“Voice of Postradiotherapy Nasopharyngeal Carcinoma Patients: Evidence of Vocal Tract Effect,” Lin, Emily, Tzer-Zen Hwang, Jeremy Hornibrook, and Tika Ormond, Journal of Voice, Vol. 22 No. 3, pp. 351-364, May 2008.

Summary: This study was aimed at identifying acoustic and physiological measures useful for monitoring voice changes in postnasopharyngeal patients with nonlaryngeal malignancies, and providing evidences of vocal tract effect on voice through comparisons between individuals with and without intact vocal tract. Simultaneous acoustic-electroglottographic signals recorded during phonation of vowels /i/ and /a/ sustained at habitual, high, and low pitch levels were compared among 10 postradiotherapy patients with nasopharyngeal carcinoma (NPC), 10 voice patients (VPs) with intact vocal tract, and 10 healthy individuals with normal voice (NORM). Results from a series of discriminant analyses revealed that the NPC group generally exhibited lower signal-to-noise (SNR) and open quotient (OQ) and higher Formant 1 frequency (F1) and speed quotient (SQ) than the NORM group. Unlike both VP and NORM groups, the NPC group failed to show a pitch effect on all voice measures, including OQ, SQ, percent jitter, percent shimmer, and SNR, suggesting an effect of radiotherapy and/or vocal tract on laryngeal behaviors. For the vowel /i/, on the other hand, only the NPC and NORM groups showed a pattern of pitch-dependent F1 raising, a reflection of increased pharyngeal narrowing. These findings suggested that the pitch effect on laryngeal behaviors differed not only between individuals with intact vocal tract and those without but also between those with structural and dynamic changes of vocal tract.

The KayPENTAX Electroglottograph (EGG), Model 6103, was used to acquire three EGG measures (i.e., Fo, OQ, and SQ) in this study.
 

“Effects of Bilateral Subthalamic Nucleus Stimulation and Medication on Parkinsonian Speech Impairment,” D’Alatri, Lucia D., Gaetano Paludetti, M. Fiorella Contarino, Stefania Galla, Maria Raffaella Marchese, and Anna Rita Bentivoglio, Journal of Voice, Vol. 22 No. 3, pp. 365-372, May 2008.

Summary: This study aimed to assess quantitatively the effect of bilateral subthalamic nucleus (STN) stimulation and medication on hypokinetic parkinsonian dysarthria. Twelve Italian patients (11 males and 1 female) with idiopathic Parkinson’s disease (mean age 60.29 ± 7.50 years) and bilateral STN implantation were studied. Neurological assessments and acoustic recordings were performed in four clinical conditions combining stimulation and medication to assess the degree of motor disabilities and speech impairment. Acoustic analysis was performed by means of the Multidimensional Voice Program and the Advanced Motor Speech Profile (Kay Elemetrics, Lincoln Park, NJ). None of the evaluated parameters deteriorated after TN deep brain stimulation. STN stimulation significantly improved motor performances and vocal tremor and provided a major stability to glottal vibration. Effect of stimulation on these parameters was superior to that of levodopa. No significant variations were observed in perceptual evaluation and in acoustic parameters related to prosody, articulation, and intensity after either stimulation or medication. The improvement of acoustic parameters related to glottal vibration and voice tremor was not accompanied by a substantial effect on speech intelligibility. STN stimulation was more effective on global motor limb dysfunctions than on dysarthria, but we did not report negative consequences on speech.

Acoustic analysis, in this study, was performed using the KayPENTAX Computerized Speech Lab (CSL), Model 4300B, in conjunction with the KayPENTAX MDVP, Model 5105, and Advanced Motor Speech Profile, Model 5141.

 

“Acoustic Changes in Chinese Patients With Cancer-Related Unilateral Vocal Fold Paralysis After Medialization Thyroplasty,” Ng, Manwa L., Ripley K. Wong, William I. Wei, Y.H. Wong, and Paul K. Y. Lam, Contemporary Issues in Communication Science and Disorders, Vol. 35, pp. 17-24, Spring 2008.

