Overdrive and Edge as Refiners of “Belting”?

Publication date: Available online 18 November 2016
Source:Journal of Voice
Author(s): Julian McGlashan, Mathias Aaen Thuesen, Cathrine Sadolin
ObjectivesWe aimed to study the categorizations “Overdrive” and “Edge” from the pedagogic method Complete Vocal Technique as refiners of the often ill-defined concept of “belting” by means of audio perception, laryngostroboscopic imaging, acoustics, long-term average spectrum (LTAS), and electroglottography (EGG).Study DesignThis is a case-control study.MethodsTwenty singers were recorded singing sustained vowels in a “belting” quality refined by audio perception as “Overdrive” and “Edge.” Two studies were performed: (1) a laryngostroboscopic examination using a videonasoendoscopic camera system (Olympus) and the Laryngostrobe program (Laryngograph); (2) a simultaneous recording of the EGG and acoustic signals using Speech Studio (Laryngograph). The images were analyzed based on consensus agreement. Statistical analysis of the acoustic, LTAS, and EGG parameters was undertaken using the Student paired t test.ResultsThe two modes of singing determined by audio perception have visibly different laryngeal gestures: Edge has a more constricted setting than that of Overdrive, where the ventricular folds seem to cover more of the vocal folds, the aryepiglottic folds show a sharper edge in Edge, and the cuneiform cartilages are rolled in anteromedially. LTAS analysis shows a statistical difference, particularly after the ninth harmonic, with a coinciding first formant. The combined group showed statistical differences in shimmer, harmonics-to-noise ratio, normalized noise energy, and mean sound pressure level (P ≥ 0.05).Conclusion“Belting” sounds can be categorized using audio perception into two modes of singing: “Overdrive” and “Edge.” This study demonstrates consistent visibly different laryngeal gestures between these modes and with some correspondingly significant differences in LTAS, EGG, and acoustic measures.



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Functional Voice Disorders: The Importance of the Psychologist in Clinical Voice Assessment

Publication date: Available online 18 November 2016
Source:Journal of Voice
Author(s): Mafalda Andrea, Óscar Dias, Mário Andrea, Maria Luísa Figueira
ObjectivesThe etiopathogenesis of functional voice disorders (FVDs) is multifactorial. The purpose of this study was to analyze the severity of depression and anxiety, and the incidence of affective and anxiety disorders, in patients who presented different types of FVDs and were followed at the University Clinic of Otolaryngology.DesignThis is a cross-sectional study.MethodsAfter ENT observation, 83 women were classified into three groups: psychogenic voice disorder (PVD = 39), primary muscle tension voice disorder (MTVD1 = 16), and secondary muscle tension voice disorder (MTVD2 = 28). A psychologist assessed the severity of depression and anxiety using the Hamilton rating scales, and screened for affective and anxiety disorders using the Mini International Neuropsychiatric Interview.ResultsSignificant differences in the mean values were found between the groups, with the MTVD1 group having higher levels of depression and anxiety. In affective disorders (current major depression and current mood disorder with psychotic symptoms) and in anxiety disorders (lifetime panic disorder, current generalized anxiety, and current panic disorder with agoraphobia), significant differences in association were found between groups.ConclusionsGroups presented with significant differences in depression and anxiety levels, and in some psychiatric diagnoses. Patients with FVDs should be independently assessed regarding their voice disorder classification. The integration of a psychologist in the clinical voice assessment team is essential, as findings have corroborated an important incidence of psychiatric disorders in FVDs patients.



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A Novel Mutation in SLC26A4 Causes Nonsyndromic Autosomal Recessive Hearing Impairment.

Background: Heterozygous mutations in GJB2 (MIM: 121011) encoding the gap junction protein connexin 26 are overrepresented in patient groups suffering from nonsyndromic sensorineural hearing impairment (HI) implying the involvement of additional genetic factors. Mutations in SLC26A4 (MIM: 605646), encoding the protein pendrin can cause both Pendred syndrome and autosomal recessive, nonsyndromic HI locus 4 type sensorineural HI (MIM: 600791). Objectives: Aim of this study was to investigate the role of SLC26A4 coding mutations in a nonsyndromic hearing impairment (NSHI) patient group bearing heterozygous GJB2 35delG mutations. Design: We analyzed the 20 coding exons of SLC26A4 in a group of patients (n = 15) bearing heterozygous 35delG mutations and exclusively suffering from congenital HI. Results: In a case of bilateral congenital hearing loss we identified a rare, novel SLC26A4 exon 2 splice donor mutation (c.164+1delG) predicted to truncate pendrin in the first cytoplasmic domain, as a compound heterozygote with the pathogenic missense mutation c.1061T>C (p.354F>S; rs111033243). Conclusions: Screening for SLC26A4 mutations may identify the genetic causes of hearing loss in patients bearing heterozygous mutations in GJB2. Hypothesis: SLC26A4 coding mutations are genetic causes for nonsyndromic HI in patients bearing heterozygous GJB2 35delG mutations. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Steerable Robot-assisted Micromanipulation in the Middle Ear: Preliminary Feasibility Evaluation.

