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The Laryngoscope Apr 2024The paralaryngeal muscles are thought to be hyperfunctional with phonation in patients with primary muscle tension dysphonia (pMTD). However, objective, quantitative...
OBJECTIVES
The paralaryngeal muscles are thought to be hyperfunctional with phonation in patients with primary muscle tension dysphonia (pMTD). However, objective, quantitative tools to assess paralaryngeal movement patterns lack. The objectives of this study were to (1) validate the use of optical flow to characterize paralaryngeal movement patterns with phonation, (2) characterize phonatory optical flow velocities and variability of the paralaryngeal muscles before and after a vocal load challenge, and (3) compare phonatory optical flow measures to standard laryngoscopic, acoustic, and self-perceptual assessments.
METHODS
Phonatory movement velocities and variability of the paralaryngeal muscles at vocal onsets and offsets were quantified from ultrasound videos and optical flow methods across 42 subjects with and without a diagnosis of pMTD, before and after a vocal load challenge. Severity of laryngoscopic mediolateral supraglottic compression, acoustic perturbation, and ratings of vocal effort and discomfort were also obtained at both time points.
RESULTS
There were no significant differences in optical flow measures of the paralaryngeal muscles with phonation between patients with pMTD and controls. Patients with pMTD had significantly more supraglottic compression, higher acoustic perturbations, and higher vocal effort and vocal tract discomfort ratings. Vocal load had a significant effect on vocal effort and discomfort but not on supraglottic compression, acoustics, or optical flow measures of the paralaryngeal muscles.
CONCLUSION
Optical flow methods can be used to study paralaryngeal muscle movement velocity and variability patterns during vocal productions, although the role of the paralaryngeal in pMTD diagnostics (e.g., vocal hyperfunction) remains suspect.
LEVEL OF EVIDENCE
2 Laryngoscope, 134:1792-1801, 2024.
Topics: Humans; Optic Flow; Dysphonia; Phonation; Laryngoscopy; Muscles
PubMed: 37772838
DOI: 10.1002/lary.31063 -
Journal of Voice : Official Journal of... May 2023In this tribute article to D.G. Miller, we review some historical and recent contributions to understanding the myoelastic-aerodynamic (MEAD) theory of phonation and the... (Review)
Review
In this tribute article to D.G. Miller, we review some historical and recent contributions to understanding the myoelastic-aerodynamic (MEAD) theory of phonation and the related acoustic phenomena in subglottal and vocal tract. At the time of the formulation of MEAD by van den Berg in late 1950s, it was assumed that vocal fold oscillations are self-sustained thanks to increased subglottal pressure pushing the glottis to open and decreased subglottal pressure allowing the glottis to close. In vivo measurements of subglottal pressures during phonation invalidated these assumptions, however, and showed that at low fundamental frequencies subglottal pressure rather tends to reach a maximum value at the beginning of glottal closure and then exhibits damped oscillations. These events can be interpreted as transient acoustic resonance phenomena in the subglottal tract that are triggered by glottal closure. They are analogous to the transient acoustic phenomena seen in the vocal tract. Rather than subglottal pressure oscillations, a more efficient mechanism of transfer of aerodynamic energy to the vocal fold vibrations has been identified in the vertical phase differences (mucosal waves) making the glottal shape more convergent during glottis opening than during glottis closing. Along with other discoveries, these findings form the basis of our current understanding of MEAD.
Topics: Humans; Biomechanical Phenomena; Phonation; Glottis; Vocal Cords; Acoustics; Vibration
PubMed: 33744068
DOI: 10.1016/j.jvoice.2021.01.023 -
Journal of Voice : Official Journal of... Mar 2018This study aimed to evaluate the developmental occurrence of inspiratory phonations (IPs) in the spontaneous cries of healthy infants across the first 10 weeks of life.
OBJECTIVE
This study aimed to evaluate the developmental occurrence of inspiratory phonations (IPs) in the spontaneous cries of healthy infants across the first 10 weeks of life.
STUDY DESIGN
This is a populational retrospective study.
PARTICIPANTS
The spontaneous crying of 17 healthy infants (10 were male) was retrospectively investigated.
MATERIALS AND METHODS
Sound files of spontaneously uttered cries that were repeatedly recorded once per week for across the first 10 weeks of life were retrospectively analyzed. Frequency spectra and waveforms were used to identify the occurrence of IPs and to measure the duration and fundamental frequency (fo) of each instance of IP.
RESULTS
A consistent number of IPs were identified across the 10-week period. All infants were observed to produce IPs in their spontaneous cries, although the frequency of occurrence was not consistent across infants. A marked sex difference was observed with female infants producing a higher number of IPs compared to males. The duration and fo of IPs did not differ significantly across the 10 weeks or between sexes.