Abstract. The present study investigated the change in the voice quality of patients with unilateral vocal fold paralysis (UVFP) of benign and malignant causes after medialization thyroplasty. Thirty-four native Cantonese adults who had been diagnosed with UVFP participated in the study. Acoustical parameters including the average voice fundamental frequency, percent jitter, relative average perturbation (RAP), percent shimmer, and noise-to-harmonic ration (NHR) were measured from the sustained vowel /a/ that was recorded before and after the thyroplasty procedure. Maximum phonation time (MPT) was also obtained.

Results indicated that, for both benign and malignant patients, all acoustical parameters except for NHR showed improvement after thyroplasty: Percent jitter, RAP, and percent shimmer values were significantly reduced, and MPT was significantly lengthened. Our findings support the notion that medialization thyroplasty is a useful palliative procedure to improve voice production in Cantonese-speaking UVFP patients. Despite the cancerous condition, it is still beneficial to malignant UVFP patients, and better voice quality can be achieved.

In this study, acoustic analysis was performed using the KayPENTAX Multi-Dimensional Voice Profile (MDVP), Model 5105.

 

“Respiratory and Laryngeal Function During Spontaneous Speaking in Teachers With Voice Disorders,” Lowell, Soren Y., Julie M. Barkmeier-Kraemer, Jeanette D. Hoit, and Brad H. Story, JSLHR, Vol. 51 No. 2, pp. 333-349, April 2008.

Purpose: To determine if respiratory and laryngeal function during spontaneous speaking were different for teachers with voice disorders compared with teachers without voice problems.

Method: Eighteen teachers, 9 with and 9 without voice disorders, were included in this study. Respiratory function was measured with magnetometry, and laryngeal function was measured with electroglottography during 3 spontaneous speaking tasks: a simulated teaching task at a typical loudness level, a simulated teaching task at an increased loudness level, and a conversational speaking task. Electroglottography measures were also obtained for 3 structured speaking tasks: a paragraph reading task, a sustained vowel, and a maximum phonation time vowel.

Results: Teachers with voice disorders started and ended their breath groups at significantly smaller lung volumes than teachers without voice problems during teaching-related speaking tasks; however there were no between-group differences in laryngeal measures. Task-related differences were found on several respiratory measures and on one laryngeal measure.

Conclusions: These findings suggest that teachers with voice disorders used different speech breathing strategies than teachers without voice problems. Implications for clinical management of teachers with voice disorders are discussed.

The KayPENTAX Electroglottograph (EGG) was used to assess laryngeal adduction characteristics during continuous speaking in this study.

  

“Fundamental Frequency Change During Offset and Onset of Voicing in Individuals with Parkinson Disease,” Goberman, Alexander M., and Michael Blomgren, Journal of Voice, Vol. 22 No. 2, pp. 178-191, March 2008.

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 (i.e., 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.

The speech samples in this study were digitized and analyzed using a KayPENTAX Computerized Speech Lab (CSL), Model 4400.

 

“The Relationship Between Perceptual Evaluation and Objective Multiparametric Evaluation of Dysphonia Severity,” Hakkesteegt, Marieke M., Michael P. Brocaar, Marjan H. Wieringa, and Louw Feenstra, Journal of Voice, Vol. 22 No. 2, pp. 138-145, March 2008.

Summary: The purpose of this study was to investigate the usefulness of the Dysphonia Severity Index (DSI) as an objective multiparametric measurement in assessing dysphonia. The DSI was compared with the score on Grade of the GRBAS scale. Investigated was also whether the DSI is related to severity of dysphonia, which was represented by different diagnosis groups. Furthermore, it was investigated whether the DSI can differentiate between a group of patients and a control group. A total of 294 patients with different voice pathologies were included. A control group consisted of 118 volunteers without any voice complaints. The voices of all participants were perceptually evaluated on Grade, and the DSI was measured. The groups of patients with voice complaints have a lower DSI and higher scores on Grade than the control group. The DSI discriminates between patients with nonorganic voice disorders, vocal fold mass lesions, and vocal fold paresis/paralysis. To determine whether the DSI discriminates between patients and controls, the sensitivity and specificity for different DSI cutoff points were calculated. With a DSI cutoff of 3.0, maximum sensitivity (0.72) and specificity (0.75) were found. We conclude that the DSI is a useful instrument to objectively measure the severity of dysphonia.

