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Journal of Speech, Language, and... Feb 2020Purpose Approximately 30% of adults over the age of 50 years present with altered vocal function. Our understanding of how these changes manifest acoustically and... (Meta-Analysis)
Meta-Analysis
Purpose Approximately 30% of adults over the age of 50 years present with altered vocal function. Our understanding of how these changes manifest acoustically and perceptually is derived from relatively modest-sized studies using a diversity of tools. Voice changes can arise from the onset of disease or disorder, but also age-related physiological changes, which may not reflect pathology as such. Here, we bring together data on acoustic, perceptual, and instrumental assessments (electroglottography), with the aim of gaining a better understanding of the changes occurring across these measurement domains. We consider these changes in the context of different acoustic features, software programs, and perceptual protocols. Method Studies of voice function in healthy older adults over the age of 50 years were sought. Literature was systematically searched with 746 abstracts reviewed. Forty-seven studies were included in the review. A meta-analysis of included studies compared voice acoustic parameters between sex and age. Sixteen acoustic parameters collected from 1,475 participants were analyzed in the meta-analysis. These included some previously unpublished analyses using data provided by authors of included studies. Results Data from the systematic review suggest that older individuals are perceived to present with higher overall scores of dysphonia and roughness, breathiness, strain, and instability. Acoustically, males have significantly higher scores on measures of perturbation, including noise-to-harmonic ratio and absolute jitter. The meta-analysis outcomes suggest that participants aged 80-89 years produce significantly higher fundamental frequency, jitter percent, shimmer percent, and shimmer in decibels compared to participants aged 60-69 years and a significant increase in relative average perturbation, jitter percent, and shimmer in decibels compared to participants aged 70-79 years. Limited data were available comparing acoustic measures using the same acoustic software. Conclusions Variations in fundamental frequency and frequency and amplitude perturbation increase as healthy adults age. It was difficult to draw definitive conclusions based on existing literature due to variability in hardware used, limited descriptions of study cohorts, or missing data from statistical analysis. Supplemental Material https://doi.org/10.23641/asha.11868663.
Topics: Age Factors; Aged; Aged, 80 and over; Aging; Female; Humans; Male; Middle Aged; Phonation; Speech Acoustics; Speech Perception; Speech Production Measurement; Voice; Voice Disorders
PubMed: 32083980
DOI: 10.1044/2019_JSLHR-19-00099 -
Scientific Reports Aug 2018A therapeutic decision in the treatment of Tis/T1a glottic carcinoma with radiotherapy (RT) or transoral laser surgery (TOS) is still an open issue. Oncologic outcome... (Comparative Study)
Comparative Study Meta-Analysis
A therapeutic decision in the treatment of Tis/T1a glottic carcinoma with radiotherapy (RT) or transoral laser surgery (TOS) is still an open issue. Oncologic outcome and voice quality may support the choice for the latter To conduct a systematic review and meta-analysis to compare oncologic and functional outcomes of TOS and RT as treatment options for Tis/T1a glottic cancer. Literature research on online databases was carried out. Potentially eligible articles were reviewed. Relevant articles were selected and evaluated. There was statistical significance favoring patients initially treated with TOS when it comes to overall survival, disease-specific survival and larynx preservation. No difference in local control was found. TMF, Jitter and Shimmmer measurements presented statistically significant results in favor of RT. Self-assessment of voice quality (VHI) and f0 showed no statistically significant differences. Maximum Phonation Time (MPT) had a better response to RT. There is a trend in favor of RT. Tis/T1a glottic cancer patients submitted to TOS had significant overall and disease specific survival and had fewer risks of having a total laryngectomy, when compared to the radiotherapy group. The self-assessment of voice quality and f0 did not show any difference; however, Jitter, Shimmer and MPT measurements favored radiotherapy.
Topics: Glottis; Humans; Laryngeal Neoplasms; Laser Therapy; Mouth; Radiotherapy; Treatment Outcome; Voice Quality
PubMed: 30093659
DOI: 10.1038/s41598-018-30218-x -
Folia Phoniatrica Et Logopaedica :... 2024Diabetes mellitus type 2 is a growing health concern that affects several systems in the body, among which is the phonatory apparatus. Voice may be affected in view of... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Diabetes mellitus type 2 is a growing health concern that affects several systems in the body, among which is the phonatory apparatus. Voice may be affected in view of the high prevalence of myopathy and neuropathy in diseased subjects. The authors aimed to answer the following question: does type 2 diabetes have an effect on voice?
