison of the Effectiveness of Injection Laryngoplasty Using Autologous Platelet-Rich Plasma or Autologous Fat With Platelet-Rich Fibrin for the Treatment of Patients With Unilateral Vocal Fold Paralysis

ObjectivesUnilateral vocal fold paralysis (UVFP) can be idiopathic or a result of surgery, cancer or neurological disease. The most common presentation is dysphonia, which causes problems with communication, and can lead to anxiety and depression. Injection laryngoplasty (IL) is a current means of treatment, but there have been few studies to determine the optimal material to use. Therefore, we aimed to compare the use of autologous platelet-rich plasma and autologous fat with platelet-rich fibrin for injection laryngoplasty under local anesthesia and general anesthesia respectively. Study designA prospective randomized controlled study was conducted at the Otolaryngology-Head and Neck Surgery Department, Ramathibodi Hospital, Faculty of Medicine, Mahidol University. MethodsThirty-four patients with UVFP were recruited. All met the inclusion criteria and were randomized to two groups, to be treated using autologous platelet-rich plasma under local anesthesia or autologous fat with platelet-rich fibrin under general anesthesia. The primary outcome was the mean difference in the Voice Handicap Index (VHI) between the groups at 1- and 6-months post. The secondary outcomes were the mean differences in voice acoustic parameters [maximum phonation time (MPT), jitter, shimmer, and harmonic to noise ratio (HNR)] between the groups at these time points. ResultsAt the measured time points, there were no significant differences in the mean VHIs (P=0.462), MPT (P=0.79), jitter (P=0.234), shimmer (P=0.863), or HNR (P=0.096) between the groups. Few people who underwent the procedure under local anesthesia developed laryngospasm while some of those in the fat with platelet-rich fibrin developed postoperative abdominal contusion or hematoma which resolved spontaneously. ConclusionsWe have found no difference in the effectiveness of IL using autologous platelet-rich plasma under local anesthesia or autologous fat with platelet-rich fibrin performed under general anesthesia in patients with UVFP. No serious or life-threatening complications were found in both groups.

The Immediate Effect of Straw Phonation in Children With Repaired Cleft Palate

ObjectiveThis study aims to investigate the immediate effect of straw phonation on the phonation of Persian-speaking children with repaired cleft palate. Study DesignQuasi-experimental intervention pre and post intervention. MethodsSeventeen children with repaired cleft palate and velopharyngeal dysfunction (VPD) were investigated. A control group was established comprising children without a cleft palate (control group), carefully matched in terms of age and gender. All participants underwent straw phonation and assessment. The assessments were made two times: at baseline and immediately after straw phonation. Each participant performs straw phonation (a short straw measuring 3mm in inner diameter and 20 cm in length) once for 3 minutes. The acoustic analysis including parameters such as jitter, shimmer, harmonics-to-noise ratio (HNR), cepstral peak prominence (CPP) parameters, as well as the electroglottography (CQ) analysis were performed at pretreatment and immediately after treatment. ResultsCompared with the pretreatment values, after treatment observation demonstrated a significant reduction in Jitt % and Shimm %, and a significant enhancement in HNR and CPP among children with repaired cleft palate. No significant difference intragroup data just in the CPP and CQ in pretreatment. ConclusionsThe proposed straw phonation technique results in an immediate positive change on the quality of voice in both groups. Moreover, assessments in clinical group showed a significantly decrease shimmer and jitter perturbation, alongside elevated levels of HNR and CPP subsequent to straw phonation, irrespective of the phonatory task.