In this study, the KayPENTAX Multi-Speech, Model 3700, was used for acoustic analysis of sound files.

 

“Pitch Deviation Analysis of Pathological Voice in Connected Speech,” Laflen, Brandon J., Cathy L. Lazarus and Milan R. Amin, Annals of Otology, Rhinology & Laryngology, Vol. 117 (2), pp. 90-97, Feb. 2008

Objectives: This study compares normal and pathologic voices using a novel voice analysis algorithm that examines pitch deviation during connected speech. The study evaluates the clinical potential of the algorithm as a mechanism to distinguish between normal and pathologic voices using connected speech.

Methods: Adult vocalizations from normal subjects and patients with known benign free-edge vocal fold lesions were analyzed. Recordings had been previously obtained in quiet under controlled conditions. Two phrases and sustained /a/ were recorded per subject. The subject populations consisted of 10 normal and 31 abnormal subjects. The voice analysis algorithm generated 2-dimensional patterns that represent pitch deviation in time and under variable window widths. Measures were collected from these patterns for window widths between 10 and 250 ms. For comparison, jitter and shimmer measures were collected from sustained /a/ by means of the Computerized Speech Lab (CSL). A t-test and tests of sensitivity and specificity assessed discrimination between normal and abnormal populations.

Results: More than 58% of the measures collected from connected speech outperformed the CSL jitter and shimmer measures in population discrimination. Twenty-five percent of the experimental measures (including /a/) indicated significantly different populations (p < .01%).

Conclusions: The results demonstrate that the algorithm distinguishes between normal and abnormal populations by use of samples of connected speech.

The KayPENTAX Computerized Speech Lab (CSL) was used to obtain the jitter and shimmer measures analyzed in this study.

 

“Current Diagnosis and Treatment of Laryngocele in Adults,” Dursun, Gursel, Ozan B. Ozgursoy, Suha Beton, and Hunkar Batikhan, Otolaryngology-Head and Neck Surgery, Vol. 136, No. 2, pp. 211-215, February 2007.

Objectives: To evaluate the treatment outcome of a series of laryngoceles and to comment on the current diagnosis and management of laryngoceles.

Study Design and Setting: A retrospective review of charts, radiological and histopathological notes, videolaryngostroboscopic records, and acoustic voice analyses of patients with laryngocele treated over a 10-year period was undertaken.

Results: Seven patients had internal laryngoceles; one had external; another one had combined laryngocele. Patients with internal laryngocele underwent endoscopic CO₂ laser resection, while those with external or combined laryngocele were treated via external approach. Quality of voice was improved and no recurrences were encountered during the follow-up. No evidence of laryngeal cancer was found on the histological examinations.

Conclusions: Endoscopic CO₂ laser resection of internal laryngocele provides a reliable and cost-effective method that minimizes hospitalization and the need for tracheotomy. We believe that advances in the applications of laser in microlaryngosurgery will alter the traditional management of all type of laryngoceles.

The acoustic analysis in this study was performed using the KayPENTAX Computerized Speech Lab in conjunction with the Multi-Dimensional Voice Program (MDVP).

 

“The Effect of Visible Speech in the Perceptual Rating of Pathological Voices,” Martens, Jan W.M.A.F., Huib Versnel, and Philippe H. Dejonckere, Archives of Otolaryngology-Head & Neck Surgery, Vol. 133 No. 2, pp. 178-185, February 2007.

Objectives: To test a simple method for improving consistency among raters for the perceptual evaluation of pathological voice quality by providing visible speech (spectrogram) as additional information because, to date, the interrater variability still limits the widespread clinical use of the best available rating system.

