BACKGROUND AND OBJECTIVES: With the present methods for assessing speech, there are procedures that make effective diagnostics possible for voice disorders. One such procedure is cepstrum. Spectrum is produced by Fourier transformation of sound waves, and if Fourier transformation is performed again about the spectrum, cepstrum is produced. This study compared cepstrum to jitter, shimmer, and noise-to-harmonic ratio (NHR) for assessment of its usefulness. Cepstrum was measured by Cepstral Peak Prominence (CPP) calculated by the Hillenbrand method and Cepstral Mean Values (CMV) calculated using the Computerized Speech Laboratory software. SUBJECTS AND METHOD: We included in the study 30 patients with vocal nodule and unilateral vocal cord palsy who were diagnosed in Kangbuk Samsung Hospital between March 2010 and May 2011, and 30 normal controls. Phonation of sustained vowel /a/ sample and running speech was subjected to acoustic analysis using CMV and CPP. Then we compared the correlation of cepstrum with other acoustic methods. RESULTS: The measured values of CPP-a were 14.16, 17.25, 20.00 and the age adjusted CPP-s values were 11.21, 12.85, 15.00 for vocal cord palsy, vocal nodule and normal group, respectively. There was significant correlation with perceptions of dysphonia (p<0.001), but in CMV-a, CMV-s, there was no significant correlation. When jitter, shimmer, and NHR were compared with cepstrum, the result showed negative correlation among the three groups but CPP values showed significant difference (p<0.001). CONCLUSION: In the assessment of voice disorders, cepstrum may be used as a reliable method for comparing other complementary analysis tools. For the acoustic analysis of voice by cepstrum, however, CPP has more reliable correlations with dysphonia than CMV.
Acoustics ; Dysphonia ; Fourier Analysis ; Hoarseness ; Humans ; Phonation ; Running ; Sound ; Vocal Cord Paralysis ; Voice ; Voice Disorders

OBJECTIVES: We intended to evaluate the relationship between voice and the menopause, so we observed vocal symptoms and voice parameters in patients of postmenopausal syndrome compared with those in premenopausal women. MATERIALS AND METHODS: Forty postmenopausal and twenty premenopausal women were included in this study. Each woman was asked to describe their subjective vocal symptoms and phonate a vowel /a/ sound for 3 seconds. The voices were recorded and analyzed by the Multi-Dimensional Voice Program and a Laryngograph. A statistical analysis of voice parameters was done by a paired-t-test. RESULTS: Vocal symptoms detected in the menopausal women were lowered pitch, voice fatigue, recurrent hoarseness, and loss of high tone. Jitter in postmenopausal group was significantly increased compared with the premenopausal group, but the fundamental frequency, shimmer, the Harmonics-to-noise ratio and the closing quotient showed no significant differences. There were no significant changes of voice parameters between menopausal patients with and without vocal symptoms. CONCLUSION: The change of voice may be objectively identified in postmenopausal women. In treating the postmenopausal symptoms, it may be required to take voice changes into consideration.
Female ; Hoarseness ; Humans ; Menopause ; Voice Disorders ; Voice*

Rationale/Objective: The Voice Handicap Index (VHI) is a selfassessment tool that evaluates the patient’s reaction and perception to a vocal disorder. This study aimed to establish, validate and assess the reliability of the Filipino translation of the Voice Handicap Index 10 (FVHI-10). Methods: The VHI-10 was translated and adapted to the Filipino language and culture with the help of the Sentro ng Wikang Filipino- University of the Philippines Manila. A self-assessment of voice quality and FVHI-10 were performed by the patients and their GRBAS scale scoring was rated by a speech language pathologist. The Spearman’s correlation between the FVHI-10 and the self-assessment and GRBAS scale scores was obtained to test for validity. To evaluate the reliability of the FVHI-10, testing through determining internal consistency was conducted through the use of Chronbach α coefficient, inter-item correlation, item-total correlation and Cronbach α coefficient if tool item was deleted. Results: Fifty five individuals participated in the study (29 males, 26 females, age range: 30-55 years) with the diagnosis of voice disorder based on complaints of hoarseness or dysphonia and laryngoscopic findings. Convergent validity was confirmed with moderate to strong correlation between the FVHI-10 and self-assessment (r=-.893, p<.05) and GRBAS scale scores (r=.427, p<.05). Reliability as measured through internal consistency was confirmed (Cronbach α=.874) (average ρ<.5) (corrected item-total correlation>0.3) (average interitem correlation=.15-.85). Conclusion The FVHI-10 was determined to be a valid and reliable instrument that can be utilized in the assessment of Filipino patients with voice disorders.
Dysphonia ; Voice Disorders ; Quality of Life

Spasmodic dysphonia is a primary task specific focal dystonia affecting the laryngeal muscle during speech. Adductor spasmodic dysphonia (ADSD) affects close to 90% of spasmodic dysphonia patients is characterized by voice breaks during vowels during speech due to intermittent hyperadduction of the vocal folds. Abcuctor spasmodic dysphonia (ABSD) is relatively rare and involves intermittent voiceless voice breaks due to prolonged voiceless consonants before initiation of the following vowels. Treatment for spasmodic dysphonia has been aimed at denervation or adjustment of the larynx to prevent the uncontrolled spasms in the laryngeal muscles from interfering with voice production. As a result there is a risk-benefit ratio in that the denervation must be adequate to reduce the detection of symptoms whereas at the same time not producing aphonia, breathiness and swallowing difficulties. This article summarizes the pathogenesis, diagnosis and treatment of the spasmodic dysphonia.
Aphonia ; Deglutition ; Denervation ; Dysphonia ; Dystonia ; Dystonic Disorders ; Humans ; Laryngeal Muscles ; Larynx ; Spasm ; Vocal Cords ; Voice ; Voice Disorders

