Perceptual and acoustic voice analysis in patients with glottis cancer after endoscopic laser cordectomy

2020 ◽  
Vol 74 (2) ◽  
pp. 1-5
Author(s):  
Bożena Kosztyła-Hojna ◽  
Jarosław Łuczaj ◽  
Greta Berger ◽  
Emilia Duchnowska ◽  
Maciej Zdrojkowski ◽  
...  
Keyword(s):  
Anterior Commissure ◽  
Voice Quality ◽  
Control Group ◽  
Maximum Phonation Time ◽  
Type Iii ◽  
Perceptual Evaluation ◽  
Type Iv ◽  
Acoustic Evaluation ◽  
Harmonic Components ◽  
Laser Cordectomy

<b>Introduction:</b> Treatment of glottis cancer, despite oncological safety, should consider postoperative voice quality. CO<sub>2</sub> laser endoscopic cordectomy allows radical removal of the tumor while maintaining respiratory, defensive and phonatory functions. <br><b>The aim:</b> The aim of the study is perceptual and acoustic evaluation of voice in patients after endoscopic CO2 III–Va laser cordectomy due to glottis cancer. <br><b>Material and method:</b> The study included 30 men after CO<sub>2</sub> cordectomy. 13 (43%) patients underwent type III cordectomy, 6 (20%) – type IV; 11 (37%) – type Va. Voice quality has been assessed 6 months after the surgery. Control group included 30 healthy men of the same age. GRBAS scale has been used in perceptual evaluation of voice. Acoustic analysis has been performed using DiagnoScope Specjalista software. Narrowband spectrography and Maximum Phonation Time (MPT) measure has been performed. <br><b>Results:</b> In study group, voice has been classified as G<sub>1</sub>R<sub>1</sub>B<sub>0</sub>A<sub>0</sub>S<sub>0</sub> after type III cordectomy; as G<sub>1</sub>R<sub>1</sub>B<sub>1</sub>A<sub>1</sub>S<sub>2</sub> in type IV and as G<sub>2</sub>R<sub>1</sub>B<sub>1</sub>A<sub>0</sub>S<sub>3</sub> in type Va. Acoustic evaluation revealed the highest values of F0, Jitter, Shimmer and NHR after Va cordectomy as well as non-harmonic components in narrowband spectrography and reduction of MPT. <br><b>Conclusions:</b> Postoperative voice quality depends on the type of cordectomy. Perceptual assessment indicates that type IV and Va cordectomy cause intensification of voice disorders. Parameters of acoustic evaluation increase with the extent of the procedure. The presence of non-harmonic components in narrowband spectrography increases with the extent of cordectomy, such as the reduction of MPT. Preservation of anterior commissure influences good voice quality in perceptual and acoustic assessment.

Psychogenic voice disorders

2018 ◽  
Vol 72 (3) ◽  
pp. 1-4 ◽  
Author(s):  
Bożena Kosztyła-Hojna
Keyword(s):  
High Speed ◽  
Acoustic Analysis ◽  
Voice Quality ◽  
Voice Disorders ◽  
Activity Period ◽  
Professional Activity ◽  
Control Group ◽  
Maximum Phonation Time ◽  
Clinical Type ◽  
Acoustic Evaluation

Introduction. Voice express the psyche and personality of a person. Psychogenic dysphonia is called Phononeurosis. Neurosis, depression or family, occupational and social conflicts are the cause of voice disturbances. The most frequent type of dysphonia is hyperfunctional dysphonia, rarer – hypofunctional type. Aim. The aim of this study is an analysis of voice quality and diagnosis of clinical type of psychogenic dysphonia. Material and methods. The analyzed group consisted of 50 patients with voice disorders treated in 2017 and the control group – 30 people with physiological voice. In the diagnosed group 60% of patients were treated for neurosis, 12% due to depression, the others reported conflict situations. In the diagnosis of clinical type of psychogenic dysphonia GRBAS scale was used, maximum phonation time (MPT) and type of breathing were assessed. The visualisation of the larynx was performed using High Speed Digital Imaging (HSDI) technique. The parametric acoustic evaluation of voice was conducted. Results. The most often clinical type of psychogenic dysphonia was hyperfunctional dysphonia, rarer hypofunctional type and vestibular voice. Dysphonia occurred the most often in women during the highest professional activity period. In the diagnosis of clinical type HSDI technique was especially useful allowing to visualization of the real vocal fold vibration and objective differentiation of hyper- and hypofunctional dysphonia. The acoustic analysis of the voice objectively confirmed the presence non-harmonic components – noise generated in the glottis in hypofunctional dysphonia. Disturbances in the way and breathing type caused irregularities in respiratory-phonic and articulation coordination.