Design: Experimental comparison between 2 different ways (with and without the addition of visible speech) of perceptual rating by trained professionals of recorded pathological voices. Furthermore, the correlation between acoustical (jitter, shimmer, and noise-harmonic ration) and perceptual parameters was investigated in both rating conditions.

Subjects: Six experts evaluated 70 recorded pathological voices using the GIRBAS (grade, instability, roughness, breathiness, asthenicity, and strain) sale in 2 separate sessions: first, conventionally, without visible speech as additional information, and several months later, with visible speech as additional information.

Main Outcome Measures: The κ interrater agreement and the correlation coefficient between GIRBAS scores and acoustic measures.

Results: We found a significant effect of visible speech on the agreement between the raters. The interrater agreement according to κ statistics was significantly stronger with the addition of visible speech than without for rating grade, roughness, and breathiness. The correlation between acoustical and perceptual parameters showed no significant effect of visible speech.

Conclusion: The addition of visible speech to the perceptual evaluation of pathological voices is an interesting clinical asset to enhance its reliability. The addition of visible speech to the clinical setting is feasible, since affordable computer programs are currently available that can provide the spectrogram in quasi-real time while conversing with the patient. The acoustical analysis might be applied in addition to perceptual rating in a multi-dimensional approach to assess voice quality.

In this study, the KayPENTAX Multi-Dimensional Voice Program (MDVP) was used for acoustical analysis; spectrograms were generated using the Kay DSP Sona-Graph, Model 7800.

 

“Effects of Vocal Training and Phonatory Task on Voice Onset Time,” McCrea, Christopher R. and Richard J. Morris, Journal of Voice, Vol. 21 No. 1, pp. 54-63, January 2007.

Summary: Objectives/Hypothesis: The purpose of this study was to examine the temporal-acoustic differences between trained singers and nonsingers during speech and singing tasks.

Methods: Thirty male participants were separated into two groups of 15 according to level of vocal training (i.e., trained or untrained). The participants spoke and sang carrier phrases containing English voiced and voiceless bilabial stops, and voice onset time (VOT) was measured for the stop consonant productions.

Results: Mixed analyses of variance revealed a significant main effect between speech and singing for /p/ and /b/, with VOT durations longer during speech than singing for /p/, and the opposite true for /b/. Furthermore, a significant phonatory task by vocal training interaction was observed for /p/ productions.

Conclusions: The results indicated that the type of phonatory task influences VOT and that these influences are most obvious in trained singers secondary to the articulatory and phonatory adjustments learned during vocal training.

The KayPENTAX Computerized Speech Lab (CSL), Model 4300B, was used to perform the acoustic analysis in this study.

 

“Transoral Approach to Laser Thyroarytenoid Myoneurectomy for Treatment of Adductor Spasmodic Dysphonia: Short-Term Results,” Su, Chih-Ying, Hui-Ching Chuang, Shang-Shyue Tsai, and Jeng-Fen Chiu, Annals of Otology, Rhinology & Laryngology, Vol. 116 (1, pp. 11-18, January 2007.

Objectives: The surgical technique for the resection of the recurrent laryngeal nerve for adductor spasmodic dysphonia (ASD) has high late failure rates. During the past decade, botulinum toxin has emerged as the treatment of choice for ASD. Although effective, it also has significant disadvantages, including a temporary effect and an unpredictable dose-response relationship. In this study we investigated the effectiveness of a new transoral approach to laser thyroarytenoid myoneurectomy for treatment of ASD.

Methods: Fourteen patients with ASD underwent transoral laser myoneurectomy of bilateral thyroarytenoid muscles. Under general anesthesia, an operating microscope and a carbon dioxide laser were used to perform myectomy of the mid-posterior belly of bilateral thyroarytenoid muscles together with neurectomy of the terminal nerve fibers among the deep muscle bundles Care was taken not to damage the vocalis ligaments, arytenoid cartilages, and lateral cricoarytenoid muscles. Preoperative and postoperative videolaryngostroboscopy and vocal assessments were studied.

