Spatial Frequency Requirements and Gaze Strategy in Visual-Only and Audiovisual Speech Perception

Purpose

The aim of this article is to examine the effects of visual image degradation on performance and gaze behavior in audiovisual and visual-only speech perception tasks.

Method

We presented vowel–consonant–vowel utterances visually filtered at a range of frequencies in visual-only, audiovisual congruent, and audiovisual incongruent conditions (Experiment 1; N = 66). In Experiment 2 (N = 20), participants performed a visual-only speech perception task and in Experiment 3 (N = 20) an audiovisual task while having their gaze behavior monitored using eye-tracking equipment.

Results

In the visual-only condition, increasing image resolution led to monotonic increases in performance, and proficient speechreaders were more affected by the removal of high spatial information than were poor speechreaders. The McGurk effect also increased with increasing visual resolution, although it was less affected by the removal of high-frequency information. Observers tended to fixate on the mouth more in visual-only perception, but gaze toward the mouth did not correlate with accuracy of silent speechreading or the magnitude of the McGurk effect.

Conclusions

The results suggest that individual differences in silent speechreading and the McGurk effect are not related. This conclusion is supported by differential influences of high-resolution visual information on the 2 tasks and differences in the pattern of gaze.

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Spatial Frequency Requirements and Gaze Strategy in Visual-Only and Audiovisual Speech Perception

Purpose

The aim of this article is to examine the effects of visual image degradation on performance and gaze behavior in audiovisual and visual-only speech perception tasks.

Method

We presented vowel–consonant–vowel utterances visually filtered at a range of frequencies in visual-only, audiovisual congruent, and audiovisual incongruent conditions (Experiment 1; N = 66). In Experiment 2 (N = 20), participants performed a visual-only speech perception task and in Experiment 3 (N = 20) an audiovisual task while having their gaze behavior monitored using eye-tracking equipment.

Results

In the visual-only condition, increasing image resolution led to monotonic increases in performance, and proficient speechreaders were more affected by the removal of high spatial information than were poor speechreaders. The McGurk effect also increased with increasing visual resolution, although it was less affected by the removal of high-frequency information. Observers tended to fixate on the mouth more in visual-only perception, but gaze toward the mouth did not correlate with accuracy of silent speechreading or the magnitude of the McGurk effect.

Conclusions

The results suggest that individual differences in silent speechreading and the McGurk effect are not related. This conclusion is supported by differential influences of high-resolution visual information on the 2 tasks and differences in the pattern of gaze.

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Spatial Frequency Requirements and Gaze Strategy in Visual-Only and Audiovisual Speech Perception

Purpose

The aim of this article is to examine the effects of visual image degradation on performance and gaze behavior in audiovisual and visual-only speech perception tasks.

Method

We presented vowel–consonant–vowel utterances visually filtered at a range of frequencies in visual-only, audiovisual congruent, and audiovisual incongruent conditions (Experiment 1; N = 66). In Experiment 2 (N = 20), participants performed a visual-only speech perception task and in Experiment 3 (N = 20) an audiovisual task while having their gaze behavior monitored using eye-tracking equipment.

Results

In the visual-only condition, increasing image resolution led to monotonic increases in performance, and proficient speechreaders were more affected by the removal of high spatial information than were poor speechreaders. The McGurk effect also increased with increasing visual resolution, although it was less affected by the removal of high-frequency information. Observers tended to fixate on the mouth more in visual-only perception, but gaze toward the mouth did not correlate with accuracy of silent speechreading or the magnitude of the McGurk effect.

Conclusions

The results suggest that individual differences in silent speechreading and the McGurk effect are not related. This conclusion is supported by differential influences of high-resolution visual information on the 2 tasks and differences in the pattern of gaze.

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Four-day Follow-up Study on the Self-reported Voice Condition and Noise Condition of Teachers: Relationship Between Vocal Parameters and Classroom Acoustics

Publication date: Available online 11 July 2016
Source:Journal of Voice
Author(s): Lady Catherine Cantor Cutiva, Giuseppina Emma Puglisi, Arianna Astolfi, Alessio Carullo
ObjectivesThis study aimed to determine the changes in self-reported voice and noise condition over a follow-up of 4 days (equivalent to one working week), to define the relationship between the objective voice parameters and the self-reported voice condition, as well as to characterize the relationship between classroom acoustics and the self-reported noise condition.Study designThis is a cohort study.MethodsWe performed voice monitoring of 27 teachers for four working days using the Voice-Care device, which provides information on the fundamental frequency, vocal sound pressure level, and phonation time percentage. The participants performed a pre-monitoring, which consisted of a brief conversation, before each monitoring session, and filled in a questionnaire after each monitored lesson, in which they indicated their opinions about their voice condition and the classroom noise conditions.ResultsThe teachers who, during the pre-monitoring, showed a higher standard deviation of the vocal sound pressure level and a greater phonation time percentage difference between the entire monitoring and the pre-monitoring sessions, reported fewer voice complaints. Decay time (DT40ME), a reverberation measure from the speakers' perspective, resulted to be associated with the self-reporting of the noise condition.ConclusionVoice disorders at work prevention programs should include strategies to exercise the respiratory and laryngeal components of voice production, because these elements may influence the variation in the vocal sound pressure level, which was found to be significantly associated with the self-reported voice condition. This study also highlights the importance of including reverberation measures, from the speakers' perspective, in the design of schools.



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Voice in Friedreich Ataxia

Publication date: Available online 5 August 2016
Source:Journal of Voice
Author(s): Adam P. Vogel, Mayumi I. Wardrop, Joanne E. Folker, Matthis Synofzik, Louise A. Corben, Martin B. Delatycki, Shaheen N. Awan
BackgroundFriedreich Ataxia (FRDA) is the most common hereditary ataxia, with dysarthria as one of its key clinical signs.ObjectiveTo describe the voice profile of individuals with FRDA to inform outcome marker development and goals of speech therapy.MethodsThirty-six individuals with FRDA and 30 age-matched controls provided sustained vowel and connected speech samples. Speech and voice samples were analyzed acoustically using the Analysis of Dysphonia in Speech and Voice program and perceptually using the Consensus Auditory-Perceptual Evaluation of Voice form. Correlations between dysphonia and overall dysarthria severity, demographic, clinical, and genetic information were explored.ResultsIndividuals with FRDA presented with mild dysphonia characterized by hoarseness (combined roughness and breathiness), increased strain, and altered pitch variability (increased in vowel productions; slightly decreased on reading samples). Acoustically, individuals with FRDA had significantly higher scores on the Cepstral Spectral Index of Dysphonia during vowel production. A combination of perceptual and acoustic measures of dysphonia used in this study was quite effective in categorizing the FRDA versus control participants, with >80% overall accuracy.ConclusionsAlthough dysphonia severity in FRDA did not correlate significantly with overall disease severity, speaking rate and syllabic duration significantly correlated with age at disease onset and disease duration, and also have an effect on listener perception of dysphonia. The relationship between dysphonia and dysarthria in FRDA suggests that reducing overall dysphonia severity via therapeutic techniques that improve phonatory stability and increase speaking rate is a viable target for speech therapy.



