Vocal Misuse Research Articles

Perceived Benefits of Interdisciplinary Coaching Strategies for Professional Vocalists: A Pilot Study

ABSTRACT Professional vocalists, specifically teachers, are at increased risk of missing work and having vocal damage due to vocal misuse and overuse. The purpose of this pilot study was to examine the perceptions of participants (N = 4) taking part in interdisciplinary voice coaching sessions with both a singing and theatre voice specialist. Participant perceptions were obtained using the Voice Handicap Index (VHI), individual weekly journals, and a post-study researcher-created questionnaire. Results are discussed in terms of potential for future research and application of results to mutli-disciplinary voice training options for professional voice users as a solution to mitigate voice problems.

Reexamining Glottalization and Health in Voice and Speech Pedagogy

ABSTRACT Throaty speech sounds like glottal stops, creaky voice, and epiglottal stops are phonemic speech sounds found in various languages cross-linguistically, yet voice and speech literature has historically associated such sounds with poor vocal technique, vocal misuse, and/or vocal abuse. Currently, there is no clear evidence to support the notion that speech sounds which serve as realizations of phonemes in one language are unhealthy when used prosodically in another. Speech sounds targeted (both historically and contemporarily) for reduction and removal from speech patterns for supposed health concerns in English-speaking voice training tend to be the same speech sounds which are targeted as socially undesirable compared with standardized accents of English. Critical examination of cross-linguistic evidence, social context, and previous historical assumptions are necessary to challenge the classification of a speech sound as poor technique or vocal misuse/abuse.

The Occurrence of Laryngeal Pathologies in a Treatment-Seeking Pediatric Population

The purpose of this study was to 1) describe the age- and sex-specific occurrence of laryngeal pathologies in a treatment-seeking pediatric population in the voice unit of Ghent University Hospital, Belgium, and 2) describe this population in terms of vocal parameters, vocal complaints, influencing factors, and treatment history and recommendation. Retrospective, observational study. All patient records were analyzed for children (0-18 years) who consulted the ear, nose, and throat department of Ghent University Hospital for the first time between July 2015 and June 2021 with complaints of dysphonia. In total, 103 children (66 males, 37 females) with a mean age of 10.01 years (SD: 3.4, range 3.93-17.96) were included in this study. Laryngeal pathology was diagnosed using a flexible videolaryngo(strobo)scopy. The influence of age and sex on laryngeal etiology (organic/functional voice disorder) was examined using a Welch-modified t test and a Fisher's exact test, respectively. Organic lesions were observed in 77.7% of the participants, with vocal fold nodules (VFNs) being the most common diagnosis (66.0%). A functional voice disorder was diagnosed in 22.3% of the children. Children with a functional voice disorder are significantly older than children with an organic voice disorder. There was no statistically significant difference between males and females in laryngeal etiology. Mean dysphonia severity index was -2.7 (SD: 3.2, range -9.3 to +3.7), the mean acoustic voice quality index 4.70 (SD: 1.5, range 2.35-8.27), and the mean pediatric voice handicap index 29.8 (SD: 13.6, range 5-60). The occurrence of vocal misuse was mentioned in 80.6% of the patient records. Organic voice disorders, especially VFNs, are predominant in treatment-seeking children with dysphonia. Functional voice disorders become more common with increasing age during childhood. A disordered vocal quality, reduced vocal capabilities and reduced voice-related quality of life were found.

Pattern and perception about vocal use and misuse among young adult in Pakistan

Background: The human voice is a prominent feature and the most susceptible to environmental changes, lifestyle, and age. Voice problems tend to be significantly under-reported and consequently less likely to be clinically treated. It is yet to be established if the cause lies in the lack of awareness or the impermanent nature of most voice disorders. Objective: To evaluate the patterns and perceptions about vocal use and misuse among young adults in Pakistan. Method: The study used a cross-sectional survey design. A convenient sampling technique was employed to collect the data from n=242 healthy young adults aged 18-25 years studying in colleges and universities of Rawalpindi and Islamabad. A 32-item survey questionnaire titled “patterns and Perceptions about voice use and Misuse” was employed, with a portion for demographic data and five sections dedicated to general awareness, self-perception about voice, and habits of vocal use and misuse. Results: The results regarding the perception and patterns of vocal use and misuse reflects that 88.3% of the participants agreed that precautionary measure would help them to avoid voice disorder. In contrast, 83.3% of the participants reported screaming and yelling as part of their vocal pattern. Participants showed a strong association with the positive attributes related to their voice such as beautiful as 82.2% of the participants reported their voice as pleasant. Conclusion: The study concluded that the outcome of participants’ perceptions and their patterns of vocal behavior were significantly atypical. Screaming and smoking were the most frequently reported response by adults but on the other hand, they did not seek professional help and did not perceive their voice as unpleasant voice. Keywords: speech therapy; voice disorder; vocal misuse; young adults

