This study investigated the prethyroplasty and postthyroplasty voices of patients with glottic in... more This study investigated the prethyroplasty and postthyroplasty voices of patients with glottic incompetence of mobile vocal folds related to vocal fold bowing and scarring. Seventeen patients underwent vocal function evaluation preoperatively and 1 month postoperatively with videostrobolaryngoscopic examination, acoustic and aerodynamic analysis, and perceptual judgment of voice characteristics. The postoperative voice outcome in this group of patients was compared to that of a group of patients with unilateral vocal fold paralysis. Patients with vocal fold bowing showed significant improvement in glottic gap size and hoarseness after the surgery. There was minimal improvement on other test measures. Patients with vocal fold scarring exhibited worse preoperative and postoperative vocal functions, with little voice improvement after surgery. The outcome of thyroplasty type I in cases of vocal fold bowing or scarring is not as good as that in unilateral vocal fold paralysis.
Typescript (photocopy). Thesis (Ph. D.)--Memphis State University, 1990. Includes bibliographical... more Typescript (photocopy). Thesis (Ph. D.)--Memphis State University, 1990. Includes bibliographical references (leaves [122]-131).
In the United States 6.8% of men, women, and children report current voice problems and approxima... more In the United States 6.8% of men, women, and children report current voice problems and approximately 29% will report some problems during their lifetime. Often this dysphonia is due to pathologies of the vocal folds. The authors (a physicist and a speech pathologist) describe an interdisciplinary approach that shows promise of detecting physiological abnormalities of the vocal folds from an
Journal of voice : official journal of the Voice Foundation, 2014
The optimal selection of speech task is essential for more reliable perceptual ratings and a bett... more The optimal selection of speech task is essential for more reliable perceptual ratings and a better understanding of the perceptual qualities of pathologic voices. Nevertheless, researchers have rarely explored this issue using the GRBAS scale. This study investigates the effect of speech task selection on interrater reliability during perceptual voice assessment. Experimental study. Sixty subjects, 39 dysphonic subjects and 21 normal controls, performed 13 speech tasks including three 5-second sustained vowel sounds (/É‘/, /i/, and /u/) each at three pitch levels (high, habitual, and low), maximum phonation of the vowel /É‘/, pitch glide, counting from 1 to 10, and oral reading of the Rainbow Passage. A group of 18 graduate students in speech-language pathology served as perceptual judges and rated the dysphonic severity for the speech samples based on three parameters in the GRBAS scale-Grade, Roughness, and Breathiness. The formalism of the AC1 statistic proposed by Gwet was applie...
Longitudinal changes of vocal efficiency and stability following thyroplasty type I were analysed... more Longitudinal changes of vocal efficiency and stability following thyroplasty type I were analysed. Fifty-three patients with unilateral vocal fold paralysis underwent vocal function evaluation preoperatively and 1, 3 and 6 months postoperatively. Vocal function assessment included videostrobolaryngoscopic examination, acoustical and aerodynamic analyses, and perceptual ratings of voice. Parameters including glottic gag size, maximum phonation time, glottic flow rate, jitter, harmonic to noise ratio, breathness, hoarseness, loudness and phrasing showed significant improvement after thyroplasty and remained stable within 1 month with only slight fluctuations over a 6 month period. Postoperative voice outcome was not affected by age, sex, duration of vocal symptoms, etiology of paralysis, or preoperative pulmonary function.
Journal of the American Academy of Audiology, 1992
Formant frequencies were determined from vocalic utterances of a prelinguistically deafened child... more Formant frequencies were determined from vocalic utterances of a prelinguistically deafened child implanted with a Nucleus 22-channel device at age 5 years. Speech samples were obtained from recordings of speech made 5 and 2 months prior to implantation and at 6, 12, 18, 24, and 36 months post implantation. Prior to implantation, first formant values showed a greater range than those of normal hearing children of comparable age, and second formant values showed a greatly reduced range and clustered around a mean of 1800 Hz. By 36 months post implantation, first formant values approximated age-matched norms. By 6 months post implantation, higher second formant values were apparent. A progressive shift in second formant values was noted through 36 months post implantation when the vocalic space most closely corresponded to age-matched normative data.