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Calendar Listings

Publication date: July 2016
Source:Journal of Voice, Volume 30, Issue 4





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New Evidence That Nonlinear Source-Filter Coupling Affects Harmonic Intensity and fo Stability During Instances of Harmonics Crossing Formants

Publication date: Available online 5 August 2016
Source:Journal of Voice
Author(s): Lynn Maxfield, Anil Palaparthi, Ingo Titze
The traditional source-filter theory of voice production describes a linear relationship between the source (glottal flow pulse) and the filter (vocal tract). Such a linear relationship does not allow for nor explain how changes in the filter may impact the stability and regularity of the source. The objective of this experiment was to examine what effect unpredictable changes to vocal tract dimensions could have on fo stability and individual harmonic intensities in situations in which low frequency harmonics cross formants in a fundamental frequency glide. To determine these effects, eight human subjects (five male, three female) were recorded producing fo glides while their vocal tracts were artificially lengthened by a section of vinyl tubing inserted into the mouth. It was hypothesized that if the source and filter operated as a purely linear system, harmonic intensities would increase and decrease at nearly the same rates as they passed through a formant bandwidth, resulting in a relatively symmetric peak on an intensity-time contour. Additionally, fo stability should not be predictably perturbed by formant/harmonic crossings in a linear system. Acoustic analysis of these recordings, however, revealed that harmonic intensity peaks were asymmetric in 76% of cases, and that 85% of fo instabilities aligned with a crossing of one of the first four harmonics with the first three formants. These results provide further evidence that nonlinear dynamics in the source-filter relationship can impact fo stability as well as harmonic intensities as harmonics cross through formant bandwidths.



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Three Simultaneous Cases of Spontaneous Pneumomediastinum With Epidural Pneumatosis During Vocal Training

Publication date: Available online 14 July 2016
Source:Journal of Voice
Author(s): Yuki Yoshimatsu, Kazushi Yamairi, Kazutaka Nakasone, Michiru Sasaki, Saori Terai, Naoki Nakamura, Naomi Maruyama, Yae Yoshida, Munetake Takata, Natsuko Iwae, Kenichiro Otani, Takao Kamimori, Hiroshi Fujiwara
ObjectiveThe aim of this study was to describe a case series of three simultaneous cases of spontaneous pneumomediastinum (SPM) with epidural pneumatosis during vocal training.MethodsA report of three cases with chart review was performed. Literature review was carried out using PubMed.ResultsThis was an extremely rare case series where at least three of the 20 participants of a vocal training in a self-development seminar developed SPM, epidural pneumatosis, pneumothorax, and subcutaneous emphysema. All cases improved with bed rest. Simultaneous cases of SPM have been reported in the past. However, the cause of simultaneous occurrence has not been explained clearly. In our cases, continuous excessive vocal training may have caused intrathoracic pressure to rise, causing SPM at a high prevalence. Epidural pneumatosis is a rare finding. Studies on epidural pneumatosis complicating SPM are limited. Air is said to easily pass through the cervical region owing to the close proximity between the mediastinum and the upper spine, resulting in epidural pneumatosis. Elevated intrathoracic pressure while the glottis is closed may worsen the risk for epidural pneumatosis. In this seminar, continuous effortful vocal training at full pitch with few pauses for breath may have contributed to this simultaneous occurrence.ConclusionsWe report three simultaneous cases of SPM and epidural pneumatosis due to demanding vocal training. Further research on this subject is desired to identify risk factors.



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Oscillatory Characteristics of the Vocal Folds Across the Tenor Passaggio

Publication date: Available online 4 August 2016
Source:Journal of Voice
Author(s): Matthias Echternach, Fabian Burk, Marie Köberlein, Christian T. Herbst, Michael Döllinger, Michael Burdumy, Bernhard Richter
IntroductionRecent research has revealed that classically trained tenors tend to constrict epilaryngeal structures when singing in and above the passaggio (ie, the frequency region where register events typically occur). These constrictions complicate visibility of vocal fold oscillatory patterns with transoral rigid high-speed video endoscopy, thus limiting the current understanding of laryngeal dynamics in the passaggio region of tenors.Materials and MethodsThis investigation analyzed seven professionally trained western classical tenors using high-speed digital imaging (HSDI) at 20,000 frames per second via transnasal flexible endoscopy. The participants produced transitions (a) from modal to falsetto register and (b) from modal to stage voice above the passaggio (SVaP) during ascending pitch glides from A3 (220 Hz) to A4 (440 Hz) on vowel /i/. HSDI data were complemented by simultaneous acoustic and electroglottographic recordings.ResultsFor many subjects both transition types were associated with constrictions of the epilaryngeal structures during the pitch glide. These constrictions appeared to be more distinct for the SVaP than for falsetto. No major irregularities of vocal fold oscillations in the sense of fundamental frequency jumps were observed for either transition type. However, during the transitions, the open quotient derived from the glottal area waveform (OQGAW) increased; in falsetto, the OQGAW was greater and the electroglottographic cepstral peak prominence was lower than in SVaP.ConclusionsEpilaryngeal constrictions should be considered typical for tenors singing at high fundamental frequencies. Vocal fold oscillatory patterns are changing not only for the register shift from modal to falsetto but also for the transition from modal to SVaP, indicating a need for laryngeal adjustments during these transitions.