Phonatory compensation in patients with larynx cancer after CO2 laser cordectomy

2019 ◽  
Vol 73 (6) ◽  
pp. 1-5
Author(s):  
Bożena Kosztyła-Hojna ◽  
Jarosław Łuczaj ◽  
Greta Berger ◽  
Emilia Duchnowska ◽  
Maciej Zdrojkowski ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Co2 Laser ◽  
Anterior Commissure ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Type Iv ◽  
Fold Type ◽  
Compensation Mechanisms ◽  
Laser Cordectomy

Introduction: CO2 laser endoscopic cordectomy is the method of laryngeal cancer treatment. The type of cordectomy (I–VI) depends on the extent of the tumor. Endoscopic laser surgery provides more satisfactory phonation conditions in comparison to open surgical procedures. The aim of the study was to classify phonatory compensation mechanisms after CO2 laser cordectomy using the HSDI. Material and methods: The study included 30 men treated and diagnosed at the Department of Otolaryngology and Department of Clinical Phonoaudiology and Logopedics, Medical University of Bialystok. The control included 30 men with no pathological changes in the larynx. Type III, IV and Va CO2 laser cordectomy have been for glottis cancer treatment. Postoperative evaluation has been conducted 6 months after the surgery. HSDI has been used in larynx visualization. Results: Type I compensation occurs most frequently in patients after type III cordectomy. Advanced glottis cancer, as an indication for type IV and V cordectomy, leads to epiglottic hyperfunction and phonation involving vestibular folds – type II and III compensation. Type IV compensation is most frequent in type IV cordectomy. Conclusions: The type compensation is connected with the extent of glottis resection. In cordectomy including anterior commissure and the part of opposite fold (type Va), supraglottic hyperfunction with the participation of vestibular folds (type II and III compensation) has been recorded. Transmuscular cordectomy (type III) most often resulted in type I compensation. Type III-Va cordectomy caused reduction or absence of MW, decrease in amplitude and aperiodicity of vibrations in HSDI.

scholarly journals A Randomized Controlled Trial of Two Semi-Occluded Vocal Tract Voice Therapy Protocols

2015 ◽  
Vol 58 (3) ◽  
pp. 535-549 ◽  
Author(s):  
Mara R. Kapsner-Smith ◽  
Eric J. Hunter ◽  
Kimberly Kirkham ◽  
Karin Cox ◽  
Ingo R. Titze
Keyword(s):  
Quality Of Life ◽  
Vocal Tract ◽  
Controlled Trial ◽  
Voice Quality ◽  
Voice Handicap Index ◽  
Voice Therapy ◽  
Control Group ◽  
Perceptual Evaluation ◽  
Therapy Program

PurposeAlthough there is a long history of use of semi-occluded vocal tract gestures in voice therapy, including phonation through thin tubes or straws, the efficacy of phonation through tubes has not been established. This study compares results from a therapy program on the basis of phonation through a flow-resistant tube (FRT) with Vocal Function Exercises (VFE), an established set of exercises that utilize oral semi-occlusions.MethodTwenty subjects (16 women, 4 men) with dysphonia and/or vocal fatigue were randomly assigned to 1 of 4 treatment conditions: (a) immediate FRT therapy, (b) immediate VFE therapy, (c) delayed FRT therapy, or (d) delayed VFE therapy. Subjects receiving delayed therapy served as a no-treatment control group.ResultsVoice Handicap Index (Jacobson et al., 1997) scores showed significant improvement for both treatment groups relative to the no-treatment group. Comparison of the effect sizes suggests FRT therapy is noninferior to VFE in terms of reduction in Voice Handicap Index scores. Significant reductions in Roughness on the Consensus Auditory-Perceptual Evaluation of Voice (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kraemer, & Hillman, 2009) were found for the FRT subjects, with no other significant voice quality findings.ConclusionsVFE and FRT therapy may improve voice quality of life in some individuals with dysphonia. FRT therapy was noninferior to VFE in improving voice quality of life in this study.

