Fundamental Frequency Histograms Measured by Electroglottography During Speech: A Pilot Study for Standardization

This study was designed to develop a database for the electroglottographic measurement of fundamental frequency (Fo) in normal subjects in running speech, for reference in the diagnosis and follow-up of dysphonic patients. A prospective pilot study included 20 healthy male volunteers without laryngeal disorder. Electroglottographic recordings of speaking Fo during connected speech (French) were obtained from two texts with different prosodic content. Fo histograms were sensitive to the variation of speaking Fo between both texts. Graphic representation of the range and distribution of the Fo of the speaker were designed as normalized Fo histograms with plot lines at 5th and 95th percentiles. Less than 5% variability of Fo histograms was recorded when recording more than 15 subjects. This pilot study designed a graphic display of standardized electroglottographic Fo measurements during the physiological condition of connected speech. As the degree of Fo variability depends on the phonetic contents of the text and on the language spoken, a separate histogram for normal subjects needs to be developed in each country or at least for each voice laboratory, with a standard, previously chosen text.     

Behavior of the Cricopharyngeal Segment During Esophageal Phonation in Laryngectomized Patients

BACKGROUND: After total laryngectomy, the interruption of the upper digestive tube and the section of the cricopharyngeal segment alter the high-pressure zone of the pharyngoesophageal transition, which will not only start to have a digestive function, but also be stimulated to take on the production of voice and speech. The pressure observed in the cricopharyngeal segment seems to act as a critical factor for the development of esophageal sound production, and manometry is the procedure capable of quantifying the pressure observed in this region. OBJECTIVE: The objective of the current study was to assess the upper esophageal sphincter pressure in laryngectomized patients who are either successful or unsuccessful esophageal speakers, both at rest and during esophageal phonation, using manometry. METHODS: Twenty laryngectomized persons aged 32 to 83 years (mean, 44.2 years) were submitted to evaluation by a speech pathologist and divided into two groups, ie, successful esophageal speakers (N=12) and unsuccessful esophageal speakers (N=8), according to a scale validated by Wepman et al (1953). The upper esophageal sphincter (UES) pressure was assessed by manometry both at rest and during the following voice emissions in Portuguese: the vowel "a," the monosyllable "pa," and the sentence "papai papou pipoca." The amplitude, the duration of the pressure wave, and the area under the curve were measured. RESULTS: At rest, the mean UES pressure was 11.83 mm Hg for successful esophageal speakers and 9.92 mm Hg for unsuccessful esophageal speakers, with no significant difference between groups; the mean for the two groups as a whole was 11.06 mm Hg. During the voice and speech sequence tests, no significant difference was observed when the emissions in Portuguese of "a," "pa," and the sentence were analyzed separately. CONCLUSION: As the pressure observed at rest did not differ between the successful esophageal speakers and the unsuccessful esophageal speakers, and the amplitude, the duration of the pressure wave, and the area under the amplitude x duration curve were also equal for both groups, we conclude that the cricopharyngeal segment pressure is not a preponderant factor for the acquisition of esophageal voice and speech.     

Quality of Life in Dysphonic Patients

Voice disorders can affect social life. Dysphonic patients report symptoms of psychological distress as a direct consequence of their dysphonia. It is assumed that their health-related quality of life (HRQL) is reduced. The purpose of this study was to find out whether changes of HRQL depend on the kind of voice disorder (organic or functional) and on the sex of the person affected. A total of 108 adult patients took part in the study, and patients with malignancies were excluded. Test persons were asked to complete the SF-36 questionnaire on their health-related quality of life without prior information about their individual diagnosis. The results of this study show that voice disorders significantly influence patients' HRQL. There are no statistically significant differences between patients suffering from organic and functional voice disorders or between dysphonic women and men. When comparing the results obtained in this study with those in the literature, surprisingly, it seems that the manner in which a person experiences a voice disorder depends on the individual cultural background. Patients with functional voice disorders have similar reduction in HRQL as those with organic voice disorders. HRQL in dysphonic women does not differ from the one in dysphonic men. The results allow for the conclusion that changes of HRQL do not depend on the kind of voice disorder and not on the sex of the person affected.     

Spectral Amplitude Measures of Adductor Spasmodic Dysphonic Speech

Spectral amplitude measures are sensitive to varying degrees of vocal fold adduction in normal speakers. This study examined the applicability of harmonic amplitude differences to adductor spasmodic dysphonia (ADSD) in comparison with normal controls. Amplitudes of the first and second harmonics (H1, H2) and of harmonics affiliated with the first, second, and third formants (A1, A2, A3) were obtained from spectra of vowels and /i/ excerpted from connected speech. Results indicated that these measures could be made reliably in ADSD. With the exception of H1(*)-H2(*), harmonic amplitude differences (H1(*)-A1, H1(*)-A2, and H1(*)-A3(*)) exhibited significant negative linear relationships (P < 0.05) with clinical judgments of overall severity. The four harmonic amplitude differences significantly differentiated between pre-BT and post-BT productions (P < 0.05). After treatment, measurements from detected significant differences between ADSD and normal controls (P < 0.05), but measurements from /i/ did not. LTAS analysis of ADSD patients' speech samples proved a good fit with harmonic amplitude difference measures. Harmonic amplitude differences also significantly correlated with perceptual judgments of breathiness and roughness (P < 0.05). These findings demonstrate high clinical applicability for harmonic amplitude differences for characterizing phonation in the speech of persons with ADSD, as well as normal speakers, and they suggest promise for future application to other voice pathologies.     

Fundamental Frequency Change During Offset and Onset of Voicing in Individuals with Parkinson Disease

SUMMARY: After years of treatment with the medication levodopa, most individuals with Parkinson disease (PD) experience fluctuations in response to their medications. Although relatively consistent perceptual voice improvements have been documented to correspond with these fluctuations, consistent quantitative data to support this finding are lacking. This mismatch may have occurred because most of this phonation research has centered on long-term phonatory measures (ie, across speaking samples and prolonged vowel tasks). The current study examined short-term phonatory behavior in individuals with PD, specifically examining fundamental frequency (F0) at the offset and onset of phonation, before and after a voiceless consonant. The F0 analysis at phonatory offset supported the conclusion that individuals with PD have difficulty with the rapid offset of voicing, and that they are stopping vocal fold vibration primarily through vocal fold abduction (without adding tension). The F0 analysis at phonatory onset revealed that all groups use some laryngeal tension at the initiation of voicing. The tension was lowest for the PD participants who were in their OFF medication state, and it was highest for the age-matched control participants and the PD participants in their ON medication states.