Vocal Function following Hemilaryngectomy

1987 ◽  
Vol 96 (5) ◽  
pp. 586-589 ◽  
Author(s):  
Minoru Hirano ◽  
Shigejiro Kurita ◽  
Hidetaka Matsuoka
Keyword(s):  
Fundamental Frequency ◽  
Vocal Fold ◽  
Skin Flap ◽  
Muscle Flap ◽  
Airflow Rate ◽  
Vocal Function ◽  
Maximum Phonation Time ◽  
The Voice

Vocal function following hemilaryngectomy was investigated in 54 cases in which a superiorly based sternohyoid muscle flap was used for glottic reconstruction. Four types of material were employed for covering the muscle flap: Hypopharyngeal mucosa, lip mucosa, thyroid perichondrium, and island cervical skin flap. The vocal function varied greatly from individual to individual; however, the following tendencies were observed in many cases: 1) the glottis did not close completely; 2) supraglottic structures (false fold, arytenoid region, and epiglottis) were hyperfunctional and vibrated instead of or together with the unaffected vocal fold; 3) vibrations of the laryngeal structures were irregular; 4) maximum phonation time was short; 5) mean airflow rate was high; 6) fundamental frequency and intensity ranges of phonation were limited; 7) the voice was rough, breathy, and/or strained; and 8) cases with poor vocal function were most frequent in the skin flap group and least frequent in the lip mucosa group.

Laser Surgery for Epithelial Hyperplasia of the Vocal Fold

1993 ◽  
Vol 102 (2) ◽  
pp. 85-91 ◽  
Author(s):  
Minoru Hirano ◽  
Kiminori Sato
Keyword(s):  
Carbon Dioxide ◽  
Laser Surgery ◽  
Vocal Fold ◽  
Carbon Dioxide Laser ◽  
Airflow Rate ◽  
Epithelial Hyperplasia ◽  
Vocal Function ◽  
Maximum Phonation Time ◽  
Cellular Atypia ◽  
Histologic Types

A total of 88 patients with epithelial hyperplasia of the vocal fold were treated with endolaryngeal microscopic carbon dioxide laser surgery during the period from 1978 to 1990. The majority of the patients were male smokers. During the follow-up period ranging from 12 to 156 months, 15 patients developed recurrence(s). The recurrent lesion was benign epithelial hyperplasia in 8 patients and invasive carcinoma in 7 patients. The recurrences occurred only in preoperative smokers. Discontinuation of smoking following laser surgery did not affect the incidence of recurrence. The incidence of development of carcinoma did not differ between two histologic types: simple hyperplasia without cellular atypia and dysplasia associated with cellular atypia. The incidence of cancer development for dysplasia cases in the present series (6%) was lower than that in previous reports in which the carbon dioxide laser was not employed for the treatment. Postoperative improvement of vocal function was manifested in an increase of the maximum phonation time, a decrease of the mean airflow rate, and an increase in vibratory amplitude and mucosal wave.

Improved Surgical Technique for Epidermoid Cysts of the Vocal Fold

1989 ◽  
Vol 98 (10) ◽  
pp. 791-795 ◽  
Author(s):  
Minoru Hirano ◽  
Yoshio Hirade ◽  
Tetsuji Yoshida ◽  
Tomoaki Sanada
Keyword(s):  
Surgical Technique ◽  
Vocal Fold ◽  
Single Incision ◽  
Surrounding Tissue ◽  
Airflow Rate ◽  
Maximum Phonation Time ◽  
Epidermoid Cysts ◽  
Present Technique ◽  
Acoustic Analyses ◽  
The Voice

An improved surgical technique for epidermoid cysts of the vocal fold is presented. This technique employs a specially designed double-bladed elevator. Following betamethasone injection around the cyst, an incision is made posterior to the cyst at its mediolateral midpoint. The incision is extended anteriorly over the cyst with the use of a double-bladed elevator. The cyst then is elevated carefully from the surrounding tissue and removed. A single incision line on the upper aspect of the vocal fold should be the result. Eight patients were operated on with the present technique. The voice was improved postoperatively in all patients. The voice improvement was reflected objectively in stroboscopic findings, maximum phonation time, airflow rate, fundamental frequency and intensity of phonation, and results of acoustic analyses of voice.