METHODS
The systematic review included search terms such as "speech, voice, larynx, glucose, diabetes, and hyperglycemia." The search strategy yielded 221 articles, only five of which satisfied the inclusion criteria. Articles were considered for inclusion using the PRISMA method. Analysis included 321 patients with type 2 diabetes mellitus and 171 controls. All studies included were case-control studies except for one study which was an observational cohort. Six parameters were chosen as endpoints for the systematic review and meta-analysis: the presence/absence of voice complaints, fundamental frequency, jitter, shimmer, noise-to-harmonic ratio, and maximum phonation time.
RESULTS
There was no significant difference in the prevalence of voice complaints (i.e., hoarseness) between diabetic patients and control groups. There was also no significant difference in any of the acoustic and aerodynamic measures between patients with type 2 diabetes and controls. These findings can be ascribed to the high resilience of the laryngeal muscles to the adverse effect of systemic diseases.
CONCLUSION
There is no consensus in the literature that the prevalence of voice symptoms in diabetic patients is significantly higher than that reported in healthy subjects.
Topics: Diabetes Mellitus, Type 2; Humans; Voice Disorders; Phonation; Voice Quality; Case-Control Studies
PubMed: 37757764
DOI: 10.1159/000534271 -
Logopedics, Phoniatrics, Vocology Dec 2020A systematic review and a meta-analysis were performed to identify the main characteristics of voice disturbances in bulbar amyotrophic lateral sclerosis. Literature... (Meta-Analysis)
Meta-Analysis
A systematic review and a meta-analysis were performed to identify the main characteristics of voice disturbances in bulbar amyotrophic lateral sclerosis. Literature searches with the keywords: "amyotrophic lateral sclerosis" and "dysarthria" and "intelligibility" were conducted in PubMed, EMBASE, Cochrane Library and Web of Science to perform the systematic review about the articulatory disorders and with the keyword "amyotrophic lateral sclerosis" and "voice" to conduct the meta-analysis about the phonetic changes in patients with bulbar ALS. Seven publications met the inclusion criteria and were included in the meta-analysis, twenty-six publications were included in the systematic review. The data within the meta-analysis revealed that several voice parameters including Jitter, Shimmer, Noise to Harmonic Ratio discriminated best between bulbar amyotrophic lateral sclerosis and healthy controls. On the other hand, significant variations of fundamental frequency were not observed. Acoustic analysis of voice and articulatory analysis contributes to identification of the earliest signs of bulbar degeneration and allows the identification of changes in voice parameters for an early detection, for predicting bulbar involvement and the worsening of disease, for targeting specific intervention. Among the voice parameters, Jitter and Shimmer discriminated better bulbar involvement, they are significantly increased in the patients, on the contrary maximum phonation time is significantly worsened. The careful monitoring of speech symptoms improves diagnostic accuracy and the close cooperation of a multidisciplinary team (physicians as otolaryngologist and physiatrist, speech and language therapists, physiotherapist, dietitians, caregivers, the patients, and their relatives) could be essential.
Topics: Acoustics; Adult; Aged; Amyotrophic Lateral Sclerosis; Female; Humans; Male; Middle Aged; Sound Spectrography; Speech Acoustics; Speech Production Measurement; Voice Disorders; Voice Quality
PubMed: 31760837
DOI: 10.1080/14015439.2019.1687748 -
Arts & Health Oct 2021Supporting the wellbeing of young people is a growing issue internationally. Reviews of adult studies suggest the potential of group singing to meet this agenda. This...
Supporting the wellbeing of young people is a growing issue internationally. Reviews of adult studies suggest the potential of group singing to meet this agenda. This review aimed to examine current evidence regarding the effects of group singing on the wellbeing and psychosocial outcomes of children and young people. A systematic integrative review of electronic databases, including primary research studies which examined wellbeing or psychosocial outcomes for children and young people involved in group singing, yielded thirteen studies. Conclusions about the effectiveness of group singing could not be drawn from quantitative studies, which were of low quality. Qualitative synthesis indicates group singing may support young people's wellbeing through mechanisms of 'social connectedness' and confidence. Current conclusions are limited and additional, high quality qualitative and quantitative research is required to build on these findings. Further careful study may support the development and funding of group singing projects.
