scholarly journals Cepstral Peak Prominence Values for Clinical Voice Evaluation

2020 ◽  
Vol 29 (3) ◽  
pp. 1596-1607 ◽  
Author(s):  
Olivia Murton ◽  
Robert Hillman ◽  
Daryush Mehta
Keyword(s):  
English Language ◽  
Voice Disorders ◽  
Reference Points ◽  
Voice Disorder ◽  
Coefficient Of Determination ◽  
Initial Attempt ◽  
Perceptual Evaluation ◽  
Cutoff Values ◽  
Preliminary Validation ◽  
Cepstral Peak Prominence

Purpose The goal of this study was to employ frequently used analysis methods and tasks to identify values for cepstral peak prominence (CPP) that can aid clinical voice evaluation. Experiment 1 identified CPP values to distinguish speakers with and without voice disorders. Experiment 2 was an initial attempt to estimate auditory-perceptual ratings of overall dysphonia severity using CPP values. Method CPP was computed using the Analysis of Dysphonia in Speech and Voice (ADSV) program and Praat. Experiment 1 included recordings from 295 patients with medically diagnosed voice disorders and 50 vocally healthy control speakers. Speakers produced sustained /a/ vowels and the English language Rainbow Passage. CPP cutoff values that best distinguished patient and control speakers were identified. Experiment 2 analyzed recordings from 32 English speakers with varying dysphonia severity and provided preliminary validation of the Experiment 1 cutoffs. Speakers sustained the /a/ vowel and read four sentences from the Consensus Auditory-Perceptual Evaluation of Voice protocol. Trained listeners provided auditory-perceptual ratings of overall dysphonia for the recordings, which were estimated using CPP values in a linear regression model whose performance was evaluated using the coefficient of determination ( r 2 ). Results Experiment 1 identified CPP cutoff values of 11.46 dB (ADSV) and 14.45 dB (Praat) for the sustained /a/ vowels and 6.11 dB (ADSV) and 9.33 dB (Praat) for the Rainbow Passage. CPP values below those thresholds indicated the presence of a voice disorder with up to 94.5% accuracy. In Experiment 2, CPP values estimated ratings of overall dysphonia with r 2 values up to .74. Conclusions The CPP cutoff values identified in Experiment 1 provide normative reference points for clinical voice evaluation based on sustained /a/ vowels and the Rainbow Passage. Experiment 2 provides an initial predictive framework that can be used to relate CPP values to the auditory perception of overall dysphonia severity based on sustained /a/ vowels and Consensus Auditory-Perceptual Evaluation of Voice sentences.

scholarly journals Multivariate Analysis of Vocal Fold Vibrations on Various Voice Disorders Using High-Speed Digital Imaging

2021 ◽  
Vol 11 (14) ◽  
pp. 6284
Author(s):  
Akihito Yamauchi ◽  
Hiroshi Imagawa ◽  
Hisayuki Yokonishi ◽  
Ken-Ichi Sakakibara ◽  
Niro Tayama
Keyword(s):  
Multivariate Analysis ◽  
Digital Imaging ◽  
Vocal Fold ◽  
High Speed ◽  
Voice Disorders ◽  
Normal Subjects ◽  
Voice Disorder ◽  
Coefficient Of Determination ◽  
Laryngeal Diseases ◽  
Disease Specific

Although many quantitative parameters have been devised to describe abnormalities in vocal fold vibration, little is known about the priority of these parameters. We conducted a prospective study using high-speed digital imaging to elucidate disease-specific key parameters (KPs) to characterize the vocal fold vibrations of individual voice disorders. From 304 patients with various voice disorders and 46 normal speakers, high-speed digital imaging of a sustained phonation at a comfortable pitch and loudness was recorded and parameters from visual-perceptual rating, laryngotopography, digital kymography, and glottal area waveform were calculated. Multivariate analysis was then applied to these parameters to elucidate the KPs to explain each voice disorder in comparison to normal subjects. Four key parameters were statistically significant for all laryngeal diseases. However, the coefficient of determination (R2) was very low (0.29). Vocal fold paralysis (8 KPs, R2 = 0.76), sulcus vocalis (4 KPs, R2 = 0.74), vocal fold scarring (1 KP, R2 = 0.68), vocal fold atrophy (6 KPs, R2 = 0.53), and laryngeal cancer (1 KP, R2 = 0.52) showed moderate-to-high R2 values. The results identified different KPs for each voice disorder; thus, disease-specific analysis is a reasonable approach.

