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Sample records for vocal fold stiffness

  1. Quantification of change in vocal fold tissue stiffness relative to depth of artificial damage.

    Science.gov (United States)

    Rohlfs, Anna-Katharina; Schmolke, Sebastian; Clauditz, Till; Hess, Markus; Müller, Frank; Püschel, Klaus; Roemer, Frank W; Schumacher, Udo; Goodyer, Eric

    2017-10-01

    To quantify changes in the biomechanical properties of human excised vocal folds with defined artificial damage. The linear skin rheometer (LSR) was used to obtain a series of rheological measurements of shear modulus from the surface of 30 human cadaver vocal folds. The tissue samples were initially measured in a native condition and then following varying intensities of thermal damage. Histological examination of each vocal fold was used to determine the depth of artificial alteration. The measured changes in stiffness were correlated with the depth of cell damage. For vocal folds in a pre-damage state the shear modulus values ranged from 537 Pa to 1,651 Pa (female) and from 583 Pa to 1,193 Pa (male). With increasing depth of damage from the intermediate layer of the lamina propria (LP), tissue stiffness increased consistently (compared with native values) following application of thermal damage to the vocal folds. The measurement showed an increase of tissue stiffness when the depth of tissue damage was extending from the intermediate LP layer downwards. Changes in the elastic characteristics of human vocal fold tissue following damage at defined depths were demonstrated in an in vitro experiment. In future, reproducible in vivo measurements of elastic vocal fold tissue alterations may enable phonosurgeons to infer the extent of subepithelial damage from changes in surface elasticity.

  2. Vocal Fold Collision Modeling

    DEFF Research Database (Denmark)

    Granados, Alba; Brunskog, Jonas; Misztal, M. K.

    2015-01-01

    When vocal folds vibrate at normal speaking frequencies, collisions occurs. The numerics and formulations behind a position-based continuum model of contact is an active field of research in the contact mechanics community. In this paper, a frictionless three-dimensional finite element model of t...

  3. Experimental study of the effects of airflow and vocal fold stiffness on male and female voice production

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    Campo, Elizabeth; Michael, Mcphail; Michael, Krane

    2011-11-01

    The effect of airflow in voice production is not fully understood, leading to difficulties when clinically diagnosing voice disorders. Many existing studies in this this area focus primarily on the male physiology. This study incorporates 2-layer, molded silicone vocal fold models whose geometry mimics the shape and dimensions of both male and female vocal folds. Measured quantities include subglottal and transglottal pressure, volume flow rate, and radiated sound. The results are used to clarify the relationship between glottal airflow and sound production. The Implications of the measurements for similarities and differences between male and phonation are discussed. Acknowledge support of NIH grant 5R01DC005642 and ARL E&F program.

  4. Radiophonosurgery of vocal fold nodules.

    Science.gov (United States)

    Ragab, Sameh M

    2009-12-01

    To describe the current support in the literature for radiophonosurgery in cases of vocal fold nodules. Radiophonosurgery is a recent innovation in the field of laryngeal surgery. It is emerging as a reliable and practical method for treating benign superficial vocal fold lesions that is increasingly becoming popular. It induces an excellent subjective and objective improvement in voice parameters. Histologically, it produces unremarkable lateral thermal damage and char penetration, which is quite crucial in a functional surgery such as in phonosurgery. Well designed probes are still lacking in the market. Radiophonosurgery provides a new approach for patients with vocal fold nodules. It combines the advantages of both cold knife and laser phonosurgery and is easy, well tolerated, precise and effective with excellent tactile and hemostatic properties.

  5. [Jinsangsanjie capsule for treating vocal fold polyps and vocal nodules].

    Science.gov (United States)

    Zhang, Sulin; Li, Yuncheng; Wang, Yanjun; Kong, Weijia

    2012-08-01

    To investigate therapeutic effects of Jinsangsanjie capsule on vocal fold polyps and vocal nodules. Seventy-five patients with vocal fold polyps and vocal nodules were treated by taking Jinsangsanjie capsule orally. After the therapeutic course, they were all followed up for 1 month. The effective rate of vocal nodule group was 93.8%, the effective rate of vocal fold polyp group was 89.7%, the effective rate of vocal nodule with acute congestion group was 100%, the effective rate of vocal fold polyp with acute congestion group was 100%, and the effective rate of hypertrophy of vocal cords with chronic congestion group was 66.7%. Jinsangsanjie capsule has definite efficacy for treatment of vocal fold polyps and vocal nodules and deserved to be recommended.

  6. Aeroelastic-aeroacoustic measurements in a self-oscillating physical model of the human vocal folds

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    Krane, Michael; Cates, Zachary

    2009-11-01

    Measurements are presented characterizing the relationship between the structure of physical models of the human vocal folds and the sound produced by their vibration by airflow from the lungs. The model vocal folds are fabricated by molding two layers of silicone rubber of specified stiffness, approximating the body/cover structure. These are mounted in a model vocal tract, where the prephonatory gap adjusted using micropositioners. Measurements conducted in an anechoic chamber include radiated sound pressure, and high-speed video of the vibrating model vocal folds, using prephonatory separation, body stiffness, and subglottal pressure as input parameters.. Essential behavior of the vocal fold models is presented. Vibration fundamental frequency and radiated sound pressure level outside the model vocal tract as a function of subglottal pressure and prephonatory gap are presented for the cases of two identical vocal folds and one vocal fold with lower stiffness, approximating vocal fold paralysis.

  7. [Temperament of children with vocal fold nodules].

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    Wei, Youhua; Wang, Zhinan; Xu, Zhongqiang; Chen, Ping; Hao, Lili

    2009-11-01

    To examine the temperament of children with vocal fold nodules. To compare the temperament dimension and temperamental types of 42 children with vocal fold nodules with 46 vocally normal children, using Chinese children's Temperament Problem Screening system (CCTPSs). The children with vocal fold nodules differed significantly from the comparison group in their temperament dimension's adaptability, intensity of reaction, mood value, persistency and temperamental types. There are more difficult and slow-to-warm-up children in patients with vocal fold nodules than vocally normal children.

  8. Regeneration of Vocal Fold Mucosa Using Tissue-Engineered Structures with Oral Mucosal Cells

    OpenAIRE

    Mioko Fukahori; Shun-Ichi Chitose; Kiminori Sato; Shintaro Sueyoshi; Takashi Kurita; Hirohito Umeno; Yu Monden; Ryoji Yamakawa

    2016-01-01

    Objectives Scarred vocal folds result in irregular vibrations during phonation due to stiffness of the vocal fold mucosa. To date, a completely satisfactory corrective procedure has yet to be achieved. We hypothesize that a potential treatment option for this disease is to replace scarred vocal folds with organotypic mucosa. The purpose of this study is to regenerate vocal fold mucosa using a tissue-engineered structure with autologous oral mucosal cells. Study Design Animal experiment using ...

  9. Vocal fold dynamics for frequency change.

    Science.gov (United States)

    Hollien, Harry

    2014-07-01

    This article provides a review of data drawn from a series of related experiments to demonstrate how frequency change (Δf0) is accomplished in the modal register. The research cited involves studies of (1) laryngeal size, (2) vocal fold length, (3) vocal fold thickness, and (4) subglottic pressure; new data describe their effect on vocal fold mass. It was found that changes in these dimensions (1) explain how the shifts in frequency are accomplished, (2) establish the way vocal fold mass can be measured, and (3) strongly support the aerodynamic-myoelastic theory of phonation. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  10. A virtual trajectory model predicts differences in vocal fold kinematics in individuals with vocal hyperfunction1

    Science.gov (United States)

    Stepp, Cara E.; Hillman, Robert E.; Heaton, James T.

    2010-01-01

    A simple, one degree of freedom virtual trajectory model of vocal fold kinematics was developed to investigate whether kinematic features of vocal fold movement confirm increased muscle stiffness. Model simulations verified that increases in stiffness were associated with changes in kinematic parameters, suggesting that increases in gesture rate would affect kinematic features to a lesser degree in vocal hyperfunction patients given the increased levels of muscle tension they typically employ to phonate. This hypothesis was tested experimentally in individuals with muscle tension dysphonia (MTD; N=10) and vocal nodules (N=10) relative to controls with healthy normal voice (N=10) who were examined with trans-nasal endoscopy during a simple vocal fold abductory-adductory task. Kinematic measures in MTD patients were less affected by increased gesture rate, consistent with the hypothesis that these individuals have elevated typical laryngeal muscle tension. Group comparisons of the difference between medium and fast gesture rates (Mann–Whitney, one-tailed) showed statistically significant differences between the control and MTD individuals on the two kinematic features examined (pnodules participants were mixed and are discussed independently. The findings support the potential use of vocal fold kinematics as an objective clinical assay of vocal hyperfunction. PMID:21117765

  11. Benign Lesions of The Vocal Fold

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    Ozgur Surmelioglu

    2013-02-01

    Full Text Available Benign lesions of vocal folds are common disorders. Fifty percent of patients who have sound complaints are found to have these lesions after endoscopic and stroboscopic examinations. Benign vocal fold diseases are primarily caused by vibratory trauma. However they may also occur as a result of viral infections and congenital causes. These lesions are often presented with the complaints of dysphonia. [Archives Medical Review Journal 2013; 22(1.000: 86-95

  12. Modeling Vocal Fold Intravascular Flow using Synthetic Replicas

    Science.gov (United States)

    Terry, Aaron D.; Ricks, Matthew T.; Thomson, Scott L.

    2017-11-01

    Vocal fold vibration that is induced by air flowing from the lungs is believed to decrease blood flow through the vocal folds. This is important due to the critical role of blood flow in maintaining tissue health. However, the precise mechanical relationships between vocal fold vibration and blood perfusion remain understudied. A platform for studying liquid perfusion in a synthetic, life-size, self-oscillating vocal fold replica has recently been developed. The replicas are fabricated using molded silicone with material properties comparable to those of human vocal fold tissues and that include embedded microchannels through which liquid is perfused. The replicas are mounted on an air flow supply tube to initiate flow-induced vibration. A liquid reservoir is attached to the microchannel to cause liquid to perfuse through replica in the anterior-posterior direction. As replica vibration is initiated and amplitude increases, perfusion flow rate decreases. In this presentation, the replica design will be presented, along with data quantifying the relationships between parameters such as replica vibration amplitude, stiffness, microchannel diameter, and perfusion flow rate. This work was supported by Grant NIDCD R01DC005788 from the National Institutes of Health.

  13. Improvement of a Vocal Fold Imaging System

    Energy Technology Data Exchange (ETDEWEB)

    Krauter, K. G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-02-01

    Medical professionals can better serve their patients through continual update of their imaging tools. A wide range of pathologies and disease may afflict human vocal cords or, as they’re also known, vocal folds. These diseases can affect human speech hampering the ability of the patient to communicate. Vocal folds must be opened for breathing and the closed to produce speech. Currently methodologies to image markers of potential pathologies are difficult to use and often fail to detect early signs of disease. These current methodologies rely on a strobe light and slower frame rate camera in an attempt to obtain images as the vocal folds travel over the full extent of their motion.

  14. A Rat Excised Larynx Model of Vocal Fold Scar

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    Welham, Nathan V.; Montequin, Douglas W.; Tateya, Ichiro; Tateya, Tomoko; Choi, Seong Hee; Bless, Diane M.

    2009-01-01

    Purpose: To develop and evaluate a rat excised larynx model for the measurement of acoustic, aerodynamic, and vocal fold vibratory changes resulting from vocal fold scar. Method: Twenty-four 4-month-old male Sprague-Dawley rats were assigned to 1 of 4 experimental groups: chronic vocal fold scar, chronic vocal fold scar treated with 100-ng basic…

  15. Modal locking between vocal fold and vocal tract oscillations

    CERN Document Server

    Aalto, Atte; Malinen, Jarmo; Vainio, Martti

    2012-01-01

    The human vocal folds are known to interact with the vocal tract acoustics during voiced speech production; namely a nonlinear source-filter coupling has been observed both by using models and in \\emph{in vivo} phonation. These phenomena are approached from two directions in this article. We first present a computational dynamical model of the speech apparatus that contains an explicit filter-source feedback mechanism from the vocal tract acoustics back to the vocal folds oscillations. The model was used to simulate vocal pitch glideswhere the trajectory was forced to cross the lowest vocal tract resonance, i.e., the lowest formant $F_1$. Similar patterns produced by human participants were then studied. Both the simulations and the experimental results reveal an effect when the glides cross the first formant (as may happen in \\textipa{[i]}). Conversely, this effect is not observed if there is no formant within the glide range (as is the case in \\textipa{[\\textscripta]}). The experiments show smaller effect c...

  16. ETIOLOGICAL FACTORS FOR VOCAL FOLD POLYP FORMATION

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    DAŠA GLUVAJIĆ

    2016-05-01

    Full Text Available Background: Vocal fold polyp is one of the most common causes for hoarseness. Many different etiological factors contribute to vocal fold polyp formation. The aim of the study was to find out whether the etiological factors for polyp formation have changed in the last 30 years.Methods: Eighty-one patients with unilateral vocal fold polyp were included in the study. A control group was composed of 50 volunteers without voice problems who matched the patients by age and gender. The data about etiological factors and the findings of phoniatric examination were obtained from the patients' medical documentation and from the questionnaires for the control group. The incidence of etiological factors was compared between the two groups. The program SPSS, Version 18 was used for statistical analysis.Results: The most frequent etiological factors were occupational voice load, GER, allergy and smoking. In 79% of patients 2 – 6 contemporary acting risk factors were found. Occupational voice load (p=0,018 and GER (p=0,004 were significantly more frequent in the patients than in the controls. The other factors did not significantly influence the polyp formation.Conclusions: There are several factors involved simultaneously in the formation of vocal fold polyps both nowadays and 30 years ago. Some of the most common factors remain the same (voice load, smoking, others are new (GER, allergy, which is probably due to the different lifestyle and working conditions than 30 years ago. Occupational voice load and GER were significantly more frequently present in the patients with polyp than in the control group. Regarding the given results it is important to instruct workers with professional vocal load about etiological factors for vocal fold polyp formation.

