Journal of Voice最新文献

Objective(s): To assess the prevalence of Helicobacter pylori in Reinke's edema patients. To evaluate and compare the disease severity of patients who are H. pylori positive with those who are H. pylori negative.

Methods: In this prospective study, subjects were recruited at the time of Reinke's edema diagnosis using flexible laryngoscopy between March of 2022 through August of 2022. Participants completed a Voice Handicap Index (VHI-10) survey and then underwent a H. pylori IgG blood test to identify infection. The severity of Reinke's edema, grade, and type were determined by a fellowship trained laryngologist.

Results: Thirty one patients participated. The cohort was 19% male. 38.7% of the cohort had a positive H. pylori test. Men had significantly greater smoking exposure in pack years than women (P = 0.003). Interestingly, the total VHI-10 score was significantly greater in patients negative for H. pylori (P = 0.05). This was also true for four of the VHI-10 domains. Patients positive for H. pylori had significantly more severe Reinke's edema in terms of type (P = 0.03) and grade (P = 0.01).

Conclusions: There is a significant relationship between H. pylori status and the severity of Reinke's edema, with patients H. pylori positive having a greater grade and type of Reinke's edema. There is also a significant inverse relationship between H. pylori status and dysphonia, a subjective Reinke's symptom.

Level of evidence: III.

Objectives: The purpose of this study was to analyze cepstral changes following intensive voice-focused treatment in Spanish speakers with Parkinson's disease (PD). A secondary aim of the study was to explore the relationship between cepstral values across time and perceptual data across speech subsystems.

Study design/methods: This study followed a one-group pretest-post test design. The smoothed cepstral peak prominence (CPPS) of conversational sentences was analyzed pretreatment and post treatment and at a 1-month follow-up session in 15 Spanish-speaking individuals with PD. A secondary data analysis was then conducted to examine CPPS values relative to perceptual changes in voice quality (VQ), ease of understanding, articulatory precision, resonance (RES), and prosody across time points.

Results: A significant difference in CPPS was established between speakers with mild and moderate dysarthria at pre treatment only. No significant differences were observed between groups at post treatment or follow-up. Within groups, both sets of speakers evidenced significant increases in CPPS post treatment as well as from pre treatment to follow-up. A positive and statistically significant correlation was observed between CPPS scores and the perceptual values for VQ and RES, irrespective of the stage of treatment.

Conclusions: Intensive voice-focused treatment may lead to improved VQ, as measured by the CPPS, in ecologically valid contexts, such as those involving conversations, with gains maintained in the short-term. Additionally, this type of treatment may result in a positive distribution of effects involving not just perceived VQ but also improved perception of RES.

Background: The neck, and specifically the prominence of the thyroid cartilage, can be considered a marker of male gender, which is often unwanted by transgender women. Chondrolaryngoplasty is traditionally performed using an open transcervical approach, which, while effective, leaves visible scars that can compromise patient satisfaction. Recent advancements, such as the transoral endoscopic vestibular approach (TOEVA), have emerged as promising alternatives, eliminating external scars and improving esthetic outcomes.

Methods: Endoscope-guided transoral buccal dissections of five human cadavers' necks were performed to visualize and expose the thyroid cartilage, followed by the chondrolaryngoplasty procedure by the same route. The technique involved three oral vestibule incisions for trocar placement, subplatysmal dissection, and resection of the thyroid cartilage prominence using laparoscopic instruments. A specially designed endoscopic rasp was utilized to refine cartilage contours.

Results: Chondrolaryngoplasty using a transoral approach proved feasible, allowing the thyroid prominence to be reduced without an apparent scar. Visualization and instrument manipulation were successful in three cases, with adaptations required in two cases due to rigor mortis altering anatomical positioning. Complications included two minor skin perforations and instrument breakage in a case with calcified cartilage, necessitating alternative tools. There were some complications related to cadaveric phenomena.

