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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 -
American Journal of Speech-language... Nov 2015Speech and other oral functions such as swallowing have been compared and contrasted with oral behaviors variously labeled quasispeech, paraspeech, speechlike, and... (Review)
Review
PURPOSE
Speech and other oral functions such as swallowing have been compared and contrasted with oral behaviors variously labeled quasispeech, paraspeech, speechlike, and nonspeech, all of which overlap to some degree in neural control, muscles deployed, and movements performed. Efforts to understand the relationships among these behaviors are hindered by the lack of explicit and widely accepted definitions. This review article offers definitions and taxonomies for nonspeech oral movements and for diverse speaking tasks, both overt and covert.
METHOD
Review of the literature included searches of Medline, Google Scholar, HighWire Press, and various online sources. Search terms pertained to speech, quasispeech, paraspeech, speechlike, and nonspeech oral movements. Searches also were carried out for associated terms in oral biology, craniofacial physiology, and motor control.
RESULTS AND CONCLUSIONS
Nonspeech movements have a broad spectrum of clinical applications, including developmental speech and language disorders, motor speech disorders, feeding and swallowing difficulties, obstructive sleep apnea syndrome, trismus, and tardive stereotypies. The role and benefit of nonspeech oral movements are controversial in many oral motor disorders. It is argued that the clinical value of these movements can be elucidated through careful definitions and task descriptions such as those proposed in this review article.
Topics: Exercise; Facial Muscles; Humans; Motor Activity; Mouth; Nonverbal Communication; Phonation; Speech; Speech Sound Disorder
PubMed: 26126128
DOI: 10.1044/2015_AJSLP-14-0179 -
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 -
Nutrients Jan 2023Dysphonia and malnutrition are major problems in patients who have suffered an ischemic stroke. Tools to assess dysphonia severity include the dysphonia severity index...
Dysphonia and malnutrition are major problems in patients who have suffered an ischemic stroke. Tools to assess dysphonia severity include the dysphonia severity index (DSI) and maximum phonation time (MPT). This study aimed to investigate whether the nutritional biomarkers transferrin, albumin, and prealbumin could be predictors of dysphonia severity. A retrospective analysis was conducted between January 2018 and October 2022. A total of 180 patients who had suffered an ischemic stroke were included. Serum transferrin, albumin, and prealbumin levels were significantly correlated with DSI and MPT levels. In a multiple regression analysis, prealbumin and transferrin were significant predictors of DSI, whereas only prealbumin was a significant predictor of MPT. Serum transferrin, albumin, and prealbumin levels in patients who have suffered an ischemic stroke may correlate with dysphonia severity as assessed using DSI and MPT. These results may provide objective evidence that nutritional biomarkers affect dysphonia severity.
Topics: Humans; Dysphonia; Voice Quality; Prealbumin; Phonation; Ischemic Stroke; Retrospective Studies; Severity of Illness Index; Transferrins; Biomarkers
PubMed: 36771359
DOI: 10.3390/nu15030652 -
The Journal of the Acoustical Society... Mar 2021In the clinic, many diagnostic and therapeutic procedures focus on the oscillation patterns of the vocal folds (VF). Dynamic characteristics of the VFs, such as...
In the clinic, many diagnostic and therapeutic procedures focus on the oscillation patterns of the vocal folds (VF). Dynamic characteristics of the VFs, such as symmetry, periodicity, and full glottal closure, are considered essential features for healthy phonation. However, the relevance of these individual factors in the complex interaction between the airflow, laryngeal structures, and the resulting acoustics has not yet been quantified. Sustained phonation was induced in nine excised porcine larynges without vocal tract (supraglottal structures had been removed above the ventricular folds). The multimodal setup was designed to simultaneously control and monitor key aspects of phonation in the three essential parts of the larynx. More specifically, measurements will comprise (1) the subglottal pressure signal, (2) high-speed recordings in the glottal plane, and (3) the acoustic signal in the supraglottal region. The automated setup regulates glottal airflow, asymmetric arytenoid adduction, and the pre-phonatory glottal gap. Statistical analysis revealed a beneficial influence of VF periodicity and glottal closure on the signal quality of the subglottal pressure and the supraglottal acoustics, whereas VF symmetry only had a negligible influence. Strong correlations were found between the subglottal and supraglottal signal quality, with significant improvement of the acoustic quality for high levels of periodicity and glottal closure.
