Normalisation of voice parameters in patients with unilateral vocal fold palsy: is it realistic?

AbstractBackgroundDisorders of voice can limit an individual's participation and impair social interaction, thus affecting overall quality of life. Perceptual and objective evaluations can provide the clinician with detailed information regarding voice disorders.MethodsThis study comprised 40 subjects aged 34–46 years, 20 of whom (10 male, 10 female) had unilateral vocal fold palsy. Data were obtained for all participants from: the Voice Handicap Index, the grade, roughness, breathiness, asthenia and strain (‘GRBAS’) scale, acoustic voice analysis, electroglottography, and voice range profiles.ResultsThe voice evaluations revealed statistically significant (p < 0.05) differences between the controls and study group, both in males and females, pre- and post-therapy.ConclusionDespite the normalisation of vocal parameters, acoustic, perceptual and self-rated assessments revealed statistically significant differences after therapy. Hence, acoustic measures, namely electroglottographic perturbation, and voice frequency and intensity range, are recommended prior to termination of therapy.

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Impact of speech therapy on the improvement of voice quality in patients with unilateral vocal fold paralysis

Polski Przegląd Otorynolaryngologiczny ◽

10.5604/01.3001.0012.7783 ◽

2018 ◽

Vol 7 (4) ◽

pp. 1-7

Author(s):

Anna Kuligowska ◽

Barbara Jamróz ◽

Joanna Chmielewska ◽

Katarzyna Jędra ◽

Tomasz Czernicki ◽

...

Keyword(s):

Vocal Fold ◽

Speech Therapy ◽

Acoustic Analysis ◽

Vocal Tract ◽

Voice Quality ◽

Maximum Phonation Time ◽

Before And After ◽

Vocal Fold Palsy ◽

The Voice

Aim of study: Evaluation of the speech therapy on voice quality in patients with unilateral vocal fold palsy. Material and methods: The study group included 11 patients, 8 women and 3 men, in age between 16 to 72 years, with unilateral vocal fold palsy, diagnosed in ENT Department of Warsaw Medical University between 2017-2018. Each person completed questionnaires: the voice disability self-assessment scale (VHI), the voice-based quality of life (VRQoL) scale, the vocal tract discomfort scale (VTD). All questionnaires were completed twice, before and after the voice therapy. In addition, the acoustic analysis of the voice, the assessment of the maximum phonation time and the breathing tract were performed twice in each patient. Each of the patients had a voice rehabilitation consisting of a series of 10 meetings. Results: Statistical analysis of the results of maximum phonation time, the self-assessment of voice disability, the quality of life depending on the voice, discomfort of the vocal tract voice acoustic analysis showed statistically significant differences in the results before and after rehabilitation (p <0.005). In addition, the improvement of the respiratory tract was observed in the majority of patients. Conclusions: Speech therapy significantly affects the voice quality of patients with unilateral laryngeal nerve palsy.

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Patient Self-Assessment and Acoustic Voice Analysis in Screening of Postoperative Vocal Fold Paresis and Paralysis

Scandinavian Journal of Surgery ◽

10.1177/14574969211007036 ◽

2021 ◽

pp. 145749692110070

Author(s):

M. Heikkinen ◽

E. Penttilä ◽

M. Qvarnström ◽

K. Mäkinen ◽

H. Löppönen ◽

...

Keyword(s):

Vocal Fold ◽

Voice Handicap Index ◽

Index Score ◽

Parathyroid Surgery ◽

Voice Analysis ◽

Self Assessment ◽

Acoustic Voice Analysis ◽

Vocal Fold Paresis ◽

The Voice ◽

Patient Self Assessment

Background and Aims: The aim of this study was to evaluate the utility of two items in vocal fold paresis and paralysis screening after thyroid and parathyroid surgery: patient self-assessment of voice using the Voice Handicap Index and computer-based acoustic voice analysis using the Multi-Dimensional Voice Program. Materials and Methods: This was a prospective study of 181 patients who underwent thyroid or parathyroid surgery over a 1-year study period (2017). Preoperatively, all patients underwent laryngoscopic vocal fold inspection and acoustic voice analysis, and they completed the Voice Handicap Index questionnaire. Postoperatively, all patients underwent laryngoscopy prior to hospital discharge; 2 weeks after the surgery, they completed the Voice Handicap Index questionnaire a second time. Two weeks postoperatively, patients with vocal fold paresis or paralysis and 20 randomly selected controls without vocal fold paresis or paralysis underwent a follow-up acoustic voice analysis. Results: Fourteen patients had a new postoperative vocal fold paresis or paralysis. Postoperatively, the total Voice Handicap Index score was significantly higher (p = 0.040) and the change between preoperative and postoperative scores was greater (p = 0.028) in vocal fold paresis or paralysis patients. A total postoperative Voice Handicap Index score > 30 had 55% sensitivity, and 90% specificity, for vocal fold paresis or paralysis. In the postoperative Multi-Dimensional Voice Program analysis, vocal fold paresis or paralysis patients had significantly more jitter (p = 0.044). Postoperative jitter > 1.33 corresponded to 55% sensitivity, and 95% specificity, for vocal fold paresis or paralysis. Conclusion: In identifying postoperative vocal fold paresis or paralysis, patient self-assessment and jitter in acoustic voice analysis have high specificity but poor sensitivity. Without routine laryngoscopy, approximately half of the patients with postoperative vocal fold paresis or paralysis could be overlooked. However, if the patient has no complaints of voice disturbance 2 weeks after thyroid or parathyroid surgery, the likelihood of vocal fold paresis or paralysis is low.

