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Background: Disorders of voice can limit an individual's participation and impair social interaction, thus affecting overall quality of life. Perceptual and objective evaluations can provide the clinician with detailed information regarding voice disorders., Methods: This study comprised 40 subjects aged 34-46 years, 20 of whom (10 male, 10 female) had unilateral vocal fold palsy. Data were obtained for all participants from: the Voice Handicap Index, the grade, roughness, breathiness, asthenia and strain ('GRBAS') scale, acoustic voice analysis, electroglottography, and voice range profiles., Results: The voice evaluations revealed statistically significant (p < 0.05) differences between the controls and study group, both in males and females, pre- and post-therapy., Conclusion: Despite the normalisation of vocal parameters, acoustic, perceptual and self-rated assessments revealed statistically significant differences after therapy. Hence, acoustic measures, namely electroglottographic perturbation, and voice frequency and intensity range, are recommended prior to termination of therapy.

Introduction: The diagnostic procedure of phonation is dominated by subjective assessment tools. It seems reasonable to seek methods of quantitative glottal cycle assessment., Objective: The aim of our study was the analysis of open quotients (OQ) of the glottis., Methods: One hundred and twenty-four people were included in the study. Methodology was based on tools available in everyday phoniatrics practice - laryngovideostroboscopy (LVS) and electroglottography (EGG). There were statistically significant differences between control and studied group. Vocal fold polyps, nodules and edema influence glottal function in a different manner, what can be illustrated by objective glottal function parameters. Establishing Videostroboscopic Open Quotient values from three parts of glottis and Electroglottographic Quasi Open Quotient (QOQ) value, can help in dividing patients with benign lesions of vocal folds according to the type of disease., Results and Conclusions: Measurement of the open quotient from three parts of the glottis helps to differentially diagnose and localize glottal vocal fold lesions. Videostroboscopic Open Quotient and Electroglottographic QOQ values can be used to quantify the glottal cycle. Videostroboscopic Open Quotient, Electroglottographic QOQ and their ratio varies depending on the type of organic dysphonia.

Background: Late-onset Pompe disease (LOPD) is a metabolic myopathy disorder characterized by progressive muscle damage and among others dysfunction of the voice apparatus, which affects speech and - above all - voice quality. Symptoms include dysphonia, instability, glottic insufficiency, and tense voice. The aim of this study was to evaluate and compare voice quality disorder in a group of 15 LOPD patients who were first examined in 2014 and then re-examined in 2017., Methods: In both 2014 and 2017, the same 15 LOPD patients, ranging in age from 15 to 57, from 10 different families, underwent the following examinations: perceptual assessment of voice quality on the RBH scale, electroglottographic recordings, and acoustic recordings. All the patients were on enzyme replacement therapy (ERT)., Results: Three years after the 2014 study, the LOPD patients demonstrated a deterioration in voice quality. A statistically significant increase in glottic insufficiency (p = 0.0399) and a shift towards tense voice (p = 0.0417) were observed. Two patients - out of three who had received presymptomatic treatment - demonstrated stable voice quality compared with 2014., Conclusions: The results suggest increased muscle weakness and progression of LOPD. The parameters Closed Quotient (calculated on the basis of an electroglottographic signal) and Peak Slope (calculated on the basis of an acoustic signal) proved to be the most sensitive.