scholarly journals Development of the Arabic Voice Pathology Database and Its Evaluation by Using Speech Features and Machine Learning Algorithms

2017 ◽  
Vol 2017 ◽  
pp. 1-13 ◽  
Author(s):  
Tamer A. Mesallam ◽  
Mohamed Farahat ◽  
Khalid H. Malki ◽  
Mansour Alsulaiman ◽  
Zulfiqar Ali ◽  
...  
Keyword(s):  
Machine Learning ◽  
English Language ◽  
Language Disorder ◽  
Learning Algorithms ◽  
Voice Disorders ◽  
Essential Element ◽  
Machine Learning Algorithms ◽  
Voice Disorder ◽  
Speech Features ◽  
The Voice

A voice disorder database is an essential element in doing research on automatic voice disorder detection and classification. Ethnicity affects the voice characteristics of a person, and so it is necessary to develop a database by collecting the voice samples of the targeted ethnic group. This will enhance the chances of arriving at a global solution for the accurate and reliable diagnosis of voice disorders by understanding the characteristics of a local group. Motivated by such idea, an Arabic voice pathology database (AVPD) is designed and developed in this study by recording three vowels, running speech, and isolated words. For each recorded samples, the perceptual severity is also provided which is a unique aspect of the AVPD. During the development of the AVPD, the shortcomings of different voice disorder databases were identified so that they could be avoided in the AVPD. In addition, the AVPD is evaluated by using six different types of speech features and four types of machine learning algorithms. The results of detection and classification of voice disorders obtained with the sustained vowel and the running speech are also compared with the results of an English-language disorder database, the Massachusetts Eye and Ear Infirmary (MEEI) database.

Evidence-Based Clinical Voice Assessment: A Systematic Review

2013 ◽  
Vol 22 (2) ◽  
pp. 212-226 ◽  
Author(s):  
Nelson Roy ◽  
Julie Barkmeier-Kraemer ◽  
Tanya Eadie ◽  
M. Preeti Sivasankar ◽  
Daryush Mehta ◽  
...  
Keyword(s):  
English Language ◽  
Voice Disorders ◽  
Communication Disorders ◽  
Test Method ◽  
Voice Disorder ◽  
Sufficient Evidence ◽  
Evidence Based ◽  
High Quality Research ◽  
Voice Assessment ◽  
Acoustic Measures

Purpose To determine what research evidence exists to support the use of voice measures in the clinical assessment of patients with voice disorders. Method The American Speech-Language-Hearing Association (ASHA) National Center for Evidence-Based Practice in Communication Disorders staff searched 29 databases for peer-reviewed English-language articles between January 1930 and April 2009 that included key words pertaining to objective and subjective voice measures, voice disorders, and diagnostic accuracy. The identified articles were systematically assessed by an ASHA-appointed committee employing a modification of the critical appraisal of diagnostic evidence rating system. Results One hundred articles met the search criteria. The majority of studies investigated acoustic measures (60%) and focused on how well a test method identified the presence or absence of a voice disorder (78%). Only 17 of the 100 articles were judged to contain adequate evidence for the measures studied to be formally considered for inclusion in clinical voice assessment. Conclusion Results provide evidence for selected acoustic, laryngeal imaging–based, auditory–perceptual, functional, and aerodynamic measures to be used as effective components in a clinical voice evaluation. However, there is clearly a pressing need for further high-quality research to produce sufficient evidence on which to recommend a comprehensive set of methods for a standard clinical voice evaluation.