Topics: Acoustics; Animals; Glottis; Larynx; Phonation; Pressure; Swine; Vocal Cords
PubMed: 33765793
DOI: 10.1121/10.0003602 -
PloS One 2022During the COVID-19 pandemic, a number of infection clusters associated with choral singing have been reported. Singing generates droplets and carries the risk of...
During the COVID-19 pandemic, a number of infection clusters associated with choral singing have been reported. Singing generates droplets and carries the risk of spreading infection. However, no reports have explored droplet flight and aerosol production rates by singing and speaking in Japanese. First, we conducted an observation experiment evaluating the maximum flight distance and number of droplets generated by singing in Japanese, using a high-speed camera and particle counter. Twenty amateur choir members, 10 male and 10 female (five members for each of the four voices), participated in the experiment. Subsequently, although the maximum distance that droplets traveled by singing in Japanese was 61 cm for men (median of 46.5, interquartile range, 36-57) and 56 cm for women (median of 27.5, interquartile range, 20-50), droplets were observed anteriorly and laterally to be up to 66.8 cm. At the singer's mouth, ≥ 5 μm droplets were observed, whereas not observed at 1 meter toward the front of the singers in women and men, respectively. In German singing, droplets were observed up to 111 cm toward the front of the singer, possibly reflecting differences in pronunciation. In Japanese reading aloud, droplets were also observed up to 47 cm toward the front, whereas no droplet dispersion was observed by speaking the Japanese /a/ vowel or singing with wearing surgical mask toward the front. The aerosols produced when reading singing the /u/ vowels were significantly higher than those in other vowels. When singing in a choral group, keeping a sufficient distance at the front and side is recommended in minimizing infectious spread. If distance is not possible, practicing with /a/ vowels and avoiding consonants may be an alternative method. Our observations lasted only 50 seconds per song, and further observational studies are needed to determine the dynamics of aerosols that stay for long periods.
Topics: COVID-19; Female; Humans; Japan; Male; Pandemics; Singing; Voice Quality
PubMed: 36006957
DOI: 10.1371/journal.pone.0272122 -
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 Obesity 2019Our aim in this investigation was to evaluate maximum phonation time in people with obesity not submitted to surgery and in people with obesity submitted to bariatric...
BACKGROUND
Our aim in this investigation was to evaluate maximum phonation time in people with obesity not submitted to surgery and in people with obesity submitted to bariatric surgery and compare it with maximum phonation time of healthy volunteers. The hypothesis was that the reduced maximum phonation time in people with obesity would be corrected after surgery due to weight loss.
METHOD
Maximum phonation time was evaluated in 52 class III patients (Group A), 62 class III patients who were treated by surgery 3 to 115 months before (Group B), 20 controls (Group C), and 15 class III patients whose maximum phonation time was evaluated before and two to six months after surgery (Group D). Maximum phonation time was measured in the sitting position with the vowels /A/, /I/, and /U/.
RESULTS
Maximal phonation time was shorter in groups A and B compared with that of controls. There was an increase in maximal phonation time after surgery (Group B); however, the difference was not significant when compared with that in group A. In group D, maximal phonation time for /A/ increased after the surgery. In group A, there was a negative correlation between maximal phonation time and weight or body mass index and a positive correlation between maximal phonation time and height. In group B, there was an almost significant positive relation between percentage of weight loss and maximal phonation time for /A/ (=0.08) and /I/ (=0.07). Mean values of spirometry testing (FEV, FVC, and FEV/FVC) in people with obesity (groups A and B), expressed as percentage of the predicted value, were within the normal range.
CONCLUSION
Compared with healthy controls, maximal phonation time is shorter in people with obesity, with a tendency to increase after bariatric surgery, as a possible consequence of weight loss.
