Journal of Voice最新文献

Aim: To investigate the occurrence of auditory impairments in individuals with dysphonia and to describe the results of behavioral and electrophysiological audiological assessments in this population.

Study design: A scoping review.

Method: A scoping review following the guidelines of the Joanna Briggs Institute Manual for Evidence Synthesis for Scoping Reviews and PRISMA-ScR. A search was carried out using the electronic databases PubMed, Scielo, and Lilacs, as well as the gray literature via Google Scholar. Using the Rayyan platform, the selection and extraction of data from the studies was carried out independently and blindly by two reviewers, with excellent agreement. The studies included in the review were subjected to extraction of the following information for analysis: authors, year of publication, objective, sample characteristics, dysphonia classification, audiological assessment procedure, and conclusion.

Results: About 100 studies were found, and 13 eligible studies were included in the analysis. Of the studies included, 92.3% (n = 12) adopted cross-sectional designs, 76.9% (n = 10) investigated auditory functions in individuals with behavioral dysphonia, and 23.1% (n = 3) with organic dysphonia. The samples consisted of children in 53.8% (n = 7) of the studies and adults in 46.2% (n = 6), both with dysphonia. Around 53.80% (n = 7) of the studies included control groups without dysphonia. As for audiological assessment methods, 53.8% (n = 7) used behavioral tests of central auditory processing, 15.4% (n = 2) electrophysiological assessment, and 30.8% (n = 4) a combination of both.

Conclusion-: Individuals with dysphonia, especially of the behavioral type, may have deficits in auditory function. The main impairments refer to central auditory processing, especially in skills involving temporal processing, figure-ground skills, and auditory closure. Electrophysiological assessment does not show any significant differences between individuals with and without behavioral dysphonia. However, the frequency of follow-up response has a potential for greater impairment in this population. In cases of organic dysphonia, small and inconsistent impairments have been found, such as prolonged latencies of auditory potentials.

Objectives: There is no Azerbaijani-Turkish scale for assessing voice-related quality of life (V-RQOL). This study aimed to adapt the V-RQOL questionnaire to Azerbaijani-Turkish and evaluate its validity and reliability through cross-cultural adaptation.

Study design: A cross-sectional and prospective validation design was adopted.

Methods: The V-RQOL was translated and culturally adapted into the Azerbaijani-Turkish language according to the methodology of standard forward-backward translations to obtain semantic, idiomatic, and conceptual equivalence. The study included 160 participants, with 80 having voice disorders and 80 not having voice disorders. Content validity with four experts through cognitive interviewing and face validity and the pilot study with 10 voice patients was performed. The construct validity was calculated by comparing the total score of the Azerbaijani-Turkish version of V-RQOL (AT-VRQOL) with the self-assessment results. The internal consistency of V-RQOL was examined using Cronbach's alpha coefficient. To calculate the test-retest reliability coefficient, the AT-VRQOL was completed twice by 30 participants, including 20 with voice disorders and 10 without voice disorders, at intervals of 2 weeks.

Results: Differences in the V-RQOL scores between participants with and without voice disorders were statistically significant (P < 0.001). The construct validity results showed that the total score of V-RQOL with the self-assessment results is correlated (r = 0.88, P < 0.001). The area under the curve value from the receiver operating characteristic curve was 100. The optimal cut-off point was 21.25, with a sensitivity of 80% and a specificity of 100%. The AT-VRQOL had high internal consistency, indicating excellent reliability (Cronbach's alpha coefficient = 0.98). The total V-RQOL scores obtained from the two administrations of the test-retest reliability were examined. It was found that there was a high degree of correlation between the scores obtained in the two administrations (r = 0.99, P < 0.001).

Conclusions: The AT-VRQOL is a valid and reliable scale that can assess patients with voice disorders in a simple, easy, rapid way to apply and not time-consuming.

Quantification of voice physiology has been a key research goal. Segmenting the glottal area to describe the vocal fold motion has seen increased attention in the last two decades. However, researchers struggled to fully automatize the segmentation task. With the advent of deep learning, fully automated solutions are within reach and have been proposed. Are we then done here? This commentary highlights the open construction sites and how glottis segmentation can be still of scientific interest in this decade.