Speech and voice symptomatology (dysarthrophonia) are often reported by patients with myasthenia gravis (MG). However, they have been poorly investigated despite their significant impact on quality of life. Quantitative methods for the assessment of dysarthrοphonia could facilitate the evaluation of these common MG symptoms. The goal of this study was to investigate the phonatory (sustained phonation and reading) and speech (diadochokinesis) function in MG patients using quantitative measures. The voice/speech of 12 MG patients (7 with anti-AchR and 5 with anti-MuSK antibodies) and 24 age-matched healthy controls was recorded and analyzed using electroglottography (EGG) and speech acoustics. For the analysis of voice, the variables that were found to distinguish MG patients compared to healthy controls were a higher average fundamental frequency (P<0.05), a higher standard deviation of the average fundamental frequency (P<0.001), a higher mean fundamental frequency of the vibrating vocal folds (P<0.005) and a higher fundamental frequency range (P<0.005). The analysis of diadochokinesis showed that MG patients had a higher mean duration of the silent interval between a series of repetitive /pa/ syllables (P<0.05), of the sound /t/ (P=0.05) and of the silent interval between a series of repetitive /ka/syllables (P<0.05). No statistical differences were found in any of these variables between the MG subgroups with anti-AchR or anti-MuSK antibodies. This study demonstrates that non-invasive physiological methods (EGG and speech acoustics) offer essential tools for the assessment of dysarthrophonia in MG patients., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Vocal-fold vibration can be analyzed in a noninvasive way by registering impedance changes within the glottis, through electroglottography. The morphology of the electroglottographic (EGG) signal is related to different vibratory patterns. In the literature, a characteristic knee in the descending portion of the signal has been reported. Some EGG signals do not exhibit this particular knee and have other types of events (inflection events) throughout the ascending and/or descending portion of the vibratory cycle. The goal of this work is to propose an automatic method to identify and classify these events. A computational algorithm was developed based on the mathematical properties of the EGG signal, which detects and reports events throughout the contact phase. Retrospective analysis of EGG signals obtained during routine voice evaluation of adult individuals with a variety of voice disorders was performed using the algorithm as well as human raters. Two judges, both experts in clinical voice analysis, and three general speech pathologists performed manual and visual evaluation of the sample set. The results obtained by the automatic method were compared with those of the human raters. Statistical analysis revealed a significant level of agreement. This automatic tool could allow professionals in the clinical setting to obtain an automatic quantitative and qualitative report of such events present in a voice sample, without having to manually analyze the whole EGG signal. In addition, it might provide the speech pathologist with more information that would complement the standard voice evaluation. It could also be a valuable tool in voice research., (Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Even though earlier studies have investigated the relationship between various subjective and instrumental measures of voice, determining a standardized set of voice parameters in evaluating dysphonic voices can help in better diagnostic distinctions and judgment of the treatment outcomes in voice disorders. Thus, the primary objective was to examine the differences in the objective and subjective measures of voice between the participants with dysphonia and participants with a clinically normal voice. The subsequent objective was to identify the group of parameters sensitive to vocal changes in dysphonia using discriminant analysis. Two groups of participants were included in the study. Group 1 comprised of 15 participants with dysphonia. Group 2 included 15 participants with a clinically normal voice. Sustained phonations of vowels were recorded from the participants of both groups and were analyzed perceptually using the GRBAS rating scale. Acoustic, cepstral, spectral, and electroglottographic measures were analyzed from dysphonic voices and normal controls. There were significant differences in both instrumental and perceptual measures between the participants with and without dysphonia. The set of five parameters that were significant predictors that discriminated the dysphonic voice from the clinically normal voice with 100% accuracy was also determined using discriminant analysis. Future investigations on the relation between the specific instrumental and perceptual measures of voice identified in the present study among individuals with various voice disorders can deliver more promising and comprehendible insights into better diagnostic distinctions of voice disorders. [ABSTRACT FROM AUTHOR]

Context: Semi-occluded vocal tract exercises (SOVTEs) helps to change the acoustic vocal tract impedance in relation to the glottal impedance, improving voice quality. SOVTE has been divided into two groups: steady and fluctuating SOVTEs based on their source of vibration and acoustic characteristics. Aims: The aim of the study was to examine and compare the difference between steady and fluctuating SOVTE with phonation of/a/and/E/on electroglottography and F1–F0 analysis. Settings and Design: Survey design. Study Type: Consort type of study. Materials and Methods: Hundred male participants within the age range of 18–25 years were selected for the study. All the participants were asked to phonate (a) and (E) vowels at a constant pitch for at least 3 s, then all samples were recorded. Assessment of contact quotient percentage value in electroglottography and PRAAT software were used for F1–F0 analysis. Data processing was done on Excel spreadsheet and scoring was processed by SPSS software. Statistical analysis used: One-way analysis of variance (ANOVA) in SPSS Statistics was used for statistical analysis. Results: Mean ± standard deviation and one-way ANOVA revealed that the significant difference was obtained at P < 0.05 in between the steady and fluctuating SOVTEs with phonation of/a/and/E/on EGG parameter and acoustic measure (F1–F0). Conclusions: The study suggested that contact quotient percentage and F1–FO (Hz) value in phonation of/E/are more than/a/. It indicates that phonation of/E/with SOVTEs has more effective in voice disorders than the phonation of/a/and that can be beneficial for treatment of organic voice disorders. [ABSTRACT FROM AUTHOR]

