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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).

The problem of characterizing voice quality has long caused debate and frustration. The richness of the available descriptive vocabulary is overwhelming, but the density and complexity of the information voices convey lead some to conclude that language can never adequately specify what we hear. Others argue that terminology lacks an empirical basis, so that language-based scales are inadequate a priori. Efforts to provide meaningful instrumental characterizations have also had limited success. Such measures may capture sound patterns but cannot at present explain what characteristics, intentions, or identity listeners attribute to the speaker based on those patterns. However, some terms continually reappear across studies. These terms align with acoustic dimensions accounting for variance across speakers and languages and correlate with size and arousal across species. This suggests that labels for quality rest on a bedrock of biology: We have evolved to perceive voices in terms of size/arousal, and these factors structure both voice acoustics and descriptive language. Such linkages could help integrate studies of signals and their meaning, producing a truly interdisciplinary approach to the study of voice.

Bodywork applied to vocal technique is an increasingly used tool in teaching practice. However, there is little research that can provide evidence of its effectiveness. This research is an exploratory and descriptive case study that investigates the self-perception of 14 voice major students after receiving a bodywork program. The main objective is to analyze if a bodywork program designed for singers affects the emission and vocal quality and, therefore, may be a good pedagogical tool in voice education. The body-mind method applied is the Méthode de Libération de Cuirasse © (MLC). To conduct the intervention, the participants performed different vocal tasks and answered a questionnaire to reveal their perceptions in relation to vocal emission, body balance, frame of mind, and degree of well-being before and after each of the sessions of bodywork. Two months after the last session, a second questionnaire was administered and a free narrative of the lived experience of participants was collected for subsequent analysis and interpretation. Results showed more comfort when singing, greater harmonic richness, greater facility in the high register, and better breath control as well as an improvement in general well-being and state of the body. [ABSTRACT FROM AUTHOR]

Previous research has predominantly examined either voice quantity or quality. We know little about the potential tradeoff between voice quantity and quality and the role of leaders in this tradeoff. This study focused on the dual aspects of voice, examining how and when the same leader attribute facilitates (inhibits) one aspect of voice, but does not facilitate (inhibit) or even hamper (facilitate) the other aspect. Specifically, we proposed that leader critical thinking stimulates the formation of employees' implicit voice theory of the need for solid data or solutions (IVT‐SDS) before one speaks up. This belief boosts the quality of employee voice especially when voice efficacy is high, but increases the frequency of employee silence especially when voice efficacy is low. In Study 1a, we experimentally tested the relationship between leader critical thinking and employees' IVT‐SDS. In Study 1b, we experimentally examined the interactive effect of employees' IVT‐SDS and their voice efficacy on both their voice quality and silence frequency. In Study 2, a multilevel, multi‐wave and multi‐source field study, we tested the entire research model. The results supported our hypotheses. We extend the research on leadership and voice by revealing a potential tradeoff between voice quality and quantity. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the voice quality of patients with temporomandibular disorders (TMDs) compared with healthy subjects using cepstral analysis and investigate the relationship between the TMD severity and the values of cepstral analysis. Methods: Subjects who met the inclusion criteria completed a general health questionnaire and the Fonseca Anamnestic Index. Patients who had TMDs with FAI were subjected to an examination based on the Diagnostic Criteria for Temporomandibular Disorders. The final sample included 65 subjects, 31 TMDs patients (with a mean age ± standard deviation of 36.64 ± 13.67 years), and 34 healthy individuals in the control group (with a mean age ± standard deviation of 30.35 ± 7.78 years). Cepstral Peak Prominence (CPP) and Smoothened Cepstral Peak Prominence (CPPS) of a sustained vowel and connected speech were computed using Praat software. Results: TMD patients indicated lower cepstral values and lower voice quality compared to the control group. Significant differences were found between TMD and control groups for all cepstral parameters (P <.001) and cepstral measurements showed a moderate to strong negative correlation with TMD severity (P <.001, rho = − 0.57 to − 0.88). Conclusion: The outcomes of the present study indicate that cepstral analysis can accurately distinguish the reduced voice quality of TMD patients from normal voice. [ABSTRACT FROM AUTHOR]

Background: Sleep inertia, characterized by reduced alertness and cognitive functioning upon waking, has been well-researched in its effects on cognitive and motor abilities. However, its impact on voice quality remains less clear. Objectives: This study aimed to investigate the relationship between sleep inertia following nocturnal sleep and changes in acoustic and perceptual voice parameters in adults. Methods: Ninety healthy participants (45 females, 45 males, ages: 18 - 30 years) took part in a pre-post study using convenience sampling. Their voices were recorded before and after nocturnal sleep across multiple tasks, including vowel /a/ phonation, spontaneous speech, text reading, and maximum phonation time (MPT). Recordings were made in a quiet room using a Zoom H6 recorder at a 44.1 kHz rate. The acoustic analysis included measures of fundamental frequency (F0), standard deviation of F0 (SD F0), vocal intensity, harmonics-to-noise ratio (HNR), cepstral peak prominence smoothed (CPPS), jitter, shimmer, and formant frequencies. Auditory-perceptual evaluation was conducted using the GRBAS Scale. Statistical analysis was performed using SPSS-19. The Shapiro-Wilk test assessed normality, and a paired t -test compared variables, separately for males and females at a 0.05 significance level. Results: Acoustic analysis revealed that both females and males experienced a decrease in mean F0, mean intensity, HNR, and CPPS, and an increase in jitter, shimmer, and SD F0 across most voice samples after sleeping. These changes were particularly significant for females in all voice samples (P < 0.001). Perceptual analysis also showed a significant increase in grade, roughness, breathiness, asthenia, and strain for both genders after sleep (P < 0.001). Conclusions: This study demonstrated that sleep inertia negatively impacts vocal performance, resulting in a decline in voice quality for both genders after sleep compared to before. Notably, this decline in voice quality was more pronounced in women than in men. [ABSTRACT FROM AUTHOR]

Summary: Previous research on employee voice endorsement has mostly focused on its antecedents. In particular, most scholars seem to consider employee voice endorsement as a factor influencing only the voicers themselves. Thus, they have ignored its interpersonal influences, such as at the team level. The present study explores the influence of underachievers' voice endorsement on team voice. Specifically, we not only examine a boundary condition in this relationship but also develop and test a new construct of supervisors' voice judgment fairness as a mediator. Data from two multi‐wave, multi‐source surveys show that when underachievers' voice quality is higher (versus lower), the positive relationship between underachievers' voice endorsement and supervisors' voice judgment fairness is stronger, which in turn enhances team voice. These results offer meaningful theoretical implications for the voice endorsement literature and practical implications for organizations. [ABSTRACT FROM AUTHOR]