Results: The 13 patients who completed more than 6 months follow-up were enrolled in this study. Moderate and marked vocal improvement was achieved in 92% of the patients (12 of 13) after laser surgery during an average follow-up period of 17 months (range, 6 to 31 months). No vocal fold atrophy or paralysis was observed in any patient. None of the patients had a recurrence during the follow-up period.

Conclusions: Transoral laser myoneurectomy of bilateral thyroarytenoid muscles is a relatively simple, effective, and valuable technique for the treatment of ASD. The durability of outcome achieved with this procedure is encouraging.

A KayPENTAX Computerized Speech Lab (CSL), Model 4300B, was used to measure acoustic parameters including mean fundamental frequency, noise-to-harmonics ratio, jitter, and shimmer.

 

“The Speaker’s Formant,” Irene Velsvik Bele, Journal of Voice, Vol. 20 No.4, pp. 555-578, December 2006.

Summary: The current study concerns speaking voice quality in two groups of professional voice users, teachers (n = 35) and actors (n = 36), representing trained and untrained voices. The voice quality of text reading at two intensity levels was acoustically analyzed. The central concept was the speaker’s formant (SPF), related to the perceptual characteristics “better normal voice quality” (BNQ) and “worse normal voice quality” (WNQ). The purpose of the current study was to get closer to the origin of the phenomenon of the SPF, and to discover the differences in spectral and formant characteristics between the two professional groups and the two voice quality groups. The acoustic analyses were long-term average spectrum (LTAS) and spectrographical measurements of formant frequencies. At very high intensities, the spectral slope was rather quadrangular without a clear SPF peak. The trained voices had a higher energy level in the SPF region compared with the untrained, significantly so in loud phonation. The SPF seemed to be related to both sufficiently strong overtones and a glottal setting, allowing for a lowering of F4 and a closeness of F3 and F4. However, the existence of SPF also in LTAS of the WNQ voices implies that more research is warranted concerning the formation of SPF, and concerning the acoustic correlates of the BNQ voices.

The spectrograms in this study were generated with a KayPENTAX DSP Sona-Graph, Model 5500.

 

“Intelligibility of Tracheoesophageal Speech in Noise,” Douglas A. McColl, Journal of Voice, Vol. 20 No. 4, pp. 605-615, December 2006.

Summary: The purpose of this investigation is to determine the extent to which background noise negatively impacts the intelligibility of tracheoesophageal (TE) speech. Four male TE speakers provided speech samples that were recorded in quiet and in noise conditions. The listener/subjects occupied a sound-treated booth and were presented with two tasks. In Task 1, the subjects were required to transcribe TE speech stimuli recorded in quiet. In Task 2, the subjects were required to transcribe TE speech stimuli recorded in noise. Repeated measures 2 x 4 factorial analyses of variance were calculated for the dataset. The results of the statistical analysis revealed that the TE speech produced in quiet was significantly more intelligible to the listeners than the TE speech produced in noise for three of the four TE speakers. Furthermore, the results seem to support the hypothesis that the activation of a Lombard effect in TE speakers may detract from their overall speech intelligibility.

In this study, the acoustical analyses of the vocal parameters (jitter, shimmer, and noise-to-harmonic ratio) were performed using the KayPENTAX CSL, Model 4300B in conjunction with the Multi-Dimensional Voice Program, (MDVP), Model 5105.

 

“The Effect of Perceptual Training on Inexperienced Listeners’ Judgments of Dysphonic Voice,” Eadie, Tanya L. and Carolyn R. Baylor, Journal of Voice, Vol. 20 No. 4, pp. 527-544, December 2006.

Objectives/hypothesis: The purpose of this study was (1) to determine whether changes in intra- and interrater reliability occur for inexperienced listeners’ judgments of overall severity, roughness, and breathiness in dysphonic and normal speakers after 2 hours of listener training; and (2) to determine the acoustic bases of inexperienced listeners’ judgments before and after training.

