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Scientific Reports Jun 2024Cochlear implant users experience difficulties controlling their vocalizations compared to normal hearing peers. However, less is known about their voice quality. The...
Cochlear implant users experience difficulties controlling their vocalizations compared to normal hearing peers. However, less is known about their voice quality. The primary aim of the present study was to determine if cochlear implant users' voice quality would be categorized as dysphonic by the Acoustic Voice Quality Index (AVQI) and smoothed cepstral peak prominence (CPPS). A secondary aim was to determine if vocal quality is further impacted when using bilateral implants compared to using only one implant. The final aim was to determine how residual hearing impacts voice quality. Twenty-seven cochlear implant users participated in the present study and were recorded while sustaining a vowel and while reading a standardized passage. These recordings were analyzed to calculate the AVQI and CPPS. The results indicate that CI users' voice quality was detrimentally affected by using their CI, raising to the level of a dysphonic voice. Specifically, when using their CI, mean AVQI scores were 4.0 and mean CPPS values were 11.4 dB, which indicates dysphonia. There were no significant differences in voice quality when comparing participants with bilateral implants to those with one implant. Finally, for participants with residual hearing, as hearing thresholds worsened, the likelihood of a dysphonic voice decreased.
Topics: Humans; Cochlear Implants; Male; Female; Middle Aged; Voice Quality; Aged; Adult; Dysphonia; Speech Acoustics; Cochlear Implantation
PubMed: 38834775
DOI: 10.1038/s41598-024-63688-3 -
Journal of Voice : Official Journal of... Jun 2024Face masks have become important after the pandemic, but the change in voice when wearing a face mask is still unclear. The study investigated the effect of face masks...
OBJECTIVES
Face masks have become important after the pandemic, but the change in voice when wearing a face mask is still unclear. The study investigated the effect of face masks on the acoustic and perceptual characteristics of voice quality associated with young and older Chinese adults.
METHODS
Voice samples of the sustained vowel /a/ and continuous speech produced by 44 older and 61 young adults with and without an ASTM level-3 surgical face mask were recorded and analyzed. Perceptual and acoustic parameters including mean fundamental frequency (F0) and intensity, perturbation measures (jitter and shimmer), harmonic-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPs), and long-term average spectrum (LTAS) measures were obtained and compared.
RESULTS
When comparing masked to unmasked voices, for both male and female speakers, F0 and intensity showed no significant changes, except for F0 of continuous speech, which increased significantly. Meanwhile, perturbation measures such as jitter and shimmer were reduced, while HNR and CPPs increased. In addition, LTAS measures included low-frequency mean spectral energy (MSE), high-frequency MSE, and spectral tilt (ST), which were different. For perceptual measures, the overall grade of dysphonia, and roughness were reduced, except for the breathiness among older male speakers, while the other vocal qualities were not changed. Between young and older speakers, significant differences in shimmer, CPPs, and perceived breathiness among male speakers, and low-frequency MSE among female speakers were found.
CONCLUSION
Wearing a surgical mask appeared to change the perceived voice quality. This is supported by the change in perturbation and LTAS measures, and HNR and CPPs values. In addition, some differences between young and older adults were observed. Oral Communication effectiveness may be affected when wearing surgical masks due to changes in voice quality. Additionally, clinicians need to exercise hightened caution in evaluating the voice quality of clients when wearing face masks.
PubMed: 38834373
DOI: 10.1016/j.jvoice.2024.04.025 -
Thyroid Research Jun 2024Ultrasound-guided thermal ablation (TA) has emerged as a robust therapeutic approach for treating solid tumors in multiple organs, including the thyroid. Yet, its...
BACKGROUND
Ultrasound-guided thermal ablation (TA) has emerged as a robust therapeutic approach for treating solid tumors in multiple organs, including the thyroid. Yet, its efficacy and safety profile in the management of Graves' Disease (GD) remains to be definitively established.
METHODS
A retrospective study was conducted on 50 GD patients treated with TA between October 2017 and December 2021. Key metrics like thyroid volume, volume reduction rate (VRR), thyroid hormones, and basal metabolic rate (BMR) were evaluated using paired Wilcoxon tests.