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A New Computational Tool for Voice Analysis Based on FFT, Wavelet Transform, and Spectrogram

ASME 2009 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2009-206192 ◽

2009 ◽

Cited By ~ 1

Author(s):

Nathalee C. de Almeida ◽

Jannayna D. Barros ◽

Heliana B. Soares ◽

Adriano de A. Bresolin ◽

Ana Maria G. Guerreiro ◽

...

Keyword(s):

Acoustic Analysis ◽

Voice Quality ◽

Digital Signal ◽

Computational Tool ◽

Voice Analysis ◽

Non Invasive ◽

Processing Techniques ◽

The Voice ◽

Signal Processing Techniques

Digital signal processing techniques have been used by acoustic analysis to evaluate the voice quality of the patient, due to the simplicity and non-invasive procedures for measurements.

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Unilateral true vocal fold paralysis: Cause of right-sided lesions

Otolaryngology ◽

10.1067/mhn.2000.101955 ◽

2000 ◽

Vol 122 (5) ◽

pp. 678-680

Author(s):

C. Anthony Hughes ◽

Sven Troost ◽

Susan Miller ◽

Thomas Troost

Keyword(s):

Vocal Fold ◽

Vocal Fold Paralysis ◽

Patient Records ◽

Voice Pitch ◽

Sex Distribution ◽

Voice Analysis ◽

Pitch Change ◽

University Center ◽

Presenting Symptoms ◽

The Voice

At the Georgetown University Center for the Voice, 778 patients were referred for evaluation between July 1, 1990, and June 30, 1995. During this 5-year period, right true vocal fold paralysis or paresis was diagnosed in 24 of these patients (3%). Videostro-boscopy, voice analysis, and patient records were reviewed. Ages ranged from 23 to 80 years, and sex distribution approximated a 1:1 ratio. The patients presenting symptoms included hoarseness, dysphagia, choking, voice pitch change, voice weakness, fatigability, and breathiness. Sources of the vocal fold dysfunction included iatrogenic, traumatic, central, and infectious causes.

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Early results for treatment of unilateral vocal fold palsy with injection medialisation under local anaesthetic

The Journal of Laryngology & Otology ◽

10.1017/s0022215109004629 ◽

2009 ◽

Vol 123 (8) ◽

pp. 873-876 ◽

Cited By ~ 6

Author(s):

R Pratap ◽

P Mehta ◽

B Blagnys ◽

P Q Montgomery

Keyword(s):

Local Anaesthetic ◽

Vocal Fold ◽

Voice Quality ◽

Therapy Outcome ◽

Collagen Injection ◽

Early Results ◽

Vocal Fold Palsy ◽

Quality Of Voice ◽

Perceptual Assessment

AbstractBackground:The diagnosis and treatment of unilateral vocal fold palsy is a common part of otolaryngology practice. In those patients in whom resolution of symptoms is slow, the resulting dysphonia can have a dramatic effect on the patient's quality of voice and life. We have previously described the procedure of direct phonoplasty under local anaesthesia using the transnasal laryngoesophagoscope.Objective:To examine the subjective and objective data for the first five patients to undergo this procedure, in the form of laryngographic speech analysis, perceptual assessment and therapy outcome measures.Results:Analysis showed a statistically significant improvement in voice quality, in all the above assessment categories, following local anaesthetic direct phonoplasty using the transnasal laryngoesophagoscope.Conclusion:Collagen injection via transnasal flexible laryngoesophagoscopy is a particularly useful technique for treating vocal fold medialisation, especially in palliative care patients and those with shortened life expectancy.

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Quality of the voice after injection of hyaluronic acid into the vocal fold

Medical Science Monitor ◽

10.12659/msm.883888 ◽

2013 ◽

Vol 19 ◽

pp. 276-282 ◽

Cited By ~ 12

Author(s):

Henryk Skarżyński

Keyword(s):

Hyaluronic Acid ◽

Vocal Fold ◽

The Voice

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Perceptual Assessment and Acoustic Voice Analysis as Screening Tests for Vocal Fold Paresis After Thyroid or Parathyroid Surgery

World Journal of Surgery ◽

10.1007/s00268-020-05863-x ◽

2020 ◽

Author(s):

Maria Heikkinen ◽

Elina Penttilä ◽

Mari Qvarnström ◽

Kimmo Mäkinen ◽

Heikki Löppönen ◽

...

