Vocal therapy of hyperkinetic dysphonia

Introduction. Hyperkinetic (hyperfunctional) dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. Objective. The objective of this study was to evaluate the effects of vocal therapy on voice condition characterized by hyperkinetic dysphonia with prenodular lesions and soft nodules. Methods. The study included 100 adult patients and 27 children aged 4-16 years with prenodular lesions and soft nodules. A subjective acoustic analysis using the GIRBAS scale was performed prior to and after vocal therapy. Twenty adult patients and 10 children underwent objective acoustic analysis including several acoustic parameters. Pathological vocal qualities (hoarse, harsh and breathy voice) were also obtained by computer analysis. Results. The subjective acoustic analysis revealed a significant (p<0.01) reduction in all dysphonia parameters after vocal treatment in adults and children. After treatment, all levels of dysphonia were lowered in 85% (85/100) of adult patients and 29% (29/100) had a normal voice. Before vocal therapy 9 children had severe, 13 had moderate and 8 slight dysphonia. After vocal therapy only 1 child had severe dysphonia, 7 had moderate, 10 had slight levels of dysphonia and 9 were without voice disorder. The objective acoustic analysis in adults revealed a significant improvement (p?0.025) in all dysphonia parameters except SD F0 and jitter %. In children, the acoustic parameters SD F0, jitter % and NNE (normal noise energy) were significantly improved (p=0.003-0.03). Pathological voice qualities were also improved in adults and children (p<0.05). Conclusion. Vocal therapy effectively improves the voice in hyperkinetic dysphonia with prenodular lesions and soft nodules in both adults and children, affecting diverse acoustic parameters.

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Multidimensional acoustic analysis of pathological voice

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0906234p ◽

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.

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Laryngeal and voice disorders in patients with gastroesophageal symptoms. Correlation with pH-monitoring

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502012001100013 ◽

2012 ◽

Vol 27 (11) ◽

pp. 821-828 ◽

Cited By ~ 5

Author(s):

Regina Helena Garcia Martins ◽

Anete Branco ◽

Elaine Lara Mendes Tavares ◽

Renata Mizusaki Iyomasa ◽

Lída Raquel de Carvalho ◽

...

Keyword(s):

Ph Monitoring ◽

Voice Disorders ◽

Clinical History ◽

Voice Disorder ◽

Monitoring Methods ◽

Acoustic Parameters ◽

Laryngeal Lesions ◽

A Prospective Study ◽

The Voice ◽

Dual Probe

PURPOSE: To investigate laryngeal and voice disorders in patients with gastroesophageal symptoms and their correlation with pH-monitoring. METHODS: A prospective study was carried out in patients attended at the Voice Disorder Outpatient Clinics of Botucatu Medical School in a five-year period and had vocal and gastroesophagic symptoms. Patients underwent videolaryngoscopy, auditory-perceptual vocal analyses, computerized acoustic vocal analysis and dual probe pH-monitoring for 24 hours. RESULTS: Fifty-seven patients were included (aged between 21 and 65 years; 45 women and 12 men), 18 had normal (31.6%) and 39 had abnormal pH-monitoring results (68.4%). Videolaryngoscopy recorded several laryngeal lesions for both patients with normal and abnormal pH-monitoring, but mostly for the latter group, highlighting posterior pachyderma. Auditory-perceptual vocal assessments identified vocal changes of several intensities for both groups but especially for patients with abnormal pH-monitoring results. All acoustic parameters, except f0, were abnormal for both groups, compared to the control population. CONCLUSION: Acoustic and perceptual vocal changes and laryngeal lesions were recorded for both patients with normal pH-monitoring results and patients with abnormal pH-monitoring results, evidencing the importance of clinical history and videolaryngoscopic findings for diagnosing acid laryngitis.

