The Effects of the Menstrual Cycle on Vibratory Characteristics of the Vocal Folds Investigated With High-Speed Digital Imaging

Assessment of the Interdependencies Between High-Speed Videoendoscopy and Simultaneously Recorded Audio Data in Various Glottal Pathologies

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.

Acute Vocal Fold Hemorrhage: Retrospective Analysis in a Voice Unit

OBJECTIVES

To describe our experience in diagnosis, evaluation, management and evolution of adult patients diagnosed with vocal fold hemorrhage (VFH) in the Voice Unit at Universidad Católica Clinical Hospital Santiago, Chile.

STUDY DESIGN

Retrospective chart review.

METHODS

Adult patients diagnosed with VFH between 2012 and 2020 were included. Demographic data, medical and vocal history, vocal symptoms and questionnaires, laryngeal videostroboscopy, treatment, and follow-up controls were reviewed.

RESULTS

A total of 34 patients were included, 52.9% (18) patients were female and 47.1% (16) male. Mean age was 42 years (22-76 years) and 47.1% were professional voice users. Principal voice symptoms were dysphonia (32/34), vocal fatigue (21/34) and throat clearing (17/34). Twenty-six (76.5%) patients had VFH and a concomitant lesion in the same vocal fold (VF), being a hemorrhagic polyp the most prevalent associated lesion (61.8%). All patients were managed initially with voice rest, showing improvement at first follow up visit according to VRQOL-STD (mean difference -32.43, P = 0.009) and VHI-10 (mean difference 11.22, P = 0.036), and laryngeal videostroboscopic resolution in 66.7% (8/12) at a mean 12.5 (range 6-30) days.

CONCLUSIONS

VFH is an infrequent phonotraumatic condition. More studies are needed to advance in knowledge of this pathology as there is contradictory evidence in the literature regarding predisposing factors, evolution and prognosis of this condition.

An investigation of syrinx morphometry and sound frequency association during the chirping period in lovebirds ( Agapornis fischeri)

Background: In the issue of biodiversity, the domestication of birds as pets and trade animals requires special attention as a conservation effort. Lovebirds ( Agapornis fischeri) are popular birds worldwide, due to their varied ornamentation and melodic chirping sound. Syrinx structure is suspected to be the main source of sound production during the chirping period. This study aimed to investigate syrinx morphometry and its correlation with sound frequency produced in lovebirds. Methods: A total of 24 lovebirds of different ages and gender were investigated. Polymerase chain reaction method was performed to determine lovebird gender, meanwhile bird age was identified based on post-hatch recordings at the breeding farm. Thus, we enrolled male (n=12) and female (n=12) lovebirds aged 2 (n=4), 3 (n=4), and 4 (n=4) months in the investigation group, respectively. Fast Fourier Transform (FFT) was performed to evaluate sound frequency during chirping period. Then, syrinx morphometry was identified using a topographic approach and methylene blue staining. Each variable was evaluated with Image J software and vernier caliper. Results: Based on a topographical approach, we reported the general cartilage structure of the tracheosyringeal, bronchosyringeal, paired protrusions, tracheolateral muscles, sternotracheal muscles, and syringeal muscles in lovebird syrinx. In particular, the tympaniform membranes lateral lead a crucial role in modulating the frequency of male lovebirds more significantly (p=0,009) compared to female. On the other hand, the tympaniform membranes lateral dexter (p=0,02) and sinister (p=0,05) in females showed wider compared to male. We also reported a negative correlation between sound frequency compared to tympaniform membranes lateral dexter (y = -913,56x + 6770,8) and sinister (y = -706,16x + 5736). Conclusions: It can be concluded that the tympaniform membranes lateral produced the lovebirds' primary sound. The sound frequency of male lovebirds was higher compared to female, however negatively correlated with the area of tympaniform membranes lateral.

