Pub Date : 2024-11-01DOI: 10.1016/j.jvoice.2022.04.013
Mehmet Emrah Cangi , Göksu Yılmaz , Emine Tabak , Ayşe Nur Duran , Tuğba Kaya
Objective
Within the scope of semi-occluded vocal tract exercises (SOVTEs), we aimed to examine the effects of four exercise combinations, which involved various fluid densities and tube submersion depths, on acoustic and electroglottographic (EGG) parameters.
Methods
Four procedures (P) were applied consecutively to 30 female participants with normal voices using different tube submersion depths and fluid densities, including P1 (2 cm, water), P2 (2 cm, nectar), P3 (10 cm, water), and P4 (10 cm, nectar). Nasometric (Nasometer II model 6450) and EGG (Electroglottograph model 6103) measurements were taken before the procedures were initiated (pre-test) and at the end of each procedure. In addition, EGG measurements were taken for each procedure during the application.
Results
For all three velar positions (oral passage, oro-nasal passage, nasal passage), the only procedure that caused a significant change compared to the pre-test stage in regard to nasalance score was P2 (2 cm nectar) in common. All other procedures except P1 (2 cm water) significantly increased velar closure compared to pre-test levels. However, when the differences between the exercises were examined, the least velar closure, compared to the other procedures, was obtained after P4 (10 cm nectar). While there was no significant difference between the procedures in the EGG measurements during the exercise, a significantly higher tendency to contact was observed after the procedures with a denser consistency, and an increase in the fundamental frequency (fo) values occurred in the pairwise comparisons of the procedures in the measurements after the exercises.
Conclusion
In SOVTEs in which water phonation is performed with a tube, the use of a fluid with a consistency denser than water can be considered a particularly promising approach. In addition, exercises performed with increasing consistencies in 2 cm depth can provide more vocal cord and velopharyngeal port closure by increasing EGG-CQ and nasalance score values. However, more care should be taken while increasing the consistency at a submersion depth of 10 cm.
{"title":"Effect of Varied Tube Phonation in Water Exercises on Nasometric and Electroglottographic parameters: Modification in Terms of Fluid Density and Tube Submerged Depth","authors":"Mehmet Emrah Cangi , Göksu Yılmaz , Emine Tabak , Ayşe Nur Duran , Tuğba Kaya","doi":"10.1016/j.jvoice.2022.04.013","DOIUrl":"10.1016/j.jvoice.2022.04.013","url":null,"abstract":"<div><h3>Objective</h3><div>Within the scope of semi-occluded vocal tract exercises (SOVTEs), we aimed to examine the effects of four exercise combinations, which involved various fluid densities and tube submersion depths, on acoustic and electroglottographic (EGG) parameters.</div></div><div><h3>Methods</h3><div>Four procedures (P) were applied consecutively to 30 female participants with normal voices using different tube submersion depths and fluid densities, including P1 <em>(2 cm, water)</em>, P2 <em>(2 cm, nectar)</em>, P3 <em>(10 cm, water)</em>, and P4 <em>(10 cm, nectar)</em>. Nasometric (Nasometer II model 6450) and EGG (Electroglottograph model 6103) measurements were taken before the procedures were initiated (pre-test) and at the end of each procedure. In addition, EGG measurements were taken for each procedure during the application.</div></div><div><h3>Results</h3><div>For all three velar positions (oral passage, oro-nasal passage, nasal passage), the only procedure that caused a significant change compared to the pre-test stage in regard to nasalance score was P2 <em>(2 cm nectar)</em> in common. All other procedures except P1 <em>(2 cm water)</em> significantly increased velar closure compared to pre-test levels. However, when the differences between the exercises were examined, the least velar closure, compared to the other procedures, was obtained after P4 <em>(10 cm nectar)</em>. While there was no significant difference between the procedures in the EGG measurements during the exercise, a significantly higher tendency to contact was observed after the procedures with a denser consistency, and an increase in the fundamental frequency <em>(f<sub>o</sub>)</em> values occurred in the pairwise comparisons of the procedures in the measurements after the exercises.</div></div><div><h3>Conclusion</h3><div><span>In SOVTEs in which water phonation is performed with a tube, the use of a fluid with a consistency denser than water can be considered a particularly promising approach. In addition, exercises performed with increasing consistencies in 2 cm depth can provide more </span>vocal cord and velopharyngeal port closure by increasing EGG-CQ and nasalance score values. However, more care should be taken while increasing the consistency at a submersion depth of 10 cm.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"38 6","pages":"Pages 1521.e39-1521.e48"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84661543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jvoice.2022.04.006
Abdullah Alarfaj, Khalid Alyahya, Halal Alutaibi, Maryam Alarfaj, Fai Alhussain
Purpose
The goal of this study is to determine how online education affects the vocal health of schoolteachers in Saudi Arabia's Eastern Province. Teachers' phono trauma is well-known as a serious occupational hazard, and online education was the primary mode of delivering instruction to students during COVID-19.