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Fundamental Frequency Variation in Crying of Mandarin and German Neonates

Publication date: Available online 7 July 2016
Source:Journal of Voice
Author(s): Kathleen Wermke, Yufang Ruan, Yun Feng, Daniela Dobnig, Sophia Stephan, Peter Wermke, Li Ma, Hongyu Chang, Youyi Liu, Volker Hesse, Hua Shu
ObjectivesThis study examined whether prenatal exposure to either a tonal or a nontonal maternal language affects fundamental frequency (fo) properties in neonatal crying.Study DesignThis is a population prospective study.ParticipantsA total of 102 neonates within the first week of life served as the participants.MethodsSpontaneously uttered cries (N = 6480) by Chinese (tonal language group) and German neonates (nontonal group) were quantitatively analyzed. For each cry utterance, mean fo and four characteristic variation measures (fo range, fo fluctuation, pitch sigma, and pitch sigma fluctuation) were calculated, averaged for individual neonates, and compared between groups.ResultsA multiple analysis of variance highlighted a significant multivariate effect for language group: Wilks λ = .76, F(6, 95) = 4.96, P < .0001, ηp² = .24. Subsequent univariate analyses revealed significant group differences for fo variation measures, with values higher in the tonal language group. The mean fo did not differ between groups.ConclusionsData regarding fo variation in infant cries have been suggested as providing critical insight into the maturity of neurophysiological vocal control. Our findings, alongside with auditive perception studies, further underscore the assumption of an early shaping effect of maternal speech, particularly fo-based features, on cry features of newborns. Further studies are needed to reexamine this observation and to assess its potential diagnostic relevance.



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Esophageal Mucosal Impedance Pattern is Distinct in Patients With Extraesophageal Reflux Symptoms and Pathologic Acid Reflux

Publication date: Available online 3 August 2016
Source:Journal of Voice
Author(s): Robert T. Kavitt, Pooja Lal, Elif Saritas Yuksel, Fehmi Ates, James C. Slaughter, C. Gaelyn Garrett, Tina Higginbotham, Michael F. Vaezi
Objectives/study designCurrent diagnostic tests for gastroesophageal reflux disease (GERD) do not consistently measure chronicity of reflux. Mucosal impedance (MI) is a minimally invasive measurement to assess esophageal conductivity changes due to GERD. We aimed to investigate MI pattern in patients with symptoms of extraesophageal reflux (EER) in a prospective longitudinal cohort study.MethodsPatients with potential symptoms of EER undergoing esophagogastroduodenoscopy (EGD) with wireless pH monitoring were studied. Participants included those with erosive esophagitis (E+), normal EGD/abnormal pH (E−/pH+), and normal EGD/normal pH (E−/pH−). MI was measured from the site of injury in patients with E+, as well as at 2, 5, and 10 cm above the squamocolumnar junction (SCJ) in all participants.ResultsForty-one patients with symptoms of EER were studied. MI measurements at 2 cm above the SCJ were significantly (P = 0.04) different among the three groups, with MI lowest for E+ and greatest for E−/pH− patients. Although not statistically significant, there is a graded increase in median (interquartile range) MI axially along the esophagus at 5 cm (P = 0.20) and at 10 cm (P = 0.27) above the SCJ, with those with reflux (E+ and E−/pH+) having a lower MI than those without.ConclusionsPatients with symptoms of EER and evidence of acid reflux have an MI lower than those without at 2 cm above the SCJ, with a trend at 5 cm and 10 cm as well. MI may be a tool to assess presence of GERD in patients presenting with EER symptoms.



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Prevalence of Voice Disorders in Iranian Primary School Students

Publication date: Available online 3 August 2016
Source:Journal of Voice
Author(s): Ali Mohammadzadeh, Nazila Sandoughdar
ObjectivesThe voice is the sound produced by vibration of our vocal cords and has an important role in verbal communication. A child's voice disorder may significantly impair his or her ability to be heard and understood. The purpose of this study was to determine the prevalence of voice disorders in primary school students.Methods and MaterialsIn this descriptive-analytical study, a total of 501 fourth through fifth grade primary school students (boys = 51.6%, girls = 48.4%) with the age range of 10–12 years were selected from nine public school systems in Tehran that were assessed in October 2013 through March 2014. Presence of a voice disorder characterized by hoarseness was identified by a dual approach including investigator screening and parent identification. We used the grade of overall dysphonia, roughness, breathiness, asthenia, and strain scale for perceptual evaluation of voice. All children were assessed with video laryngoscopy examination by an otorhinolaryngologist. The recordings were made during spontaneous speech, counting numbers, sustained utterance of the (/a/) vowel, reading a standard passage in Farsi, and the ratio of /s/ and /z/. Statistical analysis was done via chi-square test and t test.ResultsResults indicated that the prevalence of voice disorders in primary school students is 53.2%. The results indicated significant differences between gender and subjects with lesions (P = 0.00000), gender and vocal disorders (P = 0.04), and s/z ratio and type of lesion (P = 0.0002).ConclusionPhonotrauma seems to play an important role in child dysphonia, with nodules as main diagnosis.



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Further Evidence of the Construct Validity of the Transsexual Voice Questionnaire (TVQMtF) Using Principal Components Analysis

Publication date: Available online 8 August 2016
Source:Journal of Voice
Author(s): Georgia Dacakis, Jennifer M. Oates, Jacinta M. Douglas
ObjectivesThe Transsexual Voice Questionnaire (TVQ^MtF) is a population-specific self-report tool designed to capture the perceptions of male-to-female transsexual women (MtF women) regarding their vocal functioning and the voice-related impact on their everyday life. The aim of this study was to further the psychometric evaluation of the TVQ^MtF by examining its construct validity and confirming its reliability.Study DesignThis is a prospective validity and reliability study.MethodsOne hundred fifty-one MtF women provided data for principal components analysis with oblimin rotation. Data from 133 of these participants were also analyzed to evaluate the internal consistency of the TVQ^MtF.ResultsPrincipal components analysis identified a two-factor structure. The largest component (accounting for 51.99% of the variance) captured individuals' perceptions of their vocal functioning and included items related to the link between voice and gender identity. This component was labeled vocal functioning. The second component (5.82% of the variance) contained items that related to the impact of voice on the individual's participation in everyday life and was labeled social participation. Internal consistency was high (Cronbach's α = .97).ConclusionsThe findings support the construct validity of the TVQ^MtF. Additionally, the high internal consistency of the TVQ^MtF found in the current study confirms that the content of the TVQ^MtF reliably measures the self-perceptions of MtF women regarding their voice. The current findings also support the clinical utility of the TVQ^MtF providing a means of organizing TVQ^MtF responses to inform the voice training process.