Study Design: Prospective, single group, pre- and postdesign.

Methods: Thirty adult dysphonic and six normal speaker samples were selected from a database. Samples included 21 test stimuli and 15 training stimuli of both sustained vowels and connected speech. Sixteen inexperienced listeners judged all samples for overall severity, roughness, and breathiness using visual analog scales. Each listener provided pretraining ratings at baseline. Listeners were then trained using 15 anchor voice samples and 15 training stimuli. During training, listeners were provided with definitions of rating dimensions, accuracy feedback, and anchor samples. Listeners then judged test stimuli in a posttraining session. Speaker samples also were analyzed acoustically.

Results: Intrarater reliability was least variable for judgments of overall severity, but improved further with training. Listener judgments of roughness and breathiness in vowels were least reliable at baseline, but they significantly improved between listeners after training. Finally, measures of cepstral peak prominence significantly predicted all voice quality judgments except roughness in vowels, which was predicted by shimmer. The acoustic bases of group perceptual judgments did not seem to change with training.

Conclusions: These findings have implications for developing training programs in perceptual evaluation and mapping relationships between acoustic and perceptual characteristics of voice disorders.

Voice samples from the KayPENTAX Disordered Voice Database and Program, Model 4337, were used in this study; the KayPENTAX Multi-Dimensional Voice Program (MDVP), Model 5105, was used for acoustic analysis.

 

“The Effect of Speaking Context on Elicitation of Habitual Pitch,” Zraick, Richard, I., Mollie A. Gentry, Laura Smith-Olinde, and Brent A. Gregg, Journal of Voice, Vol. 20 No. 4, pp. 251-262, December 2006.

Summary: The purpose of this study was to investigate if there was an effect of speaking context on the elicitation of habitual pitch [speaking fundamental frequency (SFF)]. Six simulated speaking contexts were created (speaking during a voice evaluation, speaking in public, speaking to a peer, speaking to a superior, speaking to a subordinate, and speaking to a parent or spouse), and the SFF for 30 adult women with normal voice was compared across these contexts. A one-way analysis of variance (ANOVA) revealed a statistically significant (P < 0.001) effect of simulated speaking context on SFF, with post hoc analyses indicating a statistically significant difference in SFF while “speaking to a superior” (P < 0.001) and “speaking to a subordinate” (P < 0.001). Possible reasons for an effect of speaking context are discussed. Also, the implications of the use of varied speaking contexts when eliciting SFF are discussed, as in the possibility of an effect of speaking context on the elicitation of other clinically useful voice parameters.

In this study, voice samples were captured with the KayPENTAX Computerized Speech Lab (CSL), Model 4500, and were analyzed with the KayPENTAX Multi-Dimensional voice Program (MDVP), Model 5105.

 

“Ambulatory Monitoring of Disordered Voices,” Hillman, Robert E., James T. Heaton, Asa Masaki, Steven M. Zeitels, and Harold A. Cheyne, Annals of Otology, Rhinology & Laryngology, Vol. 115 (11), pp. 795-801, November 2006.

Objectives: Recently developed systems for ambulatory monitoring of voice use employ miniature accelerometers place at the base of the anterior neck to sense phonation. As it is hope that such systems will help improve the clinical assessment and management of voice disorders, this study was undertaken to determine the impact of dysphonia severity on the accuracy of accelerometer-based estimates of vocal function. 

Methods: Simultaneous recordings were made of oral acoustic (microphone) and neck skin acceleration signals for 6 normal speakers and 18 patients with voice disorders (mild to severe dysphonia) as they performed several speech tasks. Measures of phonation time, fundamental frequency, and sound pressure level were extracted from the two types of signals and compared.

Results: It was generally demonstrated that accelerometer-based measures closely approximated corresponding measurements obtained from a microphone signal across all levels of dysphonia severity. Furthermore, there was evidence that in some cases the accelerometer may actually represent a more robust approach for estimating phonation parameters in disordered voices.

