Objective:To determine the effectiveness of individualized voice therapy in persistent pediatric voice disorders. Methods:Thirty-eight children who were admitted to the Department of Pediatric Otolaryngology Shenzhen Hospital, Southern Medical University due to persistent voice disorder from November 2021 to October 2022 were included. All children were evaluated by dynamic laryngoscopy before voice therapy. Two voice doctors performed GRBAS score and acoustic analysis on the children's voice samples to obtain the relevant parameters including F0, Jitter, Shimmer, and MPT; All children were given personalized voice therapy for 8 weeks. Results:Among 38 children with voice disorders, 75.8%（29 cases） were diagnosed with vocal nodules, 20.6%（8 cases） were vocal polyps, and 3.4%（1 case） were vocal cysts. And in all children. And 51.7%（20 cases） had the sign of supraglottic extrusion under dynamic laryngoscopy. GRBAS scores decreased from 1.93 ± 0.62, 1.82 ± 0.55, 0.98 ± 0.54, 0.65 ± 0.48, 1.05 ± 0.52 to 0.62 ± 0.60, 0.58 ± 0.53, 0.32 ± 0.40, 0.22 ± 0.36, 0.37 ± 0.36. F0, Jitter, Shimmer decreased from（243.11±39.73） Hz, （0.85±0.99）%, （9.96±3.78）% to（225.43±43.20） Hz, （0.33±0.57）%, （7.72±4.32）%, respectively MPT was prolonged from（5.82±2.30） s to（7.87±3.21） s after treatment. All parameters changes had statistical significance. Conclusion:Voice therapy can solve children's voice problems, improve their voice quality and effectively treat children's voice disorders.
Humans ; Child ; Voice Disorders/diagnosis* ; Voice ; Voice Quality ; Acoustics ; Speech Acoustics ; Vocal Cords/surgery*

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*

Parkinson's disease (PD) is a widespread degenerative syndrome that affects the nervous system. Its early appearing symptoms include tremor, rigidity, and vocal impairment (dysphonia). Consequently, speech indicators are important in the identification of PD based on dysphonic signs. In this regard, computer-aided-diagnosis systems based on machine learning can be useful in assisting clinicians in identifying PD patients. In this work, we evaluate the performance of machine learning based techniques for PD diagnosis based on dysphonia symptoms. Several machine learning techniques were considered and trained with a set of twenty-two voice disorder measurements to classify healthy and PD patients. These machine learning methods included linear discriminant analysis (LDA), k nearest-neighbors (k-NN), naïve Bayes (NB), regression trees (RT), radial basis function neural networks (RBFNN), support vector machine (SVM), and Mahalanobis distance classifier. We evaluated the performance of these methods by means of a tenfold cross validation protocol. Experimental results show that the SVM classifier achieved higher average performance than all other classifiers in terms of overall accuracy, G-mean, and area under the curve of the receiver operating characteristic plot. The SVM classifier achieved higher performance measures than the majority of the other classifiers also in terms of sensitivity, specificity, and F-measure statistics. The LDA, k-NN and RT achieved the highest average precision. The RBFNN method yielded the highest F-measure.; however, it performed poorly in terms of other performance metrics. Finally, t tests were performed to evaluate statistical significance of the results, confirming that the SVM outperformed most of the other classifiers on the majority of performance measures. SVM is a promising method for identifying PD patients based on classification of dysphonia measurements.
Bays ; Classification ; Diagnosis ; Dysphonia ; Humans ; Machine Learning ; Methods ; Nervous System ; Parkinson Disease ; ROC Curve ; Sensitivity and Specificity ; Support Vector Machine ; Trees ; Tremor ; Voice Disorders

BACKGROUND AND OBJECTIVES: Adductor type spasmodic dysphonia (ADSD) is neurogenic disorder and focal laryngeal dystonia, while muscle tension dysphonia (MTD) is caused by functional voice disorder. Both ADSD and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. The aim of this study was to determine the utility of spectrogram analysis in the differentiation of ADSD from MTD. MATERIALS AND METHODS: From 2015 through 2017, 17 patients of ADSD and 20 of MTD, underwent acoustic recording and phonatory function studies, were enrolled. Jitter (frequency perturbation), Shimmer (amplitude perturbation) were obtained using MDVP (Multi-dimensional Voice Program) and GRBAS scale was used for perceptual evaluation. The two speech therapist evaluated a wide band (11,250 Hz) spectrogram by blind test using 4 scales (0–3 point) for four spectral findings, abrupt voice breaks, irregular wide spaced vertical striations, well defined formants and high frequency spectral noise. RESULTS: Jitter, Shimmer and GRBAS were not found different between two groups with no significant correlation (p>0.05). Abrupt voice breaks and irregular wide spaced vertical striations of ADSD were significantly higher than those of MTD with strong correlation (p < 0.01). High frequency spectral noise of MTD were higher than those of ADSD with strong correlation (p < 0.01). Well defined formants were not found different between two groups. CONCLUSION: The wide band spectrograms provided visual perceptual information can differentiate ADSD from MTD. Spectrogram analysis is a useful diagnostic tool for differentiating ADSD from MTD where perceptual analysis and clinical evaluation alone are insufficient.
Acoustics ; Compensation and Redress ; Diagnosis, Differential ; Dysphonia* ; Dystonia ; Humans ; Muscle Spasticity ; Muscle Tonus* ; Noise ; Voice ; Voice Disorders ; Voice Quality ; Weights and Measures

Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.
Amyotrophic Lateral Sclerosis ; Central Nervous System ; Compensation and Redress ; Consensus ; Diagnosis ; Diagnosis, Differential* ; Dyskinesias ; Dysphonia* ; Dystonia ; Laryngeal Muscles ; Larynx ; Muscle Spasticity ; Muscle Tonus ; Myasthenia Gravis ; Parkinson Disease ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Disorders ; Voice Quality

