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Across many species, a major function of vocal communication is to convey formidability, with low voice frequencies traditionally considered the main vehicle for projecting large size and aggression. Vocal loudness is often ignored, yet it might explain some puzzling exceptions to this frequency code. Here we demonstrate, through acoustic analyses of over 3,000 human vocalizations and four perceptual experiments, that vocalizers produce low frequencies when attempting to sound large, but loudness is prioritized for displays of strength and aggression. Our results show that, although being loud is effective for signaling strength and aggression, it poses a physiological trade-off with low frequencies because a loud voice is achieved by elevating pitch and opening the mouth wide into a-like vowels. This may explain why aggressive vocalizations are often high-pitched and why open vowels are considered "large" in sound symbolism despite their high first formant. Callers often compensate by adding vocal harshness (nonlinear vocal phenomena) to undesirably high-pitched loud vocalizations, but a combination of low and loud remains an honest predictor of both perceived and actual physical formidability. The proposed notion of a loudness-frequency trade-off thus adds a new dimension to the widely accepted frequency code and requires a fundamental rethinking of the evolutionary forces shaping the form of acoustic signals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This study explores the effect of body position on voice quality by mapping speech range profiles (SRP) across a fundamental frequency (fo) and sound pressure level (SPL) paradigm. Speech breathing patterns are also investigated to account for potential influences on voice quality. Comparisons between an upright, a supine and an inverted position among eight participants show varied small changes to adduction and voice quality between positions. The results indicate that the changes are speaker dependent and potentially influenced by the speaker's body type. In addition, shared systematic patterns of voice quality changes were observed at specific fo and SPL ranges based on the visual output of filtered SRP difference maps, indicating that the effects of body position vary across the fo and SPL dimensions. Voice quality changes were not found to be influenced by speech breathing patterns. The results advocate the use of voice mapping analyses for voice quality studies and comparative speech research of body position. Future directions for further investigation of changes in speech based on the influence of body position are discussed., Den här studien utforskar effekten av kroppsposition på röstkvalité genom att kartlägga talomfångsprofiler (SRP) över ett grundtonsfrekvens- (fo) och ljudtrycksnivås- (SPL) paradigm. Talandningsmönster undersöks också för att redogöra för potentiella influenser på röstkvalité. Jämförelser mellan en upprätt, en supin och en inverterad position bland åtta deltagare visar på varierade små förändringar av adduktion och röstkvalité mellan positioner. Resultaten indikerar att förändringarna är beroende av talaren och potentiellt influerade av talarens kroppstyp. Dessutom, delade systematiska mönster av röstkvalitésförändringar var observerade vid specifika fo och SPL omfång baserade på den visuella utmatningen av filtrerade SRP skillnadskartor, vilket indikerar att kroppspositionseffekten varierar över fo och SPL dimensionerna. Röstkvalitésförändringar var inte påvisade att vara influerade av talandningsmönster. De erhållna resultaten i den här uppsatsen förespråkar användningen av röstkartläggningsanalyser för röstkvalitésstudier och för forskning av taljämförelser mellan kroppspositioner. Framtida direktiv för vidare undersökning av talförändringar baserade på influensen av kroppsposition är diskuterade.

Objectives: This study aims to explore the effects of thyroidectomy—a surgical intervention involving the removal of the thyroid gland—on voice quality, as represented by acoustic and electroglottographic measures. Given the thyroid gland's proximity to the inferior and superior laryngeal nerves, thyroidectomy carries a potential risk of affecting vocal function. While earlier studies have documented effects on the voice range, few studies have looked at voice quality after thyroidectomy. Since voice quality effects could manifest in many ways, that a priori are unknown, we wish to apply an exploratory approach that collects many data points from several metrics. Methods: A voice-mapping analysis paradigm was applied retrospectively on a corpus of spoken and sung sentences produced by patients who had thyroid surgery. Voice quality changes were assessed objectively for 57 patients prior to surgery and 2 months after surgery, by making comparative voice maps, pre- and post-intervention, of six acoustic and electroglottographic (EGG) metrics. Results: After thyroidectomy, statistically significant changes consistent with a worsening of voice quality were observed in most metrics. For all individual metrics, however, the effect sizes were too small to be clinically relevant. Statistical clustering of the metrics helped to clarify the nature of these changes. While partial thyroidectomy demonstrated greater uniformity than did total thyroidectomy, the type of perioperative damage had no discernible impact on voice quality.ConclusionsChanges in voice quality after thyroidectomy were related mostly to increased phonatory instability in both the acoustic and EGG metrics. Clustered voice metrics exhibited a higher correlation to voice complaints than did individual voice metrics., QC 20240508

Objectives: This study aims to explore the effects of thyroidectomy—a surgical intervention involving the removal of the thyroid gland—on voice quality, as represented by acoustic and electroglottographic measures. Given the thyroid gland's proximity to the inferior and superior laryngeal nerves, thyroidectomy carries a potential risk of affecting vocal function. While earlier studies have documented effects on the voice range, few studies have looked at voice quality after thyroidectomy. Since voice quality effects could manifest in many ways, that a priori are unknown, we wish to apply an exploratory approach that collects many data points from several metrics. Methods: A voice-mapping analysis paradigm was applied retrospectively on a corpus of spoken and sung sentences produced by patients who had thyroid surgery. Voice quality changes were assessed objectively for 57 patients prior to surgery and 2 months after surgery, by making comparative voice maps, pre- and post-intervention, of six acoustic and electroglottographic (EGG) metrics. Results: After thyroidectomy, statistically significant changes consistent with a worsening of voice quality were observed in most metrics. For all individual metrics, however, the effect sizes were too small to be clinically relevant. Statistical clustering of the metrics helped to clarify the nature of these changes. While partial thyroidectomy demonstrated greater uniformity than did total thyroidectomy, the type of perioperative damage had no discernible impact on voice quality.ConclusionsChanges in voice quality after thyroidectomy were related mostly to increased phonatory instability in both the acoustic and EGG metrics. Clustered voice metrics exhibited a higher correlation to voice complaints than did individual voice metrics., QC 20240508

Recent advancements in spontaneous text-to-speech (TTS) have enabled the realistic synthesis of creaky voice, a voice quality known for its diverse pragmatic and paralinguistic functions. In this study, we used synthesized creaky voice in perceptual tests, to explore how listeners without formal training perceive two distinct types of creaky voice. We annotated a spontaneous speech corpus using creaky voice detection tools and modified a neural TTS engine with a creaky phonation embedding to control the presence of creaky phonation in the synthesized speech. We performed an objective analysis using a creak detection tool which revealed significant differences in creaky phonation levels between the two creaky voice types and modal voice. Two subjective listening experiments were performed to investigate the effect of creaky voice on perceived certainty, valence, sarcasm, and turn finality. Participants rated non-positional creak as less certain, less positive, and more indicative of turn finality, while positional creak was rated significantly more turn final compared to modal phonation., QC 20240701Part of ISBN 978-249381410-4

Objectives: This study aims to explore the effects of thyroidectomy—a surgical intervention involving the removal of the thyroid gland—on voice quality, as represented by acoustic and electroglottographic measures. Given the thyroid gland's proximity to the inferior and superior laryngeal nerves, thyroidectomy carries a potential risk of affecting vocal function. While earlier studies have documented effects on the voice range, few studies have looked at voice quality after thyroidectomy. Since voice quality effects could manifest in many ways, that a priori are unknown, we wish to apply an exploratory approach that collects many data points from several metrics. Methods: A voice-mapping analysis paradigm was applied retrospectively on a corpus of spoken and sung sentences produced by patients who had thyroid surgery. Voice quality changes were assessed objectively for 57 patients prior to surgery and 2 months after surgery, by making comparative voice maps, pre- and post-intervention, of six acoustic and electroglottographic (EGG) metrics. Results: After thyroidectomy, statistically significant changes consistent with a worsening of voice quality were observed in most metrics. For all individual metrics, however, the effect sizes were too small to be clinically relevant. Statistical clustering of the metrics helped to clarify the nature of these changes. While partial thyroidectomy demonstrated greater uniformity than did total thyroidectomy, the type of perioperative damage had no discernible impact on voice quality.ConclusionsChanges in voice quality after thyroidectomy were related mostly to increased phonatory instability in both the acoustic and EGG metrics. Clustered voice metrics exhibited a higher correlation to voice complaints than did individual voice metrics., QC 20240508

Accurate diagnosis and characterization of voice disorders requires an understanding of typical voicing: how is variation in voice quality used to convey linguistic information in typical speech? This dissertation addresses this question by examining how speakers produce and perceive creaky voice that is phonologically conditioned. ‘Creaky voice’ is a broad umbrella term used to describe voice qualities that have increased constriction, lower pitch, and/or more irregularity relative to modal voice. In English, creaky voice is typically used to convey segmental and prosodic information, but this same quality may be used to characterize dysphonic speech. Importantly, it is unknown if dysphonic and typical voices differ in their use and realization of creaky voice. Three primary research questions are explored: (1) How do typical speakers vary their voice quality to target phonologically-conditioned creaky voice? (2) How do listeners extract linguistic information from variation in voice quality? (3) How do speakers with voice disorders target phonologically-conditioned creaky voice? In Chapter 1, I present evidence that variation between a speaker’s modal and creaky voice is highly structured and predictable, despite wide cross-speaker variation in the acoustics of both qualities. As a result, each speaker produces phonologically-creaky voice in a unique way while aiming for the same target voice quality. In Chapter 2, I examine how listeners cope with this variability, and present evidence that suggests listeners can normalize to a person’s long-term voice quality when recognizing words. Finally, in Chapter 3, I present a case series of two speakers with voice disorders to examine how creaky voice might differ between typical and disordered voice quality. I conclude that production of phonologically-conditioned creak does not necessarily differ from typical speech based on acoustic measures typically used in a clinical setting, at least for speakers with mild dysphon