The causes of dysphonia can be classified into two groups, organic and functional. Functional dysphonia includes spasmodic dysphonia, muscle tension dysphonia, mutational dysphonia and conversion dysphonia, etc. The findings of laryngoscopy in these dysphonia are almost normal. Organic dysphonia is caused by anatomical problems in the larynx, especially on the vocal fold. Benign diseases of the vocal folds are common and mainly presented as voice disorders such as hoarseness, harshness, weakness, or even loss of voice. Benign neoplasm of the larynx are very rare condition except papilloma. The most common symptoms are voice change. However, they can be presented as wheezing, dyspnea, discomfort in the throat, or cervical mass depending on the size and location of the tumor. Detailed history taking and thorough laryngeal endoscopic examination are necessary for the appropriate diagnosis and treatment.
Dysphonia ; Dyspnea ; Granuloma ; Hoarseness ; Laryngoscopy ; Larynx ; Muscle Tonus ; Papilloma ; Papillomavirus Infections ; Pharynx ; Respiratory Sounds ; Respiratory Tract Infections ; Vocal Cords ; Voice ; Voice Disorders

BACKGROUND AND OBJECTIVES: Various phonation patterns yield various voice characteristics. Voice therapy using nasal stimulatory sounds seems to facilitate phonation in voice disodered patients. Under the hypothesis that nasalance may be influenced by the pattern of phonation, we studied the relationship between nasalance and voice disorders by observing abnormal supraglottic movements and vocol cord gaps in phonation. SUBJECTS AND METHOD: There were 143 patients who complained of voice problems and showed abnormal false vocal cord movements under stroboscopy. In addition to the four previously described types of MTD (muscle tension dysphonia), we described two more types of MTD (V: false vocal cord contracted posteriorly, VI: false vocal cord dilated laterally). We measured the vocal cord gaps in phonation and analyzed nasalance. RESULTS: Among those groups showing the pattern of false vocal cord (MTD 1, 2, 4), the vocal cord gaps in phonation were increased and nasalance was significantly decreased in MTD types, III and IV, and showed a tendency to decrease in MTD types, II and V, compared to the normal group. CONCLUSION: The supraglottis has a tendency to contract as the vocal cord gap in phonation increases, and this movement reduces nasalance.
Dysphonia ; Humans ; Phonation* ; Stroboscopy ; Vocal Cords ; Voice ; Voice Disorders

BACKGROUND AND OBJECTIVES: The various types of varix which has a dilated, tortous, elongated blood vessel arising from the microcirculation of the vocal folds may cause different types of dysphonia. There have not been many specific studies on the characteristics of microvascular lesions of the vocal folds, so authors tried to evaluate the shapes, traveling pathway, and predilection site of the microvascular lesions. MATERIALS AND METHODS: A retrospective review of 119 patients with dysphonia was undertaken. All findings of videotapes were evaluated according to the shapes, the traveling pathway, the predilection sites and accompanying disorders of the microvascular lesions. RESULTS: The most common shapes of the microvascular lesions were the abrupt developed type and the multiple dilated type. The longitudinal type was the most common traveling type. The superolateral surface of the vocal folds was the predilection site of the microvascular lesions. Functional voice disorders, such as laryngeal nodule, laryngeal polyp, laryngeal edema, were more common as accompanying disorders. CONCLUSION: Authors found that there were a variety of types of microvascular lesions.
Blood Vessels ; Dysphonia ; Hoarseness* ; Humans ; Laryngeal Edema ; Microcirculation ; Polyps ; Retrospective Studies ; Varicose Veins ; Videotape Recording ; Vocal Cords* ; Voice Disorders

Dysphonia ; Humans ; Vocal Cords ; Voice Disorders

Botulinum toxin (BTX) has been widely used to treat muscle spasms in many voice disorders. Most commercially available forms of BTX require reconstitution before use, which may increase the risk of contamination and requires careful titration. Recently, a liquid-type BTX type A (BTX-A) has been developed, which should simplify the procedure and enhance its efficacy. In this session, I will discuss about the differences of BTX-A from existing types and the practical issues associated with it.
Botulinum Toxins ; Dysphonia ; Spasm ; Voice Disorders

BACKGROUND AND OBJECTIVES: Voice therapy is proven to be effective, but patients are reluctant to receive the therapy when physicians recommend it. This phenomenon may due to patients'lack of trust in or low satisfaction level of the therapy. This study aimed to evaluate patients'satisfaction level after voice therapy and identify factors that could increase the satisfaction. MATERIALS AND METHODS: First, the fraction of patients who were recommended voice therapy ahead and completed it was studied, and survey was conducted on those who finished ten voice therapy sessions. The patients'1) satisfaction level during the therapy, 2) satisfaction level about physician's explanation about the therapy, 3) willingness to recommend, 4) satisfaction level about the results were assessed, and was correlated with overall satisfaction level. In each category, patients' gender-, age-, and disease type-related differences were analyzed. RESULTS: Patients under 19 years old were most satisfied during the voice therapy; patients above 40 years old showed statistically significantly higher satisfaction level regarding satisfaction with physician explanation about treatments and with treatment results compared to other ages groups. Patients above 40 also showed the highest willingness to recommend. 26.5% of patients either refused to or discontinued voice therapy. 84.3% were satisfied with treatment results. Considering variabilities among factors, patients'satisfaction with physician explanation about treatment and willingness to recommend had positive correlation. CONCLUSION: Though 26.3% of patients received voice therapy when physicians recommended, patients who completed the therapy were overall satisfied.
Humans ; Voice Disorders* ; Voice*