Acoustic Voice Research Articles

Clinical Case Study: Space Occupying Vocal Fold Lesions

Purpose: The purpose of this study was to describe a typical clinical course and to provide acoustic, aerodynamic, auditory-perceptual, and stroboscopic assessment of a patient with bilateral mid-membranous vocal fold lesions. Conclusions: The patient presented to clinic with stroboscopic evidence of phonotraumatic true vocal fold tissue changes. Her acoustic, aerodynamic, and perceptual voice evaluation also revealed values outside of the normal range. She demonstrated good ability to improve the sound and feel of her voice in response to therapeutic probes, indicating she was a good candidate for behavioral voice therapy, thus behavioral treatment was recommended as a first approach. Supplemental Material: https://doi.org/10.23641/asha.19371911

Comparison and Validation of Acoustic Voice Quality Index Version 2 and Version 3 among South Indian Population

Acoustic Voice Quality Index (AVQI) has emerged in the recent past as a robust multiparametric voice quality evaluation tool. Two versions of AVQI derived using the program PRAAT have found extensive clinical and research applications. These versions have been validated in several languages around the world. However, no research reports are available on validation of AVQI in the South Indian population. Further, studies comparing the performance of the two versions of AVQI are limited in the literature. This study was designed to validate and compare the two versions of AVQI (AVQIv02.02 and AVQIv03.01) in South Indian languages (Malayalam and Kannada). A retrospective analysis of previously recorded voice samples was carried out on a total of 160 (91 normophonic and 69 dysphonic) voice samples. These samples were perceptually rated on a GRBAS scale by five experienced speech-language pathologists. Standardized Syllable Number (SSN) necessary to derive AVQIv03.01 was computed. Following this, these samples were analyzed to obtain the AVQIv02.02 and AVQIv03.01. The concurrent validity and diagnostic accuracy of these measures were then examined and compared. A moderate agreement was obtained across the judges on perceptual evaluation of voice quality. SSN in Malayalam and Kannada languages were identified to be 29 and 25 syllables respectively. Language differences were not observed on both versions of AVQI. The concurrent validity of AVQIv03.01 (r = 0.788) was superior to that of AVQIv02.02 (r = 0.655). Further, the threshold of differentiating normophonic and dysphonic samples were determined to be >3.45 for AVQIv02.02 and >2.45 for AVQIv03.01. AVQIv03.01 is superior to AVQIv02.02 in terms of its diagnostic accuracy and concurrent validity. Current findings also extend the application of AVQI as a robust tool for the evaluation of voice characteristics to the South Indian population.

The Relationship Between Pitch Discrimination and Acoustic Voice Measures in a Cohort of Female Speakers

Evidence across a range of musically trained, hearing disordered and voice disordered populations present conflicting results regarding the relationship between pitch discrimination (PD) and voice quality. PD characteristics of female speakers with and without a musical training background and no self-reported voice disorder, and the relationship between PD and voice quality in this particular population, have not been investigated. To evaluate PD characteristics in a cohort of female participants without a self-reported voice disorder and the relationship between PD and acoustic voice measures. One hundred fourteen female participants were studied, all of whom self-reported as being non-voice disordered. All completed the Newcastle Assessment of Pitch Discrimination which involved a two-tone PD task. Their voices were recorded producing standardized vocal tasks. Voice samples were acoustically analyzed for frequency-domain measures (fundamental frequency and its standard deviation, and harmonics-to-noise ratio) and spectral-domain measures (cepstral peak prominence and the Cepstral/Spectral Index of Dysphonia). Data were analyzed for the whole cohort and for musical and non-musical training backgrounds. In the whole cohort, there were no significant correlations between PD and acoustic voice measures. PD accuracy in musically trained speakers was better than in non-trained speakers and correlated with fundamental frequency standard deviation in prolonged vowel tasks. Vocalists demonstrated superior PD accuracy and fundamental frequency standard deviation in prolonged vowels compared to instrumentalists but did not show significant correlations between PD and acoustic measures. The Newcastle Assessment of Pitch Discrimination was a reliable tool, showing moderate-good prediction value in differentiating musical background. There was little evidence of a relationship between PD and acoustic measures of voice quality, regardless of musical training background and superior PD accuracy among the musically trained. These data do not support ideas concerning the co-development of perception and action among individuals identified as having voice quality measures within normal ranges. Numerous measures of voice quality, including measures sensitive to pitch, did not distinguish across musically and non-musically trained individuals, despite individual differences in pitch discrimination.

