Voice Emission Research Articles

The Effectiveness of Voice Therapy for Teachers with Dysphonia

Objective: An incorrect voice emission is a risk factor for developing occupational voice disorders. The study aimed at assessing the effectiveness of voice therapy in female teachers with dysphonia. Methods: The study comprised 133 subjects with voice disorders, taking part in a vocal training programme. A reference group for the present study included 53 teachers with dysphonia. Questionnaire surveys, phoniatric examination and videostroboscopic evaluation were conducted at initial and control examination. Results: In the study group, an improvement after the vocal training was noted in most of the reported symptoms and also in some quantitative parameters of phoniatric examinations compared to the findings for the reference group. The number of patients who assessed their voice as normal increased significantly after the vocal training (2.3 vs. 46.6%). A significant increase in the mean maximum phonation time, from 13.3 to 16.6 s, was observed. The same applied to voice frequency range (increase from 171 to 226.8 Hz). Conclusions: The outcomes of vocal training, such as a subjective improvement of voice quality and an increase in the quantitative parameters (prolonged maximum phonation time, extended voice range) seem to be important parameters for monitoring the effectiveness of training in correct voice emission.

Vestibular fold flap for post-cordectomy laryngeal reconstruction

The development of techniques causing fewer sequelae without compromising oncologic control has led to better phonation, breathing, and postoperative swallowing in patients submitted to cordectomy. The objective of the present study was to describe post-cordectomy laryngeal reconstruction with a vestibular fold flap and to analyze the resulting laryngeal functions. Prospective study. Ten patients, 9 males and 1 female, aged 45 to 75 years (mean, 64.5 years), were evaluated. The patients had squamous cell carcinomas in the glottic region and were treated surgically by laryngofissure and cordectomy with the use of a vestibular fold flap for laryngeal reconstruction. The patients were followed up for functional laryngeal analysis that consisted of videolaryngostroboscopy, endoscopic evaluation of swallowing, and voice recording for perceptive auditory analysis, and for computing purposes. No patients depended on tracheostomy during the late postoperative period. No stenosis, anterior synechia, granuloma, or laryngocele were detected, although 1 patient developed immobility in the median position of the operated hemilarynx, which, however, was not sufficient to impair the respiratory function. No alterations in the pharyngeal phase of swallowing were observed by endoscopic evaluation. Using the GRBAS scale, we observed moderate (30%) and severe (20%) dysphonia in 50% of the patients and grade 1 dysphonia (40%) or normal (10%) dysphonia in the remaining ones. Computing analysis revealed the following mean values: fundamental frequency of 177.5 Hz, jitter 1.11%, and shimmer 7.04%. We conclude that reconstruction with a vestibular fold flap permitted the maintenance of the laryngeal functions of breathing and airway protection during swallowing, as well as the maintenance of phonation function, providing perfect voice emission according to perceptive auditory or acoustic analysis in 1 patient and moderate or severe dysphonia in one half of the cases when technical faults occurred.

Listening ability and auditory lateralisation in patients with vocal fold nodules and other laryngeal pathologies secondary to improper voice emission

The authors assessed listening ability and auditory lateralisation in patients with dysphonia resulting from improper voice emission. The authors assumed that improper voice production may origin in abnormal auditory perception. Forty-one patients with vocal fold nodules (20 children aged 5–16 years and 21 adults aged 17–64 years) were included in the study. Listening ability and auditory lateralisation were tested with the use of A. Tomatis's procedure including evaluation of listening ability assessed in air and bone conduction, selection of sounds (pitch discrimination), localisation of sounds applied to the bone conduction path, and assessment of auditory lateralisation. In almost all patients, left-sided auditory lateralisation and restricted selection of sounds were found. Those findings may support the assumption that improper voice emission may be the result of disturbances of listening.

Grasp observation influences speech production.

Subjects pronounced either the syllable 'BA' or 'GA' while observing motor acts of hand grasp directed to objects of two sizes (experiment 1). Kinematics of lip aperture and amplitude spectrum of voice were influenced by the observation of the different grasp kinematics depending on the size of the target objects. Specifically, both lip aperture and voice peak amplitude were greater when the observed hand grasp was directed to the large object. Two control experiments ruled out that the different arm velocity when reaching objects varying in size (experiment 2), and overt visual analysis of the target-object (experiment 3), affected lip movement and voice emission. Results provide behavioural evidence in favour of the hypothesis that the system involved in observation (and preparation) of grasp movements partially shares the cortical areas involved in speech production.