Phonetics of Singing in Western Classical Style

2018 ◽  
Author(s):  
Johan Sundberg
Keyword(s):  
Fundamental Frequency ◽  
Vocal Fold ◽  
Vocal Tract ◽  
Formant Frequency ◽  
Vowel Identification ◽  
Fundamental Frequencies ◽  
Vocal Fold Vibration ◽  
Syllable Duration ◽  
Classical Singing ◽  
The Voice

The function of the voice organ is basically the same in classical singing as in speech. However, loud orchestral accompaniment has necessitated the use of the voice in an economical way. As a consequence, the vowel sounds tend to deviate considerably from those in speech. Male voices cluster formant three, four, and five, so that a marked peak is produced in spectrum envelope near 3,000 Hz. This helps them to get heard through a loud orchestral accompaniment. They seem to achieve this effect by widening the lower pharynx, which makes the vowels more centralized than in speech. Singers often sing at fundamental frequencies higher than the normal first formant frequency of the vowel in the lyrics. In such cases they raise the first formant frequency so that it gets somewhat higher than the fundamental frequency. This is achieved by reducing the degree of vocal tract constriction or by widening the lip and jaw openings, constricting the vocal tract in the pharyngeal end and widening it in the mouth. These deviations from speech cause difficulties in vowel identification, particularly at high fundamental frequencies. Actually, vowel identification is almost impossible above 700 Hz (pitch F5). Another great difference between vocal sound produced in speech and the classical singing tradition concerns female voices, which need to reduce the timbral differences between voice registers. Females normally speak in modal or chest register, and the transition to falsetto tends to happen somewhere above 350 Hz. The great timbral differences between these registers are avoided by establishing control over the register function, that is, over the vocal fold vibration characteristics, so that seamless transitions are achieved. In many other respects, there are more or less close similarities between speech and singing. Thus, marking phrase structure, emphasizing important events, and emotional coloring are common principles, which may make vocal artists deviate considerably from the score’s nominal description of fundamental frequency and syllable duration.

Laryngeal Electromyography-Guided Hyaluronic Acid Vocal Fold Injections for Glottic Insufficiency

2020 ◽  
Vol 129 (11) ◽  
pp. 1063-1070
Author(s):  
Alice Q. Liu ◽  
Joel Singer ◽  
Terry Lee ◽  
Amanda Hu
Keyword(s):  
Hyaluronic Acid ◽  
Fundamental Frequency ◽  
Vocal Fold ◽  
The Novel ◽  
Completion Rates ◽  
Laryngeal Electromyography ◽  
Glottic Insufficiency ◽  
Maximum Phonation Time ◽  
Novel Technique ◽  
Glottal Insufficiency

Objectives: To assess voice outcomes using the novel technique of in-office laryngeal electromyography-guided vocal fold injections (LEVFI) with hyaluronic acid to treat glottal insufficiency. Secondary objectives included determining the complication/completion rates and if any factors were associated with improved voice outcomes. Methods: Retrospective review of patients who received their first LEVFI from August 2017 to December 2018. Three- and six-month voice outcomes were assessed. Outcomes included voice handicap index-10 (VHI-10), maximum phonation time (MPT), perceptual analysis of voice (GRBAS), fundamental frequency, and stroboscopy. Results: Of the 121 eligible patients (55.4% male, age 63.7 years), 94 (77.7%) had complete 3-month data and 59 (48.8%) had complete 6-month data. VHI-10 was significantly improved from 25.7 ± 7.5 to 20.9 ± 10.9 at 3 months ( P < .001) and to 19.1 ± 11.5 at 6 months ( P < .001). MPT improved from 6.2 ± 5.4 seconds to 9.4 ± 7.1 seconds at 3 months ( P < .001) and to 11.3 ± 8.2 seconds at 6 months ( P < .001). GRBAS was improved in 74.8% of patients ([65.2, 82.8] 95% CI) at 3 months and 80.8% ([69.9, 89.1]) 95% CI) at 6 months. Stroboscopy showed a glottic gap improvement in 74.8% of patients ([65.8, 82.4] 95% CI) at 3 months and in 80.3% ([65.9, 88.5] 95% CI) at 6 months. Fundamental frequency was unchanged, as expected. Multivariate analysis reported that no factors were associated with better voice outcomes. Overall, 177/181 (97.8%) injections were completed. There were no complications. Conclusion: In-office LEVFI is an effective, novel technique to treat glottic insufficiency with improved voice outcomes, high completion rate, and no significant complications.