Choral Conductors Vocal Loading in Rehearsal Simulation Conditions

Choir conductors represent a profession with an intensive vocal load. The present study aims to investigate the impact of 40 minutes vocal loading tasks on fundamental frequency (F0), jitter (Jitt), shimmer (Shim), median cepstral peak prominence (CPPs), and CPPs standard deviation in specific acoustic conditions. Eighteen amateur choir conductors (13 female, five male) participated in the study. The vocal loading experiment was organized in rooms where each conductor usually had choir rehearsals. The vocal loading experiment included vocal warm-up, singing, and loud reading. The STIPA test signal provided the background noise with 60 dBA @ 1m during the singing and reading tasks. The F0, Jitt, Shim, CPPs, and CPPs SD were extracted before and after vocal loading by the Vocal Holter Med (VHM) device. Additionally, Acoustic Voice Quality Index (AVQI) was estimated for participants, and all of them completed the Voice Handicap Index-30 (VHI-30) and the Singing Voice Handicap Index (SVHI). Finally, reverberation time (T30) was measured in each rehearsal room. A statistically significant decrease of CPPs SD by 0.1 dB was observed in male conductors. Associations between CPPs SD and VHI-30 (r = 0.789, P = 0.001) were found in female conductors, and between Jitt and SVHI (r = 0.9, P = 0.037) in male conductors. Female conductors with higher total score of SVHI demonstrated increase of postloading F0 (r = 0.612, P = 0.026). Forty-minute vocal loading tasks that included warm-up, intensive singing, and loud reading did not significantly impact vocal parameters in female and male conductors. In addition, the rehearsal room volume and length of reverberation time did not affect obtained vocal parameters after vocal loading.

Speech Changes After Transcranial Direct Current Stimulation in Individuals Diagnosed With Parkinson's Disease

Purpose: Parkinson's disease (PD) is a progressive neurological disease that results in motor and cognitive impairments, including impaired speech production. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that shows promise in improving limb motor skills and executive function in individuals with PD. The aim of this study was to examine the impact of tDCS on speech production in individuals diagnosed with PD. Method: Six males, aged 65–78 years, with a diagnosis of PD, participated in a double-blinded controlled crossover study to assess the immediate effects of tDCS to the premotor cortex on speech production. Auditory–perceptual (Consensus Auditory–Perceptual Evaluation—Voice) and acoustic voice outcomes (e.g., fundamental frequency, intensity, noise-to-harmonic ratio [NHR], and speech rate) were gathered pre- and post-anodal simulation and sham conditions. Measures were compared across times and conditions. Results: Speech rate was below normative levels for all participants prior to tDCS. Speech rate increased significantly in conversation following stimulation but not sham conditions and exceeded normative values for two participants. NHR increased following stimulation. No significant difference in other perturbation measures, perceptual ratings, fundamental frequency, or intensity were noted. Conclusions: All participants completed the protocol without discomfort. The observed increase in speech rate needs to be interpreted in the context of excitation resulting from neurostimulation using tDCS.

In Search of State and Trait Emotion Markers in Mobile-Sensed Language: Field Study

BackgroundEmotions and mood are important for overall well-being. Therefore, the search for continuous, effortless emotion prediction methods is an important field of study. Mobile sensing provides a promising tool and can capture one of the most telling signs of emotion: language.ObjectiveThe aim of this study is to examine the separate and combined predictive value of mobile-sensed language data sources for detecting both momentary emotional experience as well as global individual differences in emotional traits and depression.MethodsIn a 2-week experience sampling method study, we collected self-reported emotion ratings and voice recordings 10 times a day, continuous keyboard activity, and trait depression severity. We correlated state and trait emotions and depression and language, distinguishing between speech content (spoken words), speech form (voice acoustics), writing content (written words), and writing form (typing dynamics). We also investigated how well these features predicted state and trait emotions using cross-validation to select features and a hold-out set for validation.ResultsOverall, the reported emotions and mobile-sensed language demonstrated weak correlations. The most significant correlations were found between speech content and state emotions and between speech form and state emotions, ranging up to 0.25. Speech content provided the best predictions for state emotions. None of the trait emotion–language correlations remained significant after correction. Among the emotions studied, valence and happiness displayed the most significant correlations and the highest predictive performance.ConclusionsAlthough using mobile-sensed language as an emotion marker shows some promise, correlations and predictive R2 values are low.