  17. MARATHON DESPITE UNILATERAL VOCAL FOLD PARALYSIS

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    Matthias Echternach

    2008-06-01

    Full Text Available The principal symptoms of unilateral vocal fold paralysis are hoarseness and difficulty in swallowing. Dyspnea is comparatively rare (Laccourreye et al., 2003. The extent to which unilateral vocal fold paralysis may lead to respiratory problems at all - in contrast to bilateral vocal fold paralysis- has not yet well been determined. On the one hand, inspiration is impaired with unilateral vocal fold paralysis; on the other hand, neither the position of the vocal fold paralysis nor the degree of breathiness correlates with respiratory parameters (Cantarella et al., 2003; 2005. The question of what respiratory stress a patient with a vocal fold paresis can endure has not yet been dealt with.A 43 year-old female patient was suffering from recurrent unspecific respiratory complaints for four months after physical activity. During training for a marathon, she experienced no difficulty in breathing. These unspecific respiratory complaints occurred only after athletic activity and persisted for hours. The patient observed neither an increased coughing nor a stridor. Her voice remained unaltered during the attacks, nor were there any signs of a symptomatic gastroesophageal reflux or infectious disease. A cardio-pulmonary and a radiological examination by means of an X-ray of the thorax also revealed no pathological phenomena. As antiallergic and antiobstructive therapy remained unsuccessful, a laryngological examination was performed in order to exclude a vocal cord dysfunction.Surprisingly enough, the laryngostroboscopy showed, as an initial description, a vocal fold paralysis of the left vocal fold in median position (Figure 1. The anamnestic background for the cause was unclear. The only clue was a thoracotomy on the left side due to a pleuritis in childhood. A subsequent laryngoscopic examination had never been performed. Good mucosa waves and amplitudes were shown bilateral with complete glottal closure. Neither in the acoustic analysis, nor in the

  18. Laryngeal ultrasound and pediatric vocal fold nodules.

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    Ongkasuwan, Julina; Devore, Danielle; Hollas, Sarah; Jones, Jeremy; Tran, Brandon

    2017-03-01

    The term vocal fold nodules refers to bilateral thickening of the membranous folds with minimal impairment of the vibratory properties of the mucosa. Nodules are thought to be related to repetitive mechanical stress, associated with voice use patterns. Diagnosis is typically made in the office via either rigid or flexible laryngeal stroboscopy. Depending on the individual child, obtaining an optimal view of the larynx can be difficult if not impossible. Recent advances in high-frequency ultrasonography allows for transcervical examination of laryngeal structures. The goal of this project was to determine if laryngeal ultrasound (LUS) can be used to identify vocal fold nodules in dysphonic children. Prospective case-control study in which the patient acted as his or her own control. Forty-six pediatric patients were recruited for participation in this study; the mean age was 4.8 years. Twenty-three did not have any vocal fold lesions and 23 had a diagnosis of vocal fold nodules on laryngeal stroboscopy. Recorded LUSs were reviewed by two pediatric radiologists who were blinded to the nodule status. There was substantial inter-rater agreement (κ = 0.70, 95% confidence interval [CI]: 0.50-0.89) between the two radiologists regarding the presence of nodules. There was also substantial agreement (κ = 0.87, 95% CI: 0.72-1) between LUS and laryngeal stroboscopy. Sensitivity of LUS was 100% (95% CI: 85%-100%) and specificity was 87% (95% CI: 66%-97%). LUS can be used to identify vocal fold nodules in children with substantial agreement with laryngeal stroboscopy. 3b Laryngoscope, 127:676-678, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  19. Vocal fold nodules: morphological and immunohistochemical investigations.

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    Martins, Regina Helena Garcia; Defaveri, Julio; Custódio Domingues, Maria Aparecida; de Albuquerque E Silva, Rafael; Fabro, Alexandre

    2010-09-01

    The objective of this study was to investigate the morphological and immunohistochemical characteristics of vocal fold nodules. The study design was prospective and retrospective. For the histological study, we reviewed 15 slides from the surgical cases of vocal fold nodules, in which we analyzed epithelium, basal membrane (bm), and lamina propria. For the transmission and scanning electron microscopy (TEM, SEM) studies, five new cases on vocal fold nodules were included. Immunohistochemistry study was carried out in the 15 specimens, using antifibronectin, antilaminin, and anticollagen IV antibodies. The main histological alterations were epithelial hyperplasia (73.33%), basement membrane thickening (86.66%), edema, and fibrosis (93.33%). SEM--reduction in mucous lacing and increase in the desquamating cells, without epithelial erosion. TEM--hyperplasia of the epithelium, enlargement of the intercellular junctions, which was filled by fluid, subepithelial thickening of the lamina reticularis, and break points in the basal membrane. Immunohistochemistry--we identified greater immunoexpression of fibronectin on the basal membrane, on the lamina propria, and around the vessels. Antilaminin and anticollagen IV antibodies showed higher pigmentation on the endothelium of the vessels than that on the basal membrane. In vocal fold nodules, combined assessment using light microscopy, electron microscopy, and immunohistochemistry can reveal important morphological details useful in characterizing these lesions. 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  20. Assessment of thyroplasty for vocal fold paralysis

    DEFF Research Database (Denmark)

    Grøntved, Ågot Møller; Faber, Christian; Jakobsen, John

    2009-01-01

    INTRODUCTION: Thyroplasty with silicone rubber implantation is a surgical procedure for treatment of patients with vocal fold paralysis. The aim of the present study was to evaluate the outcome of the operation and to monitor which of the analyses were the more beneficial. MATERIAL AND METHODS...

  1. Phonosurgery of vocal fold polyps, cysts and nodules is beneficial

    DEFF Research Database (Denmark)

    Jensen, Jane Bjerg; Rasmussen, Niels

    2013-01-01

    This study reports our experience with microscopic phonosurgery (PS) of benign lesions of the vocal folds.......This study reports our experience with microscopic phonosurgery (PS) of benign lesions of the vocal folds....

  2. [The difference of phonation patterns in vocal fold polyps and vocal nodules].

    Science.gov (United States)

    Zhang, Biru; Zheng, Yiqing; Gong, Jian; Chen, Yongming

    2013-09-01

    To investigate the difference of phonation patterns by dividing patients with vocal fold polyps and vocal nodules into two groups according to muscle tension patterns (MTP). Fifty-six patients with vocal fold polyps and vocal nodules were divided into two groups according to phonation with MTP or not by video strobolaryngoscopy. MTP could be found in 85% patients with vocal nodules and in 55.56% patients with vocal fold polyps. Significant difference was found in patients with/without MTP, and difference was also found in every type of MTP. MTP lies in most patients with vocal nodules while only part of patients with vocal fold polyps, which indicated that vocal fold polyps and vocal nodules may demonstrate different phona

  3. Regeneration of Vocal Fold Mucosa Using Tissue-Engineered Structures with Oral Mucosal Cells.

    Science.gov (United States)

    Fukahori, Mioko; Chitose, Shun-Ichi; Sato, Kiminori; Sueyoshi, Shintaro; Kurita, Takashi; Umeno, Hirohito; Monden, Yu; Yamakawa, Ryoji

    2016-01-01

    Scarred vocal folds result in irregular vibrations during phonation due to stiffness of the vocal fold mucosa. To date, a completely satisfactory corrective procedure has yet to be achieved. We hypothesize that a potential treatment option for this disease is to replace scarred vocal folds with organotypic mucosa. The purpose of this study is to regenerate vocal fold mucosa using a tissue-engineered structure with autologous oral mucosal cells. Animal experiment using eight beagles (including three controls). A 3 mm by 3 mm specimen of canine oral mucosa was surgically excised and divided into epithelial and subepithelial tissues. Epithelial cells and fibroblasts were isolated and cultured separately. The proliferated epithelial cells were co-cultured on oriented collagen gels containing the proliferated fibroblasts for an additional two weeks. The organotypic cultured tissues were transplanted to the mucosa-deficient vocal folds. Two months after transplantation, vocal fold vibrations and morphological characteristics were observed. A tissue-engineered vocal fold mucosa, consisting of stratified epithelium and lamina propria, was successfully fabricated to closely resemble the normal layered vocal fold mucosa. Laryngeal stroboscopy revealed regular but slightly small mucosal waves at the transplanted site. Immunohistochemically, stratified epithelium expressed cytokeratin, and the distributed cells in the lamina propria expressed vimentin. Elastic Van Gieson staining revealed a decreased number of elastic fibers in the lamina propria of the transplanted site. The fabricated mucosa with autologous oral mucosal cells successfully restored the vocal fold mucosa. This reconstruction technique could offer substantial clinical advantages for treating intractable diseases such as scarring of the vocal folds.

  4. Regeneration of Vocal Fold Mucosa Using Tissue-Engineered Structures with Oral Mucosal Cells.

    Directory of Open Access Journals (Sweden)

    Mioko Fukahori

    Full Text Available Scarred vocal folds result in irregular vibrations during phonation due to stiffness of the vocal fold mucosa. To date, a completely satisfactory corrective procedure has yet to be achieved. We hypothesize that a potential treatment option for this disease is to replace scarred vocal folds with organotypic mucosa. The purpose of this study is to regenerate vocal fold mucosa using a tissue-engineered structure with autologous oral mucosal cells.Animal experiment using eight beagles (including three controls.A 3 mm by 3 mm specimen of canine oral mucosa was surgically excised and divided into epithelial and subepithelial tissues. Epithelial cells and fibroblasts were isolated and cultured separately. The proliferated epithelial cells were co-cultured on oriented collagen gels containing the proliferated fibroblasts for an additional two weeks. The organotypic cultured tissues were transplanted to the mucosa-deficient vocal folds. Two months after transplantation, vocal fold vibrations and morphological characteristics were observed.A tissue-engineered vocal fold mucosa, consisting of stratified epithelium and lamina propria, was successfully fabricated to closely resemble the normal layered vocal fold mucosa. Laryngeal stroboscopy revealed regular but slightly small mucosal waves at the transplanted site. Immunohistochemically, stratified epithelium expressed cytokeratin, and the distributed cells in the lamina propria expressed vimentin. Elastic Van Gieson staining revealed a decreased number of elastic fibers in the lamina propria of the transplanted site.The fabricated mucosa with autologous oral mucosal cells successfully restored the vocal fold mucosa. This reconstruction technique could offer substantial clinical advantages for treating intractable diseases such as scarring of the vocal folds.

  5. Image analysis of vocal fold histology

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    Reinisch, Lou; Garrett, C. Gaelyn

    2001-05-01

    To visualize the concentration gradients of collagen, elastin and ground substance in histologic sections of vocal folds, an image enhancement scheme was devised. Slides stained with Movat's solution were viewed on a light microscope. The image was digitally photographed. Using commercially available software, all pixels within a color range are selected from the mucosa presented on the image. Using the Movat's pentachrome stain, yellow to yellow-brown pixels represented mature collagen, blue to blue-green pixels represented young collagen (collagen that is not fully cross-linked) and black to dark violet pixels represented elastin. From each of the color range selections, a black and white image was created. The pixels not within the color range were black. The selected pixels within the color range were white. The image was averaged and smoothed to produce 256 levels of gray with less spatial resolution. This new grey-scale image showed the concentration gradient. These images were further enhanced with contour lines surrounding equivalent levels of gray. This technique is helpful to compare the micro-anatomy of the vocal folds. For instance, we find large concentration of the collagen deep in the mucosa and adjacent to the vocalis muscle.

  6. Automatic recognizing of vocal fold disorders from glottis images.

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    Huang, Chang-Chiun; Leu, Yi-Shing; Kuo, Chung-Feng Jeffrey; Chu, Wen-Lin; Chu, Yueng-Hsiang; Wu, Han-Cheng

    2014-09-01

    The laryngeal video stroboscope is an important instrument to test glottal diseases and read vocal fold images and voice quality for physician clinical diagnosis. This study is aimed to develop a medical system with functionality of automatic intelligent recognition of dynamic images. The static images of glottis opening to the largest extent and closing to the smallest extent were screened automatically using color space transformation and image preprocessing. The glottal area was also quantized. As the tongue base movements affected the position of laryngoscope and saliva would result in unclear images, this study used the gray scale adaptive entropy value to set the threshold in order to establish an elimination system. The proposed system can improve the effect of automatically captured images of glottis and achieve an accuracy rate of 96%. In addition, the glottal area and area segmentation threshold were calculated effectively. The glottis area segmentation was corrected, and the glottal area waveform pattern was drawn automatically to assist in vocal fold diagnosis. When developing the intelligent recognition system for vocal fold disorders, this study analyzed the characteristic values of four vocal fold patterns, namely, normal vocal fold, vocal fold paralysis, vocal fold polyp, and vocal fold cyst. It also used the support vector machine classifier to identify vocal fold disorders and achieved an identification accuracy rate of 98.75%. The results can serve as a very valuable reference for diagnosis. © IMechE 2014.

  7. The etiology of vocal fold nodules in adults.

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    Karkos, Petros D; McCormick, Maxwell

    2009-12-01

    To review the recent literature on the etiology and pathophysiology of vocal fold nodules in adults. Research regarding the etiology of vocal nodules over the past 2 years supports previous thinking regarding the central role of voice misuse, overuse, and phonatory trauma. Advanced modeling techniques have helped elucidate mechanisms by which this may occur such as vibration-induced rise in capillary pressures and varying fluid dynamics in the layered vocal fold structure. Contributory roles of personality traits, reflux, and allergy have also been hypothesized. Current research supports long-held beliefs that phonatory trauma is a central cause of vocal fold nodule formation. Innovative basic science research has unraveled mechanisms of traumatic damage and clinical research continues to identify crucial lifestyle behavior and contributing comorbid conditions that play a role in the pathogenesis of vocal fold nodules. The multifactorial etiology of vocal fold nodules requires a comprehensive history to identify contributing factors and a multidisciplinary approach to optimize treatment outcome.

  8. Biomechanical simulation of vocal fold dynamics in adults based on laryngeal high-speed videoendoscopy.

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    Michael Döllinger

    Full Text Available Human voice is generated in the larynx by the two oscillating vocal folds. Owing to the limited space and accessibility of the larynx, endoscopic investigation of the actual phonatory process in detail is challenging. Hence the biomechanics of the human phonatory process are still not yet fully understood. Therefore, we adapt a mathematical model of the vocal folds towards vocal fold oscillations to quantify gender and age related differences expressed by computed biomechanical model parameters.The vocal fold dynamics are visualized by laryngeal high-speed videoendoscopy (4000 fps. A total of 33 healthy young subjects (16 females, 17 males and 11 elderly subjects (5 females, 6 males were recorded. A numerical two-mass model is adapted to the recorded vocal fold oscillations by varying model masses, stiffness and subglottal pressure. For adapting the model towards the recorded vocal fold dynamics, three different optimization algorithms (Nelder-Mead, Particle Swarm Optimization and Simulated Bee Colony in combination with three cost functions were considered for applicability. Gender differences and age-related kinematic differences reflected by the model parameters were analyzed.The biomechanical model in combination with numerical optimization techniques allowed phonatory behavior to be simulated and laryngeal parameters involved to be quantified. All three optimization algorithms showed promising results. However, only one cost function seems to be suitable for this optimization task. The gained model parameters reflect the phonatory biomechanics for men and women well and show quantitative age- and gender-specific differences. The model parameters for younger females and males showed lower subglottal pressures, lower stiffness and higher masses than the corresponding elderly groups. Females exhibited higher subglottal pressures, smaller oscillation masses and larger stiffness than the corresponding similar aged male groups. Optimizing

  9. Botulinum toxin in the treatment of vocal fold nodules.

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    Allen, Jacqui E; Belafsky, Peter C

    2009-12-01

    Promising new techniques in the management of vocal fold nodules have been developed in the past 2 years. Simultaneously, the therapeutic use of botulinum toxin has rapidly expanded. This review explores the use of botulinum toxin in treatment of vocal nodules and summarizes current therapeutic concepts. New microsurgical instruments and techniques, refinements in laser technology, radiosurgical excision and steroid intralesional injections are all promising new techniques in the management of vocal nodules. Botulinum toxin-induced 'voice rest' is a new technique we have employed in patients with recalcitrant nodules. Successful resolution of nodules is possible with this technique, without the risk of vocal fold scarring inherent in dissection/excision techniques. Botulinum toxin usage is exponentially increasing, and large-scale, long-term studies demonstrate its safety profile. Targeted vocal fold temporary paralysis induced by botulinum toxin injection is a new, well tolerated and efficacious treatment in patients with persistent vocal fold nodules.