scholarly journals Fundamental frequency, phonation maximum time and vocal complaints in morbidly obese women

2014 ◽  
Vol 27 (1) ◽  
pp. 43-46 ◽  
Author(s):  
Lourdes Bernadete Rocha de SOUZA ◽  
Rayane Medeiros PEREIRA ◽  
Marquiony Marques dos SANTOS ◽  
Cynthia Meida de Almeida GODOY
Keyword(s):  
Fundamental Frequency ◽  
Vocal Tract ◽  
Control Group ◽  
Morbidly Obese ◽  
Obese Women ◽  
Obese People ◽  
Maximum Phonation Time ◽  
Significant Difference ◽  
The Voice ◽  
Voice Recording

Background : Obese people have abnormal deposition of fat in the vocal tract that can interfere with the acoustic voice. Aim : To relate the fundamental frequency, the maximum phonation time and voice complaints from a group of morbidly obese women. Methods : Observational, cross-sectional and descriptive study that included 44 morbidly obese women, mean age of 42.45 (±10.31) years old, observational group and 30 women without obesity, control group, with 33.79 (±4.51)years old. The voice recording was done in a quiet environment, on a laptop using the program ANAGRAF acoustic analysis of speech sounds. To extract the values of fundamental frequency the subjects were asked to produce vowel [a] at usual intensity for a period in average of three seconds. After the voice recording, participants were prompted to produce sustained vowel [ a] , [ i] and [ u] at usual intensity and height, using a stopwatch to measure the time that each participant could hold each vowel. Results : The majority, 31(70.5%), had vocal complaints, with a higher percentage for complaints of vocal fatigue 20(64.51%) and voice failures 19(61.29%) followed by dryness of the throat in 15 (48.38%) and effort to speak 13(41.93%). There was no statistically significant difference regarding the mean fundamental frequency of the voice in both groups, but there was significance between the two groups regarding maximum phonation. Conclusion : Increased adipose tissue in the vocal tract interfered in the vocal parameters.

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

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.

Quantitative Measurement of Mucosal Wave by High-Speed Photography in Excised Larynges

1998 ◽  
Vol 107 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Jack J. Jiang ◽  
Yoshimi Kadota ◽  
Eiji Yumoto ◽  
Hironobu Kurokawa ◽  
Samuel J. Lin ◽  
...  
Keyword(s):  
Fundamental Frequency ◽  
Phase Difference ◽  
Vocal Fold ◽  
High Speed ◽  
High Speed Photography ◽  
Airflow Rate ◽  
Quantitative Studies ◽  
Movement Characteristics ◽  
Dependent Variables ◽  
Measured Displacement

The movement characteristics of mucosal waves of the vocal fold are important components in normal phonation. Quantitative studies of the mucosal wave have used stroboscopic techniques from a supraglottic view. The current study measured displacement of mucosal epithelium during experimental phonation by using high-speed photography from an infraglottic view. Effects of thyroarytenoid contraction, increased mean airflow rate, and variation of vocal fold length were examined in canine larynges. Top and bottom vocal fold “lip” amplitude, fundamental frequency, and phase difference were the dependent variables examined. Thyroarytenoid contraction increased the amplitude of the top and bottom lips, decreased the fundamental frequency, and increased the phase difference. Increase in airflow through the glottis decreased the top lip amplitude and phase difference and appeared to increase the fundamental frequency and to decrease the bottom lip amplitude. Vocal fold lengthening decreased the bottom lip amplitude and increased the fundamental frequency and appeared to decrease the top lip amplitude and phase difference.

Contribution of Glottic Insufficiency to Perceived Breathiness in Classically Trained Singers

2016 ◽  
Vol 31 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Ellen Graham ◽  
Vrushali Angadi ◽  
Joanna Sloggy ◽  
Joseph Stemple
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Airflow Rate ◽  
Singing Voice ◽  
Glottic Insufficiency ◽  
Maximum Phonation Time ◽  
Breath Management ◽  
Subglottal Pressure ◽  
Glottal Insufficiency ◽  
Voice Students

