Phonation Time Research Articles

Discriminating speech traits of Alzheimer's disease assessed through a corpus of reading task for Spanish language

It is estimated that between 50% and 75% of all cases of dementia are due to Alzheimer's disease (AD), the most common neurodegenerative disease among World population. However, a long preclinical period of AD makes it difficult to differentiate between people with Mild Cognitive Impairment (MCI) that would progress to dementia from people with MCI that would not. One of the most promising solutions to detect MCI which will evolve to dementia (preAD) comes from the field of automatic speech analysis. Speech is a complex physiological and neurocognitive language-mediated process, which can be significantly altered in pathological aging and exhibit high levels of sensitivity for the diagnosis of neurological diseases. The purpose of this research is to offer a detailed perspective on the speech changes in MCI and mild AD when compared to healthy aging (HA), that would allow to detect pathological processes prior to the clinical expression of AD. Based on our previous research record on speech in HA, MCI and AD, we provide a global review of dementia-related speech traits and propose a reading-based protocol for assessing ongoing neurodegenerative processes in the elderly. We report the results of speech analysis in elderly people with different cognitive profiles, who performed a standardized reading task and were further analyzed for correlations between neurocognitive assessment indicative of cognitive impairment stage (HA, MCI or AD) and acoustic, temporal and prosodic traits in speech. We show that evolution from HA to AD exhibits a steady pattern of speech changes in parallel to the cognitive decline, which consists in significant increase in duration and phonation time, extension of pauses and voice breaks, intensification of variation in syllabic production, and decrease in speech energy and intensity leading to dysphony. In doing so, we prove that a standardized reading task is a very useful type of stimuli for detecting dementia-related speech traits and, in view of this, we discuss the relevance of reading for preclinical automated diagnosis of AD. The main contribution of this paper is a corpus of recordings of the standardized reading task performed by healthy elderly people and people with MCI and AD in Spanish language, and which can be used for further research purposes. In this respect, our work fills an important gap existing in corpora-based studies of speech and language impairments related to progression to dementia.

Functional results of endoscopic arytenoid abduction lateropexy for bilateral vocal fold palsy

PurposeEndoscopic arytenoid abduction lateropexy (EAAL) is a reliable surgical solution for the minimally invasive treatment of bilateral vocal fold palsy (BVFP), providing a stable airway by the lateralization of the arytenoid cartilages with a simple suture. The nondestructive manner of the intervention theoretically leads to higher regeneration potential, thus better voice quality. The study aimed to investigate the respiratory and phonatory outcomes of this treatment concept.Methods61 BVFP patients with significant dyspnea associated with thyroid/parathyroid surgery were treated by unilateral EAAL. Jitter, Shimmer, Harmonics to Noise Ratio, Maximum Phonation Time, Fundamental frequency, Voice Handicap Index, Dysphonia Severity Index, Friedrich’s Dysphonia Index, Global-Roughness-Breathiness scale, Quality of Life, and Peak Inspiratory Flow were evaluated 18 months after EAAL.ResultsAll patients had a stable and adequate airway during the follow-up. Ten patients (16.4%) experienced complete bilateral motion recovery with objective acoustic parameters in the physiological ranges. Most functional results of the 13 patients (21.3%) with unilateral recovery also reached the normal values. Fifteen patients (24.6%) had unilateral adduction recovery only, with slightly impaired voice quality. Eleven patients (18.0%) had false vocal fold phonation with socially acceptable voice. In 12 patients (19.7%) no significant motion recovery was detected on the glottic level.ConclusionEAAL does not interfere with the potential regeneration process and meets the most important phoniatric requirements while guaranteeing the reversibility of the procedure—therefore serving patients with transient palsy. Further, a socially acceptable voice quality and an adequate airway are ensured even in cases of permanent bilateral vocal fold paralysis.