Clinical study of benign lesions of larynx

Background: The significance of benign lesions of the larynx lies in the importance of its function in speaking and the contribution of the voice to one’s identity. Inadequate voice is a social and professional disadvantage. Although rarely life threatening. Objectives: To study benign lesions of larynx. Methods: A total number of 64 patients were studied, A thorough history of all patients included in the study was taken with respect to the presenting symptoms and their duration. The treatment advised to the patients was either conservative medical therapy and/or surgical therapy (micro laryngeal surgery). All the patients underwent micro laryngeal surgery except those patients with vocal nodules. They were advised speech therapy for 3 months, if not resolved with speech therapy underwent micro laryngeal surgery. Results: There were varied causes for the development of benign lesions of larynx in which chronic vocal misuse was predominant cause in benign vocal fold lesions. It shares 75% of the incidence. Reasons for chronic vocal misuse is related to the occupation. The commonest site of origin of lesions was from true vocal cords. Next commonest were false cords, arytenoids and interarytenoid regions. In the study group, only 18.3% patients got complete relief with voice rest and vocal rehabilitation, 82.7% patients required surgery, which included microlarygoscopy and end laryngeal surgery. Conclusion: The benign laryngeal lesion produces symptoms which can vary from mild hoarseness to life-threatening stridor, creating a lot of mental and emotional tension in the patient and the family. Early diagnosis of the lesions can lead to effective management and good recovery.

Presbylarynx, Functional Voice Disorders, Muscle Tension Dysphonia

Presbylarynx refers to age-related structural changes of the vocal folds that include muscle atrophy, reduced neuromuscular control, loss of superficial lamina propria layer, and reduced pliability. The changes result in thin and bowed vocal folds, increased vocal effort requirements, breathy voice, change in habitual pitch, and strain. The primary treatment options are voice therapy focused on strengthening breath support and the intrinsic muscles of the larynx, and optimization of resonance; injection augmentation of the vocal folds; and type I thyroplasty. Functional dysphonia is defined as change in voice quality in the absence of structural or neurological abnormalities of the larynx. Muscle tension dysphonia (MTD) is a subtype of functional voice disorders and involves laryngeal muscle tension imbalance due to excessive or dysregulated activation resulting often in strained or breathy voice. MTD can be divided into primary (psychological etiology or vocal misuse) and secondary (compensatory for organic laryngeal pathology). The mainstay of treatment for MTD is voice therapy, along with medical or surgical treatment of the underlying vocal pathology in secondary MTD. Mutational falsetto, or puberphonia, is a functional voice disorder where a high-pitched, pre-adolescent voice fails to transition to the lower pitch of adulthood. This review contains 5 figures, 7 tables, 4 videos and 10 references Key Words: Presbylarynx, Injection augmentation, Type I thyroplasty, Primary muscle tension dysphonia, Secondary muscle tension dysphonia, Muscle tension patterns, Manual circumlaryngeal therapy, Functional dysphonia, Mutational falsetto

Vocal tract discomfort and voice handicap index in patients undergoing thyroidectomy

Purpose This study aims to investigate the frequency and severity of vocal tract discomfort (VTD) symptoms and to determine the relationship between VTD and type of thyroidectomy, voice problem history, vocal abuse, and misuse behaviors, and the voice handicap index (VHI) in the thyroidectomy patients undergoing thyroidectomy, pre- and post-operatively pre- and post-thyroidectomy. Materials The sample comprised 21 thyroidectomy patients undergoing thyroidectomy, including 10 patients with total thyroidectomy and 11 patients with partial thyroidectomy. The participants underwent videolaryngoscopy examination and completed the voice history questionnaire, the VTD scale, and the VHI, before and after the surgery. Results Dryness was the most frequently occurring symptom, pre- and post-thyroidectomy. Participants with total thyroidectomy reported significantly higher frequency and severity of tickling than those in the preoperative status (p<.05). The frequency and severity of many VTD symptoms in the participants with voice problems and a vocal abuse and misuse history were higher than those without such a history at both assessment times (p<.05). There was significant correlation between the frequency and severity of VTD and VHI scores, pre-thyroidectomy pre-operatively (r = 0.488–0.575, p<.05). Conclusions An increment in the frequency and severity of tickling was reported by total thyroidectomy patients, post-thyroidectomy post-operatively. The type of thyroidectomy, voice problem history, and vocal abuse and misuse behaviors seem to influence the frequency and severity of VTD. Considering the correlation between VTD and VHI, the VTD scale provides important clinical information and can be used for evaluation and consultation purposes.

