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Medicine › Physiology

Voice and Speech Disorders

Works Count: 57010

Description

This cluster of papers focuses on the diagnosis and treatment of voice disorders, particularly in relation to conditions such as Parkinson's disease and occupational impact. It covers topics such as dysphonia, speech therapy, acoustic analysis, vocal fold disorders, telemonitoring, and voice training.

Keywords

Voice Disorders; Parkinson's Disease; Dysphonia; Speech Therapy; Acoustic Analysis; Vocal Fold; Telemonitoring; Occupational Impact; Voice Training; Laryngeal Disorders

Intensive voice treatment (LSVT(R)) for patients with Parkinson's disease: a 2 year follow up

2001-10-01
Lorraine O. Ramig
<h3>OBJECTIVES</h3> To assess long term (24 months) effects of the Lee Silverman voice treatment (LSVT®), a method designed to improve vocal function in patients with Parkinson9s disease. <h3>METHODS</h3> Thirty three … <h3>OBJECTIVES</h3> To assess long term (24 months) effects of the Lee Silverman voice treatment (LSVT®), a method designed to improve vocal function in patients with Parkinson9s disease. <h3>METHODS</h3> Thirty three patients with idiopathic Parkinson9s disease were stratified and randomly assigned to two treatment groups. One group received the LSVT®, which emphasises high phonatory-respiratory effort. The other group received respiratory therapy (RET), which emphasises high respiratory effort alone. Patients in both treatment groups sustained vowel phonation, read a passage, and produced a monologue under identical conditions before, immediately after, and 24 months after speech treatment. Change in vocal function was measured by means of acoustic analyses of voice loudness (measured as sound pressure level, or SPL) and inflection in voice fundamental frequency (measured in terms of semitone standard deviation, or STSD). <h3>RESULTS</h3> The LSVT® was significantly more effective than the RET in improving (increasing) SPL and STSD immediately post-treatment and maintaining those improvements at 2 year follow up. <h3>CONCLUSIONS</h3> The findings provide evidence for the efficacy of the LSVT® as well as the long term maintenance of these effects in the treatment of voice and speech disorders in patients with idiopathic Parkinson9s disease.
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Harmonics-to-noise ratio as an index of the degree of hoarseness

1982-06-01
Eiji Yumoto , Wilbur J. Gould , Thomas Baer
Degree of hoarseness can be evaluated by judging the extent to which noise replaces the harmonic structure in the spectrogram of a sustained vowel. However, this visual method is subjective. … Degree of hoarseness can be evaluated by judging the extent to which noise replaces the harmonic structure in the spectrogram of a sustained vowel. However, this visual method is subjective. The present study was undertaken to develop the harmonics-to-noise (H/N) ratio as an objective and quantitative evaluation of the degree of hoarseness. The computation is conceptually straightforward; 50 consecutive pitch periods of a sustained vowel /a/ are averaged; H is the energy of the averaged waveform, while N is the mean energy of the differences between the individual periods and the averaged waveform. Recordings of 42 normal voices and 41 samples with varying degrees of hoarseness were analyzed. Two experts rated the spectrogram of each voice sample, based on the amount of noise relative to that of the harmonic component. The results showed a highly significant agreement (the rank correlation coefficient = 0.849) between H/N calculations and the subjective evaluations of the spectrograms. The H/N ratio also proved useful in quantitatively assessing the results of treatment for hoarseness.

Motor Speech Disorders

1976-07-12
Emre Kokmen
The authors have limited consideration of motor speech disorders to dysarthrias of neurogenic nature. Aphasias (defined by the authors as problems of processing and symbolic formulation of the language code) … The authors have limited consideration of motor speech disorders to dysarthrias of neurogenic nature. Aphasias (defined by the authors as problems of processing and symbolic formulation of the language code) are excluded. So are the deviant patterns of speech, such as developmental disorders of articulation and those disorders arising from structural impairments, such as cleft palate. A short but useful review of the basic motor process of speech production and its evaluation by clinical and other techniques is included. A more detailed description of relatively unfamiliar methods, such as palatography and videofluoroscopy would have been desirable. The neurologist will find the chapters on principles of neurologic function and hierarchy of motor organization rather basic. Other specialists may find these useful. On the other hand, many speech pathologists may find the section on motor speech examination somewhat devoid of detail. A disproportionately large space is allotted to the examination of the

A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques

2001-02-28
Philippe H. Dejonckere , Patrick J. Bradley , Pais Clemente +6 more

Thyroplasty as a New Phonosurgical Technique

1974-01-01
Nobuhiko Isshiki , Hiroshi Morita , Hiroshi Okamura +1 more
In an attempt to examine the surgical possibility of changing the vocal cord position and tension by reforming the thyroid cartilage, an experimental study was made using 10 adult dogs. … In an attempt to examine the surgical possibility of changing the vocal cord position and tension by reforming the thyroid cartilage, an experimental study was made using 10 adult dogs. Hoarseness produced by section of the recurrent laryngeal nerve was generally much improved by vertical incision on the thyroid ala and slipping in of the lateral cartilage segment. Four types of thyroplasty were proposed from the functional viewpoint. Their effects on the vocal cord are (1) lateral compression, (2) lateral expansion, (3) relaxation (shortening) and (4) stretching (lengthening) respectively. Possible indications for each type of thyroplasty were described with reference to specific laryngeal diseases. The advantages of thyroplasty were emphasized namely, that the intervention inside the thyroid cartilage is minimal and therefore fine and reliable adjustment is possible during surgery. Thyroplasty thus offers a new possibility in phonosurgery.

Frequency and Cooccurrence of Vocal Tract Dysfunctions in the Speech of a Large Sample of Parkinson Patients

