			Home About us Contact

Voice Quality (voice + quality)

Distribution by Scientific Domains

Medical Sciences	75%
Engineering	8%

Selected Abstracts

Association Between Birth Control Pills and Voice Quality

THE LARYNGOSCOPE, Issue 6 2004
Ofer Amir PhD
Abstract Objectives/Hypothesis: The objective was to extend our knowledge of the effect of birth control pills on voice quality in women based on various acoustic measures. Study Design: A longitudinal comparative study of 14 healthy young women over a 36- to 45-day period. Methods: Voices of seven women who used birth control pills and seven women who did not were recorded repeatedly approximately 20 times. Voice samples were analyzed acoustically, using an extended set of frequency perturbation parameters (jitter, relative average perturbation, pitch period perturbation quotient), amplitude perturbation parameters (shimmer, amplitude average perturbation quotient), and noise indices (noise-to-harmonics ratio, voice turbulence index). Results: Voice quality and stability were found to be better among the women who used birth control pills. Lower values were found for all acoustic measures with the exception of voice turbulence index. Results also provided preliminary indication for vocal changes associated with the days preceding ovulation. Conclusion: In contrast to the traditional view of oral contraceptives as a risk factor for voice quality, and in keeping with the authors' previous work, the data in the present study showed that not only did oral contraceptives have no adverse effect on voice quality but, in effect, most acoustic measures showed improved voice quality among women who used the birth control pill. The differences in the noise indices between groups may also shed light on the nature of the effect of sex hormones on vocal fold activity. It was suggested that hormonal fluctuations may have more of an effect on vocal fold regulation of vibration than on glottal adduction. [source]

In the ear of the beholder: neural correlates of adaptation to voice gender

EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 3 2009
Romi Zäske
Abstract While high-level adaptation to faces has been extensively investigated, research on behavioural and neural correlates of auditory adaptation to paralinguistic social information in voices has been largely neglected. Here we replicate novel findings that adaptation to voice gender causes systematic contrastive aftereffects such that repeated exposure to female voice adaptors causes a subsequent test voice to be perceived as more male (and vice versa), even minutes after adaptation [S.R. Schweinberger et al., (2008), Current Biology, 18, 684,688). In addition, we recorded event-related potentials to test-voices morphed along a gender continuum. An attenuation in frontocentral N1,P2 amplitudes was seen when a test voice was preceded by gender-congruent voice adaptors. Additionally, similar amplitude attenuations were seen in a late parietal positive component (P3, 300,700 ms). These findings suggest that contrastive coding of voice gender takes place within the first few hundred milliseconds from voice onset, and is implemented by neurons in auditory areas that are specialised for detecting male and female voice quality. [source]

Assessment of alaryngeal speech using a sound-producing voice prosthesis in relation to sex and pharyngoesophageal segment tonicity

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2006
M. van der Torn MD
Abstract Background. A pneumatic artificial sound source incorporated in a regular tracheoesophageal shunt valve may improve alaryngeal voice quality. Methods. In 20 laryngectomees categorized for sex and pharyngoesophageal segment tonicity, a prototype sound-producing voice prosthesis (SPVP) is evaluated for a brief period and compared with their regular tracheoesophageal shunt speech. Results. Perceptual voice evaluation by an expert listener and acoustical analysis demonstrate a uniform rise of vocal pitch when using the SPVP. Female laryngectomees with an atonic pharyngoesophageal segment gain vocal strength with the SPVP. Exerted tracheal pressure and airflow rate are equivalent to those required for regular tracheoesophageal shunt valves. However, communicative suitability and speech intelligibility deteriorate by the SPVP for most patients. Tracheal phlegm clogging the SPVP is a hindrance for most patients. Conclusions. The SPVP raises vocal pitch. Female laryngectomees with an atonic or severely hypotonic pharyngoesophageal segment can benefit from a stronger voice with the SPVP. © 2005 Wiley Periodicals, Inc. Head Neck28: 400,412, 2006 [source]