CONCLUSIONS
The production of IPs is a regularly occurring phenomenon in healthy, normally developing infants' spontaneous crying. The proportional difference in the production of IPs between female and male infants, observed for the first time here, is postulated to be linked to sex-based differences (including steroidal hormones) in respiratory anatomy and physiology.
Topics: Acoustics; Age Factors; Child Development; Crying; Female; Humans; Infant; Infant, Newborn; Inhalation; Male; Phonation; Retrospective Studies; Sex Factors; Sound Spectrography; Time Factors
PubMed: 28528787
DOI: 10.1016/j.jvoice.2017.04.005 -
CoDAS 2019To investigate the immediate effect of phonation into silicone tube on self-assessment and vocal quality of gospel singers.
PURPOSE
To investigate the immediate effect of phonation into silicone tube on self-assessment and vocal quality of gospel singers.
METHODS
The sample was composed of 40 gospel singers without vocal complaint, males and females, from 18 to 40 years. The singers performed semi-occluded vocal tract exercise in LaxVox® silicone tube. The end of the tube was submerged in water (2cm depth), for three minutes. Before and after exercise, voice recording was performed for perceptive-auditory evaluation, and only after exercise, the voice and comfort phonation self-assessments (CSA) were performed. The descriptive and inferential statistical analysis were performed.
RESULTS
All participants reported improvement in voice. In addition, a significant higher proportion of them indicated phonation comfort improvement after exercise. According to the perceptive-auditory evaluation, there was no difference in the comparison of the proportions of pre- and post-exercise perceptive-auditory evaluation categories in gospel singers.
CONCLUSION
The phonation exercise into a silicone tube caused an immediate positive effect on gospel singers' voice and comfort phonation self-assessments. There was no significant difference in the perceptive-auditory evaluation before and after phonation into silicone tube in gospel singers.
Topics: Acoustics; Adolescent; Adult; Female; Humans; Male; Phonation; Prospective Studies; Self-Assessment; Silicones; Singing; Voice; Voice Quality; Voice Training; Young Adult
PubMed: 31800878
DOI: 10.1590/2317-1782/20192018117 -
Logopedics, Phoniatrics, Vocology Dec 2022To examine the power of the parameters obtained from different sustained vowels used in acoustic and electroglottographic (EGG) voice evaluation protocols to...
OBJECTIVE
To examine the power of the parameters obtained from different sustained vowels used in acoustic and electroglottographic (EGG) voice evaluation protocols to discriminate between dysphonic and non-dysphonic voice quality.
METHODS
Sixty non-dysphonic participants and 30 dysphonic participants were included in the study. In addition to the time domain amplitude and frequency perturbation parameters obtained from the sustained phonation of /ʌ/-/ɛ/-/i/-/u/ vowels, several frequency-domain spectral/cepstral parameters and EGG parameters were evaluated. The classification performance of the acoustic and electroglottographic measures was quantified using analysis and receiver operating characteristic (ROC) curve analysis.
RESULTS
As a result of ROC analysis, the discriminative diagnostic performance (area under the curve, AUC) of the test for low-vowel (/ʌ/-/ɛ/) phonation was higher than values obtained from high-vowel (/i/-/u/) phonation. For /ʌ/ and /ɛ/ sustained vowels, the parameters exhibiting the highest discrimination were fundamental frequency standard deviation (f/STD), cepstral peak prominence (CPP), relative average perturbation (RAP), pitch perturbation quotient (PPQ), and jitter percent (JITT). In the EGG parameters, on the other hand, average jitter and periodicity parameters obtained from front vowels (/ɛ/-/i/) were found to have higher AUC values compared to back vowels (/ʌ/-/u/).
CONCLUSIONS
In acoustic analyses, /ʌ/ and /ɛ/ sustained vowels give the highest diagnostic performance. In the electroglottographic evaluation, on the other hand, /ɛ/ and /i/ vowels, when the position of the tongue is forward, have better classification performance compared to /ʌ/ and /u/ vowels, when the position of the tongue is back.
Topics: Humans; Voice Quality; Speech Acoustics; ROC Curve; Phonation; Acoustics
PubMed: 34519593
DOI: 10.1080/14015439.2021.1974934 -
Journal of Voice : Official Journal of... Jan 2022Several techniques have been practiced in the field of voice therapy to balance glottal pressures and improve glottal adduction. As such, Semioccluded Vocal Tract...