1978-02-01
Jeri A. Logemann , Hilda B. Fisher , Benjamin Boshes +1 more
No AccessJournal of Speech and Hearing DisordersResearch Article1 Feb 1978Frequency and Cooccurrence of Vocal Tract Dysfunctions in the Speech of a Large Sample of Parkinson Patients Jeri A. Logemann, Hilda … No AccessJournal of Speech and Hearing DisordersResearch Article1 Feb 1978Frequency and Cooccurrence of Vocal Tract Dysfunctions in the Speech of a Large Sample of Parkinson Patients Jeri A. Logemann, Hilda B. Fisher, Benjamin Boshes, and E. Richard Blonsky Jeri A. Logemann Northwestern University Medical School, Chicago, Illinois Google Scholar More articles by this author , Hilda B. Fisher Northwestern University, Evanston, Illinois Google Scholar More articles by this author , Benjamin Boshes Northwestern University Medical School, Chicago, Illinois Google Scholar More articles by this author and E. Richard Blonsky Northwestern University Medical School, Chicago, Illinois Google Scholar More articles by this author https://doi.org/10.1044/jshd.4301.47 SectionsAboutPDF ToolsAdd to favoritesDownload CitationTrack Citations ShareFacebookTwitterLinked In In this study, the frequency of occurrence of speech and voice symptoms in 200 Parkinson patients was defined by two expert listeners from high-fidelity tape recordings of conversational speech samples and readings of the sentence version of the Fisher-Logemann Test of Articulation Competence. Specific phonemes that were misarticulated were catalogued. Other vocal-tract dysfunctions, including laryngeal disorders, rate disorders, and hypernasality, were also recorded. Cooccurrence of symptoms in each patient was tabulated. Examination of the patterns of co-occurring dysfunctions permitted classifying the 200 patients into five groups: Group 1 (45% of the patients) with laryngeal dysfunction as their only vocal-tract symptom; Group 2 (13.5% of the patients) with laryngeal and back-tongue involvement; Group 3 (17% of the patients) with laryngeal, back-tongue, and tongue-blade dysfunction; Group 4 (5.5% of the patients) with laryngeal dysfunction, back-tongue involvement, tongue-blade dysfunction, and labial misarticulations; and Group 5 (9% of the patients) with laryngeal dysfunction and misarticulations of the back tongue, tongue blade, lips, and tongue tip. Disfluencies and hypernasality did not follow a systematic pattern of cooccurrence with other vocal-tract dysfunctions. Additional Resources FiguresReferencesRelatedDetailsCited by International Journal of Language & Communication Disorders21 Oct 2022Reading fluency in Spanish patients with Parkinson's disease: A reading prosody examinationMaría del Carmen Pérez‐Sánchez, María González‐Nosti, Fernando Cuetos and Marta Álvarez‐Cañizo Revista de Logopedia, Foniatría y Audiología42:4 (197-207)1 Oct 2022Construcción de mapas articulatorios para la detección automática de la enfermedad de Parkinson por medio de la vozSurley Yansury Berrio-Zapata and Juan Rafael Orozco-Arroyave Phenomics2:5 (349-361)1 Oct 2022Deep Clinical Phenotyping of Parkinson’s Disease: Towards a New Era of Research and Clinical CareZhiheng Xu, Bo Shen, Yilin Tang, Jianjun Wu and Jian Wang Annals of Physical and Rehabilitation Medicine65:5 (101580)1 Sep 2022Non-invasive brain stimulation for treating neurogenic dysarthria: A systematic reviewPasquale Balzan, Catherine Tattersall and Rebecca Palmer International Journal of Language & Communication Disorders29 Aug 2022Clinical outcomes of PD Check‐In, a model for supported self‐managed maintenance of speech in Parkinson's disease: A Phase 1 studyAnn Finnimore, Deborah Theodoros and Anna F. Rumbach Pedagogika. Voprosy teorii i praktiki:7 (740-746)1 Aug 2022Optimization of Speech Therapy Work on the Diagnosis of Hypokinetic Dysarthria in Patients with Parkinson’s DiseaseElena Semenovna Berdnikovich Perspectives of the ASHA Special Interest Groups7:3 (959-976)13 Jun 2022What Can Altered Auditory Feedback Paradigms Tell Us About Vocal Motor Control in Individuals With Voice Disorders?Hasini R. Weerathunge, Nicole E. Tomassi and Cara E. Stepp Richa Indu and Sushil Chandra Dimri (2022) Diagnosing Parkinson’s Disease: its evolution to future 2022 International Conference on Computational Intelligence and Sustainable Engineering Solutions (CISES)10.1109/CISES54857.2022.9844353978-1-6654-8004-8 Journal of Voice36:3 (439.e9-439.e20)1 May 2022Prediction and Estimation of Parkinson’s Disease Severity Based on Voice SignalDaria Hemmerling and Magdalena Wojcik-Pedziwiatr Human Brain Mapping43:7 (2328-2347)1 May 2022Immediate and long‐term effects of speech treatment targets and intensive dosage on Parkinson's disease dysphonia and the speech motor network: Randomized controlled trialShalini Narayana, Crystal Franklin, Elizabeth Peterson, Eric J. Hunter, Donald A. Robin, Angela Halpern, Jennifer Spielman, Peter T. Fox and Lorraine O. Ramig Journal of Speech, Language, and Hearing Research65:4 (1402-1415)4 Apr 2022Longitudinal Effects of Parkinson's Disease on Speech Breathing During an Extemporaneous Connected Speech TaskMeghan Darling-White, Zeina Anspach and Jessica E. Huber Journal of Voice1 Apr 2022The Acoustic Voice Quality Index (AVQI) in People with Parkinson's Disease Before and After Intensive Voice and Articulation Therapies: Secondary Outcome of a Randomized Controlled TrialGemma Moya-Galé, Jennifer Spielman, Lorraine A. Ramig, Luca Campanelli and Youri Maryn Cerebral Cortex32:7 (1337-1349)30 Mar 2022Articulatory Gain Predicts Motor Cortex and Subthalamic Nucleus Activity During SpeechC Dastolfo-Hromack, A Bush, A Chrabaszcz, A Alhourani, W Lipski, D Wang, D J Crammond, S Shaiman, M W Dickey, L L Holt, R S Turner, J A Fiez and R M Richardson Brain Sciences12:4 (433)24 Mar 2022The Impact of PD Check-In, a Model for Supported Self-Managed Maintenance of Speech on the Quality of Life of People with Parkinson’s Disease: A Phase 1 StudyAnn Finnimore, Deborah Theodoros and Anna Rumbach International Journal of Molecular Sciences23:7 (3499)23 Mar 2022Respiratory Abnormalities in Parkinson’s Disease: What Do We Know from Studies in Humans and Animal Models?Katarzyna Kaczyńska, Magdalena Ewa Orłowska and Kryspin Andrzejewski Waseem Ahmad Mir, Iqra Nissar, Izharuddin, Danish Raza Rizvi, Sarfaraz Masood and Asif Hussain (2022) Deep Learning-based model for the detection of Parkinson’s disease using voice data 2022 First International Conference on Artificial Intelligence Trends and Pattern Recognition (ICAITPR)10.1109/ICAITPR51569.2022.9844185978-1-6654-2521-6 Frontiers in Rehabilitation Sciences214 Jan 2022Evaluating a Speech-Specific and a Computerized Step-Training-Specific Rhythmic Intervention in Parkinson's Disease: A Cross-Over, Multi-Arms Parallel StudyAnne Dorothée Rösch, Ethan Taub, Ute Gschwandtner and Peter Fuhr European Journal of Neurology29:1 (81-90)1 Jan 2022Automated speech analysis in early untreated Parkinson's disease: Relation to gender and dopaminergic transporter imagingJan Rusz, Tereza Tykalová, Michal Novotný, David Zogala, Evžen Růžička and Petr Dušek Journal of Physics: Conference Series2153:1 (012014)1 Jan 2022Classification of Parkinson’s disease patients based on spectrogram using local binary pattern descriptorsE Gelvez-Almeida, A Váasquez-Coronel, R Guatelli, V Aubin and M Mora Frontiers in Artificial Intelligence422 Dec 2021Automatic Speech Recognition in Noise for Parkinson's Disease: A Pilot StudyAlireza Goudarzi and Gemma Moya-Galé The Journal of the Acoustical Society of America150:6 (4522-4533)1 Dec 2021Validation of cepstral peak prominence in assessing early voice changes of Parkinson's disease: Effect of speaking task and ambient noiseMichal Šimek and Jan Rusz International Journal of Language & Communication Disorders12 Nov 2021PD Check‐In: The development and trial of a supported self‐management program for people with Parkinson's disease following intensive speech interventionAnn Finnimore, Deborah Theodoros and Anna F. Rumbach npj Parkinson's Disease7:111 Nov 2021Distinct patterns of speech disorder in early-onset and late-onset de-novo Parkinson’s diseaseJan Rusz, Tereza Tykalová, Michal Novotný, Evžen Růžička and Petr Dušek PLOS ONE16:10 (e0258786)15 Oct 2021Radiological correlates of vocal fold bowing as markers of Parkinson’s disease progression: A cross-sectional study utilizing dynamic laryngeal CTAndrew Ma, Kenneth K. Lau, Dominic Thyagarajan and Michael Döllinger Behavioural Brain Research (113642)1 Oct 2021Manipulation of Vocal Communication and Anxiety through Pharmacologic Modulation of Norepinephrine in the Pink1-/- Rat Model of Parkinson DiseaseJesse D. Hoffmeister, Cynthia A. Kelm-Nelson and Michelle R. Ciucci Behavioural Brain Research414 (113514)1 Sep 2021Quantification of brainstem norepinephrine relative to vocal impairment and anxiety in the Pink1-/- rat model of Parkinson diseaseJesse D. Hoffmeister, Cynthia A. Kelm-Nelson and Michelle R. Ciucci Multimedia Tools and Applications26 Jun 2021Speech-based solution to Parkinson’s disease managementBhakti Sonawane and Priyanka Sharma Journal of Speech, Language, and Hearing Research64:6S (2261-2275)18 Jun 2021Speech Intensity Response to Altered Intensity Feedback in Individuals With Parkinson's DiseaseAnita Senthinathan, Scott Adams, Allyson D. Page and Mandar Jog Frontiers in Psychology1214 Jun 2021Speech Rhythm Variation in Early-Stage Parkinson's Disease: A Study on Different Speaking TasksMarta Maffia, Rosa De Micco, Massimo Pettorino, Mattia Siciliano, Alessandro Tessitore and Anna De Meo J. C. Vasquez-Correa, T. Arias-Vergara, P Klumpp, P. A. Perez-Toro, J. R. Orozco-Arroyave and E. Noth (2021) End-2-End Modeling of Speech and Gait from Patients with Parkinson’s Disease: Comparison Between High Quality Vs. Smartphone Data ICASSP 2021 - 2021 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP)10.1109/ICASSP39728.2021.9414729978-1-7281-7605-5 Journal of Speech, Language, and Hearing Research64:6 (1773-1793)4 Jun 2021Variation in Speech Intelligibility Ratings as a Function of Speech Rate Modification in Parkinson's DiseaseThea Knowles, Scott G. Adams and Mandar Jog Journal of Voice1 Jun 2021Conversational Vocal Intensity in Parkinson's Disease: Treatment and Environmental ComparisonsRamya Konnai, Meredith Van Harn and Alice Silbergleit Brain and Behavior11:61 Jun 2021HiCommunication as a novel speech and communication treatment for Parkinson's disease: A feasibility studyEllika Schalling, Helena Winkler and Erika Franzén Frontiers in Human Neuroscience1531 May 2021Voice Analysis to Differentiate the Dopaminergic Response in People With Parkinson's DiseaseAnubhav Jain, Kian Abedinpour, Ozgur Polat, Mine Melodi Çalışkan, Afsaneh Asaei, Franz M. J. Pfister, Urban M. Fietzek and Milos Cernak The Laryngoscope31 May 2021Thyroarytenoid Muscle Gene Expression in a Rat Model of Early‐Onset Parkinson's DiseaseSarah A. Lechner, Heidi Kletzien, Stephen C. Gammie and Cynthia A. Kelm‐Nelson Journal of Speech, Language, and Hearing Research64:5 (1560-1570)11 May 2021Exploring the Acoustic Perceptual Relationship of Speech in Parkinson's DiseaseYi-Fang Chiu, Amy Neel and Travis Loux Annals of Neurology7 May 2021Speech Biomarkers in Rapid Eye Movement Sleep Behavior Disorder and Parkinson DiseaseJan Rusz, Jan Hlavnička, Michal Novotný, Tereza Tykalová, Amelie Pelletier, Jacques Montplaisir, Jean‐Francois Gagnon, Petr Dušek, Andrea Galbiati, Sara Marelli, Paul C. Timm, Luke N. Teigen, Annette Janzen, Mahboubeh Habibi, Ambra Stefani, Evi Holzknecht, Klaus Seppi, Elisa Evangelista, Anna Laura Rassu, Yves Dauvilliers, Birgit Högl, Wolfgang Oertel, Erik K. St. Louis, Luigi Ferini‐Strambi, Evžen Růžička, Ronald B. Postuma and Karel Šonka The Journal of the Acoustical Society of America149:5 (3366-3374)1 May 2021Effect of reading passage length on quantitative acoustic speech assessment in Czech-speaking individuals with Parkinson's disease treated with subthalamic nucleus deep brain stimulationPetr Krýže, Tereza Tykalová, Evžen Růžička and Jan Rusz Biomedical Signal Processing and Control66 (102418)1 Apr 2021Advances in Parkinson's Disease detection and assessment using voice and speech: A review of the articulatory and phonatory aspectsLaureano Moro-Velazquez, Jorge A. Gomez-Garcia, Julian D. Arias-Londoño, Najim Dehak and Juan I. Godino-Llorente Iqra Nissar, Waseem Ahmad Mir, Izharuddin and Tawseef Ayoub Shaikh (2021) Machine Learning Approaches for Detection and Diagnosis of Parkinson’s Disease - A Review 2021 7th International Conference on Advanced Computing and Communication Systems (ICACCS)10.1109/ICACCS51430.2021.9441885978-1-6654-0520-1 Journal of Fluency Disorders (105845)1 Mar 2021Linguistic Features of Dysfluencies in Parkinson DiseaseAngela E. Reif and Alexander M. Goberman Ingo Hertrich, Hermann Ackermann and Wolfram Ziegler (2021) Dysarthria The Handbook of Language and Speech Disorders10.1002/9781119606987.ch161 Mar 2021 Journal of Medical Internet Research19 Feb 2021Detecting Parkinson’s Disease from an Online Speech-task: Observational Study (Preprint)Wasifur Rahman, Sangwu Lee, Md. Saiful Islam, Victor Nikhil Antony, Harshil Ratnu, Mohammad Rafayet Ali, Abdullah Al Mamun, Ellen Wagner, Stella Jensen-Roberts, Emma Waddell, Taylor Myers, Meghan Pawlik, Julia Soto, Madeleine Coffey, Aayush Sarkar, Ruth Schneider, Christopher Tarolli, Karlo Lizarraga, Jamie Adams, Max A. Little, Ray Dorsey and Ehsan Hoque International Journal of Speech-Language Pathology23:1 (70-82)2 Jan 2021Communication and swallowing changes, everyday impacts and access to speech-language pathology services for people with Parkinson's disease: An Australian surveyMegan Swales, Deborah Theodoros, Anne J. Hill and Trevor Russell IEEE/ACM Transactions on Audio, Speech, and Language Processing29 (1925-1936)The Detection of Parkinson's Disease From Speech Using Voice Source InformationN.P. Narendra, Bjorn Schuller and Paavo Alku Golnaz Baghdadi, Farzad Towhidkhah and Mojdeh Rajabi (2021) Neurocognitive diseases and disorders Neurocognitive Mechanisms of Attention10.1016/B978-0-323-90935-8.00001-9 Movement Disorders29 Dec 2021Guidelines for Speech Recording and Acoustic Analyses in Dysarthrias of Movement DisordersJan Rusz, Tereza Tykalova, Lorraine O. Ramig and Elina Tripoliti npj Schizophrenia6:11 Dec 2020Language disturbances in schizophrenia: the relation with antipsychotic medicationJ. N. de Boer, A. E. Voppel, S. G. Brederoo, F. N. K. Wijnen and I. E. C. Sommer npj Parkinson's Disease6:11 Dec 2020Speech-based characterization of dopamine replacement therapy in people with Parkinson’s diseaseR. Norel, C. Agurto, S. Heisig, J. J. Rice, H. Zhang, R. Ostrand, P. W. Wacnik, B. K. Ho, V. L. Ramos and G. A. Cecchi American Journal of Speech-Language Pathology29:4 (2145-2154)12 Nov 2020The Relationship Between Speech Characteristics and Motor Subtypes of Parkinson's DiseaseKatherine A. Brown and Kristie A. Spencer Clinical Linguistics & Phonetics (1-19)28 Oct 2020Effect of linguistic context on the perception of consonants in Parkinsonian Read French speechDanielle Duez, Alain Ghio and François Viallet Perspectives of the ASHA Special Interest Groups5:5 (1290-1296)23 Oct 2020A Community-Based Program for Exercise and Social Participation for Individuals With Parkinson's Disease: A Multidisciplinary ModelGemma Moya-Galé, Amerigo Rossi and Rebecca A. States Journal of Parkinson's Disease (1-10)Dysarthria and Speech Intelligibility Following Parkinson’s Disease Globus Pallidus Internus Deep Brain StimulationShannon Y. Chiu, Takashi Tsuboi, Karen W. Hegland, Nicole E. Herndon, Aparna Wagle Shukla, Addie Patterson, Leonardo Almeida, Kelly D. Foote, Michael S. Okun and Adolfo Ramirez-Zamora Medical & Biological Engineering & Computing10 Sep 2020Estimation of Parkinson’s disease severity using speech features and extreme gradient boostingHunkar C. Tunc, C. Okan Sakar, Hulya Apaydin, Gorkem Serbes, Aysegul Gunduz, Melih Tutuncu and Fikret Gurgen Clinical Neurophysiology131:9 (2140-2147)1 Sep 2020Deficits in monitoring self-produced speech in Parkinson’s diseaseHenry Railo, Niklas Nokelainen, Saara Savolainen and Valtteri Kaasinen Revista Neurociências28 (1-9)19 Aug 2020Dificuldade na fala como preditora do declínio cognitivo na Doença de ParkinsonClarissa Evelyn Bandeira Paulino, Hilton Justino Da Silva and Zulina Souza de Lira Journal of Speech, Language, and Hearing Research63:8 (2695-2712)10 Aug 2020A Comparison of Speech Amplification and Personal Communication Devices for HypophoniaThea Knowles, Scott G. Adams, Allyson Page, Daryn Cushnie-Sparrow and Mandar Jog Medical Hypotheses141 (109722)1 Aug 2020Association analysis of Parkinson disease with vocal change characteristics using multi-objective metaheuristic optimizationElif Varol Altay and Bilal Alatas Journal of Speech, Language, and Hearing Research63:7 (2084-2098)20 Jul 2020Detection of Articulatory Deficits in Parkinson's Disease: Can Systematic Manipulations of Phonetic Complexity Help?Mili Kuruvilla-Dugdale, Mary Salazar, Anqing Zhang and Antje S. Mefferd EClinicalMedicine24 (100429)1 Jul 2020The effects of intensive speech treatment on intelligibility in Parkinson's disease: A randomised controlled trialErika S. Levy, Gemma Moya-Galé, Young Hwa M. Chang, Katherine Freeman, Karen Forrest, Mitchell F. Brin and Lorraine A. Ramig Computer Speech & Language62 (101055)1 Jul 2020A survey on automatic speech recognition systems for Portuguese language and its variationsThales Aguiar de Lima and Márjory Da Costa-Abreu Communication Sciences & Disorders25:2 (470-479)30 Jun 2020Resting-State Functional Connectivity Mediating for Phonation by the Thalamus in Parkinson’s DiseaseSun Woo Kim and Yeong-Hun Park Clinical Linguistics & Phonetics (1-15)15 Jun 2020Acoustic characteristics in relation to intelligibility reduction in noise for speakers with Parkinson’s diseaseYi-Fang Chiu, Amy Neel and Travis Loux Brain and Behavior11 Jun 2020Parkinson's disease or atypical parkinsonism? The importance of acoustic voice analysis in differential diagnosis of speech disordersRenata Kowalska‐Taczanowska, Andrzej Friedman and Dariusz Koziorowski Biomedical Signal Processing and Control57 (101818)1 Mar 2020Glottal Source Analysis of Voice Deficits in Newly Diagnosed Drug-naïve Patients with Parkinson’s Disease: Correlation Between Acoustic Speech Characteristics and Non-Speech Motor PerformanceMichal Novotný, Petr Dušek, Imen Daly, Evžen Růžička and Jan Rusz Journal of Speech, Language, and Hearing Research63:2 (433-443)26 Feb 2020Predicting Intelligibility Deficits in Parkinson's Disease With Perceptual Speech RatingsYi-Fang Chiu and Amy Neel TecnoLógicas23:47 (93-108)30 Jan 2020Cepstral Analysis and Hilbert-Huang Transform for Automatic Detection of Parkinson’s DiseaseFelipe O. López-Pabón, Tomas Arias-Vergara and Juan R. Orozco-Arroyave Rehabilitation Research and Practice2020 (1-7)24 Jan 2020Effectiveness of Lee Silverman Voice Treatment® LOUD on Japanese-Speaking Patients with Parkinson’s DiseaseKeigo Nakayama, Toshiyuki Yamamoto, Chihiro Oda, Masako Sato, Takeshi Murakami and Satoshi Horiguchi Neural Computing and Applications19 Jan 2020Machine learning ensemble for neurological disordersHarkawalpreet Kaur, Avleen Kaur Malhi and Husanbir Singh Pannu Brain & Neurorehabilitation13KSNR Clinical Consensus Statements: Rehabilitation of Patients with Parkinson's DiseaseDoo Young Kim, Hyun Mi Oh, Soo-Kyung Bok, Won Hyuk Chang, Yongmin Choi, Min Ho Chun, Soo Jeong Han, Tai-Ryoon Han, Sungju Jee, Se Hee Jung, Han Young Jung, Tae-Du Jung, Min Wook Kim, Eun Joo Kim, Hyoung Seop Kim, Yun-Hee Kim, Yongwook Kim, Deog Young Kim, Dae Yul Kim, Don-Kyu Kim, Sung-Hwa Ko, Myoung-Hwan Ko, Ju Kang Lee, Jongmin Lee, Seong Jae Lee, Sam-Gyu Lee, Seong Hoon Lim, Byung-Mo Oh, Nam-Jong Paik, Ki Deok Park, Si-Woon Park, Geun-Young Park, Joo Hyun Park, Yoon Ghil Park, Sung-Bom Pyun, Byungju Ryu, Han Gil Seo, Yong-Il Shin, Min Kyun Sohn, Seung Nam Yang, Seung Don Yoo and Woo-Kyoung Yoo IEEE Access8 (177995-178021)Silent Speech Interfaces for Speech Restoration: A ReviewJose A. Gonzalez-Lopez, Alejandro Gomez-Alanis, Juan M. Martin Donas, Jose L. Perez-Cordoba and Angel M. Gomez Telemedicine and e-Health26:1 (64-68)1 Jan 2020The Feasibility of Group Therapeutic Singing Telehealth for Persons with Parkinson's Disease in Rural IowaElizabeth L. Stegemöller, Kasandra Diaz, Judith Craig and David Brown SHS Web of Conferences78 (09006)Etude acoustique de la production de glides dans la maladie de ParkinsonVirginie Roland, Véronique Delvaux, Kathy Huet, Myriam Piccaluga, Bernard Harmegnies, F. Neveu, B. Harmegnies, L. Hriba, S. Prévost and A. Steuckardt Journal of Clinical Neuroscience1 Jan 2020Voice changes in Parkinson’s disease: What are they telling us?Andrew Ma, Kenneth K Lau and Dominic Thyagarajan Nikita Goel, Ashish Khanna, Deepak Gupta and Naman Gupta (2020) Detection of Parkinson’s Disease Using Machine Learning Techniques for Voice and Handwriting Features International Conference on Innovative Computing and Communications10.1007/978-981-15-1286-5_56 Antoinette am Zehnhoff-Dinnesen, Sevtap Akbulut, Eugenia Chávez Calderón, Muhittin Demir, Dirk Deuster, Michael Fuchs, Ahmed Geneid, Thomas Murry, Tadeus Nawka, Christiane Neuschaefer-Rube, Ewa Niebudek-Bogusz, Andrzej Obrębowski, Haldun Oguz, Arno Olthoff, Anders Overgård Jønsson, Mette Pedersen, Bernhard Richter, John Rubin, Berit Schneider-Stickler, Kevin Shields, Mariola Śliwińska-Kowalska, Bożena Wiskirska-Woźnica, Virginie Woisard and Waldemar Wojnowski (2020) Special Kinds and Clinical Manifestation of Voice Disorders Phoniatrics I10.1007/978-3-662-46780-0_5 J. I. Godino-Llorente, L. Moro-Velázquez, J. A. Gómez-García, Jeung-Yoon Choi, N. Dehak and S. Shattuck-Hufnagel (2020) Approaches to Evaluate Parkinsonian Speech Using Artificial Models Automatic Assessment of Parkinsonian Speech10.1007/978-3-030-65654-6_5 Laureano Moro-Velazquez and Najim Dehak (2020) A Review of the Use of Prosodic Aspects of Speech for the Automatic Detection and Assessment of Parkinson’s Disease Automatic Assessment of Parkinsonian Speech10.1007/978-3-030-65654-6_3 Jason A. Whitfield (2020) Sources of Intraspeaker Variation in Parkinsonian Speech Related to Speaking Style Automatic Assessment of Parkinsonian Speech10.1007/978-3-030-65654-6_2 Emerald J. Doll and Brienne Ruel (2020) Voice Therapy Neurologic and Neurodegenerative Diseases of the Larynx10.1007/978-3-030-28852-5_32 Communication Sciences & Disorders24:4 (1066-1076)31 Dec 2020Characteristics of Vocal Loudness and Auditory Evoked Response in Patients with Parkinson’s DiseaseChul-Hee Choi, Chae Rim Park and Seong Hee Choi Scientific Reports9:11 Dec 2019Phonetic relevance and phonemic grouping of speech in the automatic detection of Parkinson’s DiseaseLaureano Moro-Velazquez, Jorge A. Gomez-Garcia, Juan I. Godino-Llorente, Francisco Grandas-Perez, Stefanie Shattuck-Hufnagel, Virginia Yagüe-Jimenez and Najim Dehak Neurology93:22 (e2042-e2052)26 Nov 2019Motor speech patterns in Huntington diseaseSarah K. Diehl, Antje S. Mefferd, Ya-Chen Lin, Jessie Sellers, Katherine E. McDonell, Michael de Riesthal and Daniel O. Claassen International Journal of Speech-Language Pathology21:6 (572-583)2 Nov 2019Communication service provision and access for people with Parkinson’s disease in Australia: A national survey of speech-language pathologistsMegan Swales, Deborah Theodoros, Anne J. Hill and Trevor Russell Perspectives of the ASHA Special Interest Groups4:5 (825-841)31 Oct 2019Research-Based Updates in Swallowing and Communication Dysfunction in Parkinson Disease: Implications for Evaluation and ManagementC. K. Broadfoot, D. Abur, J. D. Hoffmeister, C. E. Stepp and M. R. Ciucci Journal of Telemedicine and Telecare (1357633X1987091)20 Aug 2019Voice therapy for Parkinson’s disease via smartphone videoconference in Malaysia: A preliminary studyMin Yen Chan, Shin Ying Chu, Kartini Ahmad and Norlinah Mohamed Ibrahim International Journal of Speech-Language Pathology (1-12)15 Aug 2019Speech-language pathologists’ perceptions of the use of telepractice in the delivery of services to people with Parkinson’s disease: A national pilot surveyMegan Swales, Deborah Theodoros, Anne J. Hill and Trevor Russell American Journal of Speech-Language Pathology28:3 (1222-1232)9 Aug 2019Visual Analog Scale Ratings and Orthographic Transcription Measures of Sentence Intelligibility in Parkinson's Disease With Variable Listener ExposureDefne Abur, Nicole M. Enos and Cara E. Stepp Hanbin Zhang, Chen Song, Aosen Wang, Chenhan Xu, Dongmei Li and Wenyao Xu (2019) PDVocal MobiCom '19: The 25th Annual International Conference on Mobile Computing and Networking10.1145/3300061.330012597814503616995 Aug 2019 PLOS ONE14:8 (e0220734)2 Aug 2019Intervention changes acoustic peak frequency and mesolimbic neurochemistry in the Pink1-/- rat model of Parkinson diseaseSharon A. Stevenson, Michelle R. Ciucci, Cynthia A. Kelm-Nelson and Sheila M. Fleming Journal of Speech, Language, and Hearing Research62:7 (2118-2132)15 Jul 2019Tongue- and Jaw-Specific Articulatory Underpinnings of Reduced and Enhanced Acoustic Vowel Contrast in Talkers With Parkinson's DiseaseAntje S. Mefferd and Mary S. DietrichAmerican Journal of Speech-Language Pathology28:2S (793-806)15 Jul 2019Effect of Clear Speech on the Duration of Silent Intervals at Syntactic and Phonemic Boundaries in the Speech of Individuals With Parkinson DiseaseAnna C. Gravelin and Jason A. Whitfield International Journal of Speech-Language Pathology21:4 (385-394)4 Jul 2019Delivering group speech maintenance therapy via telerehabilitation to people with Parkinson’s disease: A pilot studyRachel Quinn, Stacie Park, Deborah Theodoros and Anne J Hill R. Viswanathan, A. Bingham, S. Raghav, Sridhar P. Arjunan, B. Jelfs, P. Kempster and Dinesh K. Kumar (2019) Normalized Mutual Information of phonetic sound to distinguish the speech of Parkinson’s disease 2019 41st Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC)10.1109/EMBC.2019.8857112978-1-5386-1311-5 Marek Wodzinski, Andrzej Skalski, Daria Hemmerling, Juan Rafael Orozco-Arroyave and Elmar Noth (2019) Deep Learning Approach to Parkinson’s Disease Detection Using Voice Recordings and Convolutional Neural Network Dedicated to Image Classification 2019 41st Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC)10.1109/EMBC.2019.8856972978-1-5386-1311-5 Parkinsonism & Related Disorders64 (256-261)1 Jul 2019Speech difficulties in early de novo patients with Parkinson's diseaseSotirios Polychronis, Flavia Niccolini, Gennaro Pagano, Tayyabah Yousaf and Marios Politis Journal of Voice1 Jul 2019Regulation of Transglottal Airflow in Speakers With Parkinson's DiseaseLaura Panzone and Christopher R. Watts Journal of Voice33:4 (580.e11-580.e19)1 Jul 2019The Effect of Parkinson Disease Tremor Phenotype on Cepstral Peak Prominence and Transglottal Airflow in Vowels and SpeechBrittany R. Burk and Christopher R. Watts Journal of Voice33:4 (526-535)1 Jul 2019Voice Tremor in Parkinson's Disease: An Acoustic StudyPatricia Gillivan-Murphy, Nick Miller and Paul Carding Journal of Clinical Neuroscience64 (111-115)1 Jun 2019Analysis of the prevalence and onset of dysphonia and dysphagia symptoms in movement disorders at an academic medical centerMary E. Finger, Lyndsay L. Madden, Ihtsham U. Haq, Christopher J. McLouth and Mustafa S. Siddiqui The Journal of the Acoustical Society of America145:5 (2871-2884)1 May 2019Developing a large scale population screening tool for the assessment of Parkinson's disease using telephone-quality voiceSiddharth Arora, Ladan Baghai-Ravary and Athanasios Tsanas Jhon F. Moofarry, Milton Sarria-Paja and J.R. Orozco-Arroyave (2019) Parkinson’s disease detection using modulation components in speech signals 2019 XXII Symposium on Image, Signal Processing and Artificial Vision (STSIVA)10.1109/STSIVA.2019.8730245978-1-7281-1491-0 Zayrit Soumaya, Belhoussine Drissi Taoufiq, Benayad Nsiri and Ammoumou Abdelkrim (2019) Diagnosis of Parkinson disease using the wavelet transform and MFCC and SVM classifier 2019 4th World Conference on Complex Systems (WCCS)10.1109/ICoCS.2019.8930802978-1-7281-1232-9 International Journal of Language & Communication Disorders54:2 (170-188)1 Mar 2019Technology-enabled management of communication and swallowing disorders in Parkinson's disease: a systematic scoping reviewDeborah Theodoros, Danielle Aldridge, Anne J. Hill and Trevor Russell Journal of Communication Disorders78 (18-32)1 Mar 2019Characterizing the distribution of silent intervals in the connected speech of individuals with Parkinson diseaseJason A. Whitfield and Anna C. Gravelin Biomedical Signal Processing and Control48 (205-220)1 Feb 2019A forced gaussians based methodology for the differential evaluation of Parkinson's Disease by means of speech processingLaureano Moro-Velazquez, Jorge Andres Gomez-Garcia, Juan Ignacio Godino-Llorente, Jesús Villalba, Jan Rusz, Stephanie Shattuck-Hufnagel and Najim Dehak Movement Disorders Clinical Practice6:2 (150-154)1 Feb 2019Effect of Levodopa on Speech Dysfluency in Parkinson's DiseaseHannah Im, Scott Adams, Anita Abeyesekera, Marcus Pieterman, Greydon Gilmore and Mandar Jog The Japan Journal of Logopedics and Phoniatrics60:4 (286-294)Assessment of Dysarthriadysarthriaの評価Hidetaka Shiina and Makoto Kariyasu Folia Phoniatrica et Logopaedica71:5-6 (275-285)Spectral/Cepstral Analyses of Phonation in Parkinson’s Disease before and after Voice Treatment: A Preliminary StudyGhadah G. Alharbi, Michael P. Cannito, Eugene H. Buder and Shaheen N. Awan Topics in Language Disorders39:1 (71-88)Third-Party Disability in Family Members of People With Communication Disorders Associated With Parkinsonʼs DiseaseHelen Mach, Carolyn Baylor, Rebecca Hunting Pompon and Kathryn Yorkston D. Karunanithi and Paul Rodrigues (2019) A Fuzzy Rule-Based Diagnosis of Parkinson’s Disease Proceedings of the Int

