Descriptions of the Speech of Patients with Cancer of the Vocal Folds. Part II: Judgments of Age and Voice Quality

It is possible to implement help systems for diagnosis oriented to the evaluation of the fonator system using speech signal, by means of techniques based on expert systems. The application of these techniques allows the early detection of alterations in the fonator system or the temporary evaluation of patients with certain treatment, to mention some examples. The procedure of measuring the voice quality of a speaker from a digital recording consists of quantifying different acoustic characteristics of speech, which makes it possible to compare it with certain reference patterns, identified previously by a “clinical expert”. A speech acoustic quality measurement based on an auditory assessment is very hard to assess as a comparative reference amongst different voices and different human experts carrying out the assessment or evaluation. In the current bibliography, some attempts have been made to obtain objective measures of speech quality by means of multidimensional clinical measurements based on auditory methods. Well-known examples are: GRBAS scale from Japon (Hirano, M.,1981) and its extension developed and applied in Europe (Dejonckere, P. H. Remacle, M. Fresnel-Elbaz, E. Woisard, V. Crevier- Buchman, L. Millet, B.,1996), a set of perceptual and acoustic characteristics in Sweden (Hammarberg, B. & Gauffin, J., 1995), a set of phonetics characteristics with added information about the excitement of the vocal tract. The aim of these (quality speech measurements) procedures is to obtain an objective measurement from a subjective evaluation. There exist different works in which objective measurements of speech quality obtained from a recording are proposed (Alonso J. B.,2006), (Boyanov, B & Hadjitodorov, S., 1997),(Hansen, J.H.L., Gavidia-Ceballos, L. & Kaiser, J.F., 1998),(Stefan Hadjitodorov & Petar Mitev, 2002),(Michaelis D.; Frohlich M. & Strube H. W. ,1998),(Boyanov B., Doskov D., Mitev P., Hadjitodorov S. & Teston B.,2000),(Godino-Llorente, J.I.; Aguilera-Navarro, S. & Gomez-Vilda, P. , 2000). In these works a voiced sustained sound (usually a vowel) is recorded and then used to compute speech quality measurements. The utilization of a voiced sustained sound is due to the fact that during the production of this kind of sound, the speech system uses almost all its mechanisms (glottal flow of constant air, vocal folds vibration in a continuous way, …), enabling us to detect any anomaly in these mechanisms. In these works different sets of measurements are suggested in order to quantify speech quality objectively. In all these works one important fact is revealed; it is necessary to obtain different measurements of the speech signal in order to compile the different aspects of acoustic characteristics of the speech signal.

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Voice quality assessment and monitoring: Understanding vocal folds dynamics and its relationships to neurocognition

Biomedical Signal Processing and Control ◽

10.1016/j.bspc.2019.101670 ◽

2020 ◽

Vol 55 ◽

pp. 101670

Author(s):

Claudia Manfredi

Keyword(s):

Quality Assessment ◽

Voice Quality ◽

Vocal Folds ◽

Assessment And Monitoring

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Botulinum toxin as adjunctive therapy in refractory laryngeal granuloma

The Journal of Laryngology & Otology ◽

10.1017/s0022215107000710 ◽

2007 ◽

Vol 122 (8) ◽

pp. 824-828 ◽

Cited By ~ 26

Author(s):

E J Damrose ◽

J F Damrose

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin Injection ◽

Botulinum Toxin Type A ◽

Tertiary Care ◽

Voice Quality ◽

Vocal Folds ◽

Botulinum Toxin Type ◽

Care Hospital ◽

Percutaneous Injection ◽

Vocal Process

AbstractObjective:This study evaluated the role of botulinum toxin type A in the treatment of refractory laryngeal granulomas.Study design and setting:Retrospective clinical review at a tertiary care hospital. Seven patients with vocal process granulomas underwent percutaneous injection of botulinum toxin into both vocal folds, performed in an office setting. Total doses ranged from 10 to 25 U, divided between both vocal folds.Results:All patients experienced resolution of their granulomas over two to seven weeks. No patient developed aspiration pneumonia. All patients experienced hoarseness secondary to the injections, but voice quality returned to baseline in all patients as the toxin was degraded.Conclusions:Botulinum toxin is safe and effective therapy in resolving vocal process granulomas in patients refractory to traditional therapy. The optimal treatment dose remains to be determined.Significance:Percutaneous botulinum toxin injection is helpful in resolving laryngeal granulomas.