Chronic refractory cough is defined as a cough that persists despite guideline based treatment. It is seen in 20-46% of patients presenting to specialist cough clinics and it has a substantial impact on quality of life and healthcare utilization. Several terms have been used to describe this condition, including the recently introduced term cough hypersensitivity syndrome. Key symptoms include a dry irritated cough localized around the laryngeal region. Symptoms are not restricted to cough and can include globus, dyspnea, and dysphonia. Chronic refractory cough has factors in common with laryngeal hypersensitivity syndromes and chronic pain syndromes, and these similarities help to shed light on the pathophysiology of the condition. Its pathophysiology includes cough reflex sensitivity, central sensitization, peripheral sensitization, and paradoxical vocal fold movement. Chronic refractory cough often occurs after a viral infection. The diagnosis is made once the main disease that causes chronic cough have been excluded (or treated) and cough remains refractory to medical treatment. Treatments include speech pathology interventions using techniques adapted from the treatment of hyperfunctional voice disorders, as well as the use of centrally acting neuromodulators such as gabapentin and pregabalin. Potential new treatments in development also show promise.
Central Nervous System Sensitization ; Chronic Pain ; Cough* ; Delivery of Health Care ; Diagnosis ; Dysphonia ; Dyspnea ; Humans ; Hypersensitivity ; Neurotransmitter Agents ; Pregabalin ; Quality of Life ; Reflex ; Specialization ; Speech-Language Pathology ; Vocal Cords ; Voice Disorders

Nowadays, various voice disorders are sprung out towards teachers of primary and secondary school, affecting their personal life and social work. Through literature review, the author aims at clearing up series of assessments and methods of voice training which are suitable for the teachers of primary and secondary school, such as establishing a right way of respiratory, phonation and resonance, avoiding occupational risk factors such as vocal abuse or misuse to regain healthy voice. Review of the several relevant literature and commentary about voice disorders of the teachers in primary and secondary school. Although various methods of voice training were reported from time to time to guide us SLP to carry out voice therapy, however, deviations of the clinical data from scholars' different points of view are waiting for our further support through case-control study.
Faculty ; Humans ; Schools ; Voice Disorders ; diagnosis ; rehabilitation

Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) were performed to find the cause of dysphagia. The VFSS revealed continuous twitch-like involuntary movement of the laryngeal muscle around the vocal folds. Then, he was diagnosed with spasmodic dysphonia by VFSS, auditory-perceptual voice analysis, and physical examination. So, we report the first case of spasmodic dysphonia accompanied with difficulty swallowing that was confirmed by VFSS.
Deglutition Disorders ; Deglutition* ; Diagnosis* ; Dyskinesias ; Dysphonia* ; Dyspnea ; Humans ; Laryngeal Muscles ; Laryngoscopy ; Male ; Pharynx ; Physical Examination ; Spasm ; Vocal Cords ; Voice ; Young Adult

BACKGROUND AND OBJECTIVES: Adduct spasmodic dysphonia (ADSD) is a neurogenic and focal laryngeal dystonia resulting in a strained voice quality with spastic voice breaks. While muscle tension dysphonia (MTD) is caused by functional voice disorders, its symptoms are similar to those of ADSD. Because the approaches of treatment for ADSD and MTD are radically different, accurate evaluations are necessary for precise diagnosis. A spectrogram analysis for differentiating ADSD from MTD provides differentiations on four spectral findings (abrupt voice breaks, irregular wide-spaced vertical striations, well-defined formants and high-frequency spectral noise). The aim of this study was to evaluate if the spectrogram could provide detailed information on the visual characteristics that distinguish ADSD and MTD. SUBJECTS AND METHOD: 11 female patients of ADSD and 13 female patients of MTD who were diagnosed by laryngoscope and stroboscope from 2009 through 2012 were selected for this study. The speech samples of subjects were obtained using Computerized Speech Lab. The two speech therapists evaluated a wide-band (300 Hz) spectrogram by blind test using 4 scales (0-3 point) for four spectral findings. RESULTS: Abrupt voice breaks and irregular wide-spaced vertical striations of ADSD were significantly higher than those of MTD. Well-defined formants and high-frequency spectral noise were not found significantly different between two groups. CONCLUSION: The spectrograms provided visual perceptual information needed to differentiate ADSD from MTD. Voice therapy to reduce hypertension could be considered for patients of ADSD with excessive formants and noise. If spectrogram analysis were used along with other assessments, it would be more useful in distinguishing ADSD from MTD.
Diagnosis ; Dysphonia* ; Dystonia ; Female ; Humans ; Hypertension ; Laryngoscopes ; Muscle Spasticity ; Muscle Tonus* ; Noise ; Voice ; Voice Disorders ; Voice Quality ; Weights and Measures

Eagle syndrome is a rare condition caused by elongation of the styloid process or calcification of the stylohyoid ligament. Patients with Eagle syndrome typically present with dysphagia, dysphonia, cough, voice changes, otalgia, sore throat, facial pain, foreign body sensation, headache, vertigo, and neck pain. Here we report a case in which the patient initially presented with sore throat, left-sided facial pain, and cough. This case report provides a brief review of the diagnosis and nonsurgical management of this rare syndrome.
Cough ; Deglutition Disorders ; Diagnosis ; Dysphonia ; Eagles ; Earache ; Facial Pain ; Foreign Bodies ; Headache ; Humans ; Ligaments ; Neck Pain ; Ossification, Heterotopic ; Pharyngitis ; Sensation ; Temporal Bone ; Vertigo ; Voice