Typescript. Thesis (master's)--University of South Carolina, 1985. Includes bibliographical r... more Typescript. Thesis (master's)--University of South Carolina, 1985. Includes bibliographical references (leaves 67-68).
Volume 113 Number 2 Scientific Posters P 193 suprahyoid, and midline mandibular split. This poste... more Volume 113 Number 2 Scientific Posters P 193 suprahyoid, and midline mandibular split. This poster reviews a case of lingual thyroid with symptomatic hemorrhage resulting in definitive surgical excision via a suprahyoid pharyngotomy. The relative merits of this approach for removal of large, benign lesions of the base of tongue are reviewed, including excellent surgical exposure and good cosmetic result.
Hoarseness is a common symptom in older individuals and may reflect a wide variety of pathologic,... more Hoarseness is a common symptom in older individuals and may reflect a wide variety of pathologic, medical, physiologic, and/or functional causes. Although vocal fold atrophy is one of the more common reported findings in the elderly, inconclusive information is known about the differential diagnosis and cause of dysphonia in older individuals. The purpose of this investigation was to review the cause of hoarseness in all patients older than 65 years and to determine any correlation with advancing age and other demographic factors. Additionally, we wanted to determine the effect vocal pathology has on objective voice measures with advancing age. The two most common causes of hoarseness found in 393 patients older than 65 years were vocal fold bowing and unilateral vocal fold paralysis, followed by benign vocal fold lesions, voice tremor, and spasmodic dysphonia. Although objective measures of vocal function were abnormal compared with reported normative data, they did not increase in...
OBJECTIVE After thyroplasty type I, significant improvement has been reported in objective measur... more OBJECTIVE After thyroplasty type I, significant improvement has been reported in objective measures of vocal function. The purpose of this investigation was to compare the short- and long-term results in patients undergoing thyroplasty type I. METHODS Data on 26 patients who had undergone thyroplasty type I for management of unilateral vocal fold paralysis were compared from before surgery to the short-term (1-month) and long-term (>1-year) postoperative assessment points. Statistical analysis included paired t tests to assess the significance of between-group differences. RESULTS Significant differences were found between the preoperative and both postoperative evaluations for the measures of mean glottal flow rate, maximum phonation time, jitter, shimmer, and harmonic-to-noise ratio. However, no significant differences were found between the 1-month and >1-year assessment points. CONCLUSIONS The results for the parameters studied appeared to reach maximum improvement within ...
Research evidence has shown that neither traditional voice therapy nor surgery was efficacious in... more Research evidence has shown that neither traditional voice therapy nor surgery was efficacious in managing age-related dysphonia, specifically for more severe cases with pronounced fold atrophy or larger glottal gaps. The purpose of this study was to examine the efficacy of intensive respiratory-phonatory treatment (Lee Silverman voice treatment [LSVT]) for glottal incompetence associated with presbyphonia. Study Design. Nonrandomized prospective study. Methods. Two subjects with age-related vocal fold bowing received 4 weeks of the LSVT. Strobolaryngoscopic examination, phonatory function measurement, acoustical analyses, and perceptual judgments of voice were obtained at baseline and 2 weeks posttreatment. Additional acoustic measures of phonatory function, including vocal intensity, maximum phonation time, and pitch range, were also obtained during 16 treatment sessions. Results. Both subjects exhibited significant improvements in glottal closure, phonatory function, acoustic features, and perceptual ratings of voice after treatment. Significant changes of phonatory function measures were noticed relatively early and remained steady throughout the course of treatment. Conclusions. These findings provide solid evidence that speakers with age-related vocal fold bowing and dysphonia may improve glottal competence and related vocal function with neither laryngeal trauma nor maladaptive laryngeal hyperfunction after the LSVT.
Laryngeal movement disorders (LMDs), including spasmodic dysphonia and essential voice tremor, ha... more Laryngeal movement disorders (LMDs), including spasmodic dysphonia and essential voice tremor, have been described as focal disorders affecting the muscles of the larynx. Little reference has been made to possible hyperfunction of supralaryngeal structures and/or palatal involvement. Videonasolaryngoscopic examinations of 83 patients with LMDs revealed a significantly high incidence of abnormal soft palate posturing (84%). Further associations and implications are presented.