Efecto Preventivo de Ejercicios con Tubos de Resonancia en un Grupo Docente.

En múltiples estudios se ha determinado la importancia de la voz en aquellos profesionales que la utilizan como su herramienta principal de trabajo. Dentro de este grupo se encuentran locutores, agentes de call center, profesores, entre otros; la población objeto de estudio en esta investigación son los profesores universitarios, ellos trabajan durante varias horas al día usando su voz para transmitir el conocimiento dentro del aula de clase, muchas veces en condiciones poco óptimas para un desempeño laboral efectivo. Además, están expuestos a diversos factores de riesgos ambientales y organizacionales lo cual los predispone y genera diversidad de patologías laríngeas propias de su ocupación. Los participantes pertenecen a un programa de conservación de la voz. El diseño de investigación pre experimental, cuantitativo, utilizando pre-test y pos-test en una misma población, descriptivo transversal, bajo un enfoque epidemiológico. Se aplicó una encuesta de autopercepción vocal como pre-test, con el fin de identificar la percepción que tenían estos profesionales acerca de sus características vocales. Posterior a esto, se les realizó una serie de ejercicios con tubos de resonancia basados en la técnica de Tracto Vocal Semi Ocluido (TVSO) y finalmente, se le reaplicó la encuesta de autopercepción vocal como post-test para determinar los efectos y cambios fisiológicos de estos ejercicios sobre los parámetros acústicos de la voz y las características del habla tales como: inteligibilidad, naturalidad y audibilidad; logrando un efecto fisiológico terapéutico inmediato y una percepción subjetiva de mejoría posterior a la terapia, generando un cambio en el patrón vibratorio de sus pliegues vocales, minimizando el abuso y mal uso vocal, creando conciencia del cuidado que se debe tener con la voz cuando se utiliza de manera profesional por ser la herramienta principal de su trabajo.

Vocal Quality, Symptoms, and Habits in Musical Theater Actors

The purpose of this study was to measure and compare the voice characteristics and vocal complaints and habits of musical theater actors and musical theater students. Thirty participants were included in the study, 18 musical theater students and 12 professional musical theater actors. Vocal quality was measured by the multiparameter indices Dysphonia Severity Index (DSI) and Acoustic Voice Quality Index (AVQI). A perceptual evaluation of the speaking voice was performed using the GRBASI scale. All participants completed the Voice Handicap Index (VHI), the VHI adapted to the singing voice, the Vocal Tract Discomfort (VTD) Scale and the Corporal Pain Scale. Excellent scores for DSI (resp. 7.3, 7.1) and AVQI (resp. 2.6, 2.5) were found in the musical theater actors and students. All participants reported at least two symptoms of VTD and the mean scores for the VHI adapted to the singing voice were located in the clinical zone. Musical theater students reported significantly more VTD and pain symptoms compared to the professionals. No significant differences in perceptual and objective voice characteristics were found between musical theater actors and students. A higher presence of vocal misuse and stress in the students was observed. Musical theater students and actors are elite vocal performers with comparable excellent objective vocal measures (DSI, AVQI). In both groups, an increased number of VTD and complaints of the singing voice were reported. Especially students were vulnerable for stress, vocal misuse, VTD, and pain symptoms. The findings suggest that musical theater actors are a risk group for developing voice disorders requiring multidimensional voice assessment and voice care.