Treatment Methods for Different Variations Syndrome Mirizzi

2021 ◽  
Vol 04 (04) ◽  
Author(s):  
Omarov N.B., Aimagambetov M. Zh. ◽  
◽  
◽  
Keyword(s):  
Surgical Treatment ◽  
Bile Ducts ◽  
Gallstone Disease ◽  
Main Group ◽  
Mirizzi Syndrome ◽  
Long Term Results ◽  
Control Group ◽  
Type Iii ◽  
Type Iv ◽  
Number Of Patients

The number of patients with complicated forms of cholelithiasis of cholelithiasis is progressively growing. One of the complications of gallstone disease is Mirizzi syndrome (SM). The reason for the development of which is the spread of the inflammatory - destructive process from the gallbladder to the bile ducts with the formation of pressure ulcers in the common bile duct, as a result of which the formation of a cholecystobiliary fistula occurs, through which stones from the gallbladder enter the main bile ducts. The analysis of the surgical treatment of patients with cholelithiasis (GSD) treated in the UH NJSC "MUS" was carried out. There were 3842 patients in total, Patients were in the period from January 2012. to July 2018 The analysis revealed that of all these patients with gallstones, Mirizzi SM type III and IV syndrome was diagnosed in 25 (0.7%). In 14 (56%) patients with type III SM and type IV SM, 11 (44%). The main group consisted of 10 (40%) patients and 15 (60%) patients included in the control group. The main group completed: 1) In type III SM (only 4 (40%) patients). One patient underwent hepaticojejunostomy according to the clinic method (2017/0423.1). In 3 patients, cholecystohepaticocholedochoplasty was performed with U-shaped interrupted sutures on the drainage according to Vishnevsky (2017 / 0980.1); 2) In type IV SM (a total of 6 (60%) patients). 4 patients underwent hepaticojejunostomy according to the clinic method (2017/0423.1). In 2 patients, cholecystohepaticocholedochoplasty was performed with U-shaped interrupted sutures on the drainage according to Vishnevsky (2017 / 0980.1). The developed and tested methods of surgical treatment of Mirizzi syndrome of types III and IV make it possible to improve the immediate and long-term results of surgical treatment of patients with this pathology. These methods of surgical treatment allow preserving the physiology of the bile outflow without postoperative complications typical for traditional hepaticojejunostomy (incompetence of the anastomotic sutures, stricture of hepaticojejunostomy).

Results of Fascial Augmentation in Unilateral Vocal Fold Paralysis

2002 ◽  
Vol 111 (6) ◽  
pp. 523-529 ◽  
Author(s):  
Petri Reijonen ◽  
Sari Lehikoinen-Söderlund ◽  
Heikki Rihkanen
Keyword(s):  
Vocal Fold ◽  
Acoustic Analysis ◽  
Voice Quality ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Inexpensive Method ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation

The objective of this study was to evaluate the effects on voice quality of augmentation by injection of minced fascia in patients with unilateral vocal fold paralysis. Preoperative and postoperative voice samples from 14 patients (6 men and 8 women; mean age, 59 years) were analyzed by computerized acoustic analysis and blinded perceptual evaluation. Statistically significant improvements were seen in perturbation measurements (jitter and shimmer), noise-to-harmonics ratio, and maximum phonation time. A panel of evaluators rated 10 of the 14 postoperative voices as normal or near-normal. Injection laryngoplasty with minced fascia offers a new, effective, well-tolerated, and inexpensive method to medialize a paralyzed vocal fold. The graft seems to survive well, as indicated by good vocal results with a follow-up ranging from 5 to 32 months.

Medialization thyroplasty in glottis insufficiency due to unilateral vocal fold paralysis and after laser cordectomies – preliminary report

2017 ◽  
Vol 71 (1) ◽  
pp. 22-29
Author(s):  
Anna Rzepakowska ◽  
Ewa Osuch-Wójcikiewicz ◽  
Ewelina Sielska-Badurek ◽  
Kazimierz Niemczyk
Keyword(s):  
Vocal Fold ◽  
Acoustic Analysis ◽  
Standard Procedure ◽  
Thyroid Cartilage ◽  
Voice Quality ◽  
Type I ◽  
Vocal Fold Paresis ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation ◽  
Medialization Thyroplasty