Methods of sparing surgical treatment of chronic edematous-polypous laryngitis, edema Reinke

Introduction. Laryngeal pathology occupies a leading place in the general structure of diseases of the upper respiratory tract, chronic edematous-polypous laryngitis, Reinke-Gayek edema accounts for 5.5% of all benign diseases of the vocal folds. The main method of treating Reinke-Gayek's disease is surgical treatment, which consists in removing excess mucosa, or “stripping” - tearing a strip of mucosa with forceps from the vocal fold. One of the main principles of laryngeal surgery is the maximum preservation of the structures of the vocal fold, obtaining a flexible vibration of the muscular-membranous part and the mucous membrane of the vocal fold.Purpose. The purpose of our work is to improve the effectiveness of treatment of chronic edematous-polypous laryngitis using a CO2 laser.Tasks. To develop a differentiated approach to the surgical treatment of chronic edematous-polypous laryngitis using a carbon dioxide laser.Materials and Methods. We treated 46 patients with Reinke-Gayek disease, including 35 women and 11 men. The age of the patients ranged from 40 to 67 years. Preoperative examination included endoscopic examination, laryngostroboscopy. The type was determined according to the classification of H. Yonekawa, for the choice of further surgical tactics. In type II, an incision of the mucosa, aspiration of gelatinous matter from the Reinke space, and laying of the mucosa were performed. With type III, it is made by forming M-shaped flap to close the defect.Results. All patients in the preoperative period were surveyed with the VOICE HANDICAP INDEX(VHI-30) questionnaire, laryn-gostroboscopy, and maximum phonation time. In the postoperative period, the examination was performed twice, 1 month after the operation and 3 months after the operation. There is a significant increase in indicators, an increase in the maximum phonation time, a decrease in VHI-30 points.Conclusion. The use of this technique allowed to significantly accelerate the recovery of the voice, reduce the time spent in the hospital, minimally damaging the structure of the mucous membrane of the vocal folds.

Early Transthyrohyoid Injection Laryngoplasty Under Local Anaesthesia in a Single Tertiary Center of Southeast Asia: Multidimensional Voice Outcomes.

Objective:To study the effectiveness of early percutaneous transthyrohyoid injection laryngoplasty under local anesthesia in improving voice quality in unilateral vocal fold paralysis (UVFP) patients.Methods:Longitudinal data of 29 UVFP patients who underwent injection laryngoplasty within six months from the onset of the symptoms were studied. The injectate (0.5–1 mL) was hyaluronic acid-based material (Juvéderm ULTRA XC; Allergan Industrie, France) that was delivered under local anesthesia with transthyrohyoid approach using a double-bend 21G needle. Multidimensional voice outcomes employing: 1) Malay-Voice-Handicap Index-10 (mVHI-10); 2) maximum phonation time (MPT); and 3) acoustic analysis [jitter%, shimmer% and noise-harmonic ratio (NHR)] were used to assess the treatment progress. The voice parameters were measured at baseline (2 weeks pre-injection), and at the first and third months post-injection.Results:The mean age of the 29 patients was 44.69 years, with a female-to-male ratio of 3.14:1. The voice outcomes measured at different time points were evaluated with repeated measures ANOVA. Significant improvement was observed from baseline to three months post injection laryngoplasty for mVHI-10, jitter, and NHR (p<0.001), shimmer (p=0.005) and MPT (p=0.018). Following the procedure, none of the patients developed any major complications.Conclusion:Office setting early transthyrohyoid injection laryngoplasty using a double-bend needle is a safe and effective procedure in patients with UVFP with evidence of significant improvement in voice and life quality.

