Humans ; Voice ; Voice Quality

BACKGROUND AND OBJECTIVES: Voice quality may be an important issue for choosing treatment options of early glottic cancer. It has been reported that voice quality is worse after laser cordectomy compared to that of radiation therapy. But, with developed visualization tools, the precise localization of lesions became possible enabling surgeons to decide the appropriate surgical extent to preserve voice after laser cordectomy. The authors assessed the postoperative voice quality of patients who underwent laser cordectomy according to the classification by the European Laryngological Society. SUBJECTS AND METHOD: Thirty patients who were diagnosed with glottic cancer and treated with laser cordectomy between April, 1999 and January, 2006, were evaluated. All the patients were followed-up more than 6 months. Objective evaluations included maximal phonation time, fundamental frequency, jitter, shimmer, noise-to-harmonics ratio and subjective evaluation was performed by the GRBAS scale. RESULTS: The type II laser cordectomy group and some cases of the type III cordectomy showed no significant differences compared with the normal control group in both objective and subjective evaluations. CONCLUSION: This study shows that the group of laser cordectomy type II and some cases of type III had acceptable results compared to that of the normal control group. Thus, laser cordectomy could be considered as an alternative to radiation therapy in selected patients with early glottic cancer, even when preserving the quality of voice is an important issue.
Humans ; Phonation ; Voice ; Voice Quality

Humans ; Voice Disorders ; diagnosis ; Voice Quality

Humans ; Voice Disorders ; diagnosis ; pathology ; Voice Quality

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

OBJECTIVES: The purpose is to investigate effect of septoplasty and widened nasal patency on voice quality. METHODS: Fifty patients who undergone septoplasty were included in the study. Thirty-three people who had similar age and distribution were enrolled as control group. Before and 1 and 3 months after surgery, anterior rhinomanometry, voice analysis by Multi-Dimensional Voice Program, and spectrographic analysis were performed to patients. The recordings of /a/ vowel were used to evaluate average fundamental frequency (F0), jitter percent, and shimmer percent. In spectrographic analyses, F3–F4 values for the vowels /i, e, a, o, and u/, nasal formant frequencies of the consonants /m/ and /n/ in the word /mini/, and 4 formant frequencies (F1, F2, F3, and F4) for nasalized /i/ vowel following a nasal consonant /n/ in the word /mini/ were compared. The differences in nasal resonance were evaluated. All patients were asked whether change in their voices after the surgery. Preoperative and postoperative voice parameters and anterior rhinomanometry results were compared separately with the control group as well as in the patient group itself. RESULTS: Preoperative total nasal resistance (TNR) values of patients were higher than the control group (P=0.001). TNR values of patients measured one day before surgery and after surgery in the 1st and 3rd months were different and these differences were significant statistically (P=0.001). There was no significant difference between the voice analysis parameters in preoperative, postoperative 1st, and 3rd months. As a result of their subjective reviews, 12 patients (36%) noted their voices were better than before surgery and 20 patients (61%) noted no change before and after surgery. CONCLUSION: Providing widened nasal cavity has no effect on voice quality.
Humans ; Nasal Cavity ; Nasal Septum ; Rhinomanometry ; Voice Quality* ; Voice*

By analyzing the mechanism of pronunciation, traditional acoustic parameters, including fundamental frequency, Mel frequency cepstral coefficients (MFCC), linear prediction cepstrum coefficient (LPCC), frequency perturbation, amplitude perturbation, and nonlinear characteristic parameters, including entropy (sample entropy, fuzzy entropy, multi-scale entropy), box-counting dimension, intercept and Hurst, are extracted as feature vectors for identification of pathological voice. Seventy-eight normal voice samples and 73 pathological voice samples for /a/, and 78 normal samples and 80 pathological samples for /i/ are recognized based on support vector machine (SVM). The results showed that compared with traditional acoustic parameters, nonlinear characteristic parameters could be well used to distinguish between healthy and pathological voices, and the recognition rates for /a/ were all higher than those for /i/ except for multi-scale entropy. That is why the /a/ sound data is used widely in related research at home and abroad for obtaining better identification of pathological voices. Adopting multi-scale entropy for /i/ could obtain higher recognition rate than /a/ between healthy and pathological samples, which may provide some useful inspiration for evaluating vocal compensatory function.
Acoustics ; Humans ; Sound ; Speech Acoustics ; Voice Disorders ; Voice Quality

