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Karolina Dorobisz,1 Tadeusz Dorobisz,2 Katarzyna Pazdro-Zastawny,1 Marzena Kubacka,1 Sara Janczak,2 Dariusz Janczak2 1Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wroclaw, Poland; 2Department of Vascular, General and Transplant Surgery, Wroclaw Medical University, Wroclaw, PolandCorrespondence: Karolina Dorobisz, Department of Otolaryngology, Head and Neck Surgery, Wrocław Medical University, Borowska 213, Wrocław, 50-556, Poland, Tel +48 501207964, Email dorobiszkarolina@gmail.comIntroduction: Recurrent laryngeal nerve palsy is a rare but important complication after endarterectomy (CEA). The impact on voice quality after this procedure is also important. The aim of the study was to assess voice quality and vocal cord function after CEA.Material and Methods: 200 patients were enrolled in the study. Inclusion criteria were indications for CEA and patient consent to the procedure. Endoscopic examination of the larynx was performed before the procedure, immediately after the procedure, on the 2nd day after the procedure, then 3 month and 6 months after the procedure. Voice was assessed by maximum phonation time (MPT), GRBAS scale, Voice Handicap Index (VHI) and the Voice-Related Quality of Life (V-RQOL) questionnaire.Results: In the study group, the results on the GRBAS scale were significantly worse and the average MPT was shorter compared to the control group. In the V-RQOL assessment, patients rated their voice as fair or good, significantly more often noticed that they had difficulty speaking loudly and being heard, and that they felt short of air when speaking. In VHI-30, the total score was significantly higher in the study group compared to the control group. Voice disorders after the procedure were reported by 68 patients, while a disorder of the recurrent laryngeal nerve was observed immediately after the procedure in 32 patients. Most vocal cord disorders were transient. Ultimately, 3% of patients were diagnosed with vocal cord paralysis.Conclusion: Cranial nerves paralysis, including the recurrent laryngeal nerve, are a common complication after CEA. Majority the paralysis is transient, but requires appropriate diagnostic and therapeutic procedures. Vocal cord evaluation is a non-invasive and widely available examination and should be performed pre- and postoperatively after all neck surgeries. The incidence of voice disorders after CEA significantly affects the quality of life of patients and requires voice rehabilitation and patient care with psychological support.Keywords: carotid stenosis, endarterectomy, vocal cord paralysis, hoarseness, voice quality

Abstract Cochlear implant users experience difficulties controlling their vocalizations compared to normal hearing peers. However, less is known about their voice quality. The primary aim of the present study was to determine if cochlear implant users’ voice quality would be categorized as dysphonic by the Acoustic Voice Quality Index (AVQI) and smoothed cepstral peak prominence (CPPS). A secondary aim was to determine if vocal quality is further impacted when using bilateral implants compared to using only one implant. The final aim was to determine how residual hearing impacts voice quality. Twenty-seven cochlear implant users participated in the present study and were recorded while sustaining a vowel and while reading a standardized passage. These recordings were analyzed to calculate the AVQI and CPPS. The results indicate that CI users’ voice quality was detrimentally affected by using their CI, raising to the level of a dysphonic voice. Specifically, when using their CI, mean AVQI scores were 4.0 and mean CPPS values were 11.4 dB, which indicates dysphonia. There were no significant differences in voice quality when comparing participants with bilateral implants to those with one implant. Finally, for participants with residual hearing, as hearing thresholds worsened, the likelihood of a dysphonic voice decreased.

Abstract Many lecturers develop voice problems, such as hoarseness. Nevertheless, research on how voice quality influences listeners’ perception, comprehension, and retention of spoken language is limited to a small number of audio-only experiments. We aimed to address this gap by using audio-visual virtual reality (VR) to investigate the impact of a lecturer’s hoarseness on university students’ heard text recall, listening effort, and listening impression. Fifty participants were immersed in a virtual seminar room, where they engaged in a Dual-Task Paradigm. They listened to narratives presented by a virtual female professor, who spoke in either a typical or hoarse voice. Simultaneously, participants performed a secondary task. Results revealed significantly prolonged secondary-task response times with the hoarse voice compared to the typical voice, indicating increased listening effort. Subjectively, participants rated the hoarse voice as more annoying, effortful to listen to, and impeding for their cognitive performance. No effect of voice quality was found on heard text recall, suggesting that, while hoarseness may compromise certain aspects of spoken language processing, this might not necessarily result in reduced information retention. In summary, our findings underscore the importance of promoting vocal health among lecturers, which may contribute to enhanced listening conditions in learning spaces.

Objectives: Identifying voice handicap and voice-related quality of life in patients presenting pulmonary impairment associated with COVID-19 infection, comparing pulmonary parameters between these patients and individuals in the control group, as well as correlating pulmonary parameters to self-assessment questionnaires (IDV-10 and QVV). Methods: Thirty-five (35) patients presenting pulmonary impairment with COVID-19 infection were herein selected and compared to 35 individuals who were not affected by COVID-19 infection. Two self-assessment questionnaires were applied (vocal handicap index and voice quality of life protocol). Maximum phonation time Forced Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) were measured and videolaryngoscopy was performed. Results: There was statistically significant difference in scores recorded in voice self-assessment questionnaires (IDV-10 and QVV), Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) between patients with pulmonary impairment associated with COVID-19 infection and those in the control group. Correlation between PEF/PIF and scores recorded in voice self-assessment questionnaires was also observed. Conclusion: Pulmonary impairment associated with COVID-19 infection has worsened voice handicap and voice-related quality of life in the assessed patients, as well as reduced their forced expiratory and inspiratory pressure in comparison to the control group. Level of evidence: 4.

Objective: This study aimed to classify the degree of edema in patients with Reinke’s edema (RE) and examine its impact on their voice parameters using both objective and subjective assessment methods. Methods: Objective and subjective voice data of 104 patients diagnosed with RE between 2018 and 2021 were evaluated retrospectively. RE is classified into 4 groups (types 1, 2, 3, and 4). The evaluation included videolaryngostroboscopic examination, acoustic voice analysis, and aerodynamic measurements, GRBAS, Voice Handicap Index-10 (VHI-10), Voice-Related Quality of Life Scale (V-RQOL), and Reflux Septum Index (RSI). Results: Patients with type 1 RE had a significantly lower mean age than those with types 3–4. Although there were no significant differences in acoustic and aerodynamic parameters between the groups, it was observed that F0 and the maximum phonation time decreased as the degree of edema increased. The GRBASTotal, G, and R scores of types 1 and 2 were significantly lower than those of types 3 and 4, as were the scores of type 1 S. There were no statistically significant differences between the RE groups in terms of VHI-10, V-RQOL, and RSI scores. Conclusion: It has been observed that as the severity of RE increases, voice perception and quality (especially types 3 and 4) are negatively affected. Determining the degree of edema will guide the clinician in both the planning of the intervention phase and the follow-up phase.

