Folia phoniatrica最新文献

The influence of changes in middle ear impedance with and without serotympanon on the measurement of evoked otoacoustic emissions (EOAE) was investigated in 108 children between 3 and 12 years of age. Children with proven serotympanon never showed good EOAE. In those who only had changes in middle ear impedance without a serotympanon, the decrease in EOAE amplitude was more related to the magnitude of conductive hearing loss than to the change in impedance itself. These results are compared with those of a neonatal screening project in which some of the 532 healthy fullterm newborns showed poor emissions in the first days of life. It seems reasonable to assume that this is due to incomplete pneumatization of the middle ears of these children, especially as a control audiogram later in their lives showed normal hearing thresholds.

The differences of sensorimotor (global) and motor aphasias using electrophysiological recordings of cortical regions after different acoustic stimuli are described. For appreciation of the auditory perception ability of patients with aphasia slow auditory evoked potentials were recorded from temporal regions, after stimulation with tone, white noise, and word stimuli. For the global aphasia group (with speech comprehension lesion) normal cortical complexes were not recorded. These results could contribute to the discrimination of the two main types of aphasia (global and motor).

The [s] samples of 11 women, psychoacoustically classified as acceptable/unacceptable, were studied with the self-organizing map, the neural network algorithm of Kohonen. The measurement map had been previously computed with nondisordered speech samples. Fifteen-component spectral vectors, analyzed with the map, were calculated from short-time FFT spectra at 10-ms intervals. The degree of audible acceptability correlated with the location of the sample on the map. Spectral model vectors in different map locations depicted distinguishing spectral features in the [s] samples analyzed. The results demonstrate that self-organized maps are suitable for the extraction and measurement of acoustic features underlying psychoacoustic classifications, and for on-line visual imaging of speech.

Histomorphometric data (fiber frequencies, fiber diameters, and atrophy factors) were determined in laryngeal muscles [thyroarytenoid (VOC), posterior (PCA) and lateral (LCA) cricoarytenoids, and cricothyroid (CT) muscles]. Seventy-three muscles (43,700 fibers) from normal and carcinoma-infiltrated sides of the larynges of 11 patients were analyzed. The fiber diameters showed uniform values of 24.2 +/- 9.1 microns. Type-I fibers were more frequent in the PCA and less frequent in the LCA and the CT. In the VOC, the ratio was 1:1. The unilateral fixation of a vocal fold modified the structures of the LCA and the CT. The VOC and the PCA were not affected. A hypothesis based on the phonatory function of the CT is used to explain its atrophy.

Kinematic recordings of orofacial movements by means of electromagnetic articulography were performed in an akinetic-rigid Parkinsonian patient presenting with intermittent speech freezing in diadochokinesis tasks (rapid repetitions of the syllable /ta/). During freezing periods the patient produced a sustained /a/ instead of the required consonant-vowel sequences. The underlying articulatory trajectories were characterized by repetition rates amounting to 8-10 Hz concomitant with reduced movement amplitudes. Obviously, the undershooting of articulatory gestures failed to establish a sufficient occlusion of the vocal tract giving rise to the perceived speech freezing. In contrast, preserved diadochokinesis occurred at frequencies of 4-6 Hz. Most probably, the increased articulatory repetition rate reflects a pacing of orofacial movements by released tremor oscillations. Due to slowing of articulatory movements spastic dysarthrics can also present with missing syllabic modulation during oral diadochokinesis. The results of the articulographic recordings demonstrate the different pathophysiology of Parkinsonian freezing.

For the psychosomatic diagnosis of functional voice disorders, the concept of a semistructured psychosomatic interview is presented which follows the principles of psychoanalytic interviewing and of deep-psychological biographical anamnesis. It also takes into account the special features of dysphonic patients as psychosomatic patients, the characteristics of functional voice disorders, and the interrelationship of voice and psychosocial biography. The psychosomatic interview consists of the components interviewing situation, voice symptomatology and voice genesis, psychosocial biographical anamnesis and indication to psychotherapy. Beginning and end of the interview are fixed, whereas in the further course the selection of elements is fitted to the conflict constellations of the patient.

Word-initial samples of fricative [s] preceding vowels [a:], [ae:], [e:], [i:], [u:], [o:], and [y:] in Finnish words were studied with the self-organizing map. An acoustic map was first calculated from speech samples of women without speech disorders, and then the [s] samples were measured on this map. In all 10 subjects the [s] samples preceding the rounded vowels [u:] and [o:] clearly differed from the samples in front of unrounded [a:], [ae:], [e:], and [i:]. The coarticulatory phenomena observed on the map were due to changes in the composition and stability of the fricative spectrum.

Associations between different types of misarticulations and morphology as well as function of the speech articulators were assessed in 287 first-grade children. Sounds produced too far anteriorly evidently were due to immaturity of the articulatory speech movements, which showed a tendency to improve spontaneously with age. Sounds produced too far posteriorly correlated positively with problems in coordinating the movements of different muscles of the tongue, indicating a possible dyspractic origin. Children who had problems with lip tonus were prone to have laterally produced misarticulations.

Looking for possible signs of vocal fatigue, acoustic waveform perturbation was measured in normal female subjects during sustained phonation at various fundamental frequencies (Fo). At none of the pitch levels a rise of the jitter or the shimmer was found after 25 min of vocalization. On the other hand, an effect of Fo was seen from the start: above the habitual speaking Fo of our subjects' voices there was a tendency for the jitter to be higher and for the shimmer to be lower.