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Voice Parameters (voice + parameter)

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Medical Sciences	100%

Selected Abstracts

Injection versus medialization laryngoplasty for the treatment of unilateral vocal fold paralysis,

THE LARYNGOSCOPE, Issue 9 2010
Follow-Up at Six Months
Abstract Objectives/Hypothesis: To determine whether injection laryngoplasty or medialization laryngoplasty is more effective in the long-term treatment of unilateral vocal fold paralysis (UVFP). Study Design: A retrospective study of patients with UFVP who underwent either injection or medialization laryngoplasty at the University of Arkansas for Medical Sciences between July 29, 2003 and November 18, 2005. Methods: The data analyzed included patient characteristics and type of intervention, along with the pretreatment and post-treatment parameters of videostrobolaryngoscopy, perceptual voice analysis, and patients' subjective assessment of voice handicap. Results: Thirty-four patients were evaluated, 15 new and 19 from a previous study. The average time from intervention to post-treatment evaluation in the new cohort was 4.8 months (range, 1.5,10.5 months). The average time from intervention to post-treatment in the combined cohort was 6.4 months (range, 1,24 months). Improvements were demonstrated in each of the measured voice parameters in both the injection and the medialization groups, and no significant differences were found in the degree of improvement between the two groups. Limited data on aerodynamic and acoustic voice measurements showed a trend toward improvement in each treatment group. Conclusions: Injection and medialization laryngoplasty were comparable in achieving voice improvement at the average long-term follow-up of 6 months. Laryngoscope, 2010 [source]

Injection Versus Medialization Laryngoplasty for the Treatment of Unilateral Vocal Fold Paralysis,

THE LARYNGOSCOPE, Issue 11 2007
Justin E. Morgan MD
Abstract Objective/Hypothesis: To determine whether injection laryngoplasty or medialization laryngoplasty is more effective in the treatment of unilateral vocal fold paralysis. Study Design: A retrospective study of patients with unilateral vocal fold paralysis who underwent either injection or medialization laryngoplasty at the University of Arkansas for Medical Sciences between July 29, 2003 and March 8, 2005. Methods: The data analyzed included patient characteristics and type of intervention, along with the pretreatment and posttreatment voice parameters of videostrobolaryngoscopy, perceptual analysis, and patients' subjective voice assessment. Results: Nineteen patients were evaluated. The average time from intervention to posttreatment evaluation was 3 (range, 1,9) months. Improvements were demonstrated in all three voice parameters in both the injection and the medialization groups. No significant differences were found in the degree of improvement between the two groups. Videostrobolaryngoscopy and the perceptual analysis, both rated by the authors, correlated well with each other, but they both correlated poorly with the patients' subjective voice analysis. Conclusions: Injection and medialization laryngoplasty were comparable in their improvement of subjective and objective voice outcomes. Both treatment modalities should be included in the otolaryngologist's armamentarium for managing unilateral vocal fold paralysis. [source]

The efficacy of voice therapy in patients after treatment for early glottic carcinoma

CANCER, Issue 1 2006
Christine D. L. van Gogh M.D.
Abstract BACKGROUND After treatment for early glottic carcinoma, a considerable number of patients end up with voice problems that interfere with daily life activities. The objective of this randomized and controlled study was to assess the efficacy of voice therapy in these patients. METHODS Of 177 patients, 6,120 months after treatment for early glottic carcinoma, 70 patients (40%) suffered from voice impairment based on a 5-item screening questionnaire. Approximately 60% of those 70 patients were not interested in participating in the current study. Twenty-three patients who were willing to participate were assigned randomly either to a voice therapy group (n = 12 patients) or to a control group (n = 11 patients). Multidimensional voice analyses (the self-reported Voice Handicap Index [VHI], acoustic and perceptual voice quality analysis, videolaryngostroboscopy, and the Voice Range Profile) were conducted twice: before and after voice therapy or with 3 months in between for the control group. RESULTS Statistical analyses of the difference in scores (postmeasurement minus premeasurement) showed significant voice improvement after voice therapy on the total VHI score, percent jitter, and noise-to-harmonics ratio in the voice signal and on the perceptual rating of vocal fry. CONCLUSIONS Voice therapy proved to be effective in patients who had voice problems after treatment for early glottic carcinoma. Improvement not only was noticed by the patients (VHI) but also was confirmed by objective voice parameters. Cancer 2006. © 2005 American Cancer Society. [source]