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Towards a vividness in synthesized speech for audiobooks

Eesti ja soome-ugri keeleteaduse ajakiri Journal of Estonian and Finno-Ugric Linguistics ◽

10.12697/jeful.2019.10.1.09 ◽

2019 ◽

Vol 10 (1) ◽

pp. 167-190

Author(s):

Hille Pajupuu ◽

Rene Altrov ◽

Jaan Pajupuu

Keyword(s):

Acoustic Analysis ◽

Female Characters ◽

Male Voice ◽

Acoustic Parameters ◽

Web Based ◽

Male And Female ◽

Research Material ◽

Synthesized Speech ◽

The Voice

The goal of this study was to determine which acoustic parameters are significant in differentiating the speaking styles of a narrator and that of male and female characters as voiced by a reader of audiobooks. The study was initiated by a need to improve the expressivity and differentiation of speaking styles in fiction books read out by synthesized voices. The corpus used as research material was created from an audio novel, as read by a professional male voice artist. To determine whether it is possible to identify these speaking styles from the voice of the reader, a web-based perception test consisting of 48 sentences was conducted. The results showed that the listeners identified all three styles. For acoustic analysis, the openSMILE toolkit was used and 88 eGeMAPS-defined parameters were extracted for every sentence in the corpus. All styles were differentiated by 38 statistically significant parameters. To improve vividness, synthesizers aimed at reading fiction books could be trained to perform all three styles. Kokkuvõte. Hille Pajupuu, Rene Altrov ja Jaan Pajupuu: Teel audioraamatute sünteeskõne elavdamisele. Uurimuse eesmärk oli teada saada, milli sed olulisemad akustilised parameetrid eristavad audioraamatu lugeja hääles jutustaja kõnet ning mees- ja naistegelaste otsekõnet. Uurimuse tingis vajadus parandada sünteeshäälega loetavate juturaamatute väljendus rikkust ja kõnestiilide eristatavust. Uurimismaterjalina kasutati professionaalse meeshäälega loetud audioromaani „Tõde ja õigus I“ põhjal loodud korpust. Et teada saada, kas audioraamatu lugeja hääle põhjal on kuulaja võimeline eristama eri kõnestiile (jutustaja kõnet, mees- ja naistegelaste otsekõnet), koostati 48 lausest koosnev tajutest. Testi tulemused näitasid, et kuulajad tundsid ära kõik kolm kõnestiili. Akustiliseks analüüsiks kasutati kogu korpuse materjali. openSMILE’i tööriistaga ekstraheeriti kõnest iga lause jaoks 88 eGeMAPSis defineeritud parameetrit. Statistiliselt oluliselt eristasid kõnestiile 38 parameetrit, millest 18 oli seotud hääle kvaliteedi ja tämbriga, 11 hääle valjusega, 8 hääle kõrgusega ja 1 tempoga. Kuna tajutest ja akustiliste parameetrite analüüs näitasid, et audioraamatus eristusid nii jutustaja kõne, naistegelaste otsekõne kui ka meestegelaste otsekõne, võib pidada otstarbekaks õpetada juturaamatuid ettelugevaid süntesaatoreid esitama kõiki kolme kõnestiili. Märksõnad: audioraamatud, kõnestiil, otsekõne, karakteri kõne, GeMAPS, kõneanalüüs, ekspressiivne kõnesüntees

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Acoustic Analysis Before and After Voice Therapy for Laryngeal Pathology

Kathmandu University Medical Journal ◽

10.3126/kumj.v13i4.16831 ◽

2017 ◽

Vol 13 (4) ◽

pp. 323-327 ◽

Cited By ~ 4

Author(s):

S.S. Chhetri ◽

R. Gautam

Keyword(s):

Acoustic Analysis ◽

Alternative Therapy ◽

Vocal Folds ◽

Objective Evaluation ◽

Voice Therapy ◽

Good Effect ◽

Acoustic Parameters ◽

Significant Difference ◽

Before And After ◽

The Voice

Background Voice problems caused by pathologies in vocal folds are well known. Some types of laryngeal pathologies have certain acoustic characteristics. Objective evaluation helps characterize the voice and voice problems providing supporting evidences, severity of disorders. It helps assess the response to the treatment and measures the outcomes.Objective The objective of the study is to determine the effectiveness of the voice therapy and quantify the results objectively by voice parameters.Method Study includes 61 patients who presented with different types of laryngeal pathologies. Acoustic analyses and voice assessment was done with Dr. Speech ver 4 (Tiger DRS Inc.). Acoustic parameters including fundamental frequency, jitters, shimmers, Harmonic to noise ratio (HNR), Normalized noise energy (NNE) were analyzed before and after voice therapy.Result Bilateral vocal nodules were the most common pathologies comprising 44.26%. All acoustic parameters showed a significant difference after the therapy (p<0.05) except for NNE. Dysphonia due to vocal fold polyp showed no improvement even after voice therapy (p>0.05).Conclusion Acoustic analysis provides an objective, recordable data regarding the voice parameters and its pathologies. Though, few pathology require alternative therapy rather than voice therapy, overall it has a good effect on glottic closure. As the voice therapy can improve the different indices of voice, it can be viewed as imperative part of treatment and to monitor progression.