OBJECTIVE
Several techniques have been practiced in the field of voice therapy to balance glottal pressures and improve glottal adduction. As such, Semioccluded Vocal Tract Exercises using narrow diameter straws have shown promise as a technique to increase glottal contact as reflected by Closed Quotients (CQ) measured from electroglottograph (EGG). This study explored the effect of nasal resistance (NR) technique, a manually induced NR approach, on glottal adduction in phononormal subjects as a possible new therapeutic technique to assist in glottal closure.
SUBJECTS
Thirty-four vocally healthy adult females qualified for this study. All subjects were reportedly and perceptually normal.
METHODS
Subjects were instructed to perform tasks including (a) steady modal phonation, (b) straw phonation, (c) humming, and (d) NR technique in a random order. EGG measures included calculation of the CQ and jitter during the mid-section of each stimuli for a minimum of 10 EGG cycles. One-way repeated measures ANOVAs and Bonferroni post-hoc comparisons were calculated to determine differences between each phonatory task for the outcome measures of CQ and jitter.
RESULTS
Analyses revealed that the mean CQ was significantly different in all the tasks performed with humming (33.99%) at the lowest and NR technique at highest (43.88%). Though the CQ of straw phonation (40.53%) was higher than modal steady phonation (36.65%), jitter was found to be significantly lower for NR technique (0.23%). Jitter during straw phonation (0.43%) did not differ significantly from modal phonation (0.44%).
CONCLUSION
These results provide preliminary evidence that NR technique can increase CQ with lower levels of jitter compared to straw phonation using a narrow diameter of 2 mm. Future studies should expand enrollment to men, larger age ranges, and patients with hypofunctional symptoms (eg, Parkinson disease) to evaluate the potential benefits of NR as a therapeutic technique.
Topics: Adult; Electrodiagnosis; Female; Glottis; Humans; Male; Phonation; Voice Quality; Voice Training
PubMed: 32522383
DOI: 10.1016/j.jvoice.2020.04.020 -
The Laryngoscope Jul 2016To describe a nonstimulated in vivo rabbit phonation model using an Isshiki type IV thyroplasty and uninterrupted humidified glottal airflow to produce sustained audible...
OBJECTIVES/HYPOTHESIS
To describe a nonstimulated in vivo rabbit phonation model using an Isshiki type IV thyroplasty and uninterrupted humidified glottal airflow to produce sustained audible phonation.
STUDY DESIGN
Prospective animal study.
METHODS
Six New Zealand white breeder rabbits underwent a surgical procedure involving an Isshiki type IV thyroplasty and continuous airflow delivered to the glottis. Phonatory parameters were examined using high-speed laryngeal imaging and acoustic and aerodynamic analysis. Following the procedure, airflow was discontinued, and sutures remained in place to maintain the phonatory glottal configuration for microimaging using a 9.4 Tesla imaging system.
RESULTS
High-speed laryngeal imaging revealed sustained vocal fold oscillation throughout the experimental procedure. Analysis of acoustic signals revealed a mean vocal intensity of 61 dB and fundamental frequency of 590 Hz. Aerodynamic analysis revealed a mean airflow rate of 85.91 mL/s and subglottal pressure of 9 cm H2 O. Following the procedure, microimaging revealed that the in vivo phonatory glottal configuration was maintained, providing consistency between the experimental and postexperimental laryngeal geometry. The latter provides a significant milestone that is necessary for geometric reconstruction and to allow for validation of computational simulations against the in vivo rabbit preparation.
CONCLUSION
We demonstrate a nonstimulated in vivo phonation preparation using an Isshiki type IV thyroplasty and continuous humidified glottal airflow in a rabbit animal model. This preparation elicits sustained vocal fold vibration and phonatory measures that are consistent with our laboratory's prior work using direct neuromuscular stimulation for evoked phonation.
LEVEL OF EVIDENCE
N/A. Laryngoscope, 126:1589-1594, 2016.
Topics: Acoustics; Animals; Computer Simulation; Glottis; Laryngeal Muscles; Male; Models, Animal; Phonation; Pressure; Prospective Studies; Rabbits; Vibration; Vocal Cords
PubMed: 26971861
DOI: 10.1002/lary.25559 -
The Journal of the Acoustical Society... Sep 2022The measure H1-H2, the difference in amplitude between the first and second harmonics, is frequently used to distinguish phonation types and to characterize differences...
The measure H1-H2, the difference in amplitude between the first and second harmonics, is frequently used to distinguish phonation types and to characterize differences across voices and genders. While H1-H2 can differentiate voices and is used by listeners to perceive changes in voice quality, its relation to voice articulation is less straightforward. Its calculation also involves practical issues with error propagation. This paper highlights some developments in the use of H1-H2 and proposes a new measure that we call "residual H1." In residual H1, the amplitude of the first harmonic is normalized against the overall sound energy (as measured by root mean square energy) instead of against H2. Residual H1 may mitigate some of the issues with using H1-H2. The current study tests the correlation between residual H1 and electroglottographic contact quotient (CQ) and compares the ability of residual H1 vs H1-H2 to differentiate statistically across phonation types in !Xóõ and utterance-level changes in phonatory quality in Mandarin. The results show that residual H1 has a stronger correlation with CQ and differentiates contrastive and allophonic phonatory quality better than H1-H2, particularly for more constricted phonation types.