Introduction: The publication describes the characteristics of the glottis in FDs objectified by OQ, measured with VSK and EGG. Aim: The aim of the study was to objectify glottal function in different types of FDs. The scope was to use open quotients gained from various mucosal wave imaging techniques for differential diagnosis of FDs. Material and Method: The study included 204 individuals. In the study, each patient underwent otolaryngological and phoniatric examination. LVS, EGG and VSK were conducted, their results were recorded and stored using an EndoSTROB-DX- -Xion GmbH (Berlin) device with DIVAS software. Results: All patients with FDs had abnormalities in LVS. A statistical analysis showed differences in LVS characteristics according to the type of FD. The mean value of OQVSK was 0.521 in the control group and 0.565 in the study group (P < 0.05). Significant differences were found between patients with hypofunctional - 0.584 and hyperfunctional dysphonia - 0.55. The QOQEGG mean value in patients with FDs was 0.581 and in the control group 0.549 (P < 0.01). There were statistically significant differences between groups of patients with hyper- and hypofunctional dysphonias. Medians amounted to 0.574 and 0.604, respectively. Authors observed different relations of OQ with the type of FD. They decided to introduce a new parameter, illustrating the proportion of QOQEGG/OQVSK. Conclusions: Videostrobokymographic and electroglottographic open quotients differentiate euphony from dysphony. The value of OQVSK and QOQEGG and their proportion varies depending on different types of functional dysphonias. The OQVSK and QOQEGG should be included in the diagnostic algorithm of voice. [ABSTRACT FROM AUTHOR]

Introduction: Electroglottography (EGG) is the most commonly used method of indirect visual examination of vocal fold vibration.Aim: The study was conducted with an aim of assessing EGG quasi open quotient (QOQEGG) in different functional dysphonias to develop a differential diagnosis. The second aim was to check the influence of articulation on QOQEGG values.Material and methods: There were 20 people without voice problems, 20 patients with hypofunctional dysphonia and 20 patients with hyperfunctional dysphonia included in the study. Electroglottography was recorded during comfortable sustained phonation of [a], [e], [i], [o], [u].Results: There were no statistically significant differences in QOQEGG observed during phonation of different vowels in the control group and patients with hyperfunctional dysphonia. In patients with hypofunctional dysphonia, significantly higher values of QOQEGG were observed during [a] and [e]. Both in the control and in studied groups vowel [i] was vocalized significantly quieter.Conclusions: To conclude, EGG can be useful in differential diagnosis of functional dysphonia. QOQEGG is a parameter differentiating hypofunctional dysphonia from hyperfunctional dysphonia. Dissimilarities in articulation of different vowels in patients with various types of dysphonia influence values of QOQEGG. EGG study protocol in cases of functional dysphonia should include a comparison of [a], [e], [i] vowels. [ABSTRACT FROM AUTHOR]

