Thays Vaiano, Fernando A M Herbella, Flávia Badaró, M. Behlau
High-resolution manometry (HRM) is a motility diagnostic system that measures intraluminal pressure of the gastrointestinal tract using a series of closely spaced pressure sensors. The topographic plot generated by HRM software makes it possible to visualize phonation pressures at the pharynx, UES, and body of the esophagus in real time, indicating pressure intensity by color, which permits easy data interpretation. It has been largely used for swallowing study and dysphagia diagnosis. Due to the proximity of the pharyngoesophageal and laryngeal structures, this technology instigated voice researchers. Despite the few studies published so far, high-resolution manometry has yet proven to be an extremely useful tool in obtaining entire pharyngoesophageal segment pressure measurements during phonation. It also allows natural voice production not interfering with the mouth area. HRM data already brought light to subglottic pressure, vertical laryngeal excursion, cricopharyngeal muscle activation, air flow, muscle tension associated with vocalization and pressure variations associated with different phonatory stimuli.
{"title":"High-Resolution Manometry Contributions to the Physiology of Phonation","authors":"Thays Vaiano, Fernando A M Herbella, Flávia Badaró, M. Behlau","doi":"10.46634/riics.227","DOIUrl":"https://doi.org/10.46634/riics.227","url":null,"abstract":"High-resolution manometry (HRM) is a motility diagnostic system that measures intraluminal pressure of the gastrointestinal tract using a series of closely spaced pressure sensors. The topographic plot generated by HRM software makes it possible to visualize phonation pressures at the pharynx, UES, and body of the esophagus in real time, indicating pressure intensity by color, which permits easy data interpretation. It has been largely used for swallowing study and dysphagia diagnosis. Due to the proximity of the pharyngoesophageal and laryngeal structures, this technology instigated voice researchers. Despite the few studies published so far, high-resolution manometry has yet proven to be an extremely useful tool in obtaining entire pharyngoesophageal segment pressure measurements during phonation. It also allows natural voice production not interfering with the mouth area. HRM data already brought light to subglottic pressure, vertical laryngeal excursion, cricopharyngeal muscle activation, air flow, muscle tension associated with vocalization and pressure variations associated with different phonatory stimuli.","PeriodicalId":508578,"journal":{"name":"Revista de Investigación e Innovación en Ciencias de la Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139203286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antonio Velandrino-Nicolás, Francisco Cabello Luque, María Monteagudo-Santamaría, Lidia Gómez-Cobos
Objective. The aim of this study was to establish normative values for the Voice Symptom Scale (VoiSS) in the Spanish community population (without voice problems), using a sample from a large area of southeastern Spain. Method. The sample consisted of 115 adults from ages 16 to 87, 60 of whom were women and 55 were men. Participants included the family members of patients who attended the Otorhinolaryngology (ENT) and Speech Therapy Clinic at a referral hospital in the region of Murcia, Spain, and some of the clinic’s staff. All the participants reported never having suffered from any voice disorder before. Results. The normative values obtained in this study for the VoiSS were 14.61 (SD=8.18) for the total score, 7.57 (SD = 5.42) for the Impairment subscale, 1.04 (SD = 1.65) for the Emotional subscale, and 5.99 (SD = 3.61) for the Physical subscale. The percentile values were also obtained for the VoiSS scale and for its three subscales. Conclusions. This study presents normative values for the VoiSS scale that have not previously been obtained in Spain. These values can be used as a reference to detect possible voice disorders.
