scholarly journals Importance of timely diagnosis of diseases of the larynx during initial examination performed by an otorhinolaryngologist

2018 ◽  
pp. 58-64 ◽  
Author(s):  
Yu. E. Stepanova ◽  
T. V. Gotovyakhina ◽  
N. N. Makhotkina
Keyword(s):  
Vocal Fold ◽  
Voice Quality ◽  
Diagnostic Techniques ◽  
Vascular Pathology ◽  
Initial Examination ◽  
Functional Dysphonia ◽  
Urgent Task ◽  
The Voice ◽  
Constant Growth ◽  
Vocal Fold Nodules

Diagnosis and treatment of diseases of the larynx in patients with dysphonia are an urgent task of modern otorhinolaryngology. The reason for this is the constant growth of professions with high requirements for voice quality. The modern methods of diagnosis in diseases of the larynx are based on endoscopic diagnostic techniques. The article provides detailed description of the clinical and endoscopic signs of functional and organic diseases of the larynx that are significantly more prevalent in voice professionals: hypotonic and hypo-hypertonic functional dysphonia, soft and hard vocal fold nodules, acute and chronic occupational laryngitis, and vascular pathology of vocal cords. The article presents the main approaches to the treatment of diseases of the larynx, including using the drug Homeovox. The article will be useful to the otorhinolaryngologists of the outpatient network to establish the diagnosis and assign а therapy to the voice and speech professionals.

scholarly journals Multidimensional acoustic analysis of pathological voice

2009 ◽  
Vol 137 (5-6) ◽  
pp. 234-238
Author(s):  
Mirjana Petrovic-Lazic ◽  
Snezana Babac ◽  
Zoran Ivankovic ◽  
Rade Kosanovic
Keyword(s):  
Vocal Fold ◽  
Acoustic Analysis ◽  
Control Group ◽  
Acoustic Parameters ◽  
Vocal Rehabilitation ◽  
Voice Treatment ◽  
Before And After ◽  
The Voice ◽  
Vocal Fold Nodules ◽  
Pathological Voice

Introduction. There are subjective and objective ways to examine the effects of vocal therapy in voice disorders. The most precise and objective check-up is the use of computer voice analysis. Objective. The aim of the research was to perform a detailed analysis of acoustic structure of the vowel A before and after voice treatment in patients with vocal fold nodules in order to obtain objective verification of the vocal rehabilitation success. Methods. We examined 30 female patients, aged 34.6?6.69 years, with vocal fold nodules. Acoustic parameters of voice were compared with the control group consisting of 21 subjects without voice pathology. In all persons the vowel A was recorded and analyzed before and after a month of vocal therapy. The success of the vocal therapy was tracked using computer analysis of vocal structure. Signal, noise and tremor parameters were processed. Results. Of the analyzed vowel A parameters: STD, PER, JITA, JITT, RAP, vFO, ShdB, SHIM, APQ, VTI, SPI, F0, NHR, FTRI, eleven improved (p<0.05 and p<0.01). Three parameters (F0, NHR, FTRI) changed showing improvement, but the obtained differences were not statistically significant (p>0.05). Conclusion. Based on the obtained results it was concluded that vocal therapy gave satisfactory results, but that it should be continually applied until full stabilization of the voice.

scholarly journals Voice re-education and its evaluation through digital signal processing: A case study

Loquens ◽  
2017 ◽  
Vol 4 (1) ◽  
pp. 040
Author(s):  
Zulema Santana-López ◽  
Óscar Domínguez-Jaén ◽  
Jesús B. Alonso ◽  
María Del Carmen Mato-Carrodeguas
Keyword(s):  
Voice Quality ◽  
Quality Measurement ◽  
Digital Signal ◽  
Communication Process ◽  
Time Frequency ◽  
Voice Signal ◽  
Functional Dysphonia ◽  
Before And After ◽  
Voice Pathologies ◽  
The Voice

Voice pathologies, caused either by functional dysphonia or organic lesions, or even by just an inappropriate emission of the voice, may lead to vocal abuse, affecting significantly the communication process. The present study is based on the case of a single patient diagnosed with myasthenia gravis (Erb-Goldflam syndrome). In this case, this affection has caused, among other disruptions, a dysarthria. For its treatment, a technique for the education and re-education of the voice has been used, based on a resonator element: the cellophane screen. This article shows the results obtained in the patient after applying a vocal re-education technique called the Cimardi Method: the Cellophane Screen, which is a pioneering technique in this field. Changes in the patient’s voice signal have been studied before and after the application of the Cimardi Method in different domains of study: time-frequency, spectrum, and cepstrum. Moreover, parameters for voice quality measurement, such as shimmer, jitter and harmonic-to-noise ratio (HNR), have been used to quantify the results obtained with the Cimardi Method. Once the results were analyzed, it has been observed that the Cimardi Method helps to produce a more natural and free vocal emission, which is very useful as a rehabilitation therapy for those people presenting certain vocal disorders.