Endoluminal repair of distal aortic arch aneurysms causing aorto-vocal syndrome

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2008
J. P. Morales
Summary Purpose:, We have evaluated the efficacy of endovascular repair of distal aortic arch aneurysms (DAAA) causing recurrent laryngeal nerve palsy. Material and methods:, Eight patients (five male and three female) with median age of 72 years (range: 59,80) presented with left recurrent laryngeal nerve palsy associated with DAAA. All patients were considered unfit for open surgery. The median aneurysm size was 5.9 cm (range: 5,7.3). Thirteen stents were deployed: eight Gore, four Endofit and one Talent. Epidural anaesthesia was used in all patients. The left subclavian artery was covered in all and the left common carotid in three who had a preliminary right to left carotid,carotid bypass. Routine follow-up (FU) was with computed tomography (CT) at 3,6 months and yearly thereafter. Results:, Exclusion of the aneurysm sac was achieved in all patients. Thirty-day mortality was 0%, with no paraplegia or stroke. Early complications included: rupture of the external iliac artery (one) and common femoral artery thrombectomy (one). One patient died of unknown cause at 17 months. The mean FU in the remaining seven patients was 21 months (range: 6,51). Aneurysm size decreased in five, was unchanged in one and increased in one. Three patients had improvement in voice quality postoperatively. One patient had a recurrent type 1 endoleak which was restented twice. No late deaths have occurred. Conclusion:, Though technically the procedures involved were more complicated, endovascular repair of DAAA causing aorto-vocal syndrome is safe and offers a realistic alternative to open surgery. Hoarseness of the voice can improve postoperatively and is associated with reduction in aortic sac diameter. [source]

An opportunistic cross-layer architecture for voice in multi-hop wireless LANs

INTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 4 2009
Suhaib A. Obeidat
Abstract We propose an opportunistic cross-layer architecture for adaptive support of Voice over IP in multi-hop wireless LANs. As opposed to providing high call quality, we target emergencies where it is important to communicate, even if at low quality, no matter the harshness of the network conditions. With the importance of delay on voice quality in mind, we select adaptation parameters that control the ratio of real-time traffic load to available bandwidth. This is achieved in two ways: minimizing the load and maximizing the bandwidth. The PHY/MAC interaction improves the use of the spectral resources by opportunistically exploiting rate-control and packet bursts, while the MAC/application interaction controls the demand per source through voice compression. The objective is to maximize the number of calls admitted that satisfy the end-to-end delay budget. The performance of the protocol is studied extensively in the ns-2 network simulator. Results indicate that call quality degrades as load increases and overlonger paths, and a larger packet size improves performance. For long paths having low-quality channels, forward error correction, header compression, and relaxing the delay budget of the system are required to maintain call admission and quality. The proposed adaptive protocol achieves high performance improvements over the traditional, non-adaptive approach. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Martha Stewart behaving Badly: Parody and the symbolic meaning of style1

JOURNAL OF SOCIOLINGUISTICS, Issue 5 2009
Jennifer Sclafani
This study addresses the issue of how to correlate social meaning with linguistic style through an investigation of the parodic speech genre. The analysis examines two parodies of lifestyle entrepreneur Martha Stewart and compares linguistic strategies used in parodies of Stewart to her own linguistic performance on her talk show. Features considered include phonological characteristics, lexical items, politeness strategies, and voice quality. A comparative quantitative analysis of aspirated and released /t/ as employed by Stewart and her parodist reveals that a variable feature of Stewart's style is rendered categorical in the parody. It is demonstrated that both parodies exploit elements associated with Stewart's ,Good Woman' image in order to expose Stewart as a ,Bad Woman', a reputation she earned for her 2003 insider trading conviction. This study suggests that parodic performance may serve to strengthen and even iconize indexical connections between stylistic variants and their social meaning in particular contexts. [source]

Phonation type as a stylistic variable: The use of falsetto in constructing a persona1

JOURNAL OF SOCIOLINGUISTICS, Issue 4 2007
Robert J. Podesva
Although the field of sociolinguistics has witnessed a growing interest in the sociophonetic aspects of segmental and intonational variation, few studies have examined variation in voice quality. This paper addresses the gap by investigating the stylistic use of falsetto phonation. Focusing on the speech of Heath, a speaker exhibiting considerable cross-situational variation, I show that when attending a barbecue with friends, Heath's falsetto is more frequent, longer, and characterized by higher fundamental frequency (f0) levels and wider f0 ranges. Advancing recent approaches to variation which treat linguistic features as stylistic resources for constructing social meaning, I draw on an analysis of the discourse contexts in which falsetto appears to illustrate that the feature carries expressive connotations. This meaning is employed to construct a ,diva' persona and may also participate in building a gay identity. [source]

Delimiting perceptual cues used for the ethnic labeling of African American and European American voices