Methods
This is a descriptive cross-sectional study conducted among teachers in the Eastern Province area of Saudi Arabia. Teachers completed a self-administered questionnaire via an online platform, which included socio-demographic data, academic status, and the Voice Handicap Index-10 questionnaire, which assessed their vocal difficulties.
Results
A total of 335 teachers responded to the survey (78.2% females vs. 21.8% males). Nearly half (48.7%) were primary school teachers. 45.7% were currently teaching distance learning. Earphones and microphones (49.3%) were the most commonly used distance learning accessories. Noise in the classroom was a very much disturbing factor in teaching implied by 44.8% of the teachers. During the COVID-19 pandemic, the vocal handicap index-10 was significantly higher among females (P = 0.007), primary school teachers (P < 0.001), moreover those currently teaching distance learning (P = 0.001) and those who perceived that there is more work in distance teaching (P < 0.001).
Conclusion
Compared to in-person teaching, online teaching may have a positive impact on vocal health among Saudi teachers. Of all the teachers, phono trauma tends to be more among females who were primary school teachers, currently teaching distance learning, and those who perceived distance learning to be laborious.
{"title":"The Effect of Online Teaching on Vocal Health Among Saudi Teachers During COVID-19 Pandemic","authors":"Abdullah Alarfaj, Khalid Alyahya, Halal Alutaibi, Maryam Alarfaj, Fai Alhussain","doi":"10.1016/j.jvoice.2022.04.006","DOIUrl":"10.1016/j.jvoice.2022.04.006","url":null,"abstract":"<div><h3>Purpose</h3><div>The goal of this study is to determine how online education affects the vocal health of schoolteachers in Saudi Arabia's Eastern Province. Teachers' phono trauma is well-known as a serious occupational hazard, and online education was the primary mode of delivering instruction to students during COVID-19.</div></div><div><h3>Methods</h3><div>This is a descriptive cross-sectional study conducted among teachers in the Eastern Province area of Saudi Arabia. Teachers completed a self-administered questionnaire via an online platform, which included socio-demographic data, academic status, and the Voice Handicap Index-10 questionnaire, which assessed their vocal difficulties.</div></div><div><h3>Results</h3><div>A total of 335 teachers responded to the survey (78.2% females vs. 21.8% males). Nearly half (48.7%) were primary school teachers. 45.7% were currently teaching distance learning. Earphones and microphones (49.3%) were the most commonly used distance learning accessories. Noise in the classroom was a very much disturbing factor in teaching implied by 44.8% of the teachers. During the COVID-19 pandemic, the vocal handicap index-10 was significantly higher among females (<em>P</em> = 0.007), primary school teachers (<em>P</em> < 0.001), moreover those currently teaching distance learning (<em>P</em> = 0.001) and those who perceived that there is more work in distance teaching (<em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Compared to in-person teaching, online teaching may have a positive impact on vocal health among Saudi teachers. Of all the teachers, phono trauma tends to be more among females who were primary school teachers, currently teaching distance learning, and those who perceived distance learning to be laborious.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"38 6","pages":"Pages 1526.e1-1526.e10"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9010247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43413908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jvoice.2022.04.005
Giorgia Mari , Maria Raffaella Marchese , Ylenia Longobardi , Ilaria Proietti , Maria Elisabetta Marenda , Tiziana Di Cesare , Lucia D'Alatri
Objective
To evaluate results of telerehabilitation (TR) during the coronavirus disease 2019 pandemic for the treatment of dysphonia caused by permanent post-thyroidectomy unilateral vocal fold paralysis (UVFP).
Methods
Forty subjects with post-thyroidectomy UVFP (onset <1 month) underwent TR. Videostrobolaryngoscopy, acoustic and perceptual voice analysis and patient self-assessment were carried out in person before, at the end of TR and 6 months later.
Results
Twenty-five subjects spontaneously recovered full vocal fold motility at some time during follow-up, whereas 15 had a permanent UVFP at the end of the follow-up period. These subjects constituted our study group. At the early posttherapy control 10/15 subjects (66.6%) showed a complete glottal closure, while in 5/15 (33.3%) a glottal gap remained (P = 0.03). These results did not change 6 months after TR. At the late posttherapy control the maximum phonation time improved significantly (P = 0.02). Both post-therapy Voice Handicap Index scores were significantly lower than the pre-therapy ones (P = 0.04). Grade, Breathiness, and Asthenia parameters of the Grade–Roughness–Breathiness–Asthenia–Strain scale improved 6 months after TR (P < 0.05). The number of voice signals suitable for acoustic analysis increased significantly after therapy. Finally, 87% of patients were satisfied with TR.
