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The Annals of Otology, Rhinology, and... Nov 2014This study aimed to correlate maximum phonation time, vocal intensity, and dynamic extension with intraluminal esophageal and pharyngoesophageal segment pressure during...
OBJECTIVE
This study aimed to correlate maximum phonation time, vocal intensity, and dynamic extension with intraluminal esophageal and pharyngoesophageal segment pressure during tracheoesophageal phonation.
DESIGN
Prospective analysis.
SETTING
Tertiary academic hospital.
METHODS
The study was conducted on 20 total laryngectomees with alaryngeal speech and with secondary insertion of a tracheoesophageal prosthesis who were submitted to vocal recording of maximum phonation time and vocal intensity (minimum, habitual, and maximum). The participants were then submitted to manometry for the determination of the amplitude of intraluminal esophageal (proximal, middle, and distal) and pharyngoesophageal segment pressure during phonation.
RESULTS
A significant positive correlation was detected between habitual vocal intensity and the middle (0.004) and distal (0.05) esophagus, in addition to a correlation of maximum intensity with the middle esophageal portion (0.03). Dynamic extension showed correlation with the amplitude of esophageal pressure. There was no significant correlation between the variables studied and pressure of the pharyngoesophageal segment or between maximum phonation time and esophageal pressure amplitude.
CONCLUSION
The middle and distal regions of the esophagus were found to be compliant, permitting an adjustment of vocal intensity. There was no correlation between maximum phonation time and the amplitude of esophageal and pharyngoesophageal segment pressure.
Topics: Esophagus; Female; Humans; Laryngectomy; Larynx, Artificial; Male; Manometry; Middle Aged; Pharynx; Phonation; Pressure; Prospective Studies; Speech, Esophageal; Voice Quality
PubMed: 24944280
DOI: 10.1177/0003489414538766 -
CoDAS 2020This study aims to measure the pressure of the pharynx and the pharyngoesophageal segment (PES) at rest and during phonation in total laryngectomized patients, with...
PURPOSE
This study aims to measure the pressure of the pharynx and the pharyngoesophageal segment (PES) at rest and during phonation in total laryngectomized patients, with different levels of voice production.
METHODS
four total laryngectomized individuals participated in the study, All patients underwent High Resolution Manometry (MAR) at rest and during phonation. After this process, a descriptive analysis of the results was performed.
RESULTS
we observed that during rest the patients had PES pressure below normal and this data may be related to changes in the muscular connections at the level of the upper esophageal sphincter (UES) especially the interruption of the cricopharyngeal plexus. During phonation, two patients presented higher UES pressure values during phonation, when compared to the values found at rest, suggesting that introduction of air into the esophagus is followed by pharyngoesophageal contraction and that during phonation the patients with good esophageal speech may develop more pressure in this region.
CONCLUSION
Studies with a greater number of participants may help define, for example, subjects who may benefit from procedures such as cricopharyngeal myotomy or other medical conduct in order to facilitate the acquisition of esophageal voice in these patients.
Topics: Esophagus; Humans; Laryngectomy; Manometry; Pharynx; Phonation; Speech, Esophageal
PubMed: 33237186
DOI: 10.1590/2317-1782/20202019006 -
Journal of Voice : Official Journal of... May 2023Biomechanical modeling allows obtaining information on physical phenomena that cannot be directly observed. This study aims to review models that represent voice... (Review)
Review
Biomechanical modeling allows obtaining information on physical phenomena that cannot be directly observed. This study aims to review models that represent voice production. A systematic review of the literature was conducted using PubMed/Medline, SCOPUS, and IEEE Xplore databases. To select the papers, we used the protocol PRISMA Statement. A total of 53 publications were included in this review. This article considers a taxonomic classification of models found in the literature. We propose four categories in the taxonomy: (1) Models representing the Source (Vocal folds); (2) Models representing the Filter (Vocal Tract); (3) Models representing the Source - Filter Interaction; and (4) Models representing the Airflow - Source Interaction. We include a bibliographic analysis with the evolution of the publications per category. We provide an analysis of the number as well of publications in journals per year. Moreover, we present an analysis of the term occurrence and its frequency of usage, as found in the literature. In each category, different types of vocal production models are mentioned and analyzed. The models account for the analysis of evidence about aerodynamic, biomechanical, and acoustic phenomena and their correlation with the physiological processes involved in the production of the human voice. This review gives an insight into the state of the art related to the mathematical modeling of voice production, analyzed from the viewpoint of vocal physiology.