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Acoustic analysis of tracheo-oesophageal versus oesophageal speech

The Journal of Laryngology & Otology ◽

10.1017/s0022215100126660 ◽

1994 ◽

Vol 108 (4) ◽

pp. 325-328 ◽

Cited By ~ 43

Author(s):

F. Debruyne ◽

P. Delaere ◽

J. Wouters ◽

P. Uwents

Keyword(s):

Frequency Spectrum ◽

Fundamental Frequency ◽

Acoustic Analysis ◽

Respiratory Drive ◽

Spectral Slope ◽

Acoustic Parameters ◽

Vocal Quality ◽

Vibratory Pattern ◽

The Voice

AbstractIn order to evaluate the vocal quality of tracheo-oesophageal and oesophageal speech, several objective acoustic parameters were measured in the acoustic waveform (fundamental frequency, waveform perturbation) and in the frequency spectrum (harmonic prominence, spectral slope). Twelve patients using tracheo-oesophageal speech (with the Provox® valve) and 12 patients using oesophageal speech for at least two months, participated.The main results were that tracheo-oesophageal voices more often showed a detectable fundamental frequency, and that this fundamental frequency was fairly stable; there was also a tendency to more clearly defined harmonics in tracheo-oesophageal speech. This suggests a more regular vibratory pattern in the pharyngo-oesophageal segment, due to the more efficient respiratory drive in tracheo-oesophageal speech. So, a better quality of the voice can be expected, in addition to the longer phonation time and higher maximal intensity.

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Acoustic analysis of the voice in phonatory fistuloplasty after total laryngectomy

Otolaryngology ◽

10.1067/mhn.2000.98359 ◽

2000 ◽

Vol 122 (5) ◽

pp. 743-747 ◽

Cited By ~ 1

Author(s):

Mariano Rosique Arias ◽

JosÉ Luis RamÓN ◽

Matilde Campos ◽

Juan JimÉNez Cervantes

Keyword(s):

Total Laryngectomy ◽

Acoustic Analysis ◽

Voice Quality ◽

Epidermoid Carcinoma ◽

Esophageal Speech ◽

Normal Voice ◽

Carcinoma Of The Larynx ◽

Male Patients ◽

The Voice ◽

Made In

A comparative study of the voice with sustained phonation of the vowel /a/ was made in 3 groups of male patients: (1) 20 patients receiving total laryngectomy for epidermoid carcinoma of the larynx who had acquired good voice quality after a phonatory fistuloplasty with a Herrmann voice prosthesis; (2) 20 patients undergoing total laryngectomy for epidermoid carcinoma of the larynx who had learned esophageal speech; and (3) 20 subjects with normal voices. Statistical analysis yielded significant differences in fundamental voice frequency between the 3 groups, with the patients with phonatory prostheses revealing the closest to a normal voice. For other parameters used, such as jitter, shimmer, and harmonics/noise ratio, voice quality with a phonatory prosthesis was similar to that obtained with esophageal speech.

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Voice Disorder Detection via an m-Health System: Design and Results of a Clinical Study to Evaluate Vox4Health

BioMed Research International ◽

10.1155/2018/8193694 ◽

2018 ◽

Vol 2018 ◽

pp. 1-19 ◽

Cited By ~ 2

Author(s):

Ugo Cesari ◽

Giuseppe De Pietro ◽

Elio Marciano ◽

Ciro Niri ◽

Giovanna Sannino ◽

...

Keyword(s):