This study explores the effect of body position on voice quality by mapping speech range profiles (SRP) across a fundamental frequency (fo) and sound pressure level (SPL) paradigm. Speech breathing patterns are also investigated to account for potential influences on voice quality. Comparisons between an upright, a supine and an inverted position among eight participants show varied small changes to adduction and voice quality between positions. The results indicate that the changes are speaker dependent and potentially influenced by the speaker's body type. In addition, shared systematic patterns of voice quality changes were observed at specific fo and SPL ranges based on the visual output of filtered SRP difference maps, indicating that the effects of body position vary across the fo and SPL dimensions. Voice quality changes were not found to be influenced by speech breathing patterns. The results advocate the use of voice mapping analyses for voice quality studies and comparative speech research of body position. Future directions for further investigation of changes in speech based on the influence of body position are discussed., Den här studien utforskar effekten av kroppsposition på röstkvalité genom att kartlägga talomfångsprofiler (SRP) över ett grundtonsfrekvens- (fo) och ljudtrycksnivås- (SPL) paradigm. Talandningsmönster undersöks också för att redogöra för potentiella influenser på röstkvalité. Jämförelser mellan en upprätt, en supin och en inverterad position bland åtta deltagare visar på varierade små förändringar av adduktion och röstkvalité mellan positioner. Resultaten indikerar att förändringarna är beroende av talaren och potentiellt influerade av talarens kroppstyp. Dessutom, delade systematiska mönster av röstkvalitésförändringar var observerade vid specifika fo och SPL omfång baserade på den visuella utmatningen av filtrerade SRP skillnadskartor, vilket indikerar att kroppspositionseffekten varierar över fo och SPL dimensionerna. Röstkvalitésförändringar var inte påvisade att vara influerade av talandningsmönster. De erhållna resultaten i den här uppsatsen förespråkar användningen av röstkartläggningsanalyser för röstkvalitésstudier och för forskning av taljämförelser mellan kroppspositioner. Framtida direktiv för vidare undersökning av talförändringar baserade på influensen av kroppsposition är diskuterade.

Objectives: This study aims to explore the effects of thyroidectomy—a surgical intervention involving the removal of the thyroid gland—on voice quality, as represented by acoustic and electroglottographic measures. Given the thyroid gland's proximity to the inferior and superior laryngeal nerves, thyroidectomy carries a potential risk of affecting vocal function. While earlier studies have documented effects on the voice range, few studies have looked at voice quality after thyroidectomy. Since voice quality effects could manifest in many ways, that a priori are unknown, we wish to apply an exploratory approach that collects many data points from several metrics. Methods: A voice-mapping analysis paradigm was applied retrospectively on a corpus of spoken and sung sentences produced by patients who had thyroid surgery. Voice quality changes were assessed objectively for 57 patients prior to surgery and 2 months after surgery, by making comparative voice maps, pre- and post-intervention, of six acoustic and electroglottographic (EGG) metrics. Results: After thyroidectomy, statistically significant changes consistent with a worsening of voice quality were observed in most metrics. For all individual metrics, however, the effect sizes were too small to be clinically relevant. Statistical clustering of the metrics helped to clarify the nature of these changes. While partial thyroidectomy demonstrated greater uniformity than did total thyroidectomy, the type of perioperative damage had no discernible impact on voice quality.ConclusionsChanges in voice quality after thyroidectomy were related mostly to increased phonatory instability in both the acoustic and EGG metrics. Clustered voice metrics exhibited a higher correlation to voice complaints than did individual voice metrics., QC 20240508

Objective: To compare two surgical techniques, the Wendler glottoplasty (GP) and its modification, the vocal fold shortening, and retrodisplacement of the anterior commissure (VFSRAC) associated with laser assisted voice adjustment (LAVA) cordotomy, used to feminize the voice of transgender women by increasing the fundamental frequency (F0). Methods: A retrospective study of 22 trans-women (20-62 years-old) was carried out. 12 of them were treated with GP and 10 with the VFSRAC+LAVA technique. They were evaluated before surgery and 6 months after surgery and the postoperative speech therapy. Laryngostroboscopy examination, F0 measurements, Transgender Woman Voice Questionnaire (TWVQ) assessment and the perceptual assessment using a visual analog scale (PA-VAS) were obtained from all patients. Results: Laryngostroboscopic findings showed normal vocal folds before surgery and a shortening of the vocal folds, due to the anterior glottic synechia, after surgery. Significant increases of F0 were found in both groups but they were higher in the VFSRAC+LAVA group (47.75Hz in GP group vs 69.70Hz in VFSRAC+LAVA group). TWVQ scores showed a significant decrease in both groups although the difference was greater in the VFSRAC+LAVA group. Similarly, PA-VAS scores lowered significantly in both groups but VFSRAC+LAVA group presented the biggest decreases. Conclusion: Both surgical techniques produce the shortening of the vocal folds through an endoscopic approach and result in voices with higher vocal pitch. Of the two techniques presented, the VFSRAC+LAVA produces better results although when compared with previous studies it seems that the LAVA technique may not significantly contribute to the postoperative results. So, the VFSRAC technique followed by postoperative speech therapy could be recommended for trans-women who wish to feminize their voice., Depto. de Inmunología, Oftalmología y ORL, Fac. de Medicina, TRUE, inpress

Objectives: This study aims to explore the effects of thyroidectomy—a surgical intervention involving the removal of the thyroid gland—on voice quality, as represented by acoustic and electroglottographic measures. Given the thyroid gland's proximity to the inferior and superior laryngeal nerves, thyroidectomy carries a potential risk of affecting vocal function. While earlier studies have documented effects on the voice range, few studies have looked at voice quality after thyroidectomy. Since voice quality effects could manifest in many ways, that a priori are unknown, we wish to apply an exploratory approach that collects many data points from several metrics. Methods: A voice-mapping analysis paradigm was applied retrospectively on a corpus of spoken and sung sentences produced by patients who had thyroid surgery. Voice quality changes were assessed objectively for 57 patients prior to surgery and 2 months after surgery, by making comparative voice maps, pre- and post-intervention, of six acoustic and electroglottographic (EGG) metrics. Results: After thyroidectomy, statistically significant changes consistent with a worsening of voice quality were observed in most metrics. For all individual metrics, however, the effect sizes were too small to be clinically relevant. Statistical clustering of the metrics helped to clarify the nature of these changes. While partial thyroidectomy demonstrated greater uniformity than did total thyroidectomy, the type of perioperative damage had no discernible impact on voice quality.ConclusionsChanges in voice quality after thyroidectomy were related mostly to increased phonatory instability in both the acoustic and EGG metrics. Clustered voice metrics exhibited a higher correlation to voice complaints than did individual voice metrics., QC 20240508

IntroductionAlthough phonatory glottal posture and airflow pulse shape affect voice quality, studies to date have been limited by visualization of vocal fold (VF) vibration from a superior view. We performed a 3D reconstruction of VF vibratory motion during phonation from a medial view and assessed the glottal volume waveform and resulting acoustics as a function of neuromuscular stimulation.Study designIn vivo canine hemilarynx phonation.MethodsAcross 121 unique combinations of the superior laryngeal nerve (SLN) and recurrent laryngeal nerve (RLN) stimulation, the hemilarynx was excited to the oscillation with airflow. VF medial surface reference points were tracked on high-speed video, mapped into 3D space, and surface shape was restored using cubic spline interpolation. Glottal surface shape, reconstruction-based parameters, and glottal volume waveform were calculated. Fundamental frequency (F0), cepstral peak prominence (CPP), and harmonic amplitude (H1-H2) were measured from high-quality audio samples.ResultsThe glottis was convergent during opening and divergent during closing. Neuromuscular activation changed phonatory glottal shape and reduced glottal volume. Significant reduction in glottal volume and closing quotient were present with SLN stimulation. RLN stimulation significantly increased F0 and CPP and decreased H1-H2 (constricted glottis), while SLN effects were similar and synergistic with concurrent RLN stimulation.Conclusion3D reconstruction of in vivo medial surface vibration revealed effects of laryngeal nerve stimulation on glottal vibratory pattern and acoustic correlates of voice quality. SLN activation resulted in significantly quicker glottal closure per cycle, decreased glottal volume, and higher-pitched, less breathy, and less noisy voice. RLN had a similar effect on acoustic measures.Level of evidenceNA, Basic Science Laryngoscope, 133:357-365, 2023.