Assessment of pre and postoperative voice quality in cases of vocal fold polyp

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Benign vocal fold lesions comprise of a wide range of conditions resulting from vocal misuse or abuse (vocal nodules, polyps, cysts etc.), acute and chronic inflammatory changes, congenital vocal fold anomalies, vocal fold trauma and benign tumours. It results in significant impairment of vocal communication with major psychosocial impact.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The&lt;strong&gt; &lt;/strong&gt;prospective&lt;strong&gt; &lt;/strong&gt;study was conducted in Department of Otolaryngology, Vivekananda Institute of Medical Sciences, Kolkata from January 2016 to January 2018. All forty patients diagnosed with vocal fold polyp underwent phonomicrosurgery using micro-flap technique followed by voice therapy. Detailed pre-operative and post-operative (3 weeks, 6 weeks, 12 weeks follow up) voice assessment including fibre optic laryngoscopy and laryngovideo-stroboscopic findings were recorded. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Voice quality of the 40 patients with vocal fold polyps who underwent cold steel phonomicrosurgery had a statistically significant improvement at each follow up visit (3 weeks, 6 weeks and 12 weeks) as assessed by the subjective variables of voice handicap index score, visual analogue scale score and grade, roughness, breathiness, asthenia, strain score and objective variables of jitter, shimmer, harmonic-to-noise ratio, maximum phonation time and fibreoptic laryngoscopy and videolaryngostroboscopic findings. Fundamental frequency in females had statistically improved results but in males, though there was an improvement, the values were not statistically significant.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Cold steel microlaryngeal surgery using micro-flap technique offers excellent results in patients with vocal fold polyps. Perceptual, aerodynamic, acoustic, self-analysis and videolaryngostroboscopic parameters together allow multidimensional assessment of voice characteristics.&lt;/p&gt;

Awareness of hearing loss, vocal hygiene and vocal abuse among autorickshaw drivers in Mumbai

Awareness of hearing loss, vocal hygiene and vocal abuse among autorickshaw drivers in Mumbai - IJOAS- Print ISSN No: - 2582-4147 Online ISSN No:- 2582-421X Article DOI No:- 10.18231/j.ijoas.2019.003, IP Journal of Otorhinolaryngology and Allied Science-J Otorhinolaryngol Allied Sci

A rare case report: Ayurvedic management of vocal cord nodules

Vocal nodules are the consequence of functional voice disorders, which are also caused by vocal abuse or misuse. An increased vocal load, for example, due to the patient's profession, demands high-volume speech for the formation of nodules. In the present case report, a 26-year-old female patient acquired this disease followed by common cold cough. Her problems were aggravating by high-volume speech and getting fatigability also. This patient was given Anutaila Nasya with Sitopaladi Churna, Naradiya Laxmi vilasa Rasa, Yashtimadhu Ghanvati (for chewing), and Dashmoola Kwatha(Kavala). The patient was advised for strict voice rest and steam inhalation for better result. After 1 month of treatment, the patient got relief from all her complaints and gained normal voice. On examination, it was found that vocal nodules disappeared in direct laryngoscopy. Hence, this single case report shows that ayurvedic management of vocal cord nodules gives excellent result and improves patients' quality of voice.

The Impact of Vocal and Laryngeal Pathologies Among Professional Singers: A Meta-analysis

Professional singers are more likely to develop laryngeal pathologies and symptoms associated with misuse and overuse of the voice. However, different studies have shown conflicting evidence. We aim to perform a systematic review and quantitative meta-analysis to determine the prevalence and risk of laryngeal pathologies and symptoms among professional singers. Four electronic databases (MEDLINE, PubMed, EMBASE, and CINAHL) were searched, with no language restrictions. From 3368 potential studies, a total of 21 studies met our inclusion criteria. A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. All cohort, case-control, or cross-sectional studies that reported the risk of laryngeal pathologies in singers were included. Data were pooled by a random effects model and the pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. There was a positive relationship between singing and laryngeal pathologies. There was an increased risk of hoarseness (OR: 2.00, 95% CI: 1.61-2.49), gastroesophageal reflux disease (GERD) (OR: 1.45, 95% CI: 1.19-1.77), Reinke edema (OR: 2.15, 95% CI: 1.08-4.30), and polyps (OR: 2.10, 95% CI: 1.06-4.14) in professional singers. Professional singers are at an increased risk of laryngeal pathologies and symptoms associated with vocal misuse and overuse, particularly hoarseness, GERD, edema, and polyps.