Topics: Acoustics; Female; Humans; Male; Phonation; Phonetics; Speech Acoustics; Voice Quality
PubMed: 36182308
DOI: 10.1121/10.0014175 -
Journal of Voice : Official Journal of... Sep 2019This study aimed to investigate the duration of straw phonation effects using aerodynamic, electroglottographic, and acoustic metrics.
OBJECTIVE
This study aimed to investigate the duration of straw phonation effects using aerodynamic, electroglottographic, and acoustic metrics.
METHODS
Twenty-four participants were recruited to perform both a 5-minute and a 10-minute straw phonation exercise. Upon completion of the exercises, phonation threshold pressure (PTP), mean airflow, contact quotient, fundamental frequency, jitter, shimmer, and noise-to-harmonics ratio were measured over a 20-minute time frame. Parameters were measured before the intervention (baseline), immediately after the intervention (m0), 5 minutes (m5), 10 minutes (m10), 15 minutes (m15), and 20 minutes (m20) after the intervention.
RESULTS
PTP significantly decreased immediately after 5 minutes of straw phonation and returned to initial state within 5 minutes. PTP remained decreased over 5 minutes after 10 minutes of straw phonation. Mean airflow increased immediately after both 5 minutes and 10 minutes of straw phonations and remained improved for 20 minutes. No significant changes were obtained for contact quotient and acoustic parameters over the intervention period.
CONCLUSIONS
The results extended our knowledge of proper clinical application of straw phonation regarding the duration of exercise. This study confirmed that 10 minutes of straw phonation lead to optimal and relatively continuous effects in PTP and mean airflow. Although straw phonation did show lingering effects in aerodynamics, repeated practices were recommended to obtain optimum and therapeutic effects.
Topics: Acoustics; Adult; Electrodiagnosis; Equipment Design; Female; Healthy Volunteers; Humans; Male; Phonation; Predictive Value of Tests; Speech Acoustics; Time Factors; Vocal Cords; Voice Quality; Voice Training; Young Adult
PubMed: 29866635
DOI: 10.1016/j.jvoice.2018.05.002 -
The Laryngoscope Feb 2023Although phonatory glottal posture and airflow pulse shape affect voice quality, studies to date have been limited by visualization of vocal fold (VF) vibration from a...
INTRODUCTION
Although phonatory glottal posture and airflow pulse shape affect voice quality, studies to date have been limited by visualization of vocal fold (VF) vibration from a superior view. We performed a 3D reconstruction of VF vibratory motion during phonation from a medial view and assessed the glottal volume waveform and resulting acoustics as a function of neuromuscular stimulation.
STUDY DESIGN
In vivo canine hemilarynx phonation.
METHODS
Across 121 unique combinations of the superior laryngeal nerve (SLN) and recurrent laryngeal nerve (RLN) stimulation, the hemilarynx was excited to the oscillation with airflow. VF medial surface reference points were tracked on high-speed video, mapped into 3D space, and surface shape was restored using cubic spline interpolation. Glottal surface shape, reconstruction-based parameters, and glottal volume waveform were calculated. Fundamental frequency (F0), cepstral peak prominence (CPP), and harmonic amplitude (H1-H2) were measured from high-quality audio samples.
RESULTS
The glottis was convergent during opening and divergent during closing. Neuromuscular activation changed phonatory glottal shape and reduced glottal volume. Significant reduction in glottal volume and closing quotient were present with SLN stimulation. RLN stimulation significantly increased F0 and CPP and decreased H1-H2 (constricted glottis), while SLN effects were similar and synergistic with concurrent RLN stimulation.
CONCLUSION
3D reconstruction of in vivo medial surface vibration revealed effects of laryngeal nerve stimulation on glottal vibratory pattern and acoustic correlates of voice quality. SLN activation resulted in significantly quicker glottal closure per cycle, decreased glottal volume, and higher-pitched, less breathy, and less noisy voice. RLN had a similar effect on acoustic measures.
LEVEL OF EVIDENCE
NA, Basic Science Laryngoscope, 133:357-365, 2023.
Topics: Animals; Dogs; Imaging, Three-Dimensional; Glottis; Vocal Cords; Phonation; Voice Quality; Vibration
PubMed: 35633189
DOI: 10.1002/lary.30178