Search Results (238)

Background: This study aimed to investigate the relationships between kymographic parameters derived from high-speed videoendoscopy (HSV) and simultaneously recorded acoustic signals. The research provides insights into the vibratory dynamics of various glottal pathologies, assessed across different glottal widths, and their mutual relations with audio data. Methods: The study included 192 participants categorized as normophonic or having functional or organic lesions (benign, premalignant, and malignant). Parameters describing vocal fold oscillations were calculated using HSV kymography for three glottal widths, along with corresponding acoustic data. Initially, linear correlations between these parameters were assessed. Next, the consistency in cycle detection and its influence on the correlation levels were evaluated. Results: The fundamental frequency (F0) and mean Jitter (Jita) showed the highest correlations between the HSV- and audio-determined parameters (F0: 0.97, Jita: 0.40–0.70), with even stronger correlations when the number of detected cycles was consistent (F0: 0.99, Jita: 0.68–0.98). The correlations for other parameters ranged from low to moderate, with no significant differences observed between the diagnostic subgroups (functional changes and benign and malignant glottal lesions). However, in the premalignant lesions group, high correlations (0.77–0.9) were observed between the HSV and audio parameters, but only for measures describing period perturbations. Beyond F0 and mean Jitter, consistency in cycle detection did not significantly affect correlation levels. Conclusions: The simultaneous audio signal proved useful in verifying the accuracy of HSV quantification measures, particularly for F0, which showed strong agreement between the methods. Discrepancies in other parameters and low correlations between HSV-derived kymography and audio data may suggest the influence of the throat, mouth, and nose resonators, which are added to the glottal signal. While the kymographic analysis based on HSV provides detailed descriptions of vocal fold oscillations, it does not fully capture the three-dimensional structure and complex functionality of the vocal folds. Full article

Children with autism spectrum disorder (ASD) commonly show difficulty in communication and daily functional skills. The use of scripts may help establish these repertoires. Scripts may be visual (e.g., pictures depicting actions), textual (e.g., printed or written sentences depicting actions), or auditory (e.g., recorded or dictated phrases depicting actions). Background/Objectives: The purpose was to assess the efficacy of script fading in establishing the vocal verbal emission of sentences under the control of pictures representing actions from four behavioral sequences (e.g., brushing teeth) in three children with ASD. The effects of the intervention on the emergence of related non-verbal repertoires were evaluated. During intervention, the scripts were textual for one participant, who initially read the sentences. For the remaining two participants, scripts were dictated to them so they could repeat them. Across sessions, scripts were faded out by gradually omitting the words from the sentences. Results: Script fading produced the emission of sentences solely in the presence of pictures (tacts according to a Skinnerian approach of language), replicating a previous study in which the same procedure also established the same type of repertoire. However, as an extension, in the current investigation, related non-verbal actions also emerged. Other previous studies into script fading were not specifically concerned with teaching tacts and probing the emergence of related non-verbal untaught repertoires. Conclusions: The data were interpreted as indicating correspondence between verbal and non-verbal behavior or “say-do” correspondence. The data were discussed in the sense that script fading, for some learners, may improve communication with sentences that impact the acquisition of related non-verbal behavioral chains. Limitations of the research were discussed. Full article

Background/Objectives: This study aims to assess the rate of complications in patients who underwent thyroid surgery and were monitored post-operatively to explore potential correlations between various parameters that may aid in clinical decision making. Methods: An observational retrospective study was conducted on patients who underwent thyroid surgery and were followed up in our Endocrinology Unit. Patients were selected based on strict criteria. The following data were collected: sex; age; type of thyroid disease; pre-operative symptoms due to thyroid pathology; surgical procedures; post-operative complications; histopathological diagnosis; and post-operative blood levels of TSH, PTH, vitamin D, and calcium. Results: Among 340 patients, 25.29% had benign thyroid disease. Total thyroidectomy was performed in 89.4% of cases. Recurrent laryngeal nerve injury was found in 32 patients. Hypocalcemia occurred in 14 patients within 24 h post-operatively. Histopathological examination identified incidental parathyroid tissue in 5.88% of thyroidectomy specimens. Post-operative hypoparathyroidism was observed in 26 patients, and vitamin D deficiency in 68 patients. Conclusions: The study demonstrated that thyroid surgery is quite a safe procedure; however, complications may occur. A statistically significant correlation was found between the type of surgery and the risk of vocal fold palsy, without correlation with the type of thyroid disease. A thorough pre-operative evaluation by a multidisciplinary team may help reduce the risk of post-operative complications. Despite the extensive knowledge of thyroid surgery, small refinements may further improve surgical outcomes. Full article