Conclusions
With careful patient selection, TR may be considered as a promising method for voice therapy in postthyroidectomy UVFP.
{"title":"Voice Telerehabilitation in Iatrogenic Unilateral Vocal Fold Paralysis: From Necessity to Opportunity in the COVID-19 Time","authors":"Giorgia Mari , Maria Raffaella Marchese , Ylenia Longobardi , Ilaria Proietti , Maria Elisabetta Marenda , Tiziana Di Cesare , Lucia D'Alatri","doi":"10.1016/j.jvoice.2022.04.005","DOIUrl":"10.1016/j.jvoice.2022.04.005","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate results of telerehabilitation<span> (TR) during the coronavirus disease 2019<span> pandemic for the treatment of dysphonia<span> caused by permanent post-thyroidectomy unilateral vocal fold paralysis (UVFP).</span></span></span></div></div><div><h3>Methods</h3><div>Forty subjects with post-thyroidectomy UVFP (onset <1 month) underwent TR. Videostrobolaryngoscopy, acoustic and perceptual voice analysis and patient self-assessment were carried out in person before, at the end of TR and 6 months later.</div></div><div><h3>Results</h3><div>Twenty-five subjects spontaneously recovered full vocal fold motility at some time during follow-up, whereas 15 had a permanent UVFP at the end of the follow-up period. These subjects constituted our study group. At the early posttherapy control 10/15 subjects (66.6%) showed a complete glottal closure, while in 5/15 (33.3%) a glottal gap remained (<em>P</em><span> = 0.03). These results did not change 6 months after TR. At the late posttherapy control the maximum phonation time improved significantly (</span><em>P</em> = 0.02). Both post-therapy Voice Handicap Index scores were significantly lower than the pre-therapy ones (<em>P</em><span> = 0.04). Grade, Breathiness, and Asthenia parameters of the Grade–Roughness–Breathiness–Asthenia–Strain scale improved 6 months after TR (</span><em>P</em><span> < 0.05). The number of voice signals suitable for acoustic analysis increased significantly after therapy. Finally, 87% of patients were satisfied with TR.</span></div></div><div><h3>Conclusions</h3><div>With careful patient selection, TR may be considered as a promising method for voice therapy in postthyroidectomy UVFP.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"38 6","pages":"Pages 1525.e15-1525.e22"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75469064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jvoice.2022.05.005
Karol Myszel , Agata Szkiełkowska
<div><div><span>Partial deafness is a condition characterised by normal </span>hearing thresholds<span><span><span> in low frequencies and increased hearing thresholds (nearly deafness) for high frequencies. Typical hearing aids are rather of a very limited use in this condition as they do not improve understanding of speech. Patients with partial deafness can be presently treated with cochlear implants, which had not been used before due to the risk of damage of hearing remains by electrode introduced into cochlea. The purpose of our study was an objective and subjective assessment of voice quality in partial deafness patients before and after </span>cochlear implantation. The subjects in this study were 25 post-lingual, bilaterally partially deaf patients, 13 females and 12 males. The reference group composed of 55 normal hearing individuals (28 females and 27 males). The </span>acoustic analysis was performed with a multidimensional voice analysis MDVP (Multi Dimension Voice Program), and the subjective assessment was done with GRBAS scale. Initial analysis of voice changes in partial deafness patients was performed versus normal hearing individuals, then voice parameters were measured and perceptual voice assessment was done before and 9 months after cochlear implantation. Measurements of acoustic voice parameters in partially deaf patients showed changes in most of frequency, amplitude, noise and subharmonic components versus normal hearing control group. The most significant, statistically important changes were observed in fundamental frequency variation (vF0), absolute jitter (Jita), jitter percent (Jitt), amplitude perturbation quotient (APQ), smoothed amplitude perturbation quotient (sAPQ), relative average perturbation (RAP), peak amplitude variation (vAm), relative amplitude modulation (Shim), percent shimmer (%Shim), pitch perturbation quotient (PPQ), smoothed pitched perturbation quotient (sPPQ), degree of subharmonics (DSH), degree of voiceless (DUV), number of subharmonic segments (NSH), noise-to-harmonic ratio (NHR), voice turbulence index (VTI). All patients in the study group were subjects to cochlear implantation. After 9 months objective and subjective assessment of patients` voices were performed again. Statistically important changes were identified in average fundamental frequency variability (vF0), relative amplitude modulation index (ShdB), noise-to-harmonic ratio (NHR), number of subharmonics NSH, degree of subharmonics (DSH) and the degree of voiceless (DUV). Comparison of the objective voice parameters changes after cochlear implantation with subjective, perceptual voice quality assessments leads to observation, that improvement of subjective voice quality after cochlear implantation takes place parallelly with improvement of certain objective acoustic voice parameters and some correlations exist. We found, that G correlates with vF0 and Shim, R correlates with DSH and NSH, B correlates with NSH and NHR, A correlates
