The instrument accuracy limit for objectively measuring the loudness rating of telephone systems

This paper investigates a sensitivity measurement method for carbon transmitters and a calculation method for the loudness rating of a telephone system. The sensitivity varies depending on the artificial voice used for the measurement and the conditioning procedures. The most preferable methods for obtaining values which coincide with those in the subjective loudness rating test are discussed. With respect to the loudness calculation method, the algorithm, parameter values, ear leakage loss, and voice spectrum are discussed. As a result of these investigations, the deviation between the objective and subjective rating is found to be 0.7 dB for the various types of handset telephones when the measurement conditions are optimized. This deviation is considered to be the limit of measurement accuracy. The performance of currently developed objective measurement instruments is close to this limit. Considering the fluctuations accompanying repetitive subjective measurements, the objective rating corresponds satisfactorily with the subjective rating.     

Comment on "Increase in voice level and speaker comfort in lecture rooms" [J. Acoust. Soc. Am. 125, 2072-2082 (2009)] (L)

Recently, a paper written by Brunskog Gade, Paya?-Ballester and Reig-Calbo, "Increase in voice level and speaker comfort in lecture rooms" [J. Acoust. Soc. Am. 125, 2072-2082 (2009)] related teachers' variation in vocal intensity during lecturing to the room acoustic conditions, introducing an objective parameter called "room gain" to describe these variations. In a failed attempt to replicate the objective measurements by Brunskog et al., a simplified and improved method for the calculation of room gain is proposed, in addition with an alternative magnitude called "voice support." The measured parameters are consistent with those of other studies and are used here to build two empirical models relating the voice power levels measured by Brunskog et al., to the room gain and the voice support.     

Validation of the Dysphonia Severity Index in the Dr. Speech Program

PurposeThe Dysphonia Severity Index (DSI) is an objective multiparameter index of voice quality that measures and describes overall voice quality. Some studies have suggested that the reliability of devices for DSI measurement should be examined. We explored the feasibility of DSI measurements using the Dr. Speech (DRS) device, verified its effectiveness for clinical voice measurements and intradevice reliability, and examined the correlation between the DSI and self-evaluations of voice problems.MethodsSeventy adult participants (including individuals with voice problems and healthy adults) underwent objective and subjective voice assessments. These data were then used to establish a DSI_DRS model and test the intradevice (DRS device and Praat software) reliability. The clinical validation of the DSI_DRS was conducted by measuring the DSI of six other participants and comparing the observed and predicted perceived voice quality as expressed by the G score (of the GRBAS scale). Moreover, the relationship between the DSI measurements and participants’ self-evaluations of voice problems was investigated by analyzing the correlation between the DSI and the Voice Handicap Index (VHI).ResultsThe DSI_DRS discriminated 80% of participants’ voice quality ratings. There were strong correlations between the DSI and variables measured by the DRS device and Praat software. Furthermore, there was no significant correlation between the DSI_DRS and VHI.ConclusionThe DRS device can perform DSI measurements. Objective voice measurements and perceptual voice ratings reflected different aspects of vocal function and its effects. These factors should be considered in clinical practice settings.     

Evaluations of output from room acoustic computer modeling and auralization due to different sound source directionalities

Evaluations of the predictions and auralizations from the room acoustic modeling program, ODEON, have been run using three directional source types with the same sound power: (a) an omni-directional source; (b) three sources with realistically-directional characteristics based on measurements from real instruments (grand piano, violin, and singing voice); and (c) an artificial, extremely directional beaming source. Objective analyses have been run for nine source/receiver combinations in a simple hall on three acoustic parameters: relative sound pressure level (SPL), reverberation time (T30), and clarity index (C80). Auralizations were subsequently created for two source/receiver combinations and used in subjective testing with 28 subjects. Results show that, objectively, differences in SPL were negligible for the majority of cases. Some differences in T30 and C80 were found between the omni-directional and realistically-directional sources; however, subjects did not perceive any corresponding differences when comparing the auralizations, possibly due to the limited directional octave band data available. Subjects did significantly differentiate between auralizations from the omni-directional source and the extreme beaming source. Subjective results from comparing these two sources in terms of reverberation, clarity and realism were generally consistent with objective data, although source/receiver combination and musical track had some influence on the outcomes.     