Medialization thyroplasty (type I) is surgical procedure performed on the thyroid cartilage. The major indication for this surgery is significant glottis insufficiency due to unilateral vocal fold paresis. However the proce¬dure is also performed after vocal fold resections during cordectomy. The aim: The evaluation of voice results in patients after medialisation throplasty. Material and methods: In Otolaryngology Department of Medical University of Warsaw there were performed so far 8 thyroplasty procedures under local anaesthesia with implantation of medical silicon protesis. 6 patients had unilat¬eral vocal fold paresis and the rest two underwent in the past laser cordectomy due to T1a vocal carcinoma. Results: There were no complications during and post the surgery. The follow up examination in 1st , 3rd, 6th i 12th months postoperatively revealed for all patients significant improvement of glottal closure in laryngeal videostrobos¬copy. The voice quality improved both in perceptual evaluation (GRBAS scale) and acoustic analysis (F0, jitter, shim¬mer, NHR) in both patients groups. However the rate of improvement was much more significant in group with uni¬lateral vocal fold paresis. In all patients the maximum phonation time (MPT) increased. The self-evaluation of voice quality with Voice Handicap Index questionnaire confirmed also individual improvement. Conclusions: The speech rehabilitations is not successful in each patient with glottis insufficiency. The medialisation thyroplasty remains the standard procedure for permanent improvement of voice quality in those cases.

scholarly journals Voice Quality Measurement as an Indicator of Efficiency of Treatment in Laryngopharyngeal Reflux Disease

2021 ◽  
Vol 29 (2) ◽  
pp. 169-175
Author(s):  
Fousiya Machancheri ◽  
Mubeena K ◽  
Hemaraja Nayaka
Keyword(s):  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Voice Quality ◽  
Post Treatment ◽  
P Value ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation ◽  
Number Of Patients ◽  
Hygiene Measures ◽  
Laryngopharyngeal Reflux Disease

Introduction Laryngopharyngeal reflux disease can alter the structural and functional integrity of the vocal fold. Objectives of the study was to determine the effect of Laryngopharyngeal Reflux Disease (LPRD) on selected Acoustic, Aerodynamic and perceptual parameters of voice and to establish its effectiveness in therapeutic outcome. Materials and Methods The number of patients enrolled for this prospective observational study was 65, all with Reflux symptom index (RSI) more than 13. Quality of life was evaluated using voice handicap index (VHI). Perceptual evaluation of voice done by Grade Roughness Breathiness Asthenia Strain score (GRBAS) followed by acoustic and aerodynamic analysis. Patients were started on a once daily proton pump inhibitor therapy for 3 months along with vocal hygiene measures and RSI, VHI and voice analysis repeated after the treatment. Results There was significant improvement in the RSI score after treatment. Percent jitter and shimmer showed significant improvement in males post treatment (p value:<0.05). Harmonic to noise ratio improved 3 months post treatment in both sexes. Improvement noted in Maximum phonation time and GRBAS score except asthenia and strain post treatment. Conclusion Measurement of voice quality can be used as an effective tool to monitor the efficiency of treatment of LPRD.

scholarly journals Effect of Complete Respiratory Muscle Training (cRMT) on Dysphonia following Single CVA: A retrospective pilot study

2020 ◽  
Author(s):  
Robert J. Arnold ◽  
Christopher S Gaskill ◽  
Nina Bausek
Keyword(s):  
Pilot Study ◽  
Respiratory Muscle ◽  
Exercise Intervention ◽  
Intervention Group ◽  
Respiratory Muscle Training ◽  
Control Group ◽  
Muscle Training ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation ◽  
Inspiratory Muscles

AbstractBackgroundAlthough dysphonia is less prevalent than dysphagia following cerebrovascular accidents, dysphonia does contribute to the burden of disease resulting from stroke. Strengthening muscles of the larynx and respiratory tract through respiratory muscle training (RMT) has proven effective in improving voice after neurological insult. However, approaches to strengthen only the expiratory muscle groups (EMST) dominate the clinical study literature, with variable outcomes. By focusing on exhalation, the contribution of inspiratory muscles to phonation may have been overlooked. This study investigated the effect of combined respiratory muscle training (cRMT) to improve voice function in stroke patients.MethodsRecorded data of twenty patients with dysphonia following stroke were allocated to an intervention (IG) or a control group (CG) based upon whether they chose cRMT or not while awaiting pro bono voice therapy services. The intervention group (N=10) was treated daily with three 5-minute sessions of complete resistive respiratory muscle training for 28 days, while the control group (N=10) received no cRMT or other exercise intervention. Perceptual and acoustic measurements as well as a pulmonary function test were assessed pre-and post-intervention.ResultsThe intervention group demonstrated significant improvements after 28 days of combined respiratory muscle training (cRMT) in peak flow (127%), patient self-perception of voice improvement (84.41%), as well as in five of the six categories of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) overall severity (63.22%), breathiness (61.06%), strain (63.43%), pitch range (48.11%) and loudness (57.51%), compared to the control group who did not receive treatment. Furthermore, cRMT also led to significant improvements in maximum phonation time (212.5%) and acoustic parameters of vocal intensity and semitone range.ConclusionThis pilot study shows promise of the feasibility and effectiveness of cRMT to lessen the signs and symptoms of dysphonia while simultaneously improving breath support.

