Letteratura scientifica selezionata sul tema "Functional voice hyperfunction"

This report describes the experimental design and initial results of an ongoing clinical investigation of voice disorders. Its major focus is the development and use of quantitative measures to provide objective descriptions of conditions referred to as "vocal hyperfunction." The experimental design for this project is based on a descriptive theoretical framework, which holds that there are different types and stages of hyperfunctionally related voice disorders. Data consist of indirect measures derived from noninvasive aerodynamic and acoustic recordings including (a) parameters derived from inverse filtered approximations of the glottal air flow waveform; (b) estimates of transglottal pressure, average glottal air flow, glottal resistance and vocal efficiency; and (c) measures of vocal intensity and fundamental frequency. Initial results (based on comparisons among 15 voice patients and 45 normal speakers) support major assumptions that underlie the theoretical framework, and indicate that the measurement approach being utilized is capable of differentiating hyperfunctional from normal voices and hyperfunctional conditions from one another. Organic manifestations of vocal hyperfunction (nodules, polyps, contact ulcers) are accompanied by abnormally high values for the glottal waveform parameters of AC flow and maximum flow declination rate, suggesting increased potential for vocal fold trauma due to high vocal fold closure velocities and collision forces. In contrast, nonorganic manifestations of hyperfunction (functional disorders) tend to be associated with abnormally high levels of unmodulated DC flow, without high values for AC flow and maximum flow declination rate, suggesting reduced potential for vocal fold trauma. Measures also suggest different underlying mechanisms for nodules and polyps as compared to contact ulcers. Results are discussed relative to predictions based on the theoretical framework for vocal hyperfunction.

The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD). The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG) are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD.

A vowel [a]-like, synthesized speech wave was perturbated by defined and comparable jitter and shimmer levels. The signal-to-noise ratio was calculated from the speech wave spectra. Noise emerges in those spectral regions in which the harmonics have high amplitudes, that is, at low frequencies and in the formant regions. Jitter created noise levels significantly higher than shimmer. To verify the theoretical findings, the voices of 32 women with functional voice disorders were analyzed for shimmer and jitter. It was found that only jitter is relevant for differentiating between hypo- and hyperfunctional voice disorders. Jitter was reduced in hyperfunctional voice disorder. This is presumed to be an effect of the high vocal fold tension found in the disorder.

Introduction: The aim of the dissertation was to evaluate the parameters of acoustic and function analysis of the voice in patients with functional and organic dysphonia by using the DiagnoScope “Specjalista” computer program. Material and methods: The study was performed in 131 people aged 21-82 years (the mean age was 48,34 years), including 75 women, at the age of 21-75 years and 56 men at the age of 22-82 years, all treated in the Clinic of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics of the Military Medical Academy Memorial University Hospital – Central Veterans' Hospital. The study participants were divided into 3 groups: I – 45 patients aged 22-82 years with functional dysphonia (hyperfunctional type dysphonia), II – 45 patients aged 28-80 years with chronic hypertrophic laryngitis (polyp of the vocal fold, hypertrophy of the vocal fold, Reinke-type edema-hypertrophic changes in the vocal folds), III – 41 individuals, including students of the Faculty of Military Medicine of the Medical University of Łódź, at the age of 21-70 years, without disease symptoms within the vocal organ. The following examinations were performed: a laryngological subject and object examination, a videolaryngoscopic and stroboscopic examination of the larynx (including the GRBAS scale), and a videolaryngostroboscopic-phoniatric examination, encompassing the following parameters: regularity of vibrations of the vocal folds, amplitude of vibrations, marginal shift, glottis closure, voice range, the way of creating the voice, voice reposition, time of phonation) and an acoustic and voice performance diagnostic analysis by the means of the DiagnoScope “Specjalista” program. Results: The results obtained suggest that the differentiation of pathological voices from normal voices is statistically significant for parameters such as: Jitter, RAP, PPQ, AFO, SimpleQ, Shimmer, APQ, Q, APQ, HPQh, RHPQ, RHPQh, R2H, U2H, U2Hl, U2Hh, NHR, Yg. In the function analysis, statistically significant differences were found in all parameters. Conclusions: The videolaryngostroboscopic examination, voice rating scales, and the objective analysis of the voice provide an appropriate set of tests that determine the nature of voice disorders. The acoustic and function analysis of the voice enables an early diagnosis of dysphonia, both functional and organic. The acoustic and function analysis is an objective method of assessment of the voice disorders which renders it possible to use it in judicature.

