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Şimşek S, Aydinli FE, Taşkin A, Başar K, Yilmaz T, Özcebe E. Exploring the Relationship Between Acoustic Measurements and Self-Perception of Voice in Trans Women. J Voice 2024:S0892-1997(24)00086-9. [PMID: 38677906 DOI: 10.1016/j.jvoice.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE This study aimed to explore the strength and direction of the relationship between spectral cepstral-based, time-based acoustic measures and the self-perception of voice in trans women. METHODS Forty-eight trans women were included in the study. Analysis of the sustained vowel phonation was performed using Multidimensional Voice Profile Analysis (MDVP), and spectral-cepstral analyses of the sustained vowel phonation, all-voiced weighted sentence, and spontaneous speech were made via Analysis of Dysphonia in Speech and Voice (ADSV) software. For self-perceptual evaluations, the Trans Woman Voice Questionnaire (TWVQ) and the Self-perception of Voice Femininity Scale (SPVF) were used. The correlation between MDVP, spectral-cepstral parameters, and TWVQ and SPVF scores was calculated. RESULTS The present study found a positive relationship between F0, SPVF, and TWVQ. Among the perturbation parameters, the jitter was the only one found to correlate with SPVF and TWVQ. The CPPF0 parameter was found to be associated with a more feminine voice perception and a higher voice-related quality of life in all speech samples in the present study. In addition, higher CPP values achieved from vowel phonation were associated with less feminine voice perception and lower voice-related quality of life. The present study also suggests a weak correlation with the SPVF and Cepstral Peak Prominence Standard Deviation (CPPF0 SD) of the spontaneous speech sample in a negative direction. CONCLUSIONS This study found weak and moderate levels of correlations between F0, jitter (%), CPP, CPPF0, CPPF0 SD parameters, and self-perceptual measures. These findings suggested that such a level of relationship is attributable to the fact that these tools evaluate different aspects of voice in accordance with the International Classification of Functioning System. According to this pioneering study, it would be beneficial to incorporate spectral-cepstral measures into the objective assessment protocol for trans women's voices.
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Affiliation(s)
- Sinem Şimşek
- Hacettepe University, Faculty of Health Science, Department of Speech and Language Therapy, Ankara, Turkey
| | - Fatma Esen Aydinli
- Hacettepe University, Faculty of Health Science, Department of Speech and Language Therapy, Ankara, Turkey.
| | - Ayşenur Taşkin
- Hacettepe University, Faculty of Health Science, Department of Speech and Language Therapy, Ankara, Turkey
| | - Koray Başar
- Hacettepe University, Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
| | - Taner Yilmaz
- Hacettepe University, Faculty of Medicine, Department of Ear-Nose-Throat, Ankara, Turkey
| | - Esra Özcebe
- Hacettepe University, Faculty of Health Science, Department of Speech and Language Therapy, Ankara, Turkey
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Lin Y, Cheng L, Wang Q, Xu W. Effects of Medical Masks on Voice Assessment During the COVID-19 Pandemic. J Voice 2023; 37:802.e25-802.e29. [PMID: 34116888 DOI: 10.1016/j.jvoice.2021.04.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/16/2021] [Accepted: 04/27/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Voice assessment is of great significance to the evaluation of voice quality. Our study aims to explore the effects of medical masks on healthy people in acoustic, aerodynamic and formant parameters during the COVID-19 pandemic. In addition, we also attempted to verify the differences between different sexes and ages. METHODS Fifty-three healthy participants (25 males and 28 females) were involved in our study. The acoustic parameters, including fundamental frequency (F0), sound pressure level (SPL), percentage of jitter (%), percentage of shimmer (%), noise to harmonic ratio (NHR) and cepstral peak prominence (CPP), aerodynamic parameter (maximum phonation time, MPT) and formant parameters (formant frequency, F1, F2, F3) without and with wearing medical masks were included. We further investigated the potential differences in the impact on different sexes and ages (≤45 years old and >45 years old). RESULTS While wearing medical masks, the SPL significantly increased (71.22±4.25 dB, 72.42±3.96 dB, P = 0.021). Jitter and shimmer significantly decreased (jitter 1.19±0.83, 0.87±0.67 P = 0.005; shimmer 4.49±2.20, 3.66±2.02 P = 0.002), as did F3 (2855±323.34 Hz, 2781.89±353.42 Hz P = 0.004). F0, MPT, F1 and F2 showed increasing trends without statistical significance, and NHR as well as CPP showed little change without and with wearing medical masks. There were no significant differences seen between males and females. Regarding to age, a significant difference in MPT was seen (>45-year-old 16.15±6.98 s, 15.38±7.02 s; ≤45-year-old 20.26±6.47 s, 21.44±6.98 s, P = 0.032). CONCLUSION Healthy participants showed a significantly higher SPL, a smaller perturbation and an evident decrease in F3 after wearing medical masks. These changes may result from the adjustment of the vocal tract and the filtration function of medical masks, leading to the stability of voices we recorded being overstated. The impacts of medical masks on sex were not evident, while the MPT in the >45-year-old group was influenced more than that in the ≤45-year-old group.