Objective. To explore the training and use of auditory perceptual evaluation of the voice reported by Colombian speech-language pathologists. Study Design. Cross-sectional observational research with a quantitative approach. Methods. A digital questionnaire was designed and distributed to gather information regarding professionals' training process and implementation of auditory-perceptual evaluation procedures. Descriptive statistics were applied, and several generalized linear models were adjusted to determine the influence of certain variables on others. Results. The survey received responses from 40 speech-language pathologists, revealing that the most used scales for training and evaluating vocal quality within this group are direct magnitude estimations (82.5% and 77.5%). Similarly, in this group, the tasks most frequently used to train and use as an evaluation strategy are vowel assessments (38%) followed by spontaneous speech (30%). Practitioners of this group were mostly trained using a conceptual framework involving multiple exposures to rating (42.5%). The use of direct magnitude estimation in training with a normal voice showed significance (p = 0.015), as did the use of the vowel /i/ in training with an equal-appearing interval (p = 0.013). The statistical models relating the scale used to the scale on which participants were trained were also significant (p < 0.05). Conclusions. The GRBAS scale is the training tool most used by the group of speech-language pathologists of the study group in Colombia. Future efforts should focus on improving training practices for auditory-perceptual evaluation, exploring alternative conceptual frameworks, and incorporating external references to enhance validity and reliability.

Purpose. To describe the acoustic characteristics of a classroom, voice quality, fatigue, and vocal load of university professors. Methods. Exploratory, observational, longitudinal, and descriptive study with a single group of participants, including vocal monitoring data over two weeks. Acoustic characterization of the classroom, perceptual-auditory evaluation, and acoustic analysis of voice samples were conducted before and after classes. Vocal dosimetry was performed during classes, and the Vocal Fatigue Index (VFI) was assessed at the beginning of each week. Descriptive analysis of the findings was conducted, and randomization test was performed to verify the internal reliability of the judge. Results. All participants reported speaking loudly in the classroom, with the majority reporting vocal changes in the past six months, and only one participant reported a current vocal change. The classroom had acoustical measures and estimations that deviated from established standards. The professors used high vocal intensities during classes. After the classes, an increase in the absolute values of the aggregated data for CAPE-V, jitter, and fundamental frequency was found, varying within the range of normality. Furthermore, there was an observed increase in both post-lesson intensity and VFI when comparing the two-week period. Conclusions. Vocal intensities and VFI were possibly impacted by the acoustics of the classroom. The increase in average VFI between the weeks may be attributed to a cumulative fatigue sensation. Further research with a larger number of participants and in acoustically conditioned classrooms is suggested in order to evaluate collective intervention proposals aimed at reducing the vocal load on teachers.

IntroductionOur voice is key for conveying information and knowledge to others during verbal communication. However, those who heavily depend on their voice, such as teachers and university professors, often develop voice problems, signaled by hoarseness. The aim of this study was to investigate the effect of hoarseness on listeners’ memory for auditory-verbal information, listening effort, and listening impression.MethodsForty-eight normally hearing adults performed two memory tasks that were auditorily presented in varied voice quality (typical vs. hoarse). The tasks were Heard Text Recall, as part of a dual-task paradigm, and auditory Verbal Serial Recall (aVSR). Participants also completed a listening impression questionnaire for both voice qualities. Behavioral measures of memory for auditory-verbal information and listening effort were performance and response time. Subjective measures of listening effort and other aspects of listening impression were questionnaire rating scores.ResultsResults showed that, except for the aVSR, behavioral outcomes did not vary with the speaker’s voice quality. Regarding the aVSR, we found a significant interaction between voice quality and trial, indicating that participants’ recall performance dropped in the beginning of the task in the hoarse-voice condition but not in the typical-voice condition, and then increased again toward the end. Results from the listening impression questionnaire showed that listening to the hoarse voice resulted in significantly increased perceived listening effort, greater annoyance and poorer self-reported performance.DiscussionThese findings suggest that hoarseness can, at least subjectively, compromise effective listening. Vocal health may be particularly important in the educational context, where listening and learning are closely linked.

Introduction. Due to the communicative requirements inherent to the profession, the legal professional benefits from speech therapy monitoring for the proper use of the voice and to avoid the occurrence of vocal disorders. The development of specific instruments will contribute with more relevant data to guide this monitoring. Objective. To verify the applicability of the General Dysphonia Risk Screening Protocol (DRSP-G) and the Specific Dysphonia Risk Screening Protocol for Legal Professionals (DRSP-LP) and to correlate the average scores of both with vocal deviation, sex, age, professional performance time, vocal signs and symptoms, and vocal self-assessment. Methods. Fifty legal professionals participated. All participants completed the DRSP-G and DRSP-LP and recorded their voices for detection of the presence of altered vocal quality. Results. Most participants presented a high risk of dysphonia, which was higher in men. Altered vocal quality was observed in 34% of the participants. The items with the highest scores in the DRSP-G were talking a lot (76%), excessive daily coffee intake (70%), contact with smokers (60%), and insufficient hydration and sleep (48%); in the DRSP-LP, alcohol consumption (68%) and exposure to air conditioning (64%). There was no correlation between risk scores and the degree of dysphonia, or with age or length of professional experience. The DRSP-G score correlated with vocal signs and symptoms and vocal self-perception. Conclusions. The joint application of the DRSP-G and the DRSP-LP enabled a quantitative and qualitative analysis of risk factors for dysphonia in legal professionals.

Objective. The aim of this study was to identify if cochlear implant (CI) users are perceiving a decrease in life quality due to voice problems. This study evaluated 43 CI user’s perception of their voice and how it affects their quality of life through a survey. Approach. Forty-three CI users responded to a survey regarding their demographics, details about their CI, the Hearing Health Quick Test (HHQT), the Voice Related Quality of Life (V-RQOL), and the Voice Handicap Index-10 (VHI-10). The survey responses were analyzed using univariate linear regression analysis. Results. Few of the CI users scored below the cut off for normal voice related quality of life. CI users averaged 93.4 out of 100 on the V-RQOL and only four scored abnormally for the VHI-10. Lower scores on the V-RQOL were correlated with the participants having an associate degree and with participants visiting friends, family, and neighbors less often due to hearing loss. The VHI-10 scores were correlated with gender, education levels, difficulty in social situations due to hearing loss, noise exposure, and tinnitus. Limitations of the study. The small n was the primary limitation of this study. Originality. This study was one of the first to examine the voice-related quality of life in CI users. Conclusions. Overall, respondents did not perceive much voice-related difficulty. However, they were more likely to perceive voice-related difficulty if they experienced difficulty hearing in noise and avoided social situations due to hearing loss.

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.

We investigate utterance-final voice quality in bilinguals of English and Spanish, two languages which differ in the type of non-modal voice usually encountered at ends of utterances: American English often has phrase-final creak, whereas in Mexican Spanish, phrase-final voiced sounds are breathy or even devoiced. Twenty-one bilinguals from the San Diego-Tijuana border region were recorded (with electroglottography and audio) reading passages in English and Spanish. Ends of utterances were coded for their visual voice quality as “modal” (having no aspiration noise or voicing irregularity), “breathy” (having aspiration noise), “creaky” (having voicing irregularity), or “breathy-creaky” (having both aspiration noise and voicing irregularity). In utterance-final position, speakers showed more frequent use of both modal and creaky voice when speaking in English, and more frequent use of breathy and breathy-creaky voice when speaking in Spanish. We find no role of language dominance on the rates of these four voice qualities. The electroglottographic and acoustic analyses show that all voice qualities, even utterance-final creak, are produced with increased glottal spreading; the combination of distinct noise measures and amplitude of voicing can distinguish breathy, creaky, and breathy-creaky voice qualities from one another, and from modal voice.