Topics: Humans; Phonation; Biomechanical Phenomena; Vocal Cords; Voice; Acoustics
PubMed: 33678534
DOI: 10.1016/j.jvoice.2021.02.014 -
Journal of Voice : Official Journal of... Jul 2023While the vocal fold is in direct contact anteriorly with the thyroid cartilage, posteriorly the vocal fold connects to the thyroid cartilage through a soft tissue layer...
OBJECTIVE
While the vocal fold is in direct contact anteriorly with the thyroid cartilage, posteriorly the vocal fold connects to the thyroid cartilage through a soft tissue layer in the paraglottic space. Currently the paraglottic space is often neglected in computational models of phonation, in which a fixed boundary condition is often imposed on the lateral surface of the vocal fold. The goal of this study was to investigate the effect of the paraglottic space on voice production in an MRI-based vocal fold model, and how this effect may be counteracted by vocal fold stiffening due to laryngeal muscle activation.
METHODS
Parametric simulation study using an MRI-based computational vocal fold model.
RESULTS
The results showed that the presence of the paraglottic space increased the mean and amplitude of the glottal area waveform, decreased the phonation frequency and closed quotient. For the particular vocal fold geometry used in this study, the presence of the paraglottic space also reduced the occurrence of irregular vocal fold vibration. These effects of the paraglottic space became smaller with increasing paraglottic space stiffness and to a lesser degree with vocal fold stiffening.
CONCLUSIONS
The results suggest that the paraglottic space may be neglected in qualitative evaluations of normal phonation, but needs to be included in simulations of pathological phonation or vocal fold posturing.
Topics: Humans; Vocal Cords; Voice; Phonation; Glottis; Vibration; Magnetic Resonance Imaging
PubMed: 33752927
DOI: 10.1016/j.jvoice.2021.02.021 -
The Journal of the Acoustical Society... Jan 2023Synthetic vocal fold (VF) replicas were used to explore the role of nodule size and stiffness on kinematic, aerodynamic, and acoustic measures of voiced speech...
Synthetic vocal fold (VF) replicas were used to explore the role of nodule size and stiffness on kinematic, aerodynamic, and acoustic measures of voiced speech production. Emphasis was placed on determining how changes in collision pressure may contribute to the development of phonotrauma. This was performed by adding spherical beads with different sizes and moduli of elasticity at the middle of the medial surface of synthetic silicone VF models, representing nodules of varying size and stiffness. The VF models were incorporated into a hemilaryngeal flow facility. For each case, self-sustained oscillations were investigated at the phonation threshold pressure. It was found that increasing the nodule diameter increased the open quotient, phonation threshold pressure, and phonation threshold flow rate. However, these values did not change considerably as a function of the modulus of elasticity of the nodule. Nevertheless, the ratio of collision pressure to subglottal pressure increased significantly for both increasing nodule size and stiffness. This suggests that over time, both growth in size and fibrosis of nodules will lead to an increasing cycle of compensatory vocal hyperfunction that accelerates phonotrauma.
Topics: Vocal Cords; Pressure; Vibration; Phonation; Elasticity
PubMed: 36732229
DOI: 10.1121/10.0016997 -
The Journal of the Acoustical Society... Jan 2022The periodic repetitions of laryngeal adduction and abduction gestures were uttered by 16 subjects. The movement of the cuneiform tubercles was tracked over time in the...