Hypothesis: The use of a robotic manipulator with a dexterously orientable gripper will expand the ability of middle ear surgeons to perform precise tasks and access otherwise challenging anatomic regions. Background: Middle ear surgery presents unique challenges because of the constrained operative space and limited access to certain anatomic regions. Methods: A custom-designed robot with a sideways-reaching gripper was used to evaluate feasibility of manipulation tasks in different middle-ear anatomical zones. Reachable workspace within the middle ear, accuracy of free-space path following, and tool steadiness were compared between robotic telemanipulation and manual control. Preliminarily assessments of the robot's clinical utility included: 1) touching the round window niche, Eustachian tube orifice, and sinus tympani; 2) placing a stapes prosthesis; 3) removal of mockup diseased tissue in the sinus tympani. Results: The reachable workspace in the middle ear was considerably greater with the robot as compared with manual manipulation using a Rosen needle. In a simple path-tracing task outside the ear, robotic telemanipulation was associated with significantly reduced error. Within the middle ear, the robot contributed to steadier movement, but longer task completion time. The gripper successfully placed a 4.5 mm piston prosthesis, accessed the round window niche, Eustachian tube orifice, and removed mockup disease from the sinus tympani. Conclusion: This study demonstrates that robotic assistance using steerable tools allows surgeons to access challenging anatomic regions of the middle ear. Coordinated and accurate manipulation is evidenced by motion analyses and completion of feasibility tasks within the middle ear. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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The Weather and Meniere's Disease: A Longitudinal Analysis in the UK.

Hypothesis: Changes in the weather influence symptom severity in Meniere's disease (MD). Background: MD is an unpredictable condition that significantly impacts on quality of life. It is suggested that fluctuations in the weather, especially atmospheric pressure may influence the symptoms of MD. However, to date, limited research has investigated the impact of the weather on MD. Methods: In a longitudinal study, a mobile phone application collected data from 397 individuals (277 females and 120 males with an average age of 50 yr) from the UK reporting consultant-diagnosed MD. Daily symptoms (vertigo, aural fullness, tinnitus, hearing loss, and attack prevalence) and GPS locations were collected; these data were linked with Met Office weather data (including atmospheric pressure, humidity, temperature, visibility, and wind speed). Results: Symptom severity and attack prevalence were reduced on days when atmospheric pressure was higher. When atmospheric pressure was below 1,013 hectopascals, the risk of an attack was 1.30 (95% confidence interval: 1.10, 1.54); when the humidity was above 90%, the risk of an attack was 1.26 (95% confidence interval 1.06, 1.49). Conclusion: This study provides the strongest evidence to date that changes in atmospheric pressure and humidity are associated with symptom exacerbation in MD. Improving our understanding of the role of weather and other environmental triggers in Meniere's may reduce the uncertainty associated with living with this condition, significantly contributing to improved quality of life. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://ift.tt/1eRPUFd Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Intrinsic-cum-extrinsic normalization of formant data of vowels

Using a known speaker-intrinsic normalization procedure, formant data are scaled by the reciprocal of the geometric mean of the first three formant frequencies. This reduces the influence of the talker but results in a distorted vowel space. The proposed speaker-extrinsic procedure re-scales the normalized values by the mean formant values of vowels. When tested on the formant data of vowels published by Peterson and Barney, the combined approach leads to well separated clusters by reducing the spread due to talkers. The proposed procedure performs better than two top-ranked normalization procedures based on the accuracy of vowel classification as the objective measure.

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Age-related hearing loss in individuals and their caregivers: effects of coping on the quality of life among the dyads.

Age-related hearing loss in individuals and their caregivers: effects of coping on the quality of life among the dyads.

Patient Prefer Adherence. 2016;10:2279-2287

Authors: Lazzarotto S, Baumstarck K, Loundou A, Hamidou Z, Aghababian V, Leroy T, Auquier P