Background: Voice disorders significantly impact individuals’ physical, functional, and emotional well-being, necessitating comprehensive assessment tools. The Vocal Tract Discomfort Scale (VTDS) assesses the frequency and severity of vocal discomfort symptoms. Despite its global adaptations, no validated Malayalam version has existed. This study aimed to adapt and validate the VTDS for Malayalam speakers (VTDS-M). Method: The study was conducted in two phases: Phase I involved translation and cultural adaptation of VTDS into Malayalam, followed by content validation by native-speaking speech language pathologists; Phase II involved validation of VTDS-M on 150 professional voice users, categorized into normophonic (n = 105) and dysphonic (n = 45) groups based on otolaryngological and perceptual voice evaluations. Participants completed VTDS-M and VHI-M (Voice Handicap Index—Malayalam). Results: The results showed strong internal consistency (Cronbach’s α = 0.827 for frequency, 0.813 for severity). Significant differences were observed between groups for VTDS-M subscales and total scores, confirming its discriminatory capability. ROC analysis established a cut-off score of 11.5, with an AROC of 0.749, 64.4% sensitivity, and 79.0% specificity. Also, VTDS-M correlated positively with VHI-M, especially the physical and emotional subscales. Conclusions: VTDS-M demonstrated reliable psychometric properties and diagnostic accuracy, making it a valuable tool for assessing vocal discomfort in Malayalam-speaking populations specifically among the professional voice users. Future studies should explore its applicability to non-professional voice users with varied severity levels of dysphonia. Full article

Background: Hypokinetic dysarthria is a speech disorder observed in almost 90% of PD patients that can appear at any stage of the disease, usually worsening as the disease progresses. Today, speech therapy intervention in PD is seen as a possible therapeutic option to alleviate and slow down the progression of symptoms. This study aims to investigate the validity of traditional speech therapy in dysarthria with the aim of improving the quality of life of PD patients, by comparing subjective clinical assessment with objective instrumental measures (IOPI and voice analysis). Methods: This is an observational study of 30 patients with hypokinetic dysarthria due to PD. The patients underwent speech therapy treatment with a frequency of three times per week for 12 consecutive weeks. Patients were evaluated at the time of enrollment (T0), at the start of treatment (T1), and at the end of the same (T2). Six months after the end of treatment (T3), a follow-up was performed based on disability and phonatory evaluation. Results: This study showed significant improvements (<0.001) from the start (T1) to the end of treatment (T2), with increases in the Barthel Index score, Robertson Dysarthria Profile, and IOPI measurements for tongue and lip strength, along with enhanced phonometer scores and tongue endurance. Correlations highlighted that tongue endurance decreased with age, CIRS, and MDS-UPDRS, while showing a positive association with MoCA scores. Conclusions: Significant improvements were observed in tongue and lip strength, phonatory duration, intensity, and vocal quality between pre- (T1) and post-treatment (T2). This study underscores the importance of early and continuous speech therapy treatment for comprehensive speech function enhancement. Full article

