-
International Journal of Paediatric... Nov 2020Information about the functional and morphological consequences that occur following the premature loss of anterior teeth is still insufficient. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Information about the functional and morphological consequences that occur following the premature loss of anterior teeth is still insufficient.
AIM
To evaluate the consequences in children's speech and arch integrity following premature loss of primary anterior teeth compared to those without premature losses.
DESIGN
Electronic searches were performed based on the PECO criteria. Observational studies in children (P) who suffered premature loss or extraction of primary anterior teeth (E) compared to children presenting normal occlusion development (C) and the consequences to speech and dental arch perimeter (O) were included. Risk of bias and data extraction were performed. The meta-analysis evaluated the influence of premature loss of primary anterior teeth in articulatory speech disorders (distortion, omission, and substitution) and space loss in the dental arches. Random- and fixed-effect models were used, and heterogeneity was tested. The certainty of evidence was estimated using the GRADE approach.
RESULTS
From a total of 2.234 studies, six studies were included in the qualitative synthesis, and four in speech disorders meta-analysis. Despite it was not possible to perform space loss meta-analysis due to the absence of available data, qualitative analysis showed that there was no space loss after premature loss of mandibular primary incisors; a space loss, however, could be observed in children who lost primary canines at an early stage of dental development. For speech disorders results, children who lost anterior tooth presented higher chance of suffering speech distortion, than children without tooth loss (OR 5.466 [1.689, 17.692] P = .005) with low certainty of evidence. On the other hand, there were no statistically differences between premature loss of primary anterior teeth and omission (OR (a) 1.157 [0.439, 3.049] P = .767 and (OR (b) 1.393 [0.434, 4.70] P = .577) or substitution (OR (a) 1.071 [0.581, 1.974] P = .827 and OR (b) 1.218 [0.686, 2.163] P = .5), both with very low certainty of evidence.
CONCLUSIONS
Premature loss of primary anterior teeth may affect children phonation causing speech distortion. Consequences of space loss to primary dental arch still need to be further studied. Despite the speech distortion results, included articles present low-level evidence-based quality, thus new studies should be performed.
Topics: Child; Dental Arch; Humans; Incisor; Mandible; Speech; Tooth, Deciduous
PubMed: 32243000
DOI: 10.1111/ipd.12644 -
PloS One 2020It is widely believed that 'creaky voice' ('creak', 'vocal fry', 'glottal fry') is increasingly prevalent among some English speakers, particularly among young American...
BACKGROUND/AIM
It is widely believed that 'creaky voice' ('creak', 'vocal fry', 'glottal fry') is increasingly prevalent among some English speakers, particularly among young American women. Motivated by the widespread and cross-disciplinary interest in the phenomenon, this paper offers a systematic review of peer-reviewed research (up to January 2019) on the prevalence of creaky voice in varieties of English. The review aimed to understand whose and what speech has been studied, how creaky voice prevalence has been measured, and what the findings collectively reveal.
METHOD
Literature was located by searching four electronic databases (ProQuest, PubMed, SCOPUS, Web of Science) and the proceedings of two recurrent conferences ('ICPhS' and 'SST'). Studies were included if they reported the prevalence of creaky voice in naturalistic samples of English spoken by vocally-healthy speakers. Reference lists of included studies were cross-checked.
RESULTS
Only ten studies meeting inclusion criteria were identified. All studies sampled a small number of speakers and/or short durations of speech. Nine were recent studies of American-English speakers, and many of these sampled young, female, college students. Across the ten studies, creaky voice was detected using three types of methods, and prevalence was calculated using five different formulae. The findings show that prevalence varies across groups, individuals, and contexts. However, the precise nature of this variability remains unclear due to the scarcity and methodological heterogeneity of the research.
CONCLUSIONS
This paper illustrated the application of systematic literature review methods in sociophonetic research-a field in which such methods are not common. The review found that creaky voice prevalence in English is not well understood, and that widespread claims of its recent increase among young American women have not been empirically confirmed. A number of specific limitations in the existing research are highlighted, which may serve as a guide for future research design.