Karolina Dorobisz,1 Tadeusz Dorobisz,2 Katarzyna Pazdro-Zastawny,1 Marzena Kubacka,1 Sara Janczak,2 Dariusz Janczak2 1Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wroclaw, Poland; 2Department of Vascular, General and Transplant Surgery, Wroclaw Medical University, Wroclaw, PolandCorrespondence: Karolina Dorobisz, Department of Otolaryngology, Head and Neck Surgery, Wroc&lstrok;aw Medical University, Borowska 213, Wroc&lstrok;aw, 50-556, Poland, Tel +48 501207964, Email dorobiszkarolina@gmail.comIntroduction: Recurrent laryngeal nerve palsy is a rare but important complication after endarterectomy (CEA). The impact on voice quality after this procedure is also important. The aim of the study was to assess voice quality and vocal cord function after CEA.Material and Methods: 200 patients were enrolled in the study. Inclusion criteria were indications for CEA and patient consent to the procedure. Endoscopic examination of the larynx was performed before the procedure, immediately after the procedure, on the 2nd day after the procedure, then 3 month and 6 months after the procedure. Voice was assessed by maximum phonation time (MPT), GRBAS scale, Voice Handicap Index (VHI) and the Voice-Related Quality of Life (V-RQOL) questionnaire.Results: In the study group, the results on the GRBAS scale were significantly worse and the average MPT was shorter compared to the control group. In the V-RQOL assessment, patients rated their voice as fair or good, significantly more often noticed that they had difficulty speaking loudly and being heard, and that they felt short of air when speaking. In VHI-30, the total score was significantly higher in the study group compared to the control group. Voice disorders after the procedure were reported by 68 patients, while a disorder of the recurrent laryngeal nerve was observed immediately after the procedure in 32 patients. Most vocal cord disorders were transient. Ultimately, 3% of patients were diagnosed with vocal cord paralysis.Conclusion: Cranial nerves paralysis, including the recurrent laryngeal nerve, are a common complication after CEA. Majority the paralysis is transient, but requires appropriate diagnostic and therapeutic procedures. Vocal cord evaluation is a non-invasive and widely available examination and should be performed pre- and postoperatively after all neck surgeries. The incidence of voice disorders after CEA significantly affects the quality of life of patients and requires voice rehabilitation and patient care with psychological support.Keywords: carotid stenosis, endarterectomy, vocal cord paralysis, hoarseness, voice quality

Introduction: The present study aimed to validate the Voice-Related Quality of Life (V-RQOL), vocal self-assessment questionnaire for Spanish. Methods: The validation and psychometric properties were developed according to the criteria of the Scientific Advisory Committee of Medical Outcomes Trust (SAC). The Spanish translation for linguistic and cultural adaptation of the V-RQOL was used. The study involved 193 participants, including 90 vocally healthy individuals and 103 patients with voice disorders, to establish validity. To evaluate reliability, the protocol was applied to 40 participants with dysphonia, who answered it twice before the treatment. Then to determine response changes, the responses of 13 dysphonic participants to the V-RQOL for Spanish were analyzed after intervention and then compared to the initial ones. Clinicians contrasted subjects’ V-RQOL results with a perceptual analysis of voice quality using the GRBAS scale. In order to determine sensitivity and specificity cut-off values, tools results were subjected to the receiver operating characteristic curve analysis. The sensitivity was obtained from the experimental group (dysphonic group) and the specificity from the control group (non-dysphonic group). Results: This version of the V-RQOL questionnaire may be used as part of the standard assessment process of people with voice complaints and as an outcome of treatment efficacy in clinical trials. Conclusion: A validation of the V-RQOL for Spanish in Chilean population was achieved. [ABSTRACT FROM AUTHOR]

Participants tend to produce a higher or lower vocal pitch in response to upward or downward visual motion, suggesting a pitch–motion correspondence between the visual and speech production processes. However, previous studies were contaminated by factors such as the meaning of vocalized words and the intrinsic pitch or tongue movements associated with the vowels. To address these issues, we examined the pitch–motion correspondence between simple visual motion and pitched speech production. Participants were required to produce a high- or low-pitched meaningless single vowel [a] in response to the upward or downward direction of a visual motion stimulus. Using a single vowel, we eliminated the artifacts related to the meaning, intrinsic pitch, and tongue movements of multiple vocalized vowels. The results revealed that vocal responses were faster when the pitch corresponded to the visual motion (consistent condition) than when it did not (inconsistent condition). This result indicates that the pitch–motion correspondence in speech production does not depend on the stimulus meaning, intrinsic pitch, or tongue movement of the vocalized words. In other words, the present study suggests that the pitch–motion correspondence can be explained more parsimoniously as an association between simple sensory (visual motion) and motoric (vocal pitch) features. Additionally, acoustic analysis revealed that speech production aligned with visual motion exhibited lower stress, greater confidence, and higher vocal fluency. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study is to compare voice outcomes in open partial horizontal laryngectomy vs. total laryngectomy (TL) with voice prosthesis. Methods: In this retrospective monocentric study patients undergoing OPHL or TL with voice prosthesis were enrolled during the usual oncological follow-up consultations at the Otolaryngology and Audiology Unit of a University Hospital in the period between July 2022 and June 2023. Acoustic analysis (F0, HNR, NHR), maximum phonation time, I-SECEL and INFV0 scale were used to assess voice outcome. Results: Forty-three patients were enrolled. Voices of patients undergoing LT were better in quality of voice (V0) at INFV0 scale. The scores in I-SECEL and acoustic analysis were comparable. Conclusions: Voice quality could be slight better in patients undergoing TL with voice prosthesis than those undergoing OPHL. [ABSTRACT FROM AUTHOR]

Objective: To compare voice related quality of life of smoker and non-smoker university teachers. Method: This Cross-Sectional descriptive study was conducted at Riphah International University over a period of six months January to June, 2022. A sample of N=352 University teachers of both genders, aged 25 to 65 years, who were faculty members and working at least 8 hours per day in teaching positions with at least one-year experience were included in the study. Demographic sheet, Voice Related Quality of Life (VRQOL) and Voice Handicap Index (VHI) were used for data collection and analysis conducted on SPSS Version 21. Mean scores of VRQOL and VHI for smokers and non-smokers were compared using Mann Whitney U Test. & Spearman’s correlation was utilized to determine any association between the tool scores. P<0.01 was considered significant. Results: Results reveal that the mean score of Voice related quality of life scale was significantly (p=0.000) higher in smokers compared to non–smokers indicating worse voice quality in smokers. Similarly, voice handicap index scores were much higher in smokers (p=0.000) indicating more handicap in the smokers. Conclusion: The study concludes that smoking has a detrimental effect on voice and voice related quality of life of university teachers and voice related quality of life as determined by VRQOL scale is significantly better in nonsmokers. [ABSTRACT FROM AUTHOR]