The periodic repetitions of laryngeal adduction and abduction gestures were uttered by 16 subjects. The movement of the cuneiform tubercles was tracked over time in the laryngoscopic recordings of these utterances. The adduction velocity and abduction velocity were determined objectively by means of a piecewise linear model fitted to the cuneiform tubercle trajectories. The abduction was found to be significantly faster than the adduction. This was interpreted in terms of the biomechanics and active control by the nervous system. The biomechanical properties could be responsible for a velocity of abduction that is up to 51% higher compared to the velocity of adduction. Additionally, the adduction velocity may be actively limited to prevent an overshoot of the intended adduction degree when the vocal folds are approximated to initiate phonation.
Topics: Gestures; Humans; Larynx; Movement; Phonation; Vocal Cords
PubMed: 35105025
DOI: 10.1121/10.0009141 -
Journal of Voice : Official Journal of... Jul 2015Previous research suggests that independent variation of vocal loudness and glottal configuration (type and degree of vocal fold adduction) does not occur in untrained...
Previous research suggests that independent variation of vocal loudness and glottal configuration (type and degree of vocal fold adduction) does not occur in untrained speech production. This study investigated whether these factors can be varied independently in trained singing and how subglottal pressure is related to average glottal airflow, voice source properties, and sound level under these conditions. A classically trained baritone produced sustained phonations on the endoscopic vowel [i:] at pitch D4 (approximately 294 Hz), exclusively varying either (a) vocal register; (b) phonation type (from "breathy" to "pressed" via cartilaginous adduction); or (c) vocal loudness, while keeping the others constant. Phonation was documented by simultaneous recording of videokymographic, electroglottographic, airflow and voice source data, and by percutaneous measurement of relative subglottal pressure. Register shifts were clearly marked in the electroglottographic wavegram display. Compared with chest register, falsetto was produced with greater pulse amplitude of the glottal flow, H1-H2, mean airflow, and with lower maximum flow declination rate (MFDR), subglottal pressure, and sound pressure. Shifts of phonation type (breathy/flow/neutral/pressed) induced comparable systematic changes. Increase of vocal loudness resulted in increased subglottal pressure, average flow, sound pressure, MFDR, glottal flow pulse amplitude, and H1-H2. When changing either vocal register or phonation type, subglottal pressure and mean airflow showed an inverse relationship, that is, variation of glottal flow resistance. The direct relation between subglottal pressure and airflow when varying only vocal loudness demonstrated independent control of vocal loudness and glottal configuration. Achieving such independent control of phonatory control parameters would be an important target in vocal pedagogy and in voice therapy.
Topics: Adult; Endoscopy; Glottis; Humans; Kymography; Male; Singing; Speech Acoustics
PubMed: 25944295
DOI: 10.1016/j.jvoice.2014.08.009 -
Odontology Oct 2020Many modified Mallampati tests have been developed to date. Samsoon's modified Mallampati test (standard Mallampati test) is currently widely used. We newly designed...
Many modified Mallampati tests have been developed to date. Samsoon's modified Mallampati test (standard Mallampati test) is currently widely used. We newly designed seven types of assessment protocol of Mallampati test, in addition to standard Mallampati test. In this study, we studied the correlation between eight types of protocol (standard and seven alternative protocols) of Mallampati test and Cormack-Lehane test. We newly designed assessment protocols as new Mallampati test. These are different protocols depending on the presence or absence of phonation, those of protrusion of tongue, and sitting position or supine position. The oropharyngeal structures visualized by these eight types of Mallampati test for total of 145 patients undergoing dental oral surgery were evaluated. The scores derived via eight types of Mallampati test were recorded. The influence of phonation, tongue protrusion and body position on Mallampati test score was analyzed, respectively. The relationships between eight types of Mallampati test and Cormack-Lehane test were analyzed. Tongue protrusion, phonation and sitting position tended to lower the score of Mallampati test (p < 0.001, respectively). The standard Mallampati test was not correlated with Cormack-Lehane test. In the new Mallampati tests, assessment protocol with tongue protrusion, phonation and sitting position, that with tongue protrusion and supine position, or that with tongue protrusion, phonation and supine position were significantly correlated with Cormack-Lehane test, respectively. (p = 0.020, p = 0.007 and p = 0.004, respectively). The standard Mallampati test did not correlate with Cormack-Lehane test. Mallampati test with phonation, tongue protrusion and supine position were most correlated with Cormack-Lehane test.