Topics: Age Factors; Humans; Language; Phonation; Sex Factors; Speech; Speech Acoustics; Speech Perception; Speech Production Measurement; Time Factors; Voice; Voice Quality
PubMed: 32160255
DOI: 10.1371/journal.pone.0229960 -
International Journal of Language &... May 2020Acquired brain injury (ABI), such as Parkinson's disease, dementia or stroke, can result in communication difficulties that lead to an impoverished ability to connect...
BACKGROUND
Acquired brain injury (ABI), such as Parkinson's disease, dementia or stroke, can result in communication difficulties that lead to an impoverished ability to connect meaningfully with others. Choral singing is a complex task that uses multiple brain regions which are also responsible for language and communication skills. The potential therapeutic effects of group singing on communication-related outcomes across ABI aetiologies have not been systematically reviewed.
AIMS
To examine whether participation in group singing over multiple sessions improves speech, voice, language and/or communication skills in individuals with ABI-related communication disorders.
METHODS & PROCEDURES
A database search was undertaken according to the PRISMA guidelines. Search terms included: stroke OR Parkinson OR dementia OR 'acquired brain injury' AND choir OR choral OR singing OR sing OR 'choral sing ' OR group adj3 singing OR community adj3 singing AND speech OR language OR communication.
MAIN CONTRIBUTION
A total of 11 studies were included. Nine were quantitative, including one randomized and one non-randomized control trial, and two were mixed method. Nine studies were scored as level IV (uncontrolled) on the American Academy of Neurology (AAN) Classification of Evidence Matrix and two as level III (e.g., lack of blinded assessors). Eight examined speech and voice skills in Parkinson's disease, two functional communication skills in post-stroke aphasia and one communication between individuals with dementia and a significant other. One level III control trials provided evidence for a therapeutic effect of group singing on communication in individuals with Parkinson's disease.
CONCLUSIONS & IMPLICATIONS
Currently, there is only one study providing support for using group singing to improve speech and voice skills in people with Parkinson's disease, and no studies of adequate quality indicating positive effects on language and functional communication abilities in ABI. Further research using more rigorous experimental designs is required to determine whether group singing can influence communication skills in ABI. What this paper adds What is already known on the subject Music activates widespread, bilateral cortical and subcortical brain regions. Group singing is increasingly understood to have positive benefits on quality of life and health-related well-being in both healthy and clinical populations. Given the crossover in neural networks between singing, speech and language, singing activities are also thought to have positive effect of communication impairments secondary to ABI. However, to date, the research evidence supporting the application of group singing for communication impairments in ABI has not been summarized. What this paper adds to existing knowledge A total of 11 studies have looked at communication outcomes after group singing in ABI. For most of these, the quality of evidence was low (AAN level IV). It also highlights that there is a bias in the literature towards the studying individuals with Parkinson's disease (i.e., nine of the 11 studies). What are the potential or actual clinical implications of this work? This review concludes that, currently, there is emerging evidence to support positive effects of a group singing for speech and voice symptoms in individuals with Parkinson's disease, when provided using the Tamplin protocol. However, there is not yet any evidence for communication benefits for individuals with aphasia or dementia.
Topics: Art Therapy; Brain Injuries; Communication Disorders; Humans; Music Therapy; Singing; Treatment Outcome
PubMed: 32096327
DOI: 10.1111/1460-6984.12527 -
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 -
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 -
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 -
American Journal of Critical Care : An... Nov 2019To synthesize evidence of the safety and effectiveness of phonation in patients with fenestrated tracheostomy tubes.
OBJECTIVE
To synthesize evidence of the safety and effectiveness of phonation in patients with fenestrated tracheostomy tubes.
METHODS
PubMed, CINAHL, Scopus, Cochrane, and Web of Science databases were searched. The research question was, "Are fenestrated tracheostomy tubes a safe and effective option to facilitate early phonation in patients undergoing tracheostomy?" Studies of fenestrated tracheostomy tubes were assessed for risk of bias and quality of evidence. Data were abstracted, cross-checked for accuracy, and synthesized.