{"title":"Normative Values for the Spanish Version of the Voice Symptom Scale (VoiSS)","authors":"Antonio Velandrino-Nicolás, Francisco Cabello Luque, María Monteagudo-Santamaría, Lidia Gómez-Cobos","doi":"10.46634/riics.228","DOIUrl":"https://doi.org/10.46634/riics.228","url":null,"abstract":"Objective. The aim of this study was to establish normative values for the Voice Symptom Scale (VoiSS) in the Spanish community population (without voice problems), using a sample from a large area of southeastern Spain. Method. The sample consisted of 115 adults from ages 16 to 87, 60 of whom were women and 55 were men. Participants included the family members of patients who attended the Otorhinolaryngology (ENT) and Speech Therapy Clinic at a referral hospital in the region of Murcia, Spain, and some of the clinic’s staff. All the participants reported never having suffered from any voice disorder before. Results. The normative values obtained in this study for the VoiSS were 14.61 (SD=8.18) for the total score, 7.57 (SD = 5.42) for the Impairment subscale, 1.04 (SD = 1.65) for the Emotional subscale, and 5.99 (SD = 3.61) for the Physical subscale. The percentile values were also obtained for the VoiSS scale and for its three subscales. Conclusions. This study presents normative values for the VoiSS scale that have not previously been obtained in Spain. These values can be used as a reference to detect possible voice disorders.","PeriodicalId":508578,"journal":{"name":"Revista de Investigación e Innovación en Ciencias de la Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139200051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fernanda Figueroa-Martínez, Adrián Castillo-Allendes, Karla Grunewaldt, Tamara Solís-Meza, Eric J. Hunter, Jeffrey R Searl
Objectives. This pilot study aimed to identify and test a battery of time-efficient and cost-effective voice and swallowing screening tools for post-extubated patients in Chile. Methods. A panel of four experts selected and rated voice and swallowing screening tools. Seven measures were selected: smoothed cepstral peak prominence (CPPS) and maximum phonation time (MPT) for voice assessment, Volume-Viscosity Swallow Test (V-VST) for swallowing, voluntary and reflex peak cough flow for cough assessment, Eating Assessment Tool-10 (EAT-10), and Vocal Symptom Scale (VoiSS) for patient-reported outcomes. These tools were applied to four post-extubation patients within 48-72 hours post-hospital discharge, alongside the assessment of 17 matched controls. Results. Post-extubation patients showed significantly shorter MPT, lower CPPS values, increased V-VST dysphagia signs, reduced voluntary peak cough flow, and more pronounced symptoms on both the VoiSS and EAT-10 compared to controls. Limitations. The study had a modest sample size and relied solely on clinical screening tools.Value. This pilot study suggests a feasible and cost-effective approach to voice and swallowing screening for post-extubation patients, valuable in resource-constrained settings.Conclusion. While these accessible tools are not gold-standard assessments, they offer valuable insights and can guide future research. This study underscores the potential of selected tools in facilitating early detection of voice and swallowing disorders in post-extubation patients.
{"title":"Exploring the Feasibility of a Comprehensive Screening for Voice and Swallowing Function in Post-Extubation Patients: A Pilot Study","authors":"Fernanda Figueroa-Martínez, Adrián Castillo-Allendes, Karla Grunewaldt, Tamara Solís-Meza, Eric J. Hunter, Jeffrey R Searl","doi":"10.46634/riics.239","DOIUrl":"https://doi.org/10.46634/riics.239","url":null,"abstract":"Objectives. This pilot study aimed to identify and test a battery of time-efficient and cost-effective voice and swallowing screening tools for post-extubated patients in Chile. Methods. A panel of four experts selected and rated voice and swallowing screening tools. Seven measures were selected: smoothed cepstral peak prominence (CPPS) and maximum phonation time (MPT) for voice assessment, Volume-Viscosity Swallow Test (V-VST) for swallowing, voluntary and reflex peak cough flow for cough assessment, Eating Assessment Tool-10 (EAT-10), and Vocal Symptom Scale (VoiSS) for patient-reported outcomes. These tools were applied to four post-extubation patients within 48-72 hours post-hospital discharge, alongside the assessment of 17 matched controls. Results. Post-extubation patients showed significantly shorter MPT, lower CPPS values, increased V-VST dysphagia signs, reduced voluntary peak cough flow, and more pronounced symptoms on both the VoiSS and EAT-10 compared to controls. Limitations. The study had a modest sample size and relied solely on clinical screening tools.Value. This pilot study suggests a feasible and cost-effective approach to voice and swallowing screening for post-extubation patients, valuable in resource-constrained settings.Conclusion. While these accessible tools are not gold-standard assessments, they offer valuable insights and can guide future research. This study underscores the potential of selected tools in facilitating early detection of voice and swallowing disorders in post-extubation patients.","PeriodicalId":508578,"journal":{"name":"Revista de Investigación e Innovación en Ciencias de la Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139201626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Cantor-Cutiva, P. Bottalico, J. Codino, Eric J. Hunter, Adam D. Rubin
The field of voice disorders lost a true pioneer with the passing of Dr. Cristina Jackson-Menaldi (June 21, 1950 - November 20, 2020). A renowned voice pathologist and singing voice specialist, Dr. Jackson-Menaldi made significant contributions to our understanding and treatment of voice disorders. She was also a passionate advocate for voice education and disorder prevention.