Introduction: People who undergo a total laryngectomy lose their natural voice and depend on alaryngeal technologies for communication. However, these technologies are often difficult to use and lack prosody. Surface electromyographic-based silent speech interfaces are novel communication systems that overcome many of the shortcomings of traditional alaryngeal speech and have the potential to seamlessly incorporate individualized prosody. The purpose of this study was to (1) validate the ability of alaryngeal silent speech to effectively incorporate pitch modulations-a key prosodic element in natural speech-into synthesized speech assessed through listening experiments and (2) determine the key features of these communication devices according to core users.

Methodology: People with laryngectomy (n = 15) and their primary communication partners (n = 5) listened to synthesized sentences with differing prosodic content generated from deep regression neural networks developed in our prior work. Specifically, the fundamental frequency (f_o) contour of each sentence was manipulated in four ways: (1) flattened to the average f_o, (2) altered to discrete sentence-level classification of muscle activity, (3) altered to continuous mapping of muscle activity, and (4) filtered to emulate speech from an electrolarynx (EL). Listeners ranked the f_o contours of each sentence in terms of speech naturalness and the importance of various speech aid features.

Results: Continuous contours rated higher than all other types of contours, and monotonic EL contours rated the lowest. Speech aid features were rated highest to lowest in the following order: sound quality, intelligibility, pitch, delay, volume, hands-free, maintenance, cost, wearability, training, and visibility.

Conclusion: These results will help inform future development of silent speech interfaces and shape priorities of communication devices toward the preferences of their users.

Objective: Teachers are often considered to be at high risk for voice disorders. Many studies have been conducted globally. However, the risk factors included in these studies varied, and even for the same influencing factors, the results were inconsistent across studies. No uniform conclusions have yet been drawn. The aim of this study is to identify the risk factors of voice disorders in non-university teachers and to provide insights for their prevention, treatment, and mitigation of recurrence.

Methods: In this systematic review (PROSPERO/CRD42024554265), PubMed, Scopus, Web of Science, Embase, and Wiley were searched up to January 14, 2024. A manual search was performed in gray literature through OpenGrey and ProQuest Dissertations and Theses. There was no limitations to the date of publication and language. Studies with a cross-sectional or case-control design and investigating the risk factors of voice disorders in non-university teachers were included. Two researchers performed separately to select articles, extract data, and evaluate the quality of the included studies. The 95% confidence interval and odds ratio were applied to examine the effect size. A meta-analysis was performed with a random effects model using the Stata 16.0 software.

Results: A total of 23 studies were considered, with a total of 73.609 teachers. The results of this meta-analysis: sex[OR = 1.63, confidence interval (CI) (1.17, 2.28)], smoking[OR = 1.31, CI(1.00，1.72)], upper respiratory tract infections [OR = 2.88, CI(1.59，5.23)], respiratory allergies [OR = 3.02, CI(2.21, 4.10)], endocrine diseases [OR = 2.25, CI(1.52, 3.34)]; acid reflux symptoms [OR = 2.41, CI(1.32, 4.40)], stress [OR = 2.47, CI(1.45, 4.19)], lack of discipline in the classroom [OR = 1.63, CI(1.20，2.20)], physical education [OR = 1.58, CI(1.10, 2.28)], noise in the classroom [OR = 1.89, CI(1.42, 2.53)], excessive speaking [OR = 2.52, CI(1.77, 3.60)], throat clearing [OR = 2.10, CI(1.18, 3.75)], shouting [OR = 1.42, CI(1.02, 1.96)], and speaking loudly [OR = 3.06, CI(1.91, 4.91)] may contribute to the development of voice disorders. Subgroup analyses revealed that the diagnostic tool may contribute to high heterogeneity.

Conclusions: The etiopathology of voice disorders in non-university teachers is frequently complex. Multidimensional diagnosis of voice disorders plays an important role in the study of voice disorders It is imperative to undertake early vocal training and implement preventive measures to prevent the currency of voice disorders.