Abstract
OBJECTIVES: Age-related hearing loss (ARHL) impacts the daily living and quality of life (QoL) of affected individuals and the functioning of family caregivers. In the specific context of voluntary medical checkups, we examined sample dyads (ARHL individual and the caregiver) to determine whether QoL of patients and caregivers is influenced by coping strategies implemented either by themselves or their relatives.
METHODS: This was a cross-sectional study with a descriptive/correlative design performed in a French preventive health center (Regional Institute for Prevention of Aging, Marseille, France) for the beneficiaries of pension funds of private sector employees. The samples included beneficiary-caregiver dyads. The beneficiaries had bilateral (mild to moderately severe) ARHL. Self-reported data were collected as follows: QoL using the World Health Organization Quality of Life questionnaire, coping strategies using the Brief Coping Orientation to Problems Experienced Scale, and anxiety and mood using visual analog scales.
RESULTS: The final sample comprised 44 beneficiaries and 44 caregivers. The caregiver was the partner of the beneficiary in 73% of cases. The QoL scores of the social dimension were significantly lower for beneficiaries and caregivers compared with French age- and sex-matched controls. Among beneficiaries and caregivers, coping strategies based on problem solving were the most commonly used strategies. The use of positive thinking strategies was associated with higher QoL scores. The more one member of the dyad used an avoidance coping strategy, the more the other member used a positive thinking strategy.
CONCLUSION: This study emphasizes that QoL of individuals with age-related hearing impairment and their natural caregivers is related to the coping strategies that they use. This finding suggests that targeted interventions should be offered to help individuals who experience emotional difficulties to implement more efficient coping strategies.

PMID: 27853359 [PubMed - in process]

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Cochlear Implantation in Meniere's Disease With and Without Labyrinthectomy.

Objective: To investigate outcomes of cochlear implantation (CI) in patients with Meniere's disease (MD) with and without surgical labyrinthectomy. Study Design: Retrospective study. Setting: Multiple tertiary referral centers. Subjects: Thirty one ears from 27 patients (17 men, 10 women, aged 42-84) with CI in ipsilateral MD ear. Intervention: CI in ears with intact labyrinths (Group 1), CI with simultaneous surgical labyrinthectomy (Group 2), and CI sequential to surgical labyrinthectomy (Group 3). Main Outcome Measure: Within-subject improvement on Bamford Kowal Bench test or City University of New York open set sentence tests. Results: Majority of ears achieved excellent open-set speech recognition by 12 months post-CI, irrespective of intervention group. Preoperative details including patient age and sex, implant, MD and previous intervention, and audiological test results did not significantly affect outcomes. Patients with MD undergoing CI only may experience vestibular dysfunction which may cause long-term concerns. Incidental finding was noted of eight ears with fluctuating symptoms in ipsilateral ear during 12-month period post-CI, with five of eight ears showing objective fluctuating impedances and mapping. Conclusion: CI in MD can yield good hearing outcomes in all three groups and this is possible even after a long delay after labyrinthectomy. Bilateral MD patients are complex and prospective quality of life (QoL) measures would be beneficial in being better able to manage the vestibular outcomes as well as the audiological ones. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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A Comparison of Surgical Treatments for Superior Semicircular Canal Dehiscence: A Systematic Review.

Objective: We investigate the postoperative subjective and objective outcomes of different surgical treatments for superior semicircular canal dehiscence (SSCD): vestibular signs, auditory signs, vestibular evoked myogenic potential test, pure tone audiogram, speech audiogram, or video-nystagmography. Data Sources: An electronic search performed in the PubMed, Cochrane Library, and EMBASE databases on 15th of September 2015. A systematic search was conducted. Articles were included if written in English, Dutch, German, or French language. Study Selection: Original studies reporting on the pre and postoperative subjective and/or objective outcomes of surgical treatments for superior semicircular canal dehiscence were included. Data Extraction: The methodological quality of the studies was independently assessed by two reviewers using a constructed critical appraisal, to assess the directness of evidence and the risk of bias. The results of the pre and postoperative subjective and/or objective outcomes were extracted. Data Synthesis: Comparative study was conducted. Conclusion: Surgical treatment for SSCD is particularly effective for vestibular symptoms and there is no evidence for improvement of hearing loss after surgical treatment. Since plugging using transmastoid approach had a lower complication rate, lower revision rate, and a shorter hospital stay, this treatment is recommended in high disabled SSCD patients. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Consequences of Stimulus Type on Higher-Order Processing in Single-Sided Deaf Cochlear Implant Users

Single-sided deaf subjects with a cochlear implant (CI) provide the unique opportunity to compare central auditory processing of the electrical input (CI ear) and the acoustic input (normal-hearing, NH, ear) within the same individual. In these individuals, sensory processing differs between their two ears, while cognitive abilities are the same irrespectively of the sensory input. To better understand perceptual-cognitive factors modulating speech intelligibility with a CI, this electroencephalography study examined the central-auditory processing of words, the cognitive abilities, and the speech intelligibility in 10 postlingually single-sided deaf CI users. We found lower hit rates and prolonged response times for word classification during an oddball task for the CI ear when compared with the NH ear. Also, event-related potentials reflecting sensory (N1) and higher-order processing (N2/N4) were prolonged for word classification (targets versus nontargets) with the CI ear compared with the NH ear. Our results suggest that speech processing via the CI ear and the NH ear differs both at sensory (N1) and cognitive (N2/N4) processing stages, thereby affecting the behavioral performance for speech discrimination. These results provide objective evidence for cognition to be a key factor for speech perception under adverse listening conditions, such as the degraded speech signal provided from the CI.
Audiol Neurotol 2016;21:305-315

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