OBJECTIVE: To understand the vowel duration and statement reading of the adductor spasmodic dysphonia (ADSD) patients compared with their normal controls, and provide ideas for clinical diagnosis and treatment. METHOD: Twenty-nine ADSD patients were included in the research, with 31 normal controls. All subjects filled in form voice handicap index (VHI) by themselves. Maximum phonetic time (MPT) and maximum loudness phonetic time(MLPT) were tested on /a/ sound for all patients. Also, all the patients were required to read aloud a standard mandarin assay named , duration were measured with Praat5. 0 software after sounds were collected. A one-way t-test was performed to compare spasmodic group with control group on VHI, MPT, MLPT and duration for reading standard sentences. Pearson/Spearman correlation was tested. Result: The VHI of the 29 ADSD patients is 89±12, and their normal controls 15±16, indicating that the VHI in ADSD group is significantly higher than in the control group(P<0. 01). The MPT of the ADSD group is(16. 9±9. 8 s), and the control group is (25. 3±10.0)s, indicating that MPT in the ADSD group is significantly shorter than the control group(P<0. 01). The MLPT of the ADSD group is (15.7±7. 6)s, and the control group is (26. 5±11. 4)s, indicating that MLPT in the ADSD group is significantly shorter than the control group (P<0. 01). The duration of standard sentence reading of the ADSD group is (55.0±14. 2)s, and the control group is (37. 8±4. 8)s, indicating that the duration of standard sentence reading in the ADSD group is significantly longer than the control group (P<0. 01). Correlation analysis showed that MPT and MLPT are related within the ADSD group(r=0. 697,P< 0.01), other indexes being tested have no significant correlations. CONCLUSION The voice disorder condition of the ADSD patients is significantly worse than normal people. Their pronunciations on continuous vowels are not lasting compared with normal people. In the meantime, their ability to read sentences is worse than normal people, needing longer time to complete the reading task. There is a significant correlation between MLPT and MPT, which can be used as an alternative to MPT.
Case-Control Studies ; Dysphonia ; diagnosis ; Humans ; Phonetics ; Voice Quality

OBJECTIVETo investigate the reliability of RBH perceptual evaluation system, and the correlation between its perceptual and acoustic parameters inorder to providing the evidence for clinic practice.

METHODSThe voice samples were collected from 100 patients with variable dysphonia and 15 normal people. According to the R, B, H parameters of the RBH system,voice samples were rated on 4-point scale from 0 to 3. The interrater agreement and intrarater reliability were tested. The differences of the acoustic parameters between adjacent ranks in the perceptual parameters were investigated. The correlation between perceptual parameters and acoustic parameters were also studied.

RESULTSThe interrater agreement and intrarater reliability were good. Intrarater reliability was varying from 0.428 to 0.608 using Kappa coefficient; intraclass correlation coefficients for interrater agreement were 0.741-0.797 and 0.689-0.762 in the twice perceptual assessments. The differences of the acoustic parameters between adjacent ranks in the perceptual parameters (R, B, H) were significant (P < 0.05). The perceptual parameters (R, B, H) were significantly correlated with the acoustic parameters (Jitter, Shimmer, HNR, MPT and DSI, with r varying from 0.360 to 0.551 or from -0.472 to -0.620, P < 0.01).

CONCLUSIONThe reliability of RBH perceptual evaluation system is good; its 4-point scale is acceptable; the perceptual parameters are correlated with the acoustic parameters; the RBH system has broad prospects in clinic practice.