Vocal Improvement After Voice Therapy in Unilateral Vocal Fold Paralysis

Unilateral vocal fold paralysis (UVFP) is associated with changes in acoustic and aerodynamic voice measurements and can have a significant impact on a patient's quality of life. Few objective data regarding the efficacy of voice therapy for UVFP exist. The aim of this study was to retrospectively analyze voice modifications in a group of patients with UVFP before and after voice therapy. Forty patients with UVFP of different etiology were included in the study. Each subject had voice therapy with an experienced speech/language pathologist twice a week; the mean number of sessions was 12.6. A multidimensional assessment protocol was used; it included videoendoscopy, the maximum phonation time (MPT), the GIRBAS scale, spectrograms and a perturbation analysis, and the Voice Handicap Index (VHI). Pre- and posttreatment data were compared by means of the Wilcoxon and Student's t tests. A complete glottal closure was seen in 8 patients before voice therapy and in 14 afterward. Mean MPT increased significantly. In the perceptual assessment, the difference was significant for five out of six parameters. A significant improvement was found on spectrographic analysis; as for perturbation analysis, the differences in jitter, shimmer, and noise-to-harmonic ratio values were significant. VHI values showed a clear and significant improvement. A significant improvement of voice quality and quality of life after voice therapy is an often reached and reasonable goal in patients with UVFP.     

Voice Characteristics in Adults With Neurofibromatosis Type 1

Neurofibromatosis type 1 (NF1) is an autosomal dominant neurocutaneous disorder caused by mutations in the NF1 gene, which is located at the long arm of chromosome 17. Major characteristics include multiple café-au-lait spots and neurofibromas. Voice abnormalities have been reported to occur in this patient group. However, most studies relied on subjective measurements only. The present study reports the results of an objective voice assessment based on a multiparameter approach in 22 adults with NF1. Aerodynamic measurements, voice range profiles, acoustic voice quality and intonation measurements, and dysphonia severity indices were obtained and compared with data from a control group, consisting of 22 healthy adults. It was found that NF1 patients show a poorer overall voice quality compared with controls. Particularly, a reduction of vital capacity and limitations in laryngeal possibilities with respect to frequency and intensity were observed in the NF1 group.     

Unilateral recurrent laryngeal nerve paralysis:The importance of “preoperative” voice therapy

This preliminary retrospective study of 19 female patients and 22male patients with unilateral recurrent nerve lesions demonstrated the promise of objective measurements in predicting the need for surgery, the efficacy of voice therapy in ameliorating vocal symptoms, and the effects of therapy in conjunction with surgery. Sixty-eight percent (68%) of the female patients and 64% of the male patients did not elect to have surgery. Outcome satisfaction of nonsurgical and surgical patients appeared to be similar. The data from this study support the importance of preoperative therapy for patients with unilateral vocal fold paralysis.     

Genetics of Vocal Quality Characteristics in Monozygotic Twins: A Multiparameter Approach

The main purpose of this study was to determine the vocal quality characteristics among the 45 monozygotic cotwins (MT). As the performance of the voice is related to several genetically determined anatomical and physiological factors, the authors hypothesized that the vocal characteristics and the overall vocal quality by means of the Dysphonia Severity Index (DSI) will be identical in MT. An additional objective of this study was to determine whether sex and age influence vocal similarities in MT and to compare the voice characteristics of MT with the normative data of unrelated peers. As more environmental factors influence the aging of the voice, age-related differences were expected. No sex-related differences were expected. Subjective and objective assessment techniques determined the vocal quality. No significant differences were obtained, and most comparisons resulted in significant correlation coefficients. For the acoustic parameters jitter and shimmer only, no significant correlation coefficients could be obtained. It is clear that the perceptual voice characteristics, the laryngeal aerodynamic measurements of maximum phonation time (MPT), the vocal performances, and the overall vocal quality by means of the DSI are similar in MT. These vocal characteristics are not influenced either by the subjects' age or sex and are situated within the normative range of unrelated peers. To what extent other aspects (environment, anxiety, tension, etc) might play a role in the acoustical dimensions regarding frequency and amplitude perturbation, which were in the normal range, is a subject of further research.     

The Effectiveness of Group Therapy for Students With Mild Voice Disorders: A Controlled Clinical Trial

Previous studies of students studying to be teachers have indicated that these students commonly have voice disorders. Ideally, voice disorders should be treated before students start their work as teachers, but the resources for this treatment are often limited. This study examines whether group voice therapy is effective for teacher students. Accordingly, 20 teacher students with mild voice disorders received group voice therapy (in three small groups), whereas 20 students with similar voice disorders served as a control group and consequently did not receive voice therapy. Two out of three outcome measures (perceptual evaluation of voice quality and a questionnaire on the occurrence of vocal symptoms) indicated significant changes in the treatment group compared with the control group. No differences between groups were noted in the laryngeal status. The results suggest that group voice therapy seems to be an effective method to treat students with mild voice disorders.     