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Application of High Speed Digital Imaging (HSDI) technique and voice acoustic analysis in the diagnosis of the clinical form of Presbyphonia in women

Otolaryngologia Polska ◽

10.5604/01.3001.0014.1580 ◽

2020 ◽

Vol 74 (4) ◽

Author(s):

Bożena Kosztyła-Hojna ◽

Emilia Duchnowska ◽

Maciej Zdrojkowski ◽

Anna Łobaczuk-Sitnik ◽

Jolanta Biszewska

Keyword(s):

Digital Imaging ◽

High Speed ◽

Elderly Women ◽

Voice Quality ◽

Vocal Folds ◽

Clinical Form ◽

Voice Analysis ◽

Acoustic Voice Analysis ◽

Group I ◽

Glottal Insufficiency

Introduction: The aging process of voice begins after the age of 60 and has an individually variable course. Voice quality disorders at this age are called senile voice (Presbyphonia or Vox Senium). Voice pathology is particularly severe in women. The aim of the study was to diagnose the clinical form of Presbyphonia in elderly women using High Speed Digital Imaging (HSDI) and acoustic voice analysis. Material and methods: Study included 50 elderly women (average age 69) with dysphonia (Group I). Control group (Group II) included 30 women (average age 71) without voice quality disorders. Visualization assessment has been conducted with High Speed Digital Imaging (HSDI) with High Speed camera (HS). Acoustic evaluation of voice included analysis isolated vowel “a” and continuous linguistic text with Diagnoscope Specialista software. Maximum Phonation Time (MPT) has been determined. Results: In Group I, 78% of women revealed vocal folds vibrations asymmetry, vibration amplitude increase, Mucousal Wave (MW) limitation and Type D glottal insufficiency (GTs). Acoustic voice analysis proved decrease in F0, increase in Jitter, Shimmer, NHR. In 22% of women, next to vibrations asymmetry, vibration amplitude reduction and MW limitation, Type E glottal insufficiency (GTs) have been found. Acoustic voice analysis revealed slight decrease in F0 and the presence of numerous non-harmonic components in the glottis region. Conclusions: Vocal folds visualization with HSDI showed edema, less often atrophy in elderly women. Both forms of dysphonia were caused abnormal values of F0, Jitter, Shimmer, NHR in the acoustic voice evaluation and significant reduction of MPT.

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Interaction Between the Thyroarytenoid and Lateral Cricoarytenoid Muscles in the Control of Vocal Fold Adduction and Eigenfrequencies

Journal of Biomechanical Engineering ◽

10.1115/1.4028428 ◽

2014 ◽

Vol 136 (11) ◽

Cited By ~ 15

Author(s):

Jun Yin ◽

Zhaoyan Zhang

Keyword(s):

Vocal Fold ◽

Muscle Activation ◽

Cricoid Cartilage ◽

Voice Quality ◽

Three Dimensional ◽

Vocal Folds ◽

Element Model ◽

Anterior Portion ◽

Posterior Portion ◽

Laryngeal Muscle

Although it is known vocal fold adduction is achieved through laryngeal muscle activation, it is still unclear how interaction between individual laryngeal muscle activations affects vocal fold adduction and vocal fold stiffness, both of which are important factors determining vocal fold vibration and the resulting voice quality. In this study, a three-dimensional (3D) finite element model was developed to investigate vocal fold adduction and changes in vocal fold eigenfrequencies due to the interaction between the lateral cricoarytenoid (LCA) and thyroarytenoid (TA) muscles. The results showed that LCA contraction led to a medial and downward rocking motion of the arytenoid cartilage in the coronal plane about the long axis of the cricoid cartilage facet, which adducted the posterior portion of the glottis but had little influence on vocal fold eigenfrequencies. In contrast, TA activation caused a medial rotation of the vocal folds toward the glottal midline, resulting in adduction of the anterior portion of the glottis and significant increase in vocal fold eigenfrequencies. This vocal fold-stiffening effect of TA activation also reduced the posterior adductory effect of LCA activation. The implications of the results for phonation control are discussed.