Conclusion: Performing the procedure on cadavers presented some limitations related to cadaveric phenomena, such as skin stiffness and loss of elasticity, as well as difficulties with mobility, making the surgical procedure difficult. Despite these challenges, the procedure achieved satisfactory esthetic outcomes, with precise cartilage reduction and no visible scars. The procedure proved to be viable, achieving the goal of reducing the prominence of the thyroid cartilage while avoiding an apparent scar. Further clinical studies are suggested.

Objectives: As professional voice users, speech and language pathologists (SLPs) follow vocal hygiene behaviors both in the rehabilitation of voice disorders and in preventive interventions to reduce the risk among healthy users. However, it is curious to what extent SLPs adhere to vocal hygiene and healthy vocal behaviors and how this affects vocal fatigue. This study aims to investigate the extent to which SLPs perform vocal hygiene behaviors, their levels of vocal hygiene, and vocal fatigue.

Method: An online survey with 22 questions was developed to assess participants' healthy vocal behavior. In addition, the Voice Fatigue Index was employed to determine participants' levels of vocal fatigue. These two data collection tools were sent online to intern speech and language therapy students and professionals in Türkiye. Including student and professional SLPs, a total of 120 individuals partook in the study. The data were analyzed through SPSS 23.0. Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, ANOVA, pearson correlation, and Tukey post hoc test.

Results: Almost half of the participants (40.8%) stated they were careful about vocal health. No significant difference was concluded between the student and professional SLPs in terms of compliance with the vocal hygiene behaviors. Vocal Fatigue Index scores of both groups were high, but significantly high for the professionals (P < 0.05).

Conclusion: SLPs, an intern or not, seem to find it difficult to fully practice what they preach, leading to concerning fatigue levels. SLPs should regulate their living conditions to comply more with appropriate vocal hygiene behaviors.

Introduction: Patient-reported outcome measures (PROMs) represent an important part of a comprehensive voice assessment for clinical care and research. Access to multilingual PROMs enables inclusion of information from diverse patient populations. This review compares available translated and validated PROMs for adult dysphonia.

Methods: A comprehensive review of Cochrane Library, PubMed, and OnBase was performed for PROMs evaluating adult dysphonia in all languages. References were additionally queried. PROM development process, available languages, and study group demographics were compared between PROMs available in at least one language other than English. Cultural validation for each PROM was assessed against Beaton et al's six-stage cross-cultural adaptation guidelines.

Results: Of 21 PROMs assessing adult dysphonia, 13 (62%) were available in one or more language other than English, and nine (43%) were available in seven or more. Voice Handicap Index (VHI) and VHI-10 were the most widely available translated questionnaires (n = 29, n = 15) followed by Vocal Fatigue Index (VFI), Singing-VHI (S-VHI), and Voice-Related Quality of Life (V-RQOL) (n = 11). Identified questionnaires were available in English (n = 21), Persian (n = 9), Kannada (n = 8), and Turkish (n = 7) as the most common languages. Females averaged 60% (range 13%-81%) of dysphonic subject groups and 59% of non-dysphonic subject groups (range 20%-88%). Of the 113 articles that reported cultural validation techniques, 16 (14%) adequately fulfilled the cross-cultural adaptation guidelines used.

Conclusion: Multilingual PROMs for dysphonia are widely available, but linguistic representation varied. VHI, VFI, S-VHI, and V-RQOL are the most widely translated. The most represented languages were Persian, Kannada, and Turkish. Few studies adequately followed cross-cultural adaptation standards. Efforts to translate and validate questionnaires into different languages may allow more diverse assessment and comparison of larger populations with dysphonia. This review identifies translated PROMs for dysphonia and analyzes their level of cultural validation for future use.

Objective: To systematically assess the current state of speech-language-hearing (SLH) practices in health services addressing vocal care for transgender individuals, aiming to identify key themes and gaps in the existing body of knowledge.

Methods: This scoping review was based on the Joanna Briggs Institute manual and followed the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses-Extension for Scoping Reviews. It was registered with the Open Science Framework Open Source 10.17605/OSF.IO/BUCRG.

