Voice Disorders Research Articles

AROA based Pre-trained Model of Convolutional Neural Network for Voice Pathology Detection and Classification

With the demand for better, more user-friendly HMIs, voice recognition systems have risen in prominence in recent years. The use of computer-assisted vocal pathology categorization tools allows for the accurate detection of voice pathology diseases. By using these methods, vocal disorders may be diagnosed early on and treated accordingly. An effective Deep Learning-based tool for feature extraction-based vocal pathology identification is the goal of this project. This research presents the results of using EfficientNet, a pre-trained Convolutional Neural Network (CNN), on a speech pathology dataset in order to achieve the highest possible classification accuracy. An Artificial Rabbit Optimization Algorithm (AROA)-tuned set of parameters complements the model's mobNet building elements, which include a linear stack of divisible convolution and max-pooling layers activated by Swish. In order to make the suggested approach applicable to a broad variety of voice disorder problems, this study also suggests a unique training method along with several training methodologies. One speech database, the Saarbrücken voice database (SVD), has been used to test the proposed technology. Using up to 96% accuracy, the experimental findings demonstrate that the suggested CNN approach is capable of detecting speech pathologies. The suggested method demonstrates great potential for use in real-world clinical settings, where it may provide accurate classifications in as little as three seconds and expedite automated diagnosis and treatment.

EVALUATION OF ENDOSCOPIC SURGERY OUTCOMES FOR BENIGN VOCAL FOLD LESIONS AT MILITARY HOSPITAL 103

Objectives: To evaluate the endoscopic surgery outcomes for benign vocal fold lesions at Military Hospital 103. Methods: A prospective, case-by-case descriptive, clinical interventional study was conducted on 45 patients with benign vocal fold lesions who underwent endoscopic surgery at Military Hospital 103 from July 2022 to August 2023. Results: The disease is common among working-age adults whose ages range from 18 - 60 (77.8%); 100% of patients had hoarseness before surgery at all levels, of which moderate hoarseness accounted for 66.7%; 60.0% of patients had vocal fold nodules; the basic histopathological diagnosis was consistent with the clinical diagnosis. After the surgery, 82.2% of patients had no hoarseness. The average scores of voice handicap index (VHI) and VHI-10 decreased with statistical significance, p < 0.001; 80.0% of patients achieved very good results one month after surgery. Conclusion: Research results show the effectiveness of endoscopic surgery to treat benign vocal fold lesions. Both the VHI and VHI-10 scales are used to evaluate voice disorders, but in clinical practice, the VHI-10 scale may be used instead of the VHI scale.

Adaptation and Validation of Voice Handicap Index-Punjabi.

Patients with Voice problems are frequently encountered in clinics. There is no tool available in Punjabi language for evaluation of impact of voice disorder on patient's life. The aim of this study was to adapt Voice Handicap Index in Punjabi language and to obtain validity, reliability and consistency of the developed tool. The study also aims to compare the scores of VHI-Punjabi between patients with voice problems and asymptomatic age-matched controls. The study follows qualitative research design with purposive sampling. The study was conducted at the Audiology and SLP unit of ENT, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab. A total of 200 subjects in the age group of 20-50years were included, 100 each in study and control group. Combination of reverse translation, committee, and bilingual models were used for development of VHI-Punjabi. The construct validity was very good (r = 0.91). A statistically significant difference (p < 0.001) was obtained between the study group and control group in all the subtest scores and on the total scores of VHI-Punjabi. Statistical significant correlation is found in two administrations of VHI-Punjabi after a gap of 2weeks in both study group and control group (p < 0.001). To find the internal consistency of VHI-Punjabi, Chronbach alpha was calculated, which came to be 0.97. The internal consistency was high. The results of the present study indicate that VHI-Punjabi is a valid and reliable tool that can be used for evaluation of patients with different types of voice problems.