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Effects of antituberculosis treatment on self assessment, perceptual analysis and acoustic analysis of voice quality in laryngeal tuberculosis patients

The Journal of Laryngology & Otology ◽

10.1017/s0022215107008961 ◽

2008 ◽

Vol 122 (4) ◽

pp. 378-382 ◽

Cited By ~ 5

Author(s):

K Yelken ◽

M Guven ◽

M Topak ◽

E Gultekin ◽

F Turan

Keyword(s):

Acoustic Analysis ◽

Voice Quality ◽

Vocal Folds ◽

Median Score ◽

Self Assessment ◽

Tuberculosis Patients ◽

Perceptual Analysis ◽

Antituberculosis Treatment ◽

The Voice ◽

Laryngeal Tuberculosis

AbstractObjectives:To evaluate the effects of antituberculosis treatment on the voice quality of laryngeal tuberculosis patients, measured by patient self-assessment, perceptual analysis and acoustic analysis.Materials and methods:A total of 14 laryngeal tuberculosis patients were enrolled. Laryngeal tuberculosis was established either by biopsy and histopathological examination or by rapid regression of the laryngeal lesions after antituberculosis medication. Before and after treatment, all patients were evaluated perceptually (on a scale of zero to three), and 12 assessed their own voices using the voice handicap index-10 scale. Acoustic analysis was performed to allow objective evaluation.Results:Patients' ages ranged from 21 to 72 years (mean, 41). The male to female ratio was 12:2. Eight patients (57 per cent) had tuberculous involvement of the epiglottis, four (28 per cent) had involvement of the aryepiglottic fold and eight (57 per cent) had involvement of the false vocal folds. The glottis was the less commonly involved part of the larynx, including true vocal folds (28 per cent, n = 4) and posterior commissure (14 per cent, n = 2). Perceptual evaluation, on a scale of zero to three, gave the patients a median score of six; after commencement of treatment, the median score decreased to two. The mean voice handicap index-10 score decreased from 24 to 12 after treatment. An obvious improvement in acoustic analytical parameters was also found following treatment.Conclusions:Antituberculosis treatment clearly improved the voice outcomes of laryngeal tuberculosis patients, according to self-assessment, perceptual analysis and acoustic analysis.

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Noncontact Determination of the Mechanical Properties of the Human Vocal Folds

ASME 2008 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2008-193072 ◽

2008 ◽

Author(s):

Shinji Deguchi ◽

Kazutaka Kawashima

Keyword(s):

Mechanical Properties ◽

Vocal Fold ◽

Measurement Techniques ◽

Voice Quality ◽

Vocal Folds ◽

In Vivo Measurement ◽

In Vitro Measurements ◽

Excited Oscillation

Mechanical properties of the vocal folds (such as stiffness or viscoelastic properties) play an essential role in phonation. They affect not only voice quality but also onset threshold of vocal fold self-excited oscillation, a sound source of voice [1]. Many experimental data on the mechanical properties have been reported so far, in which in vitro [2] or in vivo measurement techniques [3] were employed. In vitro measurements give us detailed information on the mechanical properties, yet it would be required to consider possible loss of freshness of the specimen. Meanwhile, current in vivo measurement methods utilize a thin probe to deform the vocal fold tissue located at the back of the throat and hence need technical skills for the surveyor to successfully obtain its loading-deformation relationship.

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Parameters Acoustic and High-speed kymography identified effects of voiced vibration and vocal fry exercises

CoDAS ◽

10.1590/s2317-17822014000100010 ◽

2013 ◽

Vol 25 (6) ◽

pp. 577-583 ◽

Cited By ~ 5

Author(s):

Regina Aparecida Pimenta ◽

María Eugenia Dájer ◽

Adriana Hachiya ◽

Domingos Hiroshi Tsuji ◽

Arlindo Neto Montagnoli

Keyword(s):

Healthy Subjects ◽

High Speed ◽

Voice Quality ◽

Vocal Folds ◽

Acoustic Parameters ◽

Significance Level ◽

Whitney Test ◽

Before And After ◽

Student Test ◽

Female Voices

Purpose: To identify the immediate effects of voiced vibration and vocal fry exercises on healthy subjects by means of acoustic parameters and high-speed kymography. Methods: Thirty healthy subjects (18 women and 12 men, aged from 19 to 45 years old) participated in this study. The voices were recorded at the range of 44.100 samples/second, before and after of the vocal exercises. We developed a computational routine to extract jitter and shimmer. High-speed kymography was generated from laryngeal images for the analysis of the phase times: closed (CPh), open (OPh), of closing (cPh) and of opening (oPh) and used the paired t-Student test and the Mann-Whitney test, with a significance level of 0.05. Results: After voiced vibrations, acoustic parameters showed reduced jitter for both genders (p=0.018 for men and p<0.01 for women) and reduced shimmer for female voices (p<0.01). There was a decrease in CPh (p=0.046) and cPh (p=0.026) and an increase in OPh (p=0.05) in female vocal folds. After vocal fry, we identified decreased jitter (p<0.01) in female voices and cPh (p=0.026) in male vocal folds. Conclusion: We observed more positive immediate effects of the voiced vibrations, mainly in voice quality and vocal folds among females. Nevertheless, studies with larger male sample and investigation of the appropriate time of vocal fry are necessary to confirm the results of this search.