JOURNAL OF SOCIOLINGUISTICS, Issue 1 2004
Erik R. Thomas
A review of speech identification studies examining the abilities of listeners to distinguish African American and European American voices shows that Americans can recognize many African American voices with a high degree of accuracy even in the absence of stereotypical morphosyntactic and lexical features. Experiments to determine what cues listeners use to distinguish ethnicity have not yielded such consistent results, perhaps suggesting that listeners may access a wide variety of cues if necessary. An experiment involving African Americans with features of a European American vernacular demonstrated that African Americans with atypical features are difficult for listeners to identify. Analysis suggested that vowel quality and intonation could have misled respondents but did not rule out timing and voice quality as factors in identification. [source]

A novel internal antenna with high gain for wireless phone

MICROWAVE AND OPTICAL TECHNOLOGY LETTERS, Issue 9 2007
Ying Liu
Abstract A novel internal antenna for synchronous code division multiple access band wireless phone is presented. Traditional internal antenna is monopole or Planar Inverted-F Antenna, which have no gain high enough in the limited space in phone. The proposed antenna is composed of two antenna elements with equal magnitude and 180° phase difference, to assure voice quality with high gain. The measured maximum gain is 2.69 dBi and maximum efficiency is 70.1% in the frequency band 450,470 MHz. © 2007 Wiley Periodicals, Inc. Microwave Opt Technol Lett 49: 2112,2114, 2007; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.22708 [source]

Exploring the phonatory effects of external superior laryngeal nerve paralysis: An In vivo model,

THE LARYNGOSCOPE, Issue 4 2009
Nelson Roy PhD
Abstract Objectives/Hypothesis: Little is known regarding the phonatory consequences of unilateral external superior laryngeal nerve (ESLN) paralysis. By selectively blocking the ESLN with lidocaine HCl (with laryngeal electromyography verification), we modeled acute, unilateral cricothyroid (CT) muscle dysfunction to explore possible acoustic, aerodynamic, auditory-perceptual and auto-perceptive effects. Study Design: Prospective, repeated measures, experimental design. Methods: Ten, vocally-normal adult males underwent lidocaine block of the right ESLN. Multiple measures of phonatory function across a variety of vocal tasks/conditions were acquired before and during the block using standard data acquisition and analysis protocols. Results: During ESLN block, phonatory frequency range was significantly reduced with compression of both upper and lowermost regions of the pitch range. Mean speaking fundamental frequency increased significantly during oral reading. Acoustic analysis, aerodynamic assessment, and auditory- perceptual evaluation by blinded listeners revealed modest increases in phonatory instability (jitter), increased laryngeal airway resistance with no objective evidence of glottic insufficiency, and mild deterioration in voice quality most evident during high pitched voice productions, respectively. Participants uniformly rated their speaking and singing voices as worse during the block with significant weakness, effort, and tightness that they perceived as a mild level of impairment. Conclusions: These data support generally mild changes to the speaking voice, which extend beyond reductions in pitch range only, and shed light on the potential untoward phonatory effects of acute, unilateral CT dysfunction. Laryngoscope, 2009 [source]

Artificial Manipulation of Voice in the Human by an Implanted Stimulator

THE LARYNGOSCOPE, Issue 10 2008
FACS, Michael Broniatowski MD
Abstract Objectives/Hypothesis: Traditional approaches influencing voice quality (e.g., anatomical and chemical denervation for spasmodic dysphonia, surgical medialization for paralysis) have ignored the dynamic nature of the larynx. Study Design: We report here the first attempt to manipulate voice using an implanted stimulator to systematically control vocal fold adduction. Methods: Devices placed for aspiration in three subjects retaining speech after stroke, cerebral palsy, and multiple sclerosis were used to stimulate recurrent laryngeal nerves with 42 Hz, 52 to 200 microsecond pulses of incremental amplitudes during phonation with the tracheostomy tube occluded. Vocal fold adduction increased with stimulation strength (P < .05). Speech was analyzed with the Vox Metria program. Results: We found highly significant differences for fundamental frequency (P < .007), jitter (P < .004), and shimmer (P < .005), between natural and stimulated voice (aah and eeh) when using higher charges. Conclusions: Dynamic vocal fold manipulation seems promising in terms of versatility lacking with static approaches to voice control. [source]

Long-Term Results of Provox ActiValve, Solving the Problem of Frequent Candida- and "Underpressure"-Related Voice Prosthesis Replacements