Evaluation of Subjective and Objective Voice Characteristics in Patients With Bulimia Nervosa

ObjectiveThe present study aims to examine subjectively and objectively the voice changes in Bulimia Nervosa patients at different stages of treatment. MethodThe study was conducted with a study group including 10 patients followed up with a diagnosis of Blum,ia Nerrvosa and a control group consisting of 10 healthy participants of a similar age group without eating disorders. The reflux symptom index was used for stroboscopic evaluation. The fundamental frequency (F0), jitter, shimmer, and noise-to-harmonics ratio (NHR) were determined during acoustic voice analysis. Maximum phonation time was analysed. A subjective evaluation was performed using the Voice Handicap Index-10 (VHI-10). ResultsJitter, Shimmer, VHI-10 Score, and RFS values showed a statistically significant difference in the patient and control groups (p<0.05). The mean values of Jitter, Shimmer, VHI-10 Score, and RFS were higher in the patient group than in the control group. MPT did not differ between goups (p>0.05)Age and F0 (Hz) values showed no statistically significant difference in the patient and control groups (p>0.05). ConclusionIn BN patients, the laryngopharyngeal reflux mechanism causes negative effects on vocal cord examination and acoustic sound analysis parameters, leading to subjective dissatisfaction.

Acoustic-based diagnostics for UAV propeller damage using HNR and Gaussian Naive Bayes

PurposeThe purpose of this study is to determine propeller damage based on acoustic recordings taken from unmanned aerial vehicle (UAV) propellers operated at different thrust conditions on a test bench. Propeller damage is especially critical for fixed-wing UAVs to sustain a safe flight. The acoustic characteristics of the propeller vary with different propeller damages.Design/methodology/approachFor the research, feature extraction methods and machine learning techniques were used during damage detection from propeller acoustic data. First of all, sound recordings were obtained by operating five different damaged propellers and undamaged propellers under three different thrusts. Afterwards, the harmonic-to-noise ratio (HNR) feature extraction technique was applied to these audio recordings. Finally, model training and validation were performed by applying the Gaussian Naive Bayes machine learning technique to create a diagnostic approach.FindingsA high recall value of 96.19% was obtained in the performance results of the model trained according to damaged and undamaged propeller acoustic data. The precision value was 73.92% as moderate. The overall accuracy value of the model, which can be considered as general performance, was obtained as 81.24%. The F1 score has been found as 83.76% which provides a balanced measure of the model’s precision and recall values.Practical implicationsThis study include provides solid method to diagnose UAV propeller damage using acoustic data obtain from the microphone and allows identification of differently damaged propellers. Using that, the risk of in-flight failures can be reduced and maintenance costs can be lowered with addressing the occurred problems with UAV propeller before they worsen.Originality/valueThis study introduces a novel method to diagnose damaged UAV propellers using the HNR feature extraction technique and Gaussian Naive Bayes classification method. The study is a pioneer in the use of HNR and the Gaussian Naive Bayes and demonstrates its effectiveness in augmenting UAV safety by means of propeller damages. Furthermore, this approach contributes to UAV operational reliability by bridging the acoustic signal processing and machine learning.

Analysis of Tracheoesophageal Voice after Total Laryngectomy: A Single Center Experience.

Background/Objectives: Tracheoesophageal voice is the most commonly used voice rehabilitation technique after a total laryngectomy. The placement of the tracheoesophageal prosthesis can be performed at the same time as the total laryngectomy (primary placement) or in a second procedure after surgery (secondary placement). The purpose of this study is to analyze the substitution voice in patients with a tracheoesophageal prosthesis, considering the influence of radiotherapy and timing of prosthesis placement (primary or secondary) on voice quality. Methods: A retrospective analysis was conducted of all patients who received a tracheoesophageal phonatory prosthesis after a total laryngectomy was performed. We assessed whether patients received radiotherapy and whether they had a primary or secondary tracheoesophageal prosthesis. For the voice analysis, maximum phonation time (MPT), INFVo, SECEL, AVQI, CPPS, harmonic to noise ratio (HNR), unvoiced fraction (UVF), and number of voice breaks (NVB) were evaluated. Results: A total of 15 patients (14 males and 1 female) with a mean age of 71.8 years (SD ± 7.5) were enrolled. Eight had a primary prosthesis placement and five did not receive radiotherapy. INFVo parameters I and Vo were higher in patients with a primary placement of the phonatory prosthesis (p = 0.046 and p = 0.047). Patients who received the prosthesis secondarily had a higher mean CPPS and lower mean AVQI. Conclusions: A secondary placement of the prostheses seems to result in a minimal advantage in voice quality compared to a primary placement. Radiation therapy, on the other hand, has no effect on voice quality, according to these preliminary data.