Correlation of the Voice Handicap Index (VHI) and the Voice-Related Quality of Life Measure (V-RQOL)

The purpose of this study was to investigate the correlation between the Voice Handicap Index (VHI) and the Voice-Related Quality of Life Measure (V-RQOL), and to test conversion of scores between the two instruments. Understanding the relationship between instruments will facilitate comparison of voice outcome studies using different measures. A retrospective medical chart review of 140 consecutive patients with a chief complaint related to their voice presenting for speech pathology voice evaluation following laryngology evaluation and diagnosis was adopted. Each patient who filled out the VHI and V-RQOL within a 2-week period with no intervening treatment was included in the study. Correlation analysis for total scores was performed for the patients meeting inclusion criteria (n=132). Correlations were also performed as a function of diagnosis. Calculated VHI score based on measured V-RQOL score was compared to measured VHI score. Pearson correlation between scores on the VHI and V-RQOL was -0.82. There was no significant difference between the mean measured and mean calculated VHI scores. For individual scores, however, regression analysis did reveal a significant difference between calculated and measured VHI. The VHI and V-RQOL are highly correlated; however, this study suggests that the two instruments are not interchangeable for individuals.     

Voice field measurements—a new method of examination: the influence of hearing on the human voice

There are various methods to evaluate voice parameters. Original software was used to assess the voice quality by the staff of AUDIO-Fon centr Brno, Czech Republic. A group of hereditary deaf persons was examined. Deaf persons have all of the biological conditions to make voice except for the possibility of acoustic feedback. We examined the voices of 35 persons (20 men and 15 women) with hereditary profound hearing impairments, and we compared voice parameters with the voice of intact persons. To measure we used special software called voice field measurements (VFMs). The program graphically records voice frequency and intensity. VFM is an objective method that enables the assessment of basic physical voice characteristics. It is suitable for the examination of both intact and disturbed voice. The voice of the deaf has a higher basic voice frequency in men as well as in women. This type of voice production, ie, childlike voice, which is fixed only by a motor stereotype, is much more demanding for a mature larynx. Hearing influences both the voice development and speech production. The voice of persons with hearing impairments has a higher basic voice frequency regardless of their sex. This type of voice production, which is fixed only by a motor stereotype, ie, child voice, is much more demanding for a larynx of an adult. Thus, phonation of deaf people is more demanding and their voice production needs greater effort. Deaf people, despite an intact phonic apparatus, cannot produce more than one type of voice. They cannot modulate their voices concerning the frequency and dynamics. They cannot change their voices continually. The voice is limited in both of these parameters (frequency and dynamics). If a deaf person wants to change a voice characteristic, it is possible only by discontinuous changes-"skipping."     

Outcome of laryngeal and velopharyngeal biofeedback treatment in children and young adults: A pilot study

A relatively new management strategy for the treatment of voice disorders is the use of laryngeal (LB) and velopharyngeal biofeedback (VB). The main purpose of the present pilot study is to document the outcome of vocal and velopharyngeal performances after a well-defined LB and VB treatment. Four subjects were studied pretreatment (1 week before LB or VB treatment) and posttreatment (1 week after the LB or VB treatment). To measure and compare the effect of LB and VB, objective and subjective assessment techniques were used. Perceptual voice assessment included a perceptual rating of the voice using the GRBAS scale. Furthermore, the vocal quality in this population is modeled by means of the Dysphonia Severity Index. For the objective assessment of nasal resonance, the Nasometer and the Glatzel test were used. A perceptual evaluation of speech, the Gutzmann test, and the tests from Bzoch were used as subjective assessment techniques. Both patients selected for LB and VB treatment showed improvement of their performances. The resulting improvement, as measured by means of an objective approach, is in agreement with the perceived (auditory) improvement of voice and resonance. The use of LB and VB treatment in patients, especially in some subjects who are not responding to traditional voice or velopharyngeal therapy, must be encouraged.     

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.     

Development of methods for multidimensional measurements in the optical investigation of surface

The problems of developing methods for multidimensional (multichannel) data acquisition as applied to the optical study of the surface are considered. Unlike conventional methods of transition to multidimensional measurement, which employ mechanical scanning, the use of new-type instruments that allow for coordinate-sensitive and time measurements are discussed. Both the sensitive elements (detectors) and the instruments (hyperspectrometers) created for multidimensional coordinate-spectrum-time measurements are described. The application of hyperspectrometers makes it possible to increase manyfold the information content of measurements. The fluorescence of dye molecules deposited on the surfaces of germanium and silicon preirradiated by a laser beam is studied. The scattering spectra from these samples are examined.     

Problems and pitfalls of electroglottography

The popularity and usefulness of the electroglottograph (EGG) has increased remarkably since its introduction over a decade ago. It has been used to measure fundamental frequency of phonation, fundamental frequency perturbation, details of the vocal fold vibratory cycle, as well as to provide an indication of laryngeal vertical movement. It has also been used with a variety of speech and voice disorders. The EGG is not without its limitations and problems. Some of these are found in the electronic designs of specific instruments, whereas other problems are related to subject characteristics, the placement of the electrodes, electrode symmetry, and subject/instrument interaction. This article explores some of these concerns, primarily from the perspective of two individuals who have used the EGG extensively with children, men and women, voice patients, stutterers, and neurologically impaired persons. Some of the concerns to consider and pitfalls to avoid in the interpretation and measurement of EGG signal are discussed.     