The ForEx++ based decision tree ensemble approach for robust detection of Parkinson’s disease

The progressive reduction of dopaminergic neurons in the human brain, especially at the substantia nigra is one of the principal causes of Parkinson’s Disease (PD). Voice alteration is one of the earliest symptoms found in PD patients. Therefore, the impaired PD subjects’ acoustic voice signal plays a crucial role in detecting the presence of Parkinson's. This manuscript presents four distinct decision tree ensemble methods of PD detection on a trailblazing ForEx++ rule-based framework. The Systematically Developed Forest (SysFor) and a Penalizing Attributes Decision Forest (ForestPA) ensemble approaches has been used for PD detection. The proposed detection schemes efficiently identify positive subjects using primary voice signal features, viz., baseline, vocal fold, and time–frequency. A novel feature selection scheme termed Feature Ranking to Feature Selection (FRFS) has also been proposed to combine filter and wrapper strategies. The proposed FRFS scheme encompasses Gel’s normality test to rank and selects outstanding features from baseline, time–frequency, and vocal fold feature groups. The SysFor and ForestPA decision forests underneath the ForEx++ rule-based framework on both FRFS feature ranking and subset selection represents Parkinson’s detection approaches, which expedite a better overall impact on segregating PD from control subjects. It has been observed that the ForestPA decision forest in the ForEx++ framework on FRFS ranked features proved to be a robust Parkinson’s detection scheme. The proposed models deliver the highest accuracy of 94.12% and a lowest mean absolute error of 0.25, resulting in an Area Under Curve (AUC) value of 0.97.

Effect of Proton Pump Inhibitor on the Outcome of Laryngeal Microsurgery in Patients With Vocal Fold Mucosal Disease With Reflux Symptoms

To evaluate the effect of proton pump inhibitor (PPI) after laryngeal microsurgery (LMS) in patients with benign vocal fold (VF) mucosal disease and in patients with overt reflux symptom according to subjective and objective voice assessment. The improvement of voice handicap index-10 (VHI-10) score, reflux symptom index (RSI) score, grade, roughness, breathiness, asthenia, and strain (GRBAS) score, Jitter, Shimmer, noise to harmonics ratio (NHR), maximum phonation time of acoustic voice analysis RESULTS: A total of 47 patients (PPI group [n = 24] and non-PPI group [n = 23]) completed the study. The scores for VHI-10, RSI, GRBAS, and acoustic parameters significantly improved in both groups after surgery. In the subgroup analysis of patients with overt reflux symptoms (RSI ≥ 13; non-PPI group [n = 12], PPI group [n = 15]), significant between-group differences were observed in terms of the improvement in NHR and the strain factor. Postoperative PPI administration in patients with VF benign mucosal disease with reflux symptoms might improve subjective and objective voice outcomes after LMS.

COVID-19 disease diagnosis with light-weight CNN using modified MFCC and enhanced GFCC from human respiratory sounds.

In the last 2 years, medical researchers and clinical scientists have paid close attention to the problem of respiratory sound classification to classify COVID-19 disease symptoms. In the physical world, very few AI-based (Artificial Intelligence) techniques are often used to detect COVID-19/SARS-CoV-2 respiratory disease symptoms from the human respiratory system-generated acoustic sounds such as acoustic voice sound, breathing (inhale and exhale) sounds, and cough sound. We propose a light-weight Convolutional Neural Network (CNN) with Modified-Mel-frequency Cepstral Coefficient (M-MFCC) using different depths and kernel sizes to classify COVID-19 and other respiratory sound disease symptoms such as Asthma, Pertussis, and Bronchitis. The proposed network outperforms conventional feature extraction models and existing Deep Learning (DL) models for COVID-19/SARS-CoV-2 classification accuracy in the range of 4–10%. The model’s performance is compared with the COVID-19 crowdsourced benchmark dataset and gives a competitive performance. We applied different receptive fields and depths in the proposed model to get different contextual information that should aid in classification. And our experiments suggested 1 times 12 receptive fields and a depth of 5-Layer for the light-weight CNN to extract and identify the features from respiratory sound data. The model is also trained and tested with different modalities of data to showcase its effectiveness in classification.