Topics: Adolescent; Adult; Child; Humans; Singing
PubMed: 32762613
DOI: 10.1080/17533015.2020.1802604 -
Brazilian Journal of Otorhinolaryngology 2020There are no official diagnostic protocols for singing voice assessment. In this publication, on the basis of a literature review, standards for the singing voice... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
There are no official diagnostic protocols for singing voice assessment. In this publication, on the basis of a literature review, standards for the singing voice handicap index exclusively dedicated to voice disorders in singing have been given.
OBJECTIVE
The study aims to determine the normative values for the singing voice handicap index.
METHODS
The study is a systematic review and a meta-analysis. A systematic literature search was performed using PubMed to access relevant databases and to locate outcome studies. The "inclusion" criteria were as follows: English language, original papers and human studies retrospective and prospective papers, cross-sectional and case-control studies.
RESULTS
Eight articles were included for the final analysis. The normative value for the singing voice handicap index was 20.35 with a confidential range of 10.6-30.1 for a group of 729 healthy subjects whose voices were judged as normal, with an age range of 16-64 years.
CONCLUSION
The mean normative value of the singing voice handicap index was 20.35 with the confidence levels between 10.6 and 30.1.
Topics: Adolescent; Adult; Cross-Sectional Studies; Humans; Middle Aged; Prospective Studies; Retrospective Studies; Singing; Voice; Voice Disorders; Voice Quality; Young Adult
PubMed: 30846419
DOI: 10.1016/j.bjorl.2018.12.004 -
Supportive Care in Cancer : Official... Mar 2024This systematic review aimed to assess the impact of group singing on physical function, cancer-related symptoms, well-being (emotional, physical, social, spiritual),...
PURPOSE
This systematic review aimed to assess the impact of group singing on physical function, cancer-related symptoms, well-being (emotional, physical, social, spiritual), and health-related quality of life in individuals with cancer and their caregivers.
METHODS
A search was performed using Ovid MEDLINE, Embase, Scopus and Web of Science from inception to April 2023; key words included cancer, choir, and group singing. Observational cohort, prospective or retrospective studies, randomized controlled studies, and crossover studies were included. Two teams of independent reviewers extracted data and assessed the risk of bias using the Downs and Black Tool.
RESULTS
A total of 6 studies (6 reports) met the inclusion criteria for this review, with a mix of study designs. The overall quality of the studies was poor. Group singing significantly reduced anxiety levels in those with cancer and their caregivers, while the effects on depression were variable and there was no impact on fatigue. Caregivers reported improved well-being, self-efficacy and self-esteem. Both those with cancer and their caregivers had reductions in fear, anger, confusion; and reported improvement in energy, relaxation and connectedness at longer term follow-up compared to no treatment. Those with cancer reported improvements in health-related quality of life domains of bodily pain, vitality and mental health with group singing, though the effects on caregivers were mixed.
CONCLUSIONS
Group singing may have favourable effects on selected symptoms, aspects of well-being, and domains of health-related quality of life specific to vitality, bodily pain, and mental health in individuals with cancer and their caregivers.
Topics: Humans; Quality of Life; Caregivers; Singing; Retrospective Studies; Prospective Studies; Depression; Neoplasms; Pain
PubMed: 38520544
DOI: 10.1007/s00520-024-08449-8 -
The Laryngoscope Jan 2023To compare the results of a voice handicap index (VHI) scale and acoustic parameters in patients who underwent microlaryngeal surgery followed by either short-duration... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To compare the results of a voice handicap index (VHI) scale and acoustic parameters in patients who underwent microlaryngeal surgery followed by either short-duration (voice rest for <7 days) or long-duration (≥7 days) voice rest.
STUDY DESIGN
Systematic review and meta-analysis.
METHODS
The PubMed, Embase, and Cochrane Library databases were systematically searched for articles published before March 1, 2021. Randomized controlled trials (RCTs) that measured the voice outcomes of patients after different durations and extents of postoperative voice restriction were included in the meta-analysis.
RESULTS
Four RCTs comprising 112 patients were included in the quantitative meta-analysis. Compared with the long-duration voice rest group, the short-duration group exhibited comparable VHI scores (mean difference [MD], -7.01; 95% CI, -16.12 to 2.09; p = 0.13), maximum phonation time (MD, -2.58; 95% CI, -5.42 to 0.26; p = 0.07), and acoustic variables of jitter (MD, -1.25; 95% CI, -3.43 to 0.94; p = 0.26) and shimmer (MD, -0.79; 95% CI, -2.08 to 0.51; p = 0.24). Subgroup analysis for benign pathology and cold instruments studies demonstrated significantly better VHI scores (MD, -14.45; 95% CI, -26.19 to -2.72; p = 0.02 and MD, -15.98; 95% CI, -28.52 to -3.44; p = 0.01, respectively) in the short-duration group.
