scholarly journals Transgender man voice therapy: a case report

2020 ◽  
Vol 9 (9) ◽  
pp. e774997367
Author(s):  
Sabrina Silva dos Santos ◽  
Carla Aparecida Cielo
Keyword(s):  
Case Report ◽  
Fundamental Frequency ◽  
Speech Therapy ◽  
Hormonal Treatment ◽  
Voice Therapy ◽  
Male Voice ◽  
Maximum Phonation Time ◽  
Speech Evaluation ◽  
Therapy Sessions ◽  
The Voice

Introduction: Hormone therapy reduces the vocal fundamental frequency of transgender men, but the evidence suggests that it does not modify other female communication characteristics, what may result in insufficient male communication patterns. Objective: To describe the voice therapy and its results on the voice of a 35-year-old transgender man. Methods: His main complaints were voice incompatible with his gender and vocal oscillation after hormonal treatment, started eight months prior to the study. Based on the speech evaluation, a therapeutic planning was elaborated aiming at developing: descending pitch at the end of sentences; decreasing vowel prolongation; "chest resonance"; decreasing pitch variation; costodiaphragmatic breathing; vocal projection and quality; maximum phonation time and pauses; decrease and stabilize fundamental frequency; adjust the resonance; decrease pitch and increase loudness; decrease the tension on the labial commissures; and develop male aspects of speech and language. Ten voice therapy sessions were held once a week, lasting 45 minutes each. Results: After voice therapy, there was decreased pitch variation during speech, increased pauses, focusing on the interlocutor, and “chest resonance”; this developed descending pitch at the end of sentences, decreasing vowel prolongation, and pitch variation, as an exercise to stimulate male voice markers and vocal stability. Even after the hormone-induced vocal changes, he still had complaints about his voice, which improved with the aid of voice therapy. Conclusion: Speech therapy provided the development of male vocal markers in his voice. It became compatible with his gender and allowed him to be recognized as a man by his voice, and to be pleased with it.

Cirugía de feminización de voz con técnica glotoplastia de Wendler en Barranquilla, Colombia. Voice feminization surgery with Wendler glottoplasty technique in Barranquilla, Colombia.

2018 ◽  
Vol 45 (4) ◽  
pp. 247-253 ◽  
Author(s):  
Antonio J. Ballestas ◽  
Samir A. Ballestas ◽  
Rocio Cuello
Keyword(s):  
Fundamental Frequency ◽  
Speech Therapy ◽  
Vocal Cords ◽  
Maximum Phonation Time ◽  
Study Materials ◽  
Before And After ◽  
Upper Face ◽  
Expert Surgeon ◽  
Frequency Maximum ◽  
Male To Female

Introducción: La glotoplastia de Wendler es la técnica que en la actualidad ofrece mejores resultados entre los diferentes tipos de cirugías para la feminización de la voz. Objetivo: Describir nuestra experiencia con la Glotoplastia de Wendler durante el proceso de feminización de la voz de mujeres transgénero. Diseño: Pseudoexperimental (antes-después) Materiales y Métodos: 36 pacientes transexuales en proceso de transformación de hombre a mujer se sometieron a cirugía y rehabilitación con terapias de voz con el equipo de VOICEFEM - Voice Feminization Colombia. La técnica utilizada consiste en la creación de una sinequia de las cuerdas vocales (CCVV) previa desepitelización de la cara interna del tercio anterior de las mismas, 2 puntos de sutura con Vicryl 4/0 y vaporización con electrocauterio en la región lateral de la cara superior de las CCVV y utilización de goma biológica en la sinequia creada. La medición de la frecuencia fundamental, el tiempo máximo de fonación, y la realización del cuestionario TSEQ, se llevaron a cabo antes y después de la cirugía. Resultados: Se obtuvo un aumento de la Frecuencia fundamental promedio de 112Hz(P<0.05) a los 6 meses posteriores al procedimiento quirúrgico y una disminución de cerca de 30 puntos en los resultados del cuestionario TSEQ. Conclusión: La glotoplastia de Wendler, llevada a cabo por cirujanos con experiencia en este campo, ofrece resultados favorables con aumentos significativos de la frecuencia fundamental a mediano plazo y debe estar necesariamente asociada al manejo postquirúrgico con terapias de voz, para obtener el desenlace óptimo esperado.Introduction: Wendler’s Glottoplasty is the technique that offers the best resultsamong the different types of voice feminization surgeries. Male to Female Transgender patients have in this technique the last step for their successful transformation. Objective: To describe our experience in carrying out Wendler’s glottoplasty during the process of feminization of the voice of transgender women. Design: Pseudoexperimental (before-after) study. Materials and methods: In 36 Male to Female Transgender patients, Wendler’s glottoplasty was conducted by VOICEFEM - Voice Feminization Colombia’s team, with further speech therapy rehabilitation. This technique consists of the creation of a synechia of the vocal cords which is carried out after the de-epithelization of the vocal cords on the inner face of its anterior third, 2 stitches with Vicryl 4/0 and vaporization with electrocautery in the lateral region of vocal cords upper face, and the use of biological glue in the created synechia. The measurement of the Fundamental Frequency, Maximum Phonation time, and the completion of the TSEQ questionnaire were carried out before and after the surgery. Results: There was an increase of 112 Hz in the average of Fundamental Frequency(P<0.05) 6 months after the surgery, and a decrease of approximately 30 points in the TSEQ questionnaire results. Conclusion: Wendler’s Glottoplasty conducted by an expert surgeon, provides positive results with a significant increase for fundamental frequency in the medium term, and it is imperative to do also voice therapy rehabilitation posterior to the procedure in order to obtain the expected optimal outcome.