Injection laryngoplasty (IL) has become a mainstay in the treatment of unilateral vocal fold paralysis due to technical ease and avoidance of open surgery. The duration of IL effect depends on the injected material and has not been defined clearly. We aimed to define the effective duration of IL and to investigate the associated factors. Fifty-nine patients who underwent IL for unilateral vocal fold paralysis were included. IL was performed using a cricothyroid membrane approach under local anesthesia. During follow-up, in cases that developed subjective hoarseness with objective glottic insufficiency, a second IL was performed, and loss of IL effect was recorded. The duration of IL was analyzed using Kaplan-Meier estimates, and the associations between duration of effect and various factors such as postinjection voice therapy, injected material, and cause of paralysis were investigated using log-rank test. Of 59 patients, 20 (33.9 %) received a second IL. The median time interval between the first and second IL was 3.3 months (95% CI, 0.4∼27.8 months). The mean duration of effect after IL was 42.5 months (95% CI, 32.1∼52.9 months), and the rate of persisting effect was 63.4% at 1-year after IL (1-year effect rate) and 59.4% at 2 years after IL. The 1-year effect rate was 80.8% in cases with postinjection voice therapy and 57.8% in those without postinjection voice therapy (P = 0.084). Injected material, DM, HTN, patient age and sex, and cause of paralysis had no effect on the 1-year effect rate. The mean duration of IL effect was 42.5 months, and the rate of persisting effect was 63.4% at 1-year after IL. There were no significant factors affecting the duration of effect, although the duration tended to be slightly longer in cases with postinjection voice therapy. Further study with a prospective, randomized design is needed. [ABSTRACT FROM AUTHOR]

Many series have compared voice quality after radiotherapy or surgery for cT1 glottic carcinoma. Different meta-analyses identify better results for radiotherapy while others do not identify any difference, some finally find a superiority of surgery. The purpose of this study was to compare the voice quality in the long term of patients who underwent transoral surgery versus exclusive irradiation for the treatment of cT1 glottic carcinoma. The VOQUAL study was a pilot comparative multicenter cross-sectional study. The primary endpoint was the Voice Handicap Index comparison between two groups (radiotherapy or surgery). The voice assessment also consisted in the heteroevaluation of voice quality by the Grade, Roughness, Breathness, Asthenia, and Strain rating scale reported by Hirano. The study included 41 adult patients with cT1 carcinoma of the vocal cord treated by cordectomy or exclusive radiation in two oncologic centers. The median Voice Handicap Index value was 20 [8; 32.5] in the surgery group and 10 [4; 18.5] in the radiotherapy group. There was no statistically significant difference between the median values and the various components F, P and E of the questionnaire (P = 0.1585). The median value of the numeric dysphonia Grade, Roughness, Breathness, Asthenia, and Strain scale was 2 [0; 5] in the surgery group and 2 [0.25; 3.75] in the radiotherapy group. There was no statistically significant difference between these values (P = 0.78). Our study did not show any significant difference on the primary endpoints of Voice Handicap Index and Grade, Roughness, Breathness, Asthenia, and Strain scores. III. Clinical trial registration: The VOQUAL study was registered on the ClinicalTrials.gov platform under the number NCT04447456 , in July 2020. [ABSTRACT FROM AUTHOR]

Objective: One of the channels for individuals to access information about their health problems is websites. The readability levels of the texts on these sites are important for patient information. The aim of this study is to reveal the readability levels of texts related to voice health presented on the internet. Material and Methods: 55 websites that met the inclusion criteria from the first 100 sites that appeared via the Google search engine using the keyword “voice health” were included in the study. The 55 included sites were divided into 4 groups: personal, hospital, newspaper and company. The informational texts in these sites were evaluated according to Ateşman and Çetinkaya Readability Indexes and their readability levels were determined. Results: Ateşman Readability Index was found to be 60 in the personal website source, 65 in the hospital source, 58 in the newspaper source and 59 in the company source. Çetinkaya Readability Index was 60 in the personal website source, 65 in the hospital source, 58 in the newspaper source and 59 in the company source. 4 subgroups were found to be of medium difficulty according to the Ateşman Readability Index, and at the educational level limit according to the Çetinkaya Readability Index. The Ateşman and Çetinkaya Readability Index result in the hospital website source was statistically higher than in other website sources (p<0.05). Conclusion: Considering that people do their research on the internet about the health problems they experience, the readability level of the informational texts on these sites is important. As a result of the evaluation of the resources encountered on the websites scanned with the keyword vocal health according to Ateşman and Çetinkaya readability indexes, it was seen that the readability level was more difficult than it should be. It is recommended to increase the readability levels of internet resources containing text about voice health and to raise awareness about this issue by conducting similar studies. [ABSTRACT FROM AUTHOR]

Objective: Muscle tension dysphonia (MTD) is a functional voice condition that causes irregular and imbalanced laryngeal and paralaryngeal muscle activation. Our study aimed to examine the acoustic characteristics of patients with MTD and reveal the differences between genders. Methods: The study retrospectively reviewed the acoustic examination findings from the files of patients diagnosed with MTD during evaluations in the laryngology outpatient clinic at a tertiary reference hospital between 2015 and 2022. The parameters assessed in prolonged vowel phonation analysis were fundamental frequency (F0), jitter, shimmer, noise-to-harmonic-to-ratio, and soft phonation index; in the counting task analysis, they were intensity, frequency, and semitone. Gender differences in acoustic measurements obtained during prolonged vowel phonation and counting tasks were also examined. Results: The study included 80 individuals diagnosed with MTD. Although all parameters in the acoustic analysis of/a/ phonation were increased, differences were statistically significant only in the F0 and jitter parameters between females and males (p≤0.05). In the analysis of the counting task, the mean and minimum F0 parameters were significantly higher in females than in males (p=0.000). The mean dB level was decreased, particularly in the counting task, but the results for the intensity parameter did not differ significantly between genders (p>0.05). Conclusion: The values in the acoustic voice analysis parameters of patients with MTD were determined. These acoustic parameters are thought to guide the clinician in evaluating voice and determining voice therapy goals for MTD patients.

