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Purpose The purpose of this study was to obtain a more comprehensive understanding of the pathophysiology and impact on daily voice use of nonphonotraumatic vocal hyperfunction (NPVH). Method An ambulatory voice monitor collected 1 week of data from 36 patients with NPVH and 36 vocally healthy matched controls. A subset of 11 patients with NPVH were monitored after voice therapy. Daily voice use measures included neck-skin acceleration magnitude, fundamental frequency ( f o ), cepstral peak prominence (CPP), and the difference between the first and second harmonic magnitudes (H1–H2). Additional comparisons included 118 patients with phonotraumatic vocal hyperfunction (PVH) and 89 additional vocally healthy controls. Results The NPVH group, compared to the matched control group, exhibited increased f o (Cohen's d = 0.6), reduced CPP ( d = −0.9), and less positive H1–H2 skewness ( d = −1.1). Classifiers used CPP mean and H1–H2 mode to maximally differentiate the NPVH and matched control groups (area under the receiver operating characteristic curve of 0.78). Classifiers performed well on unseen data: the logit decreased in patients with NPVH after therapy; ≥ 85% of the control and PVH groups were identified as “normal” or “not NPVH,” respectively. Conclusions The NPVH group's daily voice use is less periodic (CPP), is higher pitched ( f o ), and has less abrupt vocal fold closure (H1–H2 skew) compared to the matched control group. The combination of CPP mean and H1–H2 mode appears to reflect a pathophysiological continuum in NPVH patients of inefficient phonation with minimal potential for phonotrauma. Further validation of the classification model is needed to better understand potential clinical uses. Supplemental Material https://doi.org/10.23641/asha.14390771

Summary Background In addition to language differences in fundamental frequency between bilinguals and monolinguals, studies have also included other acoustic parameters to analyze differences in voice production associated with the language spoken. Aim To identify differences in voice acoustic parameters during English productions between monolingual and bilingual English speakers. Method Exploratory cross-sectional study with two groups of subjects: monolingual English speakers (n = 40), and bilingual English-Spanish speakers (n = 13). Participants filled out a questionnaire and recorded one reading in English (second sentence of Rainbow passage “The rainbow is a division of white light into many beautiful colors”) under a “virtual-simulated” acoustic condition of No Noise and Medium Reverberation Time (0.8 seconds). Result Analysis by gender shows that monolingual speakers had higher fundamental frequency mode, and lower standard deviation of fundamental frequency compared to bilingual English-Spanish speakers. Bilingual male speakers had higher jitter and harmonics-to-noise ratio than monolingual speakers. On the contrary, female bilingual speakers had lower jitter and shimmer than monolingual speakers. Conclusions Speaking a second language may influence voice acoustic parameters, and therefore, should be considered when comparing acoustic speech metrics.

Summary Introduction Computer analysis of voice recordings is an integral part of the evaluation and management of voice disorders. In many practices, voice samples are taken in rooms that are not sound attenuated and/or sound-proofed; further, the technology used is rarely consistent. This will likely affect the recordings, and therefore, their analyses. Objectives The objective of this study is to compare various acoustic outcome measures taken from samples recorded in a sound-proofed booth to those recorded in more common clinic environments. Further, the effects from six different commonly used microphones will be compared. Methods Thirty-six speakers were recorded while reading a text and producing sustained vowels in a controlled acoustic environment. The collected samples were reproduced by a Head and Torso Simulator and recorded in three clinical rooms and in a sound booth using six different microphones. Newer measures (eg, Pitch Strength, cepstral peak prominence, Acoustic Voice Quality Index), as well as more traditional measures (eg Jitter, Shimmer, harmonics-to-noise ratio and Spectrum Tilt), were calculated from the samples collected with each microphone and within each room. Results The measures which are more robust to room acoustic differences, background noise, and microphone quality include Jitter and smooth cepstral peak prominence, followed by Shimmer, Acoustic Voice Quality Index, harmonics-to-noise ratio, Pitch Strength, and Spectrum Tilt. Conclusions The effect of room acoustics and background noise on voice parameters appears to be stronger than the type of microphone used for the recording. Consequently, an appropriate acoustical clinical space may be more important than the quality of the microphone.

Summary Purpose This study aimed to (1) examine the effect of dysphonia and background noise on the identifiability of vowels, and (2) evaluate the relationship between the degree of vowel intelligibility and vowel-related acoustic measurements. Method A speech perception experiment was conducted with speech samples collected from 10 adult females with healthy voices and 10 adult females with dysphonia. The speech material was 11 vowels of American English in /h/-vowel-/d/ format. Cafeteria noise was added to these samples at a signal-to-noise ratio of −6 dB. A total of 10 adults with normal hearing participated in a speech perception experiment, in which the vowels were presented with and without the noise. F1 and F2 frequencies of the vowels were measured, and their relationships with the vowel intelligibility were statistically evaluated. Results The group-level analysis showed that vowel intelligibility was lower in dysphonic speech than normal speech, both in quiet and at signal-to-noise ratio of −6 dB. The intelligibility was higher for the high vowels than the low vowels. In general, the vowel confusion pattern was similar between normal and dysphonic speech. However, data from a speaker with severe diplophonia showed a distinct confusion pattern. Voice quality ratings did not significantly correlate with the vowel intelligibility. There was a significant correlation between F2 and the vowel intelligibility in quiet. A post-hoc acoustic analysis revealed that vowels of the speakers with lower vowel intelligibility had lower acoustic energy above 1 kHz. Conclusion Dysphonia negatively affects vowel intelligibility. Low vowels were more vulnerable to the effect of dysphonia than high vowels. Among different types of dysphonic voice qualities, diplophonia appears to be particularly detrimental to vowel intelligibility. F2 significantly correlated with vowel intelligibility; however, this result requires a careful interpretation. Given that the acoustic energy above 1 kHz resulted in better intelligibility in noise, a treatment strategy that targets this frequency region may help improve intelligibility in noise. Future studies should examine the generalizability of this finding to different age and gender groups, and intelligibility as a whole.

Summary Introduction In classical singing techniques, it is common to manipulate the vocal tract to channel airflow to increase voice quality and volume. Technique varies according to the style of the music, the voice type, and range of a given singer. Although these practices are intentional, fixed physiological aspects of a singer's vocal instrument also play an extremely impactful role in determining voice quality. Objectives In the present study, the relationship between the dimensions of the maxillary dental arch and voice quality were examined in professional singers. Methods The dimensions of the palate were measured from the maxillary dental casts of 14 female singers. Audio recordings were made for the same participants while singing a sustained /a/ singing vowel, a glissando, the song "Are You Sleeping", and a selected song from their personal repertoire. The dimensions of the palate were measured from maxillary dental casts. From the recordings, two parameters were calculated: (1) the Singing Power Ratio (SPR) and (2) A2 A1 ratio. Higher SPR values indicate a stronger ring in the voice, typical of operatic singing style, while higher A2 A1 ratio values are associated with the belting singing style. Results Singers with larger frontal palate depth, smaller posterior palate depth, larger frontal palate width, and smaller posterior palate width seem to be more suitable for an operatic singing style. Singers who had larger overall depth and width of the palate measurements produced an increased second harmonic, typical of the belting style. Conclusions When considering a singer's ability to produce vocalizations successfully, physiological structure is an increasingly important factor. The present study discovered that palate depth and width are associated with statistically significant differences in SPR and A2/A1 parameters. These parameters correlate with two styles of singing, operatic, and belting respectively.