Endoscopic cordectomy. a proposal for a classification by the Working Committee, European Laryngological Society

2000-01-01
Marc Remacle , Hans Edmund Eckel , Antonio Antonelli +7 more

Consensus Auditory-Perceptual Evaluation of Voice: Development of a Standardized Clinical Protocol

2009-05-01
Gail B. Kempster , Bruce R. Gerratt , Katherine Verdolini Abbott +2 more
Purpose This article presents the development of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) following a consensus conference on perceptual voice quality measurement sponsored by the American Speech-Language-Hearing Association’s Special … Purpose This article presents the development of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) following a consensus conference on perceptual voice quality measurement sponsored by the American Speech-Language-Hearing Association’s Special Interest Division 3, Voice and Voice Disorders. The CAPE-V protocol and recording form were designed to promote a standardized approach to evaluating and documenting auditory-perceptual judgments of vocal quality. Method A summary of the consensus conference proceedings and the factors considered by the authors in developing this instrument are included. Conclusion The CAPE-V form and instructions, included as appendices to this article, enable clinicians to document perceived voice quality deviations following a standard (i.e., consistent and specified) protocol.

The Dysphonia Severity Index

2000-06-01
Floris L. Wuyts , Marc De Bodt , Geert Molenberghs +6 more
The vocal quality of a patient is modeled by means of a Dysphonia Severity Index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal … The vocal quality of a patient is modeled by means of a Dysphonia Severity Index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following selected set of voice measurements: highest frequency (F(0)-High in Hz), lowest intensity (I-Low in dB), maximum phonation time (MPT in s), and jitter (%). The DSI is derived from a multivariate analysis of 387 subjects with the goal of describing, purely based on objective measures, the perceived voice quality. It is constructed as DSI = 0.13 x MPT + 0.0053 x F(0)-High - 0.26 x I-Low - 1.18 x Jitter (%) + 12.4. The DSI for perceptually normal voices equals +5 and for severely dysphonic voices -5. The more negative the patient's index, the worse is his or her vocal quality. As such, the DSI is especially useful to evaluate therapeutic evolution of dysphonic patients. Additionally, there is a high correlation between the DSI and the Voice Handicap Index score.

Glottal airflow and transglottal air pressure measurements for male and female speakers in soft, normal, and loud voice

1988-08-01
Eva B. Holmberg , Robert E. Hillman , Joseph S. Perkell
Measurements on the inverse filtered airflow waveform (the "glottal waveform") and of estimated average transglottal pressure and glottal airflow were made from noninvasive recordings of productions of syllable sequences in … Measurements on the inverse filtered airflow waveform (the "glottal waveform") and of estimated average transglottal pressure and glottal airflow were made from noninvasive recordings of productions of syllable sequences in soft, normal, and loud voice for 25 male and 20 female speakers. Statistical analyses showed that with change from normal to loud voice, both males and females produced loud voice with increased pressure, accompanied by increased ac flow and increased maximum airflow declination rate. With change from normal voice, soft voice was produced with decreased pressure, ac flow and maximum airflow declination rate, and increased dc and average flow. Within the loudness conditions, there was no significant male-female difference in air pressure. Several glottal waveform parameters separated males and females in normal and loud voice. The data indicate higher ac flow and higher maximum airflow declination rate for males. In soft voice, the male and female glottal waveforms were more alike, and there was no significant difference in maximum airflow declination rate. The dc flow did not differ significantly between males and females. Possible relevance to biomechanical differences and differences in voice source characteristics between males and females and across loudness conditions is discussed.

Perceptual Evaluation of Voice Quality

1993-02-01
Jody Kreiman , Bruce R. Gerratt , Gail B. Kempster +2 more
The reliability of listeners’ ratings of voice quality is a central issue in voice research because of the clinical primacy of such ratings and because they are the standard against … The reliability of listeners’ ratings of voice quality is a central issue in voice research because of the clinical primacy of such ratings and because they are the standard against which other measures are evaluated. However, an extensive literature review indicates that both intrarater and interrater reliability fluctuate greatly from study to study. Further, our own data indicate that ratings of vocal roughness vary widely across individual clinicians, with a single voice often receiving nearly the full range of possible ratings. No model or theoretical framework currently exists to explain these variations, although such a model might guide development of efficient, valid, and standardized clinical protocols for voice evaluation. We propose a theoretical framework that attributes variability in ratings to several sources (including listeners’ backgrounds and biases, the task used to gather ratings, interactions between listeners and tasks, and random error). This framework may guide development of new clinical voice and speech evaluation protocols, ultimately leading to more reliable perceptual ratings and a better understanding of the perceptual qualities of pathological voices.

Vocal Fold Physiology: Contemporary Research and Clinical Issues,

1984-09-01
Chikako Sasaki
This publication represents a collection of theoretical and experimental papers presented at the 1981 Vocal Fold Physiology Conference conducted in Madison, Wis. This is the second such international conference, the … This publication represents a collection of theoretical and experimental papers presented at the 1981 Vocal Fold Physiology Conference conducted in Madison, Wis. This is the second such international conference, the first being held in 1980 at Kurume (Japan) University. The present conference represented a collaborative effort among participants selected from varied backgrounds, eg, linguistics, neurophysiology, engineering, for the purpose of disseminating recent data and stimulating new concepts for research on voice production. The book is divided into eight sections. Section 1 discusses the morphology of the laryngeal system. In Section 2, neural mechanisms of laryngeal motor control are presented. Section 3 is concerned with aerodynamics, while section 4 develops the relationship of glottal waveform to underlying physiological parameters. Section 5 covers techniques for observations of the larynx, including high-speed motion pictures, stereoendoscopy, and electroglottography. Sections 6 and 7 cover pitch-changing mechanisms and discuss the puzzle of the singer's formant. The

Acoustic Correlates of Breathy Vocal Quality

1994-08-01
James Hillenbrand , Ronald Allen Cleveland , Robert Erickson
The purpose of this study was to evaluate the effectiveness of several acoustic measures in predicting breathiness ratings. Recordings were made of eight normal men and seven normal women producing … The purpose of this study was to evaluate the effectiveness of several acoustic measures in predicting breathiness ratings. Recordings were made of eight normal men and seven normal women producing normally phonated, moderately breathy, and very breathy sustained vowels. Twenty listeners rated the degree of breathiness using a direct magnitude estimation procedure. Acoustic measures were made of: (a) signal periodicity, (b) first harmonic amplitude, and (c) spectral tilt. Periodicity measures provided the most accurate predictions of perceived breathiness, accounting for approximately 80% of the variance in breathiness ratings. The relative amplitude of the first harmonic correlated moderately with breathiness ratings, and two measures of spectral tilt correlated weakly with perceived breathiness.
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Frenchay Dysarthria Assessment

1980-01-01
Pam Enderby
This paper describes the necessity for, and the development of an assessment for dysarthria. The short easy assessment described has been found to have acceptable inter-rater reliability, even between Speech … This paper describes the necessity for, and the development of an assessment for dysarthria. The short easy assessment described has been found to have acceptable inter-rater reliability, even between Speech Therapists who have not been trained to use the test. The clinical value of the test has been proven with its use with more than a hundred patients. However, there are several areas that point to the necessity of further research.