High-Speed Characterization of Vocal Fold Vibrations in Normally Cycling and Postmenopausal Women: Randomized Double-Blind Analyses

Purpose The aim of this study was to examine the influence of menstrual cycle phases (follicular, ovulatory, luteal, and ischemic) and hormone levels (estradiol, testosterone, progesterone, and neuropeptide Y) on vocal fold vibrations in reproductive and postmenopausal women. Method Glottal area waveforms were extracted from high-speed videoendoscopy during sustained phonation, inhalation phonation, and voice onset/offset in the reproductive (n = 15) and postmenopausal (n = 13) groups. Linear mixed-model analysis was conducted to evaluate hormone levels and high-speed videoendoscopy outcome variables between the reproductive and postmenopausal groups. In the reproductive group, simple linear regression and multiple regression were conducted to determine the effects of hormones on the dependent variables. Results Group differences between reproductive and postmenopausal women were identified for stiffness index, oscillatory onset time, and oscillatory offset time. Neuropeptide Y hormone in the ischemic phase significantly predicted changes in the reproductive group for some dependent variables; however, the relationship varied for sustained phonation and inhalation phonation. Conclusion These findings provide preliminary evidence that vocal fold vibrations in the reproductive group are different predominantly in the ischemic phase due to neuropeptide Y changes.

Application of High Speed Digital Imaging (HSDI) technique and voice acoustic analysis in the diagnosis of the clinical form of Presbyphonia in women

<b>Introduction:</b> The aging process of voice begins after the age of 60 and has an individually variable course. Voice quality disorders at this age are called senile voice (Presbyphonia or Vox Senium). Voice pathology is particularly severe in women. The aim of the study was to diagnose the clinical form of Presbyphonia in elderly women using High Speed Digital Imaging (HSDI) and acoustic voice analysis. <br><b>Material and methods:</b> Study included 50 elderly women (average age 69) with dysphonia (Group I). Control group (Group II) included 30 women (average age 71) without voice quality disorders. Visualization assessment has been conducted with High Speed Digital Imaging (HSDI) with High Speed camera (HS). Acoustic evaluation of voice included analysis isolated vowel "a" and continuous linguistic text with Diagnoscope Specialista software. Maximum Phonation Time (MPT) has been determined. <br><b>Results:</b> In Group I, 78% of women revealed vocal folds vibrations asymmetry, vibration amplitude increase, Mucousal Wave (MW) limitation and Type D glottal insufficiency (GTs). Acoustic voice analysis proved decrease in F0, increase in Jitter, Shimmer, NHR. In 22% of women, next to vibrations asymmetry, vibration amplitude reduction and MW limitation, Type E glottal insufficiency (GTs) have been found. Acoustic voice analysis revealed slight decrease in F0 and the presence of numerous non-harmonic components in the glottis region. <br><b>Conclusions:</b> Vocal folds visualization with HSDI showed edema, less often atrophy in elderly women. Both forms of dysphonia were caused abnormal values of F0, Jitter, Shimmer, NHR in the acoustic voice evaluation and significant reduction of MPT.

Fundamental Frequency Variations Across the Menstrual Cycle and the Use of an Oral Contraceptive Pill

Purpose Concentrations of sex steroid hormones-estrogens, progesterone, and testosterone-have been associated with premenstrual and menstrual vocal symptoms. However, the extent to which these symptoms may be reflected on acoustical features of the voice is still debated. This study investigates variations in fundamental frequency (f _o) and related parameters in connected speech across phases of the menstrual cycle and during the use of a combined oral contraceptive pill (OCP). Method Electrolaryngographic recordings were made, and blood samples were collected at three different phases of the menstrual cycle-menstrual, follicular, and luteal-for placebo and OCP use. These two conditions were blindly and randomly allocated in the study. Speaking f _o (SFF), SFF standard deviation, SFF rate of change, SFF slope, maximum and minimum f _o, and f _o range were extracted for nine healthy females while reading a phrase from the Rainbow Passage. Concentrations of sex hormones were analyzed in serum. Nonparametric statistical tests were carried out to assess differences between phases and conditions. Results SFF, its standard deviation, and maximum f _o were significantly different between phases of the menstrual cycle for placebo use only. Menstrual phase showed the lowest values. Maximum and minimum f _o were significantly different between placebo and OCP use for menstrual and follicular phases, respectively. Conclusions Fluctuations in sex steroid hormones across the menstrual cycle alter f _o in speech more than a particular hormonal concentration. OCP use seems to have a stabilizing effect on the voice relative to f _o and related parameters in speech.