{"title":"Quality of Voice in Patients With Partial Deafness Before and After Cochlear Implantation","authors":"Karol Myszel , Agata Szkiełkowska","doi":"10.1016/j.jvoice.2022.05.005","DOIUrl":"10.1016/j.jvoice.2022.05.005","url":null,"abstract":"<div><div><span>Partial deafness is a condition characterised by normal </span>hearing thresholds<span><span><span> in low frequencies and increased hearing thresholds (nearly deafness) for high frequencies. Typical hearing aids are rather of a very limited use in this condition as they do not improve understanding of speech. Patients with partial deafness can be presently treated with cochlear implants, which had not been used before due to the risk of damage of hearing remains by electrode introduced into cochlea. The purpose of our study was an objective and subjective assessment of voice quality in partial deafness patients before and after </span>cochlear implantation. The subjects in this study were 25 post-lingual, bilaterally partially deaf patients, 13 females and 12 males. The reference group composed of 55 normal hearing individuals (28 females and 27 males). The </span>acoustic analysis was performed with a multidimensional voice analysis MDVP (Multi Dimension Voice Program), and the subjective assessment was done with GRBAS scale. Initial analysis of voice changes in partial deafness patients was performed versus normal hearing individuals, then voice parameters were measured and perceptual voice assessment was done before and 9 months after cochlear implantation. Measurements of acoustic voice parameters in partially deaf patients showed changes in most of frequency, amplitude, noise and subharmonic components versus normal hearing control group. The most significant, statistically important changes were observed in fundamental frequency variation (vF0), absolute jitter (Jita), jitter percent (Jitt), amplitude perturbation quotient (APQ), smoothed amplitude perturbation quotient (sAPQ), relative average perturbation (RAP), peak amplitude variation (vAm), relative amplitude modulation (Shim), percent shimmer (%Shim), pitch perturbation quotient (PPQ), smoothed pitched perturbation quotient (sPPQ), degree of subharmonics (DSH), degree of voiceless (DUV), number of subharmonic segments (NSH), noise-to-harmonic ratio (NHR), voice turbulence index (VTI). All patients in the study group were subjects to cochlear implantation. After 9 months objective and subjective assessment of patients` voices were performed again. Statistically important changes were identified in average fundamental frequency variability (vF0), relative amplitude modulation index (ShdB), noise-to-harmonic ratio (NHR), number of subharmonics NSH, degree of subharmonics (DSH) and the degree of voiceless (DUV). Comparison of the objective voice parameters changes after cochlear implantation with subjective, perceptual voice quality assessments leads to observation, that improvement of subjective voice quality after cochlear implantation takes place parallelly with improvement of certain objective acoustic voice parameters and some correlations exist. We found, that G correlates with vF0 and Shim, R correlates with DSH and NSH, B correlates with NSH and NHR, A correlates ","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"38 6","pages":"Pages 1531.e5-1531.e11"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73778501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jvoice.2022.04.011
Daniel W. Furnas, Judith M. Wingate
Objective
To investigate the self-reported effects of mask usage on vocal fatigue and number of vocal complaints of high school and college educators.
Method
Forty teachers at high schools and universities who reported using masks to teach in person during the Spring 2020 to Fall 2020 semesters completed an anonymous survey regarding self-report of teaching history, vocal use, vocal complaints, and vocal health. Responses were analyzed using descriptive statistics and t tests.
Results
Survey participants reported an increase in all forms of vocal complaints investigated despite an increase in amplification use. Participants also reported a decrease in daily water consumption between eight and 16 ounces of water when wearing a mask in the classroom compared to teaching prior to coronavirus disease 2019. Participants also reported a significant increase in vocal effort while teaching in a mask (P < 0.001).
Conclusion
Educators reported a significant effect of increased vocal complaints and decreased water intake while wearing masks. The decrease in water consumption and increase in vocal effort may lead to more frequent vocal complaints in teachers at the high school and college level.