RESULTS
The intervention of ultrasound-guided TA yielded a statistically significant diminution in total thyroid volume across all postoperative follow-up intervals-1, 3, 6, and 12 months-relative to pre-intervention baselines (p < 0.001). The median VRR observed at these time points were 17.5%, 26.5%, 34.4%, and 39.8%, respectively. Euthyroid status was corroborated in 96% of patients at the one-year follow-up milestone. Transient tachycardia and dysphonia were observed in three patients, while a solitary case of skin numbness was noted. Crucially, no instances of enduring injury to the recurrent laryngeal nerve (RLN) were documented.
CONCLUSIONS
Our investigation substantiates ultrasound-guided TA as a pragmatic, well-tolerated, and safe therapeutic modality for GD. It effectively improves symptoms of hyperthyroidism, engenders a substantial reduction in thyroid volume, and restores thyroid hormone and BMR to physiological levels. Given its favorable safety profile, enhanced cosmetic outcomes, and minimally invasive nature, ultrasound-guided TA is a compelling alternative to thyroidectomy for GD patients.
PubMed: 38825672
DOI: 10.1186/s13044-024-00198-4 -
Journal of Voice : Official Journal of... May 2024Dysphonia negatively affects social communication, leading to reduced quality of life. Comprehensive research on dysphonia and laryngeal mucosal diseases using...
Impact of Dietary Intake and Habits on Subjective Voice and Laryngeal Mucosal Diseases: Analysis From Korean National Health and Nutritional Examination Survey Between 2008 and 2021.
OBJECTIVES
Dysphonia negatively affects social communication, leading to reduced quality of life. Comprehensive research on dysphonia and laryngeal mucosal diseases using large-scale epidemiological data is lacking. Therefore, we investigated how dietary and habitual factors influence dysphonia and laryngeal mucosal diseases using data from the Korean National Health and Nutritional Examination Survey.
STUDY DESIGN
A population-based cross-sectional study.
METHODS
The study included individuals aged 19 years and older who both underwent laryngoscopic examinations and completed a dysphonia survey. Dietary and habitual factors and results of the laryngoscopic examinations were collected. Risk factors for dysphonia and laryngeal mucosal diseases were identified.
RESULTS
The weighted frequency of dysphonia and laryngeal mucosal diseases was 6.4% and 6.0%, respectively. In univariable analyses for dysphonia, sex, body weight change, alcohol ingestion, and various minerals and vitamins showed statistically significant associations. However, in the multivariable analysis, only age, body weight, female sex, and vitamin A intake were significantly associated with dysphonia. Age, body weight, body mass index, sex, smoking, amount of sodium intake, and alcohol intake were associated with laryngeal mucosal diseases in the univariable analyses, but in the multivariable analysis, only age, smoking, and amount of niacin intake were significant factors.
CONCLUSIONS
In this large-scale epidemiological analysis, subjective dysphonia and laryngeal mucosal diseases had different frequencies and risk factors. Age was a risk factor for both dysphonia and mucosal diseases, but smoking was only a risk factor for laryngeal mucosal diseases. Diet types, calories, and water and alcohol intake were not significant risk factors for either laryngeal mucosal diseases or dysphonia.
PubMed: 38816300
DOI: 10.1016/j.jvoice.2024.04.024 -
Movement Disorders Clinical Practice May 2024
PubMed: 38813931
DOI: 10.1002/mdc3.14061 -
Frontiers in Public Health 2024The domination of the Contemporary Commercial Music (CCM) industry in music markets has led to a significant increase in the number of CCM performers. Performing in a...
BACKGROUND
The domination of the Contemporary Commercial Music (CCM) industry in music markets has led to a significant increase in the number of CCM performers. Performing in a wide variety of singing styles involves exposing CCM singers to specific risk factors potentially leading to voice problems. This, in turn, necessitates the consideration of this particular group of voice users in the Occupational Health framework. The aim of the present research was threefold. First, it sought to profile the group of Polish CCM singers. Second, it was designed to explore the prevalence of self-reported voice problems and voice quality in this population, in both speech and singing. Third, it aimed to explore the relationships between voice problems and lifetime singing involvement, occupational voice use, smoking, alcohol consumption, vocal training, and microphone use, as potential voice risk factors.