Background Until now, it has been impossible to discriminate a pathology of the vocal folds and, in many instances, even to distinguish normal from pathological voices with an electroglottographic signal (EGG). Objectives To introduce a method for analyzing electroglottographic signals and for extracting features able to characterize phonation quantitatively. Methods The EGG signal recorded during a continuous vocal phonation is processed in order to obtain the first derivative, which is related to the velocity of movements and contact of the vocal folds. The average fundamental frequency is computed and its corresponding period is taken as the typical duration of the EGG cycle. After each glottal cycle has been identified, the EGG signal and its derivative are locally normalized in time. For each glottal cycle, the amplitude and related velocity signals are plotted in an X-Y graph thus forming a multi-layer display where each EGG cycle appears as a circular trace. This X-Y representation can be viewed as a polar graph: by increasing the angle from 0 to 360° with incremental steps corresponding to the time normalization re-sampling of the EGG cycle, mean value and variance are computed. The results are the curve of the amplitude-velocity mean cycle and the related variance curve. The shape of the mean loop is strictly associated with the relationships between amplitude-velocity changes and phonation phases. The surrounding area represents the variability of local vocal phenomena around the above mean curve. The phonation process can be characterized in more detail by computing couples of indices (mean and variance) as obtained by dividing the polar graph in 4 quadrants, roughly associated with the different phases of the glottal cycle. In our study we carried out the EGG analysis of 21 cases of normal voice and 21 cases of pathological voice, considering the variability based on the combined amplitude-velocity analysis. Results In normal subjects, the global variability indices ( VI ) (expression of Amplitude and Velocity variation) and the four VI of different physiological phases of glottal wave ( VI 1 , VI 2 , VI 3 and VI 4 ), were definitely lower than in pathological subjects. Such difference was statistically significant (p < 0.03). Conclusions The above method for analyzing the EGG signal proved to be efficient to discriminate normal subjects from pathological ones. Additional trials with more subjects are needed to confirm this preliminary data and to evaluate possible differences between different pathologies. [ABSTRACT FROM AUTHOR]

Background: Pompe disease is a progressive metabolic myopathy. Disease progression is characterized, among other features, by progressive dysfunction of the voice apparatus. The aim of this study was to employ electroglottographic, acoustic and nasalance measurement methods on patients with late-onset Pompe disease in order to provide detailed information on the effect of the disease on voice quality. Voice quality is the key factor for estimating the effectiveness of ERT in late-onset Pompe disease. The study compared clinical phoniatric examination with electroglottographic, acoustic and nasalance measurement methods. The consistency of the aforementioned analyses was assessed.Methods: The study examined 19 patients with late-onset Pompe disease (including 9 with the juvenile form of the disease). Of these, a total of 17 patients underwent otolaryngological examination with detailed phoniatric evaluation of their articulatory organs. Electroglottographic recordings and nasalance measurements (using the nasalance Separator Handle) were obtained from all patients. MATLAB (COVAREP toolkit) was used to analyse voice recording data.Results: Dysphonia observed in patients with late-onset Pompe disease is mainly caused by dysfunction of vocal fold closure and weakness of vocal muscle. However, substantial speech nasality is caused by insufficient closure of the soft palate. Electroglottographic signal analysis, acoustic and nasalance testing methods indicated that more significant changes in the function of the voice apparatus presented in the juvenile form than in the adult form of late-onset Pompe disease.Conclusions: It was found that speech nasality and electroglottographic tests are more repeatable, comparable and versatile than phoniatric examination, allowing for earlier detection of voice pathology in late-onset Pompe disease. These sensitive and non-invasive acoustic and electroglottographic methods allow for the tracking of changes in voice as patients undergo treatment or as the disease progresses. [ABSTRACT FROM AUTHOR]

Vocal changes in emotional situations may identify contributing factors in behavioral voice disorders and direct more efficient therapies. Finding appropriate measures of voicing that detect emotional conditions is a first step in this line of investigation. The purpose of this study was to determine whether electroglottography (EGG) contact quotient is a viable measure to detect vocal changes in different emotion states. Vocal responses in 18 vocally healthy participants were measured using EGG contact quotient during picture viewing from the International Affective Picture System. Results demonstrated that in negative emotional conditions participants employed significantly greater EGG contact quotient than in neutral or positive conditions. EGG contact quotient appears to be a viable measure to investigate voice and emotion. [ABSTRACT FROM AUTHOR]

