Voice Quality and Gender Stereotypes: A Study of Lebanese Women With Reinke's Edema

Reinke's Edema: New Insights into Voice Analysis, a Retrospective Study

PURPOSE

Reinke's edema (RE) is a pathological condition involving increased volume of the vocal folds and resulting in significant impact on speech, fundamental frequency, and vocal range. Literature reports few studies which analyze vocal features according to the severity of RE. The aims of this study were to investigate the aerodynamics, acoustic characteristics, and sound spectrograms of a group of RE patients and to assess whether there was any correlation with their endoscopic grading.

METHODS

A total of 98 patients were included in the study, 49 patients with RE and 49 healthy volunteers (HV). Multidimensional Voice Program was used to perform objective voice assessment. Maximum phonation time (MPT) and Voice Handicap Index (VHI) questionnaire were collected. The spectrograms of the vowel /a/ and of the word /aiuole/, which contains the five Italian vowels, of each patient were analyzed according to the classification of Yanaghiara modified by Ricci Maccarini and De Colle. Laryngological assessment was used to record vocal folds morphology according to Yonekawa's classification. Univariate analysis was used to compare group outcomes. Bivariate analysis was used to compare endoscopic grading and voice analysis results.

RESULTS

Univariate analysis of the HV and RE groups revealed statistically significant differences (P < 0.05) for the following parameters: jitter%, shimmer%, harmonic-to-noise ratio (NHR), voice turbulence index (VTI), MPT, VHI except for soft phonation index. Spearman's rank correlation showed a positive correlation between vocal parameters such as jitter%, shimmer%, NHR, VTI, and RE gradings. A negative correlation was found between MPT and RE gradings. Bivariate analysis indicated a strong positive correlation between RE grading and the spectrogram classification performed both with the vowel / a / (Rho 0.86; P = 0.0001) and with the word / aiuole / (Rho 0.81; P = 0.0001).

CONCLUSION

The present study demonstrates that patients with RE have different voice characteristics compared to HV. In particular, the voice analysis highlighted acoustic parameters that correlated to differing degrees of RE. In addition, spectrogram analysis should be considered for acoustic assessments before and after medical and surgical therapy and also in forensic medicine.

Cross-Gender Differences in English/French Bilingual Speakers: A Multiparametric Study

The present study concerns speech productions of female and male English/French bilingual speakers in both reading and semi-spontaneous speech tasks. We investigated various acoustic parameters: average fundamental sound frequency (F0), F0 range, F0 variance (SD), vowel formants (F1, F2, and F3), voice onset time (VOT) and H1-H2 (intensity difference between the first and the second harmonic frequencies, used to measure phonation type) in both languages. Our results revealed a significant effect of gender and language on all parameters. Overall, average F0 was higher in French while F0 modulation was stronger in English. Regardless of language, female speakers exhibited higher F0 than male speakers. Moreover, the higher average F0 in French was larger in female speakers. On the other hand, the smaller F0 modulation in French was stronger in male speakers. The analysis of vowel formants showed that overall, female speakers exhibited higher values than males. However, we found a significant cross-gender difference on F2 of the back vowel [u:] in English, but not on the vowel [u] in French. VOT of voiceless stops was longer in Female speakers in both languages, with a greater difference in English. VOT contrast between voiceless stops and their voiced counterparts was also significantly longer in female speakers in both languages. The scope of this cross-gender difference was greater in English. H1-H2 was higher in female speakers in both languages, indicating a breathier phonation type. Furthermore, female speakers tended to exhibit smaller H1-H2 in French, while the opposite was true in males. This resulted in a smaller cross-gender difference in French for this parameter. All these data support the idea of language- and gender-specific vocal norms, to which bilingual speakers seem to adapt. This constitutes a further argument to give social factors, such as gender dynamics, more consideration in phonetic studies.