Gender Differences in Vocal Fold Mass Treatment

The purpose of the study was to examine gender-related differences in benign vocal fold mass treatment. Adult patient with vocal fold mass diagnosed on strobovideolaryngoscopy examination were reviewed retrospectively. Patient demographics, past medical history, laboratory data, and examination findings during the initial visit and at follow-up were collected. The duration of voice therapy and the prevalence of surgery were analyzed for males and females. One hundred and fifty-eight patients (76 male and 82 female) were included. The percentage of professional voice users differed significantly between males and females. Vocal folds of females had a higher percent of reactive masses present. Females were also more likely to have a pseudocyst. Vocal folds of males showed a higher percent of masses of unspecified category on strobovideolaryngoscopy examination. A significantly greater proportion of females had abnormal high shimmer values, and abnormal low maximum phonation time; and a significantly greater proportion of females compared to males chose to participate in voice therapy. The average number of voice therapy sessions for males did not differ, nor did duration of voice therapy. A similar proportion of males and females underwent surgical mass excision. The treatment plan completed differed significantly between males and females with a higher percentage of males choosing to receive no treatment. For 45.54% of males and 59.70% of females the treatment plan consisted of voice therapy only. For 33.33% of males and 37.31% of females, the treatment plan included both voice therapy and surgery. Although gender was the strongest predictor for participation in voice therapy, professional voice uses also predicted participation in voice therapy in both men and women significantly. Professional singing in particular was not a significant predictor for participation in voice therapy. Males were significantly more likely than females to be lost to follow-up before treatment outcome could be assessed CONCLUSION: More females than males were found to have pseudocysts while more males than females had unspecified masses. Females and professional voice users were more willing than males to utilize voice therapy. No difference was found between males and females who decided to have surgery. The best treatment regimen for vocal fold mass is a combination of voice therapy and surgery, when necessary, but gender-specific differences merit further research as well as reconsideration of therapy approaches and strategies to optimize patient compliance.

Voice Outcome After Cold Knife Surgery According to the Characteristics of Vocal Fold Polyp

Voice change is one of the major symptoms in patients with vocal fold polyp. As a result, phonomicrosurgery is commonly required in these patients. Since voice outcomes after polyp treatment can be variable according to polyp characteristics, we aimed to investigate the predicting factors of postoperative voice improvements in terms of polyp characteristics in patients with vocal fold polyp who underwent cold knife surgery. A total of 77 patients who were diagnosed with vocal fold polyp and underwent phonomicrosurgery with cold knife instruments. The polyp characteristics of color, size, shape, and location were evaluated at baseline. Acoustic and aerodynamic analyses, voice handicap index questionnaire and grade, roughness, breathiness, asthenia, strain scale were evaluated at baseline and 6 weeks after surgery. All values of postoperative voice parameters improved after cold knife surgery. (P < 0.05) In patient with an organized vocal fold polyp, less improvement in postoperative values of maximum phonation time were observed. (P < 0.05) Likewise, less improvement of voice handicap index questionnaire score and grade, roughness, breathiness, asthenia, strain scale after surgery was shown in organized vocal fold polyp. (P < 0.05) CONCLUSIONS: Among the various polyp characteristics, the organized polyp was significantly related to relatively less improvement of objective and subjective voice parameters after surgery. These polyp characteristics would help to predict postoperative voice improvement and plan for personalized treatment in patients with vocal fold polyp.

Preliminary Clinical Outcomes of VOIS-Implant in Patients With Unilateral Vocal Fold Paralysis.

Evaluation of the clinical outcomes after 6 months of treatment with a novel adjustable implant, the APrevent® Vocal-Implant-System (VOIS), in conjunction with medialization thyroplasty (MT) in patients with unilateral vocal fold paralysis. Prospective case series study at single tertiary referral center. Preoperative and 1 week, 7 weeks, and 6 months postoperative glottal efficiency (maximum phonation time [MPT]), voice quality (including GRBAS-scores and acoustic parameters) and self-perceived voice-related handicap (voice handicap index [VHI-30]) were measured and analyzed, whereas type of vocal fold closure was evaluated and determined by flexible videolaryngoscopy based on Södersten and Lindestad classification (Wilcoxon signed-rank test). Thirteen patients underwent MT with VOIS under local anesthesia. Six months after surgery, the VHI-30 and MPT had improved from a preoperative mean of 75.0 ± 22.9 and 2.7± 2.1s to a postoperative mean of 20.6± 19.7 and 6.3± 4.0 s, respectively. The mean GRBAS score improved from preoperative scores of Gpreop = 2.7, Rpreop = 2.6, Bpreop = 2.6, Apreop = 2.2, and Spreop = 2.0 to Gpostop = 0.3, Rpostop = 0.3, Bpostop = 0.2, Apostop = 0.2, and Spostop = 0.3 at 6 months postoperatively. Improved glottal closure was achieved in all patients (n=13). Five patients received postoperative adjustment for the optimization of voice quality and glottal closure. No intra- or postoperative complications were observed. Significant improvements in acoustic parameters, including percentage jitter, percentage shimmer, and signal-to-noise ratio, were also observed after MT. All results were statistically significant (P< .05, Cohen's d > .8). APrevent® VOIS-Implantation is a safe procedure with good voice outcomes. Postoperative adjustments can be performed smoothly to optimize voice quality and glottal closure. 3 Laryngoscope, 132:1622-1629, 2022.