Voice and speech are educational tools and a medium of pedagogy for teachers. Teachers tend to modify their voice and speech to support learning. This study aimed to investigate whether pre-service teachers modify their speech and voice in teaching compared to peer learning speech and whether the changes can promote learning and be beneficial for the speakers. Nine pre-service physics teachers’ voices were recorded in three learning situations and in one teaching session with similar external circumstances. Duration of speech turns, pausing, speech rate, fundamental frequency (F0) and its variation, sound pressure level (SPL) and its range, and voice quality were analyzed. Results showed that the participants had longer speech turns, decreased speech rate, and increased pausing when teaching compared to speech in peer learning situations. F0 and SPL were higher in teaching, indicating that the teaching situation was more stressful than the peer learning situation. For F0, this was confirmed by correlation analysis. From the learning point, increased pausing and slower speech rate may be beneficial, but increased F0 and SPL may, on the other hand, be harmful to future teachers as they can increase the risk of vocal overloading. Voice training for future teachers is strongly recommended.

ABSTRACT Purpose: to investigate the practice of Brazilian speech-language-hearing therapists in voice therapy for older adults focused on breathing and verify possible associations between taking specific courses and having knowledge of respiratory parameters, between using incentive spirometers and respiratory devices, and between age and the use of these instruments. Methods: the sample had 156 specialists in voice, contacted via email, who answered a form in Google Forms. Specialists in voice with 3 or more years of experience were included, whereas those who did not fill out the questionnaire completely were excluded. The analysis addressed absolute and relative frequencies and associations with the chi-square test. Significance was set at 5%. Results: most participants took courses on respiratory approach. The use of facilitating sounds, vocal function exercises, and respiratory instruments stood out, with reported vocal improvements. The use of incentive spirometers was associated with respiratory devices, and age was associated with the use of respiratory instruments. Conclusion: speech-language-hearing therapists with expertise in voice provide voice therapy for dysphonic older people focusing on a respiratory approach. Professionals who use incentive spirometers also use respiratory devices. Older therapists are the ones who most use respiratory instruments and taking specific courses was not associated with knowledge on respiratory parameters.

ABSTRACT Purpose To determine the effect of an online Workplace Vocal Health and Low Stress Levels (WVHLS) Promotion Program implemented in a Colombian university during COVID-19 pandemic. Methods This research was a quasi-experimental study. Twenty-nine professors participated in this study within two groups: (1) intervention group (n=17) or (2) non-intervention group (n=12). Participants in the intervention group took part in four virtual sessions about how to improve vocal health and strategies to reduce stress levels during their homeworking and online classes. Teachers filled in a questionnaire including questions about working conditions, work-related stress, and the voice functioning (including the Vocal Fatigue Index-VFI). They also recorded a voice sample of a sustained vowel on two separate occasions (before and after the follow-up). Results At the end of the follow-up, there was a tendency to reduce Factor 1 of VFI in the intervention group. Although, all participants had a longer MPT at the end of the study compared with the baseline measures, males in the intervention group had longer MPT compared with other participants. Conclusion Our results suggest a positive effect of a WVHLS promotion program on reducing vocal fatigue perception measured by means of the Vocal Fatigue Index and improving coordination and control of breathing speech measured MPT. These changes at the end of the follow-up may indicate that holistic programs that include voice care recommendations, breathing exercises, vocal warm-up, cold-down and laryngeal relaxation vocal exercises, and stress management may be beneficial for reducing work-related stress and voice symptoms among professors.

Frequent use of psychoactive drugs, alcohol and tobacco can lead to pathological changes in the vocal cords. The aim of this study is to analyze the connection between the consumption of psychoactive substances and disturbances in the quality of the voice by reviewing the previous literature. Voice disorders in users of psychoactive substances occur over time, due to the appearance of organic changes in the vocal apparatus. Marijuana smoke causes irritation of the mucous membrane of the larynx, which causes hoarseness and hoarseness in the voice. The effect of electronic cigarettes on voice quality is milder compared to the effect of conventional cigarettes. The results of this study also show that drug users have lower results in the domain of social functioning compared to alcohol and tobacco users. The findings of this study suggest that users of psychoactive substances have respiratory disorders and worse lung function, changes in vocal folds, disturbance of auditory and perceptual parameters of voice quality and worse quality of life. Additional implications suggest the necessary help and support of speech therapists in educating users of psychoactive substances about the ways of their use and their connection with voice disorders and quality of life as a whole.

Background:Recent years have seen the development of voice indices for multi-parametric objective voice evaluation. The current study aims to review these indices and examine their efficiency through the literature.Methods: The study design is a literature review. The five databases of ‘PubMed’, ‘Scopus’, ‘Google Scholar’, ‘Science Direct’, and ‘Web of Science’ were searched using the keywords ‘voice index’, ‘acoustic’, ‘voice assessment’, and ‘acoustic analysis’. Attempts were made to include only the acoustic indices that have been validated and are fairly user-friendly.Results: Five voice indices were found that met the inclusion criteria: Dysphonia Severity Index (DSI), Acoustic Voice Quality Index (AVQI), Cepstral Spectral Index of Dysphonia (CSID), The Acoustic Breathiness Index (ABI), and Acoustic Psychometric Severity Index of Dysphonia (APSID).Conclusions: The results suggest using AVQI, ABI, DSI, and CSID in the evaluation and treatment of voice disorders. Of course, it is recommend to examine the efficacy of these indices in more languages and also developing new indices by considering more aspects of voice.

Objective: To find changes in voice quality, airway invasion during swallowing, pharyngeal residue after swallowing, acoustic and aerodynamic measurements and pulmonary function tests after total parathyroidectomy plus auto-transplantation for secondary hyperparathyroidism. Methods: We recruited 38 patients who underwent successful surgery for secondary hyperparathyroidism in this study. Voice quality was evaluated using voice handicap index (VHI-10), eating assessment tool (EAT-10), voice impairment, and the grade, roughness, breathiness, asthenia, strain (GRBAS) scale. Acoustic and aerodynamic measurements included fundamental frequency (F0), maximal phonation time, high pitch, jitter, s/z, shimmer and noise-to-harmonic ratio. Vocal cord mobility, vocal cord closure, premature spillage, the penetration–aspiration scale and the Yale pharyngeal residue severity rating scale (PRSRS) after swallowing were examined using fiber-optic endoscopy. Pulmonary function tests included forced vital capacity, forced expiratory volume in 1 s, bronchodilator test, total lung capacity, diffusion capacity of the lung for carbon monoxide, alveolar volume, and distance and O2 desaturation of the 6 min walking test (6MWT). Results: Four months after successful parathyroidectomy, VHI-10 improved significantly (p

This study considers instances of voice quality settings under a sound-symbolic and synesthetic perspective, focusing on the auditory impressions these settings might have on listeners' attributions of meaning effects and associations between vocal and visual features related to emotional expression. Three perceptual experiments are carried out. The first experiment examined the impressionistic effects of eight voice quality settings characterized by differences in pitch. The second experiment examined the impressionistic effects of seven voice quality settings characterized by productions with the presence or absence of turbulent airflow, irregularity, and tenseness. The third experiment investigated associations between facial expressions of basic emotions and voice quality characteristics. Data are considered in terms of acoustic (fundamental frequency values), articulatory (reduced or expanded length of the vocal tract), perceptual impressions of size (big/small), strength (strong/weak), brightness (dark, clear), and distinctiveness (muffled/distinct), and visual features (facial expressions of the basic emotions sadness, happiness, anger, disgust, fear, and neutrality). The results provide corroborating evidence of existing links between sound and meaning and are discussed in relation to the frequency, production, sirenic biological codes, phonetic metaphors, and the vocal and facial gestures involved in emotional expression.