Injection of botulinum toxin (Botox) into the laryngeal muscles has become the treatment of choic... more Injection of botulinum toxin (Botox) into the laryngeal muscles has become the treatment of choice for controlling the symptoms of spasmodic dysphonia (SD). Currently, no specific battery of objective tests to assess the outcome is universally accepted. The purpose of this study was to investigate demographic, clinical, and treatment factors with voice outcome following Botox injection. Sixty-eight patients with adductor SD who underwent at least one Botox injection during a 5-year period were studied. Voice outcome measures were made from patient self-reporting scales and included overall vocal quality, length of response, and duration of breathiness. Vocal quality was significantly correlated with the underlying severity of vocal symptoms prior to treatment, incidence of breathiness and unilateral versus bilateral injection. The length of response was greater in males and following bilateral injections. An increased period of breathiness significantly correlated with bilateral injections.
The Journal of the Acoustical Society of America, 2009
In the United States, 6.8% of men, women, and children report voice problems currently, while dur... more In the United States, 6.8% of men, women, and children report voice problems currently, while during their lifetime ca. 29% will complain of some dysphonia, often due to pathologies of the vocal folds. The authors (a physicist and a speech pathologist) describe an interdisciplinary approach that exhibits promise for detecting physiological abnormalities of the vocal folds from a spectral analysis of the overtone series of spoken tokens. This preliminary investigation shows that the normal human vocal fold emits overtones that are very nearly precise integral values of the fundamental. Physiological problems of the vocal folds, however, introduce mechanical nonlinearities that manifest themselves as frequency deviations from the ideal harmonic (that is, integral) values. The authors quantify this inharmonicity, describing and illustrating how one can efficiently obtain and analyze such data. They outline, as well, a proposed investigation to assess the clinical sensitivity and significance of the analysis ...
This study investigated the prethyroplasty and postthyroplasty voices of patients with glottic in... more This study investigated the prethyroplasty and postthyroplasty voices of patients with glottic incompetence of mobile vocal folds related to vocal fold bowing and scarring. Seventeen patients underwent vocal function evaluation preoperatively and 1 month postoperatively with videostrobolaryngoscopic examination, acoustic and aerodynamic analysis, and perceptual judgment of voice characteristics. The postoperative voice outcome in this group of patients was compared to that of a group of patients with unilateral vocal fold paralysis. Patients with vocal fold bowing showed significant improvement in glottic gap size and hoarseness after the surgery. There was minimal improvement on other test measures. Patients with vocal fold scarring exhibited worse preoperative and postoperative vocal functions, with little voice improvement after surgery. The outcome of thyroplasty type I in cases of vocal fold bowing or scarring is not as good as that in unilateral vocal fold paralysis.
Typescript (photocopy). Thesis (Ph. D.)--Memphis State University, 1990. Includes bibliographical... more Typescript (photocopy). Thesis (Ph. D.)--Memphis State University, 1990. Includes bibliographical references (leaves [122]-131).
In the United States 6.8% of men, women, and children report current voice problems and approxima... more In the United States 6.8% of men, women, and children report current voice problems and approximately 29% will report some problems during their lifetime. Often this dysphonia is due to pathologies of the vocal folds. The authors (a physicist and a speech pathologist) describe an interdisciplinary approach that shows promise of detecting physiological abnormalities of the vocal folds from an
Journal of voice : official journal of the Voice Foundation, 2014
The optimal selection of speech task is essential for more reliable perceptual ratings and a bett... more The optimal selection of speech task is essential for more reliable perceptual ratings and a better understanding of the perceptual qualities of pathologic voices. Nevertheless, researchers have rarely explored this issue using the GRBAS scale. This study investigates the effect of speech task selection on interrater reliability during perceptual voice assessment. Experimental study. Sixty subjects, 39 dysphonic subjects and 21 normal controls, performed 13 speech tasks including three 5-second sustained vowel sounds (/É‘/, /i/, and /u/) each at three pitch levels (high, habitual, and low), maximum phonation of the vowel /É‘/, pitch glide, counting from 1 to 10, and oral reading of the Rainbow Passage. A group of 18 graduate students in speech-language pathology served as perceptual judges and rated the dysphonic severity for the speech samples based on three parameters in the GRBAS scale-Grade, Roughness, and Breathiness. The formalism of the AC1 statistic proposed by Gwet was applie...