Effect of Partial Deafness on Voice in Children

Elevated hearing thresholds cause disturbances in auditory control of voice. This leads to voice disorders that are described by changes in acoustic parameters of voice measured objectively. Voice changes can also be detected by perceptive assessment with GRBAS scale.This article presents the results of the study performed to analyze voice characteristics in a group of children with prelingual partial deafness (PD), a condition with normal hearing at low frequencies and deep hypoacusis (near deafness) at high frequencies. Voice disorders accompanying partial deafness were not a subject of the intensive study before, therefore our study provides valuable data and help to understand more complex clinical aspects of PD.The study showed that voice characteristics in children with PD differs from children with normal hearing and shows some differences compared to voice of children with other types of hearing impairment. Major changes in PD are seen in frequency (F0, vF0), amplitude (vAm, sAPQ), noise (NHR), and tremor (FTRI) parameters. The changes were present in all groups of objective measures, which makes a difference versus normal hearing; however the most significant changes were seen in a narrower range of parameters compared to children in other types of hearing impairment.Objective parameters correlate with the subjective features of voice of children with partial deafness. With use of GRBAS scale, subjective voice assessment showed elevated indices of grade, roughness, breathy, asthenic and strained voice, which described slightly harsh, breathy, dull, and a little tensed voice.

Quebec French Translation, Cultural Adaptation, and Validation of the Singing Voice Handicap Index-10 Questionnaire for Singers with Dysphonia

OBJECTIVES/HYPOTHESISDysphonia is a common voice disorder that can significantly impact a person’s life; it requires a collaborative evaluation by both speech-language pathologists and otolaryngologists that takes the patient’s perspective into account. The aim of this study was to translate and culturally adapt the Singing Voice Handicap Index questionnaire (SVHI-10), a reliable patient-reported outcome evaluation tool for dysphonia, for the Quebec French population. The result is the Singing Voice Handicap Index-10-QC (SVHI-10-QC). STUDY DESIGNThis study was a prospective translation and validation process. METHODSThe translation process complied with international recommendations and followed a standard forward-backward translation procedure and cognitive debriefing with ten singers. The Quebec French version was administered to two study samples: 30 vocal professionals with no dysphonia and 53 vocal professionals with dysphonia as one of their primary complaints. The SVHI-10-QC was assessed for construct validity, internal consistency, discriminatory capacity, and test-retest reliability. RESULTSThe SVHI-10-QC is valid, reliable, and ready for use with singer-patients suffering from dysphonia. CONCLUSIONSThe SVHI-10-QC is a reliable and valid tool for assessing the impact of dysphonia on French Quebec singers’ quality of life.

Electrophysiological Changes on Laryngeal Motor Neuropathways Cause Voice Disorders for Postradiotherapy Patients with Nasopharyngeal Carcinoma

ObjectiveThis study explored electrophysiological changes in the laryngeal motor neuropathway and determined whether lesions in the laryngeal motor cortex (LMC) and its descending tract contribute to voice deterioration and peripheral nerve palsy in patients with nasopharyngeal carcinoma (NPC) post-radiotherapy (RT). Study DesignsProspective cohort study MethodsTwenty-two patients with NPC at 2 to 4 years post-RT (8 female and 14 male), 22 patients with NPC at 8 to 10 years post-RT (8 female and 14 male), and 22 healthy individuals (9 female and 13 male) were selected to test their magnetic evoked potentials (MEP), motor nerve conduction (MNC), and voice quality using transcranial magnetic stimulation (TMS), laryngeal electromyography (LEMG), and the XION DiVAS acoustic analysis software. Three groups were matched according to approximate age. Multiple comparisons were performed among the three groups. ResultsThe voice quality of post-RT patients with NPC deteriorated compared to that of healthy individuals. Bilateral LMC and their corticonuclear tracts to the bilateral ambiguous nuclei of post-RT patients with NPC were impaired according to multi-group comparisons of MEP amplitudes, latencies, and resting motor thresholds (RMT). The vagus and recurrent laryngeal nerves (RLN) of post-RT patients with NPC were impaired according to multi-group comparisons of the amplitude and latencies of the compound muscle action potential (CMAP) and latencies of f-waves. ConclusionsThe voice quality of patients with NPC deteriorated after RT. The pathogenesis of post-RT voice deterioration may involve radiation-induced injuries to the vagus, RLN, and bilateral LMC. Furthermore, radiation-induced injuries to the bilateral LMC may contribute to vagus and RLN palsies. These findings support the use of transcranial approaches to treating voice disorders and peripheral nerve palsies in post-RT patients with NPC.