Objectives: This study aimed to determine the positive predictive value of our NMD Suspicion Criteria in the diagnosis of NMDs. Other clinical factors routinely examined in our voice and swallowing examinations were also investigated to see if they had a significant association with the diagnosis of NMDs. Methods: This study retrospectively investigated the medical charts of patients who visited our Voice and Swallowing outpatient clinic between 2013 and 2022. Patients with previously diagnosed NMDs were excluded from the analysis. Among the remaining patients, we included those that were referred to neurologists for further evaluation due to suspicion of having an NMD based on the NMD Suspicion Criteria. The patients were then divided into groups according to the status of their diagnosis within 2 years of referral as “diagnosed”, “denied”, or “observed”. These three groups of patients were then compared according to the following clinical findings; velopharyngeal insufficiency (VPI), tongue atrophy, impaired tongue movement, dysarthria, vocal fold mobility impairment, dysphagia, involuntary movement, gait disturbances, weight loss, and a sense of fatigue in order to see if they were significantly associated with the diagnosis of NMDs. Results: Of 3769 outpatients without a confirmed diagnosis of NMDs, 37 were referred to neurologists for suspected NMDs, and 19 (51%) were diagnosed with NMDs. VPI and impaired tongue movement were significant diagnostic factors for NMDs (p = 0.014, 0.033). VPI during speech (p = 0.045) was more strongly associated with the diagnosis of NMDs than VPI during swallowing (p = 0.076). Fatigue was a significant related factor for other diseases (non-NMDs) causing Voice and Swallowing problems (p = 0.049). Conclusions: In the outpatient clinic setting, suspicion of NMD should be raised, particularly when VPI and impaired tongue movement are observed, prompting a thorough assessment of velopharyngeal closure during both speech and swallowing. Full article

Background and Objective: Arytenoid dislocation (AD) and subluxation (AS) impact vocal fold mobility, potentially affecting the quality of life. Their management, including the timing and modality of treatment, remains a subject of research. Our primary objective was to assess and compare the available treatment strategies for AS and AD. Material and methods: the protocol was registered on PROSPERO (CRD42023407521). Manuscripts retrieved from a previously published systematic review were evaluated. To comprehensively cover the last 25 years, an updated literature search was conducted, screening PubMed, Scopus, and Cochrane databases. Review Methods: We included studies that reported treatment modalities and the time to treatment (TT) for AS/AD, with outcomes objectively evaluated. Data on treatment success were pooled, and the impact of TT on recovery outcomes was analyzed. Results: Thirteen studies involving 361 patients were included. The majority of cases were attributed to iatrogenic trauma following intubation. Closed reduction (CR) was the primary treatment, with high success rates for both general (success rate: 77%, CI: 62–87%) and local anesthesia (success rate: 89%, CI: 70–97%). The standardized mean difference for the TT effect on treatment outcome was −1.24 (CI: −2.20 to −0.29). Conclusions: The absence of randomized controlled trials and the overall moderate-to-low quality of the studies highlighted the importance of the finding’s careful interpretation. This meta-analysis underscores the effectiveness of CR in managing AS/AD, with both general and local anesthesia yielding high success rates. The findings highlight the importance of TT, suggesting that early intervention is paramount. Future clinical research is needed to further refine these findings and optimize treatment protocols. Full article

Recent advances in emotion recognition through Artificial Intelligence (AI) have demonstrated potential applications in various fields (e.g., healthcare, advertising, and driving technology), with electroencephalogram (EEG)-based approaches demonstrating superior accuracy compared to facial or vocal methods due to their resistance to intentional manipulation. This study presents a novel approach to enhance EEG-based emotion estimation accuracy by emphasizing temporal features and efficient parameter space exploration. We propose a model combining Long Short-Term Memory (LSTM) with an attention mechanism to highlight temporal features in EEG data while optimizing LSTM parameters through Particle Swarm Optimization (PSO). The attention mechanism assigned weights to LSTM hidden states, and PSO dynamically optimizes the vital parameters, including units, batch size, and dropout rate. Using the DEAP and SEED datasets, which serve as benchmark datasets for emotion estimation research using EEG, we evaluate the model’s performance. For the DEAP dataset, we conduct a four-class classification of combinations of high and low valence and arousal states. We perform a three-class classification of negative, neutral, and positive emotions for the SEED dataset. The proposed model achieves an accuracy of 0.9409 on the DEAP dataset, surpassing the previous state-of-the-art accuracy of 0.9100 reported by Lin et al. The model attains an accuracy of 0.9732 on the SEED dataset, recording one of the highest accuracies among the related research. These results demonstrate that integrating the attention mechanism with PSO significantly improves the accuracy of EEG-based emotion estimation, contributing to the advancement of emotion recognition technology. Full article