Effects of sinus lifting on voice quality

CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2003
A prospective study, risk assessment
Abstract: A variety of potential complications associated with sinus lift surgery have been reported in the literature. However, potential alterations of voice quality following sinus elevation have so far not been mentioned or evaluated scientifically. For the majority of patients, slight changes of the voice pattern are of no importance. However, for voice professionals, whose voices have become part of their distinctive profession or trademark, minimal changes may have dramatic consequences. This specific group of patients, such as speakers, actors and singers, depend on the particular quality and timbre of their voice for their livelihood. Consequently, the purpose of this study was to assess the effects of sinus lifting on voice quality in the above patient group. In a collaborative interdisciplinary effort, the Departments of Oral Surgery and Otorhinolaryngology, Section of Phoniatrics and Logopedics, thoroughly evaluated a series of voice parameters of four patients undergoing sinus lifting pre- and postoperatively. The parameters analyzed included pitch, dynamic range, sound pressure level, percent jitter, percent shimmer and noise-to-harmonics ratio with special emphasis on formant analysis. No changes were detected in any of the commonly evaluated parameters. These were rated subjectively by patients and their friends or relatives and objectively with instrumental tools under isolated phoniatric lab conditions. In conclusion, sinus lift surgery appears to be a safe, predictable evidence-based method for regenerating the highly atrophic posterior maxilla, which does not jeopardize the individual characteristic voice pattern of high-profile patients critically dependent on their voices for their livelihood. Résumé Quelques complications potentielles associées à la chirurgie d'épaississement du plancher sinusal ont été rapportées dans la littérature. Les altérations potentielles de la qualité de la voix suivant l'épaississement du plancher sinusal n'ont pas encore été mentionnées et évaluées scientifiquement. Pour la majorité des patients, des petites variations dans le timbre de la voix ne sont pas importantes. Cependant, pour les professionnels de la phonation pour lesquels la voix est devenue une partie importante de leur profession, des variations même faibles peuvent entraîner des conséquences dramatiques. Ce groupe spécifique de patients, tels que les orateurs, les acteurs et les chanteurs dépendent essentiellement de la qualité et du timbre particulier de leur voix dans leur vie professionnelle. Par conséquent, le but de cette étude a été d'estimer les effets d'un épaississement du sinus sur la qualité de la voix dans ce groupe de patients. Dans un effort interdisciplinaire collaboratif, les départements de chirurgie buccale et d'otorhino-laringologie, la section de phonétique et de logopédie ont évalué de manière très précise une série de paramètres de la voix avant et après l'opération chez quatre patients ayant subi un épaississement du sinus maxillare. Les paramètres analysés contenaient la hauteur, l'étalement, le niveau de pression du son, le pourcentage de trac, le pourcentage de chatoiements et la proportion bruit-harmonie avec une insistance spéciale sur l'analyse du formant. Aucun changement n'a été détecté dans aucun des paramètres évalués couramment. Ces derniers étaient estimés subjectivement par les patients et par leurs amis ou parents, et objectivement à l'aide des instruments sous des conditions de laboratoire de phonétique isolé. En conclusion, la chirugie d'épaississement du plancher sinusal semble une méthode sûre, avec un pronostic basé sur l'évidence, permettant de regénérer les maxillaires très atrophiés qui n'empêche pas la caractéristique individuelle de la voix chez des patients avec des profils où la voix est essentielle à leur vie active. Zusammenfassung Der Einfluss einer Sinusbodenelevation auf die Stimmqualität, eine Langzeitstudie und Risikoanalyse. In der Literatur werden eine ganze Reihe von möglichen Komplikationen beschrieben, die bei dem chirurgischen Eingriff der Sinusbodenelevation auftreten können. Veränderungen der Stimme, die als Folge einer Sinusbodenelevation vorkommen können, wurden aber bis heute weder beschrieben, noch wissenschaftlich ausgewertet. Für den Grossteil der Patienten haben leichte Veränderungen der Stimme keine Bedeutung. Für Personen aber, deren Stimme bei der Ausübung ihres Berufes wichtig ist, eventuell ein Teil ihres Berufes oder gar Markenzeichen geworden ist, können kleine Veränderungen dramatische Folgen haben. Diese ausgewählte Gruppe von Patienten, wie zum Beispiel Nachrichtensprecher, Schauspieler oder Sänger, sind im täglichen Leben auf die spezifische Art und den Klang ihrer Stimme angewiesen. Daher war das Ziel dieser Studie, Einflüsse einer Sinusbodenelevation auf die Stimmqualität bei den oben erwähnten Patienten zu untersuchen. In einer interdisziplinären Zusammenarbeit untersuchten die Klinik für Oralchirurgie und Otorhinolaryngologie und die Abteilung für Phonetik und Logopädie an 4 Patienten vor und nach der Sinusbodenelevation sehr eingehend verschiedene Parameter der Stimme. Die untersuchten Parameter waren Tonhöhe, Tonvolumen, den durch den Ton erzeugten Luftdruck, Schwingungen, Vibrationen und das Verhältnis zwischen Nebengeräuschen und harmonischem Klang mit speziellem Augenmerk auf formative Analysen. Man erkannte bei keinem der oben untersuchten Parametern eine Veränderung. Sie wurden sowohl subjektiv durch die Patienten und ihre Freunde oder Verwandten, sowie objektiv mit Messinstrumenten unter absolut schallisolierten Laborbedingungen gemessen. Über die Sinusbodenelevation kann man zusammenfassend sagen, dass es sich um eine sichere, voraussagbare und auf wissenschaftlichen Grundlagen basierende Operationsmethode zum Wiederaufbau einer massiv athrophischen Maxilla im Seitenzahnbereich handelt. Sie gefährdet die individuellen Stimmcharakteristika von kritischen und sehr anspruchsvollen Patienten, die in ihrem täglichen Leben auf ihre charakteristische Stimme angwiesen sind, nicht. Resumen Se han descrito en la literatura una variedad de complicaciones asociadas con la cirugía de la elevación del seno. Pero hasta el momento no se han mencionado ni evaluado científicamente alteraciones potenciales de la calidad de voz tras la elevación del seno. Para la mayoría de los pacientes, pequeños cambios en el patrón de voz no tienen importancia. De todos modos, en los profesionales de la voz, cuyas voces se han convertido en parte distintiva de su profesión o marca, pequeños cambios pueden tener consecuencias dramáticas. Este grupo específico de pacientes, tales como locutores, actores y cantantes, dependen de la calidad particular y timbre de su voz para su sustento. Consecuentemente, el propósito de este estudio fue valorar los efectos de la elevación del seno en la calidad de voz en el anterior grupo de pacientes. En un esfuerzo de colaboración interdisciplinaria, los departamentos de Cirugía Oral y Otorrinolaringología, Sección de Foniatría y Logopedia, evaluaron e profundidad una serie de parámetros de voz de 4 pacientes que se someterían a elevación del seno pre y postoperatoriamente. Los parámetros analizados incluyeron tono, rango dinámico, nivel de presión sonoro, porcentaje de reverberación, porcentaje de tremulación y relación ruido a harmónicos con especial énfasis en el análisis formante. No se detectaron cambios en ninguno de los parámetros evaluados comúnmente. Estos se valoraron subjetivamente por los pacientes y sus amigos o parientes y objetivamente por herramientas instrumentales bajo condiciones de laboratorio de aislamiento foniátrico. En definitiva, la cirugía de elevación del seno parece ser un método seguro, predecible basado en la evidencia para regenerar el maxilar posterior altamente atrófico, que no pone en peligro las características del patrón de voz de los pacientes de características especiales dependientes de manera crítica de sus voces para su sustento. [source]

