Logopedics Phoniatrics Vocology最新文献

Objective: To conduct a systematic review of the use and results of the Provox^®Vega^TMXtraSeal^TM in the prevention of periprosthetic leakage and to propose a management protocol for this voice prosthesis.

Methods: Systematic search based on the PRISMA Statement during February 2020. Keywords were double flange, periprosthetic leakage, voice prosthesis, and laryngectomy.

Results: Four articles with 315 voice prosthesis (94 XtraSeal and 221 controls) in 55 patients were found. The XtraSeal mean duration was 114.28 ± 73.2 (CI 95%, 98.29-130.26) days compared to 102.98 ± 17.74 (CI 95%, 100.62-105.35) days of the control group. Out of 266 replacements, endoprosthetic leakage was the most frequent cause in both groups (62.41%). Periprosthetic leaks were less frequent in the XtraSeal (9.62%) than in the control group (22.43%).

Conclusions: The XtraSeal could be effective in preventing periprosthetic leakage and lengthening the time between replacements. Studies with a robust methodology are necessary to confirm these results. Managing voice prosthesis is complex and requires a multidisciplinary and systematic approach by experienced professionals to reduce replacements and complications. Incorrect placement of the XtraSeal could cause a foreign body reaction and consequently inflammation, extrusion, or pressure lesions. The Tower of Hercules protocol: (1) Measurement of the tracheoesophageal fistula using the Provox^® Measure, (2) Minimization of XtraSeal slack by avoiding the complete visualization of the prosthesis' blue ring, (3) Nasofibroscopic examination of the oesophageal wall confirming both flanges are in correct position; could prevent or minimize complications derived from the use of the XtraSeal.

Purpose: The purpose of the current study was to investigate the lag effects in two different versions of distributed practice on learning novel language vocabulary.

Method: Forty-four healthy monolingual English-speaking participants were randomly assigned to two versions of distributed practice. The two versions of distributed practice were created by altering the temporal lag between the practice sessions. Participants in both groups completed a similar practice regimen wherein they practiced 30 French occupations five times each for a total of 150 times. The pre/post-design employed in this experiment involved participants completing baseline, immediate, and delayed retention tests. The outcome measures included a comprehensive multiple-choice test and a written expression task.

Results: The findings from the comprehensive and expressive tasks indicated that the learning performance of participants across both groups was better during the immediate retention test compared to the delayed retention test. With regard to the group, participants assigned to the condensed version of distributed practice demonstrated superior learning of the novel vocabulary over participants assigned to the extended version of distributed practice.

Conclusion: The findings indicate that an increased temporal lag between the practice sessions results in a "non-monotonic function," wherein the learning continues to improve until an optimal lag, after which the learning declines as the lag continues to increase. This line of research will have a substantive impact on service-delivery models in speech-language pathology.

Purpose: The aim of this study is to explore teachers' experience and understanding of classroom communication after participating in a speech-language pathologist (SLP) led in-service training on classroom communication.

Method: This qualitative study used a focus group approach to explore how teachers describe their classroom communication. Twenty primary-school teachers participated. Thematic analysis was used to analyze the teachers' responses about their classroom communication practices 6 months after in-service training.

Results: Three core themes on teachers' understanding of their communication in the classroom were identified in the analysis: (1) awareness of voice use; (2) the use of body communication; (3) setting the stage for learning. The teachers gave many examples of voice use reflecting an increased awareness of audibility and vocal health. They reported on moving around more and using more body communication to enhance their message. Further, they expressed an increased awareness about how body posture affects voice and communication. The third theme reflects how the teachers "sets the stage for learning" i.e. how they use the prerequisites in the physical environment for successful classroom communication, including the classroom's sound environment as well as seating and furniture.

Conclusions: The findings in this study indicate that teachers increased their awareness, implemented new practices in their classroom communication and reflected on prerequisites for classroom communication as a result of the in-service training. Teachers' classroom communication developed when provided practical training and strategies to increase their awareness on communication. We conclude that this type of SLP-led training can be recommended as in-service training.

Objectives: The aim of the study was to evaluate voice and swallowing function before thyroid surgery and to explore the possible role of thyroid enlargement and laryngopharyngeal reflux (LPR).

Methods: We conducted a prospective study of patients who underwent hemi- or total thyroidectomy (n = 118) and compared the results with patients of laparoscopic cholecystectomy (n = 110). All subjects underwent videolaryngostroboscopy, filled in subjective evaluations of voice, swallowing and reflux complaints. Acoustic voice analysis (AVA), maximum phonation time (MPT) and perceptual voice evaluation were conducted.