Effectiveness of Recurrence Quantification Measures in Discriminating Subjects With and Without Voice Disorders

The objective of this study was to analyze the accuracy of recurrence quantification measurements (RQMs) in discriminating between individuals with and without voice disorders. This study consisted of a total of 541 recorded voice samples from normal and dysphonic subjects. All subjects recorded a sustained vowel /Ɛ/ and underwent a laryngoscopic examination of the larynx. Twelve RQMs and three parameters related to the topology of the phonatory system were extracted from the samples, for a total of 15 measures. The classification used quadratic discriminant analysis and includes the measures of accuracy, sensitivity, and specificity. Single measurements such as Shannon's entropy, average diagonal length, and transitivity had only acceptable performance ratings (≥70%) in discriminating between individuals with and without voice disorders. The combination of the parameters average diagonal length, Shannon's entropy, trapping time, length of the longest vertical line, tau, imbedding dimension, neighborhood radius, and transitivity produced the highest accuracy in discrimination (83.27%). Therefore, the performance of RQMs related to the formation of diagonal lines in classifying individuals with and without voice disorders was acceptable at ≥70%. A combination of RQMs showed good performance in discriminating between the study groups, with higher sensitivity and specificity.     

Psychometric Evaluation of Disease Specific Quality of Life Instruments in Voice Disorders

The objective of this study was to compare the psychometric properties of voice disordered quality of life (VQOL) instruments. Nine VQOL instruments were identified through a comprehensive literature search. Based on specific criteria, four were selected for comprehensive review: Voice Handicap Index (VHI), Voice Activity and Participation Profile (VAPP), Voice-Related Quality of Life (V-RQOL) and Voice Outcome Survey (VOS). Selected instruments were evaluated based on 11 measurement standards related to item information, versatility, practicality, breadth and depth of health measure, reliability, validity, and responsiveness. VHI and V-RQOL each met 7 of 11 criteria, with VHI showing additional preferable item information, practicality, and reliability over V-RQOL and V-RQOL showing preferable responsiveness properties over VHI. These study results do not support the Social Security Administration's recent conclusion that the VHI meets reliability and validity standards for individual decision making. Nevertheless, the present results do support the use of VHI total scores for clinical use with individual patients, and the use of V-RQOL total scores or individual dimension scores for use with groups of patients.     

Bilateral Vocal Fold Posterior Glottic/Subglottic Stenotic Web Resected with Contact Tip Nd-YAG Laser

The standard treatment for respiratory failure remains endotracheal intubation, with periods of 22 or more days being commonplace. Posterior glottic stenotic web formation, from scarring in the posterior interarytenoid area, may occur after endotracheal intubation, thermal, corrosive, or direct surgical injury. A commonly used classification system for posterior glottic stenosis divides the occurrence into four types. Type I involves an interarytenoid scar band between the vocal folds that is anterior and separate from the posterior interarytenoid mucosa. Type II stenosis involves scarring of the mucosa or musculature of the posterior interarytenoid area. Types III and IV involve unilateral and bilateral cricoarytenoid joint fixation, respectively. Strobovideolaryngoscopy (SVL), rigid and flexible fiberoptic bronchoscopy, electromyography (EMG), radiologic imaging of the neck, larynx, and trachea as well as pulmonary function tests, including flow volume loops, provide important objective measurements of upper airway obstruction. A representative case of a professional voice user who suffered a Type II posterior glottic stenosis is presented. The treatment utilized a specific contact-tip neodymium-yttrium aluminum garnet (Nd-YAG) laser delivery system to achieve precise cutting, vaporization, and coagulation simultaneously, returning tactile touch technique to the airway/voice surgeon. Completely successful restoration of voice and airway have been maintained for 2 1/2 years postoperatively.     

Comparison of fundamental frequency and perturbation measurements among three analysis systems

The need for standardization of procedures in approaches to voice measurement has been recently emphasized. The purpose of this study was to determine the extent to which the acoustic perturbation measurements from three different analysis systems agree when standardized recording and analysis procedures are used. High-quality acoustic voice recordings from 20 patients were analyzed. The results showed that, although fundamental frequency measurements were in strong agreement among the three systems tested, frequency and amplitude perturbation measurements were not in agreement. The underlying approaches to perturbation measurement appeared to be sufficiently different to produce different results. An argument is made for a standardized set of acoustic signals representing normal, dysphonic, and synthesized voices with known characteristics to facilitate testing of new acoustic analysis systems and confirm measurement accuracy and sensitivity.