The human voice is the most common `carrier' of speech, but how does linguistic voice quality affect speech production and perception? Typical `modal' voice possesses a single fundamental frequency (f0), identified as the voice's pitch. Period doubling, known as a commonly-occurring type of creaky voice, consists of alternating glottal pulses with different periods and/or amplitudes for which multiple fundamental frequencies (f0s) co-exist. Thus, the pitch during period doubling is often indeterminate, and so it is unclear whether linguistic tone is identifiable, and how linguistic tone is identified, in this voice. Although period doubling has been mostly studied in voice disorders and singing styles, it frequently occurs in non-pathological voices, and its defining characteristics remain to be determined.This dissertation contributes three studies to characterize the physical, distributional, and perceptual aspects of period-doubled voice. Simultaneous electroglottography (EGG) and audio recordings of a Mandarin read speech corpus were analyzed to capture properties of the articulation and acoustics of period doubling in Chapters 2 and 3; artificial language learning and shadowing experimentation were used to probe perception of period doubling in Chapter 4.The EGG study in Chapter 2 finds that period doubling is articulated as two alternating pulses with distinct pitches as well as voice qualities. Specifically, I show that the glottal cycles in period doubling are not generally constricted, but instead oscillate between degrees of constriction shown by alternating contact quotients, pulse shape, and speed of vocal fold contact. This in addition to the alternating frequencies likely leads to the indeterminate pitch and quality percept in period doubling. The results also pose challenges to the existing taxonomy of creaky voice subtypes based on the established acoustic attributes.The acoustic analysis in Chapter 3 finds that period doubling is characterized acous

Introduction. Teleworking as a result of COVID-19 has generated high demands that could promote the generation of vocal overexertion. Aim. To evaluate how working conditions assess changes in vocal health, evaluate work stress, and assess changes in the vocal quality of primary school teachers in the Temuco commune. Method. Eighteen elementary school teachers from the commune of Temuco, Chile, who were teleworking during the year 2021, were evaluated not only at the beginning but also at the end of the school year through the Voice Handicap Index (VHI-30), Vocal Tract Discomfort (VTD), Maslach Burnout Inventory (MBI), and acoustic analysis using long-term average spectrum and disturbance measurements. Results. Only 21% of the teachers had adequate physical space for teleworking. In addition, 52.6% had to share household responsibilities such as taking care of minor children during their teleworking day. The results show an increase in symptoms and sensations of discomfort at the level of the vocal tract measured by the VHI-30 and the VTD. Regarding job stress measured by the Burnout scale, only a significant value for the emotional exhaustion subscale was found. Besides, there were not found any significant differences in the acoustic parameters Jitter, Shimmer, HNR, and Alpha ratio. Conclusions. The vast majority of the participants reported increased discomfort and self-perceived vocal symptoms (dry throat, vocal fatigue) together with a higher level of stress, which in the long run can trigger voice disorders., Introducción. El teletrabajo producto del COVID-19 ha generado exigencias que podrían promover la generación de un sobreesfuerzo vocal. Objetivo. Evaluar cómo las condiciones de trabajo pueden afectar la salud vocal, evaluar el estrés laboral y valorar los cambios en la calidad vocal de profesoras de primaria de la comuna de Temuco. Método. Se evaluó a 18 profesoras de primaria de la comuna de Temuco, Chile, quienes se encontraban trabajando en modalidad de teletrabajo durante el año 2021, realizando una evaluación al comienzo y al final del año escolar, a través del Voice Handicap Index (VHI-30), Vocal Tract Disconfort (VTD), Maslach Burnout Inventory (MBI) y análisis acústico mediante medidas de perturbación y espectro promedio a largo plazo. Resultados. Solo el 21% de las profesoras contaba con un espacio físico adecuado para el teletrabajo. El 52,6% debía compartir responsabilidades del hogar, como el cuidado de hijos menores durante su jornada de teletrabajo. Los resultados muestran un aumento de la sintomatología y sensaciones de incomodidad a nivel del tracto vocal medidas mediante el VHI-30 y el VTD. En cuanto al estrés laboral medido por la escala de Burnout, solo se evidenció un valor significativo para la subescala agotamiento emocional. No se evidenciaron diferencias significativas en los parámetros acústicos Jitter, Shimmer, HNR y Alpha ratio. Conclusiones. La gran mayoría de las participantes manifestó un aumento del malestar y sintomatología vocal autopercibida (sequedad de garganta, fatiga vocal) en conjunto con un mayor nivel de estrés, lo que a la larga puede desencadenar trastornos de voz.

Uvod: Specifični jezički poremećaj (SJP) karakteriše kašnjenje ili atipičan obrazac u razvoju ekspresivnih i/ili receptivnih jezičkih sposobnosti uz odsustvo opšteg kognitivnog deficita, autizma, slušnih oštećenja, socijalnih i emocionalnih poremećaja i teške sredinske deprivacije. Cilj: Cilj ovog istraživanja je utvrđivanje karakteristika kvaliteta glasa i analiza učestalosti nepravilnosti u perceptivnim karakteristikama glasa kod dece sa specifičnim jezičkim poremećajem. Dodatni cilj podrazumevao je utvrđivanje polnih razlika u kvalitetu glasa kod ove dece. Metode: Uzorkom je obuhvaćeno 30 dece sa specifičnim jezičkim poremećajem, uzrasta od tri do devet godina (AS=6,40; SD=1,714), od kojih je 20 dečaka i 10 devojčica. Za procenu kvaliteta glasa korišćena je GRBAS skala. Rezultati: Dobijeni rezultati pokazuju da 36,7% ispitanika ima promuklost i šumnost u glasu, dok je napetost u glasu registrovana kod 46,7% ispitanika. Hrapavost glasa je najmanje zastupljena kod dece sa specifičnim jezičkim poremećajem (30%), dok je najčešća karakteristika kvaliteta glasa bila slabost u glasu (53,3%). Perceptivne promene glasa najčešće su okarakterisane kao promene blagog stepena, potom slede umerene, a najmanje su zastupljene izražene promene glasa. Postoje značajne razlike u stepenu promuklosti i hrapavosti glasa u odnosu na pol u korist dečaka. Zaključak: Iako su kod malog broja dece registrovane teškoće, one imaju značajne naučne i praktične implikacije. Njihova važnost ogleda se u značaju perceptivne procene glasa na ranom uzrastu od strane logopeda, koji poseduje stručne kompetencije za prepoznavanje mogućih smetnji u glasu. Na taj način ostvareni su svi uslovi za zdrav i kvalitetan glas kod dece., Introduction: Specific language impairment (SLI) is characterized by a delay or abnormality in the development of expressive and/or receptive language skills in the absence of general cognitive deficits, autism, hearing impairments, social and emotional disturbances, and severe environmental deprivation. Aim: The aim of this research was to determine the quality of voice and analysis of the frequency of irregularities in the perceptual characteristics of voice in children with specific language impairment. Also, the goal was to determine possible gender differences in the voice quality of these children. Methods: The sample included 30 children with specific language disorders, 3-9 years of age (M=6.40; SD=1.714), of which 20 were boys and 10 were girls. The GRBAS scale was used to assess voice quality. Results: The results showed that 36.7% of respondents had hoarseness in their voice, while tension in the voice was registered in 46.7% of respondents. Voice hoarseness was the least represented in children with specific language disorders (30%), while the most common voice pathology was voice weakness (53.3%). The most common perceptual voice changes were mild, followed by moderate, and the least pronounced voice changes. There were significant differences in the degree of hoarseness and roughness of voice in relation to gender, more pronounced in boys. Conclusion: Although difficulties were registered in a small number of children, they have significant scientific and practical implications. Their importance is reflected in the importance of perceptual assessment of voice in the early period by a vocal pathologist, who has a trained sensibility for expert recognition of possible voice disturbances. In this way, all possible conditions are met to preserve healthy and high-quality voice in children.

In recent years, numerous investigations have focused on voice quality (VQ) for forensic purposes. These studies notwithstanding, we lack an international picture of how VQ is generally understood by forensic practitioners and how it contrasts with the practices of voice therapists. To fill this gap, a survey was designed and sent to both cohorts: forensicists and clinicians. A total of 45 responses from 20 countries were received. Important differences were found between groups, particularly regarding perceptual assessment. One conclusion to be drawn is that more emphasis should be placed on calibration and error measurement in forensic approaches to VQ. Further collaborations with clinicians should also be encouraged.