Results: Altogether, 1517 studies were found. After excluding duplicates and applying the eligibility criteria, 103 articles were chosen for the review. The studies addressed topics such as vocal training, case/experience reports, barriers to access services, SLH pathologists' and students' perception and knowledge about the transgender voice, evaluation of programs and services, transgender people's perception and knowledge about their own voice and SLH care, acoustic/auditory-perceptual evaluation, protocols, instruments, impacts of voice on quality of life, verbal and nonverbal communication, and hormone therapy and surgeries.

Conclusions: The summary of the studies reflects the diversity of methods applied in research on transgender people's communication and voice, as well as the variety of topics. Despite the increasing publications on vocal care for transgender people, it is necessary to ensure the dissemination of evidence to support effective practices that recognize and enhance the diversity of this population. Literature data have promising SLH procedures and useful protocols to assess this population. However, they do not clearly indicate what the transgender population actually wants and needs. Furthermore, the study types have not progressed in a coherent order-that is, from preliminary studies to those with more robust methods. Thus, such knowledge may lack consolidation. Many answers to questions in both clinical and academic practices are still not entirely clear. However, it is believed that the advancement of studies will clarify them.

Objective: The aim is to examine the Reflux Symptom Score-12 (RSS-12) and assess the effectiveness of vonoprazan fumarate in managing laryngopharyngeal reflux disease (LPRD) among the Chinese population.

Methods: A total of 140 patients with LPRD who were treated at our otorhinolaryngology outpatient clinic were included. The patients were randomly divided into the vonoprazan treatment group and the esomeprazole treatment group. The outcome indicators were the pretreatment and post treatment values of the Reflux Symptom Index (RSI), RSS-12, and reflux finding score.

Results: The mean pretreatment RSS-12 and RSI values were 55.79 ± 11.94 and 18.67 ± 3.60 in the vonoprazan treatment group and 54.91 ± 11.95 and 18.44 ± 3.66 in the esomeprazole treatment group, respectively. Furthermore, both groups showed a significant decrease in the RSI and RSS-12 values after 4, 8, and 12 weeks of acid suppression therapy. In particular, 12 weeks of treatment led to a good treatment response in 91.4% and 87.1% of the patients in the vonoprazan treatment and esomeprazole treatment groups, respectively, based on their RSI values, and a favorable treatment response in 82.9% and 77.1% of those in the vonoprazan treatment and esomeprazole treatment groups, respectively, according to their RSS-12 values. More importantly, after 4 and 8 weeks of acid-suppressive therapy, the relative baseline change in RSS-12 scores in the vonoprazan treatment group was considerably larger than that in the omeprazole treatment group.

Conclusion: Compared to proton pump inhibitors (PPIs), vonoprazan fumarate has demonstrated superior early therapeutic efficacy, resulting in a notable improvement in laryngopharyngeal reflux symptoms at the start of treatment. When we extended acid-suppressive medication for 12 weeks, we saw a treatment effect comparable to that of PPIs.

Background: Voice analysis has emerged as a potential biomarker for mood state detection and monitoring in bipolar disorder (BD). The systematic review aimed to summarize the evidence for voice analysis applications in BD, examining (1) the predictive validity of voice quality outcomes for mood state detection, and (2) the correlation between voice parameters and clinical symptom scales.

Methods: A PubMed, Scopus, and Cochrane Library search was carried out by two investigators for publications investigating voice quality in BD according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. Studies were assessed using the modified methodological index for non-randomized studies (MINORS).