The Effects of Sleep Inertia on the Acoustic and Perceptual Voice Changes in Adult University Students

Background: Sleep inertia, characterized by reduced alertness and cognitive functioning upon waking, has been well-researched in its effects on cognitive and motor abilities. However, its impact on voice quality remains less clear. Objectives: This study aimed to investigate the relationship between sleep inertia following nocturnal sleep and changes in acoustic and perceptual voice parameters in adults. Methods: Ninety healthy participants (45 females, 45 males, ages: 18 - 30 years) took part in a pre-post study using convenience sampling. Their voices were recorded before and after nocturnal sleep across multiple tasks, including vowel /a/ phonation, spontaneous speech, text reading, and maximum phonation time (MPT). Recordings were made in a quiet room using a Zoom H6 recorder at a 44.1 kHz rate. The acoustic analysis included measures of fundamental frequency (F0), standard deviation of F0 (SD F0), vocal intensity, harmonics-to-noise ratio (HNR), cepstral peak prominence smoothed (CPPS), jitter, shimmer, and formant frequencies. Auditory-perceptual evaluation was conducted using the GRBAS Scale. Statistical analysis was performed using SPSS-19. The Shapiro-Wilk test assessed normality, and a paired t-test compared variables, separately for males and females at a 0.05 significance level. Results: Acoustic analysis revealed that both females and males experienced a decrease in mean F0, mean intensity, HNR, and CPPS, and an increase in jitter, shimmer, and SD F0 across most voice samples after sleeping. These changes were particularly significant for females in all voice samples (P &lt; 0.001). Perceptual analysis also showed a significant increase in grade, roughness, breathiness, asthenia, and strain for both genders after sleep (P &lt; 0.001). Conclusions: This study demonstrated that sleep inertia negatively impacts vocal performance, resulting in a decline in voice quality for both genders after sleep compared to before. Notably, this decline in voice quality was more pronounced in women than in men.

An Exploration of Voice Quality in Mothers Speaking Canadian English to Infants

ABSTRACT Research on the acoustic characteristics of Infant Directed Speech (IDS) in North American English indicates that it is generally higher-pitched than Adult Directed Speech (ADS) and has unique prosodic characteristics, which is commonly found across many spoken languages. However, very little research has addressed another important aspect of prosody: voice quality. In the current study, 25 English-speaking mothers from Canada were recorded speaking to their infant children and to an adult peer. Five acoustic measures of voice quality, including glottal constriction, spectral tilt, Harmonic-to-Noise Ratio (HNR), and Cepstral Peak Prominence (CPP), were analyzed. Only CPP, a measure of the breathiness of a speaker’s voice, and corrected H1-A2, a measure of vocal creakiness, were found to be significantly different between the IDS and ADS registers. Sociolinguistic research identifies voice quality as a key indicator of speech style and persona; we connect the pattern of breathiness in IDS to a possible “parental persona” that builds on the affective intent of IDS (rather than the pedagogical intent), with suggestions for future research.

A Prospective Comparative Analysis to Study the Impact on Voice Changes Following Endoscopic Thyroidectomy.