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Effects of Coaching and Repeated Trials on Maximum Phonational Frequency Range in Children

Publication date: Available online 3 August 2016
Source:Journal of Voice
Author(s): Estella P.-M. Ma, Trista K.-Y. Li
PurposeMaximum phonational frequency range (MPFR) is the frequency range from the lowest to the highest pitch that an individual can produce. This study investigated the effects of coaching and repeated trials on MPFR in a group of school-age children.MethodsThirty girls aged 6–11 years were randomly assigned into two groups: coaching and non-coaching. All of the participants produced the lowest and the highest phonational frequency for 10 times each. The participants in the coaching group were prompted by the clinician with verbal encouragement and a visual cue (hand-sweeping) to produce their maximum performance. The participants in the non-coaching group were simply asked to repeat the task 10 times.ResultsThe clinician's coaching helped the participants in the coaching group reach their MPFR in fewer trials. The MPFRs elicited in 10 trials were significantly greater than those elicited in fewer trials.ConclusionsThese findings suggested that coaching and repeated trials could facilitate the elicitation of MPFR more efficiently.



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Mid-membranous Vocal Fold Webs: Case Series

Publication date: Available online 12 July 2016
Source:Journal of Voice
Author(s): Laura M. Dominguez, Michael M. Johns, C. Blake Simpson
IntroductionLaryngeal webs are a rare clinical entity, with those in the mid-membranous region occurring even less commonly. This is the first case series describing this condition.Case ReportWe describe the clinical course of four patients with mid-glottic webs and propose the possible pathophysiology.DiscussionTrauma to the vocal folds followed by an inflammatory reaction is the likely event leading to the development of this lesion. Endoscopic division of this type of web has shown good postoperative voice outcomes without any recurrences.ConclusionThe mid-glottic web is a rare clinical entity for which there is no defined etiology. It is likely that trauma results in an inflammatory reaction and, ultimately, web formation. Further studies are needed to identify risk factors for this condition.



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Surgery or Rehabilitation: A Randomized Clinical Trial Comparing the Treatment of Vocal Fold Polyps via Phonosurgery and Traditional Voice Therapy with “Voice Therapy Expulsion” Training

Publication date: Available online 2 August 2016
Source:Journal of Voice
Author(s): Maria Rosaria Barillari, Umberto Volpe, Giuseppina Mirra, Francesco Giugliano, Umberto Barillari
ObjectivePhonomicrosurgery is generally considered to be the treatment of choice for removing vocal fold polyps. However, specific techniques of voice therapy may represent, in selected cases and under certain conditions, a noninvasive therapeutic option for the treatment of such laryngeal lesions. The aim of the present study is to longitudinally assess, in terms of clinical outcomes and quality of life, two groups of patients with cordal polyps, treated either with standard surgery plus standard voice therapy or with a specific training of voice therapy alone, which we have called “Voice Therapy Expulsion.”Study designThis study is a randomized controlled trial.MethodsA total of 150 patients with vocal fold polyps were randomly assigned to either standard surgery or “voice therapy expulsion” protocol. The trial was carried out at the Division of Phoniatrics and Audiology of the Second University of Naples and at the Division of Communication Disorders of Local Health Unit (3 Naples South) from January 2010 to December 2013. A thorough phoniatric evaluation, including laryngostroboscopy, acoustic voice analysis, global grade of dysphonia, instability, roughness, breathiness, asthenia, and strain scale, Voice Handicap Index, and Voice-Related Quality of Life, was performed by using standardized tools, at baseline, at the end of the treatment, and up to 1 year after treatment.ResultsWe found no significant differences between the two experimental groups in terms of clinical outcomes and personal satisfaction. However, “Voice Therapy Expulsion” was associated with higher scores for quality of life at endpoint evaluation.ConclusionsBesides phonosurgery, this specific “Voice Therapy Expulsion” technique should be considered as a valid, noninvasive, and well-tolerated therapeutic option for the treatment of selected patients with vocal fold polyps.



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Human Speech: A Restricted Use of the Mammalian Larynx

Publication date: Available online 7 July 2016
Source:Journal of Voice
Author(s): Ingo R. Titze
PurposeSpeech has been hailed as unique to human evolution. Although the inventory of distinct sounds producible with vocal tract articulators is a great advantage in human oral communication, it is argued here that the larynx as a sound source in speech is limited in its range and capability because a low fundamental frequency is ideal for phonemic intelligibility and source-filter independence.MethodFour existing data sets were combined to make an argument regarding exclusive use of the larynx for speech: (1) range of fundamental frequency, (2) laryngeal muscle activation, (3) vocal fold length in relation to sarcomere length of the major laryngeal muscles, and (4) vocal fold morphological development.ResultsLimited data support the notion that speech tends to produce a contracture of the larynx. The morphological design of the human vocal folds, like that of primates and other mammals, appears to be optimized for vocal communication over distances for which higher fundamental frequency, higher intensity, and fewer unvoiced segments are used.ConclusionThe positive message is that raising one's voice to call, shout, or sing, or executing pitch glides to stretch the vocal folds, can counteract this trend toward a contracted state.



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Voice Quality in Native and Foreign Languages Investigated by Inverse Filtering and Perceptual Analyses

Publication date: Available online 2 August 2016
Source:Journal of Voice
Author(s): Kati Järvinen, Anne-Maria Laukkanen, Ahmed Geneid
ObjectivesLanguage shift from native (L1) to foreign language (L2) may affect speaker's voice production and induce vocal fatigue. This study investigates the effects of language shift on voice source and perceptual voice quality.Study DesignThis is a comparative experimental study.Subjects and MethodsTwenty-four subjects were recorded in L1 and L2. Twelve of the subjects were native Finnish speakers and 12 were native English speakers, and the foreign languages were English and Finnish. Two groups were created based on reports of fatigability. Group 1 had the subjects who did not report more vocal fatigue in L2 than in L1, and in group 2 those who reported more vocal fatigue in L2 than in L1. Acoustic analyses by inverse filtering were conducted in L1 and L2. Also, the subjects' voices were perceptually evaluated in both languages.ResultsResults show that language shift from L1 to L2 increased perceived pressedness of voice. Acoustic analyses correlated with the perceptual evaluations. Also, the subjects who reported more vocal loading had poorer voice quality, more strenuous voice production, more pressed phonation, and a higher pitch.ConclusionsVoice production was less optimal in L2 than in L1. Speech training given in L2 could be beneficial for people who need to use L2 extensively.