THE LARYNGOSCOPE, Issue 2 2008
Jessica Soolsma MSc
Abstract Objectives: To assess the long-term results of the Provox ActiValve, a prosthesis for voice rehabilitation after total laryngectomy that was designed to lessen the need for frequent replacements caused by Candida and "underpressure." Patients and Methods: Retrospective assessment of device lifetime, indications for replacement, voice quality, and maintenance issues, measured by a structured trial specific questionnaire, in a cohort of 42 laryngectomized patients, experiencing a short Provox2 device lifetime (median, 21 days). Results: The median device lifetime of Provox ActiValve, replaced for leakage through the device and those still in situ at the date of data collection (N = 32), was 337 days (mean 376 days): a statistically significant 16-fold increase compared to the Provox2 prosthesis (P < .001). In 10 patients, replacement was fistula-related (median after 86 days): esophageal pouch (N = 4), fistula granulation (N = 3), extrusion of the device (N = 2), and periprosthetic leakage (N = 1). Eighty-six percent of the patients used a special lubricant to diminish "stickiness" of the valve. Provox ActiValve was preferred by 90% of the patients who completed the trial-specific questionnaire. Conclusions: For patients requiring frequent device-related replacements, Provox ActiValve, also long-term, provides a true solution and thereby is a valuable addition to prosthetic voice rehabilitation. [source]

Long-Term Result of the New Endoscopic Vocal Fold Medialization Surgical Technique for Laryngeal Palsy,

THE LARYNGOSCOPE, Issue 2 2006
Koichiro Nishiyama MD
Abstract Objective: The conventional surgical method for a case of unilateral laryngeal nerve paralysis with large glottal gap requires an external cervical incision. In the present study, we developed an endoscopic technique of vocal fold medialization that can make the external incision unnecessary. This procedure of autologous transplantation of fascia into the vocal fold (ATFV) was developed for the successful treatment of unilateral laryngeal nerve paralysis. However, the method seemed to be effective only for patients with a relatively mild glottal gap. Study Design and Methods: In the present study, we modified the method of medialization using the ATFV technique to obtain effective closure of a large glottal gap. To overcome this difficulty, an attempt was made to extend the site of transplantation more posteriorly so as to adduct the vocal process of the arytenoid cartilage in the body of the vocal fold. Results: This new technique was applied to eight cases of patients with unilateral laryngeal paralysis with severe dysphonia. None of the patients showed any evidence of falling off of the graft. Elongation of the maximum phonation time and a decrease in airflow rate during phonation were obtained with improvement in voice quality in all patients 1 year after the surgery. Conclusions: This method, with its less invasive approach, proved to be useful for the treatment of large glottal gap due to unilateral laryngeal nerve paralysis. [source]

Association Between Birth Control Pills and Voice Quality

Oral myofunctional and vocal characteristics in subjects subjected to oral rehabilitation with osseointegrated implants

CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2006
Karilla Matteo Sansone
Abstract Purpose: The aim of this study was to evaluate the effect of oral rehabilitation using immediately loaded fixed implant-supported mandibular prostheses, considering chewing, swallowing, speech and voice aspects. Material and methods: Fourteen patients subjected to this treatment were evaluated by a clinical examination of the stomatognathic system and perceptual evaluation of voice quality before oral rehabilitation, as well as after 1 and 4 months. Results: After oral rehabilitation, the results showed that there were no significant modifications in the aspects investigated. Conclusion: Thus, implant-supported prosthetic rehabilitation, despite providing a more satisfactory occlusal standard, did not yield changes in the functional patterns of individuals in this study. [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]

Short-term voice quality results following percutaneous medialisation of the paralysed vocal cord under local anaesthesia using calcium hydroxyapatite gel: how we do it

CLINICAL OTOLARYNGOLOGY, Issue 4 2008
Y. Karagama
First page of article [source]

Can objective parameters derived from videofluoroscopic assessment of post-laryngectomy valved speech replace current subjective measures?

