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Acta Bio-medica : Atenei Parmensis Apr 2017This article attempts to describe the aging process of the vocal folds and the main features of the aged voice. (Review)
Review
AIM
This article attempts to describe the aging process of the vocal folds and the main features of the aged voice.
BACKGROUND
In the world ageing population era, aging diseases and aging disorders are crucial. Voice disorders (presbyphonia) are common in the elderly and have a significant impact on communication and quality of life. Some of these disorders depend on the vocal folds, which consist of an extracellular matrix (ECM), fibrous proteins, interstitial proteins, and glycosaminoglycans. The density and spatial arrangement of these elements are important, as changes in their deposition can alter the biomechanical properties and vibratory function of the vocal folds.
DISCUSSION
The aging voice process is analyzed in detail from mechanical factors like pulmonary bellows alteration, to hormonal factors and life style.
CONCLUSIONS
The elderly people undergoe mechanical, anatomical and functional changes: alterations of the pulmonary bellows, systemic changes like hormonal disregulation, and laryngeal changes, that resulting in hoarseness, which is difficult to treat.
Topics: Aging; Gonadal Steroid Hormones; Humans; Life Style; Phonation; Respiratory Muscles; Vocal Cords; Voice Quality
PubMed: 28467327
DOI: 10.23750/abm.v88i1.5266 -
JAMA Otolaryngology-- Head & Neck... Feb 2018Benign vocal fold nodules affect 12% to 22% of the pediatric population, and 95% of otolaryngologists recommend voice therapy as treatment. However, no randomized... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Benign vocal fold nodules affect 12% to 22% of the pediatric population, and 95% of otolaryngologists recommend voice therapy as treatment. However, no randomized clinical trials that we are aware of have shown its benefits.
OBJECTIVE
To determine the impact of voice therapy in children with vocal fold nodules according to pretherapy and posttherapy scores on the Pediatric Voice-Related Quality of Life (PVRQOL) survey; secondary objectives included changes in phonatory parameters.
DESIGN, SETTING, AND PARTICIPANTS
For this multicenter randomized clinical trial, 114 children ages 6 to 10 years with vocal fold nodules, PVRQOL scores less than 87.5, and dysphonia for longer than 12 weeks were recruited from outpatient voice and speech clinics. This age range was identified because these patients have not experienced pubertal changes of the larynx, tolerate stroboscopy, and cooperate with voice therapy. Participants were blinded to treatment arm.
INTERVENTIONS
Participants received either indirect or direct therapy for 8 to 12 weeks. Indirect therapy focused on education and discussion of voice principles, while direct treatment used the stimulus, response, antecedent paradigm.
MAIN OUTCOMES AND MEASURES
The primary outcome measure was PVRQOL score change before and after treatment. Secondary phonatory measures were also compared.
RESULTS
Overall, 114 children were recruited for study (mean [SD] age, 8 [1.4] years; 83 males [73%]); with 57 randomized to receive either indirect or direct therapy. Both direct and indirect therapy approaches showed significant differences in PVRQOL scores pretherapy to posttherapy. The mean increase in PVRQOL score for direct therapy was 19.2, and 14.7 for indirect therapy (difference, 4.5; 95.3% CI, -10.8 to 19.8). Of 44 participants in the direct therapy group, 27 (61%) achieved a clinically meaningful PVRQOL improvement, compared with 26 of 49 (53%) for indirect therapy (difference, 8%; 95% CI, -12 to 28). Post hoc stratification showed robust effects in the direct therapy group for older children (Cohen d = 0.50) and the latter two-thirds of participants (Cohen d = 0.46). Vocal fold nodules reduced in size in 31% (22 of 70) and completely resolved in 11% (8 of 70) of participants who consented to a second set of images after going through the recruitment process.
CONCLUSIONS AND RELEVANCE
Both direct and indirect voice therapy improved voice-related quality of life in children with vocal fold nodules, although there was no significant difference between approaches. Future studies may focus upon which voice therapy approaches are effective in treating age-defined populations.
TRIAL REGISTRATION
clinicaltrials.gov Identifier: NCT01255735.
Topics: Child; Female; Humans; Laryngeal Diseases; Male; Patient Compliance; Phonation; Quality of Life; Vocal Cords; Voice Quality; Voice Training
PubMed: 29270612
DOI: 10.1001/jamaoto.2017.2618 -
Journal of Voice : Official Journal of... Jan 2020The larynx is a complex organ which has a role in a variety of functions such as phonation, breathing, and swallowing. To research these functions, it is widely accepted... (Review)
Review
The larynx is a complex organ which has a role in a variety of functions such as phonation, breathing, and swallowing. To research these functions, it is widely accepted that in vivo studies provide more anatomically and physiologically relevant findings. However, invasive procedures are generally needed to measure variables such a subglottal pressure, vocal fold tension and stiffness, and cricothyroid muscle stretch. Performing studies using excised larynges is a useful technique which makes it possible to not only measure phonation parameters but control them as well. Early studies using excised larynges mainly focused on controlling specific parameters and mathematical modeling simulations. The use of these studies has helped further research in laryngeal anatomy, imaging techniques, as well as aerodynamic, acoustic, and biomechanical properties. Here, we describe the progress of this research over the past 5 years. The number of accepted animal models has increased and ideas from excised larynx studies are starting to be applied to treatment methods for laryngeal disorders. These experiments are only valid for an excised situation and must continue to be combined with animal experimentation and clinical observations.