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.

scholarly journals Effects on Vocal Fold Collision and Phonation Threshold Pressure of Resonance Tube Phonation With Tube End in Water

2013 ◽  
Vol 56 (5) ◽  
pp. 1530-1538 ◽  
Author(s):  
Laura Enflo ◽  
Johan Sundberg ◽  
Camilla Romedahl ◽  
Anita McAllister
Keyword(s):  
Vocal Fold ◽  
Voice Quality ◽  
Glass Tube ◽  
Audio Signals ◽  
Resonance Tube ◽  
Phonation Threshold Pressure ◽  
Before And After ◽  
Subglottal Pressure ◽  
Voice Pathologies ◽  
The Voice

Purpose Resonance tube phonation in water (RTPW) or in air is a voice therapy method successfully used for treatment of several voice pathologies. Its effect on the voice has not been thoroughly studied. This investigation analyzes the effects of RTPW on collision and phonation threshold pressures (CTP and PTP), the lowest subglottal pressure needed for vocal fold collision and phonation, respectively. Method Twelve mezzo-sopranos phonated into a glass tube, the end of which was placed under the water surface in a jar. Subglottal pressure, electroglottography, and audio signals were recorded before and after exercise. Also, the perceptual effects were assessed in a listening test with an expert panel, who also rated the subjects' singing experience. Results Resonance tube phonation significantly increased CTP and also tended to improve perceived voice quality. The latter effect was mostly greater in singers who did not practice singing daily. In addition, a more pronounced perceptual effect was found in singers rated as being less experienced. Conclusion Resonance tube phonation significantly raised CTP and tended to improve perceptual ratings of voice quality. The effect on PTP did not reach significance.

Lateral neck dissection affects the voice in thyroid cancer patients

2017 ◽  
Vol 131 (10) ◽  
pp. 853-859 ◽  
Author(s):  
I-C Nam ◽  
J-S Bae ◽  
S-H Lee ◽  
J-O Park ◽  
S-Y Kim ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Medical Records ◽  
Vocal Fold ◽  
Initial Period ◽  
Voice Quality ◽  
Lateral Neck ◽  
Lateral Neck Dissection ◽  
Voice Change ◽  
Fundamental Frequencies ◽  
The Voice

AbstractObjective:This study aimed to identify the effect of lateral neck dissection on voice change in thyroidectomised patients.Methods:Medical records from 264 patients who underwent thyroidectomy with (n= 65) or without (n= 199) lateral neck dissection were reviewed. Clinical and voice evaluation data were compared between the two groups.Results:Patients who underwent surgery that included lateral neck dissection had lower fundamental frequencies and speaking fundamental frequencies. They also had a higher incidence of asymmetric mucosal wave and vocal fold oedema on videostroboscopy during the first month after surgery, with the incidence of vocal fold oedema remaining significantly higher at three months. Self-assessed voice quality scores were significantly higher in lateral neck dissection patients at both one and three months after surgery.Conclusion:In thyroidectomised patients, lateral neck dissection lowers the vocal pitch in the initial period after surgery and induces vocal fold oedema that persists for several months. Although most objective parameters improved within a month, subjective symptoms lasted for longer.

The Use of Perceptual Methods by New Clinicians for Assessing Voice Quality

1986 ◽  
Vol 51 (2) ◽  
pp. 125-133 ◽  
Author(s):  
Celia J. Bassich ◽  
Christy L. Ludlow
Keyword(s):  
Vocal Fold ◽  
Voice Quality ◽  
Three Dimensions ◽  
Professional Experience ◽  
Validity And Reliability ◽  
Five Dimensions ◽  
Extensive Training ◽  
Correct Assignment ◽  
Interjudge Reliability ◽  
Vocal Fold Nodules

The purpose of this study was to determine the validity and reliability of using perceptual ratings for assessing voice quality in patients with vocal fold nodules or polyps. A 13-dimension perceptual rating system was modeled after systems currently in clinical use. To meet the criterion of 80% mean interjudge reliability, eight hours of training were required for four previously inexperienced listeners. Extended vowel phonations of patients and controls were then rated blindly by the same listeners. Interjudge reliability was greater than .90 for three dimensions judged in the pathological phonations, while intrajudge test-retest agreement was less than 75% on five dimensions. Validity was demonstrated with 100% correct assignment to group by computing a discriminant function employing all dimensions. Despite the extensive training procedures used, our reliability data were not comparable to those reported when highly experienced judges have been used, suggesting that the task of perceptually rating voice quality is difficult and requires extensive professional experience.