Frequency Transmission of Oscillation from External Whole-Body Vibration Platform to the Larynx

PurposeThis study investigates (1) the presence of frequency transmission of oscillation from an external whole-body vibration (WBV) platform to the larynx; and (2) the factors that influence this frequency transmission. MethodsThirty participants (mean age = 22.3 years) with normal voice were exposed to four frequency-intensity levels of WBV (10 Hz-10%, 10 Hz-20%, 20 Hz-10%, 20 Hz-20%) and were instructed to produce the natural vowel /a/ three times during each WBV setting. The frequency was extracted from the middle one-second of each electroglottographic (EGG) signal after passing through a Hann band filter with a range of 6-24 Hz. Linear mixed-effects models were applied to determine the factors that influenced the absolute deviation of the frequency transmission. ResultsAll participants exhibit an extracted EGG frequency that aligns with the external WBV frequency, deviating by -0.6 to 1.2 Hz. The absolute deviation of WBV frequency transmission is consistent for both sexes across various WBV settings, except the 10 Hz-10% setting where men tend to exhibit significantly higher deviations (p = 0.018). ConclusionOscillations at a specific frequency are transmitted from an external WBV platform to the larynx. This study proposes the use of a "spring" system to investigate the effect of WBV on the larynx, and recommends further research to explore the potential of WBV in managing voice disorders.

Effects of Semi-occluded Vocal Tract Exercises with Different Vibration Sources and Duration on Healthy Adults’ Voice

Objectives: This study aimed to explore the impact of semi-occluded vocal tract exercises (SOVTE) with varied vibration sources and durations on the vocal performance of healthy adults. In addition, we sought to confirm the safety of voiced high-frequency oscillation (VHFO) intervention and provide basic data for performances in relation to straw phonation (SP).Methods: The study included 34 healthy adults with no vocal impairments, comprising 8 males and 26 females. The mean age of the participants was 23.00±2.06 years. To assess vocal characteristics during VHFO and SP, voice samples were recorded at three specific time points: prior to performing SOVTE (M0), after 1 minute of exercise (M1), and after 3 minutes of exercise (M3). Cepstral, perturbation, electroglottographic analyses were conducted on the recorded samples of vowel and sentences. Psychometric evaluation was conducted using questionnaires to gauge the self-reported severity of voice and vocal fatigue.Results: No statistically significant differences were observed in the average number of performances or duration per phonation between the two methods. When compared to baseline, CPPV significantly increased after 1 minute and 3 minutes of performance and Acoustic Psychometric Severity Index of Dysphonia decreased after 3 minutes of performance in VHFO. Both methods exhibited no significant differences in terms of psychometric and electroglottographic measurements.Conclusion: Results objectively confirmed the safety of VHFO intervention. This study is clinically significant as it lays the groundwork for future development of optimal treatment regimens and therapeutic programs for voice disorder patients, using foundational data on VHFO.

Impact of perceptual-learning strategies and background noise on disordered speech intelligibility