The Effect of An Indirect Voice Therapy Approach on the Voice of Children With Vocal Fold Nodules: A Prospective Cohort Study

To investigate the effect of a combination indirect voice therapy approach on the management of vocal nodules in the pediatric population. A prospective cohort study with thirty children (24 males and 6 females; mean age 8.8 ± 2.2) with a diagnosis of vocal fold nodule (VFN) was conducted. All participants were included in an 8-week voice therapy program consisting of vocal hygiene education and parental rule-setting. Videolaryngoscopic examination, auditory-perceptual evaluation, and acoustic voice analysis were performed immediately before and after the intervention. The comparison of videolaryngoscopic findings before and after the therapy revealed that the size of the nodules decreased significantly (P < 0.001). Findings from the laryngeal examination showed that the vast majority of children 73.3% (n = 22) had no VFN anymore after the intervention. The auditory-perceptual evaluation showed that overall severity of dysphonia decreased significantly [from 50 (40-70) to 38 (30-45), P < 0.001]. Jitter local (P = 0.031) and Jitter local abs (P = 0.043) parameters statistically differed after the therapy. There were not any statistically significant differences for mean F0, shimmer local (%), shimmer local (dB), and mean HNR. The voice therapy method in this study has a clear benefit on the voice of children with VFN and can be used in clinical practice. Specifically, clinicians should consider the parents as a core component of voice therapies and pay attention to vocal hygiene education for optimal management of VFN related childhood dysphonia.

Evaluation of noise excitation as a method for detection of hypernasality

Hypernasality is a disorder where excess nasal resonance is perceived during speech, often as a result of abnormal coupling between the oral and nasal tracts known as velopharyngeal insufficiency (VPI). The most common cause of VPI is a cleft palate, which affects around 1 in 1650 babies, around ⅓ of whom have persistent speech problems after surgery. Current equipment-based assessment methods are invasive and require expert knowledge, and perceptual assessment methods are limited by the availability of expert listeners and differing interpretations of assessment scales. Spectral analysis of hypernasality within the academic community has resulted in potentially useful spectral indicators, but these are highly variable, vowel specific, and not commonly used within clinical practice.Previous works by others have developed noise excitation technologies for the measurement of oral tract transfer functions using resonance measurement devices (RMD). These techniques provide an opportunity to investigate the structural system abnormalities which lead to hypernasality, without the need for invasive measurement equipment. Thus, the work presented in this study adapts these techniques for the detection of hypernasality. These adaptations include augmentation of the hardware and development of the software, so as to be suitable for transfer function measurement at the nostrils rather than the mouth (nRMD). The new method was tested with a single participant trained in hypernasal production, producing ‘normal’ and hypernasal vowels, and the recordings validated through a listening test by an expert listener and calculation of nasalance values using a nasality microphone. These validation stages indicated the reliability of the captured data, and analysis of the nRMD measurements indicated the presence of a systematic difference in the frequency range 2 to 2.5 kHz between normal and hypernasal speech. Further investigation is warranted to determine the generalisability of these findings across speakers, and to investigate the origins of differences manifesting in the transfer functions between conditions. This will provide new insights into the effects of nasal tract coupling on voice acoustics, which could in turn lead to the development of useful new tools to support clinicians in their work with hypernasality.

Comprehensive Evaluation of Vocal Outcomes and Quality of Life after Total Laryngectomy and Voice Restoration with J-Flap and Tracheoesophageal Puncture.