{"title":"A Tribute to Dr. Cristina Jackson-Menaldi: A Pioneer in the Field of Voice Disorders","authors":"L. Cantor-Cutiva, P. Bottalico, J. Codino, Eric J. Hunter, Adam D. Rubin","doi":"10.46634/riics.284","DOIUrl":"https://doi.org/10.46634/riics.284","url":null,"abstract":"The field of voice disorders lost a true pioneer with the passing of Dr. Cristina Jackson-Menaldi (June 21, 1950 - November 20, 2020). A renowned voice pathologist and singing voice specialist, Dr. Jackson-Menaldi made significant contributions to our understanding and treatment of voice disorders. She was also a passionate advocate for voice education and disorder prevention.","PeriodicalId":508578,"journal":{"name":"Revista de Investigación e Innovación en Ciencias de la Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139207564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective. To examine laryngeal maximum performance through a novel pitch diadochokinetic (DDK) task in people with Parkinson’s disease (PD) and healthy controls. Methods. This exploratory pilot study included a total of eight people with PD (seven male and one female) and eight healthy controls. Participants were instructed to rapidly transition or alternate between a chosen comfortable low and high pitch and were instructed to complete the task as a pitch glide. An Auditory Sawtooth Waveform Inspired Pitch Estimator-Prime model was used to first extract the pitch contour and then a customized MATLAB algorithm was used to compute and derive measures of pitch range and pitch slope. Results. Pitch range and slope were reduced in some participants with PD. Effects of age and disease duration were observed in people with PD: reductions in both pitch measures with increase in age and disease duration. Conclusions. A novel pitch DDK task may supplement the conventional laryngeal DDK task in the evaluation and treatment of motor speech and voice disorders. Individual variability analysis may provide specific diagnostic and therapeutic insights for people with PD.
{"title":"Speed of Pitch Change in People with Parkinson’s Disease: A Pilot Study","authors":"Supraja Anand","doi":"10.46634/riics.246","DOIUrl":"https://doi.org/10.46634/riics.246","url":null,"abstract":"Objective. To examine laryngeal maximum performance through a novel pitch diadochokinetic (DDK) task in people with Parkinson’s disease (PD) and healthy controls. Methods. This exploratory pilot study included a total of eight people with PD (seven male and one female) and eight healthy controls. Participants were instructed to rapidly transition or alternate between a chosen comfortable low and high pitch and were instructed to complete the task as a pitch glide. An Auditory Sawtooth Waveform Inspired Pitch Estimator-Prime model was used to first extract the pitch contour and then a customized MATLAB algorithm was used to compute and derive measures of pitch range and pitch slope. Results. Pitch range and slope were reduced in some participants with PD. Effects of age and disease duration were observed in people with PD: reductions in both pitch measures with increase in age and disease duration. Conclusions. A novel pitch DDK task may supplement the conventional laryngeal DDK task in the evaluation and treatment of motor speech and voice disorders. Individual variability analysis may provide specific diagnostic and therapeutic insights for people with PD.","PeriodicalId":508578,"journal":{"name":"Revista de Investigación e Innovación en Ciencias de la Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139196639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective. To determine the effect on voice parameters in pupils and their teacher of a three-week Workplace Vocal Health Promotion Program (WVHPP) in a school setting. Methods. Longitudinal study with a design phase and a pilot phase. Voice recordings of connected speech were used to collect information on voice functioning before and after the implementation of the program. The workplace vocal health promotion program was implemented with two purposes: (1) to reduce noisy conditions inside the classrooms that may cause loud voice production, which has been found associated with voice disorders among teachers and students and (2) to increase awareness about the relationship between noise and voice inside the classrooms. Results. The WVHPP was found to be statistically associated with a decrease in the fundamental frequency, standard deviation of the fundamental frequency, sound pressure levels, and SPL standard deviation among both pupils and their teacher. However, there was no statistically significant effect on cepstral peak prominence smoothed. Conclusion. The three-week WVHPP was found to have a significant impact on several acoustic parameters, such as the fundamental frequency and sound pressure levels. These findings highlight the potential of the WVHPP as an effective intervention for improving the vocal health of both teachers and students. However, the lack of a significant effect on cepstral peak prominence smoothed suggests that further research is needed to fully understand the impact of the WVHPP on voice quality.