Conclusions: The results generally support the recent application of accelerometers as phonation sensors in ambulatory voice monitoring systems that can be used in the clinical assessment and management of voice disorders.

In this study, the KayPENTAX Ambulatory Phonation Monitor (APM), Model 3200, was used to perform both data collection and analysis.

 

“Birth Control Bills and Nonprofessional Voice: Acoustic Analyses” Amir, Ofer, Tal Biron-Shental, and Esther Shabtai, Vol. 49 No. 5, pp. 1114-1126, October 2006. 

Purpose: Two studies are presented here. Study 1 was aimed at evaluating whether the voice characteristics of women who use birth control pills that contain different progestins differ from the voice characteristics of a control group. Study 2 presents a meta-analysis that combined the results of Study 1 with those from 3 recent studies that compared voices of women who use and do not use birth control pills.

Method: In Study 1, voice samples from 30 women with no history of voice training, who use pills with different progestins (drospirenone, desogestrel, gestodene), and 10 women who do not use the pill were recorded at specific time points across the menstrual cycle and were analyzed acoustically. In Study 2, results from Study 1 were analyzed jointly with results from three recent studies, which used similar methodologies.

Results: Results of Study 1 did not reveal acoustic differences in sustained phonation of vowels across the pill groups and controls. Results of the meta-analysis performed in Study 2 indicated that pill users exhibited lower jitter and shimmer values on sustained vowels, whereas no difference of fundamental frequency was observed among women who use the pill.

Conclusions: These results support findings from previous studies, which suggested that no adverse effect on voice was detected among nonprofessional speakers who use new-generation monophasic birth control pills, for the measures studied. Furthermore, results of the meta-analysis suggested that some acoustic properties of the voice, which are reflected in perturbation measures in sustained vowels, may be improved among women who use the pill.

The KayPENTAX Multi-Dimensional Voice Program (MDVP), Model 5105, was used to perform the acoustic analysis in this study.

 

“Articulation Rate and Vowel Space Characteristics of Young Males with Fragile X Syndrome: Preliminary Acoustic Findings” Zajac, David J., Joanne E. Roberts, Elizabeth A. Hennon, Adrianne A. Harris, Elizabeth F. Barnes, and Jan Misenheimer, Vol. 49 No. 5, pp. 1147-1155, October 2006.

Purpose: Increased speaking rate is a commonly reported perceptual characteristic among males with fragile X syndrome (FXS). The objective of this preliminary study was to determine articulation rate—one component of perceived speaking rate—and vowel space characteristics of young males with FXS.

Method: Young males with FXS (n = 38), developmental age (DA)-matched males (n = 21), and chronological age (CA)-matched males (n = 16) were audiotaped while engaged in spontaneous conversation and a picture-naming task. Articulation rate in syllables per second during intelligible utterances and vowel space area/dispersion measures were acoustically determined for each speaker.

Results: Males with FXS did not articulate significantly faster than CA-matched males. Area and dispersion of the acoustic vowel space also were similar between the 2 groups. Males with FXS, however, used significantly shorter utterances and had a tendency to pause less often than CA-matched males. In addition, males with FXS exhibited greater intraspeaker variability of formants associated with the vowel /a/.

Conclusions: These preliminary findings suggest that articulation rate may not be a primary factor contributing to perceived speaking rate of males with FXS. Limitations of the study relative to speech production tasks and utterance intelligibility are discussed.

Researchers in this study used the KayPENTAX Computerized Speech Lab (CSL), Model 4400, in the acoustic analysis performed.

 

“Response of the Female Vocal Quality and Resonance in Professional Voice Users Taking Oral Contraceptive Pills: A Multiparameter Approach,” Van Lierde, Kristiane M., Sofie Claeys, Marc De Bodt, and Paul Van Cauwenberge, Laryngoscope, Vol. 116, pp. 1894-1898, October 2006.