Simple SummaryLaryngopharyngectomy is still the treatment of choice in locally advanced pharyngolaryngeal tumors not eligible for organ preservation protocols. Loss of speech capacity has been reported as one of the factors that most affect the patient-reported quality of life. Thus, the reconstructive goals are restoring the pharynx and possibly the voice in such a scenario. For decades, tracheoesophageal puncture (TEP) has allowed proper voice rehabilitation; however, TEP has a non-neglectable financial expenditure and complication rate. Therefore, we recently reported a novel flap design and surgical technique that shares the same principles of TEP, without the need to change any device over time, named J-flap. This study aimed to analyze both techniques’ subjective and objective vocal outcomes and their impact on overall and voice-related quality of life.Background: Tracheoesophageal puncture with a voice prosthesis is the gold standard for speech rehabilitation in patients that receive a laryngopharyngectomy. However, a novel surgical technique, using a tubularized anterolateral tight flap, named “J-flap,” has been demonstrated to produce adequate voice restoration. We aimed to compare the outcomes and the quality of life of patients who underwent voice rehabilitation with both techniques. Methods: We enrolled patients that underwent laryngopharyngectomy and voice restoration surgery. The control group received a tracheoesophageal puncture with a voice prosthesis, while the study group received J-flap reconstruction. A total of 20 patients received voice prosthesis rehabilitation, while 18 received J-flap reconstruction. Speech and vocal outcomes and quality of life metrics were collected. Results: The objective phonatory performances and the acoustic voice analysis did not outline a significant difference. Speech pathologists judged the consonant pronunciation in the J-flap group as less accurate (p < 0.001). The voice handicap index revealed a moderate impairment for the J-flap group (p < 0.001). Quality of life scores were higher for the voice prosthesis group. Conclusion: Voice prostheses and J-flaps share similar objective phonatory outcomes. Quality of life was more impaired in the J-flap group. In our view, these two techniques possess complementary characteristics in clinical practice, taking into account health care system regulations and patients’ social background.

Exploring The Validity of Acoustic Measurements and Other Voice Assessments

There are different parts of a battery of voice assessments to assess voice functions and voice quality. The objective assessment of voice quality using acoustics is recommended and two measurements such as the Acoustic Voice Quality index, 03.01 (AVQI) and the Acoustic Breathiness Index (ABI) are leading in this domain. The purpose of this study was to verify the validity between these two acoustic measurements and other dimensions of the voice assessments (the Voice Handicap Index-10 (VHI-10) and the laryngeal imaging evaluation of the larynx and vocal folds). We used a retrospective database of 150 participants (37 vocally healthy participants and 113 dysphonic patients). To test the validity between the acoustic measurements and the other voice assessments the concurrent validity and diagnostic precision were analyzed using Pearson correlation coefficient and the receiver operating characteristic (ROC) statistics with likelihood ratios. The VHI-10 score presented moderate-significant correlations with the AVQI and the ABI, r= 0.477, P < 0.001 (r2= 0.228) and r= 0.426, P < 0.001 (r2=0.181), respectively. The larynx alteration presented low-significant correlations with the AVQI (r= 0.362, P < 0.001, r2= 0.131), and ABI (r= 0.371, P < 0.001, r2= 0.138), respectively. The area under the curve (AUC) of ROC was almost reasonable ranging from 0.701 to 0.737; except between ABI and VHI-10 (AUC= 0.689). The highest AUC was between the AVQI and VHI-10 at a threshold of 2.10; the highest specificity was between the ABI and VHI-10 at a threshold of 3.77. However, the lowest sensitivity was between ABI and VHI-10 while the lowest specificity was between the laryngeal diagnosis and the ABI. AVQI and ABI presented significantly lower concurrent validity and diagnostic precision when the reference is not the auditory-perceptual judgment of voice quality. However, AVQI seems to be for some validity aspects a more reasonable classifier of vocal handicap and laryngeal alteration than ABI. Both AVQI and ABI values can broaden their range of assessment for the clinical user, thus showing more relationships between the individual voice examination methods.

Reducing the GAP between science and clinic: lessons from academia and professional practice - part A: perceptual-auditory judgment of vocal quality, acoustic vocal signal analysis and voice self-assessment.

