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This study explores sidetone amplification (amplified playback of one's own voice) provided via bone conduction in participants with voice disorders. The effects of bone conduction feedback on acoustic voice parameters and vocal effort ratings are examined.Speech samples of 47 participants with voice disorders were recorded in three auditory feedback conditions: two with sidetone amplification delivered via bone conduction and one condition with no alteration of the feedback. After each task, the participants rated their vocal effort on a visual analog scale. The voice recordings were evaluated by a speech-language pathologist through the GRBAS scale and processed to calculate the within-participant centered sound pressure level (SPL) values, the mean pitch strength (PS), the time dose (Dt%), and cepstral peak prominence smoothed (CPPS). The effects of the feedback conditions on these acoustic parameters and vocal effort ratings were analyzed.The high sidetone amplification condition resulted in a statistically significant decrease in the within-participant centered SPL values and mean pitch strength across all participants. The feedback conditions had no statistically significant effects on the vocal effort ratings, time dose (Dt%), or CPPS.This study provides an evidence that bone conduction sidetone amplification contributes to a consistent adaptation in the within-participant centered SPL values (ΔSPL) in patients with vocal hyperfunction, glottal insufficiency, and organic/neurological laryngeal pathologies compared to conditions with no feedback.

Purpose: The purpose of this study is to evaluate if the Daily Phonotrauma Index (DPI) can quantitatively discriminate large differences in overall vocal status in the daily life of patients with phonotraumatic vocal hyperfunction (PVH). Method: For 1–4 weeks, 23 females with PVH wore an ambulatory voice monitor and answered three vocal status questions (i.e., difficulty producing soft, high-pitched phonation; discomfort; and fatigue) at the beginning, at 5-hr intervals, and the end of each day. DPI values were obtained for each patient's time periods of worst and best self-rated vocal status, and data for the group were analyzed for significant changes using a linear mixed-effects regression model. Results: The DPI was significantly lower during periods self-rated as “best vocal status” compared to during periods self-rated as “worst vocal status” (mean difference in DPI = 0.53) with a medium-to-large effect size (Cohen's d = −0.68). Conclusions: In a group of patients with phonotraumatic lesions, the DPI indicated lower potential for phonotrauma during time periods of better vocal status compared to time periods of worse vocal status. Assuming that a large portion of variance in vocal status for patients with PVH is associated with the extent to which voicing is phonotraumatic, these results support the validity of obtaining estimates of DPI for much shorter time periods (i.e., an estimate every 2 min of voicing) than previous studies (i.e., a single estimate for the entire day or week). Future work can investigate the DPI's use for in-clinic assessment/treatment and ambulatory biofeedback and can gain further insights into phonatory mechanisms that underlie DPI via comparisons with other physiologically relevant measures and computational vocal fold modeling.

This study explores the influence of visual input on voice production in virtual reality with healthy participants. The effects of the size and fullness of various virtual rooms on acoustic voice parameters and self-reported vocal status ratings are examined. Speech samples from healthy participants were recorded in six virtual conditions. After each condition, the participants provided subjective vocal status ratings on visual analog scales. The voice recordings were processed to calculate objective voice acoustic parameters including sound pressure level, standard deviation of fundamental frequency, mean pitch strength, time dose, and cepstral peak prominence smoothed. The effects of the virtual reality conditions on these acoustic parameters and the vocal status ratings were analyzed. The largest virtual room resulted in significantly higher (worse) vocal status ratings. The size of the virtual rooms had statistically significant effects on mean pitch strength and cepstral peak prominence smoothed, among associations with other objective voice acoustic parameters. This study provides evidence that larger and more full virtual rooms contribute to higher (worse) vocal status ratings and changes in objective voice parameters in healthy speakers.

Voice dosimeters are useful tools for gathering voice production data in the daily lives of individuals with voice disorders. In this tutorial, instructions for a low-cost (less than $100), easy-to-assemble voice dosimeter are provided. This do-it-yourself (DIY) voice dosimeter is validated based on performance results. The DIY voice dosimeter was worn by 10 vocally healthy participants. The participants produced a sustained /a/ vowel and then read a text with three different vocal efforts. These tasks were recorded by the DIY voice dosimeter and a reference microphone simultaneously. The expanded uncertainty of the mean error in the estimation of these two quantities as measured by the DIY dosimeter was performed by simultaneously comparing signals acquired through the reference microphone and the dosimeter themselves. For measures of sound pressure level, the DIY voice dosimeter had a mean error of −0.68 dB with an uncertainty of 0.56 dB. For fundamental frequency, the mean error was 1.56 Hz for female participants and 1.11 Hz for male participants, with an uncertainty of 0.62 Hz and 0.34Hz for females and males, respectively. The mean error and uncertainties for the DIY voice dosimeter are comparable to the most accurate voice dosimeters that were previously on the market.