Longitudinal changes of vocal efficiency and stability following thyroplasty type I were analysed... more Longitudinal changes of vocal efficiency and stability following thyroplasty type I were analysed. Fifty-three patients with unilateral vocal fold paralysis underwent vocal function evaluation preoperatively and 1, 3 and 6 months postoperatively. Vocal function assessment included videostrobolaryngoscopic examination, acoustical and aerodynamic analyses, and perceptual ratings of voice. Parameters including glottic gag size, maximum phonation time, glottic flow rate, jitter, harmonic to noise ratio, breathness, hoarseness, loudness and phrasing showed significant improvement after thyroplasty and remained stable within 1 month with only slight fluctuations over a 6 month period. Postoperative voice outcome was not affected by age, sex, duration of vocal symptoms, etiology of paralysis, or preoperative pulmonary function.
Journal of the American Academy of Audiology, 1992
Formant frequencies were determined from vocalic utterances of a prelinguistically deafened child... more Formant frequencies were determined from vocalic utterances of a prelinguistically deafened child implanted with a Nucleus 22-channel device at age 5 years. Speech samples were obtained from recordings of speech made 5 and 2 months prior to implantation and at 6, 12, 18, 24, and 36 months post implantation. Prior to implantation, first formant values showed a greater range than those of normal hearing children of comparable age, and second formant values showed a greatly reduced range and clustered around a mean of 1800 Hz. By 36 months post implantation, first formant values approximated age-matched norms. By 6 months post implantation, higher second formant values were apparent. A progressive shift in second formant values was noted through 36 months post implantation when the vocalic space most closely corresponded to age-matched normative data.
Typescript. Thesis (master's)--University of South Carolina, 1985. Includes bibliographical r... more Typescript. Thesis (master's)--University of South Carolina, 1985. Includes bibliographical references (leaves 67-68).
Volume 113 Number 2 Scientific Posters P 193 suprahyoid, and midline mandibular split. This poste... more Volume 113 Number 2 Scientific Posters P 193 suprahyoid, and midline mandibular split. This poster reviews a case of lingual thyroid with symptomatic hemorrhage resulting in definitive surgical excision via a suprahyoid pharyngotomy. The relative merits of this approach for removal of large, benign lesions of the base of tongue are reviewed, including excellent surgical exposure and good cosmetic result.
Hoarseness is a common symptom in older individuals and may reflect a wide variety of pathologic,... more Hoarseness is a common symptom in older individuals and may reflect a wide variety of pathologic, medical, physiologic, and/or functional causes. Although vocal fold atrophy is one of the more common reported findings in the elderly, inconclusive information is known about the differential diagnosis and cause of dysphonia in older individuals. The purpose of this investigation was to review the cause of hoarseness in all patients older than 65 years and to determine any correlation with advancing age and other demographic factors. Additionally, we wanted to determine the effect vocal pathology has on objective voice measures with advancing age. The two most common causes of hoarseness found in 393 patients older than 65 years were vocal fold bowing and unilateral vocal fold paralysis, followed by benign vocal fold lesions, voice tremor, and spasmodic dysphonia. Although objective measures of vocal function were abnormal compared with reported normative data, they did not increase in...