Extracting behavioral information from animal sounds has long been a focus of research in bioacoustics, as sound-derived data are crucial for understanding animal behavior and environmental interactions. Traditional methods, which involve manual review of extensive recordings, pose significant challenges. This study proposes an automated system for detecting and classifying animal vocalizations, enhancing efficiency in behavior analysis. The system uses a preprocessing step to segment relevant sound regions from audio recordings, followed by feature extraction using Short-Time Fourier Transform (STFT), Mel-frequency cepstral coefficients (MFCCs), and linear-frequency cepstral coefficients (LFCCs). These features are input into convolutional neural network (CNN) classifiers to evaluate performance. Experimental results demonstrate the effectiveness of different CNN models and feature extraction methods, with AlexNet, DenseNet, EfficientNet, ResNet50, and ResNet152 being evaluated. The system achieves high accuracy in classifying vocal behaviors, such as barking and howling in dogs, providing a robust tool for behavioral analysis. The study highlights the importance of automated systems in bioacoustics research and suggests future improvements using deep learning-based methods for enhanced classification performance. Full article

Background: Voice alteration is a recognized complication of thyroid surgery, impacting the quality of life and communication for affected individuals. In this prospective observational study, the Acoustic Voice Quality Index (AVQI) was employed to assess vocal outcomes after thyroidectomy. Method: Between February 2018 and August 2022, 224 patients underwent Thyroid surgery in our department, of which 74 with differentiated thyroid carcinoma (DTC) were enrolled in accordance with the inclusion criteria. Endoscopic findings and AVQI scores were evaluated before and after surgery (voice analysis was conducted using the Praat software program version 6.0.33). Results: Vocal fold impairment was present in 6.76% of patients after surgery (T1), with full recovery within 3 months. During preadmission evaluation, an AVQI score > 2.35 indicating hoarseness was present in 37 patients (despite normal vocal cord motility). Of these, 25 (67.57%), 26 (70.27%), and 24 (17.76%) maintained this trend at T1, T2, and T3, respectively. No significant variation in mean AVQI values was observed based on gender, age, and central neck dissection. Conclusion: AVQI values did not show significant variations comparing pre- and postoperative values. Thyroid surgery for DTC performed by experienced surgeons does not seem to impact significantly on patients’ voice quality. Full article

The curricula of bachelor’s and master’s degrees in education should provide optimal tools for teaching practice. An analysis of these curricula in Spanish universities reveals a lack of vocal training. The aim of the present study is to determine whether vocal training in these courses leads to greater knowledge of vocal patterns and techniques, which could lead to greater satisfaction and a lower tendency to abandon the profession. A descriptive–comparative and predictive quantitative study was carried out using an ex post facto, non-experimental, cross-sectional design. The sample consisted of 519 pre-school, primary, and secondary school teachers from all over Spain. The results have confirmed that there is a correlation between having received initial training in vocal hygiene and singing and a tendency to take additional courses in these areas. Furthermore, there is evidence that women and teachers with vocal disorders of the type studied are more aware of voice care in their profession. Finally, a lack of correlation was observed between the training received and the degree of knowledge about vocal health and hygiene. This suggests that both the quantity and quality of training in this area should be increased. Full article

Room reverberation can affect oral/aural communication and is especially critical in computer analysis of voice. High levels of reverberation can distort voice recordings, impacting the accuracy of quantifying voice production quality and vocal health evaluations. This study quantifies the impact of additive simulated reverberation on otherwise clean voice recordings as reflected in voice metrics commonly used for voice quality evaluation. From a larger database of voice recordings collected in a low-noise, low-reverberation environment, voice samples of a sustained [a:] vowel produced at two different speaker intents (comfortable and clear) by five healthy voice college-age female native English speakers were used. Using the reverb effect in Audacity, eight reverberation situations indicating a range of reverberation times (T20 between 0.004 and 1.82 s) were simulated and convolved with the original recordings. All voice samples, both original and reverberation-affected, were analyzed using freely available PRAAT software (version 6.0.13) to calculate five common voice parameters: jitter, shimmer, harmonic-to-noise ratio (HNR), alpha ratio, and smoothed cepstral peak prominence (CPPs). Statistical analyses assessed the sensitivity and variations in voice metrics to a range of simulated room reverberation conditions. Results showed that jitter, HNR, and alpha ratio were stable at simulated reverberation times below T20 of 1 s, with HNR and jitter more stable in the clear vocal style. Shimmer was highly sensitive even at T20 of 0.53 s, which would reflect a common room, while CPPs remained stable across all simulated reverberation conditions. Understanding the sensitivity and stability of these voice metrics to a range of room acoustics effects allows for targeted use of certain metrics even in less controlled environments, enabling selective application of stable measures like CPPs and cautious interpretation of shimmer, ensuring more reliable and accurate voice assessments. Full article