Purpose: This study examined the relationship between patient-perceived vocal effort (VE) using a 100-mm visual analog scale (VE-VAS) and the OMNI Vocal Effort Scale (OMNI-VES) when measures were obtained after a vocal activity. A second purpose was to evaluate how VE related to other voice assessment measures.

Method: Fifty-three speakers with adductor laryngeal dystonia (ADLD) provided speech recordings. Directly after this vocal activity, speakers rated VE using the VE-VAS and the OMNI-VES. Speakers provided ratings of their own voice quality severity using a 100-mm VAS (ADLD-OS) and completed the Voice-Related Quality of Life (V-RQOL) scale. Ten experienced speech-language pathologists rated a subset of available speech samples (n = 39) for overall voice severity using a 100-mm VAS (SLP-OS).

Results: There was a strong, significant correlation (r = 0.78, P < 0.001) between the VE-VAS and the OMNI-VES. Both VE measures were strongly and significantly correlated with speakers' ratings of their voice: VE-VAS vs ADLD-OS, r = 0.75, P < 0.001; OMNI-VES vs ADLD-OS, r = 0.85, P < 0.001. In contrast, mostly weak correlations were found between perceived VE and V-RQOL total and physical domains, respectively (VE-VAS vs V-RQOL: r = -0.21 to -0.19, P > 0.05; OMNI-VES vs V-RQOL: r = -0.37 to -0.44, P < 0.01). Finally, VE measures were moderately and significantly related to SLPs' auditory-perceptual measures of voice severity: VE-VAS vs SLP-OS, r = 0.50, P < 0.001; OMNI-VES vs SLP-OS, r = 0.57, P < 0.001.

Conclusions: ADLD speakers' perceptions of VE are strongly related when measures are obtained directly after a vocal activity, regardless of the VE scale. VE is strongly related to speaker-rated voice quality severity, but weakly related to V-RQOL. Measures of VE obtained directly after a vocal activity are moderately related to clinicians' perceptions of overall voice quality severity.

This cross-sectional study aimed to examine acoustic voice parameters among older Thai individuals in Chiang Mai-a northern Thai province with the third-largest elderly population and significant PM_2.5 exposure-and to compare these measures between normal and abnormal voice groups within this population.

Method: The study involved 125 Thai elderly with normal voices, who were selected through a multi-stage sampling process and assessed by using the GRBASI scale (Grade, Roughness, Breathiness, Asthenia, Strain, Instability), and 45 elderly Thai individuals with abnormal voices, selected through purposive sampling and diagnosed by an Ear, Nose, and Throat (ENT) doctor or assessed by using the GRBASI scale. Additionally, participants with normal voices underwent a speech discrimination test before voice recording. Participants vocalized /a/ for over 3 seconds and read a Thai passage for acoustic analysis using Praat. Analysis considered gender and age groups (60-69, 70-79, and 80+ years).

Results: Data on acoustic voice parameters among older Thai individuals in Chiang Mai were reported, showing alignment with those from previous studies on different ethnic populations, except for the intensity parameter, which was found to be lower in this study. Statistically significant differences were found between normal and abnormal voice groups. In males, differences included fundamental frequency, speaking fundamental frequency, jitter local, shimmer local, and harmonic-to-noise ratio (P = 0.008, P < 0.001, P < 0.001, P = 0.002, and P < 0.001, respectively). In females, differences included jitter local and intensity (P < 0.001 and P = 0.045, respectively).

Conclusions: The findings provide a foundation reference for voice characteristics among Chiang Mai's elderly, which could potentially be relevant to elderly populations in other northern Thai provinces exposed to similar environmental conditions or particulate matter.

Objective: This pilot investigation explored the relationship between self-reported clinical cough symptoms and objective acoustic cough data in individuals with nocturnal chronic cough.