  10. Bicarbonate availability for vocal fold epithelial defense to acidic challenge.

    Science.gov (United States)

    Durkes, Abigail; Sivasankar, M Preeti

    2014-01-01

    Bicarbonate is critical for acid-base tissue homeostasis. In this study we investigated the role of bicarbonate ion transport in vocal fold epithelial defense to acid challenges. Acidic insults to the larynx are common in gastric reflux, carcinogenesis and metastasis, and acute inflammation. Ion transport was measured in viable porcine vocal fold epithelium. First, 18 vocal folds were exposed to either the carbonic anhydrase antagonist acetazolamide or to vehicle. Second, 32 vocal folds were exposed to either a control buffer or a bicarbonate-free buffer on their luminal or basolateral surface or both. Third, 32 vocal folds were challenged with acid in the presence of bicarbonate-free or control buffer. The vocal fold transepithelial resistance was greater than 300 Ω*cm(2), suggesting robust barrier integrity. Ion transport did not change after exposure to acetazolamide (p > 0.05). Exposure to bicarbonate-free buffer did not compromise vocal fold ion transport (p > 0.05). Ion transport increased after acid challenge. This increase approached statistical significance and was the greatest for the control buffer and for the bicarbonate-free buffer applied to the basolateral surface. Bicarbonate secretion may contribute to vocal fold defense against acid challenge. Our data offer a potential novel role for bicarbonate as a therapeutic agent to reduce pH abnormalities in the larynx and prevent associated pathological changes.

  11. BENIGN LESIONS OF THE VOCAL FOLDS - HISTOPATHOLOGY AND PHONOTRAUMA

    NARCIS (Netherlands)

    DIKKERS, FG; NIKKELS, PGJ

    Benign lesions of the vocal folds have various appearances. Histopathologic examination might provide the true diagnosis. Therefore, histologic slides of 74 patients (92 vocal folds) with clinically well-defined diagnoses were single-blind examined by a pathologist. Single histologic features did

  12. Vocal Fold Mucus Aggregation in Persons with Voice Disorders

    Science.gov (United States)

    Bonilha, Heather Shaw; White, Lisa; Kuckhahn, Kelsey; Gerlach, Terri Treman; Deliyski, Dimitar D.

    2012-01-01

    Mucus aggregation on the vocal folds is a common finding from laryngeal endoscopy. Patients with voice disorders report the presence of mucus aggregation. Patients also report that mucus aggregation causes them to clear their throat, a behavior believed to be harmful to vocal fold mucosa. Even though clinicians and patients report and discuss…

  13. Comparison of benign lesion regression following vocal fold steroid injection and vocal hygiene education.

    Science.gov (United States)

    Wang, Chi-Te; Liao, Li-Jen; Lai, Mei-Shu; Cheng, Po-Wen

    2014-02-01

    This study intends to objectively quantify and compare the regression rates of vocal lesions in patients receiving either vocal fold steroid injection (VFSI) or vocal hygiene education (VHE). Potential influence of occupational vocal demands on the treatment outcome was also investigated. Retrospective case series. This study enrolled 176 patients of vocal nodules and vocal polyps. Ninety-two patients received VFSI, while 84 patients received VHE. We measured the lesion area with correction by the length of vocal fold, according to videolaryngoscopic examinations before treatment and 1 and 2 months after treatment. VFSI was associated with a higher lesion reduction rate than VHE at 1 and 2 months (P vocal nodules and patients with ordinary occupational vocal demands, VFSI achieved a higher lesion regression rate than VHE at 1 month (P 0.05). In vocal polyps, the lesion reduction rate after VFSI was higher than that following VHE at 1 and 2 months (P vocal demands, the lesion sizes decreased significantly at 1 and 2 months following VFSI (P 0.05). VHE remains the fundamental strategy for all dysphonic patients, while VFSI can be applied alternatively. Both VFSI and VHE are effective for vocal nodules and patients with ordinary occupational vocal demands, but VFSI achieves lesion regression earlier than VHE. VFSI is preferred over VHE for vocal polyps and patients with high occupational vocal demands. 4. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  14. The effect of vocal tract impedance on the vocal folds

    DEFF Research Database (Denmark)

    Agerkvist, Finn T.; Selamtzis, Andreas

    2011-01-01

    The importance of the interaction between the acoustic impedance of the vocal tract with the flow across the vocal cords is well established. In this paper we are investigating the changes in vocal tract impedance when using the different modes of phonation according to Sadolin [1], going from......) . The results show changes in the resonance frequencies of the vocal tract with increasing pitch, whereas the changes between the modes are less clear due to the measurement signal being weak in comparison to the louder modes, especially at high pitches. The electroglottograph shows a very different waveform...... to different density and speed of sound in Helium. The electroglottograph shows a change in waveform when the singer inhales helium. The percentage of the glottal cycle when the vocal cords are open, the so-called open quotient, increases from 40 to 55%. When inhaling helium the male singer was able reach Eb5...

  15. Spatiotemporal analysis of normal and pathological human vocal fold vibrations.

    Science.gov (United States)

    Krausert, Christopher R; Liang, Yufang; Zhang, Yu; Rieves, Adam L; Geurink, Kyle R; Jiang, Jack J

    2012-01-01

    For spatiotemporal analysis to become a relevant clinical tool, it must be applied to human vocal fold vibration. Receiver operating characteristic (ROC) analysis will help assess the ability of spatiotemporal parameters to detect pathological vibration. Spatiotemporal parameters of correlation length and entropy were extracted from high-speed videos of 124 subjects, 67 without vocal fold pathology and 57 with either vocal fold polyps or nodules. Mann-Whitney rank sum tests were performed to compare normal vocal fold vibrations to pathological vibrations, and ROC analysis was used to assess the diagnostic value of spatiotemporal analysis. A statistically significant difference was found between the normal and pathological groups in both correlation length (P nodules and polyps groups in either correlation length (P = .227) or entropy (P = .943). The ROC analysis showed an area under the curve of 0.63 for correlation length and 0.51 for entropy. Although they could not effectively distinguish vibration of vocal folds with nodules from those with polyps, the spatiotemporal parameters correlation length and entropy exhibit the ability to differentiate normal and pathological vocal fold vibration and may represent a diagnostic tool for objectively detecting abnormal vibration in the future, especially in neurological voice disorders and vocal folds without a visible lesion. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. The impact of intraglottal vortices on vocal fold dynamics

    Science.gov (United States)

    Erath, Byron; Pirnia, Alireza; Peterson, Sean

    2016-11-01

    During voiced speech a critical pressure is produced in the lungs that separates the vocal folds and creates a passage (the glottis) for airflow. As air passes through the vocal folds the resulting aerodynamic loading, coupled with the tissue properties of the vocal folds, produces self-sustained oscillations. Throughout each cycle a complex flow field develops, characterized by a plethora of viscous flow phenomena. Air passing through the glottis creates a jet, with periodically-shed vortices developing due to flow separation and the Kelvin-Helmholtz instability in the shear layer. These vortices have been hypothesized to be a crucial mechanism for producing vocal fold vibrations. In this study the effect of vortices on the vocal fold dynamics is investigated experimentally by passing a vortex ring over a flexible beam with the same non-dimensional mechanical properties as the vocal folds. Synchronized particle image velocimetry data are acquired in tandem with the beam dynamics. The resulting impact of the vortex ring loading on vocal fold dynamics is discussed in detail. This work was supported by the National Science Foundation Grant CBET #1511761.

  17. A nomenclature paradigm for benign midmembranous vocal fold lesions.

    Science.gov (United States)

    Rosen, Clark A; Gartner-Schmidt, Jackie; Hathaway, Bridget; Simpson, C Blake; Postma, Gregory N; Courey, Mark; Sataloff, Robert T

    2012-06-01

    There is a significant lack of uniform agreement regarding nomenclature for benign vocal fold lesions (BVFLs). This confusion results in difficulty for clinicians communicating with their patients and with each other. In addition, BVFL research and comparison of treatment methods are hampered by the lack of a detailed and uniform BVFL nomenclature. Clinical consensus conferences were held to develop an initial BVFL nomenclature paradigm. Perceptual video analysis was performed to validate the stroboscopy component of the paradigm. The culmination of the consensus conferences and the video-perceptual analysis was used to evaluate the BVFL nomenclature paradigm using a retrospective review of patients with BVFL. An initial BVFL nomenclature paradigm was proposed utilizing detailed definitions relating to vocal fold lesion morphology, stroboscopy, response to voice therapy and intraoperative findings. Video-perceptual analysis of stroboscopy demonstrated that the proposed binary stroboscopy system used in the BVFL nomenclature paradigm was valid and widely applicable. Retrospective review of 45 patients with BVFL followed to the conclusion of treatment demonstrated that slight modifications of the initial BVFL nomenclature paradigm were required. With the modified BVFL nomenclature paradigm, 96% of the patients fit into the predicted pattern and definitions of the BVFL nomenclature system. This study has validated a multidimensional BVFL nomenclature paradigm. This vocal fold nomenclature paradigm includes nine distinct vocal fold lesions: vocal fold nodules, vocal fold polyp, pseudocyst, vocal fold cyst (subepithelial or ligament), nonspecific vocal fold lesion, vocal fold fibrous mass (subepithelial or ligament), and reactive lesion. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  18. True vocal fold nodules: the role of differential diagnosis.

    Science.gov (United States)

    Kunduk, Melda; McWhorter, Andrew J

    2009-12-01

    The present article aims to discuss the current reviews and the literature published regarding the differential diagnosis of vocal fold nodules with emphasis on diagnosis and nomenclature. Benign lesions of the vocal folds, including nodules, continue to challenge practitioners in nomenclature uniformity and even histologic diagnosis. Utilization of molecular techniques is helping to better understand Reinke's space and to better differentiate these lesions. This more accurate diagnosis may help guide appropriate treatment indicating behavioral versus surgical therapy. Further study with the application of new technology in the laboratory and clinic will continue to refine our differential diagnosis and understanding of vocal fold nodules.

  19. Alternative measures to observe and record vocal fold vibrations

    NARCIS (Netherlands)

    Schutte, HK; McCafferty, G; Coman, W; Carroll, R

    1996-01-01

    Vocal fold vibration patterns form the basis for the production of vocal sound. Over the years much effort has been spend to optimize the ways to visualize and give a description of these patterns. Before video possibilities became available the description of the patterns was Very time-consuming.

  20. Prospective investigation of nimodipine for acute vocal fold paralysis.

    Science.gov (United States)

    Rosen, Clark A; Smith, Libby; Young, Vyvy; Krishna, Priya; Muldoon, Matthew F; Munin, Michael C

    2014-07-01

    Nimodipine has been shown to be beneficial for recovery from acute vocal fold paralysis (AVFP) in an animal model. prospective, open-label trial of patients with AVFP was performed using nimodipine. Consecutive patients were evaluated and offered nimodipine therapy. Fifty-three patients were considered for treatment with nimodipine. Thirteen did not qualify for inclusion, 5 were lost to follow-up, and 7 had side effects requiring cessation of treatment. Thus 28 patients (30 paralyzed vocal folds) were analyzed. Eighteen of the paralyzed vocal folds experienced recovery of purposeful motion (60%). Historical controls and laryngeal electromyography meta-analysis suggest no more than a 20% recovery rate from AVFP. This open label study using nimodipine for treatment of AVFP demonstrates tripling of the recovery rate of vocal fold motion compared with historical controls. Further study in a randomized, controlled manner is warranted. Copyright © 2013 Wiley Periodicals, Inc.

  1. Morphometric Study of Vocal Folds in Indian Cadavers

    Directory of Open Access Journals (Sweden)

    Rawal J.D.

    2015-06-01

    Full Text Available Introduction: -The larynx is an air passage and a sphincteric device used in respiration and phonation. The larynx, from inside outwards has a framework of mucosa surrounded by fibro-elastic membrane which in turn is surrounded by cartilages and then a layer of muscles. Vocal folds are intrinsic ligament of larynx covered by mucosal folds. Larynx generates sound through rhythmic opening and closing of the vocal folds. The perceived pitch of human voice mainly depends upon fundamental frequency of sound generated by larynx. Aim: - The aim of present study is to measure various dimensions of vocal folds in Indian cadavers. Material & Methods: - 50 larynx were obtained from embalmed cadavers, of which 10 larynx were of females. Vocal cords were dissected from the larynx and morphometric analysis was done. Results and Conclusions: - The average total length of the vocal folds was found to be 16.11 mm. ± 2.62 mm. in male and 14.10 mm. ± 1.54 mm. in female cadavers. The average width of the vocal folds was found to be 4.38 mm. ± 0.74 mm. in male and 3.60 mm. ± 0.64 mm. in female cadavers. The average total length of the membranous part of the vocal folds was found to be 11.90 mm. ± 1.86 mm. in male and 10.45 mm. ± 1.81 mm. in female cadavers. The average ratio of the length of the membranous and the cartilaginous parts of the vocal folds was calculated to be 3.10 ± 0.96in male and 2.85 ± 0.73in female cadavers.

  2. A HTK-based Method for Detecting Vocal Fold Pathology

    OpenAIRE

    Majidnezhad, Vahid

    2014-01-01

    Introduction: In recent years a number of methods based on acoustic analysis were developed for vocal fold pathology detection. These methods can be categorized in two categories:a) detection based on the phonemes b) detection based on the continuous speeches. While there are many researches which belong to the first category, there are few efforts for detecting vocal fold pathology based on the continuous speeches (second category). Methods: In this work, a method based on the Hidden Markov ...