Keyword(s):

Vocal Fold ◽

Roc Analysis ◽

Screening Tools ◽

Screening Tests ◽

Parathyroid Surgery ◽

Voice Analysis ◽

Acoustic Voice Analysis ◽

Vocal Fold Paresis ◽

Voice Assessment ◽

Perceptual Assessment

Abstract Background The aim of this study was to evaluate the reliability of clinician-based perceptual assessment of voice and computerized acoustic voice analysis as screening tests for vocal fold paresis or paralysis (VFP) after thyroid and parathyroid surgery. Methods This was a prospective study of 181 patients undergoing thyroid or parathyroid procedure with pre and postoperative laryngoscopic vocal fold inspection, perceptual voice assessment using grade, roughness, breathiness, asthenia, and strain (GRBAS) scale and acoustic voice analysis using the multi-dimensional voice program (MDVP). Patients were divided into 2 groups for comparison; those with new postoperative VFP and those without. Potential screening tools were evaluated using the receiving operating characteristic (ROC) analysis. Results Fourteen (6.6%) patients had a new postoperative VFP. Postoperative GRBAS scores were significantly (P < 0.05) higher in patients with VFP compared to those without. However, there were no statistically significant differences in MDVP values between the groups. Postoperative GRBAS grade score (cut off > 0) had the best sensitivity, 93%, for predicting VFP, but the specificity was only 50%. Postoperative jitter (cut off > 1.60) in MDVP had a good specificity, 90%, but only 50% sensitivity. Combining all the GRBAS and MDVP variables with P < 0.05 in the ROC analysis yielded a test with 100% sensitivity and 55% specificity. Conclusions Physician-based perceptual voice assessment has a high sensitivity for detecting postoperative VFP, but the specificity is poor. The risk of VFP is low in patients with completely normal voice at discharge. However, routine laryngoscopy after thyroid and parathyroid surgery is still the most reliable exam for VFP screening.

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Unilateral True Vocal Fold Paralysis: Cause of Right-Sided Lesions

Otolaryngology ◽

10.1016/s0194-5998(00)70195-1 ◽

2000 ◽

Vol 122 (5) ◽

pp. 678-680 ◽

Cited By ~ 6

Author(s):

C. Anthony Hughes ◽

Sven Troost ◽

Susan Miller ◽

Thomas Troost

Keyword(s):

Vocal Fold ◽

Vocal Fold Paralysis ◽

Patient Records ◽

Voice Pitch ◽

Sex Distribution ◽

Voice Analysis ◽

Pitch Change ◽

University Center ◽

Presenting Symptoms ◽

The Voice

At the Georgetown University Center for the Voice, 778 patients were referred for evaluation between July 1, 1990, and June 30, 1995. During this 5-year period, right true vocal fold paralysis or paresis was diagnosed in 24 of these patients (3%). Videostroboscopy, voice analysis, and patient records were reviewed. Ages ranged from 23 to 80 years, and sex distribution approximated a 1:1 ratio. The patients presenting symptoms included hoarseness, dysphagia, choking, voice pitch change, voice weakness, fatigability, and breathiness. Sources of the vocal fold dysfunction included iatrogenic, traumatic, central, and infectious causes.

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Impact of hydration on vocal loading using phonetogram measures

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212900 ◽

2021 ◽

Vol 7 (8) ◽

pp. 1317

Author(s):

Sujan Ghosh ◽

Indranil Chatterjee ◽

Piyali Kundu ◽

Susmi Pani ◽

Suman Kumar ◽

...

Keyword(s):

Fundamental Frequency ◽

Vocal Fold ◽

Negative Impact ◽

Vocal Folds ◽

Graphical Display ◽

Male And Female ◽

Range Profile ◽

Vocal Intensity ◽

Voice Range ◽

The Voice

Background: Vocal loading is a phenomenon that affects the vocal folds and voice parameters. Prolonged vocal loading may cause vocal fatigue. Hydration is one of the easiest precautions to reduce the effect of vocal loading. Voice range profile is an analysis of a participant’s vocal intensity and fundamental frequency ranges. Speech range profile is a graphical display of frequency intensity interactions occurring during functional speech activity. Phonetogram software can analyse VRP and SRP.Methods: Total sixty normophonic participants (thirty male and thirty female) were included in this study. Phonetogram, version 4.40 by Tiger DRS, software used to measure the voice range profile and speech range profile. For VRP, participants were asked to produce vowel /a/ and a passage reading task was given for SRP measurement.Results: All sample recording were done at pre vocal loading task, VLT and after hydration. Parameter that were used to measure the effects were Fo-range, semitone, max-F, min-F, SPL range, max-I, min-I, area (dB). Result showed that after VLT all other parameters like Fo-range, semitone, max-F, min-F, SPL range, max-I, min-I, area (dB) in VRP and SRP were reduced except min-F VRP in male, min-I VRP and min-I SRP in both male and female participants. After hydration all other parameters were improved except max-F VRP and min-F VRP in female, max-I VRP, min-F VRP and area VRP.Conclusions: This study concluded that vocal loading has negative impact on vocal fold tissue and mass.

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