Methods: Ten participants diagnosed with chronic cough with a nocturnal component underwent two study sessions, approximately 1 week apart. Participants completed questionnaires regarding cough severity and their perceptions of using a smartphone application (app) to audio record cough. Between sessions, participants utilized the continuous audio recorder while sleeping. The relationship between the number of coughs captured at night and the self-reported impact of cough awakening during sleep were analyzed.

Results: We found strong correlations (ρ = -0.78, -0.87) between formalized Leicester Cough Questionnaire scores and acoustically determined cough frequency. However, there were large differences between the average number of self-reported cough awakening events (0-3) and the number of acoustically recorded coughs (0-639). While users expressed comfort with recording and sharing acoustic data (4.8/5 Likert rating), concerns over confidentiality in daytime use were noted (4.1/5).

Conclusion: Formalized cough questionnaires provide insight into chronic cough at night but may fall short in quantifying the shear frequency of coughs patients are experiencing. Although continuous audio recordings via smartphone emerged as a comfortable means for patients to supply quantifiable data regarding the impact of chronic cough during sleep, future endeavors in cough acoustic monitoring should prioritize privacy considerations for daytime use and work to share information with health care providers.

Objective: This study aimed to investigate the knowledge, attitude, and practice patterns of otolaryngologists in Southwest China in managing pediatric dysphonia.

Study design: Cross-sectional survey.

Setting: An online survey was disseminated between August and September 2023 to hospital-based otolaryngologists in Southwest China.

Methods: The survey nominated 10 topics within pediatric dysphonia and asked the participants to rate their knowledge and confidence for 10 topics. The attitude toward the importance of managing pediatric dysphonia and its practice patterns for the disorder were also asked.

Results: A total of 334 responses were received. The results showed that otolaryngologists in Southwest China did not receive complete coverage of specific topics within pediatric dysphonia during their specialist training. Their self-rated knowledge sufficiency and confidence for the same topics were relatively neutral, indicating neither negative nor positive self-perceptions of competency. The majority of respondents held the attitude that managing pediatric dysphonia is important, and nominated specific topics within this field for continuing professional education. Common facilitators of practice were clinical skills and knowledge of pediatric dysphonia, and common barriers were the lack of professional guidelines and qualified speech-language pathologists (SLPs) in Southwest China.

Conclusion: Otolaryngologists in Southwest China do not receive sufficient training for the management of pediatric dysphonia, however, they perceive this field as important and seek further training from continuing education programs. The findings identified knowledge and training that should be targeted in official training and professional development courses for otolaryngologists who manage pediatric dysphonia without the support of SLPs.

Introduction: Spasmodic dysphonia a voice disorder characterized by loss of voluntary control of vocal fold movements during speech production. The pathophysiology is not well understood, but there have been proposed connections to areas within the brain such as the reticular formation surrounding the tractus solitarius, spinal trigeminal and ambiguus nuclei, inferior olive, and pyramids.

Objective: To determine whether there are differences on brain Magnetic resonance imaging (MRI) with and without gadolinium in patients affected by spasmodic dysphonia compared with those without to determine whether there is a central process involved in spasmodic dysphonia (SD) pathophysiology.

Methods: This was a retrospective review of patients from January 1995 through January 2023. Information from patient charts included age, sex, chief complaint, present and past medical/surgical history, social history, laryngeal Electromyography, and MRI scan results. MRI of the head had to have been performed with and without gadolinium. MRI scan reports were evaluated for the presence or absence of hyperintensities and or hypointensities on T1, T2, or Fluid-attenuated inversion recovery within specific regions of the brain. This information was compared between groups to determine whether SD patients have an increased prevalence of Central nervous system pathology and to determine the location of pathology. Data were analyzed for relationships and significance.

Results: Seventy-two SD patients were included. Most study patients had adductor SD, with a 2.6:1 ratio of adductor to abductor. The SD patients were age and sex matched with patients who had otologic and laryngologic complaints. MRI abnormalities were found in the periventricular white matter, cerebral white matter, and frontal white matter.

Conclusions: There are no significant differences in the locations of hyperintensities and hypointensities on MRI of the brain with and without gadolinium in spasmodic dysphonia patients when compared to otologic and laryngologic controls.