Multiple Perspectives on the Barriers to Identification and Management of Pediatric Voice Disorders

2017 ◽  
Vol 2 (3) ◽  
pp. 49-56
Author(s):  
Jana Childes ◽  
Alissa Acker ◽  
Dana Collins
Keyword(s):  
Academic Success ◽  
Voice Disorders ◽  
School Personnel ◽  
Voice Disorder ◽  
Multiple Perspectives ◽  
Vocal Qualities ◽  
High Prevalence ◽  
Pediatric Populations ◽  
Low Incidence ◽  
University Settings

Pediatric voice disorders are typically a low-incidence population in the average caseload of clinicians working within school and general clinic settings. This occurs despite evidence of a fairly high prevalence of childhood voice disorders and the multiple impacts the voice disorder may have on a child's social development, the perception of the child by others, and the child's academic success. There are multiple barriers that affect the identification of children with abnormal vocal qualities and their access to services. These include: the reliance on school personnel, the ability of parents and caretakers to identify abnormal vocal qualities and signs of misuse, the access to specialized medical services for appropriate diagnosis, and treatment planning and issues related to the Speech-Language Pathologists' perception of their skills and competence regarding voice management for pediatric populations. These barriers and possible solutions to them are discussed with perspectives from the school, clinic and university settings.

Voice Disorders in Obstructive Sleep Apnea: Prevalence, Risk Factors, and the Role of CPAP

2018 ◽  
Vol 128 (3) ◽  
pp. 249-262 ◽  
Author(s):  
Nelson Roy ◽  
Ray M. Merrill ◽  
Jenny Pierce ◽  
Krishna M. Sundar
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Voice Disorders ◽  
Acid Reflux ◽  
Voice Disorder ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
A Current

Objective: Obstructive sleep apnea (OSA) is characterized by frequent interruptions in breathing related to upper airway collapse during sleep and may adversely affect phonatory function. This study aimed to: (1) establish the prevalence, risks, and quality of life burden of voice disorders in OSA and (2) explore the relation between voice disorders and positive airway pressure (PAP) therapy. Study Design: Cross-sectional, descriptive epidemiology study. Methods: Analyses were based on 94 individuals with OSA (53 men, 41 women; mean age = 54.7 ± 12.8 years) who completed a telephone interview. Results: Twenty-eight percent of participants reported having a current voice disorder. Of those with a current voice disorder, 83% had experienced symptoms for at least a year, and 58% had symptoms for at least 4 years. The prevalence of a current voice disorder was greater in women than men (44% vs 15%, P = .0020) but did not vary significantly across different age groups, body mass index (BMI), apnea/hypopnea index (AHI) severity, or medical history. After adjusting for sex, consistent use of PAP therapy (with humidification) was associated with (1) lower occurrence of voice disorders in women (Mantel-Haenszel [MH] χ2 P = .0195), (2) reduced snoring severity accompanied by fewer voice disorders in men (MH χ2 P = .0101), and (3) fewer reports of acid reflux as a possible trigger for voice problems (MH χ2 P = .0226). Patients with OSA who also had a current voice disorder experienced lower overall quality of life compared to those without. Conclusions: Chronic, longstanding voice disorders are common in women with OSA and produce significant adverse effects on quality of life. Nightly PAP use (with humidification) was associated with fewer voice symptoms and reduced severity of snoring and acid reflux as possible contributors. Further research is necessary to better understand the origin of these voice disorders in OSA and their potential response to treatment.

Videostrobolaryngoscopy of Mucus Layer during Vocal Fold Vibration in Patients with Laryngeal Tension-Fatigue Syndrome

2002 ◽  
Vol 111 (6) ◽  
pp. 537-541 ◽  
Author(s):  
Tzu-Yu Hsiao ◽  
Chia-Ming Liu ◽  
Kai-Nan Lin
Keyword(s):  
Mechanical Properties ◽  
Vocal Fold ◽  
Rough Surfaces ◽  
Voice Disorders ◽  
Vocal Folds ◽  
Voice Disorder ◽  
Mucus Layer ◽  
Vocal Fold Vibration ◽  
Fatigue Syndrome ◽  
Functional Dysphonia

The mucus layer on the vocal folds was examined by videostrobolaryngoscopy in patients with laryngeal tension-fatigue syndrome, a chronic functional dysphonia due to vocal abuse and misuse. Besides the findings in previous reports (such as abnormal glottal closure, phase or amplitude asymmetry, and the irregular mucosal wave), the vocal folds during vibration had an uneven mucus surface. The occurrence of an uneven mucus layer on vocal folds was significantly greater in subjects with this voice disorder (83% or 250 of 301 patients in this series) than in those without voice disorders (18.5% or 5 of 27). The increase of mucus viscosity, mucus aggregation, and the formation of rough surfaces on the vocal folds alter the mechanical properties that contribute to vibration of the cover of the vocal folds, and thereby worsen the symptoms of dysphonia in patients with laryngeal tension-fatigue syndrome.

