Mechanical and dynamic aspects of voice production as related to voice therapy and phonosurgery

Laryngeal framework surgery can change the position and tensionof the vocal folds safely without direct surgical intervention in the vocal fold proper. Some 23 years of experience with phonosurgery have proved its usefulness in treating dysphonia related to unilateral vocal fold paralysis, vocal fold atrophy, and pitch-related dysphonias. Meanwhile, much information about the mechanism of voice production has been obtained through intraoperative findings of voice and fiberscopic examination of the larynx . Based on such knowledge together with information obtained through model experiments, the human vocal organ was reconsidered mainly from the mechanical view point, and the roles of voice therapy and singing pedagogy were discussed in relation to phonosurgery. The vocal organ may not be an ideal musical organ and is rather vulnerable, but its potential is enormous.     

Speech task effects on acoustic and aerodynamic measures of women with vocal nodules

Vowel prolongation is often used to evaluate disordered voice production. In light of previous findings showing that co-articulation has significant influence on laryngeal function measures, the practice of using prolonged vowels to represent a speech sample is questioned. To test whether disordered and normal voice during vowel production is generalizable to connected speech, three speaking tasks were investigated: sustained vowel prolongation, syllable repetition and reading. Statistical differences were found between these tasks for certain amplitude and time based laryngeal function measures for adult women with disordered and normal voice. However, for the specific measures which were statistically different, the actual numerical and perceptual differences may be quite small. From a clinical assessment standpoint, the choice of the speech task may not make an apparent difference in the objective evaluation of disordered voice.     

The effect of voice lessons on the clinical and perceptual skills of graduate students in speech-language pathology

Two groups of 10 speech-language pathology graduate students were each given 7 weeks of singing lessons to determine whether voice lessons could have an effect on their clinical and perceptual skills. Pre-, mid-, and posttests to measure various skills were designed and implemented. With use of paired sample statistical testing, statistically significant results were obtained. In addition, the subjective responses of the students show that the lessons were effective in improving pitch perception, breath control, and legato production or easy onset. This study supports efforts to integrate curricula in vocal performance and speech-language pathology.     

Neurovegetative symptoms and complaints before and after voice therapy for nonorganic habitual dysphonia

In a previous study, female patients in all age categories with a nonorganic dysphonia were found to report significantly more autonomic symptoms and complaints than healthy controls. This could not be confirmed for the male subgroup. The present study is to corroborate and nuance this observation by investigating larger groups, and to determine if, after voice therapy, the number of autonomic symptoms and complaints-particularly those ones that have no obvious relation to voice function-decreases. It is a prospective study with a matched control group; 184 patients with nonorganic dysphonia and 126 normal controls answered a questionnaire of 46 questions with 3 subsets and a consistency control. One hundred and one patients received functional voice therapy and completed the questionnaire before and after treatment. A matched control group of 42 normal subjects also filled in the questionnaire two times, with an interval of about 6 months. Neurovegetative symptoms and complaints-voice related and not related-are reported in highly significant excess by patients (especially but not exclusively females) with habitual nonorganic voice disorder. After therapy, there is a highly significant reduction in the number of autonomic symptoms and complaints (related or not related to voice), to such an extent that patients report on average no more general neurovegetative symptoms and complaints than healthy controls (even less). The number of neurovegetative symptoms and complaints connected with voice function is also strongly reduced in patients after therapy, but remains in significant excess when compared with controls.     

Coping strategies, personality, and voice quality in patients with vocal fold nodules and polyps

Emotional state affects the physiological mechanism involved inphonation. Differences in acoustical parameters of the voice under stress have been attributed to the coping mechanism used, which is based on the individual's perception of the situation. This study examines the relationship between coping strategies, personality, and voice in female subjects, ranging in age from 19.3–55.7 years, diagnosed with vocal nodules or polyps. The differences between coping strategies and personality are examined and compared with another group with no history of voice pathology. The relationship of personality and coping strategies to voice quality variables is reported. Results show that patients use emotional coping strategies more and cognitive coping strategies less than the comparison group. Type of voice pathology was found to be related to dominance, and a number of coping and personality variables were found to correlate significantly with voice quality.     

Consistency in clinicians'' and clients'' behavior in voice therapy: An exploratory study

The primary purpose of this study was to investigate consistency in clinicians' behaviors during two voice therapy sessions. The secondary purpose was to examine relationships between ratings of clinicians' and clients' behaviors. Each clinician (n = 7) was observed working with two different clients. Two experienced evaluators, using the Adjective Checklist and fivepoint semantic differential scales, rated clinicians and clients. Results indicated that 6 of 10 aspects of therapy studied were found to be relatively inconsistent, with the pace of therapy being the least stable. Ratings of individual clinician traits (e.g., favorable, unfavorable, intraception) were the most stable.