Vocal fry is a voice quality that occurs in a healthy voice, but it can also be a sign of a voice disorder. In this study, we investigated the relationship between the parameters of voice production, a dedicated psychoacoustic feature, and the perceptual aspects of vocal fry. Two perceptual experiments were carried out to determine whether the fundamental frequency, the open quotient, and the glottal area pulse skewness affect the perception of vocal fry in synthetic vowels. Thirteen listeners participated in the perceptual experiments to assess the following attributes: binary fry (yes/no) and impulsiveness, tonality, and naturalness (7-point Likert scales). The results suggest that the perception of vocal fry is mainly triggered by a low fundamental frequency, but the open quotient also plays a role, with narrower glottal area pulses slightly increasing the probability of perceived fry. Perceived tonality is inversely related to perceived impulsiveness. Internal reference standards of listeners appear to have fixed elements but may also be affected by anchoring and the short-term (i.e. within-vowel) context of the stimuli. In addition, the prominence of the peaks observed in the loudness curve over time appears to be related to graduations of fry., SCOPUS: ar.j, info:eu-repo/semantics/published

Objective: To compare two surgical techniques, the Wendler glottoplasty (GP) and its modification, the vocal fold shortening, and retrodisplacement of the anterior commissure (VFSRAC) associated with laser assisted voice adjustment (LAVA) cordotomy, used to feminize the voice of transgender women by increasing the fundamental frequency (F0). Methods: A retrospective study of 22 trans-women (20-62 years-old) was carried out. 12 of them were treated with GP and 10 with the VFSRAC+LAVA technique. They were evaluated before surgery and 6 months after surgery and the postoperative speech therapy. Laryngostroboscopy examination, F0 measurements, Transgender Woman Voice Questionnaire (TWVQ) assessment and the perceptual assessment using a visual analog scale (PA-VAS) were obtained from all patients. Results: Laryngostroboscopic findings showed normal vocal folds before surgery and a shortening of the vocal folds, due to the anterior glottic synechia, after surgery. Significant increases of F0 were found in both groups but they were higher in the VFSRAC+LAVA group (47.75Hz in GP group vs 69.70Hz in VFSRAC+LAVA group). TWVQ scores showed a significant decrease in both groups although the difference was greater in the VFSRAC+LAVA group. Similarly, PA-VAS scores lowered significantly in both groups but VFSRAC+LAVA group presented the biggest decreases. Conclusion: Both surgical techniques produce the shortening of the vocal folds through an endoscopic approach and result in voices with higher vocal pitch. Of the two techniques presented, the VFSRAC+LAVA produces better results although when compared with previous studies it seems that the LAVA technique may not significantly contribute to the postoperative results. So, the VFSRAC technique followed by postoperative speech therapy could be recommended for trans-women who wish to feminize their voice., Depto. de Inmunología, Oftalmología y ORL, Unidad Docente de Inmunología, Oftalmología y ORL, Fac. de Medicina, Fac. de Óptica y Optometría, TRUE, inpress

Although the paralinguistic and phonological significance of breathy voice is well known, its pragmatic roles have been little studied. We report a systematic exploration of the pragmatic functions of breathy voice in American English, using a small corpus of casual conversations, using the Cepstral Peak Prominence Smoothed measure as an indicator of breathy voice, and using a common workflow to find prosodic constructions and identify their meanings. We found two prosodic constructions involving breathy voice. The first involves a short region of breathy voice in the midst of a region of low pitch, functioning to mark self-directed speech. The second involves breathy voice over several seconds, combined with a moment of wider pitch range leading to a high pitch over about a second, functioning to mark an attempt to establish common ground. These interpretations were confirmed by a perception experiment., QC 20220628, Perception of speaker stance – using spontaneous speech synthesis to explore the contribution of prosody, context and speaker (VR-2020-02396), Prosodic functions of voice quality dynamics(VR-2019-02932), CAPTivating – Comparative Analysis of Public speaking with Text-to-speech (P20-0298)

The authors aim to review available reports on the potential effects of masks on voice and speech parameters. A literature search was conducted using MEDLINE and Google Scholar databases through July 2021. Several targeted populations, mask scenarios and methodologies were approached. The assessed voice parameters were divided into self-reported, acoustic and aerodynamic. It was observed that the wearing of a face mask has been shown to induce several changes in voice parameters: (1) self-reported-significantly increased vocal effort and fatigue, increased vocal tract discomfort and increased values of voice handicap index (VHI) were observed; (2) acoustics-increased voice intensity, altered formants frequency (F2 and F3) with no changes in fundamental frequency, increased harmonics-to-noise ratio (HNR) and increased mean spectral values in high-frequency levels (1000-8000 Hz), especially with KN95 mask; (3) aerodynamics-maximum phonatory time was assessed in only two reports, and showed no alterations. Despite the different populations, mask-type scenarios and methodologies described by each study, the results of this review outline the significant changes in voice characteristics with the use of face masks. Wearing a mask shows to increase the perception of vocal effort and an alteration of the vocal tract length and speech articulatory movements, leading to spectral sound changes, impaired communication and perception. Studies analyzing the effect of masks on voice aerodynamics are lacking. Further research is required to study the long-term effects of face masks on the potential development of voice pathology.

This study replicates and extends the recent findings of Lee, Keating, and Kreiman [J. Acoust. Soc. Am. 146(3), 1568-1579 (2019)] on acoustic voice variation in read speech, which showed remarkably similar acoustic voice spaces for groups of female and male talkers and the individual talkers within these groups. Principal component analysis was applied to acoustic indices of voice quality measured from phone conversations for 99/100 of the same talkers studied previously. The acoustic voice spaces derived from spontaneous speech are highly similar to those based on read speech, except that unlike read speech, variability in fundamental frequency accounted for significant acoustic variability. Implications of these findings for prototype models of speaker recognition and discrimination are considered.

Listeners rely on speech vocal cues to judge speakers’ age, size, personality, and other paralinguistic and extralinguistic features. These judgements are often based on vocal stereotypes which may be universally or culturally determined. This study examines how physical, psychological, social, and vocal features are perceived by listeners and which acoustic features may influence their judgements. An experiment integrating a perceptual test and acoustic measurements was performed. The corpus consisted of speech utterances produced by five animated film characters, dubbed in Brazilian Portuguese. The stimuli were judged by 77 Brazilian Portuguese native speakers, 46 women and 31 men, aged 20 to 50. The acoustic analysis was performed automatically. Acoustic measures included mean f0, f0 baseline, spectral emphasis and H1-H2. For inter-rater agreement analysis, Cronbach's Alpha was chosen. The results indicated close agreements among judges for all characters. Overall scores obtained for all characters were above .90. In interpreting the results, the influence sound symbolism codes may have on listeners’ judgments and the factors influencing vocal stereotypes have been considered. The discussion of the acoustic and perceptual analysis results takes into consideration if voice actors adapt their voices to fit the characters or otherwise are cast because of their natural voice characteristics

Although the paralinguistic and phonological significance of breathy voice is well known, its pragmatic roles have been little studied. We report a systematic exploration of the pragmatic functions of breathy voice in American English, using a small corpus of casual conversations, using the Cepstral Peak Prominence Smoothed measure as an indicator of breathy voice, and using a common workflow to find prosodic constructions and identify their meanings. We found two prosodic constructions involving breathy voice. The first involves a short region of breathy voice in the midst of a region of low pitch, functioning to mark self-directed speech. The second involves breathy voice over several seconds, combined with a moment of wider pitch range leading to a high pitch over about a second, functioning to mark an attempt to establish common ground. These interpretations were confirmed by a perception experiment., QC 20220628, Perception of speaker stance – using spontaneous speech synthesis to explore the contribution of prosody, context and speaker (VR-2020-02396), Prosodic functions of voice quality dynamics(VR-2019-02932), CAPTivating – Comparative Analysis of Public speaking with Text-to-speech (P20-0298)

Purpose: We investigated if outcomes differ between voice therapy groups systematically using carryover strategies (attempts to generalize new vocal skills outside the clinic) and voice therapy with no emphasis on any generalizing process (here referred to as traditional voice therapy). Method: A randomized controlled trial was conducted. Participants (53 female teachers with voice disorders) were randomly allocated into three groups: Carryover (a group receiving voice therapy using carryover strategies), Trad (a group receiving voice therapy with no emphasis on any generalizing process), Controls (a group on an eight-week non-therapy period). Prior to the trial a direct laryngoscopy was performed with a videolaryngostroboscopy system and/or nasofaryngofiberoscope with stroboscopy. Before and after therapy and at follow-up a voice evaluation protocol was implemented consisting of subjective assessments (Questionnaire on Voice Symptoms, and the Voice Activity and Participation Profile; VAPP), and objective measurements (voice sample recordings, acoustic analysis [SPL, sound pressure level; f₀, fundamental frequency; alpha-ratio, tilt of the sound spectrum slope]). Results: No differences were found between the groups. Several significant changes occurred within the groups between initial phase vs. post-therapy and initial phase vs. follow-up. In the Carryover group text reading the alpha-ratio became lower (P = 0.011) and spontaneous speech f₀ increased (P = 0.024) after the therapy and [a:] SPL increased (P = 0.042) at follow-up. In the Trad group post-therapy [a:] alpha-ratio became lower (P = 0.012) and spontaneous speech f₀ decreased (P = 0.034). After therapy VAPP scores showed improvement in voice-related quality of life in both therapy groups (Carryover P = 0.003; Trad P = 0.01) but only in Carryover at follow-up (P = 0.000). Voice symptoms decreased in the Carryover group post-therapy (P = 0.001) and at follow-up (P = 0.000) and after Controls’ eight

IntroductionVibratory asymmetry and neuromuscular compensation are often seen in laryngeal neuromuscular pathology. However, the ramifications of these findings on voice quality are unclear. This study investigated the effects of varying levels of vibratory asymmetry and neuromuscular compensation on cepstral peak prominence (CPP), an analog of voice quality.Study designIn vivo canine phonation model.MethodsVarying degrees of vocal fold vibratory asymmetry were achieved by stimulating one recurrent laryngeal nerve (RLN) over 11 levels from threshold to maximal muscle activation. For each of these levels, phonation was induced at systematically varied combinations of neuromuscular compensation: three levels each of contralateral RLN stimulation (80%, 90%, and 100% of maximal), superior laryngeal nerve (SLN) activation (0%, 50%, and 100% of maximal), and airflow levels (500, 700, and 900 mL/s). Vocal fold symmetry was determined by assessing the opening phase of the vibratory cycle in high-speed video recordings. Voice quality was estimated acoustically by calculating CPP for each voice sample.ResultsEight hundred twenty-two phonatory conditions with varying degrees of vibratory asymmetry were evaluated. CPP was highest at vibratory symmetry. Increasing levels of asymmetry resulted in significant decreases in CPP. CPP increased significantly with increasing contralateral RLN activation. CPP was significantly higher at 50% SLN activation than 0% or 100% SLN activation.ConclusionVoice quality, as approximated by CPP, is best at vibratory symmetry and deteriorates with increasing degrees of asymmetry. Voice quality may be improved with neuromuscular compensation by increased adduction of the contralateral vocal fold or increased vocal fold tension at mid-levels of SLN activation.Level of evidenceNA, Basic Science Laryngoscope, 132:130-134, 2022.