Abstract Cochlear implant users experience difficulties controlling their vocalizations compared to normal hearing peers. However, less is known about their voice quality. The primary aim of the present study was to determine if cochlear implant users’ voice quality would be categorized as dysphonic by the Acoustic Voice Quality Index (AVQI) and smoothed cepstral peak prominence (CPPS). A secondary aim was to determine if vocal quality is further impacted when using bilateral implants compared to using only one implant. The final aim was to determine how residual hearing impacts voice quality. Twenty-seven cochlear implant users participated in the present study and were recorded while sustaining a vowel and while reading a standardized passage. These recordings were analyzed to calculate the AVQI and CPPS. The results indicate that CI users’ voice quality was detrimentally affected by using their CI, raising to the level of a dysphonic voice. Specifically, when using their CI, mean AVQI scores were 4.0 and mean CPPS values were 11.4 dB, which indicates dysphonia. There were no significant differences in voice quality when comparing participants with bilateral implants to those with one implant. Finally, for participants with residual hearing, as hearing thresholds worsened, the likelihood of a dysphonic voice decreased.

Abstract Many lecturers develop voice problems, such as hoarseness. Nevertheless, research on how voice quality influences listeners’ perception, comprehension, and retention of spoken language is limited to a small number of audio-only experiments. We aimed to address this gap by using audio-visual virtual reality (VR) to investigate the impact of a lecturer’s hoarseness on university students’ heard text recall, listening effort, and listening impression. Fifty participants were immersed in a virtual seminar room, where they engaged in a Dual-Task Paradigm. They listened to narratives presented by a virtual female professor, who spoke in either a typical or hoarse voice. Simultaneously, participants performed a secondary task. Results revealed significantly prolonged secondary-task response times with the hoarse voice compared to the typical voice, indicating increased listening effort. Subjectively, participants rated the hoarse voice as more annoying, effortful to listen to, and impeding for their cognitive performance. No effect of voice quality was found on heard text recall, suggesting that, while hoarseness may compromise certain aspects of spoken language processing, this might not necessarily result in reduced information retention. In summary, our findings underscore the importance of promoting vocal health among lecturers, which may contribute to enhanced listening conditions in learning spaces.

While current voice research often focuses on laryngeal adjustments in a two-dimensional plane from a superior endoscopic view, recent computational simulations showed that vocal control is three-dimensional and the medial surface vertical thickness plays an important role in regulating the glottal closure pattern and the spectral shape of the produced voice. In contrast, while a small glottal gap is required to initiate and sustain phonation, further changes in the glottal gap within this small range have only small effects on glottal closure and spectral shape. Vocal fold stiffness, particularly along the anterior-posterior direction, plays an important role in pitch control but has only a small effect on glottal closure and spectral shape. These results suggest that voice research should pay more attention to medial surface shape in the vertical dimension. Future studies in a large population of both normal speakers and patients are needed to better characterize the three-dimensional medial surface shape, its variability between speakers, changes throughout the life span, and how it is impacted by voice disorders and clinical interventions. The implications for voice pedagogy and clinical intervention are discussed.

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.

Cochlear implant users experience difficulties controlling their vocalizations compared to normal hearing peers. However, less is known about their voice quality. The primary aim of the present study was to determine if cochlear implant users' voice quality would be categorized as dysphonic by the Acoustic Voice Quality Index (AVQI) and smoothed cepstral peak prominence (CPPS). A secondary aim was to determine if vocal quality is further impacted when using bilateral implants compared to using only one implant. The final aim was to determine how residual hearing impacts voice quality. Twenty-seven cochlear implant users participated in the present study and were recorded while sustaining a vowel and while reading a standardized passage. These recordings were analyzed to calculate the AVQI and CPPS. The results indicate that CI users' voice quality was detrimentally affected by using their CI, raising to the level of a dysphonic voice. Specifically, when using their CI, mean AVQI scores were 4.0 and mean CPPS values were 11.4 dB, which indicates dysphonia. There were no significant differences in voice quality when comparing participants with bilateral implants to those with one implant. Finally, for participants with residual hearing, as hearing thresholds worsened, the likelihood of a dysphonic voice decreased. [ABSTRACT FROM AUTHOR]

Objective: Muscle tension dysphonia (MTD) is a functional voice condition that causes irregular and imbalanced laryngeal and paralaryngeal muscle activation. Our study aimed to examine the acoustic characteristics of patients with MTD and reveal the differences between genders. Methods: The study retrospectively reviewed the acoustic examination findings from the files of patients diagnosed with MTD during evaluations in the laryngology outpatient clinic at a tertiary reference hospital between 2015 and 2022. The parameters assessed in prolonged vowel phonation analysis were fundamental frequency (F0), jitter, shimmer, noise-to-harmonic-to-ratio, and soft phonation index; in the counting task analysis, they were intensity, frequency, and semitone. Gender differences in acoustic measurements obtained during prolonged vowel phonation and counting tasks were also examined. Results: The study included 80 individuals diagnosed with MTD. Although all parameters in the acoustic analysis of/a/ phonation were increased, differences were statistically significant only in the F0 and jitter parameters between females and males (p≤0.05). In the analysis of the counting task, the mean and minimum F0 parameters were significantly higher in females than in males (p=0.000). The mean dB level was decreased, particularly in the counting task, but the results for the intensity parameter did not differ significantly between genders (p>0.05). Conclusion: The values in the acoustic voice analysis parameters of patients with MTD were determined. These acoustic parameters are thought to guide the clinician in evaluating voice and determining voice therapy goals for MTD patients. [ABSTRACT FROM AUTHOR]

Objective: To observe the effect of ABCLOVE voice training on improving the pronunciation function of patients with early laryngeal cancer after vocal cord surgery. Methods: A total of 126 patients with early laryngeal cancer after vocal cord surgery admitted to our hospital from December 2020 to January 2023 were selected as the research objects. They were divided into control group and observation group by random number table method, with 63 cases in each group. The control group was treated with drug therapy and routine voice training, and the observation group was treated with ABCLOVE voice training on the basis of the control group for 6weeks. The electronic laryngoscopy, voice disorder assessment (VHI), aerodynamic analysis and dynamic laryngoscopy were compared between the two groups before and after intervention. Results: Electronic laryngoscopy showed that the effective rate of treatment in the observation group was better than that in the control group (P＜0.05) . After intervention, the VHI score of the observation group was significantly lower than that of the control group (P＜0.05) . After intervention, the longest pronunciation time (MPT), maximum pronunciation time (MLPT) and voice disorder index (DSI) were significantly higher than those in the control group, and the fundamental frequency perturbation (Jitter), amplitude perturbation (Shimmer) and mean airflow rate (MFR) were significantly lower than those in the control group (P＜0.05) . After intervention, the scores of vocal cord closure, vocal cord mucosal wave, vocal cord movement symmetry and vocal cord vibration regularity were significantly lower than those in the control group (P＜0.05) . Conclusion: ABCLOVE voice training method can effectively improve the dysphonia of patients with early laryngeal cancer after vocal cord surgery, improve their pronunciation ability, and help to further improve their clinical efficacy. [ABSTRACT FROM AUTHOR]