Long-term voice outcomes of laryngeal framework surgery for unilateral vocal fold paralysis.

To evaluate the short- and long-term voice outcomes after unilateral medialization thyroplasty (MT) and unilateral medialization thyroplasty with arytenoid adduction (MT + AA) in patients with unilateral vocal fold paralysis. Voice outcomes were assessed preoperatively, and postoperatively at 3 and 12months according to a standardized protocol. Voice assessment was performed using Voice Handicap Index (VHI), GRBAS Grade, Maximum Phonation Time (MPT), s/z-ratio and subjective numeric rating scales on voice quality, effort, performance and influence on life. Sixty-one patients were included (34 MT and 27 MT + AA). Significant pre- to postoperative improvements were seen in all voice outcome parameters. No significant differences in post-operative values were identified between the groups. Based on our findings, we conclude that patients with unilateral vocal fold paralysis who undergo MT and MT + AA achieve comparable and significant long time voice improvement, although voices do not completely normalize. We also conclude that this does not mean that AA is a superfluous procedure, but can indicate the accurate identification of patients in need of the additional AA procedure based on clinical parameters.

Do Flexible Silicone Tubes Immersed in Water Combined With Vocalise Improve the Immediate Effect on Voice?

This study aimed to analyze the immediate effect on a singer's voice of a flexible silicone tube immersed in water combined with ascending and descending vocalise scales compared with ascending and descending vocalise scales alone. A pre- and post-intervention quasi-experimental study was conducted. Thirty adult singers between 18 and 45 years old with no laryngeal disorders performed the two techniques for 3 min each on different days. Acoustic measurements of frequency, jitter, shimmer, glottal-to-noise excitation ratio, noise, smoothed cepstral peak prominence (CPPS), maximum phonation time (MPT), voice range profile, and self-perceived vocal effort (Borg Category Ratio 10-BR Scale adapted for vocal effort) were assessed before and after performing the techniques. The results indicated an increase in singers' CPPS and MPT values and a decrease in shimmer and noise when performing with a flexible silicone tube immersed in water combined with vocalise. The singers reported a perception of decreased vocal effort after both methods. However, the diminished perceived vocal effort became more pronounced with the tube phonation technique combined with vocalise. Phonation in tubes combined with vocalise improved the vocal acoustic parameters (including cepstral measurements), increased MPT, and diminished perceived vocal effort. Although using vocalise alone diminished perceived vocal effort, this decrease was more pronounced in the tube phonation technique combined with vocalise.

The Effect of Masks and Respirators on Acoustic Voice Analysis During the COVID-19 Pandemic.

ObjectivesWorld Health Organization declared the coronavirus disease (COVID-19) as a global pandemic on March 11, 2020. The aim of this study was to determine the effectiveness and reliability of voice analysis performed with surgical masks and respirators during the pandemic and to discuss its routine applicability.MethodsThis prospective study included 204 patients who applied to our clinic between the ages of 18 and 55, whose preoperative SARS-Cov-2 PCR tests were negative. Voice analyses were performed on each patient without a mask, with a surgical mask and with a valved face-filtering piece-3 (FFP3) respirator respectively. The F0, shimmer, jitter, s/z ratio, maximum phonation time and harmonic/noise ratio (HNR) values obtained from the voice analyses were compared with each other.ResultsNo significant difference was found in terms of F0, Jitter, Shimmer, HNR, s/z and maximum phonation time values in the voice analyses performed without a mask and with a surgical mask. With an FFP3, a significant difference was found in only the Shimmer and HNR values compared to the other analysis values. When we look at the data with sex distinction, in the group of female and male patients, when the data of voice analysis obtained in three situations were compared, different results were obtained from the female and male group.ConclusionIn conclusion, it should be decided by the physician to perform the voice analysis with a surgical mask or with an FFP3, considering the clinically desired parameters.