{"title":"The Effects of Mask Usage on Reported Vocal Health of Educators","authors":"Daniel W. Furnas, Judith M. Wingate","doi":"10.1016/j.jvoice.2022.04.011","DOIUrl":"10.1016/j.jvoice.2022.04.011","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the self-reported effects of mask usage on vocal fatigue and number of vocal complaints of high school and college educators.</div></div><div><h3>Method</h3><div>Forty teachers at high schools and universities who reported using masks to teach in person during the Spring 2020 to Fall 2020 semesters completed an anonymous survey regarding self-report of teaching history, vocal use, vocal complaints, and vocal health. Responses were analyzed using descriptive statistics and <em>t</em> tests.</div></div><div><h3>Results</h3><div><span>Survey participants reported an increase in all forms of vocal complaints investigated despite an increase in amplification use. Participants also reported a decrease in daily water consumption between eight and 16 ounces of water when wearing a mask in the classroom compared to teaching prior to coronavirus disease 2019. Participants also reported a significant increase in vocal effort while teaching in a mask (</span><em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Educators reported a significant effect of increased vocal complaints and decreased water intake while wearing masks. The decrease in water consumption and increase in vocal effort may lead to more frequent vocal complaints in teachers at the high school and college level.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"38 6","pages":"Pages 1530.e1-1530.e6"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87930980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jvoice.2022.05.002
Mathias Aaen , Cathrine Sadolin , Anna White , Reza Nouraei , Julian McGlashan
Background
Rough vocal effects, extreme, or extended vocal techniques to sound intentionally hoarse or rough are an integral part of many genres and styles, and research has recently demonstrated the involvement of supraglottic narrowing and vibrations to produce such sounds. The vocal health of singing with rough vocal effects is poorly documented, especially in a longitudinal manner, while much vocal pedagogy continuously treats the sounds as harming to or dangerous for the vocal mechanism.
Objective
To longitudinally investigate the vocal health of professional singers who perform the five rough-sounding vocal effects Distortion, Growl, Grunt, Rattle, and Creaking as part of their singing and teaching.
Methods
Twenty singers underwent nasoendoscopic examination, filled in SVHI questionnaires, and were assessed by GRBAS with a 14-year interval in a retrospective longitudinal study (from 2007 to 2021). Endoscopic materials were assessed by Reflux Finding Score and a hybrid version of the Stroboscopy Rating Scale.
Results
Singers presented at initiation of study with an average SVHI of 9.2 (±9), which decreased at time of follow up 14 years later to an average of 5.12 (±6). Laryngeal assessments (RFS and SRS) revealed low averages at initiation of study as well as at conclusion of the study with only small fluctuations in averages, with findings mainly relating to arytenoid asymmetry.
Conclusion
The participating singers perform and teach rough vocal effects continually and present with healthy laryngeal mechanisms and within-normal SVHI and GRBAS scores. The findings suggest that controlled supraglottic narrowing and techniques to allow for supraglottic structures to engage in vibration as an additional noise source can be performed sustainable and in a healthy manner if performed with correct vocal technique.
{"title":"Extreme Vocals—A Retrospective Longitudinal study of Vocal Health in 20 Professional Singers Performing and Teaching Rough Vocal Effects","authors":"Mathias Aaen , Cathrine Sadolin , Anna White , Reza Nouraei , Julian McGlashan","doi":"10.1016/j.jvoice.2022.05.002","DOIUrl":"10.1016/j.jvoice.2022.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Rough vocal effects, extreme, or extended vocal techniques to sound intentionally hoarse or rough are an integral part of many genres and styles, and research has recently demonstrated the involvement of supraglottic narrowing and vibrations to produce such sounds. The vocal health of singing with rough vocal effects is poorly documented, especially in a longitudinal manner, while much vocal pedagogy continuously treats the sounds as harming to or dangerous for the vocal mechanism.</div></div><div><h3>Objective</h3><div>To longitudinally investigate the vocal health of professional singers who perform the five rough-sounding vocal effects Distortion, Growl, Grunt, Rattle, and Creaking as part of their singing and teaching.</div></div><div><h3>Methods</h3><div>Twenty singers underwent nasoendoscopic examination, filled in SVHI questionnaires, and were assessed by GRBAS with a 14-year interval in a retrospective longitudinal study (from 2007 to 2021). Endoscopic materials were assessed by Reflux Finding Score and a hybrid version of the Stroboscopy Rating Scale.</div></div><div><h3>Results</h3><div>Singers presented at initiation of study with an average SVHI of 9.2 (±9), which decreased at time of follow up 14 years later to an average of 5.12 (±6). Laryngeal assessments (RFS and SRS) revealed low averages at initiation of study as well as at conclusion of the study with only small fluctuations in averages, with findings mainly relating to arytenoid asymmetry.</div></div><div><h3>Conclusion</h3><div>The participating singers perform and teach rough vocal effects continually and present with healthy laryngeal mechanisms and within-normal SVHI and GRBAS scores. The findings suggest that controlled supraglottic narrowing and techniques to allow for supraglottic structures to engage in vibration as an additional noise source can be performed sustainable and in a healthy manner if performed with correct vocal technique.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"38 6","pages":"Pages 1526.e11-1526.e22"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90442255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jvoice.2022.05.020
Mark L. Berardi , Eric J. Hunter
Objectives
The optimization of vocal effort given a response to a voice demand is a common clinical and vocal performance goal. Increases in vocal effort are often in response to communication limitations from both the interlocutors and the communication environment. This study investigates the relationship between vocal effort and vocal demands from changes and limitations imposed by the communication environment.