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Editorial Board

Publication date: July 2016
Source:Journal of Voice, Volume 30, Issue 4





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Optimal Duration for Voice Rest After Vocal Fold Surgery: Randomized Controlled Clinical Study

Publication date: Available online 1 August 2016
Source:Journal of Voice
Author(s): Mami Kaneko, Osamu Shiromoto, Masako Fujiu-Kurachi, Yo Kishimoto, Ichiro Tateya, Shigeru Hirano
ObjectivesVoice rest is commonly recommended after phonomicrosurgery to prevent worsening of vocal fold injuries. However, the most effective duration of voice rest is unknown. Recently, early vocal stimulation was recommended as a means to improve wound healing. The purpose of this study is to examine the optimal duration of voice rest after phonomicrosurgery.Study DesignRandomized controlled clinical study.MethodsPatients undergoing phonomicrosurgery for leukoplakia, carcinoma in situ, vocal fold polyp, Reinke's edema, and cyst were chosen. Participants were randomly assigned to voice rest for 3 or 7 postoperative days. Voice therapy was administered to both groups after voice rest. Grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, stroboscopic examination, aerodynamic assessment, acoustic analysis, and Voice Handicap Index-10 (VHI-10) were performed pre- and postoperatively at 1, 3, and 6 months. Stroboscopic examination evaluated normalized mucosal wave amplitude (NMWA). Parameters were compared between both groups.ResultsThirty-one patients were analyzed (3-day group, n = 16; 7-day group, n = 15). Jitter, shimmer, and VHI-10 were significantly better in the 3-day group at 1 month post operation. GRBAS was significantly better in the 3-day group at 1 and 3 months post operation, and NMWA was significantly better in the 3-day group at 1, 3, and 6 months post operation compared to the 7-day group.ConclusionsThe data suggest that 3 days of voice rest followed by voice therapy may lead to better wound healing of the vocal fold compared to 7 days of voice rest. Appropriate mechanical stimulation during early stages of vocal fold wound healing may lead to favorable functional recovery.



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Transcultural Adaptation and Validation of the German Version of the Vocal Tract Discomfort Scale

Publication date: Available online 1 August 2016
Source:Journal of Voice
Author(s): Julia Lukaschyk, Meike Brockmann-Bauser, Ulla Beushausen
ObjectivesCurrently, there is no standardized German questionnaire to assess vocal tract discomfort in voice patients. The aim of this study was to evaluate the internal consistency, reliability, and validity of the German version of the Vocal Tract Discomfort (VTD) Scale.Study DesignThis is a cross-sectional study.MethodsFirst, a cross-cultural translation and adaptation from English to German was performed. One hundred seven patients between the ages of 18 and 76 with voice disorders were divided into two different diagnosis-related groups (organic and functional voice disorder) and 50 vocally healthy adults were included. All participants completed the VTD Scale and the Voice Handicap Index (VHI). The internal consistency of the VTD Scale was analyzed through Cronbach's α coefficient. Pearson correlation between the VDT Scale and VHI total scores was used to determine criterion validity. The VDT Scale score differences related to diagnosis groups were assessed with analysis of variance.ResultsExcellent internal consistency was found (α = 0.919, P < 0.05), and criterion validity was confirmed by a high correlation between the total VTD Scale and VHI (r = 0.674). There was a significant difference between the diagnosis groups' total VTD Scale score (F[4.135] = 15.114, P = 0.000). Furthermore, the vocally healthy adults had significantly lower values than the two diagnosis groups (x¯: 11.48, s = 8.340).ConclusionsThe German version of the VTD Scale has an excellent internal consistency and reliability, and shows high clinical validity. Thus, it is a useful instrument in voice diagnostics.



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Objective Identification of Prepubertal Female Singers and Non-singers by Singing Power Ratio Using Matlab

Publication date: Available online 29 July 2016
Source:Journal of Voice
Author(s): M. Usha, Y.V. Geetha, Y.S. Darshan
BackgroundThe field of music is increasingly gaining scope and attracting researchers from varied fields in terms of improvising the art of voice modulation in singing. There has been a lot of competition, and young budding singers are emerging with more talent. This study is aimed to develop software to differentiate a prepubertal voice as that of a singer or a non-singer using an objective tool—singing power ratio (SPR)—as an objective measure to quantify the resonant voice quality.MethodRecordings of singing and phonation were obtained from 30 singers and 30 non-singer girls (8–10 years). Three professional singers perceptually evaluated all samples using a rating scale and categorized them as singers or non-singers. Using Matlab, a program was developed to automatically calculate the SPR of a particular sample and classify it into either of two groups based on the normative values of SPR developed manually.ResultsPositive correlation for SPR of phonation or singing was found between perceptual and manual ratings, and objective values of SPR. Software could automatically give the SPR values for samples that are fed and could further differentiate them as singer or non-singer.ConclusionResearchers need not depend on professional singers or musicians for the judgment of voice for research purposes. This software uses an objective tool, which serves as an instrument to judge singing talent using singing and phonation samples of children. Also, it can be used as a first line of judgment in any singing audition process, which could ease the work of professionals.



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The Effectiveness of Pitch-raising Surgery in Male-to-Female Transsexuals: A Systematic Review

Publication date: Available online 28 July 2016
Source:Journal of Voice
Author(s): Silke Van Damme, Marjan Cosyns, Sofie Deman, Zoë Van den Eede, John Van Borsel
ObjectivesThis study aimed to review the evidence of the effectiveness of pitch-raising surgery performed in male-to-female transsexuals.MethodsA search for studies was performed in PubMed, Web of Science, Science Direct, EBSCOhost, Google Scholar, and the references in retrieved manuscripts, using as keywords “transsexual” or “transgender” combined with terms related to voice surgery. We included eight studies using cricothyroid approximation, six studies using anterior glottal web formation, and six studies using other surgery types or a combination of surgical techniques, leading to 20 studies in total.ResultsObjectively, a substantial rise in postoperative fundamental frequency was identified. Perceptually, mainly laryngeal web formation seems risky for decreasing voice quality. The majority of patients seemed satisfied with the outcome. However, none of the studies used a control group and randomization process. Further investigation regarding long-term results is necessary.ConclusionFuture research needs to investigate long-term effects of pitch-raising surgery using a stronger study design.