Values of laryngeal stroboscopy in patients with chronic laryngitis exposed to occupational factors

Values of laryngeal stroboscopy in patients with chronic laryngitis exposed to occupational factors

Autologous Fat Injection Laryngoplasty for Unilateral Vocal Fold Paralysis.

Background: Unilateral vocal palsy (UVFP) affects the voice and swallowing function and could be treated by various materials to achieve improved mucosal wave and better closure during phonation. Injection laryngoplasty is considered an exemplary method for these patients and could be injected as early as possible. We conducted a systematic review and meta-analysis for the subjective and objective outcomes of autologous fat injection laryngoplasty (AFIL) and assessed the effects for patients with UVFP. Methods: We searched studies from PubMed and EBSCO databases with PRISMA appraisal to search for articles about the effects of AFIL on UVFP. The published articles were reviewed according to our inclusion and exclusion criteria. The short- and long-term outcomes of perceptual, acoustic analysis, and quality of life were also analyzed by meta-analysis. Results: Eleven articles were reviewed, and seven studies were selected for meta-analysis. AFIL improves the perceptual outcome and some voice parameters in short-term and long-term results, i.e., jitter, shimmer, and maximal phonation time (MPT). It also significantly improved the voice handicap index (VHI) in the long term, suggesting an increase in quality of life. Conclusions: AFIL is considered a reliable treatment method for UVFP and could even last for over 12 months.

Evolution of Voice Quality in Type 1-2 Transoral CO2 Laser Cordectomy: A Prospective Comparative Study.

To compare the 12-month evolution of voice quality outcomes in patients who benefited from types 1-2 transoral CO2 laser cordectomy (TLC) for an early-stage vocal fold squamous cell carcinoma (VFSCC). Prospective uncontrolled study. Sixty patients with cT1 VFSCC were consecutively recruited from a single medical center. Thirty patients benefited from type 1 TLC, while type 2 TCL was performed in 30 patients. The following voice quality outcomes were evaluated at baseline, 3-, 6-, and 12-month post-TLC: voice handicap index (VHI), GRBAS, speech rate, maximum phonation time (MPT), and acoustic parameters. Voice quality evolution was compared between type 1 and type 2 TLC. Fifty-seven patients completed the evaluations. Type 1 TLC patients reported significant improvements of VHI, grade of dysphonia, and breathiness at 3-, 6-, and 12-month post-TLC. Speech rate and jitter values improved 6- and 12-month post-TLC. A few voice quality outcomes reported 3- or 6-month post-TLC improvements in type 2 TLC group, while VHI, grade of dysphonia improved at 6- and 12-month post-TLC. MPT significantly decreased at 6- and 12-month post-TLC, while there were no acoustic measurement changes in type 2 TLC. The effect of TLC on voice quality may depend on the type of TLC. Type 1 TLC was associated with faster voice quality improvements compared with type 2 TLC. VHI and dysphonia grade were identified as the most relevant tool of voice changes irrespective to the TLC type. 3 Laryngoscope, 132:1421-1426, 2022.

Impact of Acid, Weakly Acid and Alkaline Laryngopharyngeal Reflux on Voice Quality