During the XXVIII Brazilian Congress of SBFa, 24 specialists met and, from a leading position on scientific research as a tool for connecting laboratory and clinic, five fronts of knowledge of the voice specialty were discussed as following: Perceptual-auditory judgment of vocal quality; 2. Acoustic analysis of the vocal signal; 3. Voice self-assessment; 4. Traditional techniques of therapy; 5. Modern techniques of electrostimulation and photobiomodulation (PBMT) in voice. Part "a" of this publication was associated with the consolidation of the analyses of the first three aspects. The trend in the perceptual-auditory judgment of vocal quality was related to the use of standard protocols. The acoustic evaluation of the vocal signal is accessible and can be done descriptively or by extraction of parameters, thus preferring multiparametric measures. Finally, the analysis of the individual himself closes this triad of voice documentation, which will be the basis for the conclusion of the evaluation, reference for monitoring progress, and evaluation of treatment results.

Electromyographic Assessment of the External Laryngeal Muscles of Opera Singers During Phonation and Non-Phonation Tasks

IntroductionThe surface EMG technique (sEMG) gives valuable assessment of vocal tract as well as diagnosis or outcome assessment in dysphonia. There are very few papers on the use of sEMG in vocal professionalists. AimThe aim of this study was to evaluate the electromyographic characteristics of selected external laryngeal and neck muscles in professional opera singers. MaterialThe study material consisted of 50 subjects. Twenty-six opera professional singers and 24 healthy non-singers. MethodEach person underwent otolaryngologic and phoniatric examination, laryngeal videostroboscopy, hearing testing, multiparametric acoustic voice analysis (multidimensional voice program) and sEMG of submentalis, cricothyroid and sternocleidomastoid muscles. ResultsStatistical analysis of the values of the amplitudes of the submentalis and the cricothyroid muscles showed significant differences between the vocalists and the control group. Moreover, during vowel phonation and glissando, significantly greater differences in the asymmetry of sternocleidomastoid muscles amplitudes were observed in singers compared to the control group. In most subjects, the studied muscles did not show asymmetry during saliva swallowing. ConclusionsLaryngeal muscle function should be assessed during different phonation and non-phonation tasks. Singers have different SEMG characteristics than non-singers. Knowledge of the patient's history and endoscopic studies is needed to interpret EMG recordings.

Speech capacity in patients with voice disorders before and after surgical treatment of vocal fold tumors

Inroduction. Pathological characteristics of voice and speech in persons with benign and malignant vocal fold tumors present as different variations in the voice pitch, intensity and quality. The aim of the study was to determine the speech capacity of persons with malignant and benign vocal fold tumors before and after surgical treatment and to establish if there are differences in the speech capacity in relation to the type of tumor. Material and Methods. The sample included 67 subjects who were divided into two groups: group I - subjects with benign tumors, vocal cord lesions (polyps, cysts) and Reinke?s edema and group II - subjects with malignant tumors, aged 23 to 74 years (mean age 55.43; standard deviation 11.95). Acoustic voice analysis, maximum phonation time of the vowel /a/, analysis of temporal speech organization, and sentence melody analysis were used for measuring the speech capacity. Results. Before surgery, the speech capacity in both groups of patients was almost equal, without statistical significance between the compared groups. After surgery, there was a statistically significant difference between the speech capacity in the examined groups, with better speech capacity observed in group I (t = -3.807, p &lt; 0.001). The study did not show an isolated effect of time or tumor type on the speech capacity, but showed a combined effect (F = 10.079, p = 0.002). Conclusion. The proposed method for the assessment of the speech capacity before and after surgical treatment of vocal fold tumors is a useful tool for the prediction of the voice outcome and in planning rehabilitation procedures.

Validation of the Acoustic Voice Quality Index in the Russian language

Of this study was to validate the Acoustic Voice Quality Index (AVQI) in Russian language and determine threshold values to differentiate normal and dysphonic voices in russophone population. 41 recordings of patients with laryngeal hemiplegia and hemiparesis appeared after thyroid carcinomas' surgical treatment and laryngeal cancer from the Tomsk Cancer Research Institute were used, as well as 10 new recordings of normophonic people, composing a control group. Voice samples included the first quatrain of the poem «Sail» written by M.Yu. Lermontov, and sustained vowel «a». Four specialists who work with voice disorders (three speech-language pathologists and one phoniatrist) rated degree of dysphonia for all voice sample. Moreover, the AVQI was calculated for each sample. There was a statistically significant correlation between auditory-perceptual assessment and the AVQI (r=0.74), this confirms that AVQI is effective in evaluating voice disorders. The group of people with normal voice had relatively low values of AVQI, whereas the group of patients with laryngeal diseases had relatively high values. Analysis of ROC-curve showed that AVQI has excellent diagnostic accuracy to differentiate normal and dysphonic voices (AUC=0.966). The AVQI is the excellent tool for objective assessment of voice disorders in the Russian population/.

