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Uloza V, Pribuišis K, Ulozaite-Staniene N, Petrauskas T, Damaševičius R, Maskeliūnas R. Accuracy Analysis of the Multiparametric Acoustic Voice Indices, the VWI, AVQI, ABI, and DSI Measures, in Differentiating between Normal and Dysphonic Voices. J Clin Med 2023; 13:99. [PMID: 38202106 PMCID: PMC10779457 DOI: 10.3390/jcm13010099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
The study aimed to investigate and compare the accuracy and robustness of the multiparametric acoustic voice indices (MAVIs), namely the Dysphonia Severity Index (DSI), Acoustic Voice Quality Index (AVQI), Acoustic Breathiness Index (ABI), and Voice Wellness Index (VWI) measures in differentiating normal and dysphonic voices. The study group consisted of 129 adult individuals including 49 with normal voices and 80 patients with pathological voices. The diagnostic accuracy of the investigated MAVI in differentiating between normal and pathological voices was assessed using receiver operating characteristics (ROC). Moderate to strong positive linear correlations were observed between different MAVIs. The ROC statistical analysis revealed that all used measurements manifested in a high level of accuracy (area under the curve (AUC) of 0.80 and greater) and an acceptable level of sensitivity and specificity in discriminating between normal and pathological voices. However, with AUC 0.99, the VWI demonstrated the highest diagnostic accuracy. The highest Youden index equaled 0.93, revealing that a VWI cut-off of 4.45 corresponds with highly acceptable sensitivity (97.50%) and specificity (95.92%). In conclusion, the VWI was found to be beneficial in describing differences in voice quality status and discriminating between normal and dysphonic voices based on clinical diagnosis, i.e., dysphonia type, implying the VWI's reliable voice screening potential.
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Affiliation(s)
- Virgilijus Uloza
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, 50061 Kaunas, Lithuania; (V.U.); (K.P.); (T.P.)
| | - Kipras Pribuišis
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, 50061 Kaunas, Lithuania; (V.U.); (K.P.); (T.P.)
| | - Nora Ulozaite-Staniene
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, 50061 Kaunas, Lithuania; (V.U.); (K.P.); (T.P.)
| | - Tadas Petrauskas
- Department of Otorhinolaryngology, Lithuanian University of Health Sciences, 50061 Kaunas, Lithuania; (V.U.); (K.P.); (T.P.)
| | | | - Rytis Maskeliūnas
- Faculty of Informatics, Kaunas University of Technology, 51368 Kaunas, Lithuania
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Semmler M, Lasar S, Kremer F, Reinwald L, Wittig F, Peters G, Schraut T, Wendler O, Seyferth S, Schützenberger A, Dürr S. Extent and Effect of Covering Laryngeal Structures with Synthetic Laryngeal Mucus via Two Different Administration Techniques. J Voice 2023:S0892-1997(23)00228-X. [PMID: 37648625 DOI: 10.1016/j.jvoice.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE The first goal of this study was to investigate the coverage of laryngeal structures using two potential administration techniques for synthetic mucus: inhalation and lozenge ingestion. As a second research question, the study investigated the potential effects of these techniques on standardized voice assessment parameters. METHODS Fluorescein was added to throat lozenges and to an inhalation solution to visualize the coverage of laryngeal structures through blue light imaging. The study included 70 vocally healthy subjects. Fifty subjects underwent administration via lozenge ingestion and 20 subjects performed the inhalation process. For the first research question, the recordings from the blue light imaging system were categorized to compare the extent of coverage on individual laryngeal structures objectively. Secondly, a standardized voice evaluation protocol was performed before and after each administration to determine any measurable effects of typical voice parameters. RESULTS The administration via inhalation demonstrated complete coverage of all laryngeal structures, including the vocal folds, ventricular folds, and arytenoid cartilages, as visualized by the fluorescent dye. In contrast, the application of the lozenge predominantly covered the pharynx and laryngeal surface toward the aryepiglottic fold, but not the inferior structures. All in all, the comparison before and after administration showed no clear effect, although a minor deterioration of the acoustic signal was noted in the shimmer and cepstral peak prominence after the inhalation. CONCLUSIONS Our findings indicate that the inhalation process is a more effective technique for covering deeper laryngeal structures such as the vocal folds and ventricular folds with synthetic mucus. This knowledge enables further in vivo studies on the role of laryngeal mucus in phonation in general, and how it can be substituted or supplemented for patients with reduced glandular activity as well as for heavy voice users.