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Subjective and objective assessment of voice quality in pregnancy

Otolaryngologia Polska ◽

10.5604/01.3001.0012.7856 ◽

2018 ◽

Vol 72 (6) ◽

pp. 1-5

Author(s):

Bożena Kosztyła-Hojna ◽

Anna Łobaczuk-Sitnik ◽

Jolanta Biszewska ◽

Diana Moskal-Jasińska

Keyword(s):

Pregnant Women ◽

High Speed ◽

Objective Assessment ◽

Voice Quality ◽

Vocal Folds ◽

Objective Evaluation ◽

Subjective Assessment ◽

Third Trimester ◽

The Third ◽

Acoustic Evaluation

During pregnancy, voice quality disorders may occur in form of: edema, dryness, nervousness. The aim of the study is subjective and objective evaluation of voice quality in pregnant women. The study included 20 women in the third trimester of pregnancy, age of 20-31 diagnosed at the Department of Clinical Phonoaudiology and Logopedics, Medical University of Bialystok. Subjective assessment has been based on the GRBAS scale. Objective assessment of the vocal organ used the HSDI technique (High Speed Digital Imaging). In the laryngeal visualization, high-speed camera (HS) using rigid endoscope with 90 ° optics has been used. Vibration of vocal folds has been recorded during phonation of vowel "e" at 4000 frames / sec. The glottal closure (GTs), symmetry, regularity and synchronization of vocal folds vibration have been assessed. In estimating the degree of glottal insufficiency, kymography of the larynx has been performed by analyzing the value of Open Quotient (OQ). Objective acoustic evaluation of voice has been also conducted using DiagnoScope Specjalista Program. Hoarseness has been observed in 15 pregnant women, whereas voice fatigability in 20 patients. Using HSDI, the edema of vocal folds in part of the group has been observed. Decreased MPT has been found in all examined women in the third trimester of pregnancy. Hoarseness and fatigability of voice are the most frequent subjective symptoms of voice organ in the third trimester of pregnancy. Decreased MPT is recorded objectively, as well as edema and insufficiency of vocal folds using HSDI technique.

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Impact of Subharmonic and Aperiodic Laryngeal Dynamics on the Phonatory Process Analyzed in Ex Vivo Rabbit Models

Applied Sciences ◽

10.3390/app9091963 ◽

2019 ◽

Vol 9 (9) ◽

pp. 1963 ◽

Cited By ~ 1

Author(s):

Fabian Thornton ◽

Michael Döllinger ◽

Stefan Kniesburges ◽

David Berry ◽

Christoph Alexiou ◽

...

Keyword(s):

High Speed ◽

Ex Vivo ◽

Human Subjects ◽

Voice Quality ◽

Vocal Folds ◽

Glottal Closure ◽

Subglottal Pressure ◽

Vocal Fold Dynamics ◽

Cepstral Peak Prominence ◽

Voice Pathologies

Normal voice is characterized by periodic oscillations of the vocal folds. On the other hand, disordered voice dynamics (e.g., subharmonic and aperiodic oscillations) are often associated with voice pathologies and dysphonia. Unfortunately, not all investigations may be conducted on human subjects; hence animal laryngeal studies have been performed for many years to better understand human phonation. The rabbit larynx has been shown to be a potential model of the human larynx. Despite this fact, only a few studies regarding the phonatory parameters of rabbit larynges have been performed. Further, to the best of our knowledge, no ex vivo study has systematically investigated phonatory parameters from high-speed, audio and subglottal pressure data with irregular oscillations. To remedy this, the present study analyzes experiments with sustained phonation in 11 ex vivo rabbit larynges for 51 conditions of disordered vocal fold dynamics. (1) The results of this study support previous findings on non-disordered data, that the stronger the glottal closure insufficiency is during phonation, the worse the phonatory characteristics are; (2) aperiodic oscillations showed worse phonatory results than subharmonic oscillations; (3) in the presence of both types of irregular vibrations, the voice quality (i.e., cepstral peak prominence) of the audio and subglottal signal greatly deteriorated compared to normal/periodic vibrations. In summary, our results suggest that the presence of both types of irregular vibration have a major impact on voice quality and should be considered along with glottal closure measures in medical diagnosis and treatment.

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