Background and Objectives: Damage to the vocal folds frequently results in fibrosis, which can degrade vocal quality due to the buildup of collagen and modifications in the extracellular matrix (ECM). Conventional treatments have shown limited success in reversing fibrotic changes. Hepatocyte growth factor (HGF) and c-Met-targeting antibodies are promising due to their potential to inhibit fibrosis and promote regeneration. This research examines the effectiveness of injections containing c-Met agonistic antibodies relative to HGF in reducing fibrosis within a rat model of vocal fold injury. Materials and Methods: Forty-five Sprague Dawley rats were divided into three groups, which were HGF, c-Met agonistic antibody, and the control (PBS). The right vocal folds were injured and treated with HGF or c-Met agonistic antibody injections. RNA isolation and quantitative real-time PCR were performed to assess mRNA levels of fibrosis-related markers at 1 and 2 weeks post-injury. Histopathological analysis was conducted at 3 weeks to evaluate collagen and hyaluronic acid (HA) deposition. Results: Both the HGF and c-Met groups demonstrated reduced type III collagen mRNA expression compared to the PBS group. The c-Met group uniquely maintained fibronectin levels closer to normal. Additionally, the c-Met group showed significantly upregulated expression of hyaluronan synthase (HAS) 1 and HAS 3 at 2 weeks post-injury, indicating enhanced HA synthesis. Histological analysis showed significantly lower collagen deposition and higher HA in the c-Met group than in PBS, confirming superior anti-fibrotic effects and ECM restoration. Conclusions: c-Met agonistic antibody injections outperformed HGF in reducing fibrosis, upregulating HAS expression, and promoting HA deposition in injured vocal folds, highlighting its potential as a superior therapeutic approach for preventing fibrosis and enhancing ECM quality in vocal fold injuries. Further research on functional outcomes in larger models is recommended to validate these findings. Full article

Background: The recommended treatment for early glottic cancer is trans-oral laser microsurgery, with excellent oncological and functional outcomes. The aim of this study is to evaluate oncological and functional outcomes in patients who underwent monolateral type III laser cordectomy for early glottic cancer. Methods: A total of 104 patients were enrolled. Staging, histological type, grading, assessment of surgical margins, mean time of relapse, OS, DFS, and DSS were obtained. Maximum phonation time, GIRBAS score, shimmer, jitter, fundamental frequency, and Yanagihara score were evaluated. Patients were submitted to the VHI-10 questionnaire. Results: Correlations between patients with single recurrence and the anterior commissure involvement were analyzed, as well as correlations between patients with recurrence and the status of margins. Correlations between VHI-10 scores and anterior commissure involvement were analyzed. Conclusions: The recurrence rate was higher in patients with anterior commissure involvement. A significant inversely proportional association between DSS and assessment of surgical margins was observed. The distribution of VHI-10 scores differed significatively in patients with and without anterior commissure involvement. Vocal results reflected mild dysphonia. Full article

The effects of music exposure on vocal performers remain relatively unknown. This study aimed to assess the immediate and long-term effects of music and singing practice on the peripheral auditory system of vocal performers using otoscopy, pure-tone audiometry, and noise dosimetry. The hearing status, sound pressure levels (SPLs), and sound doses of 12 vocal performers with normal hearing at the study’s onset were evaluated. Pre- and post-study questionnaires regarding the participants’ otologic health and music-making activities, as well as repeated hearing evaluations, were implemented. Additionally, noise dosimetry was conducted on each participant’s most vocally active day of the week. Audiometric assessments generally revealed normal hearing thresholds, with some exceptions. Half of the participants exhibited elevated low-frequency thresholds and over half of the participants displayed emerging audiometric “notches” at 6000 Hz. Noise dosimetry measurements indicated that most of the participants were consistently exposed to SPLs during music-making activities that exceeded recommended limits. Questionnaire responses highlighted that the participants often engaged in extra-curricular music-making activities, frequently with piano accompaniment, and with little to no use of hearing protection devices. A few of the participants reported histories of otologic issues and potential hearing problems. Full article