Previous research has suggested that the peaks in the first derivative (dEGG) of the electroglottographic (EGG) signal are good approximate indicators of the events of glottal opening and closing. These findings were based on high-speed video (HSV) recordings with frame rates 10 times lower than the sampling frequencies of the corresponding EGG data. The present study attempts to corroborate these previous findings, utilizing super-HSV recordings. The HSV and EGG recordings (sampled at 27 and 44 kHz, respectively) of an excised canine larynx phonation were synchronized by an external TTL signal to within 0.037 ms. Data were analyzed by means of glottovibrograms, digital kymograms, the glottal area waveform and the vocal fold contact length (VFCL), a new parameter representing the time-varying degree of 'zippering' closure along the anterior-posterior (A-P) glottal axis. The temporal offsets between glottal events (depicted in the HSV recordings) and dEGG peaks in the opening and closing phase of glottal vibration ranged from 0.02 to 0.61 ms, amounting to 0.24-10.88% of the respective glottal cycle durations. All dEGG double peaks coincided with vibratory A-P phase differences. In two out of the three analyzed video sequences, peaks in the first derivative of the VFCL coincided with dEGG peaks, again co-occurring with A-P phase differences. The findings suggest that dEGG peaks do not always coincide with the events of glottal closure and initial opening. Vocal fold contacting and de-contacting do not occur at infinitesimally small instants of time, but extend over a certain interval, particularly under the influence of A-P phase differences. [ABSTRACT FROM AUTHOR]

The deleterious effects of smoking on laryngeal mucosa are indisputable. Smoking not only causes histologic (microscopic) alterations in the vocal fold epithelium but also affect the acoustic property of voice. The goal of this study was to determine the effects of smoking on the laryngeal structures and phonatory physiology via videostroboscopy, acoustic voice analysis and electroglottography. Cross-sectional and observational study was carried out in Department of ENT, Pt. J. N. M. Medical College, Raipur, in 100 male volunteers (50 smokers and 50 nonsmokers) between the ages of 18 and 60 years with no voice complaints. All subjects were analyzed for detailed history and underwent videostroboscopic, acoustic voice analysis and electroglottographic examination. Videostroboscopic examination results showed significant relationships between smoking and abnormal vocal fold edge, abnormal texture, edema, erythema, abnormal mucosal cover, abnormal phase symmetry and abnormal pliability/stiffness. Voice analysis showed that smoking has a clear effect on some acoustic voice and electroglottographic parameters. The parameters most commonly affected by smoking are fundamental frequency (F0), jitter, shimmer, F0 tremor, normalized noise energy, signal noise ratio, maximum phonation time (MPT), s/z ratio, opening rate and closing rate. The results indicate that smoking has a significant effect on laryngeal structures and phonatory physiology. [ABSTRACT FROM AUTHOR]

Highlights: [•] Electroglottogram and microphone signals analysis in normal and dysphonic subjects. [•] SampEn and cross-SampEn indicators. [•] SampEn and cross-SampEn statistically higher in pathological subjects. [•] Microphone signal more complex than electroglottogram. [ABSTRACT FROM AUTHOR]

Dysarthria and phonatory symptomatology are often reported by patients suffering from multiple sclerosis (MS), but have been poorly investigated, although related to life quality. The objective of the study was to investigate the phonatory function in MS patients using objective measures. The speech of 64 MS patients and 64 pair-matched controls was recorded and analyzed using electroglottography, a physiological method that measures the electrical conductance during the opening and closing phases of the vibrating vocal folds. Electroglottographic parameters were correlated with clinical and MRI features. Most of the variables that have been used for the analysis of voice (vocal jitter P = 0.041, standard deviation of the average fundamental frequency P = 0.018, and the mean fundamental frequency of the vibrating vocal folds P = 0.025) differentiated the MS group from the control group. Phonatory function is impaired in MS patients, and physiological methods, such as electroglottography, are useful tools to assess it. [ABSTRACT FROM AUTHOR]

Phonation threshold pressure (PTP), frequently used for characterizing vocal fold properties, is often difficult to measure. This investigation analyses the lowest pressure initiating vocal fold collision (CTP). Microphone, electroglottograph (EGG), and oral pressure signals were recorded, before and after vocal warm-up, in 15 amateur singers, repeating the syllable /pa:/ at several fundamental frequencies with gradually decreasing vocal loudness. Subglottal pressure was estimated from oral pressure during the p-occlusion, using the audio and the EGG amplitudes as criteria for PTP and CTP. The coefficient of variation was mostly lower for CTP than for PTP. Both CTP and PTP tended to be higher before than after the warm-up. The results support the conclusion that CTP is a promising parameter in investigations of vocal fold characteristics. [ABSTRACT FROM AUTHOR]