  3. Influence of the ventricular folds on a voice source with specified vocal fold motion.

    Science.gov (United States)

    McGowan, Richard S; Howe, Michael S

    2010-03-01

    The unsteady drag on the vocal folds is the major source of sound during voiced speech. The drag force is caused by vortex shedding from the vocal folds. The influence of the ventricular folds (i.e., the "false" vocal folds that protrude into the vocal tract a short distance downstream of the glottis) on the drag and the voice source are examined in this paper by means of a theoretical model involving vortex sheets in a two-dimensional geometry. The effect of the ventricular folds on the output acoustic pressure is found to be small when the movement of the vocal folds is prescribed. It is argued that the effect remains small when fluid-structure interactions account for vocal fold movement. These conclusions can be justified mathematically when the characteristic time scale for change in the velocity of the glottal jet is large compared to the time it takes for a vortex disturbance to be convicted through the vocal fold and ventricular fold region.

  4. Simulated Reflux Decreases Vocal Fold Epithelial Barrier Resistance

    Science.gov (United States)

    Erickson, Elizabeth; Sivasankar, Mahalakshmi

    2010-01-01

    Objectives/Hypothesis The vocal fold epithelium provides a barrier to the entry of inhaled and systemic challenges. However, the location of the epithelium makes it vulnerable to damage. Past research suggests, but does not directly demonstrate, that exposure to gastric reflux adversely affects the function of the epithelial barrier. Understanding the nature of reflux-induced epithelial barrier dysfunction is necessary to better recognize the mechanisms for vocal fold susceptibility to this disease. Therefore, we examined the effects of physiologically relevant reflux challenges on vocal fold transepithelial resistance and gross epithelial and subepithelial appearance. Study Design Ex vivo, mixed design with between-group and repeated-measures analyses. Methods Healthy, native porcine vocal folds (N = 52) were exposed to physiologically relevant acidic pepsin, acid-only, or pepsin-only challenges and examined with electrophysiology and light microscopy. For all challenges, vocal folds exposed to a neutral pH served as control. Results Acidic pepsin and acid-only challenges, but not pepsin-only or control challenges significantly reduced transepithelial resistance within 30 minutes. Reductions in transepithelial resistance were irreversible. Challenge exposure produced minimal gross changes in vocal fold epithelial or subepithelial appearance as evidenced by light microscopy. Conclusions These findings demonstrate that acidic environments characteristic of gastric reflux compromise epithelial barrier function without gross structural changes. In healthy, native vocal folds, reductions in transepithelial resistance could reflect reflux-related epithelial disruption. These results might guide the development of pharmacologic and therapeutic recommendations for patients with reflux, such as continued acid-suppression therapy and patient antireflux behavioral education. PMID:20564752

  5. Parameters Quantifying Dehydration in Canine Vocal Fold Lamina Propria

    Science.gov (United States)

    Hanson, Kevin P.; Zhang, Yu; Jiang, Jack J.

    2010-01-01

    Objective The goal of this study was to measure the solid and liquid volume and mass of canine vocal fold lamina propria tissue at varying dehydration levels and to calculate parameters to test the biphasic theory of vocal fold physiology and biomechanics. Study Design Open controlled experimental trial Methods The vocal fold lamina propria was dissected from 15 canine larynges, yielding 30 tissue samples. The initial volumes and masses of the tissue samples were measured. The masses of the tissue samples were then measured every 2 minutes during 30%, 50%, and 70% dehydration, with 10 samples subjected to each of the 3 treatments, followed by complete dehydration to yield the solid component of the tissue. The liquid mass and volume fractions and liquid:solid mass and volume ratios of the vocal fold lamina propria samples were calculated. Results The liquid mass and volume fractions and liquid:solid mass and volume ratios were significantly different at each dehydration level, except for the liquid:solid volume ratios at 30% vs. 50% dehydration. Linear regression analysis suggested that all of the solid and liquid parameters measured could be predicted by dehydration level based on inverse, linear relationships. Conclusions These results provide further experimental evidence supporting the biphasic theory and suggest that the extent of vocal fold lamina propria tissue dehydration may be quantified based on the biphasic model parameters. PMID:20564654

  6. Phonosurgery of vocal fold polyps, cysts and nodules is beneficial.

    Science.gov (United States)

    Jensen, Jane Bjerg; Rasmussen, Niels

    2013-02-01

    This study reports our experience with microscopic phonosurgery (PS) of benign lesions of the vocal folds. During the five-year period from 2003 to 2007, a total of 97 patients had PS for vocal fold polyps (n = 63), vocal fold cysts (n = 17), vocal fold nodules (n = 12) or vocal fold oedema (n = 5). Their average age was 41 years; 62% were women and 69% were smokers. Post-operative voice therapy was given to 45 patients. Post-operative clinical evaluation was available for data analysis in 89 patients (92%). Voice quality was assessed using the Multi-Dimensional Voice Program (MDVP), video-stroboscopy and self-reported assessment. The median follow-up time was 3.9 months. Post-operative voice quality was reported as unaffected in 85%, improved but moderately affected in 13%, and severely affected in one patient with a cyst and vocal fold sulcus. Unaffected voice quality was obtained in 91% of patients not receiving voice therapy and in 77% of patients receiving voice therapy. All lesions except one polyp in the anterior commissure were completely removed. MDVP was performed both pre- and post-operatively in 22% of patients. The effect was a significant improvement of jitter (p = 0.013), shimmer (p = 0.001) and Soft Phonation Index (p = 0.013). PS is a quick and effective treatment with uncommon and transient post-operative complications. Objective assessment of the voice pre- and post-operatively should be used consistently and applied in controlled studies evaluating the additional impact of pre- and post-operative voice therapy. not relevant. not relevant.

  7. A grading scale for pediatric vocal fold nodules.

    Science.gov (United States)

    Shah, Rahul K; Feldman, Henry A; Nuss, Roger C

    2007-02-01

    To design a grading scale for vocal fold nodules in pediatric patients. We conducted a prospective study in which a grading scale for vocal nodule size and contour based on static fiberoptic images of pediatric larynges was developed to achieve the scale presented here. Twenty-eight health care professionals each rated 28 images of pediatric vocal fold nodules. The intraclass correlation for nodule size was strong (0.77; 95% confidence interval, 0.67-0.87). The kappa statistic for nodule contour was mild (0.35; 95% confidence interval, 0.33-0.37). Agreement between experienced and other raters found no significant difference for the nodule size or contour grade of a given image. A grading scale for pediatric vocal fold nodules is presented. Interrater reliability for nodule size is high and can be reliably used by health care professionals with varying levels of experience. A validated grading scale facilitates objective analysis of outcomes when studying and following patients with vocal nodules.

  8. Jugular vein phlebectasia in paediatric patients with vocal fold nodules.

    Science.gov (United States)

    Liu, Xiang; Sun, Chang-zhi; Zou, Hua; Luo, Ren-zhong

    2013-08-01

    Jugular vein phlebectasia (JVP) may often be overlooked in clinical practice and the management for JVP include surgery and a conservative approach. We have studied the relationship between JVP and vocal fold nodules in paediatric patients as well as the effects of treatment. Twenty-three cases of paediatric vocal fold nodules with JVP were studied. All patients received voice therapy. After 6 months of treatment, hoarseness, neck appearance (subjective evaluation) and the degree of dilation of the jugular vein detected by Doppler ultrasonography were analysed. The follow-up period was 6 to 84 months. The hoarseness disappeared or lessened noticeably after treatment for 1-4 months. The neck masses also lessened (pre vs. post: 2.58 ± 0.40 vs. 1.60 ± 0.19) after treatment for 1-4 months. The visual analogue score of the post-treatment symptoms decreased significantly compared with pre-treatment (p vocal fold nodules may be related to JVP. Voice changes may also be observed in cases of paediatric JVP. Voice therapy may offer another conservative treatment option for JVP accompanied by vocal fold nodules, and it may offer better results than simple observation of JVP.

  9. Laryngeal Electromyography for Prognosis of Vocal Fold Paralysis.

    Science.gov (United States)

    Pardo-Maza, Adriana; García-Lopez, Isabel; Santiago-Pérez, Susana; Gavilán, Javier

    2017-01-01

    This study aimed to determine the value of laryngeal electromyography in the prognosis of vocal fold paralysis. This is a retrospective descriptive study. This study included 80 patients diagnosed with unilateral or bilateral vocal fold paralysis on flexible laryngoscopy between 2002 and 2014 in a tertiary medical center. Laryngeal electromyography using a standardized protocol was performed; the outcome measures were classified and analyzed into two groups according to the degree of injury. Group 1 included patients with mild to moderate injury, and group 2 included patients with severe to complete injury. Prognosis was correlated with vocal fold motion recovery status with a minimum of 6 months of follow-up since the symptoms onset using positive and negative predictive values. Sixty patients showed acute or chronic recurrent laryngeal neuropathy in laryngeal electromyography. Twelve of 41 patients included in group 1 recovered motion, and 30 of 35 patients included in group 2 did not recover, resulting in 88.2% of positive predictive value and 35.7% of negative predictive value. Our data confirm that laryngeal electromyography is a useful clinical tool in predicting poor recovery in patients with vocal fold paralysis. It allows identification of candidates for early intervention. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  10. Anatomical study of minor alterations in neonate vocal folds.

    Science.gov (United States)

    Silva, Adriano Rezende; Machado, Almiro José; Crespo, Agrício Nubiato

    2014-01-01

    Minor structural alterations of the vocal fold cover are frequent causes of voice abnormalities. They may be difficult to diagnose, and are expressed in different manners. Cases of intracordal cysts, sulcus vocalis, mucosal bridge, and laryngeal micro-diaphragm form the group of minor structural alterations of the vocal fold cover investigated in the present study. The etiopathogenesis and epidemiology of these alterations are poorly known. To evaluate the existence and anatomical characterization of minor structural alterations in the vocal folds of newborns. 56 larynxes excised from neonates of both genders were studied. They were examined fresh, or defrosted after conservation via freezing, under a microscope at magnifications of 25× and 40×. The vocal folds were inspected and palpated by two examiners, with the aim of finding minor structural alterations similar to those described classically, and other undetermined minor structural alterations. Larynges presenting abnormalities were submitted to histological examination. Six cases of abnormalities were found in different larynges: one (1.79%) compatible with a sulcus vocalis and five (8.93%) compatible with a laryngeal micro-diaphragm. No cases of cysts or mucosal bridges were found. The observed abnormalities had characteristics similar to those described in other age groups. Abnormalities similar to sulcus vocalis or micro-diaphragm may be present at birth. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  11. Radiology findings in adult patients with vocal fold paralysis

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, S. [Helsinki Medical Imaging Centre, University of Helsinki, Haartmaninkatu, Helsinki (Finland)]. E-mail: s.robinson@dzu.at; Pitkaeranta, A. [Department of Otorhinolaryngology, Haartmaninkatu, Helsinki (Finland)

    2006-10-15

    Aim: To compile imaging findings in patients with vocal fold paralysis. Materials and methods: A retrospective analysis of the medical charts of 100 consecutive patients, admitted to our department with vocal fold paralysis was undertaken. After laryngoscopy, patients were referred for radiological work-up depending on their clinical history and clinical findings. Ultrasound of the neck and/or contrast-enhanced spiral computed tomography (CT) of the neck and mediastinum was performed, extending to include the whole chest if necessary. In one patient, CT of the brain and in two patients, magnetic resonance angiography was undertaken. Analysis of the clinical and radiological data was performed to assess the most frequent causes for vocal fold paralysis. Results: In 66% of patients, the paralysis was related to previous surgery. Thirty-four percent of cases were labelled idiopathic after clinical examination. After imaging and follow-up, only 8% remained unexplained. Nine patients suffered from neoplasms, four from vascular disease, and 12 from infections. One patient developed encephalomyelitis disseminata on follow-up. Conclusion: Thorough radiological work-up helps to reduce the amount of idiopathic cases of vocal fold paralysis and guides appropriate therapy.

  12. Vocal Fold Pathologies and Three-Dimensional Flow Separation Phenomena

    Science.gov (United States)

    Apostoli, Adam G.; Weiland, Kelley S.; Plesniak, Michael W.

    2013-11-01

    Polyps and nodules are two different pathologies, which are geometric abnormalities that form on the medial surface of the vocal folds, and have been shown to significantly disrupt a person's ability to communicate. Although the mechanism by which the vocal folds self-oscillate and the three-dimensional nature of the glottal jet has been studied, the effect of irregularities caused by pathologies is not fully understood. Examining the formation and evolution of vortical structures created by a geometric protuberance is important, not only for understanding the aerodynamic forces exerted by these structures on the vocal folds, but also in the treatment of the above-mentioned pathological conditions. Using a wall-mounted prolate hemispheroid with a 2:1 aspect ratio in cross flow, the present investigation considers three-dimensional flow separation induced by a model vocal fold polyp. Building on previous work using skin friction line visualization, both the velocity flow field and wall pressure measurements around the model polyp are presented and compared. Supported by the National Science Foundation, Grant No. CBET-1236351 and GW Center for Biomimetics and Bioinspired Engineering (COBRE).

  13. A new generation videokymography for routine clinical vocal fold examination

    NARCIS (Netherlands)

    Qiu, Qingjun; Schutte, Harm K.

    2006-01-01

    Objective. This study aims to introduce a new-generation videokymographic system, which provides simultaneous laryngoscopic and kymographic image, for routine clinical vocal fold examination. Study Design: The authors explored a new imaging method for diagnosis and evaluation of voice disorders.

  14. A HTK-based Method for Detecting Vocal Fold Pathology.

    Science.gov (United States)

    Majidnezhad, Vahid

    2014-08-01

    In recent years a number of methods based on acoustic analysis were developed for vocal fold pathology detection. These methods can be categorized in two categories:a) detection based on the phonemes b) detection based on the continuous speeches. While there are many researches which belong to the first category, there are few efforts for detecting vocal fold pathology based on the continuous speeches (second category). In this work, a method based on the Hidden Markov model Toolkit (HTK) for detecting vocal fold pathology in the Russian digits is developed which belongs to the second category. It employs a three state HMM for modeling each phoneme. According to the results of the experiments, the proposed method achieves the 90% of detection accuracy. The proposed method is one of the first works for detecting vocal fold pathology based on the Russian digits (from 1 to 10) for Belorussian people. The reported accuracy is rather good and therefore it is recommended to use it as an auxiliary tool in medical centers.