Phonosurgical voice rehabilitation in patients with primary larynx cancer after laser cordectomy CO2

2017 ◽  
Vol 6 (1) ◽  
pp. 48-57
Author(s):  
Lech Chyczewski ◽  
Bożena Kosztyła-Hojna ◽  
Greta Berger
Keyword(s):  
Laryngeal Cancer ◽  
Vocal Fold ◽  
Speech Therapy ◽  
Anterior Commissure ◽  
Voice Quality ◽  
Life Quality ◽  
Voice Rehabilitation ◽  
Type I ◽  
Voice Preservation ◽  
Laser Cordectomy

The aim of the treatment of early laryngeal cancer is complete oncological cure and simultaneously voice and swallowing preservation. According to the European Laryngological Society (ELS) classification of CO2 laser cordectomy, full voice recovery is seen in subepithelial cordectomy (ELS Type I ) and near complete in subligamental cordectomy (ELS type II). Voice deterioration is usually seen after more extensive levels of cordectomy (ELS types III-V). Voice quality after microsurgical laser cordectomy depends on the presence or absence of synechiae in the anterior commissure and on the quantity of the removed thyro-arytenoid muscle. More extensive reduction of the vocal muscle quantity causes more intensive glottic incompetence. Contralateral healthy vocal fold, rudimentary, cicatrixial previously operated vocal fold and false ventricular folds may take part in postoperative supraglottic voice compensation. All patients should undergo speech and voice therapy after terminating the scaring process on the operated vocal fold. Patients routinely undergo a minimum of 6 months of voice rehabilitation which allows speech therapy to yield the best possible voice. Phonosurgical techniques i.e. medialization thyroplasty, augmentation techniques, Zeitels’s laryngoplasty or Lichtenberger’s technique in treatment of synechia in the anterior commissure are successfully performed to restore the vocal competence. Voice preservation after treatment of early laryngeal cancer of the vocal fold improves life quality of the patient.

Functional vocal results after CO2 laser endoscopic surgery for glottic tumours

2007 ◽  
Vol 122 (9) ◽  
pp. 948-951 ◽  
Author(s):  
S Motta ◽  
U Cesari ◽  
M Mesolella ◽  
G Motta
Keyword(s):  
Outcome Measures ◽  
Tertiary Care ◽  
Voice Quality ◽  
Control Group ◽  
Medical Department ◽  
Functional Compensation ◽  
Vocal Function ◽  
Main Site ◽  
Maximum Phonation Time ◽  
Age Range

AbstractIntroduction:Vocal results after endoscopic cordectomy have not yet been well defined. The aim of this study was to assess the vocal function of patients who had undergone CO2 laser cordectomy.Design:Retrospective, observational and control group study, conducted in a tertiary care medical department.Methods:One hundred and thirty-five male patients (age range 36–83 years) underwent different types of endoscopic cordectomy. Forty age-matched, euphonic male subjects were selected as controls. Patients were classified according to the main site of the phonatory neo-glottis. Outcome measures were maximum phonation time, vocal intensity and harmonic/noise ratio. Mann–Whitney and rank Spearman tests were used for statistical analysis.Results:Findings indicated statistically significant differences for all parameters, comparing patients and controls (p<0.001), and a direct positive relation between type of functional compensation and outcome measures in the study patients (p<0.001).Conclusions:The results indicate that functional compensation and outcome measures were related, and that no functional compensation enabled the study patients to achieve a voice quality comparable with that of controls.

Sign in / Sign up

Export Citation Format

Share Document