OBJECTIVE: To investigate the characteristics of adductor spasmodic dysphonia phonatory break in mandarin Chinese and select the stimuli phrases. METHOD: Thirty-eight patients with adductor spasmodic dysphonia were involved in this study. Standard phrase " fù mŭ xīn" and a speech corpus in mandarin Chinese with 229 syllables covering all vowel and constant of mandarin Chinese were selected. Every patient read the phrases above twice in normal speed and comfortable voice. Two auditory perpetual speech pathologists marked phonatory break syllables respectively. The frequency of phonatory break syllables and their located phrases were calculated, rated and described. The phrases including the most phonatory break syllables were selected as stimuli phrases, the phonatory break frequency of which was also higher than that of standard phrase "fù mŭ xīn". RESULT: Phonatory break happened in the reading of all patients. The average number of phonatory break syllables was 14 (3-33). Phonatroy break occurred when saying 177 (77.3%) syllables in the speech corpus. The syllables "guŏ, rén, zāng, diàn, chē, gè, guăn, a, bā, ne, de" broke in 23.1%-41.0% patients. These syllables belonged to the phrases "pĭng guŏ, huŏ chē, shì de, nĭ shì gè hăo rén, wŏ mén shì yŏu zŏng shì bă qĭn shì nong dé hĕn zāng, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a,wŏ yīng gāi zài xìn lĭ xiĕ yī xiē shén mē ne?". Thirty-seven patients (97.3%) had phonatory break in above mentioned words. Ratios of these words phonatory break also were more than "fù mŭ xīn". CONCLUSION Adductor spasmodic dysphonic patients exhibited different degrees of phonatory break in mandarine Chinese. The phrases" shì de, pĭng guŏ, huŏ chē, nĭ shì gè hăo rén, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a" were recommended as stimuli phrases for adductor spasmodic dysphonia evaluation.
Dysphonia ; diagnosis ; physiopathology ; Female ; Humans ; Language ; Male ; Phonation ; Spasm ; diagnosis ; physiopathology ; Voice

Vocal fatigue（VF） is the common clinical symptom of voice diseases. It can also be a separate symptom and is considered to be a signal for the body to rest and to avoid pathological damage to the vocal cords. Therefore, the early identification and evaluation of vocal fatigue is of great value to the early prevention and treatment of vocal diseases. In recent years, there are many researches on the evaluation methods of vocalization fatigue. We searched the relevant literature and summarized the application status of vocal fatigue assessment methods, in order to provide reference for the selection and development of vocal fatigue assessment tools in clinical practice.
Humans ; Voice Quality ; Voice Disorders/diagnosis* ; Vocal Cords ; Surveys and Questionnaires ; Dysphonia/diagnosis*

Myasthenia gravis (MG) is an autoimmune disease that affects neuromuscular junctions and usually manifests with muscle weakness that exhibits diurnal variability. However, MG can present with atypical symptoms, including very rarely cases presenting with a flaccid type of dysphonia. We report the first case of spasmodic dysphonia with a final diagnosis of generalized MG, which occurred in a 32-year-old female.
Adult ; Autoimmune Diseases ; Diagnosis ; Dysphonia* ; Female ; Humans ; Muscle Weakness ; Myasthenia Gravis* ; Neuromuscular Junction ; Voice Quality

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare the usefulness of Cepstral peak prominence (CPP) with parameter of Multiple Dimensional Voice Program (MDVP) in evaluating unilateral vocal fold paraylsis patients with subjective voice impairment. MATERIALS AND METHODS: From July 2014 to August 2016, 37 patients with unilateral vocal fold paralysis who had been diagnosed with unilateral vocal fold paralysis and had received two or more voice tests before and after the diagnosis were evaluated for maximum phonation time (MPT), MDVP and CPP. Respectively. Voice tests were performed with short vowel /a/ and paragraph reading. RESULTS: The CPP-a (CPP with vowel /a/) and CPP-s (CPP with paragraph reading) of the Cepstrum were statistically negatively correlated with G, R, B, and A before the voice therapy. Jitter, Shimmer, and NHR of MDVP were positively correlated with G, R, B. Jitter, Shimmer, and NHR of the MDVP were significantly correlated with the Cepstrum index. G, B, A and CPP-a and CPP-s showed a statistically significant negative correlation and a somewhat higher correlation coefficient between 0.5 and 0.78. On the other hand, in MDVP index, there was a positive correlation with G and B only with Jitter of 0.4. CONCLUSION: CPP can be an important evaluation tool in the evaluation of speech in the unilateral vocal cord paralysis when speech energy changes or the cycle is not constant during speech.
Diagnosis ; Dysphonia* ; Hand ; Humans ; Paralysis* ; Phonation ; Vocal Cord Paralysis ; Vocal Cords* ; Voice