Utterances containing verbal irony display prosodic particularities that distinguish them from non-ironic speech. While some prosodic features of irony have been identified in Spanish, previous studies have not accounted for different subtypes, nor have they examined this phenomenon in Chilean Spanish despite the unique intonation patterns in this dialect. This study examined the acoustic and prosodic correlates of five subtypes of irony (jocularity, rhetorical questions, understatements, hyperbole, and sarcasm) spontaneously occurring in the casual speech of sociolinguistic interviews with fifteen Chilean women. We segmented 3907 syllable nuclei from 197 spontaneously occurring instances of irony and compared the syllables within the ironic utterances to those in the pre-ironic utterances, along seven acoustic and prosodic variables: pitch range, duration, F0, F1, F2, H1*–H2*, and HNR. The results showed that the speakers favored jocularity and did not produce sarcasm or understatements, and that jocularity, hyperbole, and rhetorical questions significantly differed from the baseline utterances along a variety of acoustic and prosodic measures. We argue that these cues contributed to marking the ironic utterances as salient, allowing these women to talk about difficult real-life events with a touch of humor. Our study provides additional evidence for the connection between prosody and pragmatics in Chilean Spanish and lays the groundwork for further examination of irony and prosody in this and other Spanish dialects.

Introduction. Due to the COVID-19 pandemic, teaching conditions changed around the world from in-person classes to online classes, which also determined changes on teachers’ working conditions. Method: Exploratory cross-sectional study with the aim of determining the association between two voice symptoms (vocal fatigue and throat pain) with home working conditions during online classes in times of COVID-19 pandemic. Professors answered an online survey including 27 questions about four components: sociodemographic factors, characteristics of home working, quarantine characteristics, and health conditions (including voice functioning). Results: 177 college professors from Argentina, Colombia, and Chile participated in this study. First, incidence of vocal fatigue, during online classes in times of COVID-19 pandemic, represented around 50%. Although throat pain had a smaller incidence, it was also important (35%). Second, days in quarantine, number of classes per week, people living with during quarantine, and history of vocal fatigue before quarantine were important associated factors of vocal fatigue. Third, important associated factors of throat pain were number of classes per week, level of stress, years of experience, and history of throat pain before quarantine. Conclusion: Similar to pre-COVID-19, vocal fatigue and throat pain were frequently reported voice symptoms among college professors. Associated factors of these symptoms included years of experience, number of classes per week, stress, people living with during quarantine due to COVID-19, and history of voice symptoms. Workplace Health Promotion programs should include activities that facilitate a healthy occupational voice use during and post-COVID-19 pandemic, considering the implications of online teaching on teachers’ health and safety.

As speech technology is increasingly integrated into modern American society, voice assistants are a more significant part of our everyday lives. According to Apple, Siri fulfills 25 billion requests each month. As part of a software update in April 2021, users in the U.S. were presented with a choice of 4 Siris. While in beta testing, users on Twitter began to comment that they felt that some of the voices had racial identities, noting in particular that Voice 2 and Voice 3 “sounded black.” This study tests whether listeners indeed hear the different Siri voices as sounding like speakers from different groups, as well as examines voice quality features that may trigger these judgments. In order to test evaluations of the four voices, 485 American English listeners heard each Siri voice reading the Rainbow Passage, via online survey conducted on Qualtrics. Following each clip, listeners responded to questions about the speaker's demographic characteristics and personal traits. An LMER model of normalized ratings assessed the interaction of voice and race judgment revealed that indeed, Voice 2 and Voice 3 were significantly more likely to be rated as belonging to a Black speaker than Voices 1 and 4 (p < 0.001). Per-trait logistic regression models and chi-square tests examining ratings revealed Voice 3, the male voice rated as Black, was judged less competent (X2 = 108.99, x < 0.001), less professional (X2 = 90.97, p < 0.001), and funniest (X2 = 123.39, x < 0.001). Following analysis of listener judgments of voices, I conducted post-hoc analysis comparing voice quality (VQ) features to examine which may trigger the listener judgments of race. Using PraatSauce, I employed scripts to extract VQ measures previously hypothesized to pattern differently in African American English vs. Mainstream American English. VQ measures that significantly affected listener ratings of the voices are mean F0 and H1–A3c, which correlate with perceptions of pitch and breathiness. These results reveal listeners attribute human-like demographic and personal characteristics to synthesized voices. A more comprehensive understanding of social judgments of digitized voices may help us to understand how listeners evaluate human voices, with implications for speech perception and discrimination as well as recognition and synthesis.

In recent years, numerous investigations have focused on voice quality (VQ) for forensic purposes. These studies notwithstanding, we lack an international picture of how VQ is generally understood by forensic practitioners and how it contrasts with the practices of voice therapists. To fill this gap, a survey was designed and sent to both cohorts: forensicists and clinicians. A total of 45 responses from 20 countries were received. Important differences were found between groups, particularly regarding perceptual assessment. One conclusion to be drawn is that more emphasis should be placed on calibration and error measurement in forensic approaches to VQ. Further collaborations with clinicians should also be encouraged.

Objective. To estimate the productivity reduction costs associated to self-reported voice symptoms, low sleep quality, and high stress levels among college professors during homeworking in times of COVID-19 pandemic. Methods. This cross-sectional study included fifty-eight college professors who reported their reduction in productivity at work due to self-perceived stress levels, sleep quality, and voice symptoms. Results. High stress levels were reported by 24% of the participants, whereas 19% reported voice symptoms, and 3% low sleep quality. Costs associated with the three conditions were calculated for twenty-nine subjects. Productivity costs associated with high stress levels were higher (COP$32.345.925) than those for voice symptoms (COP$1.872.703) and low sleep quality (COP$319.733). Conclusion: Productivity reduction costs were higher for professors who reported high levels of stress followed by participants with self-reported voice symptoms and low sleep quality, which highlight the importance of prioritizing activities to reduce stress levels and voice symptoms in workplace health promotion programs implemented in educational settings.