To analyze pre to posttreatment voice changes regarding the type of reflux in patients with acid, weakly acid or alkaline laryngopharyngeal reflux (LPR). Patients with LPR, diagnosed using hypopharyngeal-esophageal multichannel intraluminal impedance pH-monitoring (HEMII-pH), were prospectively recruited from three University Hospitals. Patients were treated with a combination of diet, proton pump inhibitors, magaldrate and alginate for 3 months. The following clinical and voice quality outcomes were studied pre to posttreatment according to the type of reflux (acid, weakly acid, nonacid): HEMII-pH, gastrointestinal endoscopy features, reflux symptom score (RSS), reflux sign assessment (RSA), voice handicap index (VHI), perceptual voice assessment (grade of dysphonia and roughness), aerodynamic and acoustic measurements. From December 2018 to March 2021, 160 patients completed the evaluations, accounting for 60 acid, 52 weakly acid, and 48 alkaline cases of LPR. There were no baseline differences in clinical and voice quality outcomes between groups. RSS and RSA significantly improved from pre to posttreatment in the entire cohort and in all patient groups. VHI, dysphonia and roughness, maximum phonation time, Jitter, Shimmer and noise to harmonic ratio significantly improved from pre to posttreatment. Individuals with alkaline reflux reported better voice quality improvements as compared to acid and weakly acid reflux patients. Patients with acid and alkaline reflux reported better posttreatment voice quality outcomes as compared to weakly acid reflux patients. Future basic science and clinical studies are needed to better understand the histological changes of the vocal folds due to reflux of varying pH types and gastroduodenal enzyme content.

A Novel Technique for Thyroplasty Type 1, With Prolene Mesh Implant

To analyze the efficacy of a modified approach to thyroplasty type one using prolene mesh implant. Interventional study. Combined Military Hospital Kharian, Pakistan, in Ent department, from July 2020 to Jan 2021. Medialization thyroplasty with prolene mesh was performed on the patients satisfying the inclusion criteria. They were analyzed objectively as well as subjectively in terms of Mean Maximum phonation time, maximum word count, and visual analog score about the quality of voice. Data analysis was done with SPSS version 20. Pre-operative and post-operative records were compared using paired sample t-test. A total of 39 patients underwent vocal cord medialization with prolene mesh implant. The Mean age for medialization was 41.09 + 13.37. 23 patients were females and 15 were males. 26 patients had unilateral and 13 patients had bilateral vocal dysfunction. 18 of them had vocal dysfunction due to thyroidectomy, eight had idiopathic causes and 13 had miscellaneous. The improvement in mean visual analog score was 2.87 postoperatively. Median maximum phonation time increased about five seconds postoperatively, seven seconds in males, and 4.5 seconds for females. The maximum word count increased from 11.33 preoperatively to 18.28 postoperatively. There were no major complications observed in our study. These results were comparable to many other studies for vocal cord medialization with different implant materials. But prolene mesh implant offers an easily available yet cost-effective alternative with similar benefits. III (Treatment benefits: Non-randomized controlled cohort/follow-up study).

Physiological Effects of Voice Therapy for Aged Vocal Fold Atrophy Revealed by EMG Study

ObjectivesAge-related voice changes are characterized as breathy, weak and strained, and a deterioration in vocal function in the elderly has been putatively linked to a reduced intensity of speech. They contribute to undesirable voice changes known as presbyphonia. These changes are caused by histological alterations in the lamina propria of the vocal fold mucosa and atrophy of the thyroarytenoid muscle, as well as by decreased respiratory support. There are several clinical studies on presbylarynx dysphonia showing the effectiveness of voice therapy. However, physiological changes of the presbylarynx following voice therapy have not been verified. The purpose of this prospective study was to demonstrate the clinical effectiveness of voice therapy for rehabilitating presbylarynx dysphonia, using vocal function assessments and thyroarytenoid muscular activity detection on laryngeal electromyography (LEMG). Methods10 patients who were diagnosed with aged vocal fold atrophy from ages 60 to 87 years (mean age: 72 years) underwent approximately 12 weeks of voice therapy, mainly using forward-focused voice and vocal resistance training. Stroboscopic examination, aerodynamic assessment, acoustic analysis, Voice Handicap Index (VHI)-10, and LEMG were performed pre– and post–voice therapy. Vocal fold vibratory amplitude (VFVA) was measured by image analysis from the stroboscopic examinations. Turns analysis during steady phonation on LEMG was also assessed. ResultsMaximum phonation time, subglottic pressure, jitter, shimmer, VFVA, and VHI-10 significantly improved after voice therapy. The number of turns per second on LEMG also significantly increased. ConclusionOur data suggest that voice therapy may improve vocal function and thyroarytenoid muscle activity in patients with aged vocal fold atrophy.