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.

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.

scholarly journals A Descriptive Study of Benign Vocal Cord Lesions with Speech Prameters Operated with Microlaryngoscopy

2020 ◽  
pp. 9-18
Author(s):  
Dr. Tushar Govind Borade ◽  
Dr. Meena Vishwanath Kale ◽  
Dr. Ninad Subhash Gaikwad
Keyword(s):  
Vocal Cord ◽  
Speech Therapy ◽  
Voice Quality ◽  
Simple Random Sampling ◽  
Clinical History ◽  
Maximum Phonation Time ◽  
Laryngeal Surgery ◽  
Microlaryngeal Surgery ◽  
Operative Assessment ◽  
The Voice

Background:Humanity has appreciated the importance and power of the human voice. Voice disorders like benign, malignant lesions of vocal cord affect the voice quality and also can have a devastating effect on daily functioning and quality of life. These lesions can be diagnosed and treated with microlaryngoscopy. Micro-laryngoscopy is a procedure for visualization of a magnified view of the voice box (larynx) with the help of a laryngoscope assisted with an operating microscope for precise laryngeal surgery. Speech parameters helps in voice quality assessment for vocal cord lesions.Method:We have studied 30 cases of benign vocal cord lesion by simple random sampling for two years which got operated with microlaryngoscopic conventional surgery. Their pre and post-operative assessment is done with respect to speech parameters like Maximum Phonation Time, Voice Handicap Index and GRBAS Score. Clinical history and rigid Hopkins 700 also helped in diagnosing of benign vocal cord lesions. Result: After conventional microlaryngeal surgery helps in improvement in MPT, VHI score, GRBAS Score post-operatively that of 3 months follow up. The effectiveness was seen more along with voice rest, corticosteroids and most important speech therapy.

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.

scholarly journals The Effect of Voice Therapy for the Treatment of Functional Aphonia: A Preliminary Study

2021 ◽  
Vol 32 (2) ◽  
pp. 75-80
Author(s):  
No Eul Kim ◽  
Jun Seok Kim ◽  
Jae Hwan Oh ◽  
Dong Young Kim ◽  
Joo Hyun Woo
Keyword(s):  
Behavioral Therapy ◽  
Voice Quality ◽  
Retrospective Chart Review ◽  
Clinical Information ◽  
Voice Therapy ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation ◽  
Before And After ◽  
Cepstral Peak Prominence ◽  
The Voice

Background and Objectives Functional aphonia refers to in which by presenting whispering voice and almost producing very high-pitched tensed voices are produced. Voice therapy is the most effective treatment, but there is a lack of consensus for application of voice therapy. The purpose of this study was to examine the vocal characteristics of functional aphonia and the effect of voice therapy applied accordingly.Materials and Method From October 2019 to December 2020, 11 patients with functional aphonia were treated using voice therapy which was processing three stages such as vocal hygiene, trial therapy, and behavioral therapy. Of these, 7 patients who completed the voice evaluation before and after voice therapy was enrolled in this study. By retrospective chart review, clinical information such as sex, age, symptoms, duration, social and medical history, process of voice therapy, subjective and objective findings were analyzed. Voice parameters before and after voice therapy were compared.Results In GRBAS study, grade, rough, and asthenic, and in Consensus Auditory-Perceptual Evaluation of Voice, overall severity, roughness, pitch, and loudness were significantly improved after voice therapy. In Voice handicap index, all of the scores of total and sub-categories were significantly decreased. In objective voice analysis, jitter, cepstral peak prominence, and maximum phonation time were significantly improved.Conclusion The voice therapy was effective for the treatment of functional aphonia by restoring patient’s vocalization and improving voice quality, pitch and loudness.

scholarly journals Domestic dogs (Canis lupus familiaris) are sensitive to the correlation between pitch and timbre in human speech

2021 ◽  
Author(s):  
Sasha K. Sturdy ◽  
David R. R. Smith ◽  
David N. George
Keyword(s):  
Fundamental Frequency ◽  
Adult Male ◽  
Vocal Tract ◽  
Vocal Folds ◽  
Domestic Dogs ◽  
Canis Lupus Familiaris ◽  
Adult Males ◽  
Male Voice ◽  
Highly Correlated ◽  
The Voice