Emerging Scientist: Vocal Fold Immunology

2016 ◽  
Vol 1 (3) ◽  
pp. 26-32
Author(s):  
Suzanne N. King
Keyword(s):  
Wound Healing ◽  
Immune System ◽  
Innate Immune System ◽  
Vocal Fold ◽  
Acute Inflammation ◽  
Voice Quality ◽  
Innate Immune ◽  
Benign Vocal Fold Lesions ◽  
The Voice

In adults the immune system is intimately involved in restoring function lost after injury. If it is poorly regulated, the initial protective reactions that encompass wound healing can lead to pathologic changes in the vocal fold that are particularly problematic to voice quality. Inflammatory injuries can contribute to pathophysiology of benign vocal fold lesions or scarring. Cells and molecules of the innate immune system are responsible for fighting off challenges and returning the tissue to its pre-injured state. This review briefly discusses aspects of the immune system with a focus on acute inflammation and confers immunological barriers to biomaterial and cell-based approaches for restoration of the voice. Increasing the awareness of laryngeal immunology will facilitate better understanding of the obstacles being faced in bench research and highlight the need for further work.

Vocal Fold Atrophy and its Surgical Treatment

1996 ◽  
Vol 105 (3) ◽  
pp. 182-188 ◽  
Author(s):  
Nobuhiko Isshiki ◽  
Kazuhiko Shoji ◽  
Hisayoshi Kojima ◽  
Shigeru Hirano
Keyword(s):  
Decision Making ◽  
Surgical Treatment ◽  
Vocal Fold ◽  
Voice Quality ◽  
Vocal Folds ◽  
Decision Making Process ◽  
Type I ◽  
Vocal Fold Atrophy ◽  
The Voice ◽  
Type I Thyroplasty

The effectiveness of surgical treatment for vocal fold atrophy of various causes was examined. Type I thyroplasty was performed on 31 patients with vocal fold atrophy, often bilaterally and occasionally combined with type III thyroplasty. Of these 31 patients, 3 patients underwent the operation twice, for a total of 34 operations. The surgery was found to be effective in improving the voice quality and the ease of phonation. When a scar or sulcus was present, the results were not as satisfactory. The intraoperative decision-making process as to which procedure to perform is extremely important for achieving an optimal voice, and should be based on the intraoperative voice quality, fiberoptic findings, and manual tests. In operations for vocal fold atrophy in which the vocal folds are mobile, a silicone shim should be firmly fixed to prevent migration. Overcorrection is generally recommended. No complications were encountered. It was often the increased ease of phonation rather than the improved voice quality that patients appreciated after surgery.

Does neuromonitoring affect voice quality in patients subjected to a complete thyroidectomy ?

2021 ◽  
Vol 75 (5) ◽  
pp. 1-8
Author(s):  
Piotr Bryk ◽  
Stanislaw Głuszek
Keyword(s):  
Vocal Fold ◽  
Vocal Tract ◽  
Voice Quality ◽  
Recurrent Laryngeal Nerve Injury ◽  
Control Group ◽  
Study Group ◽  
Laryngeal Nerves ◽  
Vocal Fold Palsy ◽  
Recurrent Laryngeal Nerves ◽  
The Voice

Voice dysfunction is the most common complication of thyroid surgery. The use of intraoperative neuromonitoring (IONM) is to protect the recurrent laryngeal nerves, the damage of which causes voice dysfunction. The aim of the study was to evaluate voice quality in patients who underwent complete thyroidectomy operated on with the application of IONM as well as a group of patients operated on with only macroscopic nerve visualization. In the analysis, clinical voice assessment was performed with particular focus on voice efficiency using the Voice Handicap Index (VHI), Vocal Tract Discomfort (VTD) and GRBAS scale. The study group consisted of 205 patients operated on with IONM. The control group consisted of 162 patients subjected to surgery only with macroscopic visualization of recurrent laryngeal nerves, without IONM. During the follow-up period from 2 to 10 years after surgery, checkups were performed. Each patient who came for a checkup was subjected to perceptual voice evaluation with the use of the GRBAS scale, indirect laryngoscopy procedure and voice selfevaluation with two questionnaires (VHI and VTD). The frequency of vocal fold palsy did not differ significantly statistically in the study group and the control group. Both in the study group and in the control group, patients with vocal fold paralysis had statistically significantly higher results in the VHI and VTD questionnaires as well as in the GRBAS study. Patients with recurrent laryngeal nerve injury show significant differences in the scope of voice handicap, both in the voice quality assessment with the use of the GRBAS scale, and self-evaluation questionnaires: VHI and VTD. All voice disorders evaluated with self-assessment are medium voice disability.

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