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Affiliation(s)
- Marion Semmler
- University Hospital Erlangen, Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany.
| | - Sarina Lasar
- University Hospital Erlangen, Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany.
| | - Franziska Kremer
- University Hospital Erlangen, Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany.
| | - Laura Reinwald
- University Hospital Erlangen, Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany.
| | - Fiori Wittig
- University Hospital Erlangen, Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany.
| | - Gregor Peters
- University Hospital Erlangen, Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany.
| | - Tobias Schraut
- University Hospital Erlangen, Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany.
| | - Olaf Wendler
- University Hospital Erlangen, Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany.
| | - Stefan Seyferth
- Department of Chemistry and Pharmacy, Chair of Pharmaceutics, Friedrich-Alexander-University Erlangen-Nürnberg, Cauerstr. 4, 91058 Erlangen, Germany.
| | - Anne Schützenberger
- University Hospital Erlangen, Medical School, Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology Head & Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany.
| | - Stephan Dürr
- University Hospital Regensburg, Department of Otorhinolaryngology, Division of Phoniatrics and Pediatric Audiology, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany.
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Saghiri MA, Vakhnovetsky A, Vakhnovetsky J. Scoping review of the relationship between xerostomia and voice quality. Eur Arch Otorhinolaryngol 2023; 280:3087-3095. [PMID: 36995371 DOI: 10.1007/s00405-023-07941-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 03/25/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE This scoping review aims to synthesize all of the currently available information on how xerostomia correlates with vocal function and the mechanisms that underpin it. METHODS Our scoping review used PubMed, Scopus, Embase, and Web of Science databases to review articles published between January 1999 and July 2022 in accordance with the PRISMA-ScR guidelines. In addition to the academic databases, we also conducted a manual search of Google Scholar. Further investigation was conducted on studies that examined the relationship between xerostomia and vocal function. RESULTS Of the 682 initially identified articles, 21 met our inclusion criteria. Among the included studies, two articles (n = 2) revealed the mechanistic relationship between xerostomia and vocal function. Most studies (n = 12) focused on xerostomia secondary to other underlying conditions or treatments, among which radiotherapy and Sjögren's syndrome were commonly investigated. Seven studies (n = 7) provided details about common vocal parameters measured in studies of xerostomia and the voice. CONCLUSION The literature currently lacks publications regarding the relationship between xerostomia and vocal function. Most of the studies included in this review were about xerostomia secondary to other conditions or medical treatments. Therefore, the impacts on the voice that were observed were very multifaceted and the role of xerostomia alone in phonation could not be ascertained. Nevertheless, it is clear that dryness in the mouth plays some role in vocal function and further research should focus on clarifying and finding the underlying mechanism behind this relationship by incorporating high-speed imaging and cepstral peak prominence analyses.
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Affiliation(s)
- Mohammad Ali Saghiri
- Biomaterial and Prosthodontics Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, 185 South Orange Avenue, Newark, NJ, 07103, USA.
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA.
| | | | - Julia Vakhnovetsky
- Sector of Angiogenesis Regenerative Medicine, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
- Biomaterial and Prosthodontics Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA
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Yamada R, Tanaka Y, Sugimoto H, Kodama N, Yoshida R, Minagi S. Effect of continuous sweet gustatory stimulation on salivary flow rate over time. Arch Oral Biol 2023; 146:105590. [PMID: 36463789 DOI: 10.1016/j.archoralbio.2022.105590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/20/2022] [Accepted: 11/24/2022] [Indexed: 12/02/2022]
Abstract
OBJECTIVE This study aimed to determine changes in saliva secretion and subjective taste intensity during a sustained period with continuous gustatory stimulation. DESIGN Twenty-two healthy adults participated in this study. The selected taste solutions were aspartame, sucralose, and acesulfame potassium, which are nonnutritive sweeteners. The concentrations of sucralose1 and acesulfame potassium were set to show the same sweetness intensity as aspartame. Sucralose2 was twice the concentration of sucralose1. The solution was continuously fed into the oral cavity at a flow rate of 0.04 mL / min through a neck-worn precise infusion system. The salivary flow rate (g/min) after 10 min of intraoral water supply from the device was used as the baseline. Salivary flow rate, subjective taste intensity evaluated by the visual analog scale (VAS), and salivary flow rate relative to the baseline were recorded at 10, 30, 60, and 120 min after the start of the test. RESULTS In the aspartame, sucralose1, and sucralose2 groups, the salivary flow rate increased significantly from 10 min to 120 min after the start of the test when compared to the rate at baseline (p < 0.05). The relative salivary flow rate increased and the VAS value decreased significantly over time and were affected by the time factor (p < 0.001, p = 0.013, respectively) but not by the sweetener-group factor and the interaction effects. CONCLUSIONS Continuous gustatory stimulation may maintain increased salivary production for a sustained period.