Who or what has the capacity to influence voice production? Development of a transdisciplinary theoretical approach to clinical practice addressing voice and the communication of speaker socio-cultural positioning

Purpose: The purpose of this conceptual study was to develop a transdisciplinary theoretical approach to clinical practice in the area of voice that is informed by contemporary clinical and social sciences theories of voice production.Method: We used theoretical sampling to survey the clinical voice literature for different conceptualisations of forces that contribute to voice production and analysed these forces' capacity to act ("agency") on voice. We classified the selected conceptualisations according to wider theoretical perspectives that informed them and evaluated their capacity to account for the complexity of voice production.Result: We identified biological determinist, constructionist, and socio-cultural mediation theories as informing the various conceptualisations of voice production and agency. Finding all theories identified in the clinical voice literature inadequate, the conceptualisation of agency as a bioculturally mediated capacity to act was explored and found to be most suitable for a new transdisciplinary theoretical approach to clinical practice in the area of voice.Conclusion: The inextricable interplay between speaker, professional, and listener practices and supra-individual biocultural forces in voice production must be acknowledged. Clients need to be prepared to deal confidently with the multi-faceted, dynamic, and unpredictable nature of how voice function and socio-cultural positioning is produced in social encounters.

Contact Pressure Between the Vocal Folds in Reinke's Edema: Experimental Observations on an Excised Human Larynx

OBJECTIVE

To analyze the range of values of the contact pressure between the membranous vocal folds with Reinke's edema and to compare it to those observed in the absence of such a lesion.

METHODS

Two human larynges were separately tested on the experimental bench, one of them with a bilateral loose swelling of the vocal folds. Once in a glottal prephonatory configuration, airflow was increased until achievement of self-sustained oscillations while recording aerodynamic, acoustic, electroglottographic data, and contact pressure between the folds.

RESULTS

We observed well-documented variations in acoustical parameters, as the decrease of the fundamental frequency and the increase of the phonation threshold pressure. The results of the study also point to a significant increase in the amplitude of the contact pressure in presence of the Reinke's edema, and a lower degree of harmonicity of the produced sounds.

CONCLUSION

This is the first report of ex vivo study of a larynx with Reinke's edema. It highlights the increase in the contact pressure during phonation, which possibly contributes to sustain the lesion once it appeared.

Percepção auditiva de juízes leigos quanto ao gênero de mulheres com edema de Reinke

RESUMO Objetivo Investigar a percepção auditiva de juízes leigos quanto ao gênero de mulheres com edema de Reinke, relacionada com o grau do edema e a frequência fundamental da voz. Método Estudo observacional, analítico e transversal. Participaram 46 juízes leigos que analisaram 48 vozes disfônicas - 24 vozes de mulheres com Edema de Reinke (Grupo Edema de Reinke - GER) e 24 vozes de mulheres e homens com outros tipos de disfonias (Grupo Controle - GC). Os juízes analisaram a contagem de números de 1 a 10 e julgaram as vozes como pertencentes a homem ou mulher, além de descreverem também se tinham certeza ou dúvida quanto à resposta. Os resultados do GER foram associados ao Grau do Edema (1, 2 ou 3) e à frequência fundamental média (F0), analisada por meio da vogal /Ɛ/. Resultados Observou-se que a porcentagem de erros em relação ao gênero foi maior no GER quando comparada à do GC, o percentual de certezas quanto ao gênero foi maior no GC. No GER, edemas de grau 1 ocasionaram menos erros quando comparados aos graus 2 e 3. A média da F0 das mulheres cujas vozes foram julgadas como masculinas (141 Hz) foi menor do que as identificadas corretamente (149 Hz). Conclusão Por meio da avaliação de juízes leigos, as vozes das mulheres com edema de Reinke são identificadas como vozes masculinas. O aumento do grau do edema e a redução da F0 estão relacionados à maior quantidade de erros e/ou dúvidas em relação à identificação do gênero de mulheres com edema de Reinke .

Seeing Speech Production Through the Window of Complex Interactions: Introduction to the Supplement of Select Papers From the 10th International Seminar on Speech Production (ISSP) in Cologne

As the famous linguist and anthropologist C. Hockett noted about 30 years ago, "What one sees of language, as of anything, depends on the angle of view, and different explorers approach from different directions. Unfortunately, sometimes they become so enamored of their particular approach that they incline to scoff at any other, so that instead of everybody being the richer for the variety, everybody loses. … It is obviously impossible to see all of anything from a single vantage point. So it is never inappropriate to seek new perspectives" (Hockett, 1987, p. 1). This supplement takes such a broad perspective and contains a selection of peer-reviewed papers seeing speech production through the window of complex interactions between physical, linguistic, social, and communicative factors. Papers were presented at the 10th International Seminar on Speech Production in Cologne. We hope to encourage the reader to continue working in this exciting direction.