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Affiliation(s)
- Yuhong Lin
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Liyu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qingcui Wang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wen Xu
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
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Castillo-Allendes A, Guzmán-Ferrada D, Hunter EJ, Fuentes-López E. Tracking Occupational Voice State with a Visual Analog Scale: Voice Quality, Vocal Fatigue, and Effort. Laryngoscope 2023; 133:1676-1682. [PMID: 36134759 DOI: 10.1002/lary.30398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/03/2022] [Accepted: 08/17/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Due to elevated vocal health risk in industries such as call centers, there is a need to have accessible and quick self-report tools for voice symptoms. This study aimed to determine if the concurrent and construct validity of three visual analog scales (VASs) of voice quality and symptoms could be used as a screening tool in call center agents. METHODS A cross-sectional study was carried out in three call center companies. The Voice Handicap Index-10 (VHI-10) and a vocal hygiene and symptoms survey were administered to 66 call center workers. Further, acoustic parameters including harmonics-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPs), L1-L0 slope, and Alpha ratio were collected. Finally, workers completed three VASs capturing self-perception of vocal effort (VAS-1), voice quality (VAS-2), and vocal fatigue (VAS-3). Linear regression models with bootstrapping evaluated the possible relationship between the three VASs measurements, self-perceived vocal symptoms, and acoustic parameters. RESULTS VAS-1 scores were associated with HNR and voice breaks, VAS-2 with voice breaks, and VAS-3 with Alpha ratio. Using the area under a receiver operating characteristic curve (AUC), the highest AUC for detecting an altered VHI-10 questionnaire score was observed for the three VASs. Also, the highest AUC for detecting altered CPPs was reached for the VAS-1. CONCLUSIONS VAS as a self-report instrument of vocal symptoms is related to psychosocial voice impairment and alterations of acoustic voice parameters in call center workers. Such instruments could be easily implemented to identify voice complaints in these populations. LEVEL OF EVIDENCE 2 (Diagnosis research question) Laryngoscope, 133:1676-1682, 2023.
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Affiliation(s)
- Adrián Castillo-Allendes
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan, USA
| | - Daniel Guzmán-Ferrada
- Escuela de Fonoaudiología, Facultad de Ciencias de la Salud, Universidad Bernardo O'Higgins, Santiago, Chile
| | - Eric J Hunter
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan, USA
| | - Eduardo Fuentes-López
- Carrera de Fonoaudiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia, Universidad Católica de Chile, Santiago, Chile
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Thijs Z, Knickerbocker K, Watts CR. The Degree of Change and Relationship in Self-perceived Handicap and Acoustic Voice Quality Associated With Voice Therapy. J Voice 2022:S0892-1997(22)00130-8. [PMID: 35667985 DOI: 10.1016/j.jvoice.2022.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Outcome measures describing acoustic voice quality and self-perceived vocal handicap are commonly used in clinical voice practice. Previous reports of the relationship between acoustic and self-perceived measures have found only limited associations, but it is unclear if acoustic measures associated with voice quality and self-perceived voice handicap change in a similar manner over the course of voice treatment. The current study, therefore, considered the relationship between the degree of change in Acoustic Voice Quality Index (AVQI) and Voice Handicap Index (VHI-30 and VHI-10) in dysphonic patients receiving treatment in a private practice voice clinic. METHODS Data were collected retrospectively from patient records of a private practice voice clinic over 80 consecutive months. For each patient, their voice disorder diagnosis, age, and biological sex were collected as well as pre-and post-treatment measures of the AVQI and VHI-30 or VHI-10 depending on which version was used. Correlations were calculated between the AVQI and VHI-30 and the AVQI and VHI-10 before and after treatment as well as for the percentage change of AVQI and VHI-30/VHI-10. Friedman and Kruskal-Wallis tests were used to determine the pre-and post-treatment effect and group differences respectively. RESULTS Seventy-eight patients were included in the analyses. The scores of the AVQI (χ²[1] = 24.01, P < 0.001), VHI-30 (χ²[1] = 18.00, P < 0.001), and VHI-10 (χ²[1] = 38.35, P < 0.001) all improved significantly after treatment. However, correlations between the AVQI and VHI-30, and the AVQI and VHI-10 were all non-significant, except for a moderate correlation between the AVQI and VHI-10 before treatment (r[43] = 0.31, P = 0.04). The percentage change of the AVQI and the VHI-30/VHI-10 did not correlate significantly. CONCLUSIONS Voice therapy significantly improved acoustic and self-perceived vocal outcome measures. However, there was no significant relationship between these measures before or after treatment, nor was there a relationship in their degree of change. Results support the notion that VHI and AVQI measure unique constructs and that voice therapy can have a positive impact on both.