IP Phone merupakan salah perangkat pada Voice over Internet Protocol (VoIP) yang dapat menyalurkan suara menggunakan IP. Berbagai tipe IP Phone bermunculan dengan harga dan fitur yang bervariasi, sehingga menimbulkan pertanyaan terkait bagaimana perbandingan kualitas suara pada IP Phone yang dihadirkan oleh berbagai tipe tersebut, mengingat kualitas suara dalam telekomunikasi sangat penting agar tidak menimbulkan kesalahfahaman saat telekomunikasi berlangsung. Terdapat dua tipe IP Phone pada sistem yang sudah diregistrasikan dengan server sehingga dapat melakukan panggilan dengan range frekuensi 300Hz s/d 3400Hz, kemudian dari komunikasi antar IP Phone terdapat bentuk gelombang sinyal informasi input dan output, respon amplitudo suara terhadap perubahan frekuensi suara serta nilai delay dari pergeseran fasa menggunakan alat ukur Tranmission Test Set dan Oscilloscope yang digunakan untuk mengetahui karakter kualitas suara dalam komunikasi antar IP Phone sesuai hasil uji parameter. Hasil pengujian sitem dapat disimpulkan bahwa bentuk gelombang sinyal informasi input dan output pada frekuensi suara memiliki bentuk gelombang sinus, namun gelombang output pada IP Phone tipe A frekuensi 300Hz s/d 1100Hz dan IP Phone tipe B frekuensi 300Hz s/d 1300Hz mengalami distorsi, selanjutnya dari hasil nilai Peak to Peak gelombang diketahui adanya penguatan tegangan yaitu semakin besar nilai frekuensi pada input maka akan semakin kecil nilai penguatan tegangan yang dihasilkan. Nilai respon amplitudo terhadap perubahan frekuensi suara dengan nilai amplitudo input -23.5 dBm pada kedua IP Phone memiliki penguatan daya yang semakin kecil ketika nilai frekuensi suara semakin tinggi. Nilai delay yang didapatkan dari pergeseran gelombang input dan output antar IP Phone yaitu kurang dari 150 ms.

Introduction: Spasmodic dysphonia (SD) and muscle tension dysphonia (MTD ) are two different disorders with different etiology that influence the quality of voice, characterized by similar perceptual and acoustic features. It is known that the emergence of compensatory mechanisms can lead to problems in the differential diagnosis of adductor spasmodic dysphonia (ADSD) and primary hyperkinetic dysphonia (MTD) by fiberoptic video laryngoscopy (FLS). So, the goal of this paper is to determine acoustic objective differential diagnostic criteria for distinguishing between SD and MTD and confirm clinical laryngeal findings by FLS and diagnosis. Patients and methods: Eight women with MTD and eight women with SD diagnosed at the Department of Audiology and Phoniatrics of the Clinical Hospital Center Rijeka participated in this study. A phoniatrician and a speech language pathologist (SLP) participated in the diagnostic procedure. FLS and SLP assessment were performed. Samples of extended phonation of the vowel /a/ and reading were collected. The samples were analyzed in the computer program Praat, which was used to measure the duration of words and sentences, the percentage of brakes in phonation and words, and cepstral peak prominence (CPPS). Results: This study found that four acoustic parameters (word duration, sentence duration, percentage of brakes /a/, percentage of brakes (word)) separate SD and MTD well. CPPS does not separate these two groups of patients. Furthermore, it was confirmed that by analyzing the phonation pattern of the vowel /a/ in the computer program Praat it is possible to classify these two disorders with a cut-off value of 5%. If the percentage of delay in the phonation pattern of the vowel /a/ is greater than or equal to 5%, it is very likely that it is a voice sample of a person with SD. Conclusion: Acoustic measures applicable in clinical conditions were determined. It has been shown that acoustic analysis of voice samples can provide valuable differential diagnostic data. This suggests that acoustic analysis of voice samples should be an integral part of the standard diagnostic protocol for voice disorders besides FLS.

IntroductionVoice has been used to project identity in dubbing, in order to auditory portray appropriate role images in TV dramas. This study investigates the character voices of leading male characters in Empresses in the Palace.MethodsDifferent acoustic characteristics of character voices and matching relation between acoustics and role images are explored by comparing F0, CPP, harmonic amplitude differences of speech spectrum.ResultsThe voice quality of characters is related to their relative social status. The subordinates usually adopt a higher pitch or breathy voice, while the dominators use a lower pitch or modal/creaky voice. In addition, CPP, F0, and H1-A3 are the key acoustic indicators to distinguish character voices.DiscussionThese results reveal the acoustic characteristics of character voices of certain types, as well as provide guidance for dubbing vividly.

Introduction: The loss of voice after total laryngectomy is one of the main impairments in personal and social life. In order to prevent potential psycho-social consequences in the patient and his family, the restoration of phonatory function is the main objective of post-laryngectomy rehabilitation. The aim of this study was to assess quality of life in patients who received prosthetic voice after total laryngectomy. Materials and Methods: Over a one-year period, 51 patients with voice prostheses after total laryngectomy were recruited. 32 patients (62.74%) were administered radiation therapy and 9 patients (17.64%) underwent to surgical reconstruction with flaps. Each patient was administered the VHI-10 and V-RQOL self-assessment questionnaires. Results: The study showed that vocal restoration with voice prosthesis allows patients to recover a significant degree of quality of life after total laryngectomy. The average score on the V-RQOL questionnaire was 75.9 and on the VHI-10 questionnaire was 13.5. It has not been shown a statistically significant correlation between quality of life after tracheoesophageal prosthesis and radiation therapy, chemotherapy or reconstruction flaps. Younger patients showed, on average, a higher score at V-RQOL. These results allow to state that, after prosthetic rehabilitation, at least 75% of patients experienced an increase in quality of life. Moreover, the prosthetic technique (primary vs secondary) does not affect the long-term outcome and radiotherapy, chemotherapy or reconstruction flaps are not absolute contraindications to rehabilitation with voice prosthesis. Conclusion: After total laryngectomy, rehabilitation with tracheoesophageal prosthesis is a satisfactory choice to restore the patient’s ability to communicate verbally.

In the present work, we describe and discuss two studies in the field of motivating-speech research. The studies investigate voice-quality features (study 1) and pragmatic aspects (study 2) in German motivating speech, thereby adding to the current state-of-the-art in understanding motivating speech and language1. We find indications that a low amount of breathiness, a more periodic signal and a balanced distribution of specific pragmatic elements contribute to a motivating impact in German.

ABSTRACT Purpose: to identify genetically enhanced physical skills (speed, strength, endurance and motor coordination), provided by the dermatoglyphic method and to analyze the preliminary correlation between dermatoglyphic and acoustic data of lyrical and pop singers. Methods: the study was approved by the Ethics and Research Committee. Four male singers were evaluated (two lyrical and two pop singers), 31-53 years old. Data collection and analysis procedures comprised (1) Survey -Self-Perception of Vocal Characteristics in Singers (vocal habits, voice performance and phenotypic characteristics); (2) Dermatoglyphic Profile (fingerprint image digitalization: predominance of digital drawings (Arch, Loop and Whorl); scores of deltas (D10); the Total Ridge Count (TRC); digital formula and dermatoglyphic profile (aerobic, anaerobic and mix)); (3) Acoustic Analysis (the Expression Evaluator script application to the audio recordings: f0, intensity, spectral slope and long-term average spectrum - LTAS values); and (4) Integrated (Statistical) Analysis; cluster analysis. Results: correlations were found between dermatoglyphic variables (Arch, Loop, Whorl, D10, TRC) and acoustic parameters (f0 (median); intensity (asymmetry); spectral slope (mean); and LTAS (SD)). The dermatoglyphic profile did not segregate singing styles. Conclusion: the dermatoglyphic profiles showed a preliminary correlation with the acoustic vocal measures, especially f0 and LTAS measures.

