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European Review For Medical and... Apr 2024Vocal cord paralysis (VCP) is a serious complication in thyroidectomy operations; however, its management remains unclear. The present study evaluated the voice...
OBJECTIVE
Vocal cord paralysis (VCP) is a serious complication in thyroidectomy operations; however, its management remains unclear. The present study evaluated the voice parameters of patients who underwent surgery using Intraoperative Neurophysiologic Monitoring (IONM).
PATIENTS AND METHODS
A total of 52 patients (41 females and 11 males) who underwent a total thyroidectomy operation were evaluated using objective and subjective voice analysis examinations before and after surgery. Acoustic parameters, such as Fundamental Frequency (F0), Shimmer, Jitter, Noise-to-Harmonic ratio (NHR), and aerodynamic parameters, including S/Z ratio and maximum phonation time (MPT), were analyzed. Objective findings, including the VHI-10 (Voice Handicap Index) and V-RQOL (Voice-Related Quality of Life), were also analyzed. The relationship between voice parameters and IONM values was investigated.
RESULTS
The objective analysis (acoustic and aerodynamic parameters) showed no difference (p>0.05). However, the subjective analysis, which involved the VHI-10 and V-RQOL measures, revealed a significant difference before and after the operation (p<0.05). The Spearman correlation analysis showed that the NHR postoperative 1st-month parameter negatively correlated (rho=-0.317, p<0.059), while the F0 postoperative 6th-month parameter positively correlated (rho=0.347) with the amplitude difference before and after dissection (Right R2-R1 difference) for the right RLN measured in IONM.
CONCLUSIONS
Patients who are planning to undergo a thyroidectomy procedure should undergo voice assessment during both the preoperative and postoperative periods. IONM could improve voice quality outcomes.
Topics: Male; Female; Humans; Voice Quality; Thyroidectomy; Quality of Life; Acoustics; Vocal Cord Paralysis; Voice Disorders
PubMed: 38639510
DOI: 10.26355/eurrev_202404_35899 -
Scientific Reports Apr 2024Why do we prefer some singers to others? We investigated how much singing voice preferences can be traced back to objective features of the stimuli. To do so, we asked...
Why do we prefer some singers to others? We investigated how much singing voice preferences can be traced back to objective features of the stimuli. To do so, we asked participants to rate short excerpts of singing performances in terms of how much they liked them as well as in terms of 10 perceptual attributes (e.g.: pitch accuracy, tempo, breathiness). We modeled liking ratings based on these perceptual ratings, as well as based on acoustic features and low-level features derived from Music Information Retrieval (MIR). Mean liking ratings for each stimulus were highly correlated between Experiments 1 (online, US-based participants) and 2 (in the lab, German participants), suggesting a role for attributes of the stimuli in grounding average preferences. We show that acoustic and MIR features barely explain any variance in liking ratings; in contrast, perceptual features of the voices achieved around 43% of prediction. Inter-rater agreement in liking and perceptual ratings was low, indicating substantial (and unsurprising) individual differences in participants' preferences and perception of the stimuli. Our results indicate that singing voice preferences are not grounded in acoustic attributes of the voices per se, but in how these features are perceptually interpreted by listeners.
Topics: Humans; Singing; Voice Quality; Voice; Music; Acoustics
PubMed: 38637516
DOI: 10.1038/s41598-024-58924-9 -
Trauma Case Reports Jun 2024Tapia syndrome (TS) is a rare condition characterized by unilateral hypoglossal and recurrent laryngeal nerve palsy, leading to tongue deviation, swallowing difficulty...
BACKGROUND
Tapia syndrome (TS) is a rare condition characterized by unilateral hypoglossal and recurrent laryngeal nerve palsy, leading to tongue deviation, swallowing difficulty and dysphonia.
CASE REPORT
We describe a case of a 17-year-old boy who reported a bilateral TS following head and neck trauma with Hangman's fracture and right common carotid artery dissection. The confirmation occurred only after complete cognitive and motor recovery, verifying the inability to protrude the tongue and swallow, associated with complete paralysis of the vocal cords, diagnosed with fiber optic laryngoscopy.An initial recovery of tongue motility and phonation occurred after just over a month of rehabilitation.