Introduction: Hyperfunctional dysfunction is one of the most common functional dysphonia, cha-racterized by voice insufficiency with excessive tightening of the muscles inside and outside the larynx during phonation. To make the treatment process more effective, new ways of rehabilitation are constantly being sought and developed. The aim of this work is to evaluate the effectiveness of laryngotaping - an innovative method of taping around the larynx and neck muscles. Material and method: 10 patients with diagnosed hyperfunctional dysphonia participated in the study. Using the kinesiotaping principles, for 7 days, the suprahyoid and infrahyoid muscles, ster-nocleidomastoid muscles as well as the thyroid cartilage were taped. Before and after the therapy, the patients completed the VHI voice self-evaluation questionnaire. The evaluation of the larynx according to the L. Mathienson scale was also assessed palpation. Results: Analyzing the results of the VHI questionnaire and evaluation of palpation evaluation of the larynx before and after the therapy, statistically significant differences were observed. The results on average decreased by half, which is the desired effect of therapy. Discussion: The results confirm the positive impact of kinesiotaping around the larynx. However, more research is needed on a larger group of patients to fully evaluate the therapeutic effect. Conclusions: 1. Laryngotaping is an effective way to normalize muscle tone, and thus to improve the quality of the voice. 2. The presented studies require continuation, however, positive reception of the introduced therapy by patients encourages further research on a larger group of patients.

Abstract Automatic detection of voice pathologies enables non-invasive, low cost and objective assessments of the presence of disorders, as well as accelerating and improving the process of diagnosis and clinical treatment given to patients. In this work, a vector made up of 28 acoustic parameters is evaluated using principal component analysis (PCA), kernel principal component analysis (kPCA) and an auto-associative neural network (NLPCA) in four kinds of pathology detection (hyperfunctional dysphonia, functional dysphonia, laryngitis, vocal cord paralysis) using the a, i and u vowels, spoken at a high, low and normal pitch. The results indicate that the kPCA and NLPCA methods can be considered a step towards pathology detection of the vocal folds. The results show that such an approach provides acceptable results for this purpose, with the best efficiency levels of around 100%. The study brings the most commonly used approaches to speech signal processing together and leads to a comparison of the machine learning methods determining the health status of the patient

ntroduction: The publication describes the characteristics of the glottis in FDs objectified by OQ, measured with VSK and EGG. Aim: The aim of the study was to objectify glottal function in different types of FDs. The scope was to use open quotients gained from various mucosal wave imaging techniques for differential diagnosis of FDs. Material and Method: The study included 204 individuals. In the study, each patient underwent otolaryngological and phoniatric examination. LVS, EGG and VSK were conducted, their results were recorded and stored using an EndoSTROB-DX- -Xion GmbH (Berlin) device with DIVAS software. Results: All patients with FDs had abnormalities in LVS. A statistical analysis showed differences in LVS characteristics according to the type of FD. The mean value of OQVSK was 0.521 in the control group and 0.565 in the study group (P < 0.05). Significant differences were found between patients with hypofunctional – 0.584 and hyperfunctional dysphonia – 0.55. The QOQEGG mean value in patients with FDs was 0.581 and in the control group 0.549 (P < 0.01). There were statistically significant differences between groups of patients with hyper- and hypofunctional dysphonias. Medians amounted to 0.574 and 0.604, respectively. Authors observed different relations of OQ with the type of FD. They decided to introduce a new parameter, illustrating the proportion of QOQEGG/OQVSK. Conclusions: Videostrobokymographic and electroglottographic open quotients differentiate euphony from dysphony. The value of OQVSK and QOQEGG and their proportion varies depending on different types of functional dysphonias. The OQVSK and QOQEGG should be included in the diagnostic algorithm of voice.

Teachers frequently present with voice problems as result of functional voice hyperfunction and it seems that occupational duties often impede successful implementation of a conventional voice conservation strategies. The goal of this single-subject study was to investigate the practical value of personal voice amplification as an assistive option for teachers experiencing occupation-related voice problems The physical state of a teacher’s vocal chords and specific perceptual and acoustic attributes of her voice were evaluated before and after a period of conventional voice conservation, and also before and after a period during which personal voice amplification was used as an augmentative strategy. In the course of the study it was in the interest of the subject that a persistent vocal fold nodule be removed surgically. The research design was adapted accordingly and the study consequently included a pre- and post surgical phase. Physical examinations of the vocal cords reflected the positive effect of the surgical removal of a vocal fold nodule. An improvement in the general status of the vocal cords was also noted following periods during which personal voice amplification was used in combination with a conventional voice conservation strategy. Perceptual and acoustic analysis of voice quality confirmed the positive effect of the surgical intervention. Although a panel of judges did not detect an improvement in the subject’s voice quality following the assistive use of the personal amplifier, several acoustic voice parameters showed improvement or normalised after the use of personal voice amplification in combination with conventional voice conservation strategies. The subject’s repeated evaluation of her own voice experiences, as well as her view of the practicability of the two voice conservation strategies, revealed a remarkably positive attitude towards the augmentative use of personal voice amplification. The conclusion is that teachers who experience occupational voice problems could benefit from the use of personal voice amplification in combination with a conventional voice conservation strategy.
Dissertation (M (Communication Pathology))--University of Pretoria, 2006.
Speech-Language Pathology and Audiology
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