RESULTS
Of the 160 studies identified, 13 met inclusion criteria, including 6 clinical studies (104 patients), 6 case reports (13 patients), and 1 nationwide clinician survey. The primary indications for a tracheostomy were chronic ventilator dependence (83%) and airway protection (17%). Indications for fenestrated tracheostomy included inaudible phonation and poor voice intelligibility. Patients with fenestrated tubes achieved robust voice outcomes. Complications included granulation tissue (6 patients [5%]), malpositioning (1 patient [0.9%]), decreased oxygen saturation (3 patients [2.6%]), increased blood pressure (1 patient [0.9%]), increased peak pressures (2 patients [1.7%]), and air leakage (1 patient [0.9%]); subcutaneous emphysema also occurred frequently. Patient-reported symptoms included shortness of breath (4 patients [3.4%]), anxiety (3 patients [2.6%]), and chest discomfort (1 patient [0.9%]).
CONCLUSIONS
Fenestrated devices afford benefits for speech and decannulation but carry risks of granulation, aberrant airflow, and acclimation challenges. Findings highlight the need for continued innovation, education, and quality improvement around the use of fenestrated devices.
Topics: Adult; Aged; Aged, 80 and over; Airway Extubation; Critical Care Nursing; Female; Humans; Male; Middle Aged; Patient Safety; Phonation; Practice Guidelines as Topic; Respiration, Artificial; Tracheostomy
PubMed: 31676519
DOI: 10.4037/ajcc2019892 -
Journal of Voice : Official Journal of... Mar 2021Laryngeal contact granuloma is a disease of benign hypertrophic granulation tissue at the medial side of vocal process. Numerous studies of conservative and surgical...
OBJECTIVE
Laryngeal contact granuloma is a disease of benign hypertrophic granulation tissue at the medial side of vocal process. Numerous studies of conservative and surgical management have reported effectiveness, yet optimal treatment has not been standardized. We compared primary and secondary outcomes of conservative and surgical treatment using endoscopic grading, Voice Handicap Index-10 (VHI-10), maximum phonation time (MPT), and recurrence rate.
METHODS
We performed literature searches of MEDLINE, PubMed, and EMBASE from November 1985 to October 2017, with randomized controlled trials and case control studies of at least three months follow-up as the inclusion criteria. Outcomes included laryngoscopic findings, MPT, and VHI-10. Data regarding study design, outcome analysis, follow-up time, and disease remission were systematically collected.
RESULTS
A total of 1069 patients were abstracted from 19 papers. With conservative treatment, 98% of patients' laryngeal granuloma resolved within three months, and 84% for the surgical group. There was a decrease in VHI-10 of 2.69 (95% credible interval (CI) -9.52 to 3.82) and 6.48 (95% CI -15.00 to 1.94) for conservative and surgical management, respectively. MPT improvement was 1.27 s (95% CI: 2.03-5.84) for conservative treatment and 5.02 s (95% CI: 0.78-8.07) for surgical. For all 19 studies, absolute recurrence risk for control, conservative, and surgical measures were respectively 4%, 16%, and 29%.
CONCLUSIONS
Most patients treated conservatively or surgically alone responded to treatment, but conservative management was favored. VHI-10 and MPT improvement in surgical patients were noted, but only the latter was statistically significant. In regard to recurrence, conservative management had better outcome than surgical. Taken together, the results suggest that minimally symptomatic granulomas have higher response rate and lower recurrence risk when treated conservatively, while larger, symptomatic granulomas may favor surgical excision followed by medical management to reduce risk of recurrence.
Topics: Conservative Treatment; Granuloma; Granuloma, Laryngeal; Humans; Recurrence; Voice
PubMed: 31628044
DOI: 10.1016/j.jvoice.2019.08.019 -
European Journal of Pain (London,... Jan 2020Singing can have a range of health benefits; this paper reviews the evidence of the effects of group singing for chronic pain in people with long-term health conditions.
BACKGROUND AND OBJECTIVES
Singing can have a range of health benefits; this paper reviews the evidence of the effects of group singing for chronic pain in people with long-term health conditions.
