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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 -
Journal of Voice : Official Journal of... Nov 2023It is well understood that hearing plays an important role in accurate vocal production. Singers in particular rely on auditory cues and auditory feedback to reproduce...
INTRODUCTION
It is well understood that hearing plays an important role in accurate vocal production. Singers in particular rely on auditory cues and auditory feedback to reproduce specific pitch contours. Therefore, even mild hearing loss may have a detrimental effect on a singer's ability to perform. This study investigates the effect of hearing loss on self-reported vocal production in singers, specifically in the domains of pitch matching, pitch maintenance, vowel production, and dynamic control as well as the effect of hearing loss on vocal handicap.
METHODS
An 18-item electronic self-report survey was distributed to the members of the National Association of Teachers of Singing and to the Voice Foundation. Data collected included demographics, the Singing Voice Handicap Index-10 (SVHI-10), and a series of closed and open-ended questions. Demographic variables, variables related to the SVHI-10, and variables related to the newly introduced survey were included in a hierarchical regression analysis to determine significant relationships.
RESULTS
Among 206 eligible participants, 37 individuals reported a voice problem, 58 reported hearing loss, and 19 reported concurrent hearing loss and a voice problem. Among males, there were no significant differences between hearing impaired and normal hearing singers in reported pitch matching, pitch maintenance, dynamic control, and vowel matching when those with voice problems were excluded and included. However, in females, when singers with voice problems were excluded, there was a significant difference between hearing impaired and normal hearing singers in pitch matching (P = 0.38). Additionally, when singers with voice problems were included in the female subset, significant differences emerged between the hearing impaired and normal hearing singers in areas of pitch matching (P = 0.01) and vowel matching (P = 0.02). Further, controlling for gender, when excluding voice problems, there was a significant difference between the SVHI-10 scores of normal hearing (mean = 9.03) and hearing impaired participants (mean = 11.30, P = 0.02). This difference continued to be significant when including those with voice problems (normal hearing mean = 9.97, hearing impaired mean=14.1, P <0.0001). Additionally, individuals with hearing impairments were more likely to report higher perceived vocal handicap scores as reflected on the SVHI-10 than normal hearing respondents (P = 0.002). Other factors associated with higher likelihood of SVHI-10 score include older age (P = 0.008), having a voice problem (P <0.0001), and being paid to sing within the past six months (P = 0.001).
CONCLUSION
When controlling for voice problems, singers with hearing impairments subjectively did not perceive that they performed less accurately on pitch matching, pitch maintenance, dynamic control, and vowel matching, yet they scored higher on the SVHI-10 indicating vocal handicap. Further study is needed to characterize the relationship between perceived and measured vocal accuracy in singers with hearing loss.
Topics: Male; Humans; Female; Singing; Voice Quality; Voice Disorders; Surveys and Questionnaires; Hearing Loss; Deafness
PubMed: 34315652
DOI: 10.1016/j.jvoice.2021.06.021 -
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 -
NeuroImage Aug 2022The neural processing of speech and music is still a matter of debate. A long tradition that assumes shared processing capacities for the two domains contrasts with...
The neural processing of speech and music is still a matter of debate. A long tradition that assumes shared processing capacities for the two domains contrasts with views that assume domain-specific processing. We here contribute to this topic by investigating, in a functional magnetic imaging (fMRI) study, ecologically valid stimuli that are identical in wording and differ only in that one group is typically spoken (or silently read), whereas the other is sung: poems and their respective musical settings. We focus on the melodic properties of spoken poems and their sung musical counterparts by looking at proportions of significant autocorrelations (PSA) based on pitch values extracted from their recordings. Following earlier studies, we assumed a bias of poem-processing towards the left and a bias for song-processing on the right hemisphere. Furthermore, PSA values of poems and songs were expected to explain variance in left- vs. right-temporal brain areas, while continuous liking ratings obtained in the scanner should modulate activity in the reward network. Overall, poem processing compared to song processing relied on left temporal regions, including the superior temporal gyrus, whereas song processing compared to poem processing recruited more right temporal areas, including Heschl's gyrus and the superior temporal gyrus. PSA values co-varied with activation in bilateral temporal regions for poems, and in right-dominant fronto-temporal regions for songs. Continuous liking ratings were correlated with activity in the default mode network for both poems and songs. The pattern of results suggests that the neural processing of poems and their musical settings is based on their melodic properties, supported by bilateral temporal auditory areas and an additional right fronto-temporal network known to be implicated in the processing of melodies in songs. These findings take a middle ground in providing evidence for specific processing circuits for speech and music in the left and right hemisphere, but simultaneously for shared processing of melodic aspects of both poems and their musical settings in the right temporal cortex. Thus, we demonstrate the neurobiological plausibility of assuming the importance of melodic properties in spoken and sung aesthetic language alike, along with the involvement of the default mode network in the aesthetic appreciation of these properties.
Topics: Acoustic Stimulation; Auditory Perception; Brain Mapping; Humans; Magnetic Resonance Imaging; Music; Singing; Speech
PubMed: 35569784
DOI: 10.1016/j.neuroimage.2022.119310 -
International Journal of Environmental... Aug 2022Music therapy is an effective way to treat the gait disorders caused by Parkinson's disease. Rhythm music stimulation, therapeutic singing, and therapeutic instrument... (Review)
Review
Music therapy is an effective way to treat the gait disorders caused by Parkinson's disease. Rhythm music stimulation, therapeutic singing, and therapeutic instrument performance are often used in clinical practice. The mechanisms of music therapy on the gait of patients with Parkinson's disease include the compensation mechanism of cerebellum recruitment, rhythm entrainment, acceleration of motor learning, stimulation of neural coherence, and increase of cortical activity. All mechanisms work together to complete the intervention of music therapy on patients' gait and help patients to recover better. In this paper, the effect of music therapy on gait disorders in Parkinson's disease patients was reviewed, and some suggestions were put forward.
Topics: Gait; Gait Disorders, Neurologic; Humans; Music; Music Therapy; Parkinson Disease; Singing
PubMed: 35954925
DOI: 10.3390/ijerph19159568