Since the turn of the 21st century, research on phonation (the production of sound via the vibration of the vocal folds, also known as voice quality) has increased significantly. However, non-modal phonation is highly understudied in Spanish. Therefore, this study comprises a sociophonetic analysis of voice quality in Spanish, examining voice quality categorically from sociolinguistic interview speech conducted with 41 native monolingual Chilean Spanish speakers. The aim of the present paper is to interrogate how phonation varies among residents of Santiago, Chile. Specifically, it asks: what is the sociolinguistic distribution of non-modal voice quality in Chilean Spanish? How does this distribution align with work on voice quality in Spanish and in other languages? Results indicate that non-modal voice quality is used by speakers to mark prosodic boundaries such as phrase finality, aligning with robust cross- linguistic findings. Non-modal phonation is also incorporated when speakers are reporting speech, as well as when they are speaking about emotionally-charged subjects. I draw connections between these findings and those of other dialects of Spanish, and show that utterance-final devoicing, while often associated with "tierras altas" dialects of Spanish, may be more frequent in other dialects than previously indicated. I argue that further examinations of non-modal phonation should also examine third-wave approaches of attitude, emotion, and stance. [ABSTRACT FROM AUTHOR]

In this paper, we show that Icelandic uses the phonetic parameters of speaking rate, duration and voice quality (VQ) to distinguish between information-seeking questions (ISQs) and rhetorical questions (RQs). Specifically, durations are longer (speaking rate is slower) and nonmodal VQs are used more in RQs than in ISQs. Our findings for temporal parameters fit in with previous studies on the prosody of RQs in various languages. With respect to VQ, Icelandic differs, for example, from German and English in the location of breathy voice in the utterance (utterance-initial in German and English, utterance-final in Icelandic). We interpret the utterance-final position of breathiness in Icelandic RQs as a potential compensating strategy for the lack of phonological cues, i.e. boundary tones. [ABSTRACT FROM AUTHOR]

Travel and tourism advertising is critical in developing positive associations to attract visitor patronage and build sustainable post-pandemic tourism. An important part of an advertising message is delivered through voice and other aspects of audio, for example, music. However, how audio features impact viewers of travel and tourism advertisements remains unexplored in the research. This study implements advanced audio analytics to test how various features impact upon viewers. The results show that voice quality is important in developing positive affect; advertisement viewers prefer speakers with quieter voices (less mean intensity) that have a higher level of clarity (higher harmonics-to-noise ratio). This can be explained via the heuristic route of the heuristic-systematic model. Music tempo was found to be important in stimulating reactions from advertisements, with faster music being associated with a higher level of positive affect. The paper concludes with practical and theoretical implications, limitations, and suggestions for future research. [ABSTRACT FROM AUTHOR]

Everyday observations indicate that creaky voice has become common in Finland in recent years. Previous studies suggest that this trend is also occurring in other countries. This cross-sectional study investigates the use of creaky voice among Finnish university students from the 1990′s to the 2010′s. Material was obtained from a sound archive. It consisted of 200 samples from normophonic speakers (95 males, 105 females; mean age 23.7 years, SD 3.3 years, range 19–35 years). Normophonia was checked by two speech therapists in a preliminary perceptual analysis. Thereafter, two voice specialists rated the amount of creak and strain. A scale of 0–4 was used (0 = none, 4 = a lot). The inter- and intrarater reliability for the listening evaluations were satisfactory (for creaky phonation, rho = 0.611, P < 0.001 for interrater reliability and rho = 0.540, P < 0.001 for intrarater reliability; for strain, rho = 0.463, P < 0.001 and rho = 0.697, P < 0.001 for inter- and intrarater reliability, respectively). These results revealed a significant increase in the amount of perceived creak in females (from 1.04, SD 0.69 to 1.55, SD 1.06; P < 0.05, Mann-Whitney U test). In males, no significant change was found. However, the frequency of creaky voice use increased in both genders. No male speakers from the 1990′s were rated as using "a lot" of creaky voice, but 2.3% of male speakers from the 2010′s received this rating. Male speakers who were rated "quite a lot" increased from 5.9% in the 1990′s to 18.1% in the 2010′s. Female speakers rated "a lot" increased from 0% to 6%, and female speakers rated "quite a lot" increased from 7% to 25.8% over the studied time periods. Creaky phonation and strain correlated slightly in males (rho = 0.24, P < 0.05) and moderately in females (rho = 0.55, P < 0.001). Age did not correlate with the amount of creaky phonation (rho = 0.005, P > 0.10 for males, rho = -0.011, P > 0.10 for females). It can be concluded that the prevalence of creaky voice has increased among young Finnish speakers, particularly females. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Vocal cord paralysis (VCP) is a serious complication in thyroidectomy operations; however, its management remains unclear. The present study evaluated the voice parameters of patients who underwent surgery using Intraoperative Neurophysiologic Monitoring (IONM). PATIENTS AND METHODS: A total of 52 patients (41 females and 11 males) who underwent a total thyroidectomy operation were evaluated using objective and subjective voice analysis examinations before and after surgery. Acoustic parameters, such as Fundamental Frequency (F0), Shimmer, Jitter, Noise-to-Harmonic ratio (NHR), and aerodynamic parameters, including S/Z ratio and maximum phonation time (MPT), were analyzed. Objective findings, including the VHI-10 (Voice Handicap Index) and V-RQOL (Voice-Related Quality of Life), were also analyzed. The relationship between voice parameters and IONM values was investigated. RESULTS: The objective analysis (acoustic and aerodynamic parameters) showed no difference (p>0.05). However, the subjective analysis, which involved the VHI-10 and V-RQOL measures, revealed a significant difference before and after the operation (p<0.05). The Spearman correlation analysis showed that the NHR postoperative 1st-month parameter negatively correlated (rho=-0.317, p<0.059), while the F0 postoperative 6th-month parameter positively correlated (rho=0.347) with the amplitude difference before and after dissection (Right R2-R1 difference) for the right RLN measured in IONM. CONCLUSIONS: Patients who are planning to undergo a thyroidectomy procedure should undergo voice assessment during both the preoperative and postoperative periods. IONM could improve voice quality outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Identifying voice handicap and voice-related quality of life in patients presenting pulmonary impairment associated with COVID-19 infection, comparing pulmonary parameters between these patients and individuals in the control group, as well as correlating pulmonary parameters to self-assessment questionnaires (IDV-10 and QVV). Methods: Thirty-five (35) patients presenting pulmonary impairment with COVID-19 infection were herein selected and compared to 35 individuals who were not affected by COVID-19 infection. Two self-assessment questionnaires were applied (vocal handicap index and voice quality of life protocol). Maximum phonation time Forced Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) were measured and videolaryngoscopy was performed. Results: There was statistically significant difference in scores recorded in voice self-assessment questionnaires (IDV-10 and QVV), Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) between patients with pulmonary impairment associated with COVID-19 infection and those in the control group. Correlation between PEF/PIF and scores recorded in voice self-assessment questionnaires was also observed. Conclusion: Pulmonary impairment associated with COVID-19 infection has worsened voice handicap and voice-related quality of life in the assessed patients, as well as reduced their forced expiratory and inspiratory pressure in comparison to the control group. Level of evidence: 4.