Objective: There is a plethora of research showing reduced speech intelligibility for a variety of voice disorders (i.e., dysphonia, alaryngeal). Therapeutic approaches to improve intelligibility typically involve targeting the speaker (e.g., clear speech, reduced rate) with minimal attention to the listener. Therefore, there were three purposes of this study: 1) to determine the impact of background noise on the speech intelligibility of disordered speakers; 2) to determine the impact of providing listeners with perceptual-learning strategies on the speech intelligibility of speakers with a voice disorder; and 3) to determine if subjective ratings of voice quality can predict speech intelligibility. Methods: Sentences were recorded from 12 speakers (2 typical, 3 alaryngeal, 7 dysphonic). Sentences were divided into one of three groups of signal-to-noise ratios (SNR: quiet, +5 dB SNR, and 0 dB SNR) and individually presented to 129 healthy listeners divided into one of three groups (i.e., control, acknowledgment of disorder, cognitive-perceptual strategies). Orthographic transcription was used to assess speech intelligibility. In addition, three expert listeners provided subjective voice quality ratings of all speakers. Results: Listeners had significantly more intelligibility errors with increased background noise (p &lt;.001) and providing strategies to listeners did not result in a statistical improvement level F(6, 486) = 1.53, p = .17, η2p = 0.02. Regression analysis showed that the subjective voice quality overall severity was able to predict speech intelligibility in the noisy condition (0 dB SNR), accounting for 37% of the variance, R2 = .365, F(1,10) = 5.759, p = .037. Conclusion: Results suggest that increased background noise has a deleterious effect on the speech intelligibility of those with a voice disorder but that providing listeners with strategies in hopes of improving speaker intelligibility was not successful. Results did provide support, however, for the use of subjective voice quality ratings as a potential index of speech intelligibility.

Screen11: validating a screening instrument for voice disorders in accordance with the COSMIN framework

Purpose Although numerous patient-reported outcome measures have been developed and validated to quantify the impact of voice problems on different aspects of life, to our knowledge no screening instrument exists that specifically captures voice disorders in a retrospective fashion. The aim of the present study was to examine the psychometric properties and diagnostic validity of a retrospective voice screening method, Screen11, according to the COSMIN framework for health-related, patient-reported outcome measures. The items in Screen11 have been used to establish the prevalence of voice disorders in both general and occupation-specific populations in the Nordic countries. However, the instrument has not been validated. Methods The voice patient group (n = 54) in this study comprised of patients from the Turku University Central Hospital phoniatric outpatient clinic seeking help for their voice problems. For these voice patients, we recruited voice-healthy controls (n = 61) who matched in terms of gender, age, and occupation. The participants responded to the Screen11 questionnaire along with the VHI and the VAPP. Results The results of the initial exploratory factor analysis showed that all the Screen11 items loaded on a common underlying latent factor. Furthermore, Screen11 had high internal consistency (α = .93) and correlated sufficiently with other voice questionnaires. Conclusions The results indicate that Screen11, which screens for possible voice disorders at an early stage, was successfully validated. With respect to its diagnostic validity, the Screen11 sum score is preferable. A threshold of ≥ 15 should be used for differentiating patients with possible voice disorders from those with healthy voices.

Increasing Prevalence of Voice Disorders in the USA: Updates in the COVID Era.

To estimate the current prevalence of voice disorders among adults in the United States; to determine the association of individual factors with voice disorders. The 2022 National Health Interview Survey (NHIS) was analyzed to identify adults reporting voice problems in the past 12 months. Demographics were assessed, as well as the duration, severity, and resolution of the voice problem. The relationship between voice problems, gender, lost workdays, and long COVID was investigated. A comparison to the 2012 NHIS was made to determine changes in voice disorder prevalence. 29.9 million Americans (95%CI[28.3-31.5]) annually report a voice problem, representing 12.2% of the population (95%CI[11.7-12.8%]). Overall, 26.8% and 13.2% reported the severity of their voice problem as moderate or severe, respectively. Only 5.1% (95%CI[4.3-6.0%]) of respondents sought treatment. Most voice problems were resolved within 1 week (53.0%,95%CI[50.9-55.1%]). Females were more likely than males to report a voice problem (14.4% vs. 10.0%,95%CI[13.7-15.1] and [9.3-10.7], respectively). The 17.6 million Americans with long COVID symptoms were more likely to have voice complaints than those without (21.1% vs. 11.6%,95%CI[18.9-23.5%] and [11.1-12.1%], respectively). Lost workdays were not significantly higher for those with voice disorders compared to those without (17.1 vs. 12.9 days,95%CI[12.0-22.1] and [11.0-14.8], respectively). Voice problems affect approximately 1 in 8 adults in the U.S. annually, demonstrating an alarming increased prevalence since 2012 using the same survey methodology. Relatively few individuals seek care for their voice problem, despite significant self-reported impact. Further study is required regarding the impact of COVID and changes in voice use patterns on voice disorders. 3 Laryngoscope, 134:3713-3718, 2024.