Endoscopic approach has come up as a safe and feasible procedure for thyroidectomy with better cosmetic outcomes. However, concerns over its safety in terms of nerve injury and postoperative voice changes remain. This prospective study evaluated the role of vocal cord function assessment using laryngeal examination and voice analysis in patients who underwent endoscopic hemithyroidectomy either by the trans-oral endoscopic thyroidectomy vestibular approach (TOETVA) or the bilateral axillobreast approach (BABA). Thirty-nine consecutive patients were randomly allocated to either of the 2 groups of endoscopic hemithyroidectomy; 19 in TOETVA and 20 in the BABA groups. Vocal cord function was assessed subjectively using the GRBAS scale and objectively by acoustic analysis of parameters such as jitter, shimmer, mean frequency (F 0 ), noise-to-harmonic ratio (NHR), and maximum phonatory time (MPT) at baseline, postoperative day 10, and 3 months after surgery. There were no significant differences in mean GRBAS scores and values of mean frequency, jitter and shimmer between the 2 groups and on postoperative day 10 and at 3 months compared with baseline. The mean NHR and MPT showed no differences between the 2 procedures. However, there was a significant decrease in their values on day 10 postsurgery, compared with baseline. These values returned to their baseline at 3 months. The other operative parameters were comparable between the 2 groups, except for the shorter mean operative time in the TOETVA group. Perioperative quantitative voice parameters were comparable with no statistically significant difference between the 2 techniques of endoscopic thyroidectomy.

Effect of Aging on Long-Term Functional Outcomes After Open Partial Laryngectomy.

Open partial horizontal laryngectomies (OPHLs) represent a comparable alternative to total laryngectomy and nonsurgical protocols in selected cases. While short-term functional outcomes of OPHLs have been widely investigated, few have focused on the effect of aging on residual laryngeal structures. Retrospective cohort study. Tertiary care academic center. Patients who underwent OPHLs after at least 1 year follow-up and optimal functional rehabilitation were included in the study. Swallowing function was assessed according to PAS (Penetration aspiration scale) and Pooling scores. Spectrogram analysis of voice was conducted according to Yanagihara classification and acoustic parameters were also recorded. Subjective questionnaire data about phonation and swallowing were also recorded. Data obtained were compared among patients according to age at time of surgery, evaluation and duration of follow-up. Ninety-seven patients were enrolled with a mean age at surgery and evaluation of 63 and 70 years old, respectively. Median follow-up length was 5 years. OPHL type II was mostly performed. No significant correlation was observed between most of the analyzed variables and patient's age at the time of surgery and at the time of evaluation. Some acoustic parameters were negatively correlated with follow-up length, while Jitter, NHR (Noise-Harmonic Ratio), and Global grade and Roughness were significantly higher in patients >65 years old. Patients who complete rehabilitation reach equally good results as their younger peers with stability over time. Finally, the effects of aging on residual larynx are of minor entity compared to the nonoperated patients. Level IV-retrospective cohort study.

Voice disorder discrimination using vowel acoustic measures in female speakers.