Quantitative acoustic measurements for characterization of speech and voice disorders in early untreated Parkinson’s disease

2011-01-01
Jan Rusz , Roman Čmejla , Hana Růžičková +1 more
An assessment of vocal impairment is presented for separating healthy people from persons with early untreated Parkinson’s disease (PD). This study’s main purpose was to (a) determine whether voice and … An assessment of vocal impairment is presented for separating healthy people from persons with early untreated Parkinson’s disease (PD). This study’s main purpose was to (a) determine whether voice and speech disorder are present from early stages of PD before starting dopaminergic pharmacotherapy, (b) ascertain the specific characteristics of the PD-related vocal impairment, (c) identify PD-related acoustic signatures for the major part of traditional clinically used measurement methods with respect to their automatic assessment, and (d) design new automatic measurement methods of articulation. The varied speech data were collected from 46 Czech native speakers, 23 with PD. Subsequently, 19 representative measurements were pre-selected, and Wald sequential analysis was then applied to assess the efficiency of each measure and the extent of vocal impairment of each subject. It was found that measurement of the fundamental frequency variations applied to two selected tasks was the best method for separating healthy from PD subjects. On the basis of objective acoustic measures, statistical decision-making theory, and validation from practicing speech therapists, it has been demonstrated that 78% of early untreated PD subjects indicate some form of vocal impairment. The speech defects thus uncovered differ individually in various characteristics including phonation, articulation, and prosody.

Prevalence of Voice Disorders in Teachers and the General Population

2004-04-01
Nelson Roy , Ray M. Merrill , Susan L. Thibeault +3 more
Over 3 million teachers in the United States use their voice as a primary tool of trade and are thought to be at higher risk for occupation-related voice disorders than … Over 3 million teachers in the United States use their voice as a primary tool of trade and are thought to be at higher risk for occupation-related voice disorders than the general population. However, estimates regarding the prevalence of voice disorders in teachers and the general population vary considerably. To determine the extent that teachers are at greater risk for voice disorders, 2,531 randomly selected participants from Iowa and Utah (1,243 teachers and 1,288 nonteachers) were interviewed by telephone using a voice disorder questionnaire. Prevalence-the number of cases per population at risk at a specific time-was determined. The prevalence of reporting a current voice problem was significantly greater in teachers compared with nonteachers (11.0% vs. 6.2%), chi(2)(1) = 18.2, p <.001, as was the prevalence of voice disorders during their lifetime (57.7% for teachers vs. 28.8% for nonteachers), chi(2)(1) = 215.2, p <.001. Teachers were also significantly more likely than nonteachers to have consulted a physician or speech-language pathologist regarding a voice disorder (14.3% vs. 5.5%), chi(2)(1) = 55.3, p <.001. Women, compared with men, not only had a higher lifetime prevalence of voice disorders (46.3% vs. 36.9%), chi(2)(1) = 20.9, p <.001, but also had a higher prevalence of chronic voice disorders (>4 weeks in duration), compared with acute voice disorders (20.9% vs. 13.3%), chi(2)(1) = 8.7, p =.003. To assess the association between past voice disorders and possible risks, adjusted odds ratios (ORs) were estimated using multiple logistic regression. The results identified that being a teacher, being a woman, being between 40 and 59 years of age, having 16 or more years of education, and having a family history of voice disorders were each positively associated with having experienced a voice disorder in the past. These results support the notion that teaching is a high-risk occupation for voice disorders. Important information is also provided regarding additional factors that might contribute to the development of voice disorders.

Validation of an instrument to measure voice-related quality of life (V-RQOL)

1999-12-01
Norman D. Hogikyan , Girish Sethuraman

Development and Validation of the Voice Handicap Index‐10

2004-08-26
Clark A. Rosen , Annie S. Lee , Jamie Osborne +2 more
The objective was to develop an abbreviated voice handicap assessment instrument and compare it with the Voice Handicap Index (VHI).Item analysis of the VHI in individuals without voice disorders and … The objective was to develop an abbreviated voice handicap assessment instrument and compare it with the Voice Handicap Index (VHI).Item analysis of the VHI in individuals without voice disorders and patients with voice disorders and creation and validation of the abbreviated VHI.Clinical consensus review of the VHI items was held to prioritize the clinical value of each of the VHI items (30 items in all). Item analysis of the VHI was performed using the VHI responses of 100 patients with voice problems and 159 control subjects. The 10 most robust VHI items were selected using the item analysis and clinical consensus results to form the Voice Handicap Index-10 (VHI-10). Statistical analysis comparing the validity of the VHI-10 with the VHI was performed with 819 patients representing a wide spectrum of voice disorders.Statistical analysis of the VHI and VHI-10 scores from the study group showed no statistically significant differences between the VHI and the VHI-10. Irrespective of diagnosis, the correlation between the VHI and the VHI-10 was greater than .90 (P = .01). The ratios of the VHI-10 to VHI scores for a variety of voice disorder categories were analyzed and found to be consistently greater than the expected value (33%). This suggests that the VHI-10 may be a more robust instrument than the VHI.The VHI-10 is a powerful representation of the VHI that takes less time for the patient to complete without loss of validity. Thus, the VHI-10 can replace the VHI as an instrument to quantify patients' perception of their voice handicap.

Collection and Analysis of a Parkinson Speech Dataset With Multiple Types of Sound Recordings

2013-02-06
Betül Erdoğdu Şakar , M. Erdem Isenkul , C. Okan Sakar +5 more
There has been an increased interest in speech pattern analysis applications of Parkinsonism for building predictive telediagnosis and telemonitoring models. For this purpose, we have collected a wide variety of … There has been an increased interest in speech pattern analysis applications of Parkinsonism for building predictive telediagnosis and telemonitoring models. For this purpose, we have collected a wide variety of voice samples, including sustained vowels, words, and sentences compiled from a set of speaking exercises for people with Parkinson's disease. There are two main issues in learning from such a dataset that consists of multiple speech recordings per subject: 1) How predictive these various types, e.g., sustained vowels versus words, of voice samples are in Parkinson's disease (PD) diagnosis? 2) How well the central tendency and dispersion metrics serve as representatives of all sample recordings of a subject? In this paper, investigating our Parkinson dataset using well-known machine learning tools, as reported in the literature, sustained vowels are found to carry more PD-discriminative information. We have also found that rather than using each voice recording of each subject as an independent data sample, representing the samples of a subject with central tendency and dispersion metrics improves generalization of the predictive model.

Physiologic and acoustic differences between male and female voices

1989-04-01
Ingo R. Titze
Comparison is drawn between male and female larynges on the basis of overall size, vocal fold membranous length, elastic properties of tissue, and prephonatory glottal shape. Two scale factors are … Comparison is drawn between male and female larynges on the basis of overall size, vocal fold membranous length, elastic properties of tissue, and prephonatory glottal shape. Two scale factors are proposed that are useful for explaining differences in fundamental frequency, sound power, mean airflow, and glottal efficiency. Fundamental frequency is scaled primarily according to the membranous length of the vocal folds (scale factor of 1.6), whereas mean airflow, sound power, glottal efficiency, and amplitude of vibration include another scale factor (1.2) that relates to overall larynx size. Some explanations are given for observed sex differences in glottographic waveforms. In particular, the simulated (computer-modeled) vocal fold contact area is used to infer male–female differences in the shape of the glottis. The female glottis appears to converge more linearly (from bottom to top) than the male glottis, primarily because of medial surface bulging of the male vocal folds.
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Voice Disorders in Teachers and the General Population

2004-06-01
Nelson Roy , Ray M. Merrill , Susan L. Thibeault +2 more
To examine the frequency and adverse effects of voice disorders on job performance and attendance in teachers and the general population, 2,401 participants from Iowa and Utah ( n 1 … To examine the frequency and adverse effects of voice disorders on job performance and attendance in teachers and the general population, 2,401 participants from Iowa and Utah ( n 1 =1,243 teachers and n 2 =1,279 nonteachers) were randomly selected and were interviewed by telephone using a voice disorder questionnaire. Teachers were significantly more likely than nonteachers to have experienced multiple voice symptoms and signs including hoarseness, discomfort, and increased effort while using their voice, tiring or experiencing a change in voice quality after short use, difficulty projecting their voice, trouble speaking or singing softly, and a loss of their singing range (all odds ratios [ORs] p &lt;.05). Furthermore, teachers consistently attributed these voice symptoms to their occupation and were significantly more likely to indicate that their voice limited their ability to perform certain tasks at work, and had reduced activities or interactions as a result. Teachers, as compared with nonteachers, had missed more workdays over the preceding year because of voice problems and were more likely to consider changing occupations because of their voice (all comparisons p &lt;.05). These findings strongly suggest that occupationally related voice dysfunction in teachers can have significant adverse effects on job performance, attendance, and future career choices.

Populations in the U.S. workforce who rely on voice as a primary tool of trade: a preliminary report

1997-09-01
Ingo R. Titze , Julie Lemke , Doug Montequin
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Vocal quality factors: Analysis, synthesis, and perception

1991-11-01
D. G. Childers , C. K. Lee
The purpose of this study was to examine several factors of vocal quality that might be affected by changes in vocal fold vibratory patterns. Four voice types were examined: modal, … The purpose of this study was to examine several factors of vocal quality that might be affected by changes in vocal fold vibratory patterns. Four voice types were examined: modal, vocal fry, falsetto, and breathy. Three categories of analysis techniques were developed to extract source-related features from speech and electroglottographic (EGG) signals. Four factors were found to be important for characterizing the glottal excitations for the four voice types: the glottal pulse width, the glottal pulse skewness, the abruptness of glottal closure, and the turbulent noise component. The significance of these factors for voice synthesis was studied and a new voice source model that accounted for certain physiological aspects of vocal fold motion was developed and tested using speech synthesis. Perceptual listening tests were conducted to evaluate the auditory effects of the source model parameters upon synthesized speech. The effects of the spectral slope of the source excitation, the shape of the glottal excitation pulse, and the characteristics of the turbulent noise source were considered. Applications for these research results include synthesis of natural sounding speech, synthesis and modeling of vocal disorders, and the development of speaker independent (or adaptive) speech recognition systems.

Differential Diagnostic Patterns of Dysarthria

1969-06-01
Frederic L. Darley , Arnold Aronson , Joe R. Brown
Thirty-second speech samples were studied of at least 30 patients in each of 7 discrete neurologic groups, each patient unequivocally diagnosed as being a representative of his diagnostic group. Three … Thirty-second speech samples were studied of at least 30 patients in each of 7 discrete neurologic groups, each patient unequivocally diagnosed as being a representative of his diagnostic group. Three judges independently rated each of these samples on each of 38 dimensions of speech and voice using a 7-point scale of severity. Computer analysis based on the means of the three ratings on each patient on each dimension yielded results leading to these conclusions: (1) Speech indeed follows neuroanatomy and neurophysiology. There are multiple types or patterns of dysarthria, each mirroring a different kind of abnormality of motor functioning. (2) These patterns of dysarthria can be differentiated; they sound different. They consist of definitive groupings of certain dimensions of speech and voice, deviant to distinctive degrees. (3) Five types of dysarthria were delineated: flaccid dysarthria (in bulbar palsy), spastic dysarthria (in pseudobulbar palsy), ataxic dysarthria (in cerebellar disorders), hypokinetic dysarthria (in parkinsonism), and hyperkinetic dysarthria (in dystonia and chorea). Also, a mixed dysarthria combining elements of flaccid and spastic dysarthrias was identified in amyotrophic lateral sclerosis. (4) Observed occurrence of a single dimension uniquely in a given neurologic disease and distinctive co-occurrence of several dimensions can aid diagnostically in identification of neurologic disorders.

Clusters of Deviant Speech Dimensions in the Dysarthrias

1969-09-01
Frederic L. Darley , Arnold Aronson , Joe R. Brown
Correlation matrices were used to demonstrate co-occurrence of deviant speech dimensions observed. Application of this technique led to the emergence of eight distinctive clusters of dysfunction. Each of seven neurologic … Correlation matrices were used to demonstrate co-occurrence of deviant speech dimensions observed. Application of this technique led to the emergence of eight distinctive clusters of dysfunction. Each of seven neurologic disorders studied had its own unique group or pattern of clusters. However, any one cluster emerged in and was shared by more than one disorder. Inspection of the dimensions present in a cluster permitted giving the cluster a logically determined name based usually on the defective physiology responsible for the cluster. Knowledge of the neuromuscular characteristics of each disorder led to deductions concerning the neuromuscular substrate for each cluster. Intercluster correlations yielded clues concerning co-occurrence of certain neuromuscular defects. Further inspection led to identification of the probable neuromuscular bases of individual deviant speech dimensions. These conclusions may serve as hypotheses for more accurate physiologic and neurophysiologic measurements to further delineate the problems of dysarthria.

Novel Speech Signal Processing Algorithms for High-Accuracy Classification of Parkinson's Disease

2012-01-09
Athanasios Tsanas , Max A. Little , Patrick McSharry +2 more
There has been much recent research into the connection between Parkinson's disease (PD) and speech impairment.Recently, a wide range of speech signal processing algorithms (dysphonia measures) aiming to predict PD … There has been much recent research into the connection between Parkinson's disease (PD) and speech impairment.Recently, a wide range of speech signal processing algorithms (dysphonia measures) aiming to predict PD symptom severity using speech signals was introduced.In this paper, we test how accurately these novel algorithms can be used to discriminate PD subjects from healthy controls.In total, we compute 132 dysphonia measures from sustained vowels.Then, we select four parsimonious subsets of these dysphonia measures using four feature selection algorithms, and map these feature subsets to a binary classification response using two statistical classifiers: random forests and support vector machines.We use an existing database consisting of 263 samples from 43 subjects, and demonstrate that these new dysphonia measures can outperform state of the art results, reaching almost 99% overall classification accuracy using only 10 dysphonia features.We find that some of the recently proposed dysphonia measures
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Voice Training and Therapy With a Semi-Occluded Vocal Tract: Rationale and Scientific Underpinnings

2006-04-01
Ingo R. Titze
Purpose Voice therapy with a semi-occluded vocal tract has a long history. The use of lip trills, tongue trills, bilabial fricatives, humming, and phonation into tubes or straws has been … Purpose Voice therapy with a semi-occluded vocal tract has a long history. The use of lip trills, tongue trills, bilabial fricatives, humming, and phonation into tubes or straws has been hailed by clinicians, singing teachers, and voice coaches as efficacious for training and rehabilitation. Little has been done, however, to provide the scientific underpinnings. The purpose of the study was to investigate the underlying physical principles behind the training and therapy approaches that use semi-occluded vocal tract shapes. Method Computer simulation, with a self-oscillating vocal fold model and a 44 section vocal tract, was used to elucidate source–filter interactions for lip and epilarynx tube semi-occlusions. Results A semi-occlusion in the front of the vocal tract (at the lips) heightens source–tract interaction by raising the mean supraglottal and intraglottal pressures. Impedance matching by vocal fold adduction and epilarynx tube narrowing can then make the voice more efficient and more economic (in terms of tissue collision). Conclusion The efficacious effects of a lip semi-occlusion can also be realized for nonoccluded vocal tracts by a combination of vocal fold adduction and epilarynx tube adjustments. It is reasoned that therapy approaches are designed to match the glottal impedance to the input impedance of the vocal tract.