  15. Videokymography : High-speed line scanning of vocal fold vibration

    NARCIS (Netherlands)

    Svec, JG; Schutte, HK

    A digital technique for high-speed visualization of vibration, called videokymography, was developed and applied to the vocal folds. The system uses a modified video camera able to work in two modes: high-speed (nearly 8,000 images/s) and standard (50 images/s in CCIR norm). In the high-speed mode,

  16. Behavioral characteristics of children with vocal fold nodules.

    Science.gov (United States)

    Roy, Nelson; Holt, Kellianne I; Redmond, Sean; Muntz, Harlan

    2007-03-01

    Vocal fold nodules (VNs) in children are benign, bilateral lesions occurring on the mid-membranous vocal folds. Repetitive phonotraumatic behavior leading to chronic vocal fold injury and repair is frequently cited as the primary etiology; however, specific behavioral characteristics may predispose some children toward intense and potentially phonotraumatic voice use, thereby contributing secondarily to VN formation. The purpose of this case-control study was to determine whether children with VNs possess unique behavioral characteristics that may predispose them to VN development. Parents of 26 children with VNs (20 boys, 6 girls, mean age=7.2 years, SD=2.5 years), and 29 vocally normal, medical controls (22 boys, 7 girls, mean age=6.7 years, SD=2.4), completed the Childhood Behavior Checklist (CBCL/4-18, Achenbach, 1991), a standardized parent-rating scale with strong psychometric properties. No significant between-group differences were detected on any of the behavior problem syndrome scales. Group differences approached significance for the individual items "screams a lot" and "teases a lot" (VN group > Controls). The VN group scored significantly higher than the controls on the "Social Scale," a compilation of positive ratings of the child's social activity, frequency of contacts with friends, behavior with others, and behavior by themselves. Observed outcomes were consistent with previous characterizations of children with VN as "outgoing" or "extroverted" but were not consistent with other claims that this population may be at risk for "aggressive," "attentional," or "impulsive" behavior problems.

  17. Evolution of vocal fold nodules from childhood to adolescence.

    Science.gov (United States)

    De Bodt, M S; Ketelslagers, K; Peeters, T; Wuyts, F L; Mertens, F; Pattyn, J; Heylen, L; Peeters, A; Boudewyns, A; Van de Heyning, P

    2007-03-01

    Bilateral (quasi) symmetrical lesions of the anterior third of the vocal folds, commonly called vocal fold nodules (VFNs) are the most frequent vocal fold lesions in childhood caused by vocal abuse and hyperfunction. This study evaluates their long-term genesis with or without surgery and voice therapy. A group of 91 postmutational adolescents (mean age, 16 years), in whom VFNs were diagnosed in childhood, were questioned to analyze the evolution of their complaints. Thirty four of them could be clinically reexamined by means of the European Laryngological Society-protocol, including a complete laryngological investigation and voice assessment. A total of 21% of the questioned group (n=91) had voice complaints persisting into postpubescence with a statistically significant difference (P dysphonia ("G") in childhood enable a fairly correct prediction of persisting voice complaints in adolescence (sensitivity of 89% and specificity of 67%). The results of this study show a clearly different evolution for both sexes, with significant higher long-term risks for dysphonic girls with allergy.

  18. Lamina propria of the mucosa of benign lesions of the vocal folds

    NARCIS (Netherlands)

    Dikkers, FG; Nikkels, PGJ

    1999-01-01

    Objective/Hypothesis: To demonstrate a correlation between the duration and specific pattern of trauma of benign lesions of the vocal folds and their histopathologic appearance, Benign lesions of the vocal folds have various macroscopic appearances. Investigations demonstrate characteristic

  19. A numerical strategy for finite element modeling of frictionless asymmetric vocal fold collision

    DEFF Research Database (Denmark)

    Granados, Alba; Misztal, Marek Krzysztof; Brunskog, Jonas

    2016-01-01

    Analysis of voice pathologies may require vocal fold models that include relevant features such as vocal fold asymmetric collision. The present study numerically addresses the problem of frictionless asymmetric collision in a self-sustained three-dimensional continuum model of the vocal folds. Th...

  20. Genetic Characterization of Vocal Fold Lesions: Leukoplakia and Carcinoma

    Science.gov (United States)

    Bartlett, Rebecca S.; Heckman, W. Wesley; Isenberg, Jason; Thibeault, Susan L.; Dailey, Seth H.

    2012-01-01

    Objectives/Hypothesis Malignant transformation of laryngeal keratosis has been reported in a substantial subset of patients, yet reliable criteria for predicting patients most at risk have yet to be determined. Current methods for determining dysplasia ratings are susceptible to errors in biopsy sampling and interpretation. An understanding of the genetic underpinnings of the progression of vocal fold tumorigenesis may contribute to the creation of reliable and predictive diagnostic criteria. We hypothesized that genetic expression markers distinguish patients with keratotic noncancerous vocal fold lesions from invasive carcinoma. Study Design Observational cross-sectional study. Methods Real-time polymerase chain reaction (RT-PCR) was used to compare expression of 84 cancer pathway genes of patients following histologic diagnosis of nondysplastic keratotic epithelium (ND) (n = 7), dysplastic keratotic epithelium (DYS) (n = 3), and invasive carcinoma (CA) (n = 7). All patients had a clinical diagnosis of leukoplakia, and biopsies were obtained from true vocal fold tissue. Results Four genes (IGF-1, EPDR1, MMP-2, S100A4) were significantly upregulated in DYS over the ND group. Seven genes were significantly upregulated in CA over the DYS group, and 31 genes were significantly upregulated in CA over the ND group (P < .02). The expression of matrix metalloproteinases (MMP-1, MMP-2, MMP-9) was found to statistically differentiate the groups (P < .02) and suggested disease progression associated with extracellular matrix degradation and angiogenesis promotion. Conclusions With these preliminary array data, we demonstrate the feasibility of using RT-PCR to identify distinct genetic expression between diagnostic groups. Characterization of genetic changes marking the progression of vocal fold tumorigenesis may lead to robust diagnostic criteria in the future. PMID:22252855

  1. Positive therapy of andrographolide in vocal fold leukoplakia.

    Science.gov (United States)

    Xu, Jue; Xue, Tao; Bao, Ying; Wang, Dong-Hai; Ma, Bing-Liang; Yin, Chen-Yi; Yang, Guang-Hui; Ren, Gang; Lan, Long-Jiang; Wang, Jian-Qiu; Zhang, Xiao-Lan; Zhao, Yu-Qin

    2014-01-01

    Vocal fold leukoplakia is a premalignant precursor of squamous cell carcinoma. Although many efforts have been contributed to therapy of this disease, none exhibits a satisfactory result. The aims of this study were to investigate the effectiveness and feasibility of andrographolide therapy in vocal fold leukoplakia and to explore the preliminary mechanism underlying. Forty-one eligible patients were enrolled in the study. The patients were treated for 10-minute exposures of 5 ml (25mg/ml) andrographolide injection aerosols twice a day, and 2 weeks was considered as one treatment course. Electronic laryngoscope was used to observe the condition of vocal fold leukoplakia during the treatment. Every patient received one or two treatment courses, and the follow-up was carried out for 12 months. Toxic reactions of treatments were evaluated on the basis of the standards of the United States MD Anderson Cancer Center. Moreover, laryngeal carcinoma cell line Hep2 was applied to explore the mechanism of effect of andrographolide. Anti-proliferative effect on Hep2, cell nuclear morphology, express of mitogen-activated protein kinases (MAPK) and pro-apoptotic protein were detected after andrographolide treatment. We found that andrographolide exhibited significant curative effects on treatments, which were accompanied by thinning of the lesion of leukoplakia, reduction in the whitish surface area, and return of pink or red epithelium. A complete response up to 85% was observed, and no toxic side effect events occurred during the study. No patient with a complete response had a recurrence in the follow-up. Moreover, cellular experiments in Hep2 indicated that andrographolide activated MAPK pathway and caspase cascade, and finally induced apoptosis in laryngeal carcinoma cell. The advantages of andrographolide are connected with minimally invasive and localized character of the treatment and no damage of collagenous tissue structures, which are more convenient and less painful

  2. Neuromuscular compensation mechanisms in vocal fold paralysis and paresis.

    Science.gov (United States)

    Dewan, Karuna; Vahabzadeh-Hagh, Andrew; Soofer, Donna; Chhetri, Dinesh K

    2017-07-01

    Vocal fold paresis and paralysis are common conditions. Treatment options include augmentation laryngoplasty and voice therapy. The optimal management for this condition is unclear. The objective of this study was to assess possible neuromuscular compensation mechanisms that could potentially be used in the treatment of vocal fold paresis and paralysis. In vivo canine model. In an in vivo canine model, we examined three conditions: 1) unilateral right recurrent laryngeal nerve (RLN) paresis and paralysis, 2) unilateral superior laryngeal nerve (SLN) paralysis, and 3) unilateral vagal nerve paresis and paralysis. Phonatory acoustics and aerodynamics were measured in each of these conditions. Effective compensation was defined as improved acoustic and aerodynamic profile. The most effective compensation for all conditions was increasing RLN activation and decreasing glottal gap. Increasing RLN activation increased the percentage of possible phonatory conditions that achieved phonation onset. SLN activation generally led to decreased number of total phonation onset conditions within each category. Differential effects of SLN (cricothyroid [CT] muscle) activation were seen. Ipsilateral SLN activation could compensate for RLN paralysis; normal CT compensated well in unilateral SLN paralysis; and in vagal paresis/paralysis, contralateral SLN and RLN displayed antagonistic relationships. Methods to improve glottal closure should be the primary treatment for large glottal gaps. Neuromuscular compensation is possible for paresis. This study provides insights into possible compensatory mechanisms in vocal fold paresis and paralysis. NA Laryngoscope, 127:1633-1638, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  3. Modal locking between vocal fold and vocal tract oscillations: Simulations in time domain

    CERN Document Server

    Aalto, Atte; Malinen, Jarmo; Aalto, Daniel; Vainio, Martti

    2015-01-01

    It is well known that during voiced speech, the human vocal folds interact with the vocal tract acoustics. The resulting source-filter coupling has been observed using mathematical and physical models as well as in in vivo phonation. We propose a computational time-domain model of the full speech apparatus that, in particular, contains a feedback mechanism from the vocal tract acoustics to the vocal fold oscillations. It is based on numerical solution of ordinary and partial differential equations defined on vocal tract geometries that have been obtained by Magnetic Resonance Imaging. The model is used to simulate rising and falling pitch glides of [a, i] in the fundamental frequency (f_0) interval [180 Hz, 360 Hz]. The interval contains the first formant F1 of [i] as well as the subformants F1/4 and F1/3 of [a]. The simulations reveal a locking pattern of the f_0-trajectory at F1 of [i] in falling and rising glides. The subformants of [a] produce perturbations in the waveforms of glottal signals but no locki...

  4. Risk factors for the appearance of minimal pathologic lesions on vocal folds in vocal professionals

    Directory of Open Access Journals (Sweden)

    Stojanović Jasmina

    2012-01-01

    Full Text Available Background/Aim. An excessive use or misuse of voice by vocal professionals may result in symptoms such are husky voice, hoarse voice, total loss of voice, or even organic changes taking place on vocal folds - minimal pathological lesions - MAPLs. The purpose of this study was to identify the type of MAPLs which affects vocal professionals, as well as to identify the risk factors that bring about these changes. Methods. There were 94 vocal professionals who were examined altogether, out of whom 46 were affected by MAPLs, whereas 48 of them were diagnosed with no MAPLs, so that they served as the control group. All these patients were clinically examined (anamnesis, clinical examination, bacteoriological examination of nose and pharynx, radiography of paranasal cavities, allergological processing, phoniatric examination, endo-video-stroboscopic examination, as well as gastroenterologic examination, and finally endocrinological and pulmological analyses. Results. The changes that occurred most often were identified as nodules (50%; n = 23/46 and polyps (24%; n = 11/46. Risk factors causing MAPLs in vocal professionals were as follows: age, which reduced the risk by 23.9% [OR 0.861 (0.786-0.942] whereas the years of career increase the risk [OR 1.114 (1.000-1.241], as well as the presence of a chronic respiratory disease [OR 7.310 (1.712- 31.218], and the presence of gastro-oesophageal reflux disease [OR 4.542 (1.263-16.334]. The following factors did not contribute to development of MAPLs in vocal professionals: sex, a place of residence, irritation, smoking, endocrinologic disease and the presence of poly-sinusitis. Conclusion. It is necessary to introduce comprehensive procedures for prevention of MAPLs, particularly in high-risk groups. Identification of the risk factors for MAPLs and prevention of their influence on vocal professionals (given that their income depends on their vocal ability is of the highest importance.

  5. Targeting Fold Stiffness to Design Enhanced Origami Structures

    Science.gov (United States)

    Buskohl, Philip; Bazzan, Giorgio; Abbott, Andrew; Durstock, Michael; Vaia, Richard

    2014-03-01

    Structures with adaptive geometry are increasingly of interest for actuation, sensing and packaging applications. Origami structures, by definition, can ``shape-shift'' between multiple geometric configurations that are predefined by a pattern of folds. Plastic deformation and local failure at the fold lines transform an originally homogenous material into a grid with locally tailored mechanical properties that bias the response of the overall structure to external loading. Typically, origami structures focus on uniformly stiff fold lines with rigid facets. In this study, we discuss how localized variations in stiffness can influence global properties, including energy budget to transition from flat to folded structure, the preferred path through configuration space, and the final mechanical response of the folded architecture. A simple, bi-stable origami fold pattern is laser machined into polypropylene sheets of different compliance and the critical load of the transition is measured. We model the structure as a truss with bar elongation, folding, and facet bending in order to predict ways to enhance or mitigate the critical load. Targeting local folding properties to modify global performance directly extends to the analysis of more complex architectures.