Introduction: The association between the treatment of transverse maxillary deficiency and the recovery of hearing and voice functions has gained attention in recent years. Objective: This prospective controlled trial aimed to evaluate the effects of rapid maxillary expansion on hearing and voice function in children with non-cleft lip palate and bilateral cleft lip palate with transverse maxillary deficiency Methods: 53 patients (26 non-cleft and 27 bilateral cleft lip palate; mean age, 11.1 ± 1.8 years) requiring rapid maxillary expansion for correction of narrow maxillary arches were recruited for this trial. Eight sub-groups were established based on the degree of hearing loss. Pure-tone audiometric and tympanometric records were taken for each subject at four different time periods. The first records were taken before rapid maxillary expansion (T0), the second after expansion (T1) (mean, 0.8 months), the third after three months (T2) (mean, 3 months) and the fourth at the end of retention period (T3) (mean, 6 months). ANOVA and Tukey HSD post-hoc tests were used for data analysis. Additionally, voice analysis was done using an updated PRAAT software program in a computerized speech lab at T0 and T2. A paired-samplet-test was used for comparisons of mean values of T0 and T2 voice parameters within both groups. Results: Rapid maxillary expansion treatment produced a significant increase in the hearing levels and middle ear volumes of all non-cleft and bilateral cleft lip palate patients with normal hearing levels and with mild conductive hearing loss, during the T0–T1, T1–T2, T0–T2, and T0–T3 observation periods (p

Introduction. During smoking, specific morphological changes occur within the larynx, which results in changes in voice quality. Given that voice is related to quality of life, it is necessary to identify the impact of smoking on voice quality. Methods. A group of 85 respondents, aged 22 to 70 years (AS = 35.61; SD = 11.36), both sexes, categorized into two groups, smokers and non-smokers, were selected for this study. A recording of extended vocal A phonation was analyzed in the program for acoustic voice analysis - PRAAT. The research was realized at the Faculty of Medicine in Foca, during 2021. Results. A statistically significant difference was found in four out of the five examined voice parameters. Namely, a statistically significant difference was observed in the mean value of the fundamental frequency (Fo) (p = 0.042), jitter (p = 0.007), shimmer (p = 0.026) and in the noise-to-harmonic ratio (p = 0.018) between smokers and non-smokers. Also, a statistically significant difference was found between two subgroups of subjects (those who smoked less than 10 years and those who smoked longer than 10 years) in the fundamental voice frequency Fo (p = 0.011), standard deviation of the fundamental frequency STD (p = 0.047) and amplitude perturbation expressed through shimmer in percentage (Shim) (p = 0.017). For other examined voice parameters, no statistically significant difference was noticed between these two subgroups of respondents. Conclusion. Smoking affects most of the acoustic parameters of the voice, resulting in poorer voice quality. Also, the quality of the voice decreases as the smoking experience increases.

Multiparametric indices offer a more comprehensive approach to voice quality assessment by taking into account multiple acoustic parameters. Artificial intelligence technology can be utilized in healthcare to evaluate data and optimize decision-making processes. Mobile devices provide new opportunities for remote speech monitoring, allowing the use of basic mobile devices as screening tools for the early identification and treatment of voice disorders. However, it is necessary to demonstrate equivalence between mobile device signals and gold standard microphone preamplifiers. Despite the increased use and availability of technology, there is still a lack of understanding of the impact of physiological, speech/language, and cultural factors on voice assessment. Challenges to research include accounting for organic speech-related covariables, such as differences in conversing voice sound pressure level (SPL) and fundamental frequency (f0), recognizing the link between sensory and experimental acoustic outcomes, and obtaining a large dataset to understand regular variation between and within voice-disordered individuals. Our study investigated the use of cellphones to estimate the Acoustic Voice Quality Index (AVQI) in a typical clinical setting using a Pareto-optimized approach in the signal processing path. We found that there was a strong correlation between AVQI results obtained from different smartphones and a studio microphone, with no significant differences in mean AVQI scores between different smartphones. The diagnostic accuracy of different smartphones was comparable to that of a professional microphone, with optimal AVQI cut-off values that can effectively distinguish between normal and pathological voice for each smartphone used in the study. All devices met the proposed 0.8 AUC threshold and demonstrated an acceptable Youden index value.

Vocal fry is a voice quality that occurs in a healthy voice, but it can also be a sign of a voice disorder. In this study, we investigated the relationship between the parameters of voice production, a dedicated psychoacoustic feature, and the perceptual aspects of vocal fry. Two perceptual experiments were carried out to determine whether the fundamental frequency, the open quotient, and the glottal area pulse skewness affect the perception of vocal fry in synthetic vowels. Thirteen listeners participated in the perceptual experiments to assess the following attributes: binary fry (yes/no) and impulsiveness, tonality, and naturalness (7-point Likert scales). The results suggest that the perception of vocal fry is mainly triggered by a low fundamental frequency, but the open quotient also plays a role, with narrower glottal area pulses slightly increasing the probability of perceived fry. Perceived tonality is inversely related to perceived impulsiveness. Internal reference standards of listeners appear to have fixed elements but may also be affected by anchoring and the short-term (i.e., within-vowel) context of the stimuli. In addition, the prominence of the peaks observed in the loudness curve over time appears to be related to graduations of fry.

This paper describes the main phonetic features of an Italian L1 74 y. o. speaker (ESO01) after he endured total laryngectomy in 2015 with the complete removal of vocal folds due to five tumour masses. We offer an acoustic analysis of the spontaneous speech of this target speaker, in order to lay ground to the development of spontaneous speech enhancement and reconstruction algorithms for non-invasive aids. A semi-automatic analysis extracts formants’ values (F0, F1, F2, F3) on the midpoint and on 7 time-points, together with other acoustic cues. Our results show that our target speaker presents a low and rough voice, but his vowels are clearly differentiated. Furthermore, we find vocoid and air release to be extremely consistent in his acoustic characteristics during oesophageal phonation.

Introduction: The acoustic analysis is one of the well-known methods for voice evaluation. In recent years, many studies have investigated the cepstral measures compared with the other former acoustic parameters. This review article evaluates the related studies in the cepstral areas to ascertain whether they are efficient in the diagnosis of dysphonia. Materials and Methods: We reviewed the available research studies between 2009 and 2021 narratively in PubMed, Scopus, Google Scholar, and Science Direct databases. The searched keywords included “cepstral peak prominence”, “smoothed cepstral peak prominence”, “instrumental acoustic analysis”, “acoustic”, and “diagnosis”. The articles that investigated the power of Cepstral Peak Prominence (CPP) and its smoothed version (CPPS) to differentiate dysphonia versus normal voice have been included. However, the interventional studies that consider CPP and CPPS as one of their adjunct variables and studies that investigated the relationship of the cepstral measure with other parameters were not included. Results: Recent studies support the efficiency of CPP and CPPS to diagnose dysphonia. Conclusion: It is reasonable for the voice care teams to use CPP and CPPS in the patients’ initial assessment and track the effects of treatment. However, according to the relatively limited number of studies in this area, more studies are required to clarify the efficacy of cepstral measures in different voice pathologies.