Topics: Adult; Analysis of Variance; Bariatric Surgery; Female; Forced Expiratory Volume; Humans; Male; Middle Aged; Obesity, Morbid; Patient Selection; Phonation; Retrospective Studies; Treatment Outcome; Voice Disorders; Weight Loss; Young Adult
PubMed: 31976088
DOI: 10.1155/2019/5903621 -
American Journal of Speech-language... Nov 2022Voice therapy is the primary treatment for children presenting with benign morphological vocal fold changes. This study examined the number of voice therapy sessions... (Observational Study)
Observational Study
PURPOSE
Voice therapy is the primary treatment for children presenting with benign morphological vocal fold changes. This study examined the number of voice therapy sessions required to meet treatment goals and identified factors that predicted treatment length for pediatric voice patients.
METHOD
An observational cohort design was employed. Data were extracted from the University of Wisconsin-Madison Voice and Swallow Outcome Database. This study examined 62 children who completed a course of voice therapy with a speech-language pathologist (SLP) addressing dysphonia caused by benign vocal fold lesions. Extracted data included patient demographics, auditory-perceptual assessments, acoustic and aerodynamic voice measures, videostroboscopy ratings, and medical comorbidities. Linear regression was used to identify predictors of number of therapy sessions.
RESULTS
Patients received an average of 7.5 sessions of voice therapy prior to discharge. Baseline auditory-perceptual assessment of dysphonia ( = .032), phonation threshold pressure (PTP, = .005), Glottal Function Index (GFI) score ( = .006), and glottic closure pattern ( = .023) were significant predictors of number of voice therapy sessions. These measures, as well as hourglass glottic closure, predicted longer intervention duration. The regression model had an overall of .62.
CONCLUSIONS
Pediatric voice therapy addressing benign vocal fold lesions and/or laryngeal edema required an average of 7.54 sessions before voice outcomes were sufficiently improved for discharge. More severe overall SLP ratings of dysphonia, GFI scores, PTP, or hourglass glottic closure pattern significantly predicted increased number of therapy sessions prior to discharge. Future work should determine what other factors affect treatment duration and how the efficiency of pediatric voice therapy can be maximized.
Topics: Humans; Child; Dysphonia; Voice Quality; Patient Discharge; Phonation; Vocal Cords
PubMed: 36198045
DOI: 10.1044/2022_AJSLP-22-00111 -
International Journal of Occupational... Nov 2023Objective was to find personality traits in singers performing various music styles and with different singing status.
OBJECTIVES
Objective was to find personality traits in singers performing various music styles and with different singing status.
MATERIAL AND METHODS
The study consisted of 87 singers (66 females, 21 males; age: M±SD 25.5±8.2 years; 40 students, 22 professionals and 25 amateurs; 38 classical singers, 42 contemporary commercial music [CCM] singers; 55 solo singers and 22 choral singers). Participants filled in the questionnaire and demographic information form.
RESULTS
Median values compared to the Polish general population, suggest that solo, CCM, student and professional singers have a high level of conscientiousness. Those who sing in a choir, classical music, amateurs and students have relatively high level of agreeableness. High level of extraversion is observed among CCM singers and students. Students score higher on extraversion then professionals (p < 0.001). Professionals score higher on extraversion then amateurs (p < 0.01). Professionals less frequently than amateurs and students score high on agreeableness (p < 0.001). High scores on conscientiousness are significantly higher among professionals and students compared to amateurs (p < 0.001 in both cases). Solo singers have higher level of conscientiousness (p < 0.001) and openness (p < 0.001) and lower neuroticism (p < 0.01) than choral singers. Classical singers more often than CCM singers score low on openness (p < 0.01) and high on agreeableness (p < 0.01).
CONCLUSIONS
Classical singers have lower level of openness and higher level of agreeableness than CCM singers. Neuroticism is higher among choir than solo singers and conscientiousness is higher among solo than choir singers. Amateurs had the highest level of neuroticism and the lowest level of conscientiousness as compared with professional singers and students. Int J Occup Med Environ Health. 2023;36(4):541-50.
Topics: Male; Female; Humans; Singing; Music; Occupations; Students; Neuroticism; Personality
PubMed: 37750428
DOI: 10.13075/ijomeh.1896.02099