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Mitochondrial calcium uptake underlies ROS generation during aminoglycoside-induced hair cell death.

Mitochondrial calcium uptake underlies ROS generation during aminoglycoside-induced hair cell death.

J Clin Invest. 2016 Aug 8;

Authors: Esterberg R, Linbo T, Pickett SB, Wu P, Ou HC, Rubel EW, Raible DW

Abstract
Exposure to aminoglycoside antibiotics can lead to the generation of toxic levels of reactive oxygen species (ROS) within mechanosensory hair cells of the inner ear that have been implicated in hearing and balance disorders. Better understanding of the origin of aminoglycoside-induced ROS could focus the development of therapies aimed at preventing this event. In this work, we used the zebrafish lateral line system to monitor the dynamic behavior of mitochondrial and cytoplasmic oxidation occurring within the same dying hair cell following exposure to aminoglycosides. The increased oxidation observed in both mitochondria and cytoplasm of dying hair cells was highly correlated with mitochondrial calcium uptake. Application of the mitochondrial uniporter inhibitor Ru360 reduced mitochondrial and cytoplasmic oxidation, suggesting that mitochondrial calcium drives ROS generation during aminoglycoside-induced hair cell death. Furthermore, targeting mitochondria with free radical scavengers conferred superior protection against aminoglycoside exposure compared with identical, untargeted scavengers. Our findings suggest that targeted therapies aimed at preventing mitochondrial oxidation have therapeutic potential to ameliorate the toxic effects of aminoglycoside exposure.

PMID: 27500493 [PubMed - as supplied by publisher]

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Quality of life improvement after pressure equalization tube placement in Down syndrome: A prospective study.

Related Articles

Quality of life improvement after pressure equalization tube placement in Down syndrome: A prospective study.

Int J Pediatr Otorhinolaryngol. 2016 Sep;88:168-72

Authors: Labby A, Mace JC, Buncke M, MacArthur CJ

Abstract
OBJECTIVE: To evaluate quality-of-life changes after bilateral pressure equalization tube placement with or without adenoidectomy for the treatment of chronic otitis media with effusion or recurrent acute otitis media in a pediatric Down syndrome population compared to controls.
STUDY DESIGN: Prospective case-control observational study.
METHODS: The OM Outcome Survey (OMO-22) was administered to both patients with Down syndrome and controls before bilateral tube placement with or without adenoidectomy and at an average of 6-7 months postoperatively. Thirty-one patients with Down syndrome and 34 controls were recruited. Both pre-operative and post-operative between-group and within-group score comparisons were conducted for the Physical, Hearing/Balance, Speech, Emotional, and Social domains of the OMO-22.
RESULTS: Both groups experienced improvement of mean symptom scores post-operatively. Patients with Down syndrome reported significant post-operative improvement in mean Physical and Hearing domain item scores while control patients reported significant improvement in Physical, Hearing, and Emotional domain item scores. All four symptom scores in the Speech domain, both pre-operatively and post-operatively, were significantly worse for Down syndrome patients compared to controls (p ≤ 0.008).
CONCLUSIONS: Surgical placement of pressure equalizing tubes results in significant quality of life improvements in patients with Down syndrome and controls. Problems related to speech and balance are reported at a higher rate and persist despite intervention in the Down syndrome population. It is possible that longer follow up periods and/or more sensitive tools are required to measure speech improvements in the Down syndrome population after pressure equalizing tube placement ± adenoidectomy.

PMID: 27497407 [PubMed - in process]

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Mitochondrial calcium uptake underlies ROS generation during aminoglycoside-induced hair cell death.

Mitochondrial calcium uptake underlies ROS generation during aminoglycoside-induced hair cell death.

J Clin Invest. 2016 Aug 8;

Authors: Esterberg R, Linbo T, Pickett SB, Wu P, Ou HC, Rubel EW, Raible DW

Abstract
Exposure to aminoglycoside antibiotics can lead to the generation of toxic levels of reactive oxygen species (ROS) within mechanosensory hair cells of the inner ear that have been implicated in hearing and balance disorders. Better understanding of the origin of aminoglycoside-induced ROS could focus the development of therapies aimed at preventing this event. In this work, we used the zebrafish lateral line system to monitor the dynamic behavior of mitochondrial and cytoplasmic oxidation occurring within the same dying hair cell following exposure to aminoglycosides. The increased oxidation observed in both mitochondria and cytoplasm of dying hair cells was highly correlated with mitochondrial calcium uptake. Application of the mitochondrial uniporter inhibitor Ru360 reduced mitochondrial and cytoplasmic oxidation, suggesting that mitochondrial calcium drives ROS generation during aminoglycoside-induced hair cell death. Furthermore, targeting mitochondria with free radical scavengers conferred superior protection against aminoglycoside exposure compared with identical, untargeted scavengers. Our findings suggest that targeted therapies aimed at preventing mitochondrial oxidation have therapeutic potential to ameliorate the toxic effects of aminoglycoside exposure.

PMID: 27500493 [PubMed - as supplied by publisher]

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Quality of life improvement after pressure equalization tube placement in Down syndrome: A prospective study.

Related Articles

Quality of life improvement after pressure equalization tube placement in Down syndrome: A prospective study.

Int J Pediatr Otorhinolaryngol. 2016 Sep;88:168-72

Authors: Labby A, Mace JC, Buncke M, MacArthur CJ

Abstract
OBJECTIVE: To evaluate quality-of-life changes after bilateral pressure equalization tube placement with or without adenoidectomy for the treatment of chronic otitis media with effusion or recurrent acute otitis media in a pediatric Down syndrome population compared to controls.
STUDY DESIGN: Prospective case-control observational study.
METHODS: The OM Outcome Survey (OMO-22) was administered to both patients with Down syndrome and controls before bilateral tube placement with or without adenoidectomy and at an average of 6-7 months postoperatively. Thirty-one patients with Down syndrome and 34 controls were recruited. Both pre-operative and post-operative between-group and within-group score comparisons were conducted for the Physical, Hearing/Balance, Speech, Emotional, and Social domains of the OMO-22.
RESULTS: Both groups experienced improvement of mean symptom scores post-operatively. Patients with Down syndrome reported significant post-operative improvement in mean Physical and Hearing domain item scores while control patients reported significant improvement in Physical, Hearing, and Emotional domain item scores. All four symptom scores in the Speech domain, both pre-operatively and post-operatively, were significantly worse for Down syndrome patients compared to controls (p ≤ 0.008).
CONCLUSIONS: Surgical placement of pressure equalizing tubes results in significant quality of life improvements in patients with Down syndrome and controls. Problems related to speech and balance are reported at a higher rate and persist despite intervention in the Down syndrome population. It is possible that longer follow up periods and/or more sensitive tools are required to measure speech improvements in the Down syndrome population after pressure equalizing tube placement ± adenoidectomy.