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Affiliation(s)
- Ranko Yamada
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, 700-8525 Okayama, Japan
| | - Yuki Tanaka
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, 700-8525 Okayama, Japan
| | - Hikaru Sugimoto
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, 700-8525 Okayama, Japan.
| | - Naoki Kodama
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, 700-8525 Okayama, Japan
| | - Ryusuke Yoshida
- Department of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, 700-8525 Okayama, Japan
| | - Shogo Minagi
- Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, 700-8525 Okayama, Japan
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Inhalative Treatment of Laryngitis Sicca in Patients with Sjögren's Syndrome-A Pilot Study. J Clin Med 2022; 11:jcm11041081. [PMID: 35207348 PMCID: PMC8876981 DOI: 10.3390/jcm11041081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 11/16/2022] Open
Abstract
Xerostomia and keratoconjunctivitis sicca are the main symptoms of Sjögren's syndrome. Often patients also suffer from laryngeal complaints, but there is a lack of specific treatment options. The aim of this study was to evaluate the effect of a liposomal inhalation therapy. Patients with Sjögren's syndrome were included and received a two-month period of liposomal inhalation therapy. The effect was evaluated by standardized questionnaires (patient-reported indices) and measurement of unstimulated whole salivary flow and glandular stiffness. Forty-five patients were included in this study. A comparison of baseline and therapeutic values demonstrated a significant improvement of the EULAR Sjögren's syndrome patient reported index (ESSPRI) with a baseline of 5.0 ± 2.1 and a therapeutic value of 4.1 ± 2.4 (p = 0.012). This improvement was mainly based on the item on dryness within this score. Overall, the therapy was well tolerated. In conclusion, an inhalative application of liposomes had a beneficial effect on the reported dryness in patients with Sjögren's syndrome. A first insight into the effect of inhalation therapy on laryngeal symptoms could thus be obtained and at the same time the basis was created on which case calculations can be carried out in the future.
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Luo SD, Chiu TJ, Chen WC, Wang CS. Sex Differences in Otolaryngology: Focus on the Emerging Role of Estrogens in Inflammatory and Pro-Resolving Responses. Int J Mol Sci 2021; 22:ijms22168768. [PMID: 34445474 PMCID: PMC8395901 DOI: 10.3390/ijms22168768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 12/02/2022] Open
Abstract
Otolaryngology (also known as ear, nose, and throat (ENT)) diseases can be significantly affected by the level of sex hormones, which indicates that sex differences affect the manifestation, pathophysiology, and outcomes of these diseases. Recently, increasing evidence has suggested that proinflammatory responses in ENT diseases are linked to the level of sex hormones. The sex hormone receptors are present on a wide variety of immune cells; therefore, it is evident that they play crucial roles in regulating the immune system and hence affect the disease progression of ENT diseases. In this review, we focus on how sex hormones, particularly estrogens, regulate ENT diseases, such as chronic rhinosinusitis, vocal fold polyps, thyroid cancer, Sjögren’s syndrome, and head and neck cancers, from the perspectives of inflammatory responses and specialized proresolving mediator-driven resolution. This paper aims to clarify why considering sex differences in the field of basic and medical research on otolaryngology is a key component to successful therapy for both males and females in the future.
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Affiliation(s)
- Sheng-Dean Luo
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (S.-D.L.); (W.-C.C.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Tai-Jan Chiu
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Wei-Chih Chen
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (S.-D.L.); (W.-C.C.)
| | - Ching-Shuen Wang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Correspondence: ; Tel.: +886-227-361-661 (ext. 5166)
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