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Affiliation(s)
- Zoë Thijs
- Texas Christian University, Harris College of Nursing and Health Sciences, Fort Worth, Texas.
| | - Kristie Knickerbocker
- Texas Christian University, Harris College of Nursing and Health Sciences, Fort Worth, Texas; A tempo Voice Center, Fort Worth, Texas
| | - Christopher R Watts
- Texas Christian University, Harris College of Nursing and Health Sciences, Fort Worth, Texas
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Abstract
PURPOSE The purpose of this study was to explore the effects of medical masks on the voice quality of patients with voice disorders. METHOD We included 106 patients diagnosed with voice disorders. Among them, 59 were diagnosed with vocal-fold benign lesions, 27 with insufficient glottis closure, and 20 with precancerous lesions/early-stage glottic carcinoma. Perceptual parameters (GRBAS [grade, roughness, breathiness, asthenia, strain] scale), acoustic parameters (f o, sound pressure level [SPL], jitter, shimmer, noise-to-harmonic ratio [NHR], and cepstral peak prominence [CPP]), and maximum phonation time (MPT) without and with medical masks were analyzed. Changes in the GRBAS scale after wearing medical masks were also evaluated. RESULTS With medical mask wearing, the G, R, and B scales in the vocal-fold benign lesion and insufficient glottic closure groups decreased, with a statistical significance seen in the G and R scales of the vocal-fold benign lesion group (G 1.07 ± 0.59, 0.95 ± 0.68, p < .01; R 1.07 ± 0.59, 0.95 ± 0.68, p < .01). The B scale in the precancerous lesions/early-stage glottic carcinoma (95%) and vocal-fold benign lesion groups (83%) and R scale in the insufficient glottic closure group (77.8%) were stable with mask wearing. f o and SPL in the vocal-fold benign lesion group and f o and jitter in the insufficient glottic closure group increased significantly with medical masks. The NHR and CPP in each group changed little, and all the parameters in the precancerous lesions/early-stage glottic carcinoma group showed no significant change. CONCLUSIONS The effects of medical masks on the voice quality of patients with voice disorders were associated with the type of the disease, degree of hoarseness, and subjective scale influencing specific voice disorder. When wearing medical masks, the pitch and loudness of patients increased as compensation. Medical masks had the least impact on the precancerous lesions/early-stage glottic carcinoma group.
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Affiliation(s)
- Yuhong Lin
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, China
| | - Liyu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, China
| | - Qingcui Wang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, China
| | - Wen Xu
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, China
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Jin X, Liu W, Wang J, Xiao Z, Niu Y, Chen B, Zhao Y, Dai J. Clinical study of injectable collagen scaffold with autologous fat cells for repair of severe vocal fold injury. Biomed Mater 2022; 17:035004. [PMID: 35350000 DOI: 10.1088/1748-605x/ac61fd] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 03/29/2022] [Indexed: 11/11/2022]
Abstract
Cell retention and survival after transplantation remains a major problem for long-term efficiency in therapy of severe vocal fold injury with autologous cells. In this study, injectable collagen scaffold was used to deliver autologous fat cells (AFCs) for repairing of severe vocal fold injury. We found injectable collagen scaffold could enhance the retention and survival of green fluorescent protein (GFP) labeled fat cells in the transplantation sites in rats. Based on these data, a randomized controlled clinical trial was conducted to evaluate the safety and efficiency of transplantation of collagen scaffold with AFCs for severe vocal fold injury. Ten patients with vocal fold paralysis were randomly assigned to control (AFCs only) and intervention (AFCs + collagen) groups. AFCs with or without collagen scaffold were injected into vocal folds of patients under general anesthesia, respectively. The safety and efficacy were regularly assessed during 24 months post-surgery. No obvious complications occurred in all patients during the follow-up. The collagen scaffold maintained the stability of implants after injection and reconstructed the vocal fold structure. The improvement of voice quality of patients was observed through voice quality evaluation with the voice handicap index (VHI) questionnaire, as well as acoustic analysis of maximum phonation time, jitter, and shimmer. The VHI score of patients in AFCs + collagen group improved significantly than those in AFCs group at 6, 12 and 24 months post-surgery. It demonstrates the injectable collagen scaffold is safe and efficient for delivering AFCs for vocal fold injury.