PurposeThis study examined the relationship between voice quality and glottal geometry dynamics in patients with adductor spasmodic dysphonia (ADSD).MethodAn objective computer vision and machine learning system was developed to extract glottal geometry dynamics from nasolaryngoscopic video recordings for 78 patients with ADSD. General regression models were used to examine the relationship between overall voice quality and 15 variables that capture glottal geometry dynamics derived from the computer vision system. Two experts in ADSD independently rated voice quality for two separate voice tasks for every patient, yielding four different voice quality rating models.ResultsAll four of the regression models exhibited positive correlations with clinical assessments of voice quality (R 2s = .30-.34, Spearman rho = .55-.61, all with p < .001). Seven to 10 variables were included in each model. There was high overlap in the variables included between the four models, and the sign of the correlation with voice quality was consistent for each variable across all four regression models.ConclusionWe found specific glottal geometry dynamics that correspond to voice quality in ADSD.

Introduction. Due to the COVID-19 pandemic, teaching conditions changed around the world from in-person classes to online classes, which also determined changes on teachers’ working conditions. Method: Exploratory cross-sectional study with the aim of determining the association between two voice symptoms (vocal fatigue and throat pain) with home working conditions during online classes in times of COVID-19 pandemic. Professors answered an online survey including 27 questions about four components: sociodemographic factors, characteristics of home working, quarantine characteristics, and health conditions (including voice functioning). Results: 177 college professors from Argentina, Colombia, and Chile participated in this study. First, incidence of vocal fatigue, during online classes in times of COVID-19 pandemic, represented around 50%. Although throat pain had a smaller incidence, it was also important (35%). Second, days in quarantine, number of classes per week, people living with during quarantine, and history of vocal fatigue before quarantine were important associated factors of vocal fatigue. Third, important associated factors of throat pain were number of classes per week, level of stress, years of experience, and history of throat pain before quarantine. Conclusion: Similar to pre-COVID-19, vocal fatigue and throat pain were frequently reported voice symptoms among college professors. Associated factors of these symptoms included years of experience, number of classes per week, stress, people living with during quarantine due to COVID-19, and history of voice symptoms. Workplace Health Promotion programs should include activities that facilitate a healthy occupational voice use during and post-COVID-19 pandemic, considering the implications of online teaching on teachers’ health and safety., Introducción: Debido a la pandemia del COVID-19, las condiciones de enseñanza-aprendizaje cambiaron alrededor del mundo, pasando de clases presenciales a clases virtuales, lo que también determinó cambios en las condiciones de trabajo docente. Métodos: Estudio transversal exploratorio que tuvo como propósito determinar la asociación entre 2 síntomas de voz (fatiga vocal y dolor de garganta) con las condiciones de trabajo docente durante las clases virtuales en tiempos de COVID-19. Los profesores diligenciaron una encuesta virtual que incluyó 27 preguntas sobre los siguientes 4 componentes: factores sociodemográficos, características del trabajo en casa, características de la cuarentena, y condiciones de salud (incluyendo funcionamiento vocal). Resultados: 177 profesores universitarios de Argentina, Colombia y Chile participaron en este estudio. Primero, la incidencia de la fatiga vocal durante las clases virtuales en tiempos de COVID-19 representó alrededor del 50%. Aunque el dolor de garganta tuvo una menor incidencia, también fue importante (35%). Segundo, los días en cuarentena, número de clases por semana, personas con las que vivió durante la cuarentena, y los antecedentes de fatiga vocal antes de la cuarentena estuvieron estadísticamente asociados a la fatiga vocal. Tercero, los factores asociados al dolor de garganta fueron el número de clases semanales, los niveles de estrés, los años de experiencia y los antecedentes de dolor de garganta antes de la cuarentena. Conclusión: Similar a hallazgos previos al COVID-19, la fatiga vocal y el dolor de garganta son síntomas vocales frecuentemente reportados en docentes universitarios. Factores asociados de estos síntomas incluyen años de experiencia, número de clases semanales, estrés, personas con las que vivió durante la cuarentena y antecedentes de estos síntomas vocales antes del trabajo en casa. Los Programas de Promoción de la Salud en los Lugares de Trabajo deben incluir actividades que faciliten el uso ocupac

Objective. To estimate the productivity reduction costs associated to self-reported voice symptoms, low sleep quality, and high stress levels among college professors during homeworking in times of COVID-19 pandemic. Methods. This cross-sectional study included fifty-eight college professors who reported their reduction in productivity at work due to self-perceived stress levels, sleep quality, and voice symptoms. Results. High stress levels were reported by 24% of the participants, whereas 19% reported voice symptoms, and 3% low sleep quality. Costs associated with the three conditions were calculated for twenty-nine subjects. Productivity costs associated with high stress levels were higher (COP$32.345.925) than those for voice symptoms (COP$1.872.703) and low sleep quality (COP$319.733). Conclusion: Productivity reduction costs were higher for professors who reported high levels of stress followed by participants with self-reported voice symptoms and low sleep quality, which highlight the importance of prioritizing activities to reduce stress levels and voice symptoms in workplace health promotion programs implemented in educational settings., Objetivo. Estimar los costos de reducción de productividad asociados con los síntomas de voz, la baja calidad del sueño y los altos niveles de estrés entre los profesores universitarios durante el trabajo en casa en tiempos de COVID-19. Métodos. Este estudio transversal incluyó la participación de 58 docentes universitarios, los cuales reportaron la reducción de la productividad en el trabajo relacionada con sus percepciones de los niveles de estrés, la calidad del sueño y los síntomas de voz . Resultados. El 24% de los participantes informó altos niveles de estrés, mientras que el 19% informó síntomas de voz y el 3% mala calidad del sueño. Los costos asociados con las tres condiciones se calcularon para 29 sujetos. Los costos de productividad asociados a altos niveles de estrés fueron mayores (COP$32.345.925) en comparación con los síntomas de voz (COP$1.872.703) y la mala calidad del sueño (COP$319.733). Conclusiones: Los costos asociados a la reducción en la productividad fueron altos en docentes que reportaron altos niveles de estrés, seguidos de los que reportaron síntomas de voz y baja calidad del sueño. Lo anterior resalta la importancia de priorizar actividades dirigidas a reducir los niveles de estrés y los síntomas vocales en los programas de promoción de la salud en los lugares de trabajo que se implementan en las instituciones educativas.

Although the paralinguistic and phonological significance of breathy voice is well known, its pragmatic roles have been little studied. We report a systematic exploration of the pragmatic functions of breathy voice in American English, using a small corpus of casual conversations, using the Cepstral Peak Prominence Smoothed measure as an indicator of breathy voice, and using a common workflow to find prosodic constructions and identify their meanings. We found two prosodic constructions involving breathy voice. The first involves a short region of breathy voice in the midst of a region of low pitch, functioning to mark self-directed speech. The second involves breathy voice over several seconds, combined with a moment of wider pitch range leading to a high pitch over about a second, functioning to mark an attempt to establish common ground. These interpretations were confirmed by a perception experiment., QC 20220628, Perception of speaker stance – using spontaneous speech synthesis to explore the contribution of prosody, context and speaker (VR-2020-02396), Prosodic functions of voice quality dynamics(VR-2019-02932), CAPTivating – Comparative Analysis of Public speaking with Text-to-speech (P20-0298)

Although the paralinguistic and phonological significance of breathy voice is well known, its pragmatic roles have been little studied. We report a systematic exploration of the pragmatic functions of breathy voice in American English, using a small corpus of casual conversations, using the Cepstral Peak Prominence Smoothed measure as an indicator of breathy voice, and using a common workflow to find prosodic constructions and identify their meanings. We found two prosodic constructions involving breathy voice. The first involves a short region of breathy voice in the midst of a region of low pitch, functioning to mark self-directed speech. The second involves breathy voice over several seconds, combined with a moment of wider pitch range leading to a high pitch over about a second, functioning to mark an attempt to establish common ground. These interpretations were confirmed by a perception experiment., QC 20220628, Perception of speaker stance – using spontaneous speech synthesis to explore the contribution of prosody, context and speaker (VR-2020-02396), Prosodic functions of voice quality dynamics(VR-2019-02932), CAPTivating – Comparative Analysis of Public speaking with Text-to-speech (P20-0298)