Suitability of Dysphonia Measurements for Telemonitoring of Parkinson's Disease

2008-09-30
Max A. Little , Patrick McSharry , Eric J. Hunter +2 more
We present an assessment of the practical value of existing traditional and non-standard measures for discriminating healthy people from people with Parkinson's disease (PD) by detecting dysphonia. We introduce a … We present an assessment of the practical value of existing traditional and non-standard measures for discriminating healthy people from people with Parkinson's disease (PD) by detecting dysphonia. We introduce a new measure of dysphonia, Pitch Period Entropy (PPE), which is robust to many uncontrollable confounding effects including noisy acoustic environments and normal, healthy variations in voice frequency. We collected sustained phonations from 31 people, 23 with PD. We then selected 10 highly uncorrelated measures, and an exhaustive search of all possible combinations of these measures finds four that in combination lead to overall correct classification performance of 91.4%, using a kernel support vector machine. In conclusion, we find that non-standard methods in combination with traditional harmonics-to-noise ratios are best able to separate healthy from PD subjects. The selected non-standard methods are robust to many uncontrollable variations in acoustic environment and individual subjects, and are thus well-suited to telemonitoring applications.
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Speech Impairment in a Large Sample of Patients with Parkinson’s Disease

1999-01-01
Aileen K. Ho , Robert Iansek , Caterina Marigliani +2 more
This study classified speech impairment in 200 patients with Parkinson's disease (PD) into five levels of overall severity and described the corresponding type (voice, articulation, fluency) and extent (rated on … This study classified speech impairment in 200 patients with Parkinson's disease (PD) into five levels of overall severity and described the corresponding type (voice, articulation, fluency) and extent (rated on a five-point scale) of impairment for each level. From two-minute conversational speech samples, parameters of voice, fluency and articulation were assessed by two trained-raters. Voice was found to be the leading deficit, most frequently affected and impaired to a greater extent than other features in the initial stages. Articulatory and fluency deficits manifested later, articulatory impairment matching voice impairment in frequency and extent at the 'Severe' stage. At the final stage of 'Profound' impairment, articulation was the most frequently impaired feature at the lowest level of performance. This study illustrates the prominence of voice and articulatory speech motor control deficits, and draws parallels with deficits of motor set and motor set instability in skeletal controls of gait and handwriting.
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The comparative anatomy and physiology of the larynx

1950-05-01
V. E. Negus
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Voice Disorders in the General Population: Prevalence, Risk Factors, and Occupational Impact

2005-11-01
Nelson Roy , Ray M. Merrill , Steven D. Gray +1 more
Epidemiologic studies of the prevalence and risk factors of voice disorders in the general adult population are rare. The purpose of this investigation was to 1) determine the prevalence of … Epidemiologic studies of the prevalence and risk factors of voice disorders in the general adult population are rare. The purpose of this investigation was to 1) determine the prevalence of voice disorders, 2) identify variables associated with increased risk of voice disorders, and 3) establish the functional impact of voice disorders on the general population.Cross-sectional telephone survey.A random sample (n = 1,326) of adults in Iowa and Utah was interviewed using a questionnaire that addressed three areas related to voice disorders: prevalence, potential risk factors, and occupational consequences/effects.The lifetime prevalence of a voice disorder was 29.9%, with 6.6% of participants reporting a current voice disorder. Stepwise logistic regression identified specific factors that uniquely contributed to increased odds of reporting a chronic voice disorder including sex (women), age (40-59 years), voice use patterns and demands, esophageal reflux, chemical exposures, and frequent cold/sinus infections. However, tobacco or alcohol use did not independently increase the odds of reporting of a chronic voice disorder. Voice disorders adversely impacted job performance and attendance, with 4.3% of participants indicating that their voice had limited or rendered them unable to do certain tasks in their current job. Furthermore, 7.2% of employed respondents reported that they were absent from work 1 or more days in the past year because of their voice, and 2% reported more than 4 days of voice-related absence.The results of this large epidemiologic study provide valuable information regarding the prevalence of voice disorders, factors that contribute to voice disorder vulnerability, and the functional impact of voice problems on the general population.

The physics of small-amplitude oscillation of the vocal folds

1988-04-01
Ingo R. Titze
A theory of vocal fold oscillation is developed on the basis of the body-cover hypothesis. The cover is represented by a distributed surface layer that can propagate a mucosal surface … A theory of vocal fold oscillation is developed on the basis of the body-cover hypothesis. The cover is represented by a distributed surface layer that can propagate a mucosal surface wave. Linearization of the surface-wave displacement and velocity, and further small-amplitude approximations, yields closed-form expressions for conditions of oscillation. The theory predicts that the lung pressure required to sustain oscillation, i.e., the oscillation threshold pressure, is reduced by reducing the mucosal wave velocity, by bringing the vocal folds closer together and by reducing the convergence angle in the glottis. The effect of vocal tract acoustic loading is included. It is shown that vocal tract inertance reduces the oscillation threshold pressure, whereas vocal tract resistance increases it. The treatment, which is applicable to falsetto and breathy voice, as well as onset or release of phonation in the absence of vocal fold collision, is harmonized with former treatments based on two-mass models and collapsible tubes.

Clinical Practice Guideline: Hoarseness (Dysphonia)

2009-09-01
Seth Schwartz , Seth M. Cohen , Seth H. Dailey +7 more
Objective: This guideline provides evidence‐based recommendations on managing hoarseness (dysphonia), defined as a disorder characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication or reduces voice‐related … Objective: This guideline provides evidence‐based recommendations on managing hoarseness (dysphonia), defined as a disorder characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication or reduces voice‐related quality of life (QOL). Hoarseness affects nearly one‐third of the population at some point in their lives. This guideline applies to all age groups evaluated in a setting where hoarseness would be identified or managed. It is intended for all clinicians who are likely to diagnose and manage patients with hoarseness. Purpose: The primary purpose of this guideline is to improve diagnostic accuracy for hoarseness (dysphonia), reduce inappropriate antibiotic use, reduce inappropriate steroid use, reduce inappropriate use of anti‐reflux medications, reduce inappropriate use of radiographic imaging, and promote appropriate use of laryngoscopy, voice therapy, and surgery. In creating this guideline the American Academy of Otolaryngology—Head and Neck Surgery Foundation selected a panel representing the fields of neurology, speech‐language pathology, professional voice teaching, family medicine, pulmonology, geriatric medicine, nursing, internal medicine, otolaryngology–head and neck surgery, pediatrics, and consumers. Results The panel made strong recommendations that 1) the clinician should not routinely prescribe antibiotics to treat hoarseness and 2) the clinician should advocate voice therapy for patients diagnosed with hoarseness that reduces voice‐related QOL. The panel made recommendations that 1) the clinician should diagnose hoarseness (dysphonia) in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces voice‐related QOL; 2) the clinician should assess the patient with hoarseness by history and/or physical examination for factors that modify management, such as one or more of the following: recent surgical procedures involving the neck or affecting the recurrent laryngeal nerve, recent endotracheal intubation, radiation treatment to the neck, a history of tobacco abuse, and occupation as a singer or vocal performer; 3) the clinician should visualize the patient's larynx, or refer the patient to a clinician who can visualize the larynx, when hoarseness fails to resolve by a maximum of three months after onset, or irrespective of duration if a serious underlying cause is suspected; 4) the clinician should not obtain computed tomography or magnetic resonance imaging of the patient with a primary complaint of hoarseness prior to visualizing the larynx; 5) the clinician should not prescribe anti‐reflux medications for patients with hoarseness without signs or symptoms of gastroesophageal reflux disease; 6) the clinician should not routinely prescribe oral corticosteroids to treat hoarseness; 7) the clinician should visualize the larynx before prescribing voice therapy and document/communicate the results to the speech‐language pathologist; and 8) the clinician should prescribe, or refer the patient to a clinician who can prescribe, botulinum toxin injections for the treatment of hoarseness caused by adductor spasmodic dysphonia. The panel offered as options that 1) the clinician may perform laryngoscopy at any time in a patient with hoarseness, or may refer the patient to a clinician who can visualize the larynx; 2) the clinician may prescribe anti‐reflux medication for patients with hoarseness and signs of chronic laryngitis; and 3) the clinician may educate/counsel patients with hoarseness about control/preventive measures. Disclaimer: This clinical practice guideline is not intended as a sole source of guidance in managing hoarseness (dysphonia). Rather, it is designed to assist clinicians by providing an evidence‐based framework for decision‐making strategies. The guideline is not intended to replace clinical judgment or establish a protocol for all individuals with this condition, and may not provide the only appropriate approach to diagnosing and managing this problem.

Review: Occupational risks for voice problems

2001-01-01
Katherine Verdolini , Lorraine O. Ramig
The purpose of this paper is to provide a cohesive review of the literature regarding the functional consequences of voice problems and occupational risk factors for them. The salient points … The purpose of this paper is to provide a cohesive review of the literature regarding the functional consequences of voice problems and occupational risk factors for them. The salient points are as follows. According to conservative estimates, approximately 28000000 workers in the US experience daily voice problems. Many people who experience voice problems perceive them to have a negative impact on their work and their quality of life. Estimates based on empirical data suggest that, considering only lost work days and treatment expenses, the societal cost of voice problems in teachers alone may be of the order of about $2.5 billion annually in the US. In fact, across several countries, ''teacher'' consistently emerges as the common occupation most likely to seek otorhinolaryngological (ORL) evaluation for a voice problem. Other occupational categories likely to seek ORL examination for a voice problem are singer, counselor/social worker, lawyer, and clergy. Finally, US Census data indicate that keyboard operators may be at special risk for voice problems because of a near-epidemic growth of repetitive strain injury (RSI), which can adversely affect the voice especially when speech recognition software is implemented. This paper discusses frequency data, quality of life data, and treatment considerations for these voice-related occupational issues.

Accurate Telemonitoring of Parkinson's Disease Progression by Noninvasive Speech Tests

2009-11-30
Athanasios Tsanas , Max A. Little , Patrick McSharry +1 more
Tracking Parkinson's disease (PD) symptom progression often uses the unified Parkinson's disease rating scale (UPDRS) that requires the patient's presence in clinic, and time-consuming physical examinations by trained medical staff. … Tracking Parkinson's disease (PD) symptom progression often uses the unified Parkinson's disease rating scale (UPDRS) that requires the patient's presence in clinic, and time-consuming physical examinations by trained medical staff. Thus, symptom monitoring is costly and logistically inconvenient for patient and clinical staff alike, also hindering recruitment for future large-scale clinical trials. Here, for the first time, we demonstrate rapid, remote replication of UPDRS assessment with clinically useful accuracy (about 7.5 UPDRS points difference from the clinicians' estimates), using only simple, self-administered, and noninvasive speech tests. We characterize speech with signal processing algorithms, extracting clinically useful features of average PD progression. Subsequently, we select the most parsimonious model with a robust feature selection algorithm, and statistically map the selected subset of features to UPDRS using linear and nonlinear regression techniques that include classical least squares and nonparametric classification and regression trees. We verify our findings on the largest database of PD speech in existence (approximately 6000 recordings from 42 PD patients, recruited to a six-month, multicenter trial). These findings support the feasibility of frequent, remote, and accurate UPDRS tracking. This technology could play a key part in telemonitoring frameworks that enable large-scale clinical trials into novel PD treatments.

Acoustic Correlates of Breathy Vocal Quality: Dysphonic Voices and Continuous Speech

1996-04-01
James Hillenbrand , Robert A. Houde
In an earlier study, we evaluated the effectiveness of several acoustic measures in predicting breathiness ratings for sustained vowels spoken by nonpathological talkers who were asked to produce nonbreathy, moderately … In an earlier study, we evaluated the effectiveness of several acoustic measures in predicting breathiness ratings for sustained vowels spoken by nonpathological talkers who were asked to produce nonbreathy, moderately breathy, and very breathy phonation (Hillenbrand, Cleveland, &amp; Erickson, 1994). The purpose of the present study was to extend these results to speakers with laryngeal pathologies and to conduct tests using connected speech in addition to sustained vowels. Breathiness ratings were obtained from a sustained vowel and a 12-word sentence spoken by 20 pathological and 5 nonpathological talkers. Acoustic measures were made of (a) signal periodicity, (b) first harmonic amplitude, and (c) spectral tilt. For the sustained vowels, a frequency domain measure of periodicity provided the most accurate predictions of perceived breathiness, accounting for 92% of the variance in breathiness ratings. The relative amplitude of the first harmonic and two measures of spectral tilt correlated moderately with breathiness ratings. For the sentences, both signal periodicity and spectral tilt provided accurate predictions of breathiness ratings, accounting for 70%-85% of the variance.

Improved technique for estimating pleural pressure from esophageal balloons

1964-03-01
J. Milic‐Emili , J. Mead , Jeffrey M. Turner +1 more
Esophageal pressure has been measured in eight healthy men during breath holding (glottis open) at various fixed lung volumes with a rubber balloon (length: 10 cm; perimeter: 3.5 cm; wall … Esophageal pressure has been measured in eight healthy men during breath holding (glottis open) at various fixed lung volumes with a rubber balloon (length: 10 cm; perimeter: 3.5 cm; wall thickness: ca. 0.06 mm) containing various volumes of air. The tip of the balloon was placed at a constant distance of 45 cm from the nares. Esophageal pressure was found to increase with balloon volume at all lung volumes but not uniformly, the effect of balloon volume being greatest at both extremes of the vital capacity. As a result, lung volume-pressure curves obtained from balloons containing volumes of gas such as are commonly used are distorted. One can avoid these distortions by repeating measurements at different balloon volumes and extrapolating esophageal pressure to zero balloon volume, or by making measurements at very small balloon volumes. A close approximation of the extrapolated pressures was obtained with the present balloon containing 0.2 ml air. The esophageal pressures at or near zero balloon volume probably reflect closely local absolute pleural pressures over the full vital capacity range in some subjects and above 20% of the vital capacity in most subjects. lung volume-pressure curves Submitted on August 13, 1963

Understanding voice problems: A physiological perspective for diagnosis and treatment

1990-09-01
Robert T. Sataloff

Recommended Protocols for Instrumental Assessment of Voice: American Speech-Language-Hearing Association Expert Panel to Develop a Protocol for Instrumental Assessment of Vocal Function

2018-06-27
Rita R. Patel , Shaheen N. Awan , Julie Barkmeier‐Kraemer +6 more
The aim of this study was to recommend protocols for instrumental assessment of voice production in the areas of laryngeal endoscopic imaging, acoustic analyses, and aerodynamic procedures, which will (a) … The aim of this study was to recommend protocols for instrumental assessment of voice production in the areas of laryngeal endoscopic imaging, acoustic analyses, and aerodynamic procedures, which will (a) improve the evidence for voice assessment measures, (b) enable valid comparisons of assessment results within and across clients and facilities, and (c) facilitate the evaluation of treatment efficacy.Existing evidence was combined with expert consensus in areas with a lack of evidence. In addition, a survey of clinicians and a peer review of an initial version of the protocol via VoiceServe and the American Speech-Language-Hearing Association's Special Interest Group 3 (Voice and Voice Disorders) Community were used to create the recommendations for the final protocols.The protocols include recommendations regarding technical specifications for data acquisition, voice and speech tasks, analysis methods, and reporting of results for instrumental evaluation of voice production in the areas of laryngeal endoscopic imaging, acoustics, and aerodynamics.The recommended protocols for instrumental assessment of voice using laryngeal endoscopic imaging, acoustic, and aerodynamic methods will enable clinicians and researchers to collect a uniform set of valid and reliable measures that can be compared across assessments, clients, and facilities.
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A comparative analysis of speech signal processing algorithms for Parkinson’s disease classification and the use of the tunable Q-factor wavelet transform

2018-10-16
C. Okan Sakar , Görkem Serbes , Ayşegül Gündüz +7 more

The Voice Handicap Index (VHI)

1997-08-01
Barbara H. Jacobson , Alex Johnson , Cynthia Grywalski +4 more
To date, no instruments exist to quantify the psychosocial consequences of voice disorders. The aim of the present investigation was the development of a statistically robust Voice Handicap Index (VHI). … To date, no instruments exist to quantify the psychosocial consequences of voice disorders. The aim of the present investigation was the development of a statistically robust Voice Handicap Index (VHI). An 85-item version of this instrument was administered to 65 consecutive patients seen in the Voice Clinic at Henry Ford Hospital. The data were subjected to measures of internal consistency reliability and the initial 85-item version was reduced to a 30-item final version. This final version was administered to 63 consecutive patients on two occasions in an attempt to assess test-retest stability, which proved to be strong. The findings of the latter analysis demonstrated that a change between two administrations of 18 points represents a significant shift in psychosocial function.