BACKGROUND AND OBJECTIVES: There have been no systematic studies addressing the voice problems among Korean classical singers. The purpose of this study was to analyze the voice problems in Korean classical singers and provide a guide in the management of their voice problems. MATERIALS AND METHODS: The voice problems in 222 classical singers who visited Ewha woman's university hospital with dysphonia were analyzed, using laryngovideostroboscopy, aerodynamic and acoustic analyzer. RESULTS: The most common voice symptom in Korean classical singers was hoarseness (62.1%) and their most common lesion in the vocal folds was vocal nodule (42.8%). In classical singers who had vocal nodule, there was no significant reduction of expiratory pressure (p<0.05), but the mean air flow rate was increased (p<0.05). There were no significant differences between classical singers who had vocal nodule and normal adults in jitter, shimmer and noise to harmonic ratio (NHR). CONCLUSION: This study reveals that numerous voice problems can be present even in trained classical singers. Also, we recognized the fact that normal voice may occur even in the presence of abnormal laryngeal findings in trained professional classical singers because of their training to protect and refine their vocal skills. Therefore, in future studies, it may be useful for laryngologists to obtain a baseline assessment of laryngeal function in trained classical singers to permit accurate diagnosis of the causes of voice dysfunction in voice professionals whose baseline laryngeal behavior may be unusual.
Acoustics ; Adult ; Diagnosis ; Dysphonia ; Hoarseness ; Humans ; Noise ; Singing* ; Vocal Cords ; Voice*

An irritable larynx syndrome is characterized by a sudden episodic dyspnea and dysphonia that is difficult to diagnose, and patients are often treated unnecessarily and/or too much. A correct diagnosis can be made by monitoring the larynx closing in the reversed direction during inhalation and posterior chink with videolaryngoscopy and by measuring a decrease in air flow volume during inhalation with a lung function test. Patients can be effectively treated with thorough differential diagnosis. Medications targeting precipitating factors, physical therapy sessions to improve abnormal larynx movement, counseling to reduce patients'anxiety rising from dyspnea, and etc. can effectively alleviate symptoms.
Behavior Therapy ; Counseling ; Diagnosis ; Diagnosis, Differential ; Dysphonia ; Dyspnea* ; Humans ; Inhalation ; Larynx* ; Precipitating Factors ; Respiratory Function Tests ; Vocal Cord Dysfunction

Voice is a physical phenomenon, generated by vocal fold and expiratory airflow. Dysphonia should come from abnormal vocal fold and airflow. Occassionally larynx looks normal in show, but it is actually not. There should be undetected structural or functional abnormalities. So when ENT doctors face dysphonia patients who looks normal larynx, should make a diagnosis through close observation. In this review article we present some dysphonia diseases which looks normal larynx. For example vocal fatigue, vocal fold paresis, posterior glottic diastasis, muscle tension dysphonia and psychogenic dysphonia.
Diagnosis ; Diagnosis, Differential* ; Dysphonia* ; Fatigue ; Humans ; Larynx* ; Muscle Tonus ; Paresis ; Physical Phenomena ; Pulmonary Ventilation ; Vocal Cords ; Voice

Riedels thyroiditis is a rare variant of thyroiditis that is characterized by replacement of the normal thyroid parenchyma by extensive fibrosis. Typically, the thyroid is diffusely involved and a painless, hard anterior neck mass shows clinical features similar to those of anaplastic thyroid carcinoma, that is, a rapidly enlarging, hard, fixed thyroid mass and symptoms such as dysphagia, dysphonia, and dyspnea. We encountered a case of Riedels thyroiditis in a 41-year-old female patient with a longstanding benign thyroid nodule for 6 years; she subsequently presented with a rapidly growing, hard, fixed, thyroid mass mimicking anaplastic thyroid cancer. The clinical features were indistinguishable from those of anaplastic transformation, but open biopsy excluded anaplastic thyroid cancer. After surgery, the final diagnosis of Riedels thyroiditis was made based on typical microscopic findings and immunohistochemical studies. We have reported this case and reviewed the related literature.
Adult ; Biopsy ; Deglutition Disorders ; Diagnosis ; Dysphonia ; Dyspnea ; Female ; Fibrosis ; Humans ; Neck ; Thyroid Carcinoma, Anaplastic ; Thyroid Gland* ; Thyroid Nodule ; Thyroiditis*