Objectives: The purpose of this study was to analyze the vocal quality and resonance (nasality and nasalance values) during the menstrual cycle in professional voice users using oral contraceptive pills (OCPs). Although professional voice users are more sensitive and aware of their vocal quality, no changes of voice and resonance characteristics were expected because OCPs create a stable hormonal balance through the menstrual cycle.

Study Design: The authors conducted a comparative study of 24 healthy, young professional voice users using OCPs. One assessment was performed between the 10th and 17th day of pill intake, when hormonal levels reached a steady state. The second assessment was performed during the first 3 days of menses, when no pills were taken and hormonal levels were minimized.

Methods: Subjective (perceptual evaluation of voice and nasality) and objective (aerodynamic, voice range, acoustic, Dysphonia Severity Index [DSI], nasometer) assessment techniques were used.

Results: The Mann-Whitney U test showed no significant difference between the perceptual evaluation of the voice and the nasality in the two assessments. The paired Student t test showed no significant difference regarding the maximum phonation time, the vocal performance, the acoustic parameters, and the DSI.

Conclusion: These findings indicate that OCPs do not have an impact on the objective and subjective voice and resonance parameters in young professional voice users. This information is specifically relevant to professional voice users who are more aware of vocal quality changes and ear, nose and throat specialists/voice therapists who treat professional voice users with voice problems/disorders. Further research regarding the impact of increased vocal load during the premenstrual or menstrual phase in professional voice users using OCPs should be considered.

The KayPENTAX Nasometer, Model 6200, was used to obtain nasalance values in this study. The KayPENTAX Voice Range Profile (VRP) and Multi-Dimensional Voice Program (MDVP) were used to obtain voice range measures and perform the acoustic analysis, respectively.

 

“Clinical Evaluation of Parkinson’s-Related Dysphonia,” Sewall, Gregory K., Jack Jiang, and Charles N. Ford, Laryngoscope, Vol. 116, pp. 1740-1744, October 2006.

Objective/Hypothesis: Nearly one third of patients with idiopathic Parkinson’s disease (IPD) cite dysphonia, characterized subjectively as causing a harsh and breathy voice, as their most debilitating deficit. Medical or behavioral treatments may lead to voice improvement. The purpose of this study was 1) to determine whether vocal fold injection of Cymetra (micronized form of collagen, elastin, proteoglycans; Lifecell Co.) is associated with changes in dysphonic voice characteristics in subjects with IPD, as judged perceptually using a standard instrument Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), and (2) which acoustic and aerodynamic measurements of voice are most reflective of any observed perceptual changes in voice.

Study Design: Prospective clinical evaluation of patients with Parkinson’s-related dysphonia (PRD).

Methods: Six patients with PRD were evaluated before treatment for the presence of dysphonia and glottal gap. All subjects underwent trans-oral vocal fold collagen injection using topical anesthesia in the otolaryngology clinic as part of their clinical care. At the initial clinic visit, and 10 to 14 days after vocal fold collagen injection, patients were asked to complete the Voice Handicap Index (VHI), a questionnaire concerning voice-related quality of life, and perceptual analyses of voice quality were performed. In addition, patients underwent acoustic (pitch/loudness range, maximum phonation time [MPT], and aerodynamic phonation threshold pressure [PTP] voice analysis.

Results: Five of six subjects had self-perceived improvements in voice after treatment, as determined by the VHI (range, +8 to -24). All five subjects who completed testing demonstrated decreased PTP (range, -1.3 to -2.7, P = .002). Five of six subjects demonstrated statistically significant improvements in MPT (range, -2-16 s, P = .05). Five of six subjects had improved pitch range (-26-343 Hz), whereas all subjects had increased intensity range (0.6-23 dB) after injection.

Conclusion: Trans-oral collagen injection in patients with PRD is safe, well tolerated, and is an effective temporary method of subjectively improving voice and speech in selected patients with IPD. Reduction of glottal gap with collagen improved MPT and subglottal PTP. The resulting gain of vocal efficiency may reduce vocal fatigue and provide a useful adjunct to voice therapy for PRD.