The use of smartphones and the concept of Mobile Health (mHealth) is recent in vocology and its possible benefits in the treatment and vocal training in telepractice context. A narrative review was carried out with the objective of describing the benefits of mHealth through the smartphone in the context of speech therapy telepractice in vocal disorders. A search was conducted for articles in Pubmed, ScienceDirect and Google Scholar, in studies associated with the use of the smartphone in vocology, considering normal human voices, pathological and synthetic voices, related to  intervention, evaluation, assessment, monitoring, prevention, intervention, supervision, education, consultation and training. A total of 42 studies were obtained, of which 15 were selected according to the inclusion criteria. The studies analyzed are related to voice recording for acoustic analysis with a smartphone, teletherapy with a smartphone, and peripheral devices for vocal analysis and monitoring. The potential of mobile devices to increase accessibility, reduce costs and favor therapeutic follow-up with objective measures in various contexts of vocal health is highlighted., El uso de los smartphones y el concepto de mobile health (mHealth) es reciente en vocología y sus posibles beneficios en el tratamiento y entrenamiento vocal en contexto de telepráctica. Se realizó una revisión narrativa con el objetivo describir los beneficios de la mHealth a través del smartphone en el contexto de la telepráctica fonoaudiológica de los trastornos vocales. Se buscaron artículos científicos en Pubmed, ScienceDirect y Google Scholar, asociados al uso del smartphone en vocología, considerando voces humanas normales, patológicas y voces sintéticas; relacionados a la intervención, evaluación, valoración, monitoreo, prevención, intervención, supervisión, educación, consulta y entrenamiento vocal. Se revisaron 42 estudios, de los cuales fueron seleccionados 15 de acuerdo a los criterios de inclusión. Los estudios analizados se relacionan con grabación de voz para análisis acústico con smartphone, teleterapia con smartphone y dispositivos periféricos para análisis vocal y seguimiento. Se destaca el potencial de los dispositivos móviles para incrementar accecibilidad, reducir costos y favorecer el seguimiento terapéutico con medidas objetivas en diversos contextos de salud vocal.

Although the paralinguistic and phonological significance of breathy voice is well known, its pragmatic roles have been little studied. We report a systematic exploration of the pragmatic functions of breathy voice in American English, using a small corpus of casual conversations, using the Cepstral Peak Prominence Smoothed measure as an indicator of breathy voice, and using a common workflow to find prosodic constructions and identify their meanings. We found two prosodic constructions involving breathy voice. The first involves a short region of breathy voice in the midst of a region of low pitch, functioning to mark self-directed speech. The second involves breathy voice over several seconds, combined with a moment of wider pitch range leading to a high pitch over about a second, functioning to mark an attempt to establish common ground. These interpretations were confirmed by a perception experiment., QC 20220628, Perception of speaker stance – using spontaneous speech synthesis to explore the contribution of prosody, context and speaker (VR-2020-02396), Prosodic functions of voice quality dynamics(VR-2019-02932), CAPTivating – Comparative Analysis of Public speaking with Text-to-speech (P20-0298)

Today the telephone service in the world has become indispensable, not only in the commercial sphere, but also in the social sphere. Therefore, the lack of optimization in the presentation of this public service in Anco Huallo, Chincheros, led to establish an investigation where its main objective is to know the relationship between service quality and customer retention, for this it was necessary to collect and analyze quantitative data, which contributed to the creation of a theoretical basis on the relationship of the study variables. Being used as a theoretical basis the General Regulation of the Quality of Public Telecommunications Services issued by the regulatory entity, while for data collection a questionnaire was structured with 10 questions for the variable quality of service and 11 questions for the variable retention of the client, the same that was applied in survey format. Giving the as a result in the reliability analysis of Cronbach's Alpha of each instrument a 0.61 and 0.65, showing high reliability. On the other hand, the Spearman Rho coefficient was used to determine the relationship between service quality and customer retention, resulting in a value of 0.691; concluding that there is a significantly moderate relationship between the study variables., Hoy en día el servicio telefónico en el mundo ha pasado a ser indispensable, no solo en el ámbito comercial, sino también en el social. Por lo que, la falta de optimización en la presentación de este servicio público en Anco Huallo, Chincheros, llevó a establecer una investigación en donde su principal objetivo es conocer la relación que existe entre la calidad de servicio y la retención del cliente, para ello fue necesario recoger y analizar datos cuantitativos, que aportaron a la creación de una base teórica sobre la relación de las variables de estudio. Siendo utilizado como fundamento teórico el Reglamento General de la Calidad de los Servicios Públicos de Telecomunicaciones emitido por el ente regulador, mientras que para la recolección de datos se estructuro un cuestionario con 10 preguntas para la variable calidad de servicio y 11 preguntas para la variable retención del cliente, la misma que fue aplicado en formato de encuesta. Dando como resultado en el análisis de confiabilidad de Alfa de Cronbach de cada instrumento un 0,61 y 0,65, ello muestra una alta confiabilidad. Por otra parte, se usó del coeficiente Rho de Spearman para conocer la relación entre la calidad de servicio y la retención de los clientes, se obtuvo como resultado un valor 0,691; concluyéndose que existe una relación significativamente moderada entre las variables de estudio.

Based on a review of the medical literature, the authors document the key technical points and pitfalls in type I thyroplasty with Montgomery® implant, and the main results and indications in unilateral laryngeal immobility.

A principal components analysis was performed on a set (10) of acoustic, aerodynamic, perceptual and laryngoscopic data obtained from 87 dysphonic patients. Two principal components were clearly identified: the first represents in some way the glottal air leakage, resulting in turbulent noise, particularly obvious in higher spectral frequencies, and giving the perceptual impression of breathiness; the second accounts rather for the degree of aperiodicity in vocal fold oscillation, reflected in jitter measurements and with a perceptual correlate of harshness or roughness. Morphological changes of vocal folds correlate more closely with this second principal component. Among acoustic parameters, harmonics-to-noise ratio in the formant zone and magnitude of the dominant cepstrum peak seem to integrate to some extent the effects of both principal components.

Today the telephone service in the world has become indispensable, not only in the commercial sphere, but also in the social sphere. Therefore, the lack of optimization in the presentation of this public service in Anco Huallo, Chincheros, led to establish an investigation where its main objective is to know the relationship between service quality and customer retention, for this it was necessary to collect and analyze quantitative data, which contributed to the creation of a theoretical basis on the relationship of the study variables. Being used as a theoretical basis the General Regulation of the Quality of Public Telecommunications Services issued by the regulatory entity, while for data collection a questionnaire was structured with 10 questions for the variable quality of service and 11 questions for the variable retention of the client, the same that was applied in survey format. Giving the as a result in the reliability analysis of Cronbach's Alpha of each instrument a 0.61 and 0.65, showing high reliability. On the other hand, the Spearman Rho coefficient was used to determine the relationship between service quality and customer retention, resulting in a value of 0.691; concluding that there is a significantly moderate relationship between the study variables., Hoy en día el servicio telefónico en el mundo ha pasado a ser indispensable, no solo en el ámbito comercial, sino también en el social. Por lo que, la falta de optimización en la presentación de este servicio público en Anco Huallo, Chincheros, llevó a establecer una investigación en donde su principal objetivo es conocer la relación que existe entre la calidad de servicio y la retención del cliente, para ello fue necesario recoger y analizar datos cuantitativos, que aportaron a la creación de una base teórica sobre la relación de las variables de estudio. Siendo utilizado como fundamento teórico el Reglamento General de la Calidad de los Servicios Públicos de Telecomunicaciones emitido por el ente regulador, mientras que para la recolección de datos se estructuro un cuestionario con 10 preguntas para la variable calidad de servicio y 11 preguntas para la variable retención del cliente, la misma que fue aplicado en formato de encuesta. Dando como resultado en el análisis de confiabilidad de Alfa de Cronbach de cada instrumento un 0,61 y 0,65, ello muestra una alta confiabilidad. Por otra parte, se usó del coeficiente Rho de Spearman para conocer la relación entre la calidad de servicio y la retención de los clientes, se obtuvo como resultado un valor 0,691; concluyéndose que existe una relación significativamente moderada entre las variables de estudio.

Objectives/hypothesisArytenoid adduction (AA) is performed to treat unilateral vocal fold paralysis with a large posterior glottal gap. However, the voice effects of AA suture position remain unclear. This study aimed to evaluate voice production and quality as a function of AA suture position on the thyroid ala in a neuromuscularly intact in vivo larynx.Study designAnimal model.MethodsUnilateral recurrent laryngeal nerve and vagal paralysis were modeled in two canines. AA suture position was varied across five equidistant positions on the anterior inferior thyroid ala, from a paramedian position anteriorly to the oblique line posteriorly. Phonation was performed over 8 × 8 graded level combinations of recurrent and superior laryngeal nerve stimulation per suture position. The primary outcome was percent successful phonatory conditions. Secondary outcomes included fundamental frequency (F0), phonation onset pressure (PTP), cepstral peak prominence (CPP), and laryngeal posture.ResultsAnterior suture positions resulted in a greater percentage of successful phonatory conditions compared to posterior sutures. Suture position 2, located at the anterior inferior thyroid ala, resulted in the highest percentage of successful phonatory conditions, lowest PTP, and lower muscle activation levels to achieve higher CPP. Posterior sutures resulted in wider glottal gap and more effective F0 and vocal fold strain increase with cricothyroid muscle contraction, but with fewer successful phonatory conditions and higher PTP. Trends were consistent across both paralysis types.ConclusionsAA suture placed in the anterior inferior thyroid ala resulted in the best acoustic, aerodynamic, and voice quality outcomes. This study provides scientific evidence for maintaining current clinical practice.Level of evidenceNA Laryngoscope, 131:846-852, 2021.