Well-being and associated factors among elementary school teachers in southern Brazil

ABSTRACT Purpose: to verify the prevalence of well-being and its association with sociodemographic features, health and work-related conditions, and vocal behavior in elementary school teachers in the city of Pelotas, RS. Methods: a cross-sectional observational study with 575 teachers from urban and rural areas. The participants answered a structured questionnaire that included items on sociodemographic, health and work-related conditions. The Faces Scale (Andrews) was used to evaluate their psychological well-being. The Vocal Behavior Profile verified occurrences of abuse and vocal misuse. Poisson regression was used for the multivariate analysis. Results: of the total sample, 79.5% of teachers experienced well-being. It was observed that vocal behavior profile was significantly associated with well-being, and the number of students in the classroom showed a trend towards significance. Conclusion: most teachers had a satisfactory well-being perception. Moreover, a lower well-being perception in the teaching population was mainly related to abusive vocal behavior and, less clearly, to the high number of students per classroom.

Adaptation and validation of Mandarin Chinese version of the pediatric Voice Handicap Index (pVHI)

ObjectiveThe aim of this study was to adapt and validate the English version of pediatric voice handicap index (pVHI) into Mandarin Chinese. MethodsA cross-sectional study was performed from May 2016 to April 2017. A total of 367 parents participated in this study, and 338 parents completed the translated questionnaire without missing data, including 213 parents of children with voice disorders (patients group), and 125 parents of children without voice disorders (control group). The internal consistency, test-retest reliability, contents validity, construct validity, clinical validity, and cutoff point were calculated. ResultsThe most common voice disorder in the patients group was vocal fold nodules (77.9%), followed by chronic laryngitis (18.8%), and vocal fold polyps (3.3%). The prevalence for voice disorders was higher in boys (67.1%) than girls (32.9%). The most common vocal misuse and abuse habit was shouting loudly (n = 186, 87.3%), followed by speaking for a long time (n = 158, 74.2%), and crying loudly (n = 99, 46.5%). The internal consistency for the Mandarin Chinese version of pVHI was excellent in patients group (Cronbach α = 0.95). The inter-class correlation coefficient indicated strong test-retest reliability (ICC = 0.99). The principal-component analysis demonstrated three-factor eigenvalues greater than 1, and the cumulative proportion was 66.23%. The mean total scores and mean subscales scores were significantly higher in the patients group than the control group (p < 0.05). The physical domain had the highest mean score among the three subscales (functional, physical and emotional) in the patients group. The optimal cutoff point of the Mandarin Chinese version of pVHI was 9.5 points with a sensitivity of 80.3% and a specificity of 84.8%. ConclusionThe Mandarin Chinese version of pVHI was a reliable and valid tool to assess the parents' perception about their children's voice disorders. It is recommended that it can be used as a screening tool for discriminating between children with and without dysphonia.

Pediatric Vocal Fold Nodule Etiology: What Are Its Usual Causes in Children?

In this study, the relation between phonotrauma and presence of siblings and social activities was investigated, and the incidence of voice disorders in the mothers of children with vocal fold nodules was studied with objective (clinical voice analysis) and subjective (laryngostroboscopy, Voice Handicap Index) methods. Twenty-nine children with vocal fold nodules (age range 5-14 years), 45 age-matched children without any voice disorders as a control group, and their mothers were included in the study. All patients had laryngostroboscopy and clinical voice analysis, and their mothers filled out the Pediatric Voice Handicap Index. We noted the most common place or situation where children used their voice in excessively high volume according to their mothers, including home, school, sportive activities, and singing or reciting poem activities, to recognize the major cause of phonotrauma. In addition, presence of siblings was recorded. It was found that 15 patients (51.7%) had younger siblings, seven patients (24.1%) had older siblings, five patients (17.2%) had both younger and older siblings, and two patients (6.8%) did not have any siblings. It was seen that excessive usage of high-volume voice at home had a correlation with presence of only younger siblings, and both younger and older siblings tended to cause phonotrauma at home (86.7%). Additionally, eight boys (44.4%) reported presence of sportive activities, whereas none of the girls had such an activity (P = 0.012). Presence of siblings seems to be an important factor for vocal nodule formation. Maternal relationship does not seem to be a major factor for vocal misuse.