MATERIALS AND METHODS
The study was conducted in Poland from January 2020 to April 2023. An online survey included socio-demographic information, singing involvement characteristics, and singers' voice self-assessment. The prevalence of voice problems was assessed by the Polish versions of the Vocal Tract Discomfort Scale (VTDS) and the Singing Voice Handicap Index (SVHI). Also, a self-reported dysphonia symptoms protocol was applied. The perceived overall voice quality was assessed by a Visual Analogue Scale (VAS) of 100 mm.
RESULTS
412 singers, 310 women and 102 men, completed the survey. Nearly half of the studied population declared lifetime singing experience over 10 years with an average daily singing time of 1 or 2 h. 283 participants received vocal training. For 11.4% of respondents, singing was the primary income source, and 42% defined their career goals as voice-related. The median scores of the VTDS were 11.00 (0-44) and 12.00 (0-40) for the Frequency and Severity subscales, respectively. The median SVHI score of 33 (0-139) was significantly higher than the normative values determined in a systematic review and meta-analysis (2018). Strong positive correlations were observed between SVHI and both VTD subscales: Frequency ( = 0.632, < 0.001) and Severity ( = 0.611, < 0.001). The relationships between most of the other variables studied were weak or negligible.
CONCLUSION
The examined CCM singers exhibited substantial diversity with regard to musical genre preferences, aspirations pertaining to singing endeavors, career affiliations, and source of income. Singing voice assessment revealed a greater degree of voice problems in the examined cohort than so far reported in the literature, based on the SVH and VTDS.
Topics: Humans; Poland; Singing; Male; Female; Adult; Cross-Sectional Studies; Middle Aged; Music; Voice Quality; Voice Disorders; Self-Assessment; Surveys and Questionnaires; Prevalence; Risk Factors; Young Adult; Speech
PubMed: 38813421
DOI: 10.3389/fpubh.2024.1256152 -
Journal of Voice : Official Journal of... May 2024Voice disorders, such as dysphonia, are common among the general population. These pathologies often remain untreated until they reach a high level of severity....
Voice disorders, such as dysphonia, are common among the general population. These pathologies often remain untreated until they reach a high level of severity. Assisting the detection of voice disorders could facilitate early diagnosis and subsequent treatment. In this study, we address the practical aspects of automatic voice disorders detection (AVDD). In real-world scenarios, data annotated for voice disorders is usually scarce due to various challenges involved in the collection and annotation of such data. However, some relatively large datasets are available for a reduced number of domains. In this context, we propose the use of a combination of out-of-domain and in-domain data for training a deep neural network-based AVDD system, and offer guidance on the minimum amount of in-domain data required to achieve acceptable performance. Further, we propose the use of a cost-based metric, the normalized expected cost (EC), to evaluate performance of AVDD systems in a way that closely reflects the needs of the application. As an added benefit, optimal decisions for the EC can be made in a principled way given by Bayes decision theory. Finally, we argue that for medical applications like AVDD, the categorical decisions need to be accompanied by interpretable scores that reflect the confidence of the system. Even very accurate models often produce scores that are not suited for interpretation. Here, we show that such models can be easily improved by adding a calibration stage-trained with just a few minutes of in-domain data. The outputs of the resulting calibrated system can then better support practitioners in their decision-making process.
PubMed: 38811307
DOI: 10.1016/j.jvoice.2024.03.001 -
Folia Phoniatrica Et Logopaedica :... May 2024This paper aims at observing the impact of dysphonic voice on children's reception of a linguistic message by evaluating their reaction times (RT) to instructions given...
INTRODUCTION
This paper aims at observing the impact of dysphonic voice on children's reception of a linguistic message by evaluating their reaction times (RT) to instructions given by functional dysphonic and control female schoolteachers' (ST).
METHODS
French minimal pairs such as /muʃ/ ("mouche" fly) vs. /buʃ/ ("bouche" mouth) embedded in a carrier sentence "click on the drawing of…" were produced by two groups of 10 dysphonic and control female ST, matched in age and year of experience. The phonemical contrasts observed are voicing, nasality, consonantal place of articulation, vowel roundedness and vowel place of articulation. The experimentation was presented in the form of a computer game to children from 7 to 10 years-old. Two images illustrating the target words were presented, accompanied by the oral instructions recorded by ST. With a two-button box created for the experiment, children had to click as quickly as possible on the image corresponding to the instruction.