No agreed-upon method currently exists for objective measurement of perceived voice quality. This paper describes validation of a psychoacoustic model designed to fill this gap. This model includes parameters to characterize the harmonic and inharmonic voice sources, vocal tract transfer function, fundamental frequency, and amplitude of the voice, which together serve to completely quantify the integral sound of a target voice sample. In experiment 1, 200 voices with and without diagnosed vocal pathology were fit with the model using analysis-by-synthesis. The resulting synthetic voice samples were not distinguishable from the original voice tokens, suggesting that the model has all the parameters it needs to fully quantify voice quality. In experiment 2 parameters that model the harmonic voice source were removed one by one, and the voice tokens were re-synthesized with the reduced model. In every case the lower-dimensional models provided worse perceptual matches to the quality of the natural tokens than did the original set, indicating that the psychoacoustic model cannot be reduced in dimensionality without loss of fit to the data. Results confirm that this model can be validly applied to quantify voice quality in clinical and research applications.

ObjectivesLaryngeal vibratory asymmetry occurring with paresis may result in a perceptually normal or abnormal voice. The present study aims to determine the relationships between the degree of vibratory asymmetry, acoustic measures, and perception of sound stimuli.Study designAnimal Model of Voice Production, Perceptual Analysis of Voice.MethodsIn an in vivo canine model of phonation, symmetric and asymmetric laryngeal vibration were obtained via graded unilateral recurrent laryngeal nerve (RLN) stimulation simulating near paralysis to full activation. Phonation was performed at various contralateral RLN and bilateral superior laryngeal nerve stimulation levels. Naïve listeners rated the perceptual quality of 182 unique phonatory samples using a visual sort-and-rate task. Cepstral peak prominence (CPP) was calculated for each phonatory condition. The relationships among vibratory symmetry, CPP, and perceptual ratings were evaluated.ResultsA significant relationship emerged between RLN stimulation and perceptual rating, such that sound samples from low RLN levels were preferred to those from high RLN levels. When symmetric vibration was achieved at mid-RLN stimulation, listeners preferred samples from symmetric vibration over those from asymmetric vibration. However, when symmetry was achieved at high RLN levels, a strained voice quality resulted that listeners dispreferred over asymmetric conditions at lower RLN levels. CPP did not have a linear relationship with perceptual ratings.ConclusionsLaryngeal vibratory asymmetry produces variable perceptual differences in phonatory sound quality. Though CPP has been correlated with dysphonia in previous research, its complex relationship with quality limits its usefulness as clinical marker of voice quality perception.Level of evidenceNA, basic science Laryngoscope, 131:2740-2746, 2021.

Purpose Many children with cerebral palsy (CP) are described as having altered vocal quality. The current study utilizes psychoacoustic measures, namely, low-amplitude (H1*-H2*) and high-amplitude (H1*-A2*) spectral tilt and cepstral peak prominence (CPP), to identify the vocal fold articulation characteristics in this population. Method Eight children with CP and eight typically developing (TD) peers produced vowel singletons [i, ɑ, u] and a story retell task with the same vowels in the words "beets, Bobby, boots." H1*-H2*, H1*-A2*, and CPP were extracted from each vowel. Results were analyzed with mixed linear models to identify the effect of Group (CP, TD), Task (vowel singleton, story retell), and Vowel [i, ɑ, u] on the dependent variables. Results Children with CP have lower spectral tilt values (H1*-H2* and H1*-A2*) and lower CPP values than their TD peers. For both groups, vowel singletons were associated with lower CPP values as compared to story retell. Finally, the vowel [ɑ] was associated with higher spectral tilt and higher CPP values as compared to [i, u]. Conclusions Children with CP have more constricted and creaky vocal quality due to lower spectral tilt and greater noise. Unlike adults, children demonstrate poorer vocal fold articulation when producing vowel singletons as compared to story retell. Finally, low vowels like [ɑ] seem to be produced with less constriction and noise as compared to high vowels.

Introduction. Transsexual women frequently encounter problems in adjusting their voices to the characteristics of their new gender. In order to help in the change to the desired voice, two techniques are often used: the surgical (Thyroplasty) and clinical (Speech Therapy). Objective. The aim of this integrative study is to verify through scientific publications the relationship between the two techniques and observe which is the most effective. Method. A systematic database search was conducted considering the keywords: Transsexual Persons AND Voice Feminization AND Thyroplasty OR Voice Training. Results. Nine articles corresponded to observational studies and three used a quasi-experimental methodology. The groups studied include a broad age spectrum and the quality of the evidence is low. No study reports economic aspects of the interventions. There is no evidence of long-term follow-up. Conclusions. The vocal treatment route with hormonal addition can be a first line, and, in case of not reporting improvements, surgery appears as another option. Recommendation. The recommendation is for Speech Therapy, which has no significant risks of complications and is relatively cheap., Introducción. Las mujeres transgénero encuentran frecuentemente problemas en ajustar su voz a la frecuencia femenina. Para favorecer el cambio vocal deseado por estos individuos, se ofrecen dos técnicas: una quirúrgica (tiroplastía) y otra clínica (terapia vocal). Objetivo. Esta revisión integrativa pretende verificar las publicaciones científicas relacionadas con las dos técnicas, observando cuál reporta mayor efectividad. Método. Se realizó una búsqueda en bases de datos, considerando las palabras clave: Transsexual Persons AND Voice Feminization AND Thyroplasty OR Voice Training. Resultados. Nueve artículos corresponden a estudios observacionales y tres utilizaron una metodología cuasi experimental. Los grupos estudiados incluyen un amplio espectro etario. Ninguno de los estudios informa aspectos económicos de las intervenciones. No existe evidencia de seguimiento a largo plazo. Conclusiones. La vía de tratamiento vocal con adición hormonal puede ser una primera línea, y en caso de no reportar mejoras, la cirugía aparece como otra opción. Recomendación. La recomendación es que se realice terapia vocal, que no implica riesgos significativos de complicaciones, siendo además un abordaje relativamente económico.

Introduction. Singing is a type of sportive activity and, like sports medicine, professional voice medicine is interested in the habilitation and rehabilitation of the vocal performer. The vocal needs of the professional vocal performer may not be similar to other professional or non-professional voice users. Like a professional athlete, a vocal performer’s ability to perform for many decades at a high level will be enhanced by basing artistic and lifestyle decisions on a scientifically sound foundation. Objective. The aim of this study is to present a multidimensional introduction to the methods of SVT, incorporating the principles of sport and exercise medicine, and physical therapy and rehabilitation. Reflection. Singing voice therapy needs to provide answers to “what”, “why”, “how”, and “when” questions. SVT must first correctly identify the problem, leading to the “how to do” solutions for a wide variety of cases, followed by a schedule of prescribed activities including answers to the “why” question (which exercise relates to which muscle). The periodization and motor learning principles provide a temporal answer to the “when” question when developing habilitation and/or rehabilitative protocols. Conclusion. Singing is not only an artistic expression but also a sportive performance. The clinical approach to the professional voice is a multidimensional and multi-layered team effort. All practices are structured by blending scientific and pedagogical knowledge., Introducción. El canto es una forma de actividad deportiva y, al igual que la medicina deportiva, la medicina vocal profesional se interesa por la habilitación y rehabilitación del intérprete vocal. Las necesidades vocales del intérprete vocal profesional pueden no ser similares a las de otros usuarios de voz profesionales o no profesionales. Al igual que un atleta profesional, la capacidad de un intérprete vocal para desempeñarse durante muchas décadas a un alto nivel se mejorará al basar las decisiones artísticas y de estilo de vida en un fundamento científicamente sólido. Objetivo. El objetivo de este estudio es presentar una introducción multidimensional a los métodos de TSV, incorporando los principios de la medicina del deporte y el ejercicio, y la fisioterapia y rehabilitación. Reflexión. La terapia de la voz cantada debe proporcionar respuestas a preguntas de “qué”, “por qué”, “cómo” y “cuándo”. SVT primero debe identificar correctamente el problema, lo que lleva a las soluciones de "cómo hacer" para una amplia variedad de casos, seguido de un programa de actividades prescritas que incluyen respuestas a la pregunta "por qué" (qué ejercicio se relaciona con qué músculo). Los principios de periodización y aprendizaje motor proporcionan una respuesta temporal a la pregunta de "cuándo", al desarrollar protocolos de habilitación y/o rehabilitación. Conclusión. Cantar no es solo una expresión artística, sino también una actuación deportiva. El enfoque clínico de la voz profesional es un esfuerzo de equipo multidimensional y de múltiples capas. Todas las prácticas están estructuradas, al combinar conocimientos científicos y pedagógicos.

Introduction Laryngopharyngeal reflux disease can alter the structural and functional integrity of the vocal fold. Objectives of the study was to determine the effect of Laryngopharyngeal Reflux Disease (LPRD) on selected Acoustic, Aerodynamic and perceptual parameters of voice and to establish its effectiveness in therapeutic outcome. Materials and Methods The number of patients enrolled for this prospective observational study was 65, all with Reflux symptom index (RSI) more than 13. Quality of life was evaluated using voice handicap index (VHI). Perceptual evaluation of voice done by Grade Roughness Breathiness Asthenia Strain score (GRBAS) followed by acoustic and aerodynamic analysis. Patients were started on a once daily proton pump inhibitor therapy for 3 months along with vocal hygiene measures and RSI, VHI and voice analysis repeated after the treatment. Results There was significant improvement in the RSI score after treatment. Percent jitter and shimmer showed significant improvement in males post treatment (p value:<0.05). Harmonic to noise ratio improved 3 months post treatment in both sexes. Improvement noted in Maximum phonation time and GRBAS score except asthenia and strain post treatment. Conclusion Measurement of voice quality can be used as an effective tool to monitor the efficiency of treatment of LPRD.