Topics: Animals; Biomechanical Phenomena; Computer Simulation; Humans; Laryngectomy; Larynx; Models, Animal; Models, Theoretical; Phonation
PubMed: 30262190
DOI: 10.1016/j.jvoice.2018.07.023 -
The European Respiratory Journal May 2022
Topics: Humans; Lung; Pulmonary Disease, Chronic Obstructive; Singing; Thorax
PubMed: 35589115
DOI: 10.1183/13993003.02961-2021 -
Nature Neuroscience Dec 2023Mammalian vocalizations are critical for communication and are produced through the process of phonation, in which expiratory muscles force air through the tensed vocal...
Mammalian vocalizations are critical for communication and are produced through the process of phonation, in which expiratory muscles force air through the tensed vocal folds of the larynx, which vibrate to produce sound. Despite the importance of phonation, the motor circuits in the brain that control it remain poorly understood. In this study, we identified a subpopulation of ~160 neuropeptide precursor Nts (neurotensin)-expressing neurons in the mouse brainstem nucleus retroambiguus (RAm) that are robustly activated during both neonatal isolation cries and adult social vocalizations. The activity of these neurons is necessary and sufficient for vocalization and bidirectionally controls sound volume. RAm Nts neurons project to all brainstem and spinal cord motor centers involved in phonation and activate laryngeal and expiratory muscles essential for phonation and volume control. Thus, RAm Nts neurons form the core of a brain circuit for making sound and controlling its volume, which are two foundations of vocal communication.
Topics: Animals; Male; Sheep; Mice; Vocalization, Animal; Larynx; Neurons; Brain Stem; Phonation; Mammals
PubMed: 37996531
DOI: 10.1038/s41593-023-01478-2 -
Cognitive Science May 2021Sound symbolism is a non-arbitrary correspondence between sound and meaning. The majority of studies on sound symbolism have focused on consonants and vowels, and the...
Sound symbolism is a non-arbitrary correspondence between sound and meaning. The majority of studies on sound symbolism have focused on consonants and vowels, and the sound-symbolic properties of suprasegmentals, particularly phonation types, have been largely neglected. This study examines the size and shape symbolism of four phonation types: modal and creaky voices, falsetto, and whisper. Japanese speakers heard 12 novel words (e.g., /íbi/, /ápa/) pronounced with the four types of phonation and rated the size and roundedness/pointedness each of the 48 stimuli seemed to represent on seven-point scales. The results showed that phonation types as well as consonantal and vocalic features influenced the ratings. Creaky voice was associated with larger and more pointed images than modal voice, which was in turn associated with larger and more pointed images than whisper. Falsetto was also associated with roundedness but not with smallness. These results shed new light on the acoustic approaches to sound symbolism and suggest the significance of phonation types and other suprasegmental features in the phenomenon.
Topics: Hearing; Humans; Language; Phonation; Sound; Symbolism
PubMed: 34018216
DOI: 10.1111/cogs.12982 -
Current Biology : CB Mar 2023Bass describes the fascinating life history, behavior, and neurobiology of the California singing fish, including its remarkable vocal abilities.
Bass describes the fascinating life history, behavior, and neurobiology of the California singing fish, including its remarkable vocal abilities.
Topics: Animals; Singing; Fishes; California; Vocalization, Animal
PubMed: 36977377
DOI: 10.1016/j.cub.2023.02.014 -
Journal of Voice : Official Journal of... Sep 2021Synthetic vocal fold (VF) models used for studying the physics of voice production are comprised of silicone and fabricated using traditional casting processes. The...
OBJECTIVE
Synthetic vocal fold (VF) models used for studying the physics of voice production are comprised of silicone and fabricated using traditional casting processes. The purpose of this study was to develop and demonstrate a new method of creating synthetic VF models through 3D printing in order to reduce model fabrication time, increase yield, and lay the foundation for future models with more life-like geometric, material, and vibratory properties.
STUDY DESIGN
Basic science.
METHODS
A 3D printing technique based on embedding a UV-curable liquid silicone into a gel-like medium was selected and refined. Cubes were printed and subjected to tensile testing to characterize their material properties. Self-oscillating VF models were then printed, coated with a thin layer of silicone representing the epithelium, and used in phonation tests to gather onset pressure, frequency, and amplitude data.
RESULTS
The cubes were found to be anisotropic, exhibiting different modulus values depending on the orientation of the printed layers. The VF models self-oscillated and withstood the strains induced by phonation. Print parameters were found to affect model vibration frequency and onset pressure. Primarily due to the design of the VF models, their onset pressures were higher than what is found in human VFs. However, their frequencies were within a comparable range.
CONCLUSION
The results demonstrate the ability to 3D print synthetic, self-oscillating VF models. It is anticipated that this method will be further refined and used in future studies exploring flow-induced vibratory characteristics of phonation.
Topics: Humans; Models, Anatomic; Models, Biological; Phonation; Printing, Three-Dimensional; Vibration; Vocal Cords; Voice
PubMed: 32312610
DOI: 10.1016/j.jvoice.2020.01.030 -
Ear, Nose, & Throat Journal Feb 2024This case highlights the consequences of colon interposition on phonation and swallowing. Findings in this patient included laryngopharyngeal reflux, vocal fold...
SIGNIFICANCE STATEMENT
This case highlights the consequences of colon interposition on phonation and swallowing. Findings in this patient included laryngopharyngeal reflux, vocal fold paralysis, poor esophageal peristalsis, failed bolus transfers, and others. The mechanical and functional differences between the colon and the esophagus can impact bolus transfer, reflux, and phonation. Further research is required to identify the mechanisms by which colon interposition can impact voice and swallowing.
Topics: Humans; Dysphonia; Voice; Phonation; Laryngopharyngeal Reflux; Colon
PubMed: 34427138
DOI: 10.1177/01455613211041786 -
Journal of Voice : Official Journal of... Mar 2021
Topics: Humans; Music; Pandemics; Singing; Voice Quality
PubMed: 32826118
DOI: 10.1016/j.jvoice.2020.07.031