AbstractThe perceived pitch of human voices is highly correlated with the fundamental frequency (f0) of the laryngeal source, which is determined largely by the length and mass of the vocal folds. The vocal folds are larger in adult males than in adult females, and men’s voices consequently have a lower pitch than women’s. The length of the supralaryngeal vocal tract (vocal-tract length; VTL) affects the resonant frequencies (formants) of speech which characterize the timbre of the voice. Men’s longer vocal tracts produce lower frequency, and less dispersed, formants than women’s shorter vocal tracts. Pitch and timbre combine to influence the perception of speaker characteristics such as size and age. Together, they can be used to categorize speaker sex with almost perfect accuracy. While it is known that domestic dogs can match a voice to a person of the same sex, there has been no investigation into whether dogs are sensitive to the correlation between pitch and timbre. We recorded a female voice giving three commands (‘Sit’, ‘Lay down’, ‘Come here’), and manipulated the recordings to lower the fundamental frequency (thus lowering pitch), increase simulated VTL (hence affecting timbre), or both (synthesized adult male voice). Dogs responded to the original adult female and synthesized adult male voices equivalently. Their tendency to obey the commands was, however, reduced when either pitch or timbre was manipulated alone. These results suggest that dogs are sensitive to both the pitch and timbre of human voices, and that they learn about the natural covariation of these perceptual attributes.

scholarly journals An Analysis on Aerodynamic and Acoustic Changes After Thyroidectomy

2016 ◽  
Vol 101 (5-6) ◽  
pp. 233-240 ◽  
Author(s):  
Beyhan Yılmaz ◽  
Salih Bakır ◽  
Edip Erdal Yılmaz ◽  
Engin Şengül ◽  
Ömer Uslukaya ◽  
...  
Keyword(s):  
Fundamental Frequency ◽  
Malignant Tumors ◽  
Laryngeal Nerve ◽  
Benign Tumors ◽  
Acoustic Parameters ◽  
Tumor Patients ◽  
Maximum Phonation Time ◽  
Voice Changes ◽  
Laryngeal Nerve Injury ◽  
The Voice

The purpose of this study was to investigate the aerodynamic and acoustic changes after thyroidectomy without laryngeal nerve injury by using objective methods. Voice samples of sustained /α/ recorded from 44 adults preoperatively and nearly 1 week and 3 months after thyroidectomy were analyzed for mean vocal fundamental frequency (Mean Fo, Hz), maximum fundamental frequency (Max Fo, Hz), minimum fundamental frequency (Min Fo, Hz), jitter, shimmer, glottal to noise excitation ratio (GNE), irregularity, noise, overall severity, S time, Z time, S/Z ratio, and maximum phonation time (MPT). Voice samples were analyzed using the lingWAVES software. The comparisons of preoperative and early and late postoperative acoustic parameters revealed significant differences in Mean F0, Max F0, MPT, and S Time between the early and late postoperative periods. The voice changes after thyroidectomy were not affected by age, sex, or surgical procedure, but they differed between the benign and malignant nature of the tumor. Patients with malignant tumors showed a greater decrease in Mean F0 and Max F0 compared with the patients with benign tumors, and this difference was statistically significant. Voice changes may occur after thyroidectomy even in the patients with no evidence of laryngeal nerve damage, and these changes can be assessed with objective measurement methods. This information should be explained to the patients during the preoperative counseling, and proper informed consent is ethically and legally required for all planned thyroidectomies.

Treatment of Vocal Fold Immobility by Glutaraldehyde—Cross-Linked Collagen Injection: Longc-Term Results

1995 ◽  
Vol 104 (6) ◽  
pp. 437-441 ◽  
Author(s):  
Marc Remacle ◽  
Jean-Marc Dujardin ◽  
Georges Lawson
Keyword(s):  
Vocal Fold ◽  
Speech Therapy ◽  
Systemic Reaction ◽  
Long Term Effects ◽  
Maximum Phonation Time ◽  
Long Term Stability ◽  
Vocal Fold Immobility ◽  
The Voice

Fifty-three cases of unilateral vocal fold immobility treated by glutaraldehyde—cross-linked (GAX) collagen over a 6-year period with a mean follow-up of 4.5 years were reviewed for assessment of the immediate and long-term effects on phonation. The mean amount injected was 1.47 mL. No long-term local or systemic reaction to the collagen was seen. The median preoperative maximum phonation time (MPT) was 7.5 seconds, the median immediate postoperative MPT 12 seconds, and the median long-term postoperative MPT 11 seconds. The median preoperative phonatory quotient (PQ) was 564 mL/s. The median immediate postoperative PQ was 320 mL/s, whereas the median long-term postoperative PQ was 385 mL/s. The quantitative improvement in the voice as measured by the PQ was thus 67% for the short range and 49% for the long range. The decline in the results over time was 20.3%. Vocal frequency analysis showed that the fundamental frequency and harmonics returned and were maintained in the long term for more than 80% of the patients with the help of speech therapy. This relative stability is explained by the findings of previous histological work. The fact that collagen, unlike Teflon, does not cause an inflammatory reaction and the partial maintenance of the improvement achieved, which is to be compared with the instability of the effects produced by resorbable substances, make it the “least objectionable” injectable for the treatment of unilateral glottic fold immobility. One must overcompensate 20% to 30%, given the results of the long-term stability studies.

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