Methods
Thirty-seven participants rated their vocal effort associated with a map description task in a range of communication demands. These demands included communication distance (from 1 m to 4 m), loudness goal (54 dB–66 dB), and excess background noise (53 dBA–71 dBA). The vocal effort ratings were compared across the different types and extents of vocal demand conditions.
Results
As would be expected, there were significant increases in vocal effort levels from the control condition to the extremes of the distance and loudness goal vocal demands. Each increase in background noise resulted in distinct increases in vocal effort level. Participants were able to use the vocal effort scale to efficiently quantify expected increases in vocal demands.
Conclusions
Increases of vocal effort level accompany increases to vocal demands that exceed the habitual or expected communication. While voice training and vocal therapy are essential for reducing internal vocal demands, clients with a goal to reduce vocal effort should also consider external vocal demands such as communication distance and background noise.
{"title":"Self-Perception of Vocal Effort in Response to Modeled Communication Demands","authors":"Mark L. Berardi , Eric J. Hunter","doi":"10.1016/j.jvoice.2022.05.020","DOIUrl":"10.1016/j.jvoice.2022.05.020","url":null,"abstract":"<div><h3>Objectives</h3><div>The optimization of vocal effort given a response to a voice demand is a common clinical and vocal performance goal. Increases in vocal effort are often in response to communication limitations from both the interlocutors and the communication environment. This study investigates the relationship between vocal effort and vocal demands from changes and limitations imposed by the communication environment.</div></div><div><h3>Methods</h3><div>Thirty-seven participants rated their vocal effort associated with a map description task in a range of communication demands. These demands included communication distance (from 1 m to 4 m), loudness goal (54 dB–66 dB), and excess background noise (53 dBA–71 dBA). The vocal effort ratings were compared across the different types and extents of vocal demand conditions.</div></div><div><h3>Results</h3><div>As would be expected, there were significant increases in vocal effort levels from the control condition to the extremes of the distance and loudness goal vocal demands. Each increase in background noise resulted in distinct increases in vocal effort level. Participants were able to use the vocal effort scale to efficiently quantify expected increases in vocal demands.</div></div><div><h3>Conclusions</h3><div>Increases of vocal effort level accompany increases to vocal demands that exceed the habitual or expected communication. While voice training and vocal therapy are essential for reducing internal vocal demands, clients with a goal to reduce vocal effort should also consider external vocal demands such as communication distance and background noise.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"38 6","pages":"Pages 1344-1351"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9115857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jvoice.2022.05.016
Narihiro Kodama , Eiji Yumoto , Tetsuji Sanuki
Objective
To evaluate whether vocal function exercises (VFE) could be an adjunct treatment for patients with unilateral vocal fold paralysis (UVFP) who were not satisfied with their postoperative voices after reinnervation surgeries.
Study Design
Retrospective.
Methods
Medical records of the patients with UVFP who underwent laryngeal reinnervation between October 2011 and October 2014 were reviewed. Patients were classified into two groups: one received VFE according to patients’ desire (VFE group) and the other did not have voice therapy (control group). Effects of VFE were assessed by vocal fold vibration (regularity, amplitude and glottal gap), aerodynamic measurements (maximum phonation time (MPT) and mean airflow rate (MFR)), GRBAS scale, acoustic parameters (pitch range, pitch perturbation and amplitude perturbation quotients (PPQ, APQ), and noise-to-harmonics ratio (NHR)) and subjective evaluation by patients (Voice Handicap Index-10 (VHI-10)). Phonatory function was also compared between the two groups at three time points: before reinnervation surgery, before VFE, and after VFE.
Results
Thirty patients were enrolled (11 men, 19 women). The VFE group included eight patients, and 22 patients served as controls. In the VFE group, several parameters (amplitude, MPT, MFR, pitch range, APQ, and NHR) did not improve significantly after surgery, while all parameters examined improved significantly in the control group. After VFE, amplitude, glottal gap, MFR, B score, pitch range, and PPQ showed significant improvement, while the control group did not show a significant improvement except in VHI-10, during the corresponding period. Significant differences in G and B scores and VHI-10 between the two groups were observed at the third time point.
Conclusions
VFE may be used as an adjunct treatment for patients with UVFP who are not satisfied with their voices after reinnervation surgery. However, phonatory function after VFE may not reach the same level as for those who are satisfied with their voices after reinnervation surgery.