Breathiness in the singing voice is problematic for classical singers. Voice students and singing teachers typically attribute breathiness to breath management issues and breathing technique. The present study sought to determine whether glottic insufficiency may also contribute to breathiness in a singer’s voice. Studies have revealed a relationship between insufficient vocal fold closure and inefficiency in the speaking voice. However, the effect of insufficient vocal fold closure on vocal efficiency in singers has yet to be determined. Two groups of voice students identified with and without breathiness issues underwent aerodynamic and acoustic voice assessment as well as laryngeal stroboscopy of the vocal folds to quantify the prevalence of insufficient vocal fold closure, also known as glottic insufficiency. These assessments revealed four groups: 1) those with glottic insufficiency and no perceived voice breathiness; 2) those with glottic sufficiency and perceived voice breathiness; 3) those with glottic insufficiency and perceived breathiness; and 4) those with glottic sufficiency and no perceived breathiness. Results suggest that previously undiscovered glottal insufficiency is common in young singers, particularly women, though the correlation with identified breathiness was not statistically significant. Acoustic and aerodynamic measures including noise-to-harmonics ratio, maximum phonation time, airflow rate, subglottal pressure, and laryngeal airway resistance were most sensitive to glottic insufficiency.

Impact of unilateral carbon dioxide laser posterior transverse cordotomy on vocal and aerodynamic parameters in bilateral vocal fold paralysis

2016 ◽  
Vol 130 (4) ◽  
pp. 373-379 ◽  
Author(s):  
M B Asik ◽  
O Karasimav ◽  
H Birkent ◽  
A L Merati ◽  
M Gerek ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Vocal Fold ◽  
Carbon Dioxide Laser ◽  
Vocal Fold Paralysis ◽  
Bicycle Ergometry ◽  
Maximum Phonation Time ◽  
Post Operative Period ◽  
Bilateral Vocal Fold Paralysis ◽  
Aerodynamic Parameters ◽  
The Voice

AbstractObjectives:Carbon dioxide laser posterior transverse cordotomy is a common option for bilateral vocal fold paralysis. This study prospectively evaluated aerodynamic and acoustic effects of unilateral carbon dioxide laser posterior transverse cordotomy in bilateral vocal fold paralysis patients.Methods:The study comprised 11 bilateral vocal fold paralysis patients (9 females, 2 males), with a mean age of 46.6 ± 14.1 years. All patients were treated by laser posterior transverse cordotomy. Pre-operative and two-month post-operative assessments were conducted, including: dyspnoea scales, maximum phonation time measurement, spirometry and bicycle ergometry.Results:All subjective and objective aerodynamic parameters showed statistically significant improvements between the pre- and post-operative period. Objective spirometric and ergometric parameters showed a significant increase post-operatively. The changes in objective voice parameters (fundamental frequency (f0), jitter, shimmer, soft phonation index and noise-to-harmonic ratio) were statistically non-significant; however, there was a significant improvement in subjective voice parameters post-operatively, as assessed by the voice handicap index and grade-roughness-breathiness-asthenia-strain scale (p = 0.026 and p = 0.018 respectively).Conclusion:Unilateral carbon dioxide laser posterior transverse cordotomy is an effective procedure that results in improved dyspnoea and aerodynamic performance with some worsening of voice parameters.

Changes in the male voice at puberty: vocal fold length and its relationship to the fundamental frequency of the voice

1998 ◽  
Vol 112 (5) ◽  
pp. 451-454 ◽  
Author(s):  
Meredydd Harries ◽  
Sarah Hawkins ◽  
Jeremy Hacking ◽  
Ieuan Hughes
Keyword(s):  
Fundamental Frequency ◽  
Vocal Fold ◽  
Gradual Increase ◽  
Vocal Folds ◽  
Frequency Change ◽  
Male Voice ◽  
Pubertal Stage ◽  
Sudden Drop ◽  
Ultrasound Measurements ◽  
The Voice

AbstractUltrasound measurements of the vocal folds were taken for a number of boys passing through puberty. The boys were grouped according to their pubertal stage as defined by Tanner and there was a gradual increase in the length of the vocal folds as puberty progressed. The fundamental frequency of the boys' speaking voice was recorded via laryngography and a good correlation between the length of the vocal folds and the frequency of the voice was seen. The sudden drop in frequency seen between Tanner stages 3 and 4 did not correlate with similar changes in the length of the vocal folds at this time but stroboscopic findings suggest a change in the structure and mass of the vocal folds at this time of maximum frequency change.

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