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Affiliation(s)
- Xiaofeng Jin
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, People's Republic of China
| | - Weiyuan Liu
- Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Jian Wang
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, People's Republic of China
| | - Zhifeng Xiao
- Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Yanyan Niu
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, People's Republic of China
| | - Bing Chen
- Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Yannan Zhao
- Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Jianwu Dai
- Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
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Donohue C, Carnaby G, Garand KLF. How to Interpret and Evaluate a Meta-Analysis in the Field of Speech-Language Pathology: A Tutorial for Clinicians. Am J Speech Lang Pathol 2022; 31:664-677. [PMID: 35201845 DOI: 10.1044/2021_ajslp-21-00267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE This tutorial will provide speech-language pathologists with practical considerations and pragmatic tools for interpreting and critically evaluating a meta-analysis. Meta-analysis, which is a statistical procedure that involves combining research data across multiple high-quality research studies, is often considered the highest level of research evidence. Although meta-analyses are commonly deployed in clinical research after completing a systematic review, few clinicians or clinician scientists within the field of speech-language pathology receive formal training to conduct, interpret, or assess meta-analyses to determine the effectiveness of a treatment or procedure for evidence-based practice. CONCLUSION Clinicians within the field of speech-language pathology may use the foundational knowledge and practical guidelines outlined in this tutorial about meta-analyses to expand their knowledge of research methods and to shape their clinical practice.
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Affiliation(s)
- Cara Donohue
- Aerodigestive Research Core Laboratory, Department of Speech, Language, and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville
| | - Giselle Carnaby
- Department of Management, Policy, and Community Health, School of Health Sciences, The University of Texas Health Science Center, Houston
| | - Kendrea L Focht Garand
- Department of Speech Pathology and Audiology, College of Allied Health Professions, University of South Alabama, Mobile
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Zengin M, Akdaglı Ekici A, Dogan G, Atan D, Alagoz A. The Effect of Different Types of Laryngeal Mask Airways on Sound Quality: A Prospective Randomized Study. Cureus 2021; 13:e19056. [PMID: 34858744 PMCID: PMC8614239 DOI: 10.7759/cureus.19056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2021] [Indexed: 11/21/2022] Open
Abstract
Background Although the deterioration in sound quality is not as much as endotracheal intubation, it can also be seen after the use of laryngeal mask airway (LMA). The aim of this study is to investigate the effects of different LMA types on voice performance. Methods This study included 88 patients aged 18-80 years, whose surgical procedure was not planned to take longer than 120 minutes. In the acoustic voice analysis, F0, jitter%, and shimmer% were examined. In addition, the Voice Handicap Index (VHI)-30 questionnaire has completed an evaluation of voice quality. The patients were randomly divided into two groups (I-gel LMA [n=44]; Classic LMA [n=44]) according to the closed envelope method. Results A total of 88 patients were included in the study. Demographic data of the patients were statistically similar between the groups (p > 0.05). The changes in the preoperative and postoperative F0, jitter, and VHI-30 values in the I-gel group were statistically significant (p: 0.002, p: 0.001, p < 0.001). Shimmer values were not significantly different (p: 0.762). In the classical LMA group, preoperative and postoperative F0, jitter, shimmer, and VHI-30 values were statistically significantly different (p: 0.001, p: 0.012, p: 0.036, p < 0.001). Conclusion I-gel LMA and classic LMA negatively affect voice performance in the preoperative and postoperative periods. This situation was also observed in the VHI-30 index test. However, when this situation was evaluated in terms of shimmer analysis, the decrease in voice quality in the early postoperative period was more limited in the I-gel group.
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Affiliation(s)
- Musa Zengin
- Anesthesiology and Reanimation, University of Health Sciences, Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, TUR
| | - Arzu Akdaglı Ekici
- Anesthesiology and Reanimation, Hitit University, Erol Olcok Training and Research Hospital, Corum, TUR
| | - Guvenc Dogan
- Anesthesiology and Reanimation, Hitit University, Erol Olcok Training and Research Hospital, Corum, TUR
| | - Dogan Atan
- Otorhinolaryngology, Lokman Hekim University Faculty of Medicine, Ankara, TUR
| | - Ali Alagoz
- Anesthesiology and Reanimation, University of Health Sciences, Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, TUR
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