{"title":"Effect of Voice Therapy as a Supplement After Reinnervation Surgery for Breathy Dysphonia Due to Unilateral Vocal Fold Paralysis","authors":"Narihiro Kodama , Eiji Yumoto , Tetsuji Sanuki","doi":"10.1016/j.jvoice.2022.05.016","DOIUrl":"10.1016/j.jvoice.2022.05.016","url":null,"abstract":"<div><h3>Objective</h3><div><span>To evaluate whether vocal function exercises (VFE) could be an adjunct treatment for patients with unilateral vocal fold paralysis (UVFP) who were not satisfied with their postoperative voices after </span>reinnervation surgeries.</div></div><div><h3>Study Design</h3><div>Retrospective.</div></div><div><h3>Methods</h3><div><span>Medical records of the patients with UVFP who underwent laryngeal reinnervation between October 2011 and October 2014 were reviewed. Patients were classified into two groups: one received VFE according to patients’ desire (VFE group) and the other did not have voice therapy (control group). Effects of VFE were assessed by vocal fold vibration (regularity, amplitude and glottal gap), aerodynamic measurements (maximum </span>phonation time (MPT) and mean airflow rate (MFR)), GRBAS scale, acoustic parameters (pitch range, pitch perturbation and amplitude perturbation quotients (PPQ, APQ), and noise-to-harmonics ratio (NHR)) and subjective evaluation by patients (Voice Handicap Index-10 (VHI-10)). Phonatory function was also compared between the two groups at three time points: before reinnervation surgery, before VFE, and after VFE.</div></div><div><h3>Results</h3><div>Thirty patients were enrolled (11 men, 19 women). The VFE group included eight patients, and 22 patients served as controls. In the VFE group, several parameters (amplitude, MPT, MFR, pitch range, APQ, and NHR) did not improve significantly after surgery, while all parameters examined improved significantly in the control group. After VFE, amplitude, glottal gap, MFR, B score, pitch range, and PPQ showed significant improvement, while the control group did not show a significant improvement except in VHI-10, during the corresponding period. Significant differences in G and B scores and VHI-10 between the two groups were observed at the third time point.</div></div><div><h3>Conclusions</h3><div>VFE may be used as an adjunct treatment for patients with UVFP who are not satisfied with their voices after reinnervation surgery. However, phonatory function after VFE may not reach the same level as for those who are satisfied with their voices after reinnervation surgery.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"38 6","pages":"Pages 1369-1376"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40403901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jvoice.2022.05.018
Nurhayati Mohd Mossadeq , Khairy Anuar Mohd Khairuddin , Mohd Normani Zakaria
Auditory-perceptual rating of voice is one component of voice evaluation, and the CAPE-V is one of the tools for this purpose. Because of its advantages, the CAPE-V has been adapted into several languages. Accordingly, the adaptation of the CAPE-V into Malay is essential for its utility among the Malaysian population, which this study aimed to accomplish. This study involved translating the CAPE-V into Malay, termed the Malay CAPE-V, followed by establishing its validity. The translation processes (ie, forward translation and backward translation) involved four different translators ie, three speech-language therapists (SLTs), and one linguist with at least 14 years of experience. Most items were similarly translated, except for a few, which were subsequently accepted as similar, following consensus among the translators. In the examination of content validity, two raters (ie, SLTs) with at least 12 years of clinical experience reviewed and scored the tested items. Given that the scale-level content validity index average value (S-CVI/Ave) was above the acceptable level, all items were retained. The examination of construct validity and concurrent validity involved ratings of voice samples recorded from 38 participants, comprising 19 individuals with normal and disordered voices, respectively. The ratings were performed by three raters (ie, SLTs) with at least 12 years of clinical experience. For the construct validity, the Mann-Whitney U test indicated significantly higher scores of the vocal parameters of the Malay CAPE-V for the disordered voice group than for the normal voice group. Meanwhile, for the concurrent validity, the Spearman correlation indicated that all relationships between the scores of the vocal parameters of the Malay CAPE-V and GRBAS Scale were significant, with most of them achieving a very strong positive correlation. The results demonstrated that the Malay CAPE-V is a valid tool for an auditory-perceptual rating of voice among the Malaysian population.