Machine Learning ◽

Clinical Practice ◽

Clinical Study ◽

Health System ◽

Acoustic Analysis ◽

Machine Learning Techniques ◽

Voice Disorder ◽

Rule Based ◽

Learning Techniques ◽

The Voice

Objectives. The current study presents a clinical evaluation of Vox4Health, an m-health system able to estimate the possible presence of a voice disorder by calculating and analyzing the main acoustic measures required for the acoustic analysis, namely, the Fundamental Frequency, jitter, shimmer, and Harmonic to Noise Ratio. The acoustic analysis is an objective, effective, and noninvasive tool used in clinical practice to perform a quantitative evaluation of voice quality. Materials and Methods. A clinical study was carried out in collaboration with medical staff of the University of Naples Federico II. 208 volunteers were recruited (mean age, 44.2 ± 13.9 years), 58 healthy subjects (mean age, 36.7 ± 13.3 years) and 150 pathological ones (mean age, 47 ± 13.1 years). The evaluation of Vox4Health was made in terms of classification performance, i.e., sensitivity, specificity, and accuracy, by using a rule-based algorithm that considers the most characteristic acoustic parameters to classify if the voice is healthy or pathological. The performance has been compared with that achieved by using Praat, one of the most commonly used tools in clinical practice. Results. Using a rule-based algorithm, the best accuracy in the detection of voice disorders, 72.6%, was obtained by using the jitter or shimmer value. Moreover, the best sensitivity is about 96% and it was always obtained by using jitter. Finally, the best specificity was achieved by using the Fundamental Frequency and it is equal to 56.9%. Additionally, in order to improve the classification accuracy of the next version of the Vox4Health app, an evaluation by using machine learning techniques was conducted. We performed some preliminary tests adopting different machine learning techniques able to classify the voice as healthy or pathological. The best accuracy (77.4%) was obtained by the Logistic Model Tree algorithm, while the best sensitivity (99.3%) was achieved using the Support Vector Machine. Finally, Instance-based Learning performed the best specificity (36.2%). Conclusions. Considering the achieved accuracy, Vox4Health has been considered by the medical experts as a “good screening tool” for the detection of voice disorders in its current version. However, this accuracy is improved when machine learning classifiers are considered rather than the rule-based algorithm.

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Acoustic Analysis of the Voice in Phonatory Fistuloplasty after Total Laryngectomy

Otolaryngology ◽

10.1016/s0194-5998(00)70208-7 ◽

2000 ◽

Vol 122 (5) ◽

pp. 743-747 ◽

Cited By ~ 8

Author(s):

Mariano Rosique Arias ◽

José Luis Ramón ◽

Matilde Campos ◽

Juan Jiménez Cervantes

Keyword(s):

Total Laryngectomy ◽

Acoustic Analysis ◽

Voice Quality ◽

Epidermoid Carcinoma ◽

Esophageal Speech ◽

Normal Voice ◽

Carcinoma Of The Larynx ◽

Male Patients ◽

The Voice ◽

Made In

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Role of Voice Therapy in Patients with Mutational Falsetto

International Journal of Phonosurgery & Laryngology ◽

10.5005/jp-journals-10023-1098 ◽

2015 ◽

Vol 5 (1) ◽

pp. 25-27 ◽

Cited By ~ 1

Author(s):

Raj Kumar ◽

Alok Kumar Agrahari

Keyword(s):

Acoustic Analysis ◽

Voice Therapy ◽

Voice Disorder ◽

P Value ◽

Perceptual Analysis ◽

Emotional Component ◽

Male Patients ◽

The Voice ◽

Post Therapy

ABSTRACT Background Mutational falsetto is the most common mutational voice disorder, found in all ages. Clinicians often miss this diagnosis due to unfamiliarity with the condition. The voice of a person with mutational falsetto is high pitched, weak, thin, breathy, hoarse and monopitched. Objective This study was carried out to evaluate the efficacy of voice therapy in persons with mutational falsetto. Methods Eleven male patients with ages between 18 and 26 years (mean age 22.18 years, SD 2.52) diagnosed with mutational falsetto underwent acoustical analysis using Praat Software, perceptual analysis using grade, roughness, breathiness, asthenia and strain (GRBAS) scale and psychosocial analysis using emotional component of voice handicap index (VHI). All the components were analyzed pre- and postvoice therapy. Results Improvement in acoustic analysis parameters was statistically significant with p-value less than 0.0001(pretherapy mean of fundamental frequency (F0) was 217.45 with SD 8.68, whereas post-therapy mean of F0 was 127.50 with SD 5.32). Significant improvement in perceptual analysis was seen post-therapy on GRBAS scale. Improvement in psychosocial aspect was also statistically significant with p-value less than 0.0001 (pre-therapy mean 26.18, SD 1.72 post-therapy mean 7, SD 1.15). Conclusion Voice therapy plays an important role in lowering F0 and alleviation mental agony of the patients with mutational falsetto. How to cite this article Varma A, Agrahari AK, Kumar R, Kumar V. Role of Voice Therapy in Patients with Mutational Falsetto. Int J Phonosurg Laryngol 2015;5(1):25-27

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

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig3.49 ◽

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.

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