DATABASE AND DATA TREATMENT
We searched for published peer-reviewed singing studies reporting pain measures (intensity, interference and depression) using major electronic databases (last search date 31 July 2018). After screening 123 full texts, 13 studies met the inclusion criteria: five randomized controlled trials (RCTs), seven non-RCTs and one qualitative study. Included studies were appraised using Downs and Black and the Critical Appraisals Skills Programme quality assessments.
RESULTS
Included studies reported differences in the type of singing intervention, long-term condition and pain measures. Due to the high heterogeneity, we conducted a narrative review. Singing interventions were found to reduce pain intensity in most studies, but there was more equivocal support for reducing pain interference and depression. Additionally, qualitative data synthesis identified three key linked and complementary themes: physical, psychological and social benefits.
CONCLUSION
Group singing appears to have the potential to reduce pain intensity, pain interference and depression; however, we conclude that there is only partial support for singing on some pain outcomes based on the limited available evidence of varied quality. Given the positive findings of qualitative studies, this review recommends that practitioners are encouraged to continue this work. More studies of better quality are needed. Future studies should adopt more robust methodology and report their singing intervention in details. Group singing may be an effective and safe approach for reducing persistent pain and depression in people with long-term health conditions.
SIGNIFICANCE
This systematic review assesses research evidence for the effectiveness of group singing on chronic pain in people with long-term health conditions. Narrative syntheses revealed that there is partial support for singing effects on some pain outcomes based on the limited available evidence of varied quality. Qualitative data provided additional support of physical, psychological and social benefits. The review highlights implications for practice and future studies.
Topics: Chronic Pain; Humans; Qualitative Research; Singing
PubMed: 31549451
DOI: 10.1002/ejp.1485 -
JAMA Otolaryngology-- Head & Neck... Oct 2019Widespread legalization of cannabis throughout the United States has created a knowledge gap that leaves practitioners who manage voice disorders uninformed about this...
IMPORTANCE
Widespread legalization of cannabis throughout the United States has created a knowledge gap that leaves practitioners who manage voice disorders uninformed about this substance, commonly referred to as marijuana. The association of cannabis inhalation and voice disorders is rarely reported. However, studies on the association between cannabis inhalation and respiration have been published; therefore, these studies may serve as a surrogate for studies on the association between cannabis and phonation.
OBJECTIVE
To review the literature on the association of cannabis-only consumption via smoking and vaping with the health and function of the vocal mechanism to aid clinical recommendations for patients with voice disorders.
EVIDENCE REVIEW
This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. An electronic search in MEDLINE via PubMed, CINAHL, Scopus, and Cochrane Library databases for original research on inhaled cannabis was performed from January 1, 2007, through August 10, 2018. The search strategy included Medical Subject Heading terms and keywords marijuana, cannabis, respiratory, lungs, larynx, voice, phonation, and vocal with Boolean operators (AND, OR). Studies of participants of legal age (≥18 years) who had cannabis-only clinical data and used nonsynthetic cannabinoids were included in the review.
FINDINGS
This systematic review identified 6 clinical science studies and 13 basic science or animal studies. The only study to date that has evaluated the association between laryngeal symptoms and inhaling cannabis found that human smokers assessed by indirect laryngoscopy with mirror examination exhibited dark vocal folds. Analyses of 6 other clinical science articles indicated an association between cannabis inhalation and respiratory problems that were reduced with smoking cessation or switching to vaporizing. Lung function was maintained in light cannabis smoke exposure after long-term use. Analyses of basic science and animal articles indicated that cannabis smoking was associated with lung and throat injuries attributable to smoking degradation by-products, similar to injuries seen in human tobacco smoking.
CONCLUSIONS AND RELEVANCE
The findings suggest that cannabis-only smoking is associated with changes in vocal fold appearance, respiratory symptoms, and negative lung function changes, especially in heavy smokers. Details about patterns of cannabis consumption appear to be relevant to gather in patients with voice disorders. Results further suggest that cannabis smokers presenting with a voice disorder should undergo laryngeal imaging and complete pulmonary function testing when indicated and receive education about consumption methods and their association with voice disorders.
PubMed: 31393535
DOI: 10.1001/jamaoto.2019.1986