PMID: 27497407 [PubMed - in process]

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Identifying and optimizing communication in patients with hearing loss.

Related Articles

Identifying and optimizing communication in patients with hearing loss.

Am J Health Syst Pharm. 2016 Aug 15;73(16):1255-9

Authors: Zeitlin D

PMID: 27496841 [PubMed - in process]

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Postural sway in children: A literature review

Publication date: September 2016
Source:Gait & Posture, Volume 49
Author(s): Evi Verbecque, Luc Vereeck, Ann Hallemans
Background and aimStatic posturography can serve as an easy and fast way to determine whether a child possesses sufficient balance control in different sensory conditions. Therefore, the aim of this review is to map age-related differences in postural sway during childhood in typically developing children, using static posturography and to provide an overview of the available (age-specific) reference values in scientific literature.MethodsThe search strategy was performed in five databases (Pubmed, Web of Science, ScienceDirect, Cochrane Clinical Trials, Medline (Ovid)) November 2nd 2014 and updated twice: March 16th 2015 and July 20th 2015. The following keywords were used: (children OR child) AND (“postural control” OR “postural stability” OR equilibrium OR posture OR “postural balance”[mesh]) AND (“quiet stance” OR standing OR stance OR “quiet stance” OR static) AND (“postural sway” OR posturography OR “body sway” OR stabilography OR “trunk sway” OR “medio-lateral sway” OR “antero-posterior sway”). Relevant studies were identified using predefined selection criteria, applied on title and abstract (phase 1) and on full text (phase 2), supplemented with reference screening after the second phase.ResultsA total of 14 studies met the criteria. This review showed three main findings: 1) during natural bipedal stance with the eyes open, all studies reported a decrease in postural sway with increasing age, with conflicting results on the (non-)linearity of its development, 2) with eyes closed, all children show more sway than with eyes open and 3) only four studies reported numeric sway values that could serve as reference values, mainly focusing on children aged five and older.ConclusionConsiderable disagreement exists on the (non-)linearity of the development of postural sway in children. By choosing arbitrary age categories, it remains unclear between which age groups differences are situated. Future research is necessary to determine for which age groups age-specific reference values are relevant.



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Postural sway in children: A literature review

Publication date: September 2016
Source:Gait & Posture, Volume 49
Author(s): Evi Verbecque, Luc Vereeck, Ann Hallemans
Background and aimStatic posturography can serve as an easy and fast way to determine whether a child possesses sufficient balance control in different sensory conditions. Therefore, the aim of this review is to map age-related differences in postural sway during childhood in typically developing children, using static posturography and to provide an overview of the available (age-specific) reference values in scientific literature.MethodsThe search strategy was performed in five databases (Pubmed, Web of Science, ScienceDirect, Cochrane Clinical Trials, Medline (Ovid)) November 2nd 2014 and updated twice: March 16th 2015 and July 20th 2015. The following keywords were used: (children OR child) AND (“postural control” OR “postural stability” OR equilibrium OR posture OR “postural balance”[mesh]) AND (“quiet stance” OR standing OR stance OR “quiet stance” OR static) AND (“postural sway” OR posturography OR “body sway” OR stabilography OR “trunk sway” OR “medio-lateral sway” OR “antero-posterior sway”). Relevant studies were identified using predefined selection criteria, applied on title and abstract (phase 1) and on full text (phase 2), supplemented with reference screening after the second phase.ResultsA total of 14 studies met the criteria. This review showed three main findings: 1) during natural bipedal stance with the eyes open, all studies reported a decrease in postural sway with increasing age, with conflicting results on the (non-)linearity of its development, 2) with eyes closed, all children show more sway than with eyes open and 3) only four studies reported numeric sway values that could serve as reference values, mainly focusing on children aged five and older.ConclusionConsiderable disagreement exists on the (non-)linearity of the development of postural sway in children. By choosing arbitrary age categories, it remains unclear between which age groups differences are situated. Future research is necessary to determine for which age groups age-specific reference values are relevant.



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Postural sway in children: A literature review

Publication date: September 2016
Source:Gait & Posture, Volume 49
Author(s): Evi Verbecque, Luc Vereeck, Ann Hallemans
Background and aimStatic posturography can serve as an easy and fast way to determine whether a child possesses sufficient balance control in different sensory conditions. Therefore, the aim of this review is to map age-related differences in postural sway during childhood in typically developing children, using static posturography and to provide an overview of the available (age-specific) reference values in scientific literature.MethodsThe search strategy was performed in five databases (Pubmed, Web of Science, ScienceDirect, Cochrane Clinical Trials, Medline (Ovid)) November 2nd 2014 and updated twice: March 16th 2015 and July 20th 2015. The following keywords were used: (children OR child) AND (“postural control” OR “postural stability” OR equilibrium OR posture OR “postural balance”[mesh]) AND (“quiet stance” OR standing OR stance OR “quiet stance” OR static) AND (“postural sway” OR posturography OR “body sway” OR stabilography OR “trunk sway” OR “medio-lateral sway” OR “antero-posterior sway”). Relevant studies were identified using predefined selection criteria, applied on title and abstract (phase 1) and on full text (phase 2), supplemented with reference screening after the second phase.ResultsA total of 14 studies met the criteria. This review showed three main findings: 1) during natural bipedal stance with the eyes open, all studies reported a decrease in postural sway with increasing age, with conflicting results on the (non-)linearity of its development, 2) with eyes closed, all children show more sway than with eyes open and 3) only four studies reported numeric sway values that could serve as reference values, mainly focusing on children aged five and older.ConclusionConsiderable disagreement exists on the (non-)linearity of the development of postural sway in children. By choosing arbitrary age categories, it remains unclear between which age groups differences are situated. Future research is necessary to determine for which age groups age-specific reference values are relevant.