Results: Of the 400 identified publications, 16 studies met the inclusion accounting for 575 BD patients. Machine learning approaches were implemented in 87.5% of studies, with classification accuracies ranging from 70.9% to 96.9%. Manic state detection showed the strongest predictive validity [area under the curve (AUC) up to 0.89], while depression detection demonstrated moderate performance (AUC: 0.66-0.78). Individual-specific models outperformed population-level approaches (correlation coefficients: 0.78 versus 0.44). Voice quality showed significant correlations with standardized clinical scales, particularly Young Mania Rating Scale and Hamilton Depression Rating Scale (normalized root mean square errors: 1.985 and 3.945, respectively). Prosodic features were examined in 81.25% of studies, with pitch consistently elevated during manic episodes. MINORS varied from 10 to 14, with notable limitations in sample size calculations and blinding procedures.

Conclusions: Voice quality is a promising biomarker in BD, particularly for manic state detection and individualized monitoring. While controlled settings showed strong performance, naturalistic applications yielded more modest results. Future research should focus on standardizing protocols across different environments and conducting large-scale longitudinal studies with robust methodological controls.

Objectives: To compare certain acoustic, aerodynamic, and perceptual parameters before and after an hour-long class to analyze vocal loading characteristics in female Bharatanatyam dance teachers.

Study design: Prospective study.

Method: The study included 52 female Bharatanatyam dance teachers aged 19 to 40years. A brief case history was taken to recruit the participants and document the essential details. Multiparametric voice assessment was done before and after an hour-long dance class for the parameters Mean Intensity, Mean Pitch, Pitch Standard Deviation, Harmonics to Noise Ratio, Jitter percentage, Shimmer, Cepstral Peak Prominence, Acoustic Voice Quality Index, s/z ratio, Maximum Phonation Time (MPT), GRBAS, and Voice-Related Quality of Life assessment.

Results: Acoustic Voice Quality Index values above 2.22 in 65.38% of participants before class, indicative of dysphonia. The mean Voice-Related Quality of Life score was 1.98±1.67. The Wilcoxon signed-rank test showed significant differences in mean intensity (P=0.00) and jitter percentage (P=0.012). The paired t test revealed significant differences in mean pitch (P=0.00), Cepstral Peak Prominence (P=0.027), and MPT (P=0.00). No significant difference was found in the GRBAS grade evaluation (P=0.439) before and after the class.

Conclusion: In the present study, significant changes in several acoustic parameters, MPT, and Acoustic Voice Quality Index indicating dysphonia, highlight the impact of vocal loading on the voice of female Bharatanatyam dance teachers.

Background: Methods to elicit the vital capacity (VC) include forced vital capacity (FVC) and slow vital capacity (SVC). Because the FVC maneuver can be affected by air trapping or inefficiencies in lung emptying vs. the SVC, the SVC-FVC difference may be substantial and diagnostically meaningful in elderly individuals and patients with respiratory obstruction. However, the degree of SVC-FVC difference in non-respiratory disordered individuals is unclear - some studies indicate a negligible difference, and other studies/guidelines suggest a mean difference in this target group up to 200 mL. This study examined the relationship between FVC vs. SVCs in a group of typical young adult speakers with three forms of measurement device (pneumotach-based; turbine flow meter; vortex whistle).

Methods: FVC and SVCs were collected from 66 non-respiratory disordered subjects (18-30 years) using three methods: a pneumotach system (KoKo Sx1000); a turbine flow spirometer (Micro Spirometer); and 3-D printed vortex whistles and analysis software. FVC and SVC measures were compared and correlated.

Results: The upper limit of the 95% CIs for the mean SVC-FVC difference were observed to be < 60-115 mL, depending upon the measurement system used. However, mean SVC-FVC differences were nonsignificant in all methods. Strong correlations between FVC vs. SVC were observed within each device (r's > 0.95), and both FVC and SVC measurements were highly correlated between devices (r's > 0.90).

Conclusion: Mean SVC tends to be slightly greater than mean FVC, though this difference is nonsignificant in typical young adult subjects, making VC measures from SVC vs. FVC essentially interchangeable in this target group. Any SVC vs. FVC differences are detectable via both pneumotach-based spirometry and lower-cost technologies. The SVC method has several benefits vs. FVC for speech-language pathologists who may be conducting VC testing with a large variety of patient groups in diverse (often non-medical) settings.