{"title":"Cross-cultural Adaptation of the Consensus Auditory-perceptual Evaluation of Voice (CAPE-V) Into Malay: A Validity Study","authors":"Nurhayati Mohd Mossadeq , Khairy Anuar Mohd Khairuddin , Mohd Normani Zakaria","doi":"10.1016/j.jvoice.2022.05.018","DOIUrl":"10.1016/j.jvoice.2022.05.018","url":null,"abstract":"<div><div><span><span>Auditory-perceptual rating of voice is one component of voice evaluation, and the CAPE-V is one of the tools for this purpose. Because of its advantages, the CAPE-V has been adapted into several languages. Accordingly, the adaptation of the CAPE-V into Malay is essential for its utility among the Malaysian population, which this study aimed to accomplish. This study involved translating<span> the CAPE-V into Malay, termed the Malay CAPE-V, followed by establishing its validity. The translation processes (ie, forward translation and backward translation) involved four different translators ie, three speech-language therapists (SLTs), and one linguist with at least 14 years of experience. Most items were similarly translated, except for a few, which were subsequently accepted as similar, following consensus among the translators. In the examination of content validity, two raters (ie, SLTs) with at least 12 years of clinical experience reviewed and scored the tested items. Given that the scale-level content validity index average value (S-CVI/Ave) was above the acceptable level, all items were retained. The examination of </span></span>construct validity and concurrent validity involved ratings of voice samples recorded from 38 participants, comprising 19 individuals with normal and disordered voices, respectively. The ratings were performed by three raters (ie, SLTs) with at least 12 years of clinical experience. For the construct validity, the Mann-Whitney </span><em>U</em><span> test indicated significantly higher scores of the vocal parameters of the Malay CAPE-V for the disordered voice group than for the normal voice group. Meanwhile, for the concurrent validity, the Spearman correlation indicated that all relationships between the scores of the vocal parameters of the Malay CAPE-V and GRBAS Scale were significant, with most of them achieving a very strong positive correlation. The results demonstrated that the Malay CAPE-V is a valid tool for an auditory-perceptual rating of voice among the Malaysian population.</span></div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"38 6","pages":"Pages 1527.e27-1527.e35"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40405431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jvoice.2022.05.021
Letícia Alvieri Riato Alonso , Eliana Maria Gradim Fabbron , Célia Maria Giacheti
Purpose
To verify the relationship between obesity, voice and behavior in childhood and adolescence, through an integrative review.
Methods
The researchers surveyed the articles indexed in the following databases: Embase, Web of Science, Scopus and Pubmed, using uniterms found in the Medical Subject Headings, related to the subject of the study, combined by the Boolean operators “and” and “or”, published until January 2022. In the end, three reviewers selected the articles.
Results
When searching for studies related to voice, obesity and behavior, 62 articles were found that did not meet the selection criteria and were excluded. Given this result, new searches were carried out with the following crossing strategies: voice and obesity and; Voice, Behavior and Child Behavior Checklist (CBCL). After the evaluation of the reviewers, two articles were selected referring to the intersection “voice and obesity in children and adolescents” and, two studies, in the intersection between “voice, behavior and CBCL”. The first study on voice and obesity showed that the greater the abdominal circumference, the greater the maximum expiratory force and sound pressure found. The second study showed high Jitter and NHR values in obese children. Furthermore, studies on voice, behavior and CBCL showed that children with vocal nodules were more sociable than children without vocal nodules, and had behaviors described as “screams a lot” and “teases a lot”. On the other hand, another study found potential risks of behavioral changes in the face of vocal complaints.
Conclusions
Although this literature review did not find studies associating obesity with vocal and behavioral disorders, the literature found showed the presence of vocal alteration in some acoustic parameters in obese children. Regarding voice, behavior and CBCL, two studies were found reporting the presence of behavioral changes in children with voice-related complaints, according to the opinion of their parents.
{"title":"Voice and Behavior of Children and Adolescents With Obesity: Integrative Literature Review","authors":"Letícia Alvieri Riato Alonso , Eliana Maria Gradim Fabbron , Célia Maria Giacheti","doi":"10.1016/j.jvoice.2022.05.021","DOIUrl":"10.1016/j.jvoice.2022.05.021","url":null,"abstract":"<div><h3>Purpose</h3><div>To verify the relationship between obesity, voice and behavior in childhood and adolescence, through an integrative review.</div></div><div><h3>Methods</h3><div>The researchers surveyed the articles indexed in the following databases: Embase<span><span>, Web of Science, Scopus and Pubmed, using uniterms found in the </span>Medical Subject Headings, related to the subject of the study, combined by the Boolean operators “and” and “or”, published until January 2022. In the end, three reviewers selected the articles.</span></div></div><div><h3>Results</h3><div><span>When searching for studies related to voice, obesity and behavior, 62 articles were found that did not meet the selection criteria and were excluded. Given this result, new searches were carried out with the following crossing strategies: voice and obesity and; Voice, Behavior and Child Behavior Checklist (CBCL). After the evaluation of the reviewers, two articles were selected referring to the intersection “voice and obesity in children and adolescents” and, two studies, in the intersection between “voice, behavior and CBCL”. The first study on voice and obesity showed that the greater the </span>abdominal circumference, the greater the maximum expiratory force and sound pressure found. The second study showed high Jitter and NHR values in obese children. Furthermore, studies on voice, behavior and CBCL showed that children with vocal nodules were more sociable than children without vocal nodules, and had behaviors described as “screams a lot” and “teases a lot”. On the other hand, another study found potential risks of behavioral changes in the face of vocal complaints.</div></div><div><h3>Conclusions</h3><div>Although this literature review did not find studies associating obesity with vocal and behavioral disorders, the literature found showed the presence of vocal alteration in some acoustic parameters in obese children. Regarding voice, behavior and CBCL, two studies were found reporting the presence of behavioral changes in children with voice-related complaints, according to the opinion of their parents.</div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"38 6","pages":"Pages 1326-1333"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40487945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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