Sustained vowels are important vocal tasks that have been investigated in discriminating voice disorders using acoustic analysis. To date, no study has combined vowel acoustic measures only that evaluate major aspects of the pathological voice signals in voice disorder discrimination. To investigate the value of vowel acoustic measures that quantify glottal noise, signal stability, signal periodicity, spectral slope and overall voice quality in discriminating female speakers with and without voice disorders. Sustained vowel /ɑ/ samples were extracted from 133 voice-disordered female patients and 97 non-voice disordered female speakers and were signal typed prior to analysis. Praat software was used to measure harmonics-to-noise ratio (HNR), glottal-to-noise excitation ratio (GNE), the standard deviation of fundamental frequency (F0SD) and cepstral peak prominence (CPPp); and the Analysis of Dysphonia in Speech and Voice (ADSV) program was used to measure CPPadsv, low/high spectral ratio (LH) and the cepstral/spectral index of dysphonia (CSID). Outcome measures included sensitivity, specificity, and discrimination accuracy. As individual acoustic measures, only spectral-based measures showed good (CPPadsv) and acceptable (CSID) discrimination results. The HNR, GNE and CPPp measures had acceptable sensitivity but poor or non-acceptable specificity and discrimination accuracy. Logistic regression models with all Praat measures (F0SD, HNR, GNE, CPPp) plus ADSV measures (CPPadsv, LH or CSID) provided excellent sensitivity, good-to-excellent specificity and excellent discrimination accuracy. ROC analysis for all individual measures showed that CPPadsv, CSID, CPPp, GNE and F0SD had the highest area under the curve (AUC) values. A combination of acoustic measures that evaluate the major aspects of vocal dysfunction resulted in good to excellent voice discrimination outcomes. Individual acoustic measures had lower discrimination ability than combined measures. The findings implied that acoustic measures extracted from a prolonged vowel were useful in voice disorder discrimination. What is already known on this subject Acoustic measures hold great value in discriminating voice disorders from normal voices. However, no study has evaluated discrimination values of a combination of sustained vowel acoustic measures that quantify additive noise, signal stability, signal periodicity, spectral slope and overall voice quality in single-gender cohorts. Previous studies have not used signal typing (the classification of the acoustic signals) for time-based measures, impacting the reliability of discrimination. What this study adds to the existing knowledge This study was the first to implement signal typing to include sustained vowel samples of Types 1 and 2 signals for discrimination statistics. We showed that a combination of vocal acoustic measures using time- and spectral-based extraction from the sustained /ɑ/ vowel evaluating additive noise, signal stability, signal periodicity, spectral slope and overall voice quality resulted in good to excellent sensitivity, specificity and discrimination accuracy. As individual measures, traditional time-based measures such as HNR had rather limited discrimination values whilst spectral-based measures provided higher discrimination values. Measures that are sensitive to signal types have low discrimination ability. What are the potential or actual clinical implications of this work? The sustained vowel /ɑ/ is a relevant, universal vocal task for clinical application using acoustic measures to discriminate female speakers with and without voice disorders if signal typing is implemented. Clinical voice assessment using vowels may not be effective if relying solely on time-based measurements. Spectral-based measures perform better in voice disorder discrimination given their insensitivity to signal types. The most effective voice disorder discrimination could only be obtained using a combination of acoustic measures that quantify major phenomena in the signals of disordered voices. Using measures extracted from both programs, Praat and ADSV, is useful given that specific settings in a program may impact on discrimination accuracy.

Can Voice Parameters Provide Cutoff Values to Predict Dysphagia in Individuals with Multiple Sclerosis?

In dysphagia assessment, along with well-defined measurements and signs, voice parameters can potentially support clinical decision as a marker, but more evidence is needed. This study aims to determine the voice parameters that can predict the risk of dysphagia and to determine optimal cutoff values in individuals with multiple sclerosis (IwMS). Seventy-six adults participated in the study, including 39 IwMS and 37 healthy individuals (HI). The study used the Dysphagia in Multiple Sclerosis Questionnaire (DYMUS), Gugging Swallowing Screen (GUSS), and Voice Handicap Index (VHI-10) and recorded voice samples using Praat programme. Voice recordings were taken pre- and post-swallowing. The voice parameters analysed are fundamental frequency (F0), standard deviation F0 (SD F0), jitter (local), shimmer (local), and harmonic-to-noise ratio (HNR). Roc analysis was performed to examine the diagnostic accuracy performance of the risk for dysphagia/penetration. The parameters of IwMS pre-swallowing differed significantly from those of HI on the VHI-10, DYMUS, GUSS scores, and jitter (local), shimmer (local), and HNR. IwMS but not HI exhibited significant differences in shimmer (local) and HNR between the pre- and post-swallowing measurements. In IwMS, GUSS revealed significant differences in shimmer (local) pre- and post-swallowing between the groups with and without dysphagia/penetration. In the ROC analysis results, the area under the curve (AUC) for shimmer (local) pre-swallowing was 73.1% (cutoff = 1.69); post-swallowing, it was 78.6% (cutoff = 1.57). In conclusion, IwMS can be associated with differences in shimmer (local) and HNR parameters, low quality of life-related to voice, and dysphagia/penetration risk. The AUC values for shimmer (local) in IwMS pre- and post-swallowing may help to strengthen diagnostic decisions of dysphagia risk.