  6. Classification of laryngeal disorders based on shape and vascular defects of vocal folds.

    Science.gov (United States)

    Irem Turkmen, H; Elif Karsligil, M; Kocak, Ismail

    2015-07-01

    Vocal fold disorders such as laryngitis, vocal nodules, and vocal polyps may cause hoarseness, breathing and swallowing difficulties due to vocal fold malfunction. Despite the fact that state of the art medical imaging techniques help physicians to obtain more detailed information, difficulty in differentiating minor anomalies of vocal folds encourages physicians to research new strategies and technologies to aid the diagnostic process. Recent studies on vocal fold disorders note the potential role of the vascular structure of vocal folds in differential diagnosis of anomalies. However, standards of clinical usage of the blood vessels have not been well established yet due to the lack of objective and comprehensive evaluation of the vascular structure. In this paper, we present a novel approach that categorizes vocal folds into healthy, nodule, polyp, sulcus vocalis, and laryngitis classes exploiting visible blood vessels on the superior surface of vocal folds and shapes of vocal fold edges by using image processing techniques and machine learning methods. We first detected the vocal folds on videolaryngostroboscopy images by using Histogram of Oriented Gradients (HOG) descriptors. Then we examined the shape of vocal fold edges in order to provide features such as size and splay portion of mass lesions. We developed a new vessel centerline extraction procedure that is specialized to the vascular structure of vocal folds. Extracted vessel centerlines were evaluated in order to get vascular features of vocal folds, such as the amount of vessels in the longitudinal and transverse form. During the last step, categorization of vocal folds was performed by a novel binary decision tree architecture, which evaluates features of the vocal fold edge shape and vascular structure. The performance of the proposed system was evaluated by using laryngeal images of 70 patients. Sensitivity of 86%, 94%, 80%, 73%, and 76% were obtained for healthy, polyp, nodule, laryngitis, and

  7. Recurrent Vocal Fold Paralysis and Parsonage-Turner Syndrome

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius Pinto

    2013-01-01

    Full Text Available Background. Parsonage-Turner syndrome, or neuralgic amyotrophy (NA, is an acute brachial plexus neuritis that typically presents with unilateral shoulder pain and amyotrophy but also can affect other peripheral nerves, including the recurrent laryngeal nerve. Idiopathic vocal fold paralysis (VFP represents approximately 12% of the VFP cases and recurrence is extremely rare. Methods and Results. We report a man with isolated recurrent unilateral right VFP and a diagnosis of NA years before. Conclusions. We emphasize that shoulder pain and amyotrophy should be inquired in any patient suffering from inexplicable dysphonia, and Parsonage-Turner syndrome should be considered in the differential diagnosis of idiopathic VFP.

  8. Is voice therapy effective for the treatment of dysphonic patients with benign vocal fold lesions?

    Science.gov (United States)

    Ogawa, Makoto; Inohara, Hidenori

    2017-08-22

    To update our knowledge regarding the effectiveness of voice therapy for the treatment of vocal disturbance associated with benign vocal fold lesions, including vocal polyps, nodules and cysts, and for determining the utility of voice therapy in treating organic voice disorders, while highlighting problems for the future development of this clinical field. We conducted a review of the most recent literature on the therapeutic effects of voice therapy, vocal hygiene education or direct vocal training on vocal quality, the lesion appearance and discomfort felt by patients due to the clinical entity of benign vocal fold mass lesions. Although voice therapy is principally indicated for the treatment of functional dysphonia without any organic abnormalities in the vocal folds, a number of clinicians have attempted to perform voice therapy even in dysphonic patients with benign mass lesions in the vocal folds. The two major possible reasons for the effectiveness of voice therapy on vocal disturbance associated with benign vocal fold lesions are hypothesized to be the regression of lesions and the correction of excessive/inappropriate muscle contraction of the phonatory organs. According to the current literature, a substantial proportion of vocal polyps certainly tend to shrink after voice therapy, but whether or not the regression results from voice therapy, vocal hygiene education or a natural cure is unclear at present due to the lack of controlled studies comparing two groups with and without interventions. Regarding vocal nodules, no studies have investigated the effectiveness of voice therapy using proper experimental methodology. Vocal cysts are difficult to cure by voice therapy without surgical excision according to previous studies. Evidences remains insufficient to support the use of voice therapy against benign vocal fold lesions. Evidences at present is therefore still insufficient to support the use of voice therapy for the treatment of benign vocal fold

  9. Fascia implantation with fibroblast growth factor on vocal fold paralysis.

    Science.gov (United States)

    Nagai, Hiromi; Nishiyama, Koichiro; Seino, Yutomo; Kimura, Yu; Tabata, Yasuhiko; Okamoto, Makito

    2013-01-01

    The purpose of this prospective study was to determine the effect of autologous transplantation of fascia into the vocal fold (ATFV) with controlled release of basic fibroblast growth factor (bFGF) on unilateral vocal fold paralysis (UVFP) in a rat model. Unilateral recurrent laryngeal nerve (RLN) section was performed on 15 rats. Ten rats received an autologous fascia implant and gelatin hydrogel with or without bFGF (1 μg) to their larynxes (fascia only, "fascia group"; bFGF + fascia, "fascia + bFGF group"), while the rest underwent RLN transection ("RLN section group"). Four months later, evaluation of the laryngeal glottal gap and histological analysis were performed. The glottal gap was significantly reduced in the fascia + bFGF group, and fat volume increased significantly relative to the RLN section. The volume of the remaining fascia in the bFGF + fascia group was significantly greater than that of the fascia group. ATFV with controlled release of bFGF may compensate for diminished laryngeal volume in UVFP by reducing resorption of the implanted fascia and increasing fat volume. Our findings suggest that this modality may represent an attractive option for treating UVFP. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Adapted to roar: functional morphology of tiger and lion vocal folds.

    Directory of Open Access Journals (Sweden)

    Sarah A Klemuk

    Full Text Available Vocal production requires active control of the respiratory system, larynx and vocal tract. Vocal sounds in mammals are produced by flow-induced vocal fold oscillation, which requires vocal fold tissue that can sustain the mechanical stress during phonation. Our understanding of the relationship between morphology and vocal function of vocal folds is very limited. Here we tested the hypothesis that vocal fold morphology and viscoelastic properties allow a prediction of fundamental frequency range of sounds that can be produced, and minimal lung pressure necessary to initiate phonation. We tested the hypothesis in lions and tigers who are well-known for producing low frequency and very loud roaring sounds that expose vocal folds to large stresses. In histological sections, we found that the Panthera vocal fold lamina propria consists of a lateral region with adipocytes embedded in a network of collagen and elastin fibers and hyaluronan. There is also a medial region that contains only fibrous proteins and hyaluronan but no fat cells. Young's moduli range between 10 and 2000 kPa for strains up to 60%. Shear moduli ranged between 0.1 and 2 kPa and differed between layers. Biomechanical and morphological data were used to make predictions of fundamental frequency and subglottal pressure ranges. Such predictions agreed well with measurements from natural phonation and phonation of excised larynges, respectively. We assume that fat shapes Panthera vocal folds into an advantageous geometry for phonation and it protects vocal folds. Its primary function is probably not to increase vocal fold mass as suggested previously. The large square-shaped Panthera vocal fold eases phonation onset and thereby extends the dynamic range of the voice.

  11. Vocal fold motion outcome based on excellent prognosis with laryngeal electromyography.

    Science.gov (United States)

    Smith, Libby J; Rosen, Clark A; Munin, Michael C

    2016-10-01

    As laryngeal electromyography (LEMG) becomes more refined, accurate predictions of vocal fold motion recovery are possible. Focus has been on outcomes for patients with poor prognosis for vocal fold motion recovery. Limited information is available regarding the expected rate of purposeful vocal fold motion recovery when there is good to normal motor recruitment, no signs of denervation, and no signs of synkinetic activity with LEMG, termed excellent prognosis. The objective of this study is to determine the rate of vocal fold motion recovery with excellent prognosis findings on LEMG after acute recurrent laryngeal nerve injury. Retrospective review. Patients undergoing a standardized LEMG protocol, consisting of qualitative (evaluation of motor recruitment, motor unit configuration, detection of fibrillations, presence of synkinesis) and quantitative (turns analysis) measurements were evaluated for purposeful vocal-fold motion recovery, calculated after at least 6 months since onset of injury. Twenty-three patients who underwent LEMG for acute vocal fold paralysis met the inclusion criteria of excellent prognosis. Eighteen patients (78.3%) recovered vocal fold motion, as determined by flexible laryngoscopy. Nearly 80% of patients determined to have excellent prognosis for vocal fold motion recovery experienced return of vocal fold motion. This information will help clinicians not only counsel their patients on expectations but will also help guide treatment. 4. Laryngoscope, 126:2310-2314, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Noninvasive monitoring of vocal fold vertical vibration using the acoustic Doppler effect.

    Science.gov (United States)

    Tao, Chao; Jiang, Jack J; Wu, Dan; Liu, Xiaojun; Chodara, Ann

    2012-11-01

    To validate a proposed method of noninvasively monitoring vocal fold vertical vibration through utilization of the acoustic Doppler effect and the waveguide property of the vocal tract. Validation case-control study. In this device, an ultrasound beam is generated and directed into the mouth. The vocal tract, acting as a natural waveguide, guides the ultrasound beam toward the vibrating vocal folds. The vertical velocity of vocal fold vibration is then recovered from the Doppler frequency of the reflected ultrasound. One subject (age 32, male) was studied and measurements were taken under three modes of vocal fold vibration: breathing (no vibration), whispering (irregular vibration), and normal phonation (regular vibration). The peak-to-peak amplitude of the measured velocity of vocal fold vertical vibration was about 0.16 m/s, and the fundamental frequency was 172 Hz; the extracted velocity information showed a reasonable waveform and value in comparison with the previous studies. In all three modes of phonation, the Doppler frequencies derived from the reflected ultrasound corresponded with the vertical velocity of vocal fold vibration as expected. The proposed method can accurately represent the characteristics of different phonation modes such as no phonation, whisper and normal phonation. The proposed device could be used in daily monitoring and assessment of vocal function and vocal fold vibration. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  13. Learning to detect vocal hyperfunction from ambulatory neck-surface acceleration features: initial results for vocal fold nodules.

    Science.gov (United States)

    Ghassemi, Marzyeh; Van Stan, Jarrad H; Mehta, Daryush D; Zañartu, Matías; Cheyne, Harold A; Hillman, Robert E; Guttag, John V

    2014-06-01

    Voice disorders are medical conditions that often result from vocal abuse/misuse which is referred to generically as vocal hyperfunction. Standard voice assessment approaches cannot accurately determine the actual nature, prevalence, and pathological impact of hyperfunctional vocal behaviors because such behaviors can vary greatly across the course of an individual's typical day and may not be clearly demonstrated during a brief clinical encounter. Thus, it would be clinically valuable to develop noninvasive ambulatory measures that can reliably differentiate vocal hyperfunction from normal patterns of vocal behavior. As an initial step toward this goal we used an accelerometer taped to the neck surface to provide a continuous, noninvasive acceleration signal designed to capture some aspects of vocal behavior related to vocal cord nodules, a common manifestation of vocal hyperfunction. We gathered data from 12 female adult patients diagnosed with vocal fold nodules and 12 control speakers matched for age and occupation. We derived features from weeklong neck-surface acceleration recordings by using distributions of sound pressure level and fundamental frequency over 5-min windows of the acceleration signal and normalized these features so that intersubject comparisons were meaningful. We then used supervised machine learning to show that the two groups exhibit distinct vocal behaviors that can be detected using the acceleration signal. We were able to correctly classify 22 of the 24 subjects, suggesting that in the future measures of the acceleration signal could be used to detect patients with the types of aberrant vocal behaviors that are associated with hyperfunctional voice disorders.

  14. Apoptosis and Vocal Fold Disease: Clinically Relevant Implications of Epithelial Cell Death

    Science.gov (United States)

    Novaleski, Carolyn K.; Carter, Bruce D.; Sivasankar, M. Preeti; Ridner, Sheila H.; Dietrich, Mary S.; Rousseau, Bernard

    2017-01-01

    Purpose: Vocal fold diseases affecting the epithelium have a detrimental impact on vocal function. This review article provides an overview of apoptosis, the most commonly studied type of programmed cell death. Because apoptosis can damage epithelial cells, this article examines the implications of apoptosis on diseases affecting the vocal fold…

  15. Characterization of Vocal Fold Vibration in Sulcus Vocalis Using High-Speed Digital Imaging

    Science.gov (United States)

    Yamauchi, Akihito; Yokonishi, Hisayuki; Imagawa, Hiroshi; Sakakibara, Ken-Ichi; Nito, Takaharu; Tayama, Niro; Yamasoba, Tatsuya

    2017-01-01

    Purpose: The aim of the present study was to qualitatively and quantitatively characterize vocal fold vibrations in sulcus vocalis by high-speed digital imaging (HSDI) and to clarify the correlations between HSDI-derived parameters and traditional vocal parameters. Method: HSDI was performed in 20 vocally healthy subjects (8 men and 12 women) and…

  16. Nonmedical Treatments of Vocal Fold Nodules: A Systematic Review.

    Science.gov (United States)

    Mansuri, Banafshe; Tohidast, Seyed Abolfazl; Soltaninejad, Nasibe; Kamali, Mohammad; Ghelichi, Leila; Azimi, Hadi

    2017-10-11

    The aim of the present systematic review was to investigate the nonmedical treatments of vocal fold nodules (VFNs). The present study is a systematic review. The following electronic databases were searched from inception until August 2016: PubMed, Scopus, ScienceDirect, Ovid, ISI (Web of Sciences), Cochrane, PsychINFO, The Cochrane Central Register of Controlled Trials, and Google Scholar. Reference lists of included articles were evaluated for additional data. Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used to carry out and report the review. The methodological quality of the articles included was evaluated using the Physiotherapy Evidence Database scale. Due to the heterogeneity of the studies, a narrative synthesis of the evidence was performed to summarize the evidence. Out of 2,099 records identified, 21 articles met the inclusion criteria and thus were included in the review. The studies investigated in the present review were different in terms of study design, participant characteristics, types of assessments and treatments, and treatment delivery. However, nonmedical treatments of VFNs were found to be successful in improving vocal quality, decreasing VFN sizes, and resolving these nodules. The results of the present review could provide primary evidence related to the effectiveness of nonmedical treatment of VFNs. Yet further studies with a high level of evidence, a rigorous methodological quality, and long-term follow-up evaluations are required to make stronger claims. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  17. The human vocal fold layers. Their delineation inside vocal fold as a background to create 3D digital and synthetic glottal model

    Czech Academy of Sciences Publication Activity Database

    Klepáček, I.; Jirák, D.; Dušková-Smrčková, Miroslava; Janoušková, Olga; Vampola, T.

    2016-01-01

    Roč. 30, č. 5 (2016), s. 529-537 ISSN 0892-1997 R&D Projects: GA ČR(CZ) GAP101/12/1306 Institutional support: RVO:61389013 Keywords : human vocal fold * vocal ligamentous complex * lamina propria Subject RIV: CD - Macromolecular Chemistry Impact factor: 1.381, year: 2016

  18. High-speed Imaging of Vocal Fold Vibration Onset Delay: Normal Versus Abnormal.

    Science.gov (United States)

    Woo, Peak

    2017-05-01

    Vocal fold vibration onset delay (VFVOD) is heard frequently in spasmodic dysphonia and in muscle tension dysphonia. VFVOD changes due to other vocal pathologies have not been investigated. VFVOD during sustained vowel production was estimated with high-speed video in 10 normal and 40 pathologic subjects (scars, vocal fold paralysis, vocal fold nodules, and polyps). Analysis of high-speed video was done using digital kymography. VFVOD can be divided into two portions. Pre-phonation delay (PPD) is the duration when the vocal folds are nearly approximated to the time of first observed oscillation. Steady state delay (SSD) is the time when vocal folds are observed to come into oscillation until steady state of oscillation is observed. Normal subjects have almost zero PPD with vocal fold oscillation observed before full vocal fold adduction. Pathologic cases showed prolonged PPD because of (1) false cord adduction, (2) prolonged true vocal fold adduction, and (3) delay to onset of vocal fold vibration. Normal subjects have SSD of three to five cycles before steady state. Pathologic states result in increased SSD. Causes for increased SSD include (1) slow ramping up to steady state, (2) partial vibration of vocal folds, and (3) diplophonia with alternating beats before achieving steady state. There are significant differences between normal and pathology groups in both PPD and SSD. VFVOD is elevated in pathologic states. This can be due to increase in PPD or SSD. VFVOD is an under-recognized phenomenon that may contribute to complaints of vocal fatigue and dysphonia. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  19. Suture lateralization in patients with bilateral vocal fold paralysis.