CONCLUSION
In addition to the lack of awareness due to the rarity of the syndrome, the diagnosis of TS may be delayed in patients who are unconscious or who have slow cognitive recovery following head trauma. The case we present may help to increase awareness and avoid unnecessary diagnostic investigations.
PubMed: 38633379
DOI: 10.1016/j.tcr.2024.101029 -
Otolaryngologia Polska = the Polish... Apr 2024<b><br>Introduction:</b> Electromyography (EMG) of the larynx provides information on the electrophysiological condition of laryngeal muscles and...
<b><br>Introduction:</b> Electromyography (EMG) of the larynx provides information on the electrophysiological condition of laryngeal muscles and innervation. Integration of information obtained from the EMG exams with the clinical parameters as obtained by other methods for laryngeal assessment (endoscopy, perceptual and acoustic analysis, voice self-assessment) provides a multidimensional picture of dysphonia, which is of particular importance in patients with vocal fold (VF) mobility disorders accompanied by glottic insufficiency.</br> <b><br>Aim:</b> The aim of this study was to evaluate laryngeal EMG records acquired in subjects with unilateral vocal fold immobilization with signs of atrophy and glottic insufficiency.</br> <b><br>Material and methods:</b> From the available material of 74 EMG records of patients referred for the exam due to unilateral laryngeal paralysis, records of 17 patients with endoscopic features suggestive of complete laryngeal muscle denervation were selected. The EMG study of thyroarytenoid muscles of mobile and immobile VFs was evaluated qualitatively and quantitatively at rest and during volitional activity involving free phonation of vowel /e/ [ε].</br> <b><br>Results:</b> In all patients, the EMG records from mobile VFs were significantly different from those from immobile VFs. Despite endoscopic features of paralysis, no VF activity whatsoever was observed in as few as 2 patients so as to meet the neurophysiological definition of paralysis. In 88% of cases, electromyographic activity of the thyroarytenoid muscle was observed despite immobilization and atrophy of the vocal fold. In these patients, neurogenic type of record was observed with numerous high- -amplitude mobility units. On the basis of the results, quantitative features of EMG records indicative of paralysis and residual activity of the thyroarytenoid muscle were determined.</br> <b><br>Conclusions:</b> Qualitative and quantitative analysis of laryngeal EMG records provides detailed information on the condition of vocal fold muscles and innervation. EMG records of mobile vs immobile VFs differ significantly from each other. Endoscopic evaluation does not provide sufficient basis for the diagnosis of complete laryngeal muscle denervation.</br>.
Topics: Humans; Vocal Cords; Vocal Cord Paralysis; Electromyography; Laryngeal Muscles; Endoscopy; Dysphonia; Atrophy
PubMed: 38623857
DOI: 10.5604/01.3001.0053.8704 -
Diagnostics (Basel, Switzerland) Mar 2024Malocclusions have a continuously increasing prevalence from one generation to another as a result of climate change, soil, atmosphere, and water pollution. All of these...
Malocclusions have a continuously increasing prevalence from one generation to another as a result of climate change, soil, atmosphere, and water pollution. All of these aspects have unfavorable consequences for the nutritional scheme. Thus, nutrition, together with other etiopathogenic factors, contributes to complex alterations in the somatic development of the entire organism and, implicitly, of the cephalic extremity. The study group included 4147 children from randomly selected schools from Vâlcea County, Romania. The aim of this study is to determine the prevalence of malocclusions in schoolchildren in Vâlcea County, Romania, according to the three main classes of malocclusions (according to Angle's classification), age groups (from 6 to 10 years old and from 11 to 14 years old), gender (male and female), and place of origin (rural and urban). For Angle class I malocclusions, we recorded the highest prevalence (48.78% of the total number of schoolchildren with malocclusions), followed by Angle class II malocclusions (45.85% of the total number of schoolchildren with malocclusions), and for Angle class III malocclusions we found the lowest prevalence (5.37% of the total number of schoolchildren with malocclusions). According to gender, we found the highest prevalence in the female gender (29.90% of the total number of female subjects), while in the male gender, we recorded a prevalence of 27.70% of the total number of male subjects. Regarding the place of origin, there is a higher prevalence of malocclusions in urban areas (29.16%). The study subgroup included 140 children randomly selected from the total number of subjects in the study group. They were included in a more advanced study. The aim is to find potential associations between the presence of malocclusions and various oral variables. Categorical variables were expressed as numerical values and percentages, and their association was evaluated with either the Chi-square test of association or homogeneity, or the Fisher Exact test. The acquired data were incorporated into a binomial logistic regression model to assess the likelihood of developing malocclusions in relation to the following variables: defective phonation, bruxism, frequency of teeth brushing, onychophagia, oral respiration, infantile deglutition, placing objects between the maxillaries, thumb sucking, and salivary aspects. It is also aimed at comparing the results obtained with similar ones from the specialized literature.