Introduction Laryngopharyngeal reflux disease can alter the structural and functional integrity of the vocal fold. Objectives of the study was to determine the effect of Laryngopharyngeal Reflux Disease (LPRD) on selected Acoustic, Aerodynamic and perceptual parameters of voice and to establish its effectiveness in therapeutic outcome. Materials and Methods The number of patients enrolled for this prospective observational study was 65, all with Reflux symptom index (RSI) more than 13. Quality of life was evaluated using voice handicap index (VHI). Perceptual evaluation of voice done by Grade Roughness Breathiness Asthenia Strain score (GRBAS) followed by acoustic and aerodynamic analysis. Patients were started on a once daily proton pump inhibitor therapy for 3 months along with vocal hygiene measures and RSI, VHI and voice analysis repeated after the treatment. Results There was significant improvement in the RSI score after treatment. Percent jitter and shimmer showed significant improvement in males post treatment (p value:<0.05). Harmonic to noise ratio improved 3 months post treatment in both sexes. Improvement noted in Maximum phonation time and GRBAS score except asthenia and strain post treatment. Conclusion Measurement of voice quality can be used as an effective tool to monitor the efficiency of treatment of LPRD.

Introduction Laryngopharyngeal reflux disease can alter the structural and functional integrity of the vocal fold. Objectives of the study was to determine the effect of Laryngopharyngeal Reflux Disease (LPRD) on selected Acoustic, Aerodynamic and perceptual parameters of voice and to establish its effectiveness in therapeutic outcome. Materials and Methods The number of patients enrolled for this prospective observational study was 65, all with Reflux symptom index (RSI) more than 13. Quality of life was evaluated using voice handicap index (VHI). Perceptual evaluation of voice done by Grade Roughness Breathiness Asthenia Strain score (GRBAS) followed by acoustic and aerodynamic analysis. Patients were started on a once daily proton pump inhibitor therapy for 3 months along with vocal hygiene measures and RSI, VHI and voice analysis repeated after the treatment. Results There was significant improvement in the RSI score after treatment. Percent jitter and shimmer showed significant improvement in males post treatment (p value:<0.05). Harmonic to noise ratio improved 3 months post treatment in both sexes. Improvement noted in Maximum phonation time and GRBAS score except asthenia and strain post treatment. Conclusion Measurement of voice quality can be used as an effective tool to monitor the efficiency of treatment of LPRD.

The objective of the study was to determine the voice and swallowing disorders in patients with neurological deficiencies secondary to subarachnoid hemorrhage due to ruptured brain aneurysm. The study is descriptive in cross section; performed on 30 patients from the Guillermo Almenara Irigoyen National Hospital in Peru, who met the eligibility criteria. The quality of voice and swallowing was evaluated by means of the Clinical Evaluation of Voice and Swallowing in patients with Hemorrhagic Stroke using the sound level meter, laryngeal auscultation and pulse oximeter. The results obtained were, according to the quality of the voice: timbre 63.3% opaque, tone 86.7% low tone, intensity an intensity decreased by 90%; 86.7% duration is short. In the characteristics of the swallowing of the oral phase in food textures 83.3% deficient, number of chews 76.7% deficient, in time / duration of chewing 86.7% deficient and nutritional remains 90% present. Swallowing characteristics in the pharyngeal phase according to the number of swallows, 46.7% inadequate, according to cough and throat clearing, 36.7% present it and 73.3% presence of apnea. Degree of dysphonia 70% of Grade II. Dysphagia degree 60% have severe degree. Therefore, it is concluded that there are voice alterations with a predominance of opaque timbre, severe tone, decreased intensity and short duration, swallowing disorders in the oral phase and the presence of a high percentage of severe grade dysphagia and dysphonia of grade II., El objetivo del estudio fue determinar las alteraciones de la voz y de la deglución en pacientes con deficiencias neurológicas secundarias a hemorragia subaracnoidea por ruptura de aneurisma cerebral. El estudio es descriptivo de corte transversal; realizado en 30 pacientes del Hospital Nacional Guillermo Almenara Irigoyen de Perú, quienes cumplieron los criterios de elegibilidad. Las cualidades de la voz y deglución fueron evaluadas mediante la Evaluación Clínica de la Voz y de la Deglución en pacientes con Accidente Cerebrovascular hemorrágico que emplea el sonómetro, auscultación laríngea y pulsioxímetro. Los resultados obtenidos fueron: según las cualidades de la voz: timbre un 63,3% opaco, tono el 86,7% tono grave, intensidad una intensidad disminuida con un 90%; la duración un 86,7% corta. En Características de la deglución de la fase oral en texturas alimenticias el 83,3% deficiente, número de masticaciones un 76,7% deficiente, en tiempo/duración de la masticación 86,7% deficiente y restos alimenticios el 90% presente. Características de la deglución en la fase faríngea según número de degluciones un 46,7% inadecuado, según tos y carraspeo 36,7 % lo presentan y el 73,3% presencia de apnea. Grado de disfonía un 70% de Grado II. Grado de disfagia un 60% de presenta grado grave. Por lo que se concluye que existen alteraciones de la voz con predominancia del timbre opaco, tono grave, intensidad disminuida y duración de tipo corta, alteraciones de la deglución en la fase oral y presencia de un alto porcentaje de disfagia de grado severa y disfonía de grado II.

In this study we propose a new tool for the perceptual assessment of voice quality. For its design, we have adapted the Simplified Vocal Profile Analysis so that the new tool features two main characteristics: (1) the ordinal scalar degrees of the original protocol are turned into a visual analog scale; and (2) the original paper-based version of the protocol is now a computer-based implementation. In order to assess the reliability of the new tool, five phoneticians listened to 12 different speakers and evaluated their voice quality using the proposed tool. Inter-rater agreement was then calculated using the Intraclass Correlation Coefficient. The results show that high agreement was reached for most of the perceptual settings of the protocol. Yet more investigations seem necessary into the continuous nature of the perceptual dimensions making up the voice quality of a speaker. As a preliminary approach to the graphical possibilities that the visual analog scale offers to the Simplified Vocal Profile Analysis, we explore the usefulness of multiple dot plots and propose an adaptation of the Bland-Altman plot to be used in pairwise comparisons. In this study, these visualization techniques are tested on two pairs of identical twins.

ObjectivesVocal fold (VF) stiffness and geometry are determinant variables in voice production. Type 1 medialization thyroplasty (MT), the primary surgical treatment for glottic insufficiency, changes both of these variables. Understanding the cause and effect relationship between these variables and acoustic output might improve voice outcomes after MT. In this study, the effects of thyroplasty implants with variable stiffness on glottal shape and acoustics were investigated.MethodsIn an ex vivo human larynx phonation model, bilateral MT with implants of four stiffness levels (1386, 21.6, 9.3, and 5.5 kPa) were performed. Resulting acoustics and aerodynamics were measured across multiple airflow levels. A vertical partial hemilaryngectomy was performed and stereoscopic images of the VF medial surface taken to reconstruct its three-dimensional (3D) surface contour. The results were compared across implants.ResultsThe effects of implant stiffness on acoustics varied by airflow. Softer implants resulted in improved acoustics, as measured by cepstral peak prominence (CPP), at lower airflow levels compared to stiffer implants but this relationship reversed at high airflow levels. Stiffer implants generally required less airflow to generate a given subglottal pressure. Stiffer implants resulted in greater medialized surface area and maximal medialization, but all implants had similar effects on overall VF medial surface contour.ConclusionSofter implants result in less medialization but better acoustics at low airflow rates. Stiffer implants provide better acoustics and more stable pressure-flow relationships at higher airflow rates. This highlights a potential role for patient-specific customized thyroplasty implants of various stiffness levels.Level of evidenceNA.

Glottal insufficiency due to vocal fold paralysis, paresis, or atrophy often leads to degraded voice quality. One of the primary surgical intervention procedures to treat glottal insufficiency is medialization laryngoplasty, in which an implant is inserted through a lateral window on the thyroid cartilage to medialize the vocal folds. While the goal of medialization is to modify the vocal fold structure to restore normal phonation, few studies have attempted to quantify such structural changes of the vocal folds. The goal of this study is to quantify the three-dimensional structural changes of the vocal folds due to implant insertion in medialization laryngoplasty, and evaluate its potential effect on voice production. Medialization laryngoplasty were performed in excised human larynges using implants of different stiffness. Magnetic resonance images of the larynges were obtained with and without implant insertion. The results showed that implant insertion significantly changed the original body-cover structure of the vocal folds, with the implant taking over the large space used to be occupied by the original body layer and the vocal fold being stretched into a thin layer wrapped around the implant. The medial-lateral dimension of the vocal fold was significantly reduced from about 4 mm to 1 mm, and the vocal fold was stretched in the coronal plane by about 70%. It is hypothesized that use of implants with stiffness comparable to that of the vocal folds is beneficial because the degree of medialization can be adjusted without much negative effects on phonation frequency, phonation threshold pressure, or vibration amplitude.