Development and validity of type II sulcus vocalis in excised canine larynx

AbstractObjectivesThis study aims to develop a sulcus vocalis model in the excised canine larynx and to investigate the validity of the model.MethodsType II sulcus vocalis was created by continuous intradermal suture in six excised canine larynges. We investigated the validity of the model based on phonatory (aerodynamic and acoustic) measures, laryngeal videostroboscopy (LVS), and histological examination. The aeroacoustic parameters included phonation threshold pressure (PTP), fundamental frequency (Fo), jitter %, shimmer %, and harmonics‐to‐noise ratio (HNR).ResultsIn all the experimental specimens, there were significant increases in the PTP ([6.61 ± 1.66] cm H2O, p &lt; 0.01), the Fo ([106.48 ± 49.59] Hz, p = 0.003), the jitter ([0.76 ± 0.42]%, p = 0.007), the shimmer ([6.87 ± 2.99%, p = 0.002]), while the HNR decreased ([5.71 ± 4.68] dB, p = 0.031), compared to that of the untreated canine larynges. The estabilished model simulated the histology with type Ⅱ sulcus.ConclusionsType Ⅱ sulcus vocalis was successfully created in excised canine larynx. The aeroacoustic and LVS analysis of this model resembled the characteristics of patients with sulcus vocalis. The model could be helpful to elucidate the pathology of the phonation, and evaluate and compare the treatments for sulcus vocalis.

Effect of Face Masks on Voice Quality Associated with Young and Older Chinese Adult Speakers

ObjectivesFace masks have become important after the pandemic, but the change in voice when wearing a face mask is still unclear. The study investigated the effect of face masks on the acoustic and perceptual characteristics of voice quality associated with young and older Chinese adults. MethodsVoice samples of the sustained vowel /a/ and continuous speech produced by 44 older and 61 young adults with and without an ASTM level-3 surgical face mask were recorded and analyzed. Perceptual and acoustic parameters including mean fundamental frequency (F0) and intensity, perturbation measures (jitter and shimmer), harmonic-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPs), and long-term average spectrum (LTAS) measures were obtained and compared. ResultsWhen comparing masked to unmasked voices, for both male and female speakers, F0 and intensity showed no significant changes, except for F0 of continuous speech, which increased significantly. Meanwhile, perturbation measures including jitter and shimmer were reduced, HNR and CPPs were increased, and LTAS measures encompass low frequency mean spectral energy (MSE), high frequency MSE, and spectral tilt (ST) were different. For perceptual measures, the overall grade of dysphonia, and roughness were reduced, except for the breathiness among older male speakers, while the other vocal qualities were not changed. Between young and older speakers, significant differences in shimmer, CPPs, and perceived breathiness among male speakers, and low frequency MSE among female speakers were found. ConclusionWearing a surgical mask appeared to change the perceived voice quality. This is supported by the change in perturbation and LTAS measures, and HNR and CPPs values. In addition, some differences between young and older male adults were observed. Communication effectiveness may be affected when wearing surgical masks due to changes in voice quality. Additionally, clinicians need to exercise caution in evaluating the voice quality of clients when wearing face masks.

A Study on Voice Measures in Patients with Parkinson’s Disease

This research aims to identify acoustic features which can distinguish patients with Parkinson's disease (PD patients) and healthy speakers. Thirty PD patients and 30 healthy speakers were recruited in the experiment, and their speech was collected, including three vowels (/i/, /a/, and /u/) and nine consonants (/p/, /pʰ/, /t/, /tʰ/, /k/, /kʰ/, /l/, /m/, and /n/). Acoustic features like fundamental frequency (F0), Jitter, Shimmer, harmonics-to-noise ratio (HNR), first formant (F1), second formant (F2), third formant (F3), first bandwidth (B1), second bandwidth (B2), third bandwidth (B3), voice onset, voice onset time were analyzed in our experiment. Two-sample independent t test and the nonparametric Mann-Whitney U (MWU) test were carried out alternatively to compare the acoustic measures between the PD patients and healthy speakers. In addition, after figuring out the effective acoustic features for distinguishing PD patients and healthy speakers, we adopted two methods to detect PD patients: (1) Built classifiers based on the effective acoustic featuresand (2) Trained support vector machine classifiers via the effective acoustic features. Significant differences were found between the male PD group and the male health control in vowel /i/ (Jitter and Shimmer) and /a/ (Shimmer and HNR). Among female subjects, significant differences were observed in F0 standard deviation (F0 SD) of /u/ between the two groups. Additionally, significant differences between PD group and health control were also found in the F3 of /i/ and /n/, whereas other acoustic features showed no significant differences between the two groups. The HNR of vowel /a/ performed the best classification accuracy compared with the other six acoustic features above found to distinguish PD patients and healthy speakers. PD can cause changes in the articulation and phonation of PD patients, wherein increases or decreases occur in some acoustic features. Therefore, the use of acoustic features to detect PD is expected to be a low-cost and large-scale diagnostic method.