RESULTS
Our results show that the reaction times of all children are affected by the schoolteacher's dysphonia, regardless of their age and that they have significantly longer RT when discriminating minimal pairs contrasting in voicing when the instruction is given by a dysphonic speaker compared to the same instruction given by a control speaker.
CONCLUSION
These observations could be explained by the fact that functional dysphonia is associated with improper use of the vocal folds, and thus an alteration of voicing.
PubMed: 38810611
DOI: 10.1159/000539562 -
The Laryngoscope May 2024Type 4 posterior glottic stenosis and bilateral vocal fold paralysis are clinically challenging causes of bilateral vocal fold immobility (BVFI) that result in glottic...
INTRODUCTION
Type 4 posterior glottic stenosis and bilateral vocal fold paralysis are clinically challenging causes of bilateral vocal fold immobility (BVFI) that result in glottic airway obstruction. Established procedures for BVFI typically worsen dysphonia. We hypothesize the use of thyroarytenoid myomectomy (TAM) in the setting of BVFI will improve dyspnea with decreased detriment to voice.
METHODS
Eleven unilateral TAM procedures were performed between April 2021 and June 2023 at a single institution. Pre- and postoperative patient reported outcomes were compared. Representative images of maximal glottic opening were analyzed in ImageJ to calculate ipsilateral bowing index (BI), total BI, maximum glottic surface area (MGSA), and maximum opening angle (MOA). Statistical comparisons were performed with paired t-tests when normality was confirmed with Shapiro-Wilk test and otherwise with Wilcoxon signed-rank tests, with threshold for significance of α = 0.05. Interrater reliability for objective glottal measures was compared with intraclass correlation coefficient (ICC).
RESULTS
Dyspnea Index improved from mean (standard error) of 24.1 (3.8) to 9.1 (3.3), p = 0.004. Voice Handicap Index-10 improved from 20.0 (4) to 10.3 (3.8), p = 0.011. Glottal Function Index improved from 9.6 (1.4) to 6.3 (1.3), p = 0.017. There was no significant difference in ipsilateral BI, total BI, MOA, and median MGSA. There was good to excellent ICCs for all comparisons (0.83-0.95).
CONCLUSIONS
TAM demonstrated significant improvement in symptoms from BVFI while not significantly altering glottal structure. These data suggest TAM improves dyspnea in patients with BVFI without significantly impairing voice.
LEVEL OF EVIDENCE
4 Laryngoscope, 2024.
PubMed: 38807469
DOI: 10.1002/lary.31545 -
Journal of Voice : Official Journal of... May 2024Hyperfunctional voice disorder (HFVD) is a disorder of multifactorial origin. It can be speculated that an eclectic voice therapy program that uses combinatory...
PURPOSE
Hyperfunctional voice disorder (HFVD) is a disorder of multifactorial origin. It can be speculated that an eclectic voice therapy program that uses combinatory approaches could bring about better efficiency of voice in these individuals. Nevertheless, very less attempts have been made to examine the efficacy of eclectic voice therapy using multidimensional voice outcome measures in the treatment of HFVD.
METHOD
Ten individuals with HFVD in the age range of 20-55years attended Comprehensive Voice Habilitation Program (CVHP), an eclectic voice therapy approach for 15 sessions spread across 3weeks. A stroboscopy examination was performed at the baseline and post-therapy to track the changes in laryngeal functions. Further, perceptual voice analysis, Acoustic Voice Quality Index (AVQI), and Voice Handicap Index in Kannada (VHI-K) were obtained at the baseline, post-therapy, and two follow-ups to report the therapy outcomes. Related samples Friedman's Two-way Analysis of Variance by Ranks and Wilcoxon Signed Rank Test were used to note the pre-post and follow-up changes in voice outcomes.
RESULTS
Stroboscopy findings revealed significant improvement in movement patterns of the vocal folds and a reduction in ventricular hyperadduction. Perceptual ratings and AVQI scores decreased in post-therapy and follow-up evaluations indicating a decrease in dysphonia severity over time. In addition, a significant decrease in VHI-K scores indicated the alleviation of self-perceived disability/handicap.
CONCLUSION
The current study provided preliminary evidence to support the efficacy of eclectic voice therapy in HFVD by documenting significant changes in the voice-related outcome measures.
PubMed: 38806326
DOI: 10.1016/j.jvoice.2024.04.027