Results: We found no difference in voice quality between study and control group, neither in subjective complaints nor in AVA or perceptual evaluation. We did find indicative signs of minor laryngeal changes in thyroid group. Swallowing Impairment Score (SIS) revealed worse swallowing function in thyroid patients (p = 0.0006). Comparison of Reflux Symptom Index (RSI) scores revealed that thyroid group patients have higher values compared to control group (p = 0.006). Nevertheless, Reflux Finding Score (RFS) showed identical scores in both groups (p = 0.220). In thyroid group there was a strong positive correlation between RSI and SIS (ρ = 0.641), but no correlation between RFS and SIS (ρ = -0.002). In addition, we found a weak positive correlation between thyroid weight and RFS (ρ = 0.379).

Conclusions: Changes in laryngeal area caused by thyroid disorders do not lead to subjective but indicate slight objective disturbances in voice quality. We detected a decline in swallowing quality within thyroid patients. Higher RSI scores and a positive correlation between RFS and thyroid weight, indicate a possible role of thyroid gland in LPR.

Purpose: The purpose of this study is to compare patient-reported voice handicap and auditory-perceptual measures of voice between healthy individuals and COVID-19 patients, as well as to investigate the effect of clinical factors on voice quality.

Methods: COVID-19 patients (n = 138) and 90 healthy controls were included in the study. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) was used to grade voice samples based on overall severity, roughness, breathiness, strain, pitch, and loudness. The Voice Handicap Index-10 was completed by all participants (VHI-10). Physical (pVHI), emotional (eVHI) and functional (fVHI) subscores were calculated. Clinical data were collected (disease stage, CT grade, neutrophil/lymphocyte ratio, CRP, and symptoms).

Results: A statistically significant difference between patient and control groups in VHI-10 and CAPE-V scores was detected (p < 0.001). Except eVHI, total score and all subscale scores were higher in patients with COVID-19 as the pVHI was the most affected (η² = 0.324) subscale. All scores of CAPE-V were significantly worse in patients with COVID-19 as highest impact of COVID-19 was on breathiness (η² = 0.518). Pre-existing pulmonary comorbidity_, dyspnoea and N/L was significantly associated with the VHI-10 overall score (β_pc = 4.27, β_dyspnoea = 5.69 and β_nl = 0.25). The overall severity of CAPE-V was significantly dependent on dyspnoea and pulmonary comorbidity (β_dyspnoea = 11.25, β_pc = 10.12). VHI ≥4 and CAPE-V overall severity ≥11 were good indicators of COVID-19 related dysphonia.

Conclusions: COVID-19 causes patient-reported voice handicap and deteriorates auditory-perceptual measures of voice. COVID-19 related voice impairment was mainly associated with the decreased respiratory capacity.

Aim: This study aims to show speech and language, sensory-motor, and emotional progress after one year of therapy according to the needs of and resources for a child with multiple disabilities and blindness due to retinopathy of prematurity (ROP).Methods: A 45-month-old boy was examined by a multidisciplinary team and assessed using the Sensory Profile 2, The Vineland Adaptive Behavior Scale II, The Communication Matrix, and The Scale for Evaluation of Psychophysiological Abilities of Children Aged 0-7. After a year of daily individually adopted speech and language therapy followed by supplementary therapeutics method, based on a multidisciplinary approach, the child was reassessed using the same battery of tests.Results: The obtained results might indicate the importance of factors such as a multidisciplinary approach, individualization, communication pathways, therapist's characteristics, and trust when working with children with multiple disabilities.Conclusion: Taking into account all the features of multiple disabilities during the treatment course, continuous monitoring, modification, and adaptation of applied therapy method proved successful in this case.

Purpose: In overtone singing a singer produces two pitches simultaneously, a low-pitched, continuous drone plus a melody played on the higher, flutelike and strongly enhanced overtones of the drone. The purpose of this study was to analyse underlying acoustical, phonatory and articulatory phenomena.Methods: The voice source was analyzed by inverse filtering the sound, the articulation from a dynamic MRI video of the vocal tract profile, and the lip opening from a frontal-view video recording. Vocal tract cross-distances were measured in the MR recording and converted to area functions, the formant frequencies of which computed.Results: Inverse filtering revealed that the overtone enhancement resulted from a close clustering of formants 2 and 3. The MRI material showed that for low enhanced overtone frequencies (F_E) the tongue tip was raised and strongly retracted, while for high F_E the tongue tip was less retracted but forming a longer constriction. Thus, the tongue configuration changed from an apical/anterior to a dorsal/posterior articulation. The formant frequencies derived from the area functions matched almost perfectly those used for the inverse filtering. Further, analyses of the area functions revealed that the second formant frequency was strongly dependent on the back cavity, and the third on the front cavity, which acted like a Helmholtz resonator, tuned by the tongue tip position and lip opening.Conclusions: This type of overtone singing can be fully explained by the well-established source-filter theory of voice production, as recently found by Bergevin et al. [1] for another type of overtone singing.