BACKGROUND AND OBJECTIVES: Though patients who have undergone surgery due to pathologic voice with benign laryngeal diseases are concerned about postoperative voice quality, there was no way to propose postoperative voice objectively. For this reason, the authors studied to synthesize predictive postoperative voice based on preoperative voice. MATERIALS AND METHOD: The authors evaluated 47 patients who experienced laryngeal microsurgery due to pathologic voice with benign laryngeal diseases. The voice was analysed by Computerized Speech Lab 4300B. Linear Prediction and Pitch Synchronous Overlap and Add methods were used to synthesize the predictive voice. Assessments for the synthetic voice were sound waves, spectrographic patterns with preoperative voice, and an acoustic evaluation of the postoperative voice. RESULTS: Synthetic voice showed improvement of noise component in a high frequency range that was seen in preoperative voice on spectrographic analysis. In the perceptual test, the degree of similarity in both postoperative and synthetic voice was similar and almost the same in 75% of test voice. CONCLUSION: The synthesized voice from this program was not completely identical to the real postoperative voice, but most of the tested synthetic voice was satisfactory in the perceptual test. So we conclude that this study is meaningful as a first trial that showed the possibility of synthesizing a postoperative voices by using its preoperative voice.
Acoustics ; Humans ; Laryngeal Diseases* ; Microsurgery ; Noise ; Sound ; Voice Quality ; Voice*

BACKGROUND AND OBJECTIVES: Voice quality is determined by the vibration of the vocal cord. Therefore, visualization of the vibratory characteristics of the vocal cord is very important in patients with voice changes. Several methods for directly visualizing the vibrations of the vocal cord have been developed, although none have been commercially available or widely used. Recently, videokymography (VKG) has been developed for direct observation of vibratory characteristics in the vocal cord. VKG achieves a frequency of 7812.5 Hz, which is enough to cover the whole frequency range of the human vocal cord. However, there have been no useful parameters for interpretation of the VKG findings. MATERIALS AND METHODS: We evaluated the vocal cord vibration of 92 subjects (23 of normal, 69 of benign laryngeal lesion) and suggested 9 parameters. We analyzed VKG recordings of subjects using these parameters and interpreted the typical and common VKG findings in each case. RESULTS: There were typical differences in glottal contact, site of glottal contact, shape of glottal contact, mucosal wave, periodicity and symmetry between two groups. Amplitude of upper lip and contact quotient had a highly significant correlation between them. CONCLUSIONS: The authors suggest that these parameters would be useful to quantify the VKG findings.
Humans ; Kymography ; Lip ; Periodicity ; Vibration ; Vocal Cords ; Voice ; Voice Quality

BACKGROUND AND OBJECTIVES: It is generally believed that reconstruction of the glottic region after vertical partial laryngectomy (VPL) can improve glottic and supraglottic function. But reports on secondary healing without glottic reconstruction after VPL are lacking. This study attempts to obtain an objective phonatory data after VPL without glottic reconstruction. MATERIALS AND METHODS: From 1993 to 2001, 13 patients, who had been treated with VPL without glottic reconstruction, and 44 patients who underwent VPL were included in this study. Patients who had been followed up postoperatively less than 12 months were excluded from this study. Seven lesions were classified as T1 glottic cancer and six as T2 glottic cancer ; classic VPL (11 cases) and frontolateral VPL (2 cases). For the evaluation of voice, acoustic (fundamental frequency (Fo), jitter, shimmer, noise to harmonic ratio (NHR)), aerodynamic (maximal phonation time (MPT), mean flow rate (MFR)) analysis and videostroboscopy were done. RESULTS: There were significant differences in Fo, jitter, shimmer, NHR, MPT and MFR between VPL group and the normal control group. In videostroboscopy, the following tendencies were observed in many cases: incopmplete glottic closure, decreased and irregular mucosal wave and amplitude, supraglottic voicing, abnormal arytenoid movement and anterior commissure blunting. CONCLUSION: We had objective phonatory data after VPL without glottic reconstruction, which showed that voice quality after VPL without glottic reconstruction were somewhat unsatisfactory. Further studies on other surgical techniques of VPL would help to elucidate better ways of improving voice quality in these patients.
Acoustics ; Humans ; Laryngectomy* ; Noise ; Phonation ; Voice Quality ; Voice*