Topics: Humans; Intubation, Intratracheal; Laryngoscopy; Oropharynx; Phonation; Supine Position
PubMed: 32040653
DOI: 10.1007/s10266-020-00490-3 -
CoDAS 2021To verify the immediate effect of the Excitomotor Electrical Current, called Functional Electrical Stimulation (FES), on vocal quality, Maximum Phonation Time (MPT) and...
PURPOSE
To verify the immediate effect of the Excitomotor Electrical Current, called Functional Electrical Stimulation (FES), on vocal quality, Maximum Phonation Time (MPT) and possible discomfort, in women without vocal alteration, with application at Maximum Supported Intensity (MSI) and associated with phonation.
METHODS
Experimental study with 20 normophonic adult women. They emitted the sustained vowel / a / and then it was applied to FES during emission of the same vowel. There were five series with three minutes of emission each, interspersed with passive rest. The electrical stimulus was at the MSI by the participant, adjusted by series. Before and after the emissions the voices were recorded and the MPT and the intensity of the stimuli were collected. The vocal quality was rated by judges. Statistical analysis made it possible to compare pre and post emission / electrostimulation data in each phase. Qualitative analysis was performed based on self-reported symptoms.
RESULTS
There was no difference in vocal quality and MPT between pre and post moments in both phases. The difference between MSI and stimulus perception intensity was greater in series 1 than in series 2. There was an increase in MSI in series 5 compared to series 1. No significant negative symptoms or within 48h after procedures were reported.
CONCLUSION
The FES at MSI, associated with phonation, did not generate an immediate change in vocal quality, in the MPT or self-reported discomforts by women without vocal alteration, even with a gradual increase in the stimulus, series by series.
Topics: Adult; Electric Stimulation Therapy; Female; Humans; Phonation; Time Factors; Voice Disorders; Voice Quality
PubMed: 33909842
DOI: 10.1590/2317-1782/20202019190 -
Journal of Voice : Official Journal of... Jan 2022Phonation type, a phonatory dimension ranging from hypofunctional/breathy to hyperfunctional/pressed, is important both from a clinical and acoustical point of view;...
Phonation type, a phonatory dimension ranging from hypofunctional/breathy to hyperfunctional/pressed, is important both from a clinical and acoustical point of view; hyperfunctional voice can lead to voice disorders and hypofunctional voice reduces text intelligibility. Five male singers sang diminuendo sequences of the syllable /pae/ and three of them also produced speech or singing samples with different phonation types which were rated for phonatory pressedness by a panel of voice experts. The sequences were analyzed by inverse filtering and the associated subglottal pressures were estimated as the oral pressures during the /p/ occlusion. The results showed strong quasi-linear correlations between the peak-to-peak amplitude of the flow glottogram (henceforth pulse amplitude) and mean subglottal pressure, mean airflow, and the level difference between the first and second voice source partials L-L. These correlations were found to vary systematically with phonation type. Regardless of phonation type, the correlation between the pulse amplitude and the amplitude of the voice source fundamental frequency was very close to 1.0. The level difference between the first and second spectrum partials L-L in narrow-band long-term-average spectra of speech and singing was found to vary systematically with phonation type in a manner related to voice experts' ratings of perceived degree of pressedness. The findings support the assumption that the combination of subglottal pressure and level of the voice source fundamental is useful for an objective measure of phonation type.
Topics: Glottis; Humans; Male; Phonation; Singing; Speech; Voice
PubMed: 32402665
DOI: 10.1016/j.jvoice.2020.03.018