The aim of our research is to provide an overview of scientific literature on prosodic variation and to construct prosodic portraits of ten book characters voiced by one linguistic persona. The main objectives are determining the variability of prosodic features of a linguistic persona and identifying the prosodic characteristics that are stereotypically associated with a particular social/cultural group and/or an emotional state. Thus, the object of the research are pitch, rate and voice quality characteristics of a linguistic persona in voice acting. The new aspect brought to the field is the focus on variation of prosodic features of one linguistic persona performing ten different voice-overs. The method used for the purpose is acoustic analysis. The material is David Crystal’s autobiography read by the author. The data suggest the presence of relevant discriminating parameters common to the three distinctive age and gender groups and prove the necessity to resort to cluster analysis while constructing a prosodic portrait. Thus, frequency aspect helps to affiliate a character to a particular gender-age group while temporal aspect is associated with the emotional state of the speaker. Voice quality may indicate age group of a speaker but its parameters are found to be most constant among all prosodic cues. It is revealed that specific personal characteristics of a character depend on the combinations of pitch, articulation rate and voice quality parameters.

The purpose was to determine the incidence of voice disorders in a group of professional actors and singers, to compare the two groups, and to investigate the potential causes of their voice problems.

Abstract Objectives Vocal fold (VF) stiffness and geometry are determinant variables in voice production. Type 1 medialization thyroplasty (MT), the primary surgical treatment for glottic insufficiency, changes both of these variables. Understanding the cause and effect relationship between these variables and acoustic output might improve voice outcomes after MT. In this study, the effects of thyroplasty implants with variable stiffness on glottal shape and acoustics were investigated. Methods In an ex vivo human larynx phonation model, bilateral MT with implants of four stiffness levels (1386, 21.6, 9.3, and 5.5 kPa) were performed. Resulting acoustics and aerodynamics were measured across multiple airflow levels. A vertical partial hemilaryngectomy was performed and stereoscopic images of the VF medial surface taken to reconstruct its three‐dimensional (3D) surface contour. The results were compared across implants. Results The effects of implant stiffness on acoustics varied by airflow. Softer implants resulted in improved acoustics, as measured by cepstral peak prominence (CPP), at lower airflow levels compared to stiffer implants but this relationship reversed at high airflow levels. Stiffer implants generally required less airflow to generate a given subglottal pressure. Stiffer implants resulted in greater medialized surface area and maximal medialization, but all implants had similar effects on overall VF medial surface contour. Conclusion Softer implants result in less medialization but better acoustics at low airflow rates. Stiffer implants provide better acoustics and more stable pressure‐flow relationships at higher airflow rates. This highlights a potential role for patient‐specific customized thyroplasty implants of various stiffness levels. Level of Evidence NA.

Introduction/Objective. Tonsillitis is a very common condition found in the pediatric population but also in adult patients. One of the consequences of such conditions is poor voice quality. Hoarseness, poor voice impostation, interruption, and hypernazalization are just some of the differences in patient voice quality. The objective of this paper was to examine the effects of tonsillectomy on the voice quality. Methods. The sample included 37 patients, 17 female and 20 male, ranging in age 3–39 years. The method involved recording patients one month before and one month after tonsillectomy with a digital sound recorder, with recordings analyzed in the Praat program. The variables monitored in the basic voice were as follows: voice pitch, standard deviation of voice, degree of voice interruption, jitter, shimmer, and signal-to-noise ratio. In the statistical analysis, in addition to standard descriptive analyzes, t-test and ACNOVA were also used. Results. The results showed that there are effects of tonsillectomy on standard deviation of baseline voice (p = 0.002), shimmer (p = 0.002), baseline voice interruption rate (p = 0.023), signal to noise ratio (p = 0.003). There were no differences in the effects of tonsillectomy with respect to the sex of the subjects. Conclusion. Based on the conducted research, there were some methodological conclusions that could be considered as a recommendation for future research: increase the number of persons in the sample, introduce a variable of chronological age, type of surgical intervention, and gradation of size of the tonsil and adenoid tissue.

Introduction. Singing is a type of sportive activity and, like sports medicine, professional voice medicine is interested in the habilitation and rehabilitation of the vocal performer. The vocal needs of the professional vocal performer may not be similar to other professional or non-professional voice users. Like a professional athlete, a vocal performer’s ability to perform for many decades at a high level will be enhanced by basing artistic and lifestyle decisions on a scientifically sound foundation. Objective. The aim of this study is to present a multidimensional introduction to the methods of SVT, incorporating the principles of sport and exercise medicine, and physical therapy and rehabilitation. Reflection. Singing voice therapy needs to provide answers to “what”, “why”, “how”, and “when” questions. SVT must first correctly identify the problem, leading to the “how to do” solutions for a wide variety of cases, followed by a schedule of prescribed activities including answers to the “why” question (which exercise relates to which muscle). The periodization and motor learning principles provide a temporal answer to the “when” question when developing habilitation and/or rehabilitative protocols. Conclusion. Singing is not only an artistic expression but also a sportive performance. The clinical approach to the professional voice is a multidimensional and multi-layered team effort. All practices are structured by blending scientific and pedagogical knowledge.

Introduction Minor structural alterations of the vocal fold cover are important causes of dysphonia. The variability in the type of alteration and the grade of vocal deviation affects the definition of the conduit and the results of treatment. Objective To characterize the occurrence, the selected treatments adopted and vocal quality before and after treatment in patients with minor structural alterations of the vocal folds cover. Methods This was a cross-sectional study based on the records of patients treated by an interdisciplinary team at the laryngology outpatient clinic of a public university hospital from 2010 to 2018. Data collection consisted of access to a database of information on otorhinolaryngological diagnostic hypotheses, intervention and perceptual-auditory vocal assessments before and after the treatment. Data from 102 subjects were analyzed. Association tests were applied between the perceptual-auditory vocal results and the different alterations found and between these and the adopted treatments. The results of the degrees of vocal deviation before and after treatment were also compared. Results The degree of roughness was associated with the sulcus vocalis, and in this alteration the highest occurrence was mild degree of roughness. There was an improvement in the breathiness and general grade of vocal deviation after treatment. Conclusion Cysts were the most frequent structural alteration in the population studied. There was an association between the degree of general deviation and that of roughness in sulcus vocalis cases. The breathiness and the general grade of vocal deviation improved after treatment regardless of the type of treatment and alteration.