Purpose: While many examples of speech pathology intervention approaches for children with speech sound disorders (SSDs) exist in English and some other European languages, approaches with children in other languages are largely unknown. The aim was to determine current speech-language pathologists (SLPs) intervention practices with children with SSDs in the ME, and to then compare these with international practices.

Methods: Data were collected by online questionnaire using Qualtrics. One hundred and eighty-nine SLPs completed the survey. Participants were required to be Arabic first language speaking SLPs practicing in the ME (e.g. Kuwait, Saudi Arabia, UAE, and Egypt), working with children with SSDs.

Results: The respondents reported a frequent use of phonological awareness, traditional articulation therapy, auditory discrimination, minimal pairs, and whole language therapy approaches in the treatment of children with SSDs, like their counterparts in Australia, the USA, UK, and Portugal. Gaps between research recommendations for evidence-based practice and actual clinical practice are identified, and discussed.

Conclusions: Future research should investigate the efficacy of speech-therapy approaches to improve service delivery for Arabic-speaking children with SSDs in the ME.

Objective: Although speaking rate is central for many speech disorders, no consensus exists regarding the measurement of this feature. The purpose of this study was to examine the correlations between perceptual listener evaluations and various measures of speaking rate. Furthermore, the study investigated the relationship between speaking rate and articulation rate and how pauses in speech affect the perceived tempo.

Method: Nine healthy females were selected to produce stimuli representing three habitual speech tempi during semi-spontaneous speech: slow (n = 3), neutral (n = 3) and fast (n = 3). Speaking rate was analyzed both by manual calculation and through automatic detection by a script to the computer-based program Praat. Thirty untrained male and female listeners evaluated the recordings with regard to speech tempo on visual analogue scales from very slow to very fast.

Results: Large, significant correlations (Pearson's r) were found between all objective measures of speaking rate and perceptual listener evaluations. Words/minute showed the largest correlation (.91), followed by syllables/second (.89), while articulation rate (pauses excluded) as automatically measured by the script, showed the smallest correlation (.69). Possible explanations for the findings are discussed.

Conclusion: Untrained listeners' evaluation of speech tempo in normal subjects correlated strongly with objective measurements. The results both support the use of auditive-perceptual evaluation of tempo and the use of automatic script analysis for clinical use. Speaking rate (pauses included) showed better consistency with perceptual listener evaluations than articulation rate.

Purpose: Sound pressure level (SPL), fundamental frequency (F₀), time dose (D_t), cycle dose (D_c), and distance dose (D_d) are components affecting a vocal demand response. The study aimed to investigate the impact of sound field amplification systems (SFAS) on teachers' vocal parameters and determine the user comfort of SFAS use in teachers.

Methods: Twenty female teachers underwent long-term voice dosimetry with Vocal Holter Med (PR.O.Voice Srl) during everyday teaching activities. The SFAS PentaClassRuna (Certes) was installed in classrooms. Voice dosimetry was provided in two different acoustical conditions-without the use of SFAS (one to two days) and with SFAS (one to three days). Teachers underwent voice acoustic and laryngoscopic evaluation before voice dosimetry. Two teachers' groups were formed: teachers with and without vocal nodules. The visual analogue scale measured the user comfort of SFAS.

Results: There were no significant differences in vocal parameters and vocal doses between teachers with and without vocal nodules. Voice amplification significantly decreased average F₀(-4.4 Hz), D_t%(-3.1%), D_c (-0.4 kcycles), and D_d (-1.3 m) in teachers without vocal nodules and F₀ (-8.9 Hz) in teachers with vocal nodules. Vocal doses (D_t%, D_c, D_d) significantly decreased in classrooms with longer reverberation time. The user comfort of the SFAS during the lessons was high in both teachers groups.

Conclusions: SFAS was a mediator between the classroom's environment and the teacher's vocal demand response; it changed teachers' voice production parameters and reduced vocal demand response to satisfy the communication requirements. In addition, voice amplification was more beneficial for teachers without vocal fold lesions.