Blend in Singing Ensemble Performance: Vibrato Production in a Vocal Quartet

"Blend" is a defining characteristic of good vocal ensemble performance. To achieve this, directors often consider vibrato as a feature to be controlled and consequently restrict its use. Analysis of individual voices in ensemble situations presents several challenges, including the isolation of voices for analysis from recordings. This study considers vibrato production as a feature that contributes to blend through an ecological study of a vocal quartet. A vocal ensemble was recorded using head-worn microphones and electrolaryngograph electrodes to enable fundamental frequency analysis of the individual voices. The same four-part material was recorded over several weeks of rehearsal to allow analysis of conscious and subconscious changes to vibrato production over time. Alongside the recording of their rehearsal discussions, singers were also asked for opinions on vibrato production in connection with blend. The results indicate that vibrato is adjusted to some extent by individual singers to improve blend, with some instances of synchrony between voice parts. Some conscious alterations to vibrato were made to improve blend; however, these are not always evident in the data, suggesting that singers' own perceptions of their performance may be influenced by other factors. These findings indicate a need for further studies of vibrato as a feature of blend, particularly in terms of the synergies between expectation and actual production, and potential synchronicity between singers; increased understanding of vibrato in an ensemble setting will lead to more efficient rehearsal techniques and vocal training, and could prevent vocal misuse leading to pathology in the future.

University Vocal Training and Vocal Health of Music Educators and Music Therapists

The purpose of this study was to describe the university vocal training and vocal health of music educators and music therapists. The participants ( N = 426), music educators ( n = 351) and music therapists ( n = 75), completed a survey addressing demographics, vocal training, voice usage, and vocal health. Both groups reported singing at least 50% of the work day; moreover, music educators complained of vocal fatigue and hoarseness at the end of the week. Music educators expressed concern about their vocal health, due to the unique demands of music instruction and large classes. A majority of participants, particularly instrumental concentration majors, expressed a desire for more career-focused vocal training. Results suggest that additional university training in vocal health could help prevent vocal abuse and misuse among music educators and therapists; furthermore, music educators may be better qualified to promote healthy singing among developing voices.

"King archie, who was quite grouchy" - a vocal dysphonia health education project

PURPOSE: one major cause of dysphonia can be linked to the presence of vocal folds nodules - a condition commonly seen in children due to vocal misuse and/or vocal abuse. The present health education project, also directed to parents and educators, aims at making children (the project's chief target-population) aware of how to make a correct use of their voice. METHOD: the target population includes parents, educators and children from both sexes and aged between five and eight years old. RESULT: a health education initiative was developed, which main instrument consists in a children's literature book, supplemented by an interactive CD. The instrument relies on a simple and easy-to-follow story where the issue of child dysphonia is addressed. CONCLUSIONS: the developed health education instrument is substantial for its chief target-population; it works as a suitable vehicle for promoting, in children, access, sensibility and awareness regarding aspects of one's voice one should be attentive to.

Evaluation of fundamental frequency in individuals with normal voice and those with vocal nodules

Introduction: Vocal nodules are non-malignant lesions of vocal cords caused by vocal misuse and abuse. Nodules can be viewed as the reaction of vocal tissue to a constant stress induced by frequent and severe movements. Acoustic signs of people with vocal fold nodules somehow differ from those with normal voice. However, there is no universal agreement on the exact amount difference between acoustics of normal voice and pathologic voice heard at the presence of vocal nodule and this, in turn, has resulted in different reported acoustic measurements. In this study, we used the standardized Rangin Kaman passage for vocal assessment of normal people and patients with voice nodule. Materials and Methods: In a cross-sectional descriptive– analytical study, 20 people with normal voice (10 males and 10 females) and 20 patients with vocal nodules (10 males and 10 females) with an age range of 40 to 59 years were randomly assigned into two age groups of 40 to 59 and 50 to 59 years. Each of these age groups included 10 subjects with normal voice (5 males and 5 females) and 10 ones with bilateral vocal nodules (5 males and 5 females). Thus, 20 voice samples were obtained from each age group. These voice samples were acoustically compared to each other on the basis of fundamental frequency and fundamental frequency variation range. Results: Results showed that the differences in fundamental frequencies was significant when all samples were considered (P = 0.043). For detecting local differences, repeated analysis of variance was performed for men and women separately. In men, significant differences of fundamental frequency were neither observed between normal and pathological samples nor between two age groups as a whole (P = 0.59). In women, differences of mean in fundamental frequency between two age groups were significant (P = 0.007). Conclusion: Mean fundamental frequency analysis can discriminates between normal voice and voice with nodules only in 50 to 59-year age group. Although nodules were recognizable through stroboscope, acoustic signs varied depending on the amount of influence exerted by the nodule on the voice. Keywords: Speech fundamental frequency, Fundamental frequency variation range, Voice, Nodules