Grieving a Previous Voice: The Psychological Implications of a Singer with a Functional Voice Disorder

Grieving a Previous Voice: The Psychological Implications of a Singer with a Functional Voice Disorder

Voice self-assessment in individuals with Parkinson's Disease as compared to general voice disorders

BackgroundIndividuals with Parkinson's Disease (IwPD) often fail to adjust their voice in different situations, without awareness of this limitation. Clinicians use self-report questionnaires that are typically designed for individuals with General Voice Disorders (GVD) in the vocal assessment of IwPD. However, these instruments may not consider that IwPD have a reduced self-perception of their vocal deficits. This study aimed to compare self-reported vocal symptoms and voice loudness between IwPD and GVD. Methods28 IwPD and 26 with GVD completed the Voice Symptom Scale (VoiSS) questionnaire to evaluate their voice self-perception. Vocal loudness (dB) was also assessed. Univariate and multivariate analyses were used to compare the outcomes from these measures between the two groups. Principal Component Analysis and Hierarchical Clustering Analysis were applied to explore data patterns related to voice symptoms. ResultsIwPD reported significantly fewer vocal symptoms than those with GVD in all VoiSS questionnaire domains. Multivariate principal component analysis found no significant correlations between VoiSS scores and participant similarities in voice measures. Despite experiencing hypophonia, IwPD scored lower in all VoiSS domains but still fell in the healthy voice range. Hierarchical Clustering Analysis grouped participants into three distinct categories, primarily based on age, vocal loudness, and VoiSS domain scores, distinguishing between PD and GVD individuals. ConclusionsIwPD reported fewer vocal symptoms than GVD. The voice self-assessment seems to be unreliable to assess vocal symptoms in IwPD, at least regarding loudness. New self-report instruments tailored to PD individuals are needed due to their particular voice characteristics.

Prevalence and Risk Factors of Voice Disorders Among Teachers in Saudi Arabia.

Introduction Voice is a crucial tool for communication, and voice problems are more likely to occur in professionals who frequently use their voice for work. Teachers, whose profession requires sustained vocal use, are particularly susceptible to occupation-related voice disorders. This study aimed to quantify the prevalence of voice disorders among teachers in Saudi Arabia, with the general population serving as a control group, and to identify associated risk factors. Methods A cross-sectional study was conducted utilizing an online self-administered questionnaire, which was completed by both teachers and the general population in Saudi Arabia. The latter group acted as a control. The questionnaire included sections on sociodemographic data, teaching patterns, symptoms of voice issues, and the Voice Handicap Index-10 (VHI-10) for assessing voice disorders among participants. Results The study included 640 participants, with 438 (68.4%) being teachers, the majority of whom were females (N = 406; 63.4%). The most common voice-related symptoms reported by teachers were hoarseness (N = 210; 37.9%) and dry throat (N = 147; 26.9%). Voice disorders, as determined by the VHI, affected 355 (55.5%) of the teachers. A high VHI score was associated with a diagnosis of voice disorders and GERD. There was no significant difference in the VHI scores between teachers and the general population (p > 0.05). Conclusion Teachers in Saudi Arabia exhibited a higher prevalence of voice disorders compared to the general population. Risk factors, such as smoking, longer teaching experience, and more teaching hours per week, were more common among teachers with voice disorders. Further investigative studies are warranted to elucidate the causal relationships between these variables and voice disorders.

Mechanisms of Swallowing, Speech and Voice Disorders in Parkinson's Disease: Literature Review with Our First Evidence for the Periperal Nervous System Involvement.