Early Cochlear Implantation Allows Deaf Children to Control Voice Pitch and Loudness independently.

Congenitally deaf children with a cochlear implant (CI) improve their speech production intelligibility, but their prosody, including stress and intonation produced by voice pitch and loudness changes, often differs from normal hearing people, which affects their fluent oral communication. This study is aimed to clarify abnormal characteristics of voice pitch and loudness control in CI recipients using a newly developed visually guided pitch change task. We included 13 normal hearing volunteers (NH group) and 17 congenitally deaf CI users who showed good speech intelligibility. The 17 CI users were divided into Early-CI and Late-CI groups, based on their age at implantation of 2.5 years. Using the visually guided pitch change task and acoustic voice analysis of sustained vowels, we assessed their vocal skills to maintain constant pitch and loudness and intentionally change the voice pitch independent from loudness. At the time of examination, the mean age was 24.1, 12.7, and 18.9 years in the NH, Early-CI, and Late-CI groups. During constant vowel production, Early-CI and Late-CI groups showed more significant fluctuations in pitch and loudness than the NH group. However, when focusing on intentionally changing only the pitch of the voice, the Early-CI group was significantly better than the Late-CI group and comparable to the NH group in terms of their ability to change vocal pitch independently from loudness. Among congenitally deaf patients, age at implantation was associated with the development of voice skills to control voice pitch and loudness separately, which may influence their fluent prosody production.

Результаты хирургического лечения с использованием СО2-лазера у больных с двусторонним параличом гортани

Introduction. Despite advances in modern surgery, the percentage of patients with bilateral paralysis of the larynx is not decreasing. There are many author’s methods of treatment, but there is no single algorithm. This problem remains relevant, especially among people of working age. Research objective: Optimization of surgical treatment of patients with bilateral paralysis of the larynx using a CO2-laser. Materials and methods. For 2014–2018, 143 patients diagnosed with bilateral paralysis of the larynx were treated. The patients underwent a general clinical examination, video endolaryngoscopy, video stroboscopy, spirometry, acoustic voice analysis. For a subjective assessment of the condition, patients filled out the VOICE HANDICAP INDEX (VHI) voice questionnaire, the 36-Item Short Form Survey (SF-36) quality of life questionnaire. Depending on the degree of stenosis, age, body mass index, the presence of a tracheostomy, comorbidities, the following operations were performed using a CO2-laser: posterior partial chordotomy, posterior vestibulo-chordotomy, posterior chordotomy with wound defect plasty. Results and discussion: The patients followed up for 6 to 12 months in the postoperative period. A positive outcome achieved in 128 patients (90%). 15 patients needed a second operation. Tracheostomy patients were decannulated on days 3 to 5. Conclusion. Restoration of respiratory function was achieved by expanding the lumen of the glottis in the posterior parts of the larynx, while maintaining a socially adapted voice was achieved due to intact anterior two-thirds of the vocal folds. These methods are among the most effective and minimally invasive methods for the treatment of bilateral paralysis of the larynx.

Learning Acoustic Assessment of Voice: An Action Research-Based SoTL Project

The purpose of this action research, scholarship of teaching and learning study was to develop and integrate effective, student-informed teaching methods for voice acoustics instruction in a graduate speech-language pathology voice disorders course. An online focus group was used to determine what aspects of voice acoustics to include in the course as well as how these aspects were to be covered. A blend of face-to-face, technology-assisted, and practice-based teaching/learning activities resulted from the focused group and were employed in the course. An open-ended application question was used to measure student learning regarding application of voice acoustics to the understanding of human voice. A summative assessment of student recall and application of voice acoustics to speech-language pathology practice was also administered. Results showed significant, positive change pre- to post-course on the open-ended application question. Results of the summative assessment revealed that the largest distribution of student scores was in the 90%-100% range. While individual classes in different programs will differ, this project provides instructors with a baseline format from which to work to tailor acoustics instruction in their own classrooms.