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Effects of sustained release dexamethasone hydrogels in hearing preservation cochlear implantation

Publication date: Available online 9 August 2016
Source:Hearing Research
Author(s): Clemens Honeder, Chengjing Zhu, Hanna Schöpper, Julia Clara Gausterer, Manuel Walter, Lukas David Landegger, Nodir Saidov, Dominik Riss, Roberto Plasenzotti, Franz Gabor, Christoph Arnoldner
It has been shown that glucocorticoids reduce the hearing threshold shifts associated with cochlear implantation. Previous studies evaluated the administration of glucocorticoids immediately before surgery or the repeated pre- or perioperative systemic application of glucocorticoids. The aim of this study was to evaluate the effects of a sustained release dexamethasone hydrogel in hearing preservation cochlear implantation. To address this issue, a guinea pig model of cochlear implantation was used. 30 normal hearing pigmented guinea pigs were randomized into a group receiving a single dose of a dexamethasone/poloxamer407 hydrogel one day prior to surgery, a second group receiving the hydrogel application seven days prior to surgery and a control group. A silicone cochlear implant electrode designed for the use in guinea pigs was inserted to a depth of 5 mm through a cochleostomy. Compound action potentials of the auditory nerve (frequency range 0.5 - 32 kHz) were measured preoperatively, directly postoperatively and on postoperative days 3, 7, 14, 21, and 28. Following the last audiometry, temporal bones were harvested and histologically evaluated.Dexamethasone hydrogel application one day prior to surgery resulted in significantly reduced hearing threshold shifts at low, middle and high frequencies measured at postoperative day 28 (p < 0.05). Application of the hydrogel seven days prior to surgery did not show such an effect. Dexamethasone application one day prior to surgery resulted in increased outer hair cell counts in the cochlear apex and in reduced spiral ganglion cell counts in the basal and middle turn of the cochlea, a finding that was associated with a higher rate of electrode translocation in this group.In this study, we were able to demonstrate functional benefits of a single preoperative intratympanic application of a sustained release dexamethasone hydrogel in a guinea pig model of cochlear implantation.



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Effects of sustained release dexamethasone hydrogels in hearing preservation cochlear implantation

Publication date: Available online 9 August 2016
Source:Hearing Research
Author(s): Clemens Honeder, Chengjing Zhu, Hanna Schöpper, Julia Clara Gausterer, Manuel Walter, Lukas David Landegger, Nodir Saidov, Dominik Riss, Roberto Plasenzotti, Franz Gabor, Christoph Arnoldner
It has been shown that glucocorticoids reduce the hearing threshold shifts associated with cochlear implantation. Previous studies evaluated the administration of glucocorticoids immediately before surgery or the repeated pre- or perioperative systemic application of glucocorticoids. The aim of this study was to evaluate the effects of a sustained release dexamethasone hydrogel in hearing preservation cochlear implantation. To address this issue, a guinea pig model of cochlear implantation was used. 30 normal hearing pigmented guinea pigs were randomized into a group receiving a single dose of a dexamethasone/poloxamer407 hydrogel one day prior to surgery, a second group receiving the hydrogel application seven days prior to surgery and a control group. A silicone cochlear implant electrode designed for the use in guinea pigs was inserted to a depth of 5 mm through a cochleostomy. Compound action potentials of the auditory nerve (frequency range 0.5 - 32 kHz) were measured preoperatively, directly postoperatively and on postoperative days 3, 7, 14, 21, and 28. Following the last audiometry, temporal bones were harvested and histologically evaluated.Dexamethasone hydrogel application one day prior to surgery resulted in significantly reduced hearing threshold shifts at low, middle and high frequencies measured at postoperative day 28 (p < 0.05). Application of the hydrogel seven days prior to surgery did not show such an effect. Dexamethasone application one day prior to surgery resulted in increased outer hair cell counts in the cochlear apex and in reduced spiral ganglion cell counts in the basal and middle turn of the cochlea, a finding that was associated with a higher rate of electrode translocation in this group.In this study, we were able to demonstrate functional benefits of a single preoperative intratympanic application of a sustained release dexamethasone hydrogel in a guinea pig model of cochlear implantation.



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Effects of sustained release dexamethasone hydrogels in hearing preservation cochlear implantation

Publication date: Available online 9 August 2016
Source:Hearing Research
Author(s): Clemens Honeder, Chengjing Zhu, Hanna Schöpper, Julia Clara Gausterer, Manuel Walter, Lukas David Landegger, Nodir Saidov, Dominik Riss, Roberto Plasenzotti, Franz Gabor, Christoph Arnoldner
It has been shown that glucocorticoids reduce the hearing threshold shifts associated with cochlear implantation. Previous studies evaluated the administration of glucocorticoids immediately before surgery or the repeated pre- or perioperative systemic application of glucocorticoids. The aim of this study was to evaluate the effects of a sustained release dexamethasone hydrogel in hearing preservation cochlear implantation. To address this issue, a guinea pig model of cochlear implantation was used. 30 normal hearing pigmented guinea pigs were randomized into a group receiving a single dose of a dexamethasone/poloxamer407 hydrogel one day prior to surgery, a second group receiving the hydrogel application seven days prior to surgery and a control group. A silicone cochlear implant electrode designed for the use in guinea pigs was inserted to a depth of 5 mm through a cochleostomy. Compound action potentials of the auditory nerve (frequency range 0.5 - 32 kHz) were measured preoperatively, directly postoperatively and on postoperative days 3, 7, 14, 21, and 28. Following the last audiometry, temporal bones were harvested and histologically evaluated.Dexamethasone hydrogel application one day prior to surgery resulted in significantly reduced hearing threshold shifts at low, middle and high frequencies measured at postoperative day 28 (p < 0.05). Application of the hydrogel seven days prior to surgery did not show such an effect. Dexamethasone application one day prior to surgery resulted in increased outer hair cell counts in the cochlear apex and in reduced spiral ganglion cell counts in the basal and middle turn of the cochlea, a finding that was associated with a higher rate of electrode translocation in this group.In this study, we were able to demonstrate functional benefits of a single preoperative intratympanic application of a sustained release dexamethasone hydrogel in a guinea pig model of cochlear implantation.



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