The majority of patients with Parkinson's disease (PD) develop swallowing, speech, and voice (SSV) disorders. Importantly, swallowing difficulty or dysphagia and related aspiration are life-threatening conditions for PD patients. Although PD treatments have significant therapeutic effects on limb motor function, their effects on SSV disorders are less impressive. A large gap in our knowledge is that the mechanisms of SSV disorders in PD are poorly understood. PD was long considered to be a central nervous system disorder caused by the death of dopaminergic neurons in the basal ganglia. Aggregates of phosphorylated α-synuclein (PAS) underlie PD pathology. SSV disorders were thought to be caused by the same dopaminergic problem as those causing impaired limb movement; however, there is little evidence to support this. The pharynx, larynx, and tongue play a critical role in performing upper airway (UA) motor tasks and their dysfunction results in disordered SSV. This review aims to provide an overview on the neuromuscular organization patterns, functions of the UA structures, clinical features of SSV disorders, and gaps in knowledge regarding the pathophysiology underlying SSV disorders in PD, and evidence supporting the hypothesis that SSV disorders in PD could be associated, at least in part, with PAS damage to the peripheral nervous system controlling the UA structures. Determining the presence and distribution of PAS lesions in the pharynx, larynx, and tongue will facilitate the identification of peripheral therapeutic targets and set a foundation for the development of new therapies to treat SSV disorders in PD.

Effect of vocal loading on voice parameters in trainee actors

Introduction: Prolonged use of voice or vocal load can be a risk factor for individuals and can end up in vocal fatigue and dysphonia. Vocal loading can alter tissue structure and affect the voice quality forever. An obvious factor to be considered is the vocal use by a professional voice user. Actors are a group of professionals who can be affected by the long-term use of voice. There is a higher prevalence of inflammatory lesion in acting students and they were found to have poor vocal hygiene habits; which shows that these future elite vocal performers are at risk for developing a voice disorder. Aim: To study the objective and subjective changes in voice characteristics post vocal loading task in trainee actors. Method: A total 37 trainee actors (14 females and 23 males) participated in the study. The age range of the participants were 20 – 39 years and the range of the training period was 6 – 12 months. The participants were instructed to read a passage for 30 – 45 minutes at a loudness level of 70 – 80 dB SPL. Individuals with perceptually normal voice in terms of pitch and intensity and with a score less than 1 in GRBASI (Grade, Roughness, Breathiness, Asthenia, Strain, Instability) rating scale were included in the study. Acoustic, and perceptual evaluation were measured immediately before and after vocal loading task. Acoustic analysis was done using MDVP, whereas The Auditory Perceptual Rating Scale and GRABASI rating scale were used for perceptual analysis. Self-rating of the voice after vocal loading task was measured after the vocal loading task using Vocal Fatigue Index.1 Results and conclusion: The results revealed a significant difference in perceptual parameters post vocal loading task. The f0, jitter and HNR (Harmonic to Noise Ratio) showed a significant increase in the values after the vocal loading task. However, shimmer and RAP (Relative Amplitude Perturbation) did not show significant difference in the values post vocal loading task. The self-rating of the voice after the vocal loading task revealed that 54% of the trainee actors did not perceive vocal fatigue. The study hence shows significant effects of vocal loading in perceptual and acoustic analysis whereas the self-rating shows less perception of vocal changes in training actors. The acoustic, perceptual and self-rating of the voice quality before and after vocal loading task can aid in effective training and management of the trainee actors. However, the actors themselves are not equipped to measure the voice changes acoustically or perceptually and would take much longer time to perceive changes in their voice quality. Therefore, it is important to give a vocal hygiene programme in the preventive stage, that is, in the training period.

Vocal Range Variations Elicited With a Standard Mandarin Reading Passage in Individuals With Voice Disorders.

This study examined whether the "Three Bears Passage" (TB), a standard Mandarin reading passage, could elicit significant vocal range variations in individuals with voice disorders. Relative sensitivity of TB versus another existing standard reading passage, "Passage in Mandarin" (PM), for differentiating between individuals with and without voice disorders was also evaluated. Forty-two individuals with normal voice and 30 individuals with voice disorders participated in the study. Maximum fundamental frequency (f0), minimum f0, mean f0, f0 range, maximum vocal intensity, minimum intensity, mean intensity, and intensity range of all participants reading aloud the two passages were measured with Praat to construct speech range profiles (SRPs). Significantly larger vocal range was found for TB than for PM in individuals with voice disorders, including significantly higher maximum f0, mean f0, maximum intensity, mean intensity, and significantly larger f0 range and intensity range. Significantly more limited vocal range was observed in individuals with voice disorders than those without, with more obviously restricted SRPs while reading aloud TB compared to PM. Receiver operating characteristic analysis suggested that TB was more sensitive than PM in distinguishing between individuals with and without voice disorders. Our findings supported the potential of TB as a standard clinical assessment tool for evaluating pathological changes in vocal range. Future studies should explore if therapeutic approaches based on the passage or variations of it could be developed for overcoming functional limitations and restrictions in vocal range for specific voice disorders.