OBJECTIVE After thyroplasty type I, significant improvement has been reported in objective measur... more OBJECTIVE After thyroplasty type I, significant improvement has been reported in objective measures of vocal function. The purpose of this investigation was to compare the short- and long-term results in patients undergoing thyroplasty type I. METHODS Data on 26 patients who had undergone thyroplasty type I for management of unilateral vocal fold paralysis were compared from before surgery to the short-term (1-month) and long-term (>1-year) postoperative assessment points. Statistical analysis included paired t tests to assess the significance of between-group differences. RESULTS Significant differences were found between the preoperative and both postoperative evaluations for the measures of mean glottal flow rate, maximum phonation time, jitter, shimmer, and harmonic-to-noise ratio. However, no significant differences were found between the 1-month and >1-year assessment points. CONCLUSIONS The results for the parameters studied appeared to reach maximum improvement within ...
Research evidence has shown that neither traditional voice therapy nor surgery was efficacious in... more Research evidence has shown that neither traditional voice therapy nor surgery was efficacious in managing age-related dysphonia, specifically for more severe cases with pronounced fold atrophy or larger glottal gaps. The purpose of this study was to examine the efficacy of intensive respiratory-phonatory treatment (Lee Silverman voice treatment [LSVT]) for glottal incompetence associated with presbyphonia. Study Design. Nonrandomized prospective study. Methods. Two subjects with age-related vocal fold bowing received 4 weeks of the LSVT. Strobolaryngoscopic examination, phonatory function measurement, acoustical analyses, and perceptual judgments of voice were obtained at baseline and 2 weeks posttreatment. Additional acoustic measures of phonatory function, including vocal intensity, maximum phonation time, and pitch range, were also obtained during 16 treatment sessions. Results. Both subjects exhibited significant improvements in glottal closure, phonatory function, acoustic features, and perceptual ratings of voice after treatment. Significant changes of phonatory function measures were noticed relatively early and remained steady throughout the course of treatment. Conclusions. These findings provide solid evidence that speakers with age-related vocal fold bowing and dysphonia may improve glottal competence and related vocal function with neither laryngeal trauma nor maladaptive laryngeal hyperfunction after the LSVT.
Laryngeal movement disorders (LMDs), including spasmodic dysphonia and essential voice tremor, ha... more Laryngeal movement disorders (LMDs), including spasmodic dysphonia and essential voice tremor, have been described as focal disorders affecting the muscles of the larynx. Little reference has been made to possible hyperfunction of supralaryngeal structures and/or palatal involvement. Videonasolaryngoscopic examinations of 83 patients with LMDs revealed a significantly high incidence of abnormal soft palate posturing (84%). Further associations and implications are presented.
Injection of botulinum toxin (Botox) into the laryngeal muscles has become the treatment of choic... more Injection of botulinum toxin (Botox) into the laryngeal muscles has become the treatment of choice for controlling the symptoms of spasmodic dysphonia (SD). Currently, no specific battery of objective tests to assess the outcome is universally accepted. The purpose of this study was to investigate demographic, clinical, and treatment factors with voice outcome following Botox injection. Sixty-eight patients with adductor SD who underwent at least one Botox injection during a 5-year period were studied. Voice outcome measures were made from patient self-reporting scales and included overall vocal quality, length of response, and duration of breathiness. Vocal quality was significantly correlated with the underlying severity of vocal symptoms prior to treatment, incidence of breathiness and unilateral versus bilateral injection. The length of response was greater in males and following bilateral injections. An increased period of breathiness significantly correlated with bilateral injections.
The Journal of the Acoustical Society of America, 2009
In the United States, 6.8% of men, women, and children report voice problems currently, while dur... more In the United States, 6.8% of men, women, and children report voice problems currently, while during their lifetime ca. 29% will complain of some dysphonia, often due to pathologies of the vocal folds. The authors (a physicist and a speech pathologist) describe an interdisciplinary approach that exhibits promise for detecting physiological abnormalities of the vocal folds from a spectral analysis of the overtone series of spoken tokens. This preliminary investigation shows that the normal human vocal fold emits overtones that are very nearly precise integral values of the fundamental. Physiological problems of the vocal folds, however, introduce mechanical nonlinearities that manifest themselves as frequency deviations from the ideal harmonic (that is, integral) values. The authors quantify this inharmonicity, describing and illustrating how one can efficiently obtain and analyze such data. They outline, as well, a proposed investigation to assess the clinical sensitivity and significance of the analysis ...
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