    Science.gov (United States)

    Su, Wan-Fu; Liu, Shao-Cheng; Tang, Wei-Sheng; Yang, Mei-Chen; Lin, Yuan-Yung; Huang, Tung-Tsun

    2014-09-01

    To introduce a simplified suture lateralization (SL) technique to treat patients with bilateral vocal fold paralysis (BVFP). A retrospective study of surgical procedures by manual chart review. The proposed endoscopic SL procedure was used for 20 patients operated on for BVFP between 2007 and 2013, with three attempts to remove a tracheostomy tube and 17 attempts to resolve the dyspnea. An adjustment procedure was also used to correct any excessive lateralization according to the individual's clinical symptoms, such as intolerable aspiration after SL in elderly patients and excessive breathiness of voice in socially active patients. St George's respiratory questionnaire was used to subjectively evaluate the efficacy of lateralization of vocal folds. Pulmonary function test with flow-volume loop was used to objectively evaluate the improvement of BVFP-related upper airway obstruction after surgery. Phonatory ability tests were also used to evaluate the degree of deterioration of voice quality. Twenty patients underwent 22 episodes of SL. Two adjustment procedures were performed to correct excessive breathiness of voice or intolerable aspiration. Respiration was adequate in all 19 patients without artificial airways. Voice quality was socially acceptable in 19 of the patients and even equal to preoperative voice quality in 14 of them. Temporary mild aspiration occurred in 18 patients only in the first few days after the procedure. One decannulation failure and refusing adjustment procedure occurred in one elderly patient. All the patients were followed up for surgical outcomes for at least 9 and 33 months on average. SL is a simple, reversible, and minimally invasive reconstructive procedure for patients with BVFP. Our study supported its applicability for selected patients. Copyright © 2014 The Voice Foundation. All rights reserved.

  20. Mesenchymal Stem Cell Therapy for the Treatment of Vocal Fold Scarring

    DEFF Research Database (Denmark)

    Wingstrand, Vibe Lindeblad; Larsen, Christian Grønhøj; Jensen, David H

    2016-01-01

    the biomechanical properties of injured vocal folds. This study evaluated the biomechanical effects of mesenchymal stem cell therapy for the treatment of vocal fold scarring. DATA SOURCES: PubMed, Embase, the Cochrane Library and Google Scholar were searched. METHODS: Controlled studies that assessed...

  1. An optical flow-based state-space model of the vocal folds

    DEFF Research Database (Denmark)

    Granados, Alba; Brunskog, Jonas

    2017-01-01

    High-speed movies of the vocal fold vibration are valuable data to reveal vocal fold features for voice pathology diagnosis. This work presents a suitable Bayesian model and a purely theoretical discussion for further development of a framework for continuum biomechanical features estimation. A l...

  2. "Finding a Voice": Imaging Features after Phonosurgical Procedures for Vocal Fold Paralysis.

    Science.gov (United States)

    Vachha, B A; Ginat, D T; Mallur, P; Cunnane, M; Moonis, G

    2016-09-01

    Altered communication (hoarseness, dysphonia, and breathy voice) that can result from vocal fold paralysis, secondary to numerous etiologies, may be amenable to surgical restoration. In this article, both traditional and cutting-edge phonosurgical procedures targeting the symptoms resulting from vocal fold paralysis are reviewed, with emphasis on the characteristic imaging appearances of various injectable materials, implants, and augmentation procedures used in the treatment of vocal fold paralysis. In addition, complications of injection laryngoplasty and medialization laryngoplasty are illustrated. Familiarity with the expected imaging changes following treatment of vocal fold paralysis may prevent the misinterpretation of posttreatment changes as pathology. Identifying common complications related to injection laryngoplasty and localization of displaced implants is crucial in determining specific management in patients who have undergone phonosurgical procedures for the management of vocal fold paralysis. © 2016 by American Journal of Neuroradiology.

  3. A new videokymography system for evaluation of the vibration pattern of entire vocal folds.

    Science.gov (United States)

    Wang, Soo-Geun; Park, Hee-June; Lee, Byung-Joo; Lee, Sung-Mo; Ko, Bumjun; Lee, Sang Min; Park, Young Min

    2016-06-01

    To overcome the limitations of previous videokymography methods, we developed a new videokymography system for the evaluation of the whole mucosal wave of the entire vocal cord mucous membrane. To confirm the usefulness of the new videokymography system, we performed videokymography to evaluate the mucosal wave of the vocal folds during modal and falsetto phonation in normal adult males. Additionally, we serially performed both laryngeal videostroboscopy and the new videokymography method in patients diagnosed with acute ulcerative laryngitis. Using the new videokymography system, the mucosal wave pattern of entire vocal folds was captured during the examination. The opening and closing durations could be differentiated, and the symmetry of amplitude and phase could be assessed. The shape of the medial and lateral peaks could be assessed. In patients with acute laryngitis, the new videokymography system showed an enhanced ability to evaluate the flexibility of the vocal folds. The new videokymography system enables recording of the whole mucosal wave pattern of entire vocal folds. Although further studies are required to confirm its clinical efficacy for the evaluation of vocal folds, the system can be applied to evaluate the static and dynamic status of vocal folds in patients with vocal cord diseases. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Effects of Vocal Fold Nodules on Glottal Cycle Measurements Derived from High-Speed Videoendoscopy in Children

    OpenAIRE

    Patel, Rita R.; Harikrishnan Unnikrishnan; Donohue, Kevin D.

    2016-01-01

    The goal of this study is to quantify the effects of vocal fold nodules on vibratory motion in children using high-speed videoendoscopy. Differences in vibratory motion were evaluated in 20 children with vocal fold nodules (5-11 years) and 20 age and gender matched typically developing children (5-11 years) during sustained phonation at typical pitch and loudness. Normalized kinematic features of vocal fold displacements from the mid-membranous vocal fold point were extracted from the steady-...

  5. A numerical strategy for finite element modeling of frictionless asymmetric vocal fold collision.

    Science.gov (United States)

    Granados, Alba; Misztal, Marek Krzysztof; Brunskog, Jonas; Visseq, Vincent; Erleben, Kenny

    2017-02-01

    Analysis of voice pathologies may require vocal fold models that include relevant features such as vocal fold asymmetric collision. The present study numerically addresses the problem of frictionless asymmetric collision in a self-sustained three-dimensional continuum model of the vocal folds. Theoretical background and numerical analysis of the finite-element position-based contact model are presented, along with validation. A novel contact detection mechanism capable to detect collision in asymmetric oscillations is developed. The effect of inexact contact constraint enforcement on vocal fold dynamics is examined by different variational methods for inequality constrained minimization problems, namely, the Lagrange multiplier method and the penalty method. In contrast to the penalty solution, which is related to classical spring-like contact forces, numerical examples show that the parameter-independent Lagrange multiplier solution is more robust and accurate in the estimation of dynamical and mechanical features at vocal fold contact. Furthermore, special attention is paid to the temporal integration schemes in relation to the contact problem, the results suggesting an advantage of highly diffusive schemes. Finally, vocal fold contact enforcement is shown to affect asymmetric oscillations. The present model may be adapted to existing vocal fold models, which may contribute to a better understanding of the effect of the nonlinear contact phenomenon on phonation. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Process of tight junction recovery in the injured vocal fold epithelium: Morphological and paracellular permeability analysis.

    Science.gov (United States)

    Suzuki, Ryo; Katsuno, Tatsuya; Kishimoto, Yo; Nakamura, Ryosuke; Mizuta, Masanobu; Suehiro, Atsushi; Yamashita, Masaru; Nakamura, Tatsuo; Tateya, Ichiro; Omori, Koichi

    2017-10-31

    The vocal fold epithelium that includes tight junction (TJ)-based barrier function protects underlying connective tissues from external insults. TJs play an important role to control paracellular permeability of not only solutes but also ions, and preserve the vocal fold homeostasis. However, the distribution of TJs and paracellular diffusion barrier across the entire vocal fold epithelium are still unknown. The aim of this study was to identify the distribution of TJs in the vocal fold epithelium and to characterize the recovery process of TJ-based paracellular diffusion barrier in a rat model of vocal fold injury. Animal experiments with controls. Normal and vocal fold-injured rats were used. Larynges were harvested for immunohistochemical examination of TJ proteins. For functional analysis, a tracer permeability assay was performed using EZ-Link Sulfo-NHS-LC-Biotin. TJ proteins occludin and zonula occludens 1 signals were localized to the junctional regions of the most luminal cell layers of the vocal fold epithelium. The injured region had been recovered with epithelium at 5 days postinjury, but the paracellular diffusion barrier assays revealed that biotinylation reagents diffused into the lamina propria at 5 days postinjury, and were blocked at the epithelium at 14 and 28 days postinjury. It was strongly suggested that TJs in the vocal fold epithelium exist at the junctional regions of the first layer of stratified squamous epithelium. TJ-based paracellular diffusion barrier following vocal fold injury is recovered by 14 days postinjury, and this period corresponds with the time course of structural changes in the regenerating epithelium layer. NA Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  7. Investigating the three-dimensional flow separation induced by a model vocal fold polyp.

    Science.gov (United States)

    Stewart, Kelley C; Erath, Byron D; Plesniak, Michael W

    2014-02-03

    The fluid-structure energy exchange process for normal speech has been studied extensively, but it is not well understood for pathological conditions. Polyps and nodules, which are geometric abnormalities that form on the medial surface of the vocal folds, can disrupt vocal fold dynamics and thus can have devastating consequences on a patient's ability to communicate. Our laboratory has reported particle image velocimetry (PIV) measurements, within an investigation of a model polyp located on the medial surface of an in vitro driven vocal fold model, which show that such a geometric abnormality considerably disrupts the glottal jet behavior. This flow field adjustment is a likely reason for the severe degradation of the vocal quality in patients with polyps. A more complete understanding of the formation and propagation of vortical structures from a geometric protuberance, such as a vocal fold polyp, and the resulting influence on the aerodynamic loadings that drive the vocal fold dynamics, is necessary for advancing the treatment of this pathological condition. The present investigation concerns the three-dimensional flow separation induced by a wall-mounted prolate hemispheroid with a 2:1 aspect ratio in cross flow, i.e. a model vocal fold polyp, using an oil-film visualization technique. Unsteady, three-dimensional flow separation and its impact of the wall pressure loading are examined using skin friction line visualization and wall pressure measurements.

  8. Augmentation after microsurgical removal of vocal fold nodules.

    Science.gov (United States)

    Hsiung, Ming-Wang; Lee, Jin-Chin

    2009-12-01

    Innovative otolaryngologists, speech language pathologists, and voice scientists have continued to move forward in understanding the etiology and treatment of vocal nodules. The present article reviews the publications with respect to the advances in this area. There is support for the notion that there is a positive relationship between vocal nodules and the presence of a posterior glottic chink (PGC). Generalized tension in all the laryngeal muscle is often associated with the PGC due to persistent posterior cricoarytenoid muscle pull during phonation. This phenomenon leads to secondary mucosal change with formation of vocal nodules. Fat augmentation after microsurgical removal of vocal nodules can reduce both the occurrence of a PGC and posterior cricoarytenoid muscle activity and subsequently decrease vocal nodule recurrence. Therefore, the treatment efficiency and protocol are direct and fast. Finally, long-term outcomes studies have demonstrated improvements in vocal disability with both objective and subjective evaluation. Fat augmentation is an effective autogenous implant which may be considered in the management of patients after microsurgical removal of nodules.

  9. Effects of poroelastic coefficients on normal vibration modes in vocal-fold tissues.

    Science.gov (United States)

    Tao, Chao; Liu, Xiaojun

    2011-02-01

    The vocal-fold tissue is treated as a transversally isotropic fluid-saturated porous material. Effects of poroelastic coefficients on eigenfrequencies and eigenmodes of the vocal-fold vibration are investigated using the Ritz method. The study demonstrates that the often-used elastic model is only a particular case of the poroelastic model with an infinite fluid-solid mass coupling parameter. The elastic model may be considered appropriate for the vocal-fold tissue when the absolute value of the fluid-solid mass coupling parameter is larger than 10(5) kg/m(3). Otherwise, the poroelastic model may be more accurate. The degree of compressibility of the vocal tissue can also been described by the poroelastic coefficients. Finally, it is revealed that the liquid and solid components in a poroelastic model could have different modal shapes when the coupling between them is weak. The mode decoupling could cause desynchronization and irregular vibration of the folds.

  10. Resolving pressure from DPIV measurements in a dynamically scaled-up vocal fold model

    Science.gov (United States)

    Lambert, Lori; Krane, Michael; Sherman, Erica; Wei, Timothy

    2012-11-01

    This presentation highlights application of control volume analysis to DPIV measurements in a dynamically scaled human vocal fold model. For the first time spatially and temporally resolved pressure field information can be extracted from voice experiments. The vocal fold model was built around a computer driven mechanism that replicates both the transverse vibrations as well as the streamwise rocking of human vocal folds. A range of experiments were conducted corresponding to 50 - 200 Hz life frequencies. Volumetric flow rate and maximum velocity measurements will be presented for several control surfaces in the glottal flow. The direction of the glottal jet (coandă) was noted for each instantaneous oscillation cycle. The pressure forces acting in the glottis were calculated using the streamwise and transverse linear momentum equations and control volume analysis. In addition to serving as a baseline study, data from these experiments provide the comparison for follow on studies of diseased and abnormal vocal fold vibrations. Supported by NIH.

  11. Modeling and imaging of the vocal fold vibration for voice health

    DEFF Research Database (Denmark)

    Granados, Alba

    displacements captured with laryngeal high-speed videoendoscopy. A dense optical ow algorithm is adapted to the complex nature of the image sequence, and numerical errors are treated to improve the accuracy of the results. Principal components decomposition is applied to extract the underlying modes......, analysis and inference. This thesis deals with biomechanical models of the vocal fold, specially of the collision, and laryngeal videoendoscopic analysis procedures suitable for the inference of the underlying vocal fold characteristics. The rst part of this research is devoted to frictionless contact...... modeling during asymmetric vocal fold vibration. The prediction problem is numerically addressed with a self-sustained three-dimensional nite element model of the vocal fold with position-based contact constraints. A novel contact detection mechanism is shown to successfully detect collision in asymmetric...