Laser Surgery in the Larynx Early Clinical Experience with Continuous Co<sub>2</sub> Laser

1972-12-01
M. Stuart Strong , Geza J. Jako

Clinical examination of voice

1981-01-01
実 平野

Now You See It, Now You Don't: Laryngoscopy Findings of Paradoxical Vocal Fold Motion

2025-06-25
William Strober , Matthew R. Naunheim , Matthew L. Rohlfing +3 more | The Laryngoscope
ABSTRACT Objective The key exam finding in the diagnosis of paradoxical vocal fold motion (PVFM) is visualization of adduction of the true vocal folds during inspiration on laryngoscopy. This study … ABSTRACT Objective The key exam finding in the diagnosis of paradoxical vocal fold motion (PVFM) is visualization of adduction of the true vocal folds during inspiration on laryngoscopy. This study aims to assess the reliability of visualizing PVFM on laryngoscopic exam. Methods Laryngoscopic exams of 60 patients being evaluated for PVFM were rated by 13 individual otolaryngologists at 2 different timepoints, 1 month apart. At the second timepoint, half of the exams were accompanied by a clinical history potentially suggestive of PVFM. Raters were asked to determine whether patients exhibited PVFM on the video shown, the degree of adduction of the vocal folds (complete, partial, or none), and the level of certainty with the diagnosis. Inter‐rater and intra‐rater reliability were calculated using Fleiss' and Cohen's kappa, respectively. Results Interpretation of the presence of PVFM was quite variable. There was only fair inter‐rater reliability (Fleiss' kappa = 0.36 at Timepoint 1 and 0.34 at Timepoint 2) and moderate to fair intra‐rater reliability (median Cohen's kappa = 0.47 for videos without clinical history and 0.36 for videos shown with clinical histories). Ratings on degree of adduction were quite heterogeneous. Conclusion Though laryngoscopic findings of PVFM are the gold standard physical exam finding in support of diagnosis, only fair agreement was found when raters assessed laryngoscopy recordings for PVFM. Intra‐rater reliability was also quite varied. Improvement in assessment of vocal fold function and understanding the role of clinical history in diagnosis may improve the care of patients with suspected PVFM. Level of Evidence 3.

ASO Author Reflections: Can Artificial Intelligence Improve Confidence and Timing in Recurrent Laryngeal Nerve Recognition?

2025-06-25
Tasuku Furube , Masashi Takeuchi , Hirofumi Kawakubo +2 more | Annals of Surgical Oncology

Pathologic Processes in the Larynx Leading to a Change in the Voice Function

2025-06-25
Dimo Nedelchev , М. Милков , Десислава Kонстантинова +4 more | Journal of Craniofacial Surgery
Objectives: Phonetics is the study of the acoustics of the human voice. The larynx functions not only as an air passage but also as a vocal organ. The vibration of … Objectives: Phonetics is the study of the acoustics of the human voice. The larynx functions not only as an air passage but also as a vocal organ. The vibration of the vocal cords produces sound as air is exhaled. Phonation occurs in the larynx, where a triangular opening, known as the vocal fold, forms during breathing. The goal is to review the literature on the most common pathologic processes in the larynx that lead to changes in voice function. Methods: From January 2000 to September 2024, the PubMed, BioMed Central, ScienceDirect, Scopus, Web of Science, and Embase databases were used to conduct a systematic analysis of scientific publications investigating the most common types of pathologic processes in the larynx that lead to voice function changes. Results: Laryngeal pathology is common and arises from various factors. The development of oncological diseases in this region is no exception. Clinicians must be well aware of the symptoms associated with the existing disorder, whether inflammatory, traumatic, or oncological. The most frequently observed symptoms include hoarseness, voice changes, dysphonia, aphonia, and pain. Conclusions: Laryngeal pathology is common among patients today. This prevalence can be attributed to numerous harmful environmental factors, including allergens and carcinogens. Poor voice quality adversely affects the quality of life for those impacted. Oncological diseases in the laryngeal region influence life expectancy.

Trends in Etiology and Outcomes of Acquired Unilateral Vocal Fold Paralysis: A Multicenter Retrospective Study in Peninsular Malaysia

2025-06-24
Nadhirah Mohd Shakri , Jason Yun Bing Lo , Marina Mat Baki +6 more | ORL
Introduction: Unilateral vocal fold paralysis (UVFP) results from either mechanical or neurological causes, significantly impacting voice, breathing, and swallowing functions. Thyroid and parathyroid surgeries are commonly implicated as surgical causes; … Introduction: Unilateral vocal fold paralysis (UVFP) results from either mechanical or neurological causes, significantly impacting voice, breathing, and swallowing functions. Thyroid and parathyroid surgeries are commonly implicated as surgical causes; however, non-surgical etiologies remain diverse. Some studies have suggested a change in the trend of UVFP etiologies over time, likely due to advancements in surgical techniques, improved diagnostics, and evolving healthcare practices. This study examines trends in etiology and outcomes of UVFP with early interventions in a multicenter setting in Malaysia over two decades. Methods: A retrospective, multicenter review of UVFP cases was conducted over two periods: 2004–2012 and 2013–2021. Data on patient demographics, UVFP etiology, laterality, and intervention outcomes were analyzed. Interventions included voice therapy alone or in combination with early surgical interventions. Statistical analysis was performed to compare trends and outcomes across periods. Results: Thyroid and parathyroid surgeries remained the predominant surgical cause of UVFP. Iatrogenic UVFP was more commonly right-sided, while non-surgical cases predominantly involved the left side. No significant differences were observed in the distribution of surgical and non-surgical etiologies between the two study periods. Early interventions demonstrated significantly better voice outcomes compared to voice therapy alone (p &lt; 0.05). Conclusion: This is the first long-term, multicenter study in Malaysia addressing UVFP trends and outcomes. Early surgical interventions provide superior outcomes compared to conservative approaches, highlighting the need for timely diagnosis and management to optimize patient care.

Una voz que se transforma: una reflexión sobre la modificación vocal en personas trans y de género diverso

2025-06-24
Carolina Alejandra Orellana Venegas | Athenea Digital Revista de pensamiento e investigación social
La voz es una característica propia de la expresión de género de toda persona. En el caso de las personas trans y de género diverso, este sonido no siempre refleja … La voz es una característica propia de la expresión de género de toda persona. En el caso de las personas trans y de género diverso, este sonido no siempre refleja su identidad. Es por ello que podrían recurrir a opciones de modificación vocal. El primer abordaje de modificación vocal ofrecido a esta población se centró en lograr la normatividad. Este ensayo propone abordar los aspectos vocales desde una mirada amplia que cuestione los sistemas y formas que patologizan a esta población, tomando ideas de Michel Foucault y Judith Butler sobre el desafío a la heteronormatividad, de Maurice Merleau-Ponty sobre la experiencia corporal, y de Donna Haraway y Karen Barad en relación con el posthumanismo, la tecnología y la intra-acción.

What Indication Criteria are Applied to Patients Receiving Total TMJ Replacement? A Systematic Review

2025-06-24
Mustafa Mian , Rita Kumar | International Journal of Oral and Maxillofacial Surgery

Sex-related vocal attributes and specificities of the female voice

2025-06-24
Filipa M.B. Lã | Deleted Journal
Sex-specific morphological differences in the three main subsystems of the vocal apparatus—respiratory, oscillatory, and resonatory—affect both the production and the perception of voice. Thus, these differences should be considered by … Sex-specific morphological differences in the three main subsystems of the vocal apparatus—respiratory, oscillatory, and resonatory—affect both the production and the perception of voice. Thus, these differences should be considered by all who care about the voice and are here explored. Special attention is given to the female voice because, besides the impacts of sex steroid hormones (i.e., estrogens, progesterone and testosterone) on voice function, the variability in concentrations of these hormones across female’s biological reproductive development is considerably greater as compared to males (Lã &amp; Ardura, 2022). Note that here, female/ male is referred to the sex at birth.

The Connection Between EAT-10 Score and Yale Pharyngeal Residual Score in Oral Cancer Patients

2025-06-24
Chen Meng | International Journal of Oral and Maxillofacial Surgery

Establishing Baseline Values for Normal Tongue Squamous Cells: An Analysis of Atypical Variations

2025-06-24
Eiji Mitate | International Journal of Oral and Maxillofacial Surgery

Tongue SCC in Young Adults Under 45: A Retrospective Analysis and Comparison with Traditional Older Patient Cohorts

2025-06-24
S. W. Pang , Gary Brierly , Scott C. Borgna +6 more | International Journal of Oral and Maxillofacial Surgery

A Comparative Study of Laryngeal Aerodynamic Parameters Between Adult Smokers Versus Non-smokers

2025-06-23
Bidisha Das , Indranil Chatterjee , S. N. Chatterjee | Indian Journal of Otolaryngology and Head & Neck Surgery

Prediction of Voice Therapy Outcomes Using Machine Learning Approaches and SHAP Analysis: A K-VRQOL-Based Analysis

2025-06-23
Ji Hye Park , Ah Ra Jung , Jina Lee +1 more | Applied Sciences
This study aims to identify personal, clinical, and acoustic predictors of therapy outcomes based on changes in Korean voice-related quality of life (K-VRQOL) scores, as well as to compare the … This study aims to identify personal, clinical, and acoustic predictors of therapy outcomes based on changes in Korean voice-related quality of life (K-VRQOL) scores, as well as to compare the predictive performance of traditional regression and machine learning models. A total of 102 participants undergoing voice therapy are retrospectively analyzed. Multiple regression analysis and four machine learning algorithms—random forest (RF), gradient boosting (GB), light gradient boosting machine (LightGBM), and extreme gradient boosting (XGBoost)—are applied to predict changes in K-VRQOL scores across the total, physical, and emotional domains. The Shapley additive explanations (SHAP) approach is used to evaluate the relative contribution of each variable to the prediction outcomes. Female gender and comorbidity status emerge as significant predictors in both the total and physical domains. Among the acoustic features, jitter, SFF, and MPT are closely associated with improvements in physical voice function. LightGBM demonstrates the best overall performance, particularly in the total domain (R2 = 32.54%), while GB excels in the physical domain. The emotional domain shows relatively low predictive power across the models. SHAP analysis reveals interpretable patterns, highlighting jitter and speaking fundamental frequency (SFF) as key contributors in high-performing models. Integrating statistical and machine learning approaches provides a robust framework for predicting and interpreting voice therapy outcomes. These findings support the use of explainable artificial intelligence (AI) to enhance clinical decision-making and pave the way for personalized voice rehabilitation strategies.

Establishing a Method for Measuring Laryngeal Prominence Size Using <scp>2D</scp> Photography

2025-06-23
Keerthi E. Kurian , Eric D. Miller , Gia Oscherwitz +3 more | The Laryngoscope
For patients seeking chondrolaryngoplasty, little data exists on the visible differences between cisgender laryngeal prominences. This study aimed to establish a method for quantifying measurements of the laryngeal prominence in … For patients seeking chondrolaryngoplasty, little data exists on the visible differences between cisgender laryngeal prominences. This study aimed to establish a method for quantifying measurements of the laryngeal prominence in cis-females and -males using 2D photography to aid pre-operative counseling and surgical planning. A retrospective review of frontal and lateral photographs of cisgender adults from a facial plastics clinic at an academic center was conducted. A protocol was developed to measure length, area, maximum projection, and angle of the laryngeal prominence. Two fellowship-trained laryngologists identified the prominence, and three trained reviewers performed measurements. Inter- and intra-rater reliability was assessed. Mann-Whitney U tests assessed differences between male and female subjects. Spearman's correlation coefficient analyzed relationships between age, BMI, and measurements. Inter-rater reliability was good for prominence length (0.79), excellent for area (0.95) and maximum projection (0.98), and moderate for angle of prominence (0.72). Intra-rater reliability was excellent across all measures. Male and female measurements were significantly different (p < 0.001). In male subjects, the area of prominence (p = 0.003), maximum projection (p = 0.002), and angle (p = 0.001) negatively correlated with BMI. This study demonstrated a reliable, reproducible protocol for measuring the laryngeal prominence on lateral 2D photographs. Surgeons performing chondrolaryngoplasty can use photography to quantify thyroid notch anatomy effectively, aiding in surgical planning and tracking postoperative outcomes.

Research on automatic assessment of the severity of unilateral vocal cord paralysis based on Mel-spectrogram and convolutional neural networks

2025-06-21
Shuailing Ma , Weizhi Liao , Yi Zhang +6 more | BioMedical Engineering OnLine
This study aims to develop an AI-powered platform using Mel-spectrogram analysis and convolutional neural networks (CNN) to automate the severity assessment of unilateral vocal fold paralysis (UVCP) through voice analysis, … This study aims to develop an AI-powered platform using Mel-spectrogram analysis and convolutional neural networks (CNN) to automate the severity assessment of unilateral vocal fold paralysis (UVCP) through voice analysis, providing an objective basis for individualized clinical treatment plans. To accurately identify the severity of UVCP, this study developed the CNN model TripleConvNet. Voice samples were collected from 131 healthy individuals and 292 confirmed UVCP patients from the Eye and ENT Hospital of Fudan University. Based on vocal fold compensation function, the patients were divided into three groups: decompensated (84 cases), partially compensated (98 cases), and fully compensated (110 cases). Using Mel-spectrograms and their first- and second-order differential features as inputs, the TripleConvNet model classified patients by severity and was systematically evaluated for its performance in UVCP severity grading tasks. TripleConvNet achieved a classification accuracy of 74.3% in distinguishing between healthy voices and the UVCP decompensated, partially compensated, and fully compensated groups. This study demonstrates the potential of deep learning-based non-invasive voice analysis for precise grading of UVCP severity. The proposed method offers a promising clinical tool to assist physicians in disease assessment and personalized treatment planning.