scholarly journals Occupational Voice Disorders in Slovakia Today and in the Past

2019 ◽  
Vol 19 (1) ◽  
pp. 38-44
Author(s):  
M Mikolajcikova ◽  
V Ferencikova ◽  
K Fiolkova ◽  
V Sokolikova ◽  
Z Matuskova ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Medical Information ◽  
Slovak Republic ◽  
Voice Disorders ◽  
University Hospital ◽  
Voice Disorder ◽  
Occupational Health Services ◽  
Teaching Staff ◽  
Low Incidence

Abstract Introduction: Voice disorders primarily affect workers in professions with increased voice demands, such as teaching personnel in educational system, singers, lecturers, actors or managers. Severe voice disorders often require a permanent change of work position. Methods: Retrospective analysis of a set of patients with occupational voice disorders who were hospitalized at the Clinic of Occupational Medicine and Toxicology, Martin University Hospital (COMaT, MUH) in the years of 2000–2017. Comparison of the data obtained with the National Centre of Medical Information (NCMI) data on the occurrence of occupational voice disorders throughout the Slovak Republic (SR). Comparison with the retrospective analysis of reported occupational voice disorders in the years of 1967-1996. Case report of a patient with an occupational voice disorder. Results: We point to a long-term low incidence of occupational voice disorders. In the years of 2000-2017, 24 cases of occupational voice disorders were reported in Slovakia, of which 20 cases were reported under item 42-1 and 4 cases under item 42-2 in the List of Occupational Diseases. Through the COMaT, MUH 11 cases of occupational voice disorders were reported during these years, of which 9 cases were listed under item 42-1 and 2 cases under item 42-2. From 1967 to 1996 there were 52 occupational voice disorders reported in Slovakia, of which 45 were under item 42-1 and 7 under item 42-2. Conclusions: As there is a tendency to underestimate the voice difficulties among teaching staff, it is necessary to provide better information about the possible consequences, prevention, and treatment of these diseases. All of this should be in the competency of occupational health services.

scholarly journals Common mistakes in the diagnosis of laryngeal pathology

2020 ◽  
Vol 19 (2) ◽  
pp. 93-99
Author(s):  
A. I. Kryukov ◽  
◽  
S. G. Romanenko ◽  
O. G. Pavlikhin ◽  
E. V. Lesogorova ◽  
...  
Keyword(s):  
Laryngeal Cancer ◽  
Correct Diagnosis ◽  
Voice Quality ◽  
Voice Disorders ◽  
Voice Disorder ◽  
Laryngeal Diseases ◽  
Root Cause ◽  
Incorrect Diagnosis ◽  
Reinke’S Edema ◽  
Chronic Laryngitis

The article The article describes in detail the main stages of the diagnosis of voice disorders with an indication of the methods and major errors leading to an incorrect diagnosis. Since in some cases, impaired voice quality is the first and/ or only symptom of concomitant diseases of organs or systems of various etiologies, an expanded diagnostic search is required to make a correct diagnosis. The features of receiving of complaints and medical history from patients with laryngeal diseases, the guidelines for laryngoscopy are described. A description of the laryngoscopic vew is presented, which helps in the diagnosis of the initial stages of Reinke’s edema, hyperplastic laryngitis and early stages of laryngeal cancer. The relationship between the functional and organic pathology of the larynx is very close, it can be difficult to understand the root cause of voice disorder, this leads to incorrect treatment tactics, the progression and relapse of the disease. The causes of laryngeal diseases of an organic and functional nature, the features of the clinical picture and the differential diagnosis of voice disorders are considered. Cases of diagnosis, a clinic of chronic laryngitis, laryngomycosis, and laryngeal cancer are described; the main approaches to the treatment of laryngeal diseases are presented. The article will be useful to otorhinolaryngologists, phoniatricians of outpatient and inpatient care.

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