Adductory Vocal Fold Kinematic Trajectories During Conventional Versus High-Speed Videoendoscopy

Objective Prephonatory vocal fold angle trajectories may supply useful information about the laryngeal system but were examined in previous studies using sigmoidal curves fit to data collected at 30 frames per second (fps). Here, high-speed videoendoscopy (HSV) was used to investigate the impacts of video frame rate and sigmoidal fitting strategy on vocal fold adductory patterns for voicing onsets. Method Twenty-five participants with healthy voices performed /ifi/ sequences under flexible nasendoscopy at 1,000 fps. Glottic angles were extracted during adduction for voicing onset; resulting vocal fold trajectories (i.e., changes in glottic angle over time) were down-sampled to simulate different frame rate conditions (30-1,000 fps). Vocal fold adduction data were fit with asymmetric sigmoids using 5 fitting strategies with varying parameter restrictions. Adduction trajectories and maximum adduction velocities were compared between the fits and the actual HSV data. Adduction trajectory errors between HSV data and fits were evaluated using root-mean-square error and maximum angular velocity error. Results Simulated data were generally well fit by sigmoid models; however, when compared to the actual 1,000-fps data, sigmoid fits were found to overestimate maximum angle velocities. Errors decreased as frame rate increased, reaching a plateau by 120 fps. Conclusion In healthy adults, vocal fold kinematic behavior during adduction is generally sigmoidal, although such fits can produce substantial errors when data are acquired at frame rates lower than 120 fps.

Fertility-Dependent Acoustic Variation in Women's Voices Previously Shown to Affect Listener Physiology and Perception

Previous research demonstrates that listeners perceive women's voices as more attractive when recorded at high compared to low fertility phases of the menstrual cycle. This effect has been repeated with multiple voice recording samples, but one stimuli set has shown particularly robust replications. First collected by Pipitone and Gallup (2008), women were recorded counting from 1-10 on approximately the same day and time once a week for 4 weeks. Repeatedly, studies using these recordings have shown that naturally cycling women recorded at high fertility are rated as more attractive compared to voices of the same women at low fertility. Additionally, these stimuli have been shown to elicit autonomic nervous system arousal and precipitate a rise in testosterone levels among listeners. Although previous studies have examined the acoustic properties of voices across the menstrual cycle, they reach little consensus. The current study evaluates Pipitone and Gallup's voice stimuli from an acoustic perspective, analyzing specific vocal characteristics of both naturally cycling women and women taking hormonal contraceptives. Results show that among naturally cycling women, variation in vocal amplitude (shimmer) was significantly lower in high fertility recordings compared to the women's voices at low fertility. Harmonics-to-noise ratio and variation in voice pitch (jitter) also fluctuated systematically across voices sampled at different times during the menstrual cycle, though these effects were not statistically significant. It is possible that these acoustic changes could account for some of the replicated perceptual, hormonal, and physiological changes documented in prior literature using these voice stimuli.

Vocal Fold Vibration in Older Adults With and Without Age-Related Dysphonia

PURPOSE

The purpose of this study was to identify the extent to which 7 measures of glottal area timing and regularity differ between older adults with and without age-related dysphonia (ARD).

METHOD

Laryngeal high-speed videoendoscopy was completed at 4,000 frames per second for 42 adults aged 70 years and older (ARD: 9 female, 5 male; control group: 15 female, 13 male). Relative glottal gap, open quotient, speed index, maximum area declination rate, harmonics-to-noise ratio, harmonic richness factor, and standard deviation of fundamental frequency were measured from a 0.5-s segment of the glottal area waveform. Eta squared (η2) was computed to estimate group effect.

RESULTS

Small effect sizes (η2 = .18-.35) were present for relative glottal gap, open quotient, maximum area declination rate, harmonic richness factor, and standard deviation of fundamental frequency. Speed index and glottal harmonics-to-noise ratio did not explain group membership (η2 = .001 and .05, respectively).

CONCLUSION

These findings provide evidence that vocal fold vibration in ARD is different than in normal aging, whereas the overlap in values for every measure is consistent with the concept that normal aging and ARD exist as a continuum of health and disease.