PubMed: 38611618
DOI: 10.3390/diagnostics14070705 -
Technisches Messen : TM Mar 2024This paper presents a measurement setup which is able to measure the distribution of small scale pressure on an area of 15.2 mm × 30.4 mm with a sample rate up to...
This paper presents a measurement setup which is able to measure the distribution of small scale pressure on an area of 15.2 mm × 30.4 mm with a sample rate up to 1.2 kHz. It was used to investigate the contact pressures of vocal folds during phonation. This was performed in ex vivo experiments of 11 porcine larynges. The contact pressure at the medial surface and other phonation parameters, as the glottal resistance and the closing velocity of the vocal fold, were measured at different adduction and elongation levels and air flow rates. A statistical analysis was carried out. It could be shown that the contact pressure rises, when the vocal fold is manipulated or when the flow rate is increased.
PubMed: 38586303
DOI: 10.1515/teme-2023-0002 -
American Journal of Otolaryngology 2024In early glottic squamous cell carcinoma, similar results have been described in terms of disease control between transoral laser microsurgery (TLM) and radiation... (Meta-Analysis)
Meta-Analysis Comparative Study Review
PURPOSE
In early glottic squamous cell carcinoma, similar results have been described in terms of disease control between transoral laser microsurgery (TLM) and radiation therapy (RT). During the past two decades, several studies compared subjective vocal outcomes of exclusive RT with those of TLM, showing a trend towards improving results for TLM over time. However, the objective differences in terms of spectro-acoustic voice parameters between exclusive RT and TLM have been less frequently investigated. The aim of this systematic review with meta-analysis was to evaluate voice quality after TLM and RT treatment for early glottic carcinoma, based on acoustic analysis parameters including jitter, shimmer, noise to harmonic ratio, fundamental frequency and maximum phonation time.
MATERIAL AND METHODS
A search of the English published literature was conducted on the Pubmed, Scopus and Cochrane databases following PRISMA guidelines.
RESULTS
A total of 441 titles were retrieved from the search. After full-text screening and application of inclusion/exclusion criteria, 12 articles were included. We found no significant differences between TLM and RT treatment in the considered acoustic analysis parameters, except for Shimmer, with more favorable values reported in the RT group.
CONCLUSIONS
Considering the spread of the disease and expecting an improvement in long-term survival over time, well-designed and multicentric studies involving larger populations with a long-term follow up are mandatory to better assess objective voice outcomes in terms of spectro-acoustic voice parameters.
Topics: Humans; Laryngeal Neoplasms; Microsurgery; Glottis; Laser Therapy; Voice Quality; Neoplasm Staging; Treatment Outcome; Carcinoma, Squamous Cell; Speech Acoustics; Male
PubMed: 38579506
DOI: 10.1016/j.amjoto.2024.104272 -
Noise & HealthFunctional dysphonia can impair the language expression ability and adversely affect the career development of some patients. Therefore, an active exploration of...
OBJECTIVE
Functional dysphonia can impair the language expression ability and adversely affect the career development of some patients. Therefore, an active exploration of effective treatment options is imperative. This study investigated the effect of Akson therapy on acoustic parameters in patients with functional dysphonia.
MATERIALS AND METHODS
In this retrospective analysis, 79 patients with functional dysphonia who received conventional voice correction training from June 2020 to June 2021 were included in the reference group (RG). Our hospital has implemented Akson therapy since July 2021. Correspondingly, 72 patients with functional dysphonia who underwent Akson therapy from July 2021 to July 2022 were enrolled in the observation group (OG). The acoustic parameters such as fundamental frequency (F0), jitter, shimmer, and normalized noise energy (NNE); the aerodynamic parameters including maximum phonation time (MPT), mean airflow rate (MFR), and Voice Handicap Index-10 (VHI-10) score; and the Grade, Roughness, Breathiness, Asthenia, and Strain scale (GRBAS) score were measured before and after treatment and compared between the two groups.