Introduction Laryngopharyngeal reflux disease can alter the structural and functional integrity of the vocal fold. Objectives of the study was to determine the effect of Laryngopharyngeal Reflux Disease (LPRD) on selected Acoustic, Aerodynamic and perceptual parameters of voice and to establish its effectiveness in therapeutic outcome. Materials and Methods The number of patients enrolled for this prospective observational study was 65, all with Reflux symptom index (RSI) more than 13. Quality of life was evaluated using voice handicap index (VHI). Perceptual evaluation of voice done by Grade Roughness Breathiness Asthenia Strain score (GRBAS) followed by acoustic and aerodynamic analysis. Patients were started on a once daily proton pump inhibitor therapy for 3 months along with vocal hygiene measures and RSI, VHI and voice analysis repeated after the treatment. Results There was significant improvement in the RSI score after treatment. Percent jitter and shimmer showed significant improvement in males post treatment (p value:

Introduction Laryngopharyngeal reflux disease can alter the structural and functional integrity of the vocal fold. Objectives of the study was to determine the effect of Laryngopharyngeal Reflux Disease (LPRD) on selected Acoustic, Aerodynamic and perceptual parameters of voice and to establish its effectiveness in therapeutic outcome. Materials and Methods The number of patients enrolled for this prospective observational study was 65, all with Reflux symptom index (RSI) more than 13. Quality of life was evaluated using voice handicap index (VHI). Perceptual evaluation of voice done by Grade Roughness Breathiness Asthenia Strain score (GRBAS) followed by acoustic and aerodynamic analysis. Patients were started on a once daily proton pump inhibitor therapy for 3 months along with vocal hygiene measures and RSI, VHI and voice analysis repeated after the treatment. Results There was significant improvement in the RSI score after treatment. Percent jitter and shimmer showed significant improvement in males post treatment (p value:

Introduction: Majority of the patient undergo endotracheal intubation for various time duration, when given general anaesthesia. Injury in airway mucosa or vocal cords due to endotracheal intubation can be a contributing factor. Ketamine without affecting local healing process has an antiproinflammatory effect as it limits exacerbation of systemic inflammation. Aim: To study the role of ketamine gargles as a pharmacological measure in order to attenuate POST, HOV and cough followed by endotracheal intubation during surgeries under general anaesthesia. Materials and Methods: A randomised controlled study was carried out for a duration of 22 months from the institutional ethical committee (Study Approval No. SVIEC/ON/MEDI/ BNPG18/D19046), on 50 patients of American Society of Anaesthesiologists (ASA) grade I and II. They were allocated into two groups of 25 patients. Group (K): ketamine 50 mg in 29 mL 0.9% normal saline and Group (C): 30 mL 0.9% normal saline. Patients were advised to gargle for 30 seconds just 5 minutes prior to induction of anaesthesia. Patients were intubated with appropriate size of the endotracheal tube and were extubated when fully awake and conscious. Pateints were shifted to postoperative ward and were kept in propped up position with oxygen. Pateints were assessed at 1,2,4,24 hours for incidence of POST, HOV and cough. Assessment was made as per the 4 point scale grading system. The statistical analysis was performed using unpaired t-test, p

ABSTRACT Purpose To evaluate and compare the parameters of Digital kymography obtained through the High-speed Videolaryngoscopy of women without laryngeal disorders, of women with vocal fold nodules and of women with vocal cysts. Methods A cross-sectional observational study in which 60 women aged 18 years and 45 years were selected. Three study groups were formed: 20 women without laryngeal disorder forming the control group (Group 1), 20 women with diagnosis of vocal fold nodules forming Group 2 and 20 women with diagnosis of vocal cysts forming Group 3. Subsequently the participants were evaluated by High-speed Videolaryngoscopy for analysis and comparison of laryngeal images using Digital kymography. The laryngeal parameters processed by the program KIPS® were: minimum, maximum and mean opening; dominant amplitude of the left and right vocal folds; dominant frequency of the right and left vocal folds; and close. Results The analysis of Digital kymography suggests that the presence of the vocal fold nodules and the vocal cysts tend to restrict more to the maximum and minimum opening of the vocal fold and the dominant amplitude of the opening variation in the middle region of the glottis. Conclusion Digital kymography parameters were similar in the presence of vocal fold nodules and vocal cysts lesions.

Introduction: Patients with muscle tension dysphonia (MTD) suffer from several physical discomforts in their vocal tract. However, few studies have examined the effects of voice therapy (VT) on the vocal tract discomfort (VTD) in patients with voice disorders. Therefore, the aim of the present study was to investigate the effects of VT on the VTD in patients with MTD. Materials and Methods: This study was carried out on 25 subjects with MTD, including 5 men and 20 women, with the mean age of 37.20±5.70 years. The participants underwent 10 consecutive sessions of VT twice a week. The acoustic voice analysis, auditory-perceptual assessment, and the Persian version of the vocal tract discomfort (VTDp) scale were used to compare the pre- and post-treatment results. Results: After VT, significant improvements were observed in the acoustic characteristics, including jitter, shimmer, and harmonics-to-noise ratio (P

Amaç: Bu çalışmada allerjik rinittte farklı tedavilerin ses kalitesine olan etkisini araştırılması amaçlanmıştır. Bu nedenle allerjik rinit hastalarında farklı tedavilerinde, tedavi öncesi ve tedavi sonrası objektif ve sübjektif ses parametrelerini karşılaştırılmıştır.Gereç ve Yöntem: 1.grupta intranasal steroid sprey, 2.grupta intranasal steroid sprey+oral antihistaminik tedavisi verdik. Objektif analizde Praat analiz sisteminde temel frekans(F0), shimmer%, jitter%, ses-harmoni oranı(NHR) ortalama değerlerini ; sübjektif ses analizinde total nasal semptom skoru(TNSS) ve ses handikap indeksi(VHI) skorlarını karşılaştırılmıştır. .Bulgular: Grup 1'de F0 hariç her iki grupta da tedavi sonrası tüm ses parametreleri gelişti. 2. grupta tedaviden sonra F0 değerleri tedaviden öncekilerden anlamlı derecede yüksekti; 1. gruptaki F0 değerleri daha yüksekti ancak anlamlı değildi. Subjektif parametreler ile F0,% jitter,% shimmer ve NHR değerleri dahil objektif parametreler arasında grup 1 ve grup 2 arasında anlamlı fark yoktu.Sonuç: Allerjik rinit tedavisinde hem intranasal steroid sprey hem de intranasal steroid sprey+oral antihistaminik kullanımı ile ses kalitesi artmaktadır. Ancak kombine tedavi ile objektif ve sübjektif ses analizlerinde anlamlı farklılık saptanmamıştır.

Laser surgery (LS) or radiotherapy (RT) is normally recommended in early glottic cancer. The objective of this study was to perform a comprehensive meta-analysis of acoustic and perceptual outcomes to compare voice quality of LS or RT in early-stage glottic cancer. Data sources were obtained after searching PubMed, Google Scholar, EBSCO, and RISS using the following search terms: glottic cancer, glottic carcinoma, endoscopic surgery, laser surgery, radiotherapy, radiation, voice, voice quality, and grade, roughness, breathiness, asthenia, and strain (GRBAS) scale. Articles that compared voice outcomes between LS and RT were identified. This meta-analysis included 15 articles with 744 patients, including 400 in the LS group and 344 in the RT group. Random effects models were selected. Forest plots included standardized mean differences, standard errors, variance, 95% confidence intervals (lower limit to upper limit), z-values, and P-values. In perceptual analysis, grade (G) and asthenia (A) of RT were significantly better than LS. There was no statistically significant difference in roughness (R), breath (B), or strain (S) between LS and RT groups. Jitter, shimmer, and noise to harmonic ratio measurements showed significant differences, resulting in enhanced posttreatment effect of RT compared to LS. Results of our meta-analysis suggested that RT might lead to superior voice quality than LS in early glottic cancer.