Artificial intelligence in assessment and intervention of speech and language disorders: A literature review

2025-06-21
Eren Balo , Batuhan Ökte , Semra Selvi-Balo | The European Research Journal
Artificial intelligence (AI) is a broad term that refers to the use of computers to replicate intelligent behavior with minimal human intervention. AI is rapidly transforming various sectors, including speech … Artificial intelligence (AI) is a broad term that refers to the use of computers to replicate intelligent behavior with minimal human intervention. AI is rapidly transforming various sectors, including speech and language pathology, by offering innovative solutions to enhance therapeutic practices and client outcomes. Its application in speech and language pathology spans several domains, including medical diagnosis, therapeutic planning, and rehabilitation, utilizing tools such as machine learning and deep learning to enhance data analysis and pattern recognition. The primary aim of this study is to provide resources for speech and language pathologists on the topic of artificial intelligence by presenting research findings on the assessment and intervention of speech and language disorders using AI. Accordingly, AI studies in speech and language pathology found in the literature were included. The results of these studies were summarized, and information was provided on the use of AI in assessing and treating speech and language disorders, including swallowing disorders, voice disorders, acquired language disorders, motor and speech sound disorders, cleft palate speech, and developmental language disorder. Existing literature acknowledges and supports the growing popularity of AI and AI-based algorithms in speech and language pathology. Although the current evidence remains insufficient and concerns about ethics and implementation persist, advancing technology offers promise for applying AI in this field.

Voice-related challenges experienced by transgender and gender diverse individuals in Belgium

2025-06-20
Tine Papeleu , Jennifer Oates , Joz Motmans +3 more | International Journal of Transgender Health

A novel fusion architecture for detecting Parkinson’s Disease using semi-supervised speech embeddings

2025-06-20
Tariq Adnan , Abdelrahman Abdelkader , Zipei Liu +4 more | npj Parkinson s Disease

Voice-related Biomarkers in Singing: Suggested Clinical Measurements Standards of Voice Complaints, Listeners’ Evaluation, Acoustical Measurement and Airflow

2025-06-19
Marius Pedersen | Journal of Clinical Medical Research
The routine use of voice-related biomarkers of basic acoustic parameters, fundamental frequency (F0), Jitter, Shimmer and Harmonics to Noise Ratio (HNR), Voice Handicap Index (VHI), GRABAS test and Maximum Phonation … The routine use of voice-related biomarkers of basic acoustic parameters, fundamental frequency (F0), Jitter, Shimmer and Harmonics to Noise Ratio (HNR), Voice Handicap Index (VHI), GRABAS test and Maximum Phonation Time (MPT) in singing pedagogy is suggested. These measures make it possible to evaluate voice pedagogy methods in a way that opens for a valid discussion of scientific evidence in future Randomized Controlled Studies (RCTs). In the modern era, voice educators face a new set of technical computer-related challenges and there is a need to safeguard vocal health in diverse performances. The abundant literature of singing pedagogy should be revised and seen from these approaches. The history of singing pedagogy was therefore studied. This article traces the development of singing pedagogy in practice in cooperation with medical doctors. The evaluation was that routinely measuring the voice with voice-related biomarkers, also with the help of artificial intelligence, especially during the training period and also in periods of voice hazards, will not only add substantially to the dialogue between laryngologists/phoniatricians and singing pedagogy, but also be a great help.

StellarisPat: A Novel Signum and LU-Ternary Feature Extraction Approach for Speech-Based Parkinson’s Disease Detection

2025-06-19
Burak Çelik , Ayhan Akbal | Research Square (Research Square)
<title>Abstract</title> Parkinson’s disease classification (PDC) is a critical research area in digital health and machine learning. This study introduces a new textural feature extractor, StellarisPat, which leverages signum and ternary … <title>Abstract</title> Parkinson’s disease classification (PDC) is a critical research area in digital health and machine learning. This study introduces a new textural feature extractor, StellarisPat, which leverages signum and ternary kernels for feature extraction. A multi-leveled feature extraction approach is employed, where levels are generated using multi level discrete wavelet transform (MDWT). StellarisPat extracts features from each level, and the most discriminative features are selected using a hybrid feature selector that combines neighborhood component analysis (NCA) and chi-square (Chi2) methods, termed NCA-Chi2. A PDC dataset was collected, comprising speech signals from Parkinson’s patients (Med On and Med Off) and healthy controls, with a total of three classes. Evaluation of the proposed technique was carried out using a two shallow classifiers: k-nearest neighbors and support vector machine. Additionally, an iterative majority voting (IMV) is applied for feature fusion to enhance classification performance. The proposed StellarisPat-based hybrid model achieved classification accuracies of 96.09% and 95.22% using k-NN and SVM, respectively, demonstrating its effectiveness for PDC.

Handwriting-Based Gender Classification Using Robotic and Machine Learning Models

2025-06-19
Belen Esther Aleman , Moises Díaz , Miguel A. Ferrer +2 more | Cognitive Computation
Abstract Handwriting analysis provides insights into motor control and cognitive processes, with potential differences arising from biological gender and neurological conditions such as Parkinson’s disease (PD). Investigating these differences can … Abstract Handwriting analysis provides insights into motor control and cognitive processes, with potential differences arising from biological gender and neurological conditions such as Parkinson’s disease (PD). Investigating these differences can lead to improved understanding of motor and cognitive functions. This study introduces a novel methodology that integrates robotic features to estimate gender from handwriting. Kinematic and dynamic features are estimated by simulating handwriting with a robotic model. Linear predictive coding (LPC) and singular spectrum analysis (SSA) are applied to the kinematic and dynamic sequences. Machine learning algorithms are used to classify handwriting as male or female. Handwriting samples from healthy individuals (BiosecurID database) and PD patients (PaHaW dataset) were analyzed. The proposed method demonstrates state-of-the-art performance in gender classification, revealing significant differences between healthy and unhealthy individuals. The robotic-based approach successfully mimics arm movements during writing, highlighting distinct motor patterns associated with gender and health status. This research advances the understanding of gender-based differences in motor and cognitive function, particularly in populations with neurological conditions. The integration of robotic features and machine learning provides a promising pathway for future investigations in handwriting analysis, gender classification, and neurodegenerative disease diagnosis.

Improvement in MRI Findings in Pustulotic Arthro-osteitis Post-tonsillectomy

2025-06-19
T Yasuda , Noboru Hagino | JCR Journal of Clinical Rheumatology

Dynamically Quantifying Vocal Fold Thickness: Effects of Medialization Implant Location on Glottal Shape and Phonation

2025-06-18
Charles Farbos de Luzan , Jacob Michaud-Dorko , Rebecca J. Howell +2 more | Bioengineering
Unilateral vocal fold paralysis (UVFP) can lead to significant dysphonia. Medialization thyroplasty type 1 (TT1) is a common surgical intervention aiming at improving vocal quality by optimally positioning the paralyzed … Unilateral vocal fold paralysis (UVFP) can lead to significant dysphonia. Medialization thyroplasty type 1 (TT1) is a common surgical intervention aiming at improving vocal quality by optimally positioning the paralyzed fold to generate the necessary vibrations for phonation. Implants are generally placed through the thyroid cartilage in a sedated patient and positioned either underneath the level of the vocal folds (infraglottal medialization or IM) or at the level of the vocal folds (glottal medialization or GM). Using high-speed three-dimensional digital image correlation (3D-DIC) in an ex vivo canine hemilarynx model, this study explores the impact of implant location, specifically IM versus GM on the pre-phonatory and dynamic vertical thickness, glottal divergence, flow rate (Q), and cepstral peak prominence (CPP) under varying adduction and subglottal pressure conditions. IM consistently increased glottal divergence and dynamic vertical thickness, particularly in under-adducted states (AL1), despite producing lower static thickness than GM. CPP remained unaffected by the implant condition, but Q decreased significantly with IM under AL1, indicating enhanced glottal resistance and closure. These findings suggest that IM may offer superior functional outcomes by restoring divergent glottal shaping and improving vibratory efficiency. This study also introduces a validated method for dynamically quantifying vocal fold thickness and emphasizes the importance of implant depth in medialization thyroplasty strategies.

Exploring the Relationship Between Vocal Symptoms, Work-Related Stress, and Indoor Air Quality Among Teachers

2025-06-18
Pathangalil Sreekumar Sujitha , Naseeba Faburikage Bidaruge , P. A. Jasna Nasrin +1 more | Indian Journal of Otolaryngology and Head & Neck Surgery

Biofeedback therapy in patients with dysphonia and benign laryngeal pathology after endolaryngeal interventions

2025-06-18
С Г Романенко , О Г Павлихин , D.I. Kurbanova +4 more | Russian Bulletin of Otorhinolaryngology
Objective. To increase the effectiveness of voice restoration in patients with benign organic laryngeal pathology and functional dysphonia after endolaryngeal interventions. Material and methods. 360 patients who underwent surgery for … Objective. To increase the effectiveness of voice restoration in patients with benign organic laryngeal pathology and functional dysphonia after endolaryngeal interventions. Material and methods. 360 patients who underwent surgery for benign organic pathology of the vocal folds were examined. The examination was performed using videolaryngoscopy, videolaryngostroboscopy, computer acoustic analysis of the voice, and a subjective assessment of vocal function by a doctor on the N. Yanagihara scale. Results. In 58 patients in the postoperative period, after the relief of inflammatory phenomena, the voice did not recover, due to the pathological type of phonation: nodular, hypotonic or hypertonic. Voice restoration measures were carried out: phonotherapy for patients of the 1st group, phonotherapy and biofeedback therapy sessions for patients of the 2nd group. According to subjective and objective assessments, biofeedback therapy significantly accelerated voice recovery in patients with hypertonic phonation. Biofeedback therapy had no significant effect on the restoration of vocal function in patients with nodular and hypotonic phonation. Conclusion. In cases where the voice does not fully recover after endolaryngeal interventions, additional therapeutic measures are required: phonotherapy and biofeedback therapy.

In‐Office Transnasal Botulinum Toxin Injections for Retrograde Cricopharyngeal Dysfunction

2025-06-18
Jérôme R. Lechien , Stéphane Hans , Marie Mailly | The Laryngoscope
This paper introduces a new transnasal in-office technique for botulinum toxin injection into the cricopharyngeal muscle of patients with retrograde cricopharyngeal dysfunction (R-CPD). This paper introduces a new transnasal in-office technique for botulinum toxin injection into the cricopharyngeal muscle of patients with retrograde cricopharyngeal dysfunction (R-CPD).

Effectiveness of Teletherapy in Managing Voice Disorders: A Systematic Review

2025-06-18
Maya Varma , Srikanth Nayak , Rohini R. Rao +1 more | Indian Journal of Otolaryngology and Head & Neck Surgery

Utility of Computed Tomography for Identifying Vocal Fold Motion Impairment Etiology

2025-06-18
Boripat Hirunpat , Siriporn Hirunpat , Nuttha Sanghan +2 more | The Journal of Laryngology & Otology

Five-Year Outcomes of Transoral Laser Microsurgery for Early-Stage Glottic Cancer: A Single-Center Retrospective Study

2025-06-17
Thanh Tuan Nguyen | Research Square (Research Square)
<title>Abstract</title> Background This study aimed to evaluate the clinical and functional outcomes of patients with early-stage glottic laryngeal cancer treated by transoral laser microsurgery (TLM) at Ho Chi Minh City … <title>Abstract</title> Background This study aimed to evaluate the clinical and functional outcomes of patients with early-stage glottic laryngeal cancer treated by transoral laser microsurgery (TLM) at Ho Chi Minh City ENT Hospital over a five-year period. Methods Ninety-six patients diagnosed with T1-T2N0M0 glottic squamous cell carcinoma and treated exclusively with TLM between 2018 and 2020 were included. Surgical procedures were performed according to the European Laryngological Society classification of endoscopic cordectomies. Outcomes assessed included local control, overall survival (OS), disease-specific survival (DSS), postoperative complications, and functional voice and swallowing preservation over a minimum follow-up of 5 years. Results The 5-year local control rate was 91.7%, with an overall survival rate of 89.6% and disease-specific survival of 100%. Postoperative complications were minimal and manageable, with no permanent tracheostomy or feeding tubes required. The majority of patients maintained satisfactory voice and swallowing function. Conclusions Transoral laser microsurgery (TLM) demonstrates favorable oncologic efficacy and functional preservation in the treatment of early-stage glottic laryngeal cancer. The ability to achieve organ preservation without compromising oncologic safety highlights TLM as a preferred therapeutic option for patients with T1-T2 glottic carcinoma.

Voice Feminization in Male-to-Female Transgender Patients: A Perspective on Modified Wendler Glottoplasty

2025-06-17
Raja Fakhoury , Asimakis Asimakopoulos , Vyas Prasad +3 more | Ear Nose & Throat Journal

Speech Motor Control and Laryngeal Diadochokinesis in Typically Developing Normophonic Children

2025-06-17
Göksu Yılmaz , Ayşe Buse Saraç , Ahmet Konrot +5 more | International Journal of Pediatric Otorhinolaryngology

Physiologic Voice Therapy for Vocal Nodules Using Water Resistance Therapy: A Long-Term Study

2025-06-17
Akhila Rahul , Sruthi K. Vinod , Thamanna Fathima +1 more | Indian Journal of Otolaryngology and Head & Neck Surgery

Autopercepção da qualidade de vida em voz em professores de educação física do ensino fundamental

2025-06-17
Juliana Cemin , Kaio Vinícius Freitas de Andrade | Cuadernos de Educación y Desarrollo
O estudo teve como objetivo analisar a qualidade de vida relacionada à voz dos professores de Educação Física do Ensino Fundamental das escolas públicas municipais de Joinville. Com uma abordagem … O estudo teve como objetivo analisar a qualidade de vida relacionada à voz dos professores de Educação Física do Ensino Fundamental das escolas públicas municipais de Joinville. Com uma abordagem quantitativa e delineamento transversal, foram coletados dados entre 2015 e 2018, a partir do programa municipal de saúde vocal (PSV), através do protocolo qualidade de vida em voz (QVV). Este estudo evidenciou predominância do sexo feminino entre os docentes de Educação Física, destacando uma lacuna significativa na literatura acadêmica relacionada às especificidades vocais desses profissionais. Observou-se que o impacto da voz no desempenho docente nesta área foi pouco reconhecido pelos professores analisados, com exceção da questão “Tenho dificuldade em falar forte (alto) ou ser ouvido em ambientes ruidosos” que aproximadamente metade dos professores referem alguma dificuldade. observou-se deficiência na percepção da população estudada acerca de suas necessidades vocais, as quais demandam intervenções efetivas em saúde que integrem a relação entre voz e qualidade de vida.