RESULTS
The F0, jitter, shimmer, NNE, MPT, and MFR values as well as the VHI-10 score and the grade (G), roughness (R), and breathiness (B) scores on the GRBAS did not significantly differ between the two groups before treatment (P > 0.05). However, significantly lower F0, jitter, shimmer, NNE, and MFR values and higher MPT levels were found in the OG compared to the RG after treatment (P < 0.001). Furthermore, the VHI-10 score and the G, R, and B scores were significantly lower in the OG than in the RG after treatment (P < 0.001), whereas the asthenia (A) and strain (S) scores remained at 0 before and after treatment.
CONCLUSION
Akson therapy can improve the acoustic parameters of patients with functional dysphonia to a certain extent, indicating its potential application value.
Topics: Humans; Dysphonia; Retrospective Studies; Asthenia; Voice Quality; Acoustics
PubMed: 38570303
DOI: 10.4103/nah.nah_99_23 -
Journal of Voice : Official Journal of... Mar 2024To describe what is known from scientific literature on the use of laryngoscopy to enhance singing pedagogy and foster improvements in vocal development. (Review)
Review
AIM
To describe what is known from scientific literature on the use of laryngoscopy to enhance singing pedagogy and foster improvements in vocal development.
DESIGN
The scoping review methodological framework by Arksey and O'Malley was used.
REVIEW METHODS
A systematic search was conducted and peer-reviewed scientific papers were screened through the Rayyan software. Data were extracted and synthesized thematically as narrative text.
DATA SOURCES
Searches were carried out on January 2023 in the Web of Science, MEDLINE, PsychINFO, ERIC, Scopus, Google Scholar, Embase and Academic Search Elite databases using relevant keywords to capture evidence, limited to peer-reviewed scientific papers in Nordic or English language.
RESULTS
A total of 1413 studies were screened and assessed for eligibility. Two studies met the inclusion criteria reporting results on the use of laryngoscope in development of singers' voices. Different designs were applied and the charted data characteristics varied. Two populations were explored; one cohort of trained professional female musical theater singers and one cohort of students (both sexes) recruited from a music school. Results from examinations with laryngoscopy regarding vowel quality, register quality, anterior-posterior compression scores, and maximum phonation time are presented. None of the retrieved studies aimed to apply laryngoscopy to enhance singing pedagogy.
CONCLUSION
Use of laryngoscopy to enable the singer to directly see their song instrument in order to foster improvements in vocal development, have been subject to little exploration. Only two studies were retrieved in our systematic search, none aimed to study potential pedagogical aspects of applying laryngoscopy. These findings support further investigation of the users', especially singers' and voice teachers' perspective, to guide and inform best practice for use of laryngoscopy as a pedagogical tool in a song development context.
PubMed: 38553319
DOI: 10.1016/j.jvoice.2024.02.029 -
Healthcare (Basel, Switzerland) Mar 2024Head and neck cancer, the seventh most common cancer worldwide, often affects the larynx, with a higher incidence in men. Total laryngectomy, a common treatment, results... (Review)
Review
Head and neck cancer, the seventh most common cancer worldwide, often affects the larynx, with a higher incidence in men. Total laryngectomy, a common treatment, results in the loss of phonation, and tracheoesophageal voice rehabilitation is the current rehabilitation method of choice. Despite ongoing debates regarding the timing of tracheoesophageal puncture (TEP), a crucial procedure for voice prosthesis placement, the secondary puncture continues to be the preferred choice in the majority of cases. This underscores the persistent controversy and the absence of consensus in this field. The aim of this manuscript was to define evidence-based recommendations regarding the procedure of primary TEP with voice prosthesis placement, establish the conditions and requirements for performing primary TEP, determine the indications and contraindications of primary TEP, as well as to define the complications and management of primary TEP. A total of 19 statements were formulated, with 78.95% of them having a Level of Evidence 4 and a Grade of Recommendation C. There is not sufficient evidence comparing the outcomes of primary TEP versus secondary TEP. Future studies with robust methodologies are needed to clarify the role of primary and secondary TEP in the rehabilitation of patients undergoing total laryngectomy.
PubMed: 38540616
DOI: 10.3390/healthcare12060652