Conclusion: A detailed understanding of clinical and voice characteristics will help to differentiate sulcus configuration and plan rational management strategies for each type. Objectives: To investigate the clinical and voice characteristics of patients with sulcus configuration of vocal folds during phonation. Patients and methods: A total of 146 patients with bilateral sulcus configuration of vocal folds were enrolled in this study. Based on videostroboscopic findings, patients were classified into three groups: physiologic sulcus configuration group (type I), pathologic sulcus configuration group, including sulcus vergeture (type II), and sulcus vocalis (type III). Voice analyses were obtained from a recorded speech sample. Results: Thirty-two patients (21.9%) were type I, 61 (41.8%) were type II, and 53 (36.3%) were type III. Different sulcus configuration groups had significantly different roughness and mean fundamental frequency. Type III was significantly different from type I and type II in grade, breathiness, mean flow rate, subglottic pressure, maximum phonation time, Jitter%, and harmonics to noise ratio. The pathologic sulcus showed distinctive features in electroglottograph waveform. [ABSTRACT FROM AUTHOR]

Summary Objectives The purpose of this study was to investigate electroglottography (EGG) contact quotient modulation with emotional state in the presence of increased arousal. Study Design A within-subject reversal paradigm using multiple experimental conditions. Methods A total of 11 healthy undergraduate students underwent emotion induction with intermittent startles to increase physiologic arousal. During emotion induction, they vocalized on the vowel /u/ while EGG was recorded. Results EGG contact quotient was significantly greater for negative emotions compared with positive emotions with increased arousal commensurate with past research. In addition, overall EGG contact quotient was greater with elevated arousal. However, the effect sizes were small. Conclusions EGG contact quotient appears to increase with elevated arousal and be greater for negative mood states than positive mood states confirming that emotion states directly influence vocal functioning. [ABSTRACT FROM AUTHOR]

Summary: Objectives: The aim of this study was to verify whether the electroglottography (EGG) perturbation parameters could be superior indicators to traditional acoustic (Ac) measures, particularly for the detection of mild vocal roughness. Methods: Thirty-nine participants with muscle tension dysphonia (the MTD group), 48 dysphonic participants with vocal fold lesions (the organic group), and 40 nondysphonic participants (the control group) were enrolled in the study. Based on the severity of vocal roughness, each of the two dysphonic groups was divided into mildly and severely dysphonic subgroups. The Ac and EGG signals during sustained /e:/ phonation were recorded simultaneously. The period and amplitude perturbation quotients of both signals (Ac-PPQ/-APQ and EGG-PPQ/-APQ) were calculated. The receiver operating characteristic (ROC) analyses were applied to evaluate the discriminative capabilities. Results: In the analyses between the control and each of the two dysphonic groups, the values of the areas under the curve (AUC) for EGG-PPQ were significantly higher than those for Ac-PPQ. Next, the ROC analyses between the control and mildly dysphonic MTD subgroup demonstrated that the AUC values for EGG-PPQ/EGG-APQ were significantly higher than those for Ac-PPQ/Ac-APQ. In the analyses of the mildly dysphonic organic group, the AUC value for EGG-PPQ was significantly higher than that for Ac-PPQ. Conclusions: The present study demonstrated that both the period and the amplitude perturbation parameters of the EGG signals showed higher diagnostic accuracies than those of Ac signals, especially for the detection of mild vocal roughness. These results suggest that the EGG perturbation parameters could provide better information than the traditional Ac perturbations. [Copyright &y& Elsevier]

The purpose of the study was to determine how electroglottographic measures change with voice recovery in women with vocal fold palsy compared with healthy speakers, and which coefficient best represents dysphonia. An electroglottograph with speech studio 1.04 software was used to record and analyse the data. Electroglottographic data were collected from 22 female patients and 16 healthy female speakers. Our findings show that the mean values of open quotient (OpQ), closing quotient (ClQ), % Irregularity and contact quotient (Qx) differ between the groups of patients and controls. % Irregularity, Qx and OpQ significantly correlated with the perceptual degree of dysphonia. Electroglottographic recordings can objectify dysphonia in patients with vocal fold palsy. Electroglottography is a suitable non-invasive tool for tracking the patients' long-term progress. % Irregularity best represents the vocal fold dysfunction in patients with a vocal fold palsy. [ABSTRACT FROM AUTHOR]