Uncovering Gender-Specific and Cross-Gender Features in Mandarin Deception: An Acoustic and Electroglottographic Approach.

This study aimed to investigate the acoustic and electroglottographic (EGG) profiles of Mandarin deception, including global characteristics and the influence of gender. Thirty-six Mandarin speakers participated in an interactive interview game in which they provided both deceptive and truthful answers to 14 biographical questions. Acoustic and EGG signals of the participants' responses were simultaneously recorded; 20 acoustic and 14 EGG features were analyzed using binary logistic regression models. Increases in fundamental frequency (F0) mean, intensity mean, first formant (F1), fifth formant (F5), contact quotient (CQ), decontacting-time quotient (DTQ), and contact index (CI) as well as decreases in jitter, shimmer, harmonics-to-noise ratio (HNR), and fourth formant (F4) were significantly correlated with global deception. Cross-gender features included increases in intensity mean and F5 and decreases in jitter, HNR, and F4, whereas gender-specific features encompassed increases in F0 mean, shimmer, F1, third formant, and DTQ, as well as decreases in F0 maximum and CQ for female deception, and increases in CQ and CI and decreases in shimmer for male deception. The results suggest that Mandarin deception could be tied to underlying pragmatic functions, emotional arousal, decreased glottal contact skewness, and more pressed phonation. Disparities in gender-specific features lend support to differences in the use of pragmatics, levels of deception-induced emotional arousal, skewness of glottal contact patterns, and phonation types.

Effects of Speech Characteristics on Electroglottographic and Instrumental Acoustic Voice Analysis Metrics in Women With Structural Dysphonia Before and After Treatment.

Literature suggests a dependency of the acoustic metrics, smoothed cepstral peak prominence (CPPS) and harmonics-to-noise ratio (HNR), on human voice loudness and fundamental frequency (F0). Even though this has been explained with different oscillatory patterns of the vocal folds, so far, it has not been specifically investigated. In the present work, the influence of three elicitation levels, calibrated sound pressure level (SPL), F0 and vowel on the electroglottographic (EGG) and time-differentiated EGG (dEGG) metrics hybrid open quotient (OQ), dEGG OQ and peak dEGG, as well as on the acoustic metrics CPPS and HNR, was examined, and their suitability for voice assessment was evaluated. In a retrospective study, 29 women with a mean age of 25 years (± 8.9, range: 18-53) diagnosed with structural vocal fold pathologies were examined before and after voice therapy or phonosurgery. Both acoustic and EGG signals were recorded simultaneously during the phonation of the sustained vowels /ɑ/, /i/, and /u/ at three elicited levels of loudness (soft/comfortable/loud) and unconstrained F0 conditions. A linear mixed-model analysis showed a significant effect of elicitation effort levels on peak dEGG, HNR, and CPPS (all p < .01). Calibrated SPL significantly influenced HNR and CPPS (both p < .01). Furthermore, F0 had a significant effect on peak dEGG and CPPS (p < .0001). All metrics showed significant changes with regard to vowel (all p < .05). However, the treatment had no effect on the examined metrics, regardless of the treatment type (surgery vs. voice therapy). The value of the investigated metrics for voice assessment purposes when sampled without sufficient control of SPL and F0 is limited, in that they are significantly influenced by the phonatory context, be it speech or elicited sustained vowels. Future studies should explore the diagnostic value of new data collation approaches such as voice mapping, which take SPL and F0 effects into account.