Voice source characteristics in six premier country singers

Voice source characteristics as derived from inverse filtering were analyzed in 6 country singers' speech and singing. Results showed that the closed quotient varied systematically with vocal loudness, and that glottal compliance (the ratio between transglottal AC volume displacement and subglottal pressure) decreased with increases in fundamental frequency but remained unaffected by vocal loudness. No striking differences were found in source characteristics between speech and singing within subjects. The degree of phonatory press, as judged by a panel of 19 expert listeners, appeared related to the range in which the singer was singing and to the sound pressure level gain from a doubling of subglottal pressure.     

Use of injectable autologous collagen for correcting glottic gaps: Initial results

We report our results pertaining to the use of injectable autologous collagen for the correction of dysphonia resulting from a glottic gap. To date 20 cases have been treated, 13 of which were for unilateral vocal fold immobility and 7 for sulcus vergeture and/or scar. Collagen is extracted from the skin. Approximately 5 cm2 is necessary to yield 2 ml. Injection must take place in the deep layer of Reinke's space. No patient suffered from any local or general intolerance. The phonatory glottic gap was totally or partially closed. In the paralysis group, the improvements were the following: the median maximum phonation time improved from 5.8 seconds to 11 seconds, the median mean flow rate from 0.13 ml/s to 0.09 ml/s, the median glottic gap from 8.4 to 4.5 ml/dB per s, the median intensity range from 21 to 29 dB, and the median frequency range from 141 to 195 Hz. The spectral analysis layout classification improved from 2 to 3.     

Voice Therapy Improves Quality of Life in Age-Related Dysphonia: A Case-Control Study

The objective of the study is to determine the efficacy of voice therapy in the treatment of age-related dysphonia. The study was conducted using a retrospective case-control chart review. The medical records of 54 patients older than 60 years diagnosed with age-related dysphonia without complicating diagnoses were reviewed. Patients who chose to undergo voice therapy were grouped as cases. Patients who chose not to undergo voice therapy were grouped as controls. The voice-related quality of life (VRQOL) measure was used to measure outcomes before and after treatment in cases and at a minimum 2-month follow-up in controls. Of the 54 patients, 19 (10 female, 9 male; mean age 73 years) chose to undergo voice therapy and filled in >1 VRQOL questionnaire. Six patients (3 female, 3 male; mean age 66 years) chose not to undergo voice therapy and filled in >1 VRQOL questionnaire. The 19 cases experienced a mean improvement in VRQOL score of 19.21 (2-tailed matched pairs t test P=0.00038) after a mean of 4.1 voice therapy sessions and 5.1 months. The six controls experienced a mean change in VRQOL score of 0.42 (2-tailed matched pairs t test P=0.96) after a mean of 3.3 months. Voice therapy leads to statistically significant improvement in the VRQOL life in elderly patients with age-related dysphonia. It is an efficacious noninvasive therapy for this disease.     

A Review of Patient Adherence to the Recommendation for Voice Therapy

SUMMARY: Voice therapy is a preferred treatment for many voice problems. Many patients referred to voice therapy by their otolaryngologist fail to follow through with the recommendation. Unlike other behavior change therapies, there are no studies documenting the incidence of poor patient attendance in voice therapy. The primary purpose of this study was to document initial patient adherence to the physician's recommendation for voice therapy. A retrospective review of 294 charts was conducted at 2 voice institutions in Atlanta, GA. Reviews included adherence to (1) the physician's referral to the speech-language pathologist and (2) the speech-language pathologist's recommendation for follow-up voice therapy. Thirty-eight percent of patients did not adhere to the physician's recommendation to attend voice therapy. Of those who initiated follow-through, 47% did not return after the initial speech-language pathology evaluation session. There was no significant difference in attendance by gender or by age group. The primary reasons reported for nonattendance were insurance denials, resolution of the problem, and distance to the clinic. The attendance rates described in this study were low but consistent with research published in the fields of otolaryngology, gastroenterology, and psychology. Poor patient attendance is an important area to consider in outcomes research and the cost to healthcare.     

Changes in Objective Acoustic Measurements and Subjective Voice Complaints in Call Center Customer-Service Advisors During One Working Day

SUMMARY: The aim of this study was to investigate how different acoustic parameters, extracted both from speech pressure waveforms and glottal flows, can be used in measuring vocal loading in modern working environments and how these parameters reflect the possible changes in the vocal function during a working day. In addition, correlations between objective acoustic parameters and subjective voice symptoms were addressed. The subjects were 24 female and 8 male customer-service advisors, who mainly use telephone during their working hours. Speech samples were recorded from continuous speech four times during a working day and voice symptom questionnaires were completed simultaneously. Among the various objective parameters, only F0 resulted in a statistically significant increase for both genders. No correlations between the changes in objective and subjective parameters appeared. However, the results encourage researchers within the field of occupational voice use to apply versatile measurement techniques in studying occupational voice loading.     

Epidemiological Study of Voice Disorders Among Teaching Professionals of La Rioja, Spain

The purpose of the present study was to calculate the prevalence and incidence of voice disorders among teaching staff and find out the associated occupational risk factors. A case-control study was performed with 905 teachers, 579 cases and 326 controls; 492 were randomly selected and 413 volunteered. All teachers were asked to fill out a standard questionnaire. Next, a complete laryngeal exam was performed including a general ear, nose, and throat evaluation and videolaryngostroboscopy. The prevalence of voice disorders among teaching staff was 57%. The most prevalent lesions were vocal overstrain (18%), nodular lesions (14%), and hyperfunctional dysphonia (8%). The incidence rate was 3.87 new cases per year per 1000 teachers. Women had organic lesions three times more than men (odds ratio [OR]: 3.52, confidence interval [CI]: 2.04-6.09). However, men had chronic laryngitis three times more than women (OR: 2.93, CI: 1.50-5.71) and functional dysphonia nearly twice more than women (OR: 1.81, CI: 1.21-2.69). We find a significant risk of suffering voice disorders in teachers who smoke daily (OR: 2.31, CI: 1.58-3.37) and who drink several cups of coffee or tea (OR: 1.87, CI: 1.36-2.56). It is advisable to carry out an annual evaluation of all teaching staff on account of the high prevalence of voice disorders among them.     

Optimally weighted maximum a posteriori probabilities based on minimum classification error for dual-microphone voice activity detection

The dual-microphone voice activity detection (VAD) technique is proposed by applying discriminative weight training to achieve optimal weighting of spatial features available within the dual-microphone VAD. Since the motivation behind our method is to use the relevant spatial information available from the two microphones, we employ the phase difference, coherence, and power level difference ratio (PLDR) as a feature vector, and then use this feature vector to derive the maximum a posteriori (MAP) probabilities. Then, we combine each MAP probability based on a discriminative weight training, i.e., the minimum classification error (MCE) method to offer an optimal VAD decision in a spectral domain, which successfully represents the dynamic evolution of speech over time even in the non-stationary noise environments. The proposed dual-microphone VAD algorithm outperforms conventional dual-microphone VAD methods based on only single feature among the PLDR, phase difference, and spectral coherence.