CLINICAL OTOLARYNGOLOGY, Issue 6 2006
An e-tool-based analysis
Objectives:, The primary purpose of this study was to assess the pharyngoesophageal segment in total laryngectomy patients using a videofluoroscopy e-tool. Study design:, Cross-sectional study. Setting:,, Head and Neck Oncology Unit, Tertiary Referral Centre. Patients:, Forty-two patients following total laryngectomy. Intervention:, Videofluoroscopy using an e-tool (JRuler). Main outcome measures:, Subjective and objective videofluoroscopy parameters correlated with the GRBAS scale and treatment variables. Results:, Of 32 men and 10 women, mean age 63.5 years (10.8) the majority (64.3%) had a reasonable voice (good = 11 and poor = 4 patients). Comparing subjective and objective parameters, significant correlations were only seen with a smaller minimal neoglottic distance at phonation with no regurgitation of barium at phonation (P = 0.05) and a type 1 shape of neoglottis at phonation (P = 0.02). There were also significant correlations between smaller maximum sub-neoglottic distance at phonation and type 1 shape of neoglottis (P = 0.02), smaller maximum sub-neoglottic distance at rest and absence of stasis of barium at phonation (P = 0.05) and the length of neoglottis at phonation and type 1 shape of neoglottis (P = 0.01). For perceptual evaluation, significant correlation was seen only between G1 voice and a smaller minimal neoglottic distance at phonation (P = 0.03) amongst the subjective and objective parameters. There were no correlations between visual parameters and the clinical parameters. Conclusions:, Our observations suggest that this interesting concept has limitations. While objective and quantifiable data can be obtained using videofluoroscopy in laryngectomees, only a few correlate with each other and with voice quality. [source]

The reliability and validity of patient self-rating of their own voice quality

CLINICAL OTOLARYNGOLOGY, Issue 4 2005
M. Lee
Objectives:, To provide preliminary data on the reliability and validity of dysphonic patients rating their own voice quality. Design:, Prospective reliability/validity assessment of voice ratings in dysphonic patients. Setting:, The Royal Free Hampstead NHS Primary Care Trust. Participants:, Thirty-five adult dysphonia patients recruited from ENT referrals to a speech and language therapy department. Exclusion criteria were (i) a hearing impairment which may affect auditory discrimination and (ii) a diagnosis of cognitive impairment which may affect task comprehension. Main outcome measures:, Patient intra-rater reliability was assessed by test,retest ratings, using G (Grade), R (Rough), B (Breathy), A (Asthenic), S (Strained) (GRBAS). Validity was assessed by comparing (i) patient,clinician inter-rater reliability, (ii) patients' GRBAS ratings with their Vocal Performance Questionnaire (VPQ) responses. Result:, (i) Patients had lower intrarater reliability than clinicians (for G of GRBAS, kappa = 0.51 versus 0.74); (ii) patients consistently rated their voices more severely than clinicians (for G of GRBAS, mean rating = 1.4 versus 1.0); (iii) clinician,patient inter-rater agreement was no better than chance (paired t -test, all P < 0.05); (iv) patient ratings correlated significantly with vocal performance scores (r > 0.4, P < 0.05). Conclusions:, Patients appear to have good validity and consistency using GRBAS as a self-perception tool. However, validity measured in terms of agreement with clinician ratings is poor. Voice patients may rate what they perceive rather than what they hear. Disagreement between patient and clinician ratings has implications for therapy aims, prognosis, patient expectations and outcomes. Where disagreement persists, the clinician may have to determine whether therapy priorities need redesigning to reflect patients' perceived needs, or to evaluate whether patient perceptions and expectations are unrealistic. [source]

Dynamic behaviour and localization of pseudoglottis in alaryngeal voice related to voice quality

CLINICAL OTOLARYNGOLOGY, Issue 4 2000
A.J.G.E. Peeters
Objective. To evaluate the pseudoglottic position and dynamic behaviour of alaryngeal voice after laryngectomy related to voice quality. Patients and methods. Pseudoglottic vibrations during sustained phonation were evaluated by videofluoroscopy, videostroboscopy and videokymography in 15 laryngectomees and related to perceptual voice quality, assessed by two independent speech therapists. Videokymography can be used to identify irregular vibrations. This combined with videofluoroscopy and videostroboscopy characterizes the dynamic behaviour of the pseudoglottis. Results. Videofluoroscopy and videostroboscopy demonstrated a mid-neopharyngeal pseudoglottis in 10 laryngectomees, five of whom had an additional inferior located pseudoglottis. Four patients only had a pseudoglottis localized low in the neopharynx and one patient had no pseudoglottis at all. Videokymographic evaluation of pseudoglottic vibrations could be obtained in eight patients, surprisingly demonstrating a regular vibration pattern in all cases. Good alaryngeal voice quality was related to a mid-neopharyngeal pseudoglottis. This is consistent with our experience concerning botulinum toxin treatment for neopharyngeal hypertonicity (injection in the low pseudoglottis reduced phonatory pressure and increased voice quality, whereas injection in the mid-neopharyngeal pseudoglottis resulted in voice deterioration). Conclusion. Good alaryngeal voice quality is related to a mid-neopharyngeal pseudoglottis which should be taken into consideration when treating hypertonicity. [source]