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.

Developing portable computerized diagnostic tools for Parkinson’s disease (PD) based on Parkinsonian dysarthria requires identifying the voice features most sensitive to PD symptoms. Numerous studies have explored the correlations of various acoustic features with PD diagnosis and progression. Despite achieving high accuracies in some cases, these proposed features or methods have not yet been integrated into publicly available PD diagnostic tools due to their limited robustness. The Acoustic Voice Quality Index (AVQI), introduced by Maryn, has the potential to be a voice severity measure capable of distinguishing people with PD from healthy individuals. This study investigates the effectiveness of AVQI in identifying people with PD and the reliable preprocessing techniques to compute AVQI from short-duration sustained vowels. AVQI data extracted from the PC-GITA dataset underwent several statistical analyses to compare the validity of AVQI using truncated and concatenated sustained vowels. Statistical distribution and receiver operating characteristic (ROC) curve analyses were used to assess AVQI’s effectiveness. The results demonstrate that AVQI can distinguish PD among female participants with an accuracy of 75.33% and an area under the curve (AUC) of 0.74. These findings also confirm the suitability of using concatenated sustained vowels for calculating AVQI from short recordings. They highlight AVQI’s potential application in portable PD diagnostic tools, underscoring its relevance in clinical practice.

To study the possibility of using acoustic parameters, i.e., Acoustic Voice Quality Index (AVQI) and Maximum Phonation Time (MPT) for predicting the degree of lung involvement in COVID-19 patients. This cross-sectional case–control study was conducted on the voice samples collected from 163 healthy individuals and 181 patients with COVID-19. Each participant produced a sustained vowel/a/, and a phonetically balanced Persian text containing 36 syllables. AVQI and MPT were measured using Praat scripts. Each patient underwent a non-enhanced chest computed tomographic scan and the Total Opacity score was rated to assess the degree of lung involvement. The results revealed significant differences between patients with COVID-19 and healthy individuals in terms of AVQI and MPT. A significant difference was also observed between male and female participants in AVQI and MPT. The results from the receiver operating characteristic curve analysis and area under the curve indicated that MPT (0.909) had higher diagnostic accuracy than AVQI (0.771). A significant relationship was observed between AVQI and TO scores. In the case of MPT, however, no such relationship was observed. The findings indicated that MPT was a better classifier in differentiating patients from healthy individuals, in comparison with AVQI. The results also showed that AVQI can be used as a predictor of the degree of patients' and recovered individuals' lung involvement. A formula is suggested for calculating the degree of lung involvement using AVQI. [ABSTRACT FROM AUTHOR]

AbstractUnderstanding the impact of listening effort (LE) and fatigue has become increasingly crucial in optimizing the learning experience with the growing prevalence of online classrooms as a mode of instruction. The purpose of this study was to investigate the LE, fatigue, and voice quality experienced by students during online and face-to-face class sessions. A total of 110 participants with an average age of 20.76 (range 18–28) comprising first year undergraduate students in Speech and Language Therapy and Audiology programs in Turkey, rated their LE during the 2022–2023 spring semester using the Listening Effort Screening Questionnaire (LESQ) and assessed their fatigue with the Multidimensional Fatigue Inventory (MFI-20). Voice quality of lecturers was assessed using smoothed cepstral peak prominence (CPPS) measurements. Data were collected from both online and face-to-face sessions. The results revealed that participants reported increased LE and fatigue during online sessions compared to face-to-face sessions and the differences were statistically significant. Correlation analysis showed significant relationships (p < 0.05) between audio-video streaming quality and LE-related items in the LESQ, as well as MFI sub-scales and total scores. The findings revealed a relationship between an increased preference for face-to-face classrooms and higher levels of LE and fatigue, emphasizing the significance of these factors in shaping the learning experience. CPPS measurements indicated a dysphonic voice quality during online classroom audio streaming. These findings highlight the challenges of online classes in terms of increased LE, fatigue, and voice quality issues. Understanding these factors is crucial for improving online instruction and student experience. [ABSTRACT FROM AUTHOR]

To investigate the effects of auditory training with synthesized voices on intra- and inter-rater agreement of the auditory-perceptual voice analysis of roughness and breathiness. This was an experimental study consisting of four auditory training sessions. The sample consisted of twenty raters, students from a Speech-Language Pathology course, who had previous experience with auditory-perceptual assessment. The raters participated in the four training sessions with a seven-day break in between sessions. Each training consisted of three tasks: 1) Pre-training activity: Participants were asked to rate 20 natural voices, normal and dysphonic, from zero to three, according to the parameters of roughness and breathiness; 2) Training activity: Synthesized voice anchor stimuli were presented, and participants were asked to rate them from zero to three. Four stimuli were related to roughness and four to breathiness. Participants heard 20 voice stimuli and were instructed to pair the natural voice with the synthesized anchor stimulus that most resembled it; and 3) Post-training activity: the 20 voices from the pre-training activity were randomized and participants rated the same voices, without prior knowledge that these were repeated. Statistical analysis of data was performed using the AC 2 test, to assess the extent of agreement between raters, and the Friedman test to compare the training sessions. A 5% significance level was considered. For the auditory-perceptual voice analysis of roughness, intra-rater agreement results ranged from 79% to 86% between the first and fourth auditory training session, with improvement in intra-rater agreement from the fourth session forward (P = 0.005). For the analysis of breathiness, results ranged from 88% to 92% between the first and fourth auditory training sessions, with improvement from the fourth session forward (P = 0.036). Inter-rater agreement results for the auditory-perceptual analysis of roughness ranged from 23% to 34%, and from 48% to 61% for breathiness, with no differences regarding training (P = 0.855). The auditory-perceptual breathiness parameter had a higher AC 2 indicator compared to the roughness parameter, suggesting better agreement. The intra-rater agreement showed improvement starting from the fourth auditory training session for the assessment of roughness and breathiness. The auditory training program did not show a positive inter-rater agreement impact. [ABSTRACT FROM AUTHOR]