CONCLUSIONS
The limited evidence does not demonstrate benefit in voice outcomes from long-duration voice rest and suggests potential unfavorable effects on compliance and quality of life, providing a rationale for short-duration voice rest after microlaryngeal surgery. More studies are required to determine the optimal duration and extent of postoperative voice rest.
LEVEL OF EVIDENCE
1 Laryngoscope, 133:154-161, 2023.
Topics: Humans; Voice Quality; Phonation; Laryngeal Diseases; Disability Evaluation; Voice Disorders
PubMed: 35218027
DOI: 10.1002/lary.30082 -
European Archives of... Sep 2022Transoral laser microsurgery (TOLMS) with carbon dioxide is a safe approach for laryngeal carcinoma. In literature there are three main methods for evaluating speech... (Review)
Review
PURPOSE
Transoral laser microsurgery (TOLMS) with carbon dioxide is a safe approach for laryngeal carcinoma. In literature there are three main methods for evaluating speech outcomes: acoustic and aerodynamics analysis, perceptual evaluation and patient-reported outcomes (PROs). The aim of this study was to systematically review the literature about the voice quality outcomes of TOLMS according to type of cordectomy.
METHODS
A systematic literature review was performed and all the results until December 2021 were extrapolated. We evaluated the acoustic and aerodynamics parameters (fundamental frequency, harmonics to noise ratio, jitter, shimmer and maximum phonation time), perceptual data (GRBAS scale) and patient-related outcomes (VHI scale).
RESULTS
24 studies met the inclusion criteria for a total number of 1207 patients enrolled. The number for each type of cordectomy are: 287 type I (23.78%), 311 type II (25.78%), 328 type III (27.14%), 129 type 4 (10.69%) and 152 type V (12.60%). Patients are grouped according to the type of cordectomy in: limited cordectomy (type I and II) and extended cordectomy (types III-IV-V). The difference between two groups is statistically significative in terms of acoustic analysis, perceptual data and patient-related outcomes (p < 0.05).
CONCLUSIONS
Patients who underwent type I or II cordectomy have significantly better quality of voice in terms of VHI, perceptual voice quality evaluations and acoustic parameters compared to type III, IV and V cordectomies. The effect of TOLMS on the voice should depend from the extent of the resection and in particular from the scar of the vocal muscle.
Topics: Carbon Dioxide; Glottis; Humans; Laryngeal Neoplasms; Laser Therapy; Lasers, Gas; Microsurgery; Retrospective Studies; Treatment Outcome; Voice Quality
PubMed: 35505113
DOI: 10.1007/s00405-022-07418-3 -
International Journal of Pediatric... Jun 2020The anatomical, physiological, and phenotypic characteristics of children with Down Syndrome results in deviated acoustic and aerodynamic measures in their voice. These...
PURPOSE
The anatomical, physiological, and phenotypic characteristics of children with Down Syndrome results in deviated acoustic and aerodynamic measures in their voice. These deviant vocal presentations may negatively affect the quality of life of children with Down syndrome. The present study aimed to systematically review the available literature on acoustic and aerodynamic voice characteristics of children with Down syndrome.
METHOD
A systematic review of studies on acoustic and aerodynamic measures of voice in children with Down Syndrome (using PubMed/MEDLINE, CINAHL, Scopus, ProQuest, Cochrane, Ovid, Science Direct) was carried out. Keywords based on Population-Investigation-Outcome were used to develop search strings. Two authors screened titles and abstracts independently, and appropriate studies were analyzed in detail for data extraction.
RESULTS
Out of the 1432 studies, two studies met the inclusion criteria. Different acoustic and aerodynamic measures were employed, such as fundamental frequency, intensity, phonation time, jitter, shimmer and ESGP, MAFR, and LAR.
CONCLUSION
Overall, there was a lack of standardized criteria for the evaluation of acoustic and aerodynamic characteristics in the Down syndrome population. Acoustically, there was no significant difference between children with DS and typically developing children. However, aerodynamic studies suggest that there is a significant impairment of glottal valving in children with Down syndrome.
Topics: Child; Down Syndrome; Glottis; Humans; Phonation; Speech Acoustics; Voice Quality
PubMed: 32087479
DOI: 10.1016/j.ijporl.2020.109946