Life following total laryngectomy: mixed-model analyses of longitudinal patient-reported outcomes in a prospective cohort

2025-06-17
Anthony M. Tonsbeek , Caroline A. Hundepool , Mark J. W. van der Oest +3 more | Oral Oncology
Few studies have longitudinally assessed health-related quality of life (HRQOL) in total laryngectomy (TLE) patients. This study aimed to assess the course of HRQOL following TLE, including associations with patient-specific … Few studies have longitudinally assessed health-related quality of life (HRQOL) in total laryngectomy (TLE) patients. This study aimed to assess the course of HRQOL following TLE, including associations with patient-specific factors. A prospective single-center cohort study from 2014 to 2023 was performed. All consecutive TLE patients with PROM data collected from an electronic healthcare monitoring system were included. Main outcomes were: Voice Handicap Index (VHI), Hospital Anxiety and Depression Scale (HADS-A, HADS-D), EORTC-QLQ-HN-35 and QLQ-C30. Mixed-models were used to analyze PROM scores over time. Among 128 TLE patients with both pre- and postoperative PROM data, all HRQOL scores significantly improved over time, except HADS-A and HADS-D scores. Preoperative HRQOL was significantly associated with all postoperative HRQOL scores. Requirement for reconstruction was associated with better HADS-A (β = -0.3, 95 % CI -0.6 to -0.1, p = 0.020) and EORTC-QLQ-C30 scores (β = 4.5, 95 % CI 0.1-8.9, p = 0.047). Strictures were associated with worse VHI-scores (β = 27.1, 95 % CI 12.2-42.1, p = 0.001) and EORTC-QLQ-HN-35 swallowing (β = 2.2, 95 % CI 1.1-3.3, p < 0.001), speech (β = 11.8, 95 % CI 1.9-21.8, p < 0.001), and social eating scores (β = 1.4, 95 % CI 0.3-2.6, p = 0.015). Fistulas were associated with a worse EORTC-QLQ-C30 summary score (β = -10.8, 95 % CI -18.3 to -3.2, p = 0.006). Adjuvant radiotherapy was associated with better HADS-A (β = -0.3, 95 % CI -0.5 to 0, p = 0.034) and HADS-D (β = -0.4, 95 % CI -0.7 to -0.1, p = 0.014) scores. Several factors are associated with postoperative HRQOL after TLE. In addition to improving reconstructive outcomes, providing additional patient guidance and patient-tailored supportive interventions may enhance HRQOL and coping processes after TLE.

A Comparative Study of the Vocal Outcomes Following Type 1 Versus Type 2 Transoral Laser Micro Laryngeal Cordectomy

2025-06-16
Nupur Kapoor Nerurkar , Sonali Tyagi | Indian Journal of Otolaryngology and Head & Neck Surgery

Auditory-Motor Control of Fundamental Frequency in Essential Vocal Tremor

2025-06-16
Nayanika Ghosh , Elizabeth Eidson , Chun-Liang Chan +3 more | Journal of Speech Language and Hearing Research
Purpose: The purpose of this study was to assess feedforward control of voice in essential vocal tremor (EVT) by measuring adaptive responses to gradual perturbation of the pitch of the … Purpose: The purpose of this study was to assess feedforward control of voice in essential vocal tremor (EVT) by measuring adaptive responses to gradual perturbation of the pitch of the auditory feedback and to assess feedback control of voice in EVT by measuring reflexive responses to sudden perturbation of the pitch of the auditory feedback. Method: Ten participants with EVT and 10 age-, sex-, and gender-matched controls produced sustained vowels while the fundamental frequency ( f o ) of their auditory feedback was gradually perturbed to assess feedforward control and suddenly perturbed to assess feedback control. Acoustical analyses estimated the mean f o of their adaptive and reflexive responses. Participants with EVT also underwent comprehensive auditory, acoustical, physiological, and cognitive assessments to assist with interpretation of their responses to pitch perturbations. Results: Participants with EVT and controls produced compensatory responses to gradual and sudden pitch perturbations. The differences in adaptive and reflexive response magnitudes for participants with EVT and controls were not statistically significant. However, participants with EVT exhibited significantly lower variability in their adaptive responses relative to control participants. There was no apparent pattern in auditory, acoustical, physiological, or cognitive assessment findings that accounted for the differences in adaptive response magnitudes across participants with EVT. Conclusions: These findings indicated that speakers with EVT had typical adaptive and reflexive response magnitudes, suggesting that speakers with EVT may have typical feedforward and feedback control of pitch in EVT. However, the sources of observed differences in the variability of adaptive response magnitudes require further investigation. Supplemental Material: https://doi.org/10.23641/asha.29132213

The GRAM-KAN approach: dysarthria speech identification with easy call corpus

2025-06-16
J Jayaprakash , S. Suguna | Iran Journal of Computer Science

Benefits of Gender-Affirming Voice and Communication Training for Young People

2025-06-16
Brett R. Myers , Catharine DeLong | Transgender Health

Chest binding practices and health impacts for transmasculine individuals: A mixed methods analysis

2025-06-16
Theo G. Beltran , Ashleigh J. Rich , Mannat Malik +6 more | medRxiv (Cold Spring Harbor Laboratory)
Background: There is a large knowledge gap among health care providers regarding the importance of chest-binding among transmasculine people. With increased passage of anti-transgender laws denying rights and health care … Background: There is a large knowledge gap among health care providers regarding the importance of chest-binding among transmasculine people. With increased passage of anti-transgender laws denying rights and health care services for transgender youth, it is more important than ever to document their experiences within healthcare settings. Methods: This mixed methods study integrated quantitative and qualitative data. Participants were transmasculine individuals who completed surveys (N=44) or in-depth interviews (N=21) in Baltimore or Towson metropolitan areas in 2016. Results: The majority of transmasculine survey participants bound in their lifetime (n=36, 82%). Among them, 43% (n=19) reported binding seven days per week and 52% (n=23) bound eight or more hours per day on average. Of survey participants, 39% felt healthcare providers were not comfortable with transgender people. Interview themes included physical health challenges of binding, provider de-prioritization of binding, gender affirmation as a facilitator of safety, need for safer binding education, and binding as mental health promotion. Conclusion: Binding is an important part of gender affirmation for many transmasculine people, with social, safety and mental health benefits. However, many transmasculine people report barriers to social and healthcare provider support around binding. Healthcare providers should understand the benefits of binding and be prepared to discuss safer binding practices with transmasculine patients.

Differential Diagnostic Patterns of Acquired Motor Speech Disorders in Children: A Preliminary Investigation of Four Case Studies

2025-06-16
Drew Mancini , Caitlin Cain , Allison Hilger | American Journal of Speech-Language Pathology
Purpose: This clinical focus article aimed to explore how motor speech disorders (MSDs) manifest in children with acquired brain injury (ABI) and determine if an adult diagnostic system, such as … Purpose: This clinical focus article aimed to explore how motor speech disorders (MSDs) manifest in children with acquired brain injury (ABI) and determine if an adult diagnostic system, such as the Mayo Clinic System, applies to pediatric cases. Method: Four children with ABI with differing loci of impairment were evaluated to compare perceptual speech features and how they align or diverge from expected adult profiles with similar loci of impairment. Two expert speech-language pathologists identified perceptual speech features from the recorded motor speech evaluations and determined motor speech disorder diagnosis and severity based on consensus. Results: Three out of the four children had clear motor speech disorder diagnoses (flaccid dysarthria, ataxic dysarthria, and apraxia). The one child with a less clear diagnosis had mixed dysarthria from diffuse traumatic brain injury. Regardless, the perceptual speech and nonspeech features identified per child matched with expected findings from neuroimaging and expected motor speech profiles from the Mayo Clinic System. Conclusions: From this preliminary study, children with ABI fit into expected motor speech subgroups based on the Mayo Clinic classification system. Differential diagnosis in pediatric MSDs in the hospital setting has clinical implications for evaluation, treatment, and interdisciplinary communication with other health care providers.

Rephrasing Messages on Demand: Effects on Speech Production in Parkinson's Disease

2025-06-16
Annalise R. Fletcher , Alan Wisler , Samantha Budge +2 more | American Journal of Speech-Language Pathology
Purpose: When faced with challenging communicative situations, people with dysarthria are commonly advised to rephrase their message, using common words and keeping sentences short and manageable. However, it remains unclear … Purpose: When faced with challenging communicative situations, people with dysarthria are commonly advised to rephrase their message, using common words and keeping sentences short and manageable. However, it remains unclear whether relevant clinical populations can implement these changes on demand. The goals of this study were to (a) identify lexical changes that occur when speakers are prompted to rephrase sentences and (b) examine how rephrasing messages affects acoustic measures of speech production and listener perceptual ratings. Method: Speech samples were collected from 11 speakers with Parkinson's disease and 11 age-matched adults. In a baseline condition, speakers read 29 sentences from the Natural Stories Corpus. Following this, speakers received verbal instructions on how to rephrase statements and were prompted to make each sentence easier to understand (rephrasing condition). Transcripts from both conditions were analyzed to measure lexical diversity and sophistication. Sentence-level measures of average sound pressure level, pitch variability, speech rate, pause duration, and listener ratings of ease of understanding were also investigated. Results: Both speaker groups were able to significantly reduce the lexical diversity and sophistication of sentences following a brief educational protocol. However, rephrased speech stimuli were not judged as easier to understand. Acoustically, rephrased stimuli were associated with greater pause durations and a reduction in average speech intensity. Conclusions: Speakers, both with and without a diagnosis of Parkinson's disease, can simplify their language when prompted to do so. However, it is possible that the cognitive demands associated with rephrasing language could interfere with the clarity of speech production.

Minimal Detectable Change of Experienced and Novice Listeners' Ratings of Overall Severity of Voice Quality in Adductor Laryngeal Dystonia

2025-06-13
Tanya L. Eadie , Cara Sauder , Katherine L. Marks +5 more | Journal of Speech Language and Hearing Research
Purpose: This study determined the minimal detectable change (MDC) scores for experienced and novice listeners' ratings of overall severity of voice quality for speakers with adductor laryngeal dystonia (ADLD) and … Purpose: This study determined the minimal detectable change (MDC) scores for experienced and novice listeners' ratings of overall severity of voice quality for speakers with adductor laryngeal dystonia (ADLD) and typical controls. We also determined MDCs as a function of speaker severity and listener experience. Method: Ten experienced listeners (ELs) and 12 novice listeners (NLs) rated overall severity of voice quality in 39 speakers with ADLD and 10 controls using a 100-mm visual analog scale across two rating sessions. MDCs at the 95% confidence level (MDC 95 ) were calculated for all speakers. MDC 95 scores also were calculated as a function of speaker group, perceived speaker severity using averaged EL ratings as the reference standard (grouped as typical, mild, moderate, severe), and listener experience group. Results: The MDC 95 for EL ratings of overall severity of voice quality for all speakers was 11.10 mm; for NLs, the MDC 95 was 8.73 mm. As a function of speaker group, the MDC 95 for EL ratings was 12.31 mm for speakers with ADLD ( n = 39) and 0.89 mm for controls ( n = 10). For NLs, the MDC 95 was 9.32 mm for speakers with ADLD and 4.72 mm for controls. As a function of speaker severity ( n = 13 typical, n = 9 mild, n = 12 moderate, n = 15 severe), MDC 95 scores ranged from 4.22 to 13.77 mm for ELs, whereas MDC 95 scores ranged from 4.95 mm to 12.25 mm for NLs. Across both listener groups, mildly and moderately dysphonic speakers required larger MDC 95 scores compared to speakers without dysphonia for such differences to be considered beyond measurement error. Differences in MDC 95 scores ranged from 1 to 4 mm between listener groups across speaker severities. Conclusion: Results have implications for measuring and interpreting auditory-perceptual outcomes for speakers with ADLD with different voice quality severities when they are evaluated by ELs and NLs in clinical and research contexts.

1034-P: The Association of Voice Features with Glycemic Control in Adults with Diabetes—A Pilot Study

2025-06-13
Boonsong Ongphiphadhanakul , Wichai Aekplakorn , Nittaya Kasemkosin | Diabetes
Introduction and Objective: Recent evidence suggests that voice analysis can assist in diabetes screening. However, its potential for monitoring glycemic control remains uncertain. Therefore this study explores the association between … Introduction and Objective: Recent evidence suggests that voice analysis can assist in diabetes screening. However, its potential for monitoring glycemic control remains uncertain. Therefore this study explores the association between voice parameters and HbA1c levels in individuals with diabetes aged older than 50 years. Methods: In this cross-sectional study, we recruited adults aged &amp;gt; 50 years with a confirmed diagnosis of diabetes (n = 117). Participants were asked to phonate the vowel “ah,” and voice recordings were obtained through smartphones. The extended Geneva Minimalistic Acoustic Parameter Set (eGeMAPS) parameters were extracted from these recordings to capture 88 voice features. Stepwise multiple linear regression was conducted to identify which voice parameters independently associated with HbA1c levels, adjusting for relevant clinical covariates. Results: Using stepwise linear regression analysis,18 eGeMAPS voice features out of 88 showed significant correlations with HbA1c. Clinical parameters including age, sex and body mass index were not significantly associated with HbA1c levels in the regression model. The top 3 features independently associated with HbA1c as determined by the standardized regression coefficients were: the amplitude ratio of the second formant relative to the fundamental frequency (beta = 1.54, P &amp;lt; 0.0001), the variability in the first formant frequency (beta = 0.56, P &amp;lt; 0.001), the relative distribution of spectral energy between the fundamental frequency and higher harmonics (beta = -0.52, P &amp;lt; 0.0001). Altogether, voice features explained approximately 35% of the variability in glycemic control (adjusted R² = 0.35, P &amp;lt; 0.0001). Conclusion: Our results suggest that voice-based biomarkers hold promise as a noninvasive adjunct for assessing diabetes control. Disclosure B. Ongphiphadhanakul: None. W. Aekplakorn: None. B. Ongphiphadhanakul: None. N. Kasemkosin: None. Funding The National Research Council of Thailand

FedOcw: optimized federated learning for cross-lingual speech-based Parkinson’s disease detection

2025-06-13
Changqin Quan , Zhonglue Chen , Kang Ren +1 more | npj Digital Medicine

Examination of Endoscopic Marsupialization of Vocal Fold Cyst Under Topical Anesthesia

2025-06-13
Ray Motohashi , Ryoji Tokashiki , Yusuke Shoji +2 more | Cureus

Exploring Benign Vocal Cord Polyp Treatment: A Holistic Analysis of Plasma Ablation and Laser Excision Phonosurgery Practices Incorporating Subjective, Objective, and Videostroboscopic Assessments

2025-06-12
Sajith Abraham , Karthika Chettuvatti , Ramandeep Singh Virk | Indian Journal of Otolaryngology and Head & Neck Surgery

Job Accommodations and Job Loss From Unilateral Vocal Fold Paralysis

2025-06-12
Koffi L. Lakpa , Andrew J. Bowen , Ezra Menon +7 more | Otolaryngology
Abstract Objective Unilateral vocal fold paralysis (UVFP) is a debilitating injury that affects a person's ability to communicate and swallow. Although clinical aspects are understood, how UVFP affects a person's … Abstract Objective Unilateral vocal fold paralysis (UVFP) is a debilitating injury that affects a person's ability to communicate and swallow. Although clinical aspects are understood, how UVFP affects a person's employment and job security is poorly characterized. This study aims to elucidate how frequently patients request job accommodations or experience job loss related to UVFP. Study Design Cross‐sectional survey. Setting Thirty‐four US tertiary care voice centers. Methods We analyzed data from a prospective cohort of patients with UVFP recruited from 34 vocal Cord Paralysis Experience (CoPE) collaborative voice centers. Sociodemographic information, clinical and treatment history, and patient‐reported outcome measures were collected. Patients also provided employment information, whether they requested job accommodations, and if they experienced job loss due to UVFP. Results In all, 613 participants (mean age 58 years, 65% women, 84% Caucasian) enrolled in CoPE. In total, 64 (10%) had requested job accommodations, and 46 (7.5%) reported job loss due to UVFP. Women (odds ratio [OR] 2.6, 95% CI: 1.4‐5.0, P = .004) and participants with higher levels of education were more likely to request work accommodations (OR 4.5, 95% CI: 1.4‐14.7, P = .01). Conclusion UVFP has major impacts on employment with 1 in 10 patients requesting job accommodations and 1 in 13 experiencing job loss. Our results raise awareness of the importance of timely, effective treatment for UVFP and should alert treating clinicians to provide support to patients who may require job accommodations.