Introduction: Asymmetry of vocal fold (VF) vibration is common in patients with voice complaints and also observed in 10% of normophonic individuals. Although thyroarytenoid (TA) muscle activation plays a crucial role in regulating VF vibration, how TA activation asymmetry relates to voice acoustics and perception is unclear. We evaluated the relationship between TA activation asymmetry and the resulting acoustics and perception. Methods: An in vivo canine model of phonation was used to create symmetric and increasingly asymmetric VF vibratory conditions via graded stimulation of bilateral TA muscles. Naïve listeners (n = 89) rated the perceptual quality of 100 unique voice samples using a visual sort‐and‐rate task. For each phonatory condition, cepstral peak prominence (CPP), harmonic amplitude (H1‐H2), and root‐mean‐square (RMS) energy of the voice were measured. The relationships between these metrics, vibratory asymmetry, and perceptual ratings were evaluated. Results: Increasing levels of TA asymmetry resulted in declining listener preference. Furthermore, only severely asymmetric audio samples were perceptually distinguishable from symmetric and mildly asymmetric conditions. CPP was negatively correlated with TA asymmetry: voices produced with larger degrees of asymmetry were associated with lower CPP values. Listeners preferred audio samples with higher values of CPP, high RMS energy, and lower H1‐H2 (less breathy). Conclusion: Listeners are sensitive to changes in voice acoustics related to vibratory asymmetry. Although increasing vibratory asymmetry is correlated with decreased perceptual ratings, mild asymmetries are perceptually tolerated. This study contributes to our understanding of voice production and quality by identifying perceptually salient and clinically meaningful asymmetry. Level of Evidence: N/A (Basic Science Study) Laryngoscope, 134:1327–1332, 2024 [ABSTRACT FROM AUTHOR]

Introduction: Analysis of medial surface dynamics of the vocal folds (VF) is critical to understanding voice production and treatment of voice disorders. We analyzed VF medial surface vibratory dynamics, evaluating the effects of airflow and nerve stimulation using 3D reconstruction and empirical eigenfunctions (EEF). Study Design: In vivo canine hemilarynx phonation. Methods: An in vivo canine hemilarynx was phonated while graded stimulation of the recurrent and superior laryngeal nerves (RLN and SLN) was performed. For each phonatory condition, vibratory cycles were 3D reconstructed from tattooed landmarks on the VF medial surface at low, medium, and high airflows. Parameters describing medial surface trajectory shape were calculated, and underlying patterns were emphasized using EEFs. Fundamental frequency and smoothed cepstral peak prominence (CPPS) were calculated from acoustic data. Results: Convex‐hull area of landmark trajectories increased with increasing flow and decreasing nerve activation level. Trajectory shapes observed included circular, ellipsoid, bent, and figure‐eight. They were more circular on the superior and anterior VF, and more elliptical and line‐like on the inferior and posterior VF. The EEFs capturing synchronal opening and closing (EEF1) and alternating convergent/divergent (EEF2) glottis shapes were mostly unaffected by flow and nerve stimulation levels. CPPS increased with higher airflow except for low RLN activation and very dominant SLN stimulation. Conclusion: We analyzed VF vibration as a function of neuromuscular stimulation and airflow levels. Oscillation patterns such as figure‐eight and bent trajectories were linked to high nerve activation and flow. Further studies investigating longer sections of 3D reconstructed oscillations are needed. Level of Evidence: N/A, Basic Science Laryngoscope, 134:1249–1257, 2024 [ABSTRACT FROM AUTHOR]

We investigate utterance-final voice quality in bilinguals of English and Spanish, two languages which differ in the type of non-modal voice usually encountered at ends of utterances: American English often has phrase-final creak, whereas in Mexican Spanish, phrase-final voiced sounds are breathy or even devoiced. Twenty-one bilinguals from the San Diego-Tijuana border region were recorded (with electroglottography and audio) reading passages in English and Spanish. Ends of utterances were coded for their visual voice quality as "modal" (having no aspiration noise or voicing irregularity), "breathy" (having aspiration noise), "creaky" (having voicing irregularity), or "breathy-creaky" (having both aspiration noise and voicing irregularity). In utterance-final position, speakers showed more frequent use of both modal and creaky voice when speaking in English, and more frequent use of breathy and breathy-creaky voice when speaking in Spanish. We find no role of language dominance on the rates of these four voice qualities. The electroglottographic and acoustic analyses show that all voice qualities, even utterance-final creak, are produced with increased glottal spreading; the combination of distinct noise measures and amplitude of voicing can distinguish breathy, creaky, and breathy-creaky voice qualities from one another, and from modal voice. [ABSTRACT FROM AUTHOR]

Voice and speech are educational tools and a medium of pedagogy for teachers. Teachers tend to modify their voice and speech to support learning. This study aimed to investigate whether pre-service teachers modify their speech and voice in teaching compared to peer learning speech and whether the changes can promote learning and be beneficial for the speakers. Nine pre-service physics teachers' voices were recorded in three learning situations and in one teaching session with similar external circumstances. Duration of speech turns, pausing, speech rate, fundamental frequency (F0) and its variation, sound pressure level (SPL) and its range, and voice quality were analyzed. Results showed that the participants had longer speech turns, decreased speech rate, and increased pausing when teaching compared to speech in peer learning situations. F0 and SPL were higher in teaching, indicating that the teaching situation was more stressful than the peer learning situation. For F0, this was confirmed by correlation analysis. From the learning point, increased pausing and slower speech rate may be beneficial, but increased F0 and SPL may, on the other hand, be harmful to future teachers as they can increase the risk of vocal overloading. Voice training for future teachers is strongly recommended. [ABSTRACT FROM AUTHOR]