{"title":"Impact of a Three-Week Workplace Vocal Health Promotion Program on a Teacher and Students' Voice Parameters","authors":"L. Cantor-Cutiva, Adriana Maria Cantor-Cutiva","doi":"10.46634/riics.180","DOIUrl":"https://doi.org/10.46634/riics.180","url":null,"abstract":"Objective. To determine the effect on voice parameters in pupils and their teacher of a three-week Workplace Vocal Health Promotion Program (WVHPP) in a school setting. Methods. Longitudinal study with a design phase and a pilot phase. Voice recordings of connected speech were used to collect information on voice functioning before and after the implementation of the program. The workplace vocal health promotion program was implemented with two purposes: (1) to reduce noisy conditions inside the classrooms that may cause loud voice production, which has been found associated with voice disorders among teachers and students and (2) to increase awareness about the relationship between noise and voice inside the classrooms. Results. The WVHPP was found to be statistically associated with a decrease in the fundamental frequency, standard deviation of the fundamental frequency, sound pressure levels, and SPL standard deviation among both pupils and their teacher. However, there was no statistically significant effect on cepstral peak prominence smoothed. Conclusion. The three-week WVHPP was found to have a significant impact on several acoustic parameters, such as the fundamental frequency and sound pressure levels. These findings highlight the potential of the WVHPP as an effective intervention for improving the vocal health of both teachers and students. However, the lack of a significant effect on cepstral peak prominence smoothed suggests that further research is needed to fully understand the impact of the WVHPP on voice quality.","PeriodicalId":508578,"journal":{"name":"Revista de Investigación e Innovación en Ciencias de la Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139208214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. Laryngopharyngeal reflux (LPR) manifests with a constellation of common throat symptoms and inconclusive signs on laryngoscopic exam. It is a diagnosis, often made clinically, that can lead to prescriptions of proton pump inhibitors that are unnecessary and potentially harmful. Glottic insufficiency (GI) and the accompanying hyperfunctional laryngeal behaviors can also present with similar, common throat complaints that may or may not include a qualitative change to the voice. Methods. This is a reflection article. It is written to summarize, explain, and support with evidence the opinion of the author on the topic of how symptoms of voice disorders can easily be mistaken for symptoms of LPR. The offered reflection is based on his experience, research and the available literature. Reflection. This article intends to explore the similarities between GI and LPR, how to ultimately differentiate them and how to approach treatment with a broader differential diagnosis. Conclusion. LPR and GI can present with identical, vague throat, and voice symptoms. Empiric medication trials, behavioral interventions and objective laryngovideostroboscopy, impedance-based reflux, and esophageal motility testing may all be needed, sometimes in a trial and error fashion, to correctly diagnose and treat a patient’s symptoms.
导言。喉咽反流（LPR）表现为一系列常见的咽喉症状和喉镜检查的不确定体征。临床诊断时往往会开出不必要且可能有害的质子泵抑制剂处方。声门功能不全（GI）和伴随的喉功能亢进行为也会出现类似的常见咽喉症状，可能会也可能不会包括声音的质变。方法。这是一篇反思文章。文章旨在总结、解释并用证据支持作者关于嗓音疾病症状如何容易被误认为 LPR 症状的观点。所提供的反思基于作者的经验、研究和现有文献。反思。本文旨在探讨 GI 和 LPR 之间的相似之处、如何最终将它们区分开来以及如何通过更广泛的鉴别诊断来进行治疗。结论。LPR 和 GI 可表现为相同、模糊的咽喉和嗓音症状。 为了正确诊断和治疗患者的症状，可能需要进行经验性药物试验、行为干预和客观的喉视频曲速镜检查、基于阻抗的反流和食管运动测试，有时需要反复试验。
{"title":"Is it always Laryngopharyngeal Reflux? How Voice Disorders Can Manifest as LPR","authors":"Thomas L. Carroll","doi":"10.46634/riics.262","DOIUrl":"https://doi.org/10.46634/riics.262","url":null,"abstract":"Introduction. Laryngopharyngeal reflux (LPR) manifests with a constellation of common throat symptoms and inconclusive signs on laryngoscopic exam. It is a diagnosis, often made clinically, that can lead to prescriptions of proton pump inhibitors that are unnecessary and potentially harmful. Glottic insufficiency (GI) and the accompanying hyperfunctional laryngeal behaviors can also present with similar, common throat complaints that may or may not include a qualitative change to the voice. Methods. This is a reflection article. It is written to summarize, explain, and support with evidence the opinion of the author on the topic of how symptoms of voice disorders can easily be mistaken for symptoms of LPR. The offered reflection is based on his experience, research and the available literature. Reflection. This article intends to explore the similarities between GI and LPR, how to ultimately differentiate them and how to approach treatment with a broader differential diagnosis. Conclusion. LPR and GI can present with identical, vague throat, and voice symptoms. Empiric medication trials, behavioral interventions and objective laryngovideostroboscopy, impedance-based reflux, and esophageal motility testing may all be needed, sometimes in a trial and error fashion, to correctly diagnose and treat a patient’s symptoms.","PeriodicalId":508578,"journal":{"name":"Revista de Investigación e Innovación en Ciencias de la Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139201251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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