Impact of subclinical mental disorders of voice function and quality of life in voice-speaking professions during the COVID-2019 pandemic

Objective: To investigate the risk of mental distress during the COVID-19 pandemic in individuals of the voice-speech professions and the possibility of its impact on voice function and quality of life. Materials and Methods: The study involved 33 people of voice-speech professions who were treated at the University Clinic of Zaporizhzhia State Medical University in 2020. The presence of mental disorders was determined by questionnaires using the hospital anxiety and depression scale (HADS). The patients were divided into 2 groups, depending on the absence and presence of significantly expressed symptoms. A specialized phoniatric examination using functional loads (measuring the time of maximum phonation (PMF), perceptual assessment of the voice according to the GRBAS scale), videostroboscopy of the larynx were carried out. The assessment of the mental impact of voice disorders on the quality of life was carried out according to the Voice Handicap Index (VHI) questionnaire. The statistical significance of the comparative indicators and the connection of their changes were established using the Spearman's rank correlation coefficient. Results: It was found that among the surveyed 33 people, 22 patients (group 1) had subclinical anxiety and depression, and 11 (group 2) had no significant symptoms. Patients with subclinically severe mental disorders (n = 22) showed a significant increase in the emotional indicator by 85.37% (p≤0.01). A high positive relationship was found between subclinical levels of anxiety and depression and disturbances in the phonatory cycle of the larynx. When conducting a Spearman correlation analysis between the data of perceptual assessment of the voice according to the GRBAS system, data of video stroboscopy of the larynx, indicators of anxiety and depression, and the results of the VHI questionnaire, a positive relationship of a high degree was established between the level of anxiety and vibratory insufficiency of the vocal folds (rs=0.95; p≤0.05), negative with the Navy (rs=-0.59; p≤0.05), as well as physical (rs=0.75; p≤0.05) and emotional (rs=0.79; p≤0.05) components of average quality of life. The data obtained indicate a significant effect of subclinical disorders of the mental state on impaired voice function and the emotional component of the quality of life in persons of vocal-speech professions. Conclusions: Screening of mental health in persons of voice-speech professions together with a baseline assessment of voice function and quality of life are important steps for monitoring potential voice disorders and the formation of risk groups in order to carry out preventive and therapeutic measures for voice disorders.

Survey of acoustic analysis of voice in healthy residents of Ukraine

Introduction: Acoustic analysis of voice is a method for assessing its quality, which has a relatively low cost. It quite simple to use, and is non-invasive. One of the programs of spectral analysis of voice is the program Praat, which allows to explore its acoustic characteristics and analyze the forms, also its allows to edit sound segments and print the spectrogram. The purpose: Investigate the acoustic parameters of the voice Ukrainians of different ages and genders and perform the calculation of reference intervals (RI) for these indicators. Material and methods: We had examined150 healthy Ukrainians aged 18 to 70. The study was performed using a Behringer C1U condenser microphone and Praat software (version 5.1.12.). The following acoustic characteristics of the voice were studied: the fundamental frequency of voice (F0) in Hz, the maximum phonation time (MPT) in seconds, the Harmonic to Noise Ratio (HNR) in dB, Jitter in%, Shimmer in%. Four groups were formed for the study: 1a – young women (18-44 years); 2a – young men (18-44 years); 1b – middle-aged women (45-59 years); 2b – middle-aged men (45-59 years). Results: Young and middle-aged men showed significantly higher MPT than women of relevant age. The value of MPT in women with age increased slightly, in men decreased slightly. RI for the indicator of MPT, in 1a group is 11,35-31,28 s, in 2a group – 15,55-39,53 s, in 1b group -14,30-33,01 s, and in 2b group –12,59-31,90 s. The value of F0 in young and middle-aged women is statistically higher than in men of the same age group (p &lt;0.001). With age, this figure decreases slightly in women and men. RI for the indicator F0, in 1a group is 107,0-316,5 Hz, in 2a group – 94,1-139,3 Hz, in 1b group – 94,3-339,1 Hz, and in 2b group – 80,3 -174,3Hz.A comparative analysis of the HNR in young and middle-aged men didn’t show significant differences. In middle-aged women this value is significantly higher than in young women. RI for the HNR in group 1a is 14,194-26,946 dB; in group 2a – 17,328-28,675 dB; in group 1b -15,254-26,536 dB, and in group 2b – 13,545-30,368 dB. The Jitter index in men and young women does not differ statistically. This figure increases statistically in men with age, in women this rate the same level. RI for the Jitter in 1a group – 0,110-0,436%; in 2a group – 0,101-0,472%; in 1b group – 0,094-0,520% and in 2b group – 0,117-0,460%. A comparative analysis of Shimmer in men and young women didn't show significant differences, but in middle-aged women this figure decreased statistically compared to young women. In men, this figure has not changed with age. The RI for the Shimmer index is 1,974-14,128% in group 1a; 2,592-12,378% in group 2a; 2,008-6,788% in group 1b; 2,016-12,260% – In group 2b. Conclusions: Indicators of spectral analysis of voice in young and middle-aged women and men are relatively stable and do not change significantly in this time period.