Speaking without vocal folds using a machine-learning-assisted wearable sensing-actuation system

Voice disorders resulting from various pathological vocal fold conditions or postoperative recovery of laryngeal cancer surgeries, are common causes of dysphonia. Here, we present a self-powered wearable sensing-actuation system based on soft magnetoelasticity that enables assisted speaking without relying on the vocal folds. It holds a lightweighted mass of approximately 7.2 g, skin-alike modulus of 7.83 × 105 Pa, stability against skin perspiration, and a maximum stretchability of 164%. The wearable sensing component can effectively capture extrinsic laryngeal muscle movement and convert them into high-fidelity and analyzable electrical signals, which can be translated into speech signals with the assistance of machine learning algorithms with an accuracy of 94.68%. Then, with the wearable actuation component, the speech could be expressed as voice signals while circumventing vocal fold vibration. We expect this approach could facilitate the restoration of normal voice function and significantly enhance the quality of life for patients with dysfunctional vocal folds.

Paediatric voice disorder: who to refer and how to assess? A summary of recent literature.

The purpose of this review is to update the reader with recent advances and current opinion on the assessment and management of paediatric voice disorders. Access to advanced multidisciplinary paediatric voice clinics has increased over the last decade. Often the assessment is combined between speech therapy/pathology and ENT surgery. Vocal fold nodules remain the most prevalent diagnosis at a paediatric voice clinic, but significant diseases will also present, for example laryngeal papilloma. Recently, more consideration of the psychosocial aspect of voice disorders and evaluation of auditory processing disorders have shown how these can have a negative impact. There also appears to be a lack of parental and teacher awareness of paediatric voice disorders and their significance. We would recommend multiparametric assessment and analysis of all children with a voice disorder. Most paediatric voice conditions will respond to skilled voice therapy. However, the exact techniques and dosage requires further evaluation and research. Paediatric voice conditions are common and should not be dismissed, as they may represent significant disease, for example papilloma, vagal palsy or have a significant psychosocial impact on the child.

100th anniversary of the Otolaryngology Chair and and Department of the Stefan Batory University(Part I)

&lt;b&gt;Introduction:&lt;/b&gt; After regaining independence, work immediately began to revive the University of Vilnius. Already on 30 December 30, 1918, the Polish Committee in Vilnius announced the establishment of the University of Vilnius, closed by the Russians in 1832, under the name Stefan Batory University. The Chair and Department of Otolaryngology was established on July 31, 1923, when Dr. Jan Szmurło was nominated as a full professor of laryngology and otiatry and was appointed as chief. The beginnings of the activity were very difficult, the Faculty of Medicine, University Chairs and Departments had to be created from scratch.&lt;b&gt;Aim:&lt;/b&gt; The aim of the work was to present the establishment and activities of the Chair and Department of Otolaryngology of the Stefan Batory University in Vilnius, which existed from 1923 to 1939.&lt;b&gt;Description:&lt;/b&gt; The Vilnius Department was known and appreciated not only in the country, but also abroad. Its most important achievements include: the creation of one of the first Speech and Voice Disorders Department, scientific works in the field of voice and speech disorders and vertigo, which laid the foundations for the creation of separate sciences in Poland – phoniatrics and otoneurology, publishing the only complete textbook on otorhinolaryngology, research works on a global scale over the scleroderma.&lt;b&gt;Conclusions:&lt;/b&gt; Despite its short operation (only 16 years), the Vilnius Deparment has made an invaluable contribution to the development of otorhinolaryngology not only in the country, but also in the world.