Multidimensional assessment of female tracheoesophageal prosthetic speech

CLINICAL OTOLARYNGOLOGY, Issue 6 2006
R. Kazi
Objective:, The objective of this study was to undertake a multidimensional assessment of female tracheoesophageal prosthetic speech. Study Design:, A cross-sectional cohort study. Setting:, Head and Neck Unit in a tertiary oncology referral centre. Patients:, Ten female and 10 male total laryngectomy patients with no signs of recurrence and using voice prosthesis were compared to 10 normal female speakers. Intervention(s):, Electroglottographic and acoustic analysis of voice parameters for both sustained vowel /i/ and connected speech, perceptual evaluation using GRBAS (with 2 experienced raters) and questionnaire assessment using the University of Washington Quality of Life and the Voice Handicap Index. Statistical analysis was done using the Statistical Package for Social Sciences, (v. 14, SPSS Inc., Chicago III). Results:, Median age of the female larygectomy patiemts was 65 years (range: 41-81), that of male laryngectomees was 66.5 years (range: 40-79) and that of the normal female subjects was 47.5 years (range: 35-72). All electroglottographic, acoustic parameters and GRBAS ratings of the female laryngectomy patients were significantly worse as compared with the normal female subjects. The median fundamental frequency (111.8 Hz) was comparable to male tracheoesophageal speakers (115.8 Hz). Mean composite University of Washington Quality of Life score and overall Voice Handicap Index score was 79.3(12.5) and 47.5(27.6) for the female laryngectomy patients and for the males was 81.2 (9.6) and 39.4(18.7). Conclusions:, Gender frequency differences as seen in normal subjects are lost following a laryngectomy operation as evidenced by electroglottographic and perceptual data. Although the quality of life scores are comparable to the male tracheoesophageal speakers, they exhibit a greater voice handicap as compared to their male counterparts. [source]