Voice Quality Measurement as an Indicator of Efficiency of Treatment in Laryngopharyngeal Reflux Disease

Introduction Laryngopharyngeal reflux disease can alter the structural and functional integrity of the vocal fold. Objectives of the study was to determine the effect of Laryngopharyngeal Reflux Disease (LPRD) on selected Acoustic, Aerodynamic and perceptual parameters of voice and to establish its effectiveness in therapeutic outcome. Materials and Methods The number of patients enrolled for this prospective observational study was 65, all with Reflux symptom index (RSI) more than 13. Quality of life was evaluated using voice handicap index (VHI). Perceptual evaluation of voice done by Grade Roughness Breathiness Asthenia Strain score (GRBAS) followed by acoustic and aerodynamic analysis. Patients were started on a once daily proton pump inhibitor therapy for 3 months along with vocal hygiene measures and RSI, VHI and voice analysis repeated after the treatment. Results There was significant improvement in the RSI score after treatment. Percent jitter and shimmer showed significant improvement in males post treatment (p value:&lt;0.05). Harmonic to noise ratio improved 3 months post treatment in both sexes. Improvement noted in Maximum phonation time and GRBAS score except asthenia and strain post treatment. Conclusion Measurement of voice quality can be used as an effective tool to monitor the efficiency of treatment of LPRD.

Autologous Adipose Tissue Injection of Vocal Cords in Presbyphonia.

This series evaluates the long-term results of autologous adipose injection (AAI) in patients older than 65 years with presbyphonia. Retrospective cohort study. Academic secondary medical center. This was a retrospective study with a minimum follow-up of 12 months. All patients underwent AAI for atrophy of both vocal folds due to presbyphonia. We measured subjective parameters as Voice Handicap Index-10 (VHI-10) or GRBAS scale (grade, roughness, breathiness, asthenia, strain) and objective measures such as maximum phonation time (MPT) or square pixel closure defect. We reviewed the medical records of patients undergoing AAI during the 2011-2018 period. An analysis of the demographic variables of the group was performed, as well as the values of VHI-10, GRBAS, and MPT, and the minimum closure defect measured in square pixels and the number of closed frames in the glottal cycle before and after the intervention. At 12 months, 17 of 18 patients reported subjective and VHI-10 improvement. The mean preoperative VHI-10 (26.7) was significantly higher than the postoperative value (14.4), and the GRBAS scale had a preoperative mean of 8.7 and a postoperative mean of 4.3, both with statistical significance. MPT increased from 7.7 to 12.4 seconds (P < .0001). The minimum closure defect measurements obtained in square pixels changed from 305 to 124, achieving complete closure in 3 patients. The closed phase of the glottal cycle change from 14.3% to 38.2% after the AAI. AAI improves long-term vocal fold closure, demonstrating utility in patients with presbyphonia.