Background: Hoarseness affects a significant portion of the population, impacting communication and quality of life. While systemic hydration and dietary modifications have been suggested as management strategies, empirical evidence supporting their efficacy remains sparse. Methods: This prospective study at the District Hospital in Sheopur involved 100 participants with hoarseness, assessing the impact of hydration and dietary interventions over six months. Voice quality was measured using the Voice Handicap Index (VHI) and acoustic parameters pre- and post-intervention. Adherence to interventions was monitored and correlated with outcomes. Results: Postintervention, significant improvements were observed in VHI scores (from 30 ± 10 to 20 ± 8, p < 0.001) and acoustic measures. A strong correlation was found between high adherence to the prescribed interventions and improvement in voice quality (Spearman's rho for VHI improvement = 0.70, p < 0.001). Despite overall positive outcomes, 10% of participants experienced worsened symptoms, indicating variability in individual responses. Conclusion: The study provides empirical support for the efficacy of hydration and dietary modifications in improving voice quality among individuals with hoarseness. High adherence to the intervention was a key factor in achieving significant voice improvement, emphasizing the importance of patient engagement and tailored support in treatment plans. [ABSTRACT FROM AUTHOR]

Early glottic cancer can be treated with laser resection or radiotherapy. In an earlier study, we found that voice function after laser resection was inferior to that after radiotherapy. This study was designed to determine if reduced margins at laser resection improved voice function without impairing oncologic results. A total of 268 patients with previously untreated T1–T2 glottic carcinoma were studied. They were primarily treated with either radiotherapy (n = 119) or laser resection (n = 149). Survival, need for additional treatment (radiotherapy and/or total layngectomi) and voice function was compared. Median follow up time was 7 years with range 0.5–16.6. There was no difference in the overall survival (p =.065) or disease-specific survival. (p =.126). After radiotherapy 32/119 patients and after laser resection 57/149 patients had recurrence. Total rate of laryngectomy was 24% in the radiotherapy group, and 8% in the laser resection group (p =.001). Voice analysis (T1A) showed more roughness in the radiotherapy group, otherwise no difference. By reducing the surgical margins, we have achieved a better voice function (T1A) but more patients have needed repeated laser excisions and some have also needed supplementary radiotherapy. The risk of laryngectomy and survival were apparently not affected. [ABSTRACT FROM AUTHOR]

There is a lack of effective treatment for idiopathic unilateral vocal fold paralysis (IUVFP). A better phonation was reported by patients after laryngeal nerve stimulation during our clinical examination. This study aims to investigate immediate effect of recurrent laryngeal nerve (RLN) stimulation on phonation in patients with IUVFP. Sixty-two patients with clinically identified IUVFP underwent RLN stimulation with needle electrodes. Laryngoscopy, acoustic analysis, and voice perception assessment were performed for quantitative comparison of vocal function and voice quality before and after the intervention. Laryngoscopic images showed a larger motion range of the paralyzed vocal fold (p <.01) and better glottal closure (p <.01) after RLN stimulation. Acoustic analysis revealed that the dysphonia severity index increased significantly (p <.01) while the jitter and shimmer decreased after the intervention (p <.05). According to perceptual evaluation, RLN stimulation significantly increased RBH grades in patients with IUVFP (p <.01). Furthermore, the improvement in voice perception had a moderate positive correlation with the decrease in the glottal closure. This study shows a short-term improvement of phonation in IUVFP patients after RLN stimulation, which provides proof-of-concept for trialing a controlled delivery of RLN stimulation and assessing durability of any observed responses. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to evaluate the effectiveness of voice therapy in patients with organic and functional dysphonia by using objective and subjective parameters. Material and Methods: One hundred and ten patients who met the criteria were included in the study. All patients underwent general ear-nose-throat (ENT) examinations. Videolaryngostroboscopic and flexible nasopharyngolaringoscopic laryngeal examinations were performed and image recordings were taken. Acoustic and aerodynamic voice analyzes were performed. Fundamental frequency (F0- Hz), jitter (%), shimmer (decibel-dB), harmonic noise ratio (HNR-dB) and maximum phonation time (MBT sec) were measured. The Voice-Related Quality of Life Questionnaire (VRQOL) was used for subjective voice evaluation. Voice therapy was given to the patients by the ENT physician who was conducting the research. At the end of the therapy, all measurements were repeated and the difference was analyzed. Results: Of the 110 patients, 76 were women and 34 were men. The mean age was 43.17±13.67 years. The median duration of dysphonia was 7 (minimum 1 to maximum 180) months. Organic dysphonia was detected in 70 patients, 53 had functional dysphonia. The distribution of organic dysphonias was 38.57% vocal cord nodules, 48.57% vocal cord paralysis, and 12.85% sulcus vocalis. 42.5% of functional dysphonias were muscle tension dysphonia, 57.5% of them were psychogenic dysphonia. After the voice therapy MBT and HNR were improved, jitter and shimmer values were reduced, and VRQOL scores increased in vocal cord paralysis, and nodules. In sulcus vocalis group, there were no significant changes in the acoustic, aerodynamic measurements, and VRQOL scores. In functional dysphonia group, positive changes were observed in acoustic analysis parameters with voice therapy. Also there was a significant improvement in quality of life scores. Conclusion: Voice therapy is an effective treatment method in suitable patient groups. It improves both sound quality and quality of life. When approaching patients with dysphonia, it should be primarily considered as a treatment method that is lowcost, easy to implement, and allows close patient follow-up. [ABSTRACT FROM AUTHOR]

Within-speaker variability, which results from the plasticity of speech production, is an inherent feature of speaker comparison. This study examines targeted modifications of voice quality, both phonatory and articulatory, in Czech. Fifteen speakers were instructed to read a text in 15 different versions (e.g. palatalised voice, denasalised voice, breathy phonation, or a combination of open jaw and creaky voice). Acoustic analyses revealed that F3 is relatively stable across various voice quality settings, while harmonicity and spectral slope indicators are sensitive to the phonatory modifications. A perceptual test, administered online to 120 participants, showed that palatalised, pharyngealised, creaky, and pressed voice were regarded as most different from the speakers' habitual voices. Finally, automatic speaker recognition scores were very good with the targeted voice quality modifications, with LLR between 3 and 10. Pressed phonation turned out to have the greatest effect on all three types of analysis. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Investigación e Innovación en Ciencias de la Salud (RIICS) is the property of Fundacion Universitaria Maria Cano and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Investigación e Innovación en Ciencias de la Salud (RIICS) is the property of Fundacion Universitaria Maria Cano and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)