  12. Nonsurgical Treatment for Vocal Fold Leukoplakia: An Analysis of 178 Cases

    OpenAIRE

    Min Chen; Lei Cheng; Chang-jiang Li; Jian Chen; Yi-lai Shu; Hai-tao Wu

    2017-01-01

    Objective To assess the effectiveness and identify vocal fold leukoplakia types appropriate for nonsurgical treatment. Methods The vocal fold leukoplakia in 178 patients was divided by gross appearance into three subtypes: flat and smooth, elevated and smooth, and rough. All patients received nonsurgical treatment including smoking and drinking cessation, voice rest, omeprazole, and Chinese medication therapy. The clinical response of three subtypes was assessed after a 6-month follow-up. Res...

  13. Imaging and Analysis of Human Vocal Fold Vibration Using Two-Dimensional (2D) Scanning Videokymography.

    Science.gov (United States)

    Park, Hee-June; Cha, Wonjae; Kim, Geun-Hyo; Jeon, Gye-Rok; Lee, Byung Joo; Shin, Bum-Joo; Choi, Yang-Gyu; Wang, Soo-Geun

    2016-05-01

    Laryngeal videokymography and high-speed digital kymography are the currently available techniques for studying aperiodic vibration of the vocal folds. However, videokymography has a fundamental limitation that only linear portions of the vocal fold mucosa can be visualized, whereas high-speed digital kymography has the disadvantages of lack of immediate feedback during examination and considerable waiting time before kymographic visualization. We developed a new system, two-dimensional (2D) scanning videokymography, that provides a possible alternative for evaluation of the vibratory pattern of the vocal folds. Herein, we report the application of 2D scanning videokymography for visualization of vocal fold vibration in humans and an analysis of its parameters. Two young healthy volunteers (one man and one woman) took part in this study. The vibratory patterns of their vocal folds were evaluated using 2D scanning videokymography and laryngeal stroboscopy. Two-dimensional scanning videokymography provided a high-definition image of the vibratory movements of the vocal folds. In analysis of the images acquired by the device, various parameters including fundamental frequency; ratio of the vibratory phases; phase, amplitude, and glottal area symmetry; and cycle-to-cycle variability were extracted. Our results indicate that 2D scanning videokymography is a useful and promising tool for visualization of the vibratory movement of the vocal folds. This new technique might improve our understanding of the mechanism of vocal fold vibration and contribute to voice research as well as clinical practice. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  14. Correlation of vocal fold nodule size in children and perceptual assessment of voice quality.

    Science.gov (United States)

    Nuss, Roger C; Ward, Jessica; Huang, Lin; Volk, Mark; Woodnorth, Geralyn Harvey

    2010-10-01

    We examined the relationship between the size of vocal fold nodules and perceptual rating of voice quality in children. We carried out an Institutional Review Board-approved retrospective study in a voice clinic within a tertiary-care pediatric medical center. We studied children seen between 2000 and 2009 with a primary diagnosis of vocal fold nodules as the cause of their voice disturbance. Pediatric vocal fold nodule size was rated with a published validated scale, and voice quality was rated on the Consensus Auditory-Perceptual Evaluation of Voice scale. One hundred forty-five patients met the inclusion criteria. Small nodules were noted in 23% of patients, medium nodules in 39%, and large nodules in 37%. Univariate and multivariate analyses demonstrated a statistically significant relationship (p vocal fold nodule size and rated perceptual qualities of overall severity of voice disturbance, roughness, strain, pitch, and loudness. With the exception of loudness, as vocal fold nodule size increased, the mean value of perceptual characteristics became larger. The age of the patient was a significant factor associated with the overall severity of the voice disturbance and roughness. The overall severity of a child's voice disturbance and qualities of roughness, strain, pitch, and loudness have a strong correlational relationship with pediatric vocal fold nodule size, which is suggestive of causality.

  15. Material and shape optimization for multi-layered vocal fold models using transient loadings.

    Science.gov (United States)

    Schmidt, Bastian; Leugering, Günter; Stingl, Michael; Hüttner, Björn; Agaimy, Abbas; Döllinger, Michael

    2013-08-01

    Commonly applied models to study vocal fold vibrations in combination with air flow distributions are self-sustained physical models of the larynx consisting of artificial silicone vocal folds. Choosing appropriate mechanical parameters and layer geometries for these vocal fold models while considering simplifications due to manufacturing restrictions is difficult but crucial for achieving realistic behavior. In earlier work by Schmidt et al. [J. Acoust. Soc. Am. 129, 2168-2180 (2011)], the authors presented an approach in which material parameters of a static numerical vocal fold model were optimized to achieve an agreement of the displacement field with data retrieved from hemilarynx experiments. This method is now generalized to a fully transient setting. Moreover in addition to the material parameters, the extended approach is capable of finding optimized layer geometries. Depending on chosen material restriction, significant modifications of the reference geometry are predicted. The additional flexibility in the design space leads to a significantly more realistic deformation behavior. At the same time, the predicted biomechanical and geometrical results are still feasible for manufacturing physical vocal fold models consisting of several silicone layers. As a consequence, the proposed combined experimental and numerical method is suited to guide the construction of physical vocal fold models.

  16. Effects of dehydration on the viscoelastic properties of vocal folds in large deformations.

    Science.gov (United States)

    Miri, Amir K; Barthelat, François; Mongeau, Luc

    2012-11-01

    Dehydration may alter vocal fold viscoelastic properties, thereby hampering phonation. The effects of water loss induced by an osmotic pressure potential on vocal fold tissue viscoelastic properties were investigated. Porcine vocal folds were dehydrated by immersion in a hypertonic solution, and quasi-static and low-frequency dynamic traction tests were performed for elongations of up to 50%. Digital image correlation was used to determine local strains from surface deformations. The elastic modulus and the loss factor were then determined for normal and dehydrated tissues. An eight-chain hyperelastic model was used to describe the observed nonlinear stress-stretch behavior. Contrary to the expectations, the mass history indicated that the tissue absorbed water during cyclic extension when submerged in a hypertonic solution. During loading history, the elastic modulus was increased for dehydrated tissues as a function of strain. The response of dehydrated tissues was much less affected when the load was released. This observation suggests that hydration should be considered in micromechanical models of the vocal folds. The internal hysteresis, which is often linked to phonation effort, increased significantly with water loss. The effects of dehydration on the viscoelastic properties of vocal fold tissue were quantified in a systematic way. A better understanding of the role of hydration on the mechanical properties of vocal fold tissue may help to establish objective dehydration and phonotrauma criteria. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  17. Computational Analysis of Glottal Aerodynamics and Vocal Fold Vibrations during Phonation

    Science.gov (United States)

    Zheng, Xudong; Luo, Haoxiang; Mittal, Rajat

    2006-11-01

    Phonation is a complex biological phenomenon which results from a highly coupled biomechanical interaction between glottal aerodynamics and vocal fold tissue. During phonation, a self-sustained vocal fold vibration is observed and a turbulent jet is formed between the vibrating vocal folds. However, due to the complexity of human airway and nonlinearity of flow-tissue interaction, the physics of phonation is still not well understood. In this study, a high fidelity computational model is used to study this problem. Several key features are incorporated in the current study including (a) the use of modern computer graphic reconstruction technology for reconstructing the 3D human airway from CT-scan data, (b) accurate Immersed Boundary Method (IBM) for the glottal flow and (c) A three-layer finite-element anisotropic vocal fold tissue model for modeling the vocal fold vibration. Results from this study are presented with emphasis on the glottal aerodynamics and associated vocal-fold vibrations. This research is funded by NIH (NIDCD grant R01 DC007125-01A1)

  18. Correspondence between laryngeal vocal fold movement and muscle activity during speech and nonspeech gestures.

    Science.gov (United States)

    Poletto, Christopher J; Verdun, Laura P; Strominger, Robert; Ludlow, Christy L

    2004-09-01

    To better understand the role of each of the laryngeal muscles in producing vocal fold movement, activation of these muscles was correlated with laryngeal movement during different tasks such as sniff, cough or throat clear, and speech syllable production. Four muscles [the posterior cricoarytenoid, lateral cricoarytenoid, cricothyroid (CT), and thyroarytenoid (TA)] were recorded with bipolar hooked wire electrodes placed bilaterally in four normal subjects. A nasoendoscope was used to record vocal fold movement while simultaneously recording muscle activity. Muscle activation level was correlated with ipsilateral vocal fold angle for vocal fold opening and closing. Pearson correlation coefficients and their statistical significance were computed for each trial. Significant effects of muscle (P speech, the CT and TA activity correlated with both opening and closing. Laryngeal muscle patterning to produce vocal fold movement differed across tasks; reciprocal muscle activity only occurred on cough, whereas speech and sniff often involved simultaneous contraction of muscle antagonists. In conclusion, different combinations of muscle activation are used for biomechanical control of vocal fold opening and closing movements during respiratory, airway protection, and speech tasks.

  19. Three-Dimensional Flow Separation Induced by a Model Vocal Fold Polyp

    Science.gov (United States)

    Stewart, Kelley C.; Erath, Byron D.; Plesniak, Michael W.

    2012-11-01

    The fluid-structure energy exchange process for normal speech has been studied extensively, but it is not well understood for pathological conditions. Polyps and nodules, which are geometric abnormalities that form on the medial surface of the vocal folds, can disrupt vocal fold dynamics and thus can have devastating consequences on a patient's ability to communicate. A recent in-vitro investigation of a model polyp in a driven vocal fold apparatus demonstrated that such a geometric abnormality considerably disrupts the glottal jet behavior and that this flow field adjustment was a likely reason for the severe degradation of the vocal quality in patients. Understanding of the formation and propagation of vortical structures from a geometric protuberance, and their subsequent impact on the aerodynamic loadings that drive vocal fold dynamic, is a critical component in advancing the treatment of this pathological condition. The present investigation concerns the three-dimensional flow separation induced by a wall-mounted prolate hemispheroid with a 2:1 aspect ratio in cross flow, i.e. a model vocal fold polyp. Unsteady three-dimensional flow separation and its impact of the wall pressure loading are examined using skin friction line visualization and wall pressure measurements. Supported by the National Science Foundation, Grant No. CBET-1236351 and GW Center for Biomimetics and Bioinspired Engineering (COBRE).

  20. Comprehensive Outcome Researches of Intralesional Steroid Injection on Benign Vocal Fold Lesions.

    Science.gov (United States)

    Wang, Chi-Te; Lai, Mei-Shu; Hsiao, Tzu-Yu

    2015-09-01

    This study investigated multidimensional treatment outcomes, including prognostic factors and side effects of vocal fold steroid injection (VFSI). We recruited 126 consecutive patients, including patients with 49 nodules, 47 polyps, and 30 mucus retention cysts. All the patients received VFSI under local anesthesia in the office settings. Treatment outcomes were evaluated 1 and 2 months after the procedure, including endoscopic evaluation, perceptual voice quality (GRB scores), acoustic analysis, and 10-item Voice Handicap Index (VHI-10). More than 80% of the patients reported subjective improvements after VFSI. Objective measurements revealed significant improvements from baseline in most of the outcome parameters (Pvocal demands and fibrotic vocal nodules were significantly associated with poorer clinical responses as measured by the VHI-10 and GRB scores, respectively. For vocal polyps, dysphonia for more than 12 months were significantly associated with higher postoperative VHI-10 scores, whereas patients with laryngopharyngeal reflux (LPR) showed significantly poor postoperative voice quality as measured by GRB scores. Side effects after VFSI included hematoma (27%), triamcinolone deposits (4%), and vocal atrophy (1%), which resolved spontaneously within 1-2 months. Presentation with vocal fold ectasias/varicosities and higher vocal demands were significantly correlated with postoperative vocal hematoma. This study demonstrated significant improvements after VFSI in vocal nodules, polyps, and cysts. Occupational vocal demand and subtypes of vocal nodules are closely related to the treatment outcomes after VFSI, whereas symptom duration and LPR were significant prognostic factors for VFSI treatment outcomes in vocal polyps. Side effects after receiving VFSI were mostly self-limited without sequel, whereas the incidence rates might be varied by the injection approach and the timing for postoperative follow-up. Copyright © 2015 The Voice Foundation. Published by

  1. In Vivo Measurement of Pediatric Vocal Fold Motion Using Structured Light Laser Projection

    Science.gov (United States)

    Patel, Rita R.; Donohue, Kevin D.; Lau, Daniel; Unnikrishnan, Harikrishnan

    2013-01-01

    Summary Objective The aim of the study was to present the development of a miniature structured light laser projection endoscope and to quantify vocal fold length and vibratory features related to impact stress of the pediatric glottis using high-speed imaging. Study Design The custom-developed laser projection system consists of a green laser with a 4-mm diameter optics module at the tip of the endoscope, projecting 20 vertical laser lines on the glottis. Measurements of absolute phonatory vocal fold length, membranous vocal fold length, peak amplitude, amplitude-to-length ratio, average closing velocity, and impact velocity were obtained in five children (6–9 years), two adult male and three adult female participants without voice disorders, and one child (10 years) with bilateral vocal fold nodules during modal phonation. Results Independent measurements made on the glottal length of a vocal fold phantom demonstrated a 0.13 mm bias error with a standard deviation of 0.23 mm, indicating adequate precision and accuracy for measuring vocal fold structures and displacement. First, in vivo measurements of amplitude-to-length ratio, peak closing velocity, and impact velocity during phonation in pediatric population and a child with vocal fold nodules are reported. Conclusion The proposed laser projection system can be used to obtain in vivo measurements of absolute length and vibratory features in children and adults. Children have large amplitude-to-length ratio compared with typically developing adults, whereas nodules result in larger peak amplitude, amplitude-to-length ratio, average closing velocity, and impact velocity compared with typically developing children. PMID:23809569

  2. In Vivo measurement of pediatric vocal fold motion using structured light laser projection.

    Science.gov (United States)

    Patel, Rita R; Donohue, Kevin D; Lau, Daniel; Unnikrishnan, Harikrishnan

    2013-07-01

    The aim of the study was to present the development of a miniature structured light laser projection endoscope and to quantify vocal fold length and vibratory features related to impact stress of the pediatric glottis using high-speed imaging. The custom-developed laser projection system consists of a green laser with a 4-mm diameter optics module at the tip of the endoscope, projecting 20 vertical laser lines on the glottis. Measurements of absolute phonatory vocal fold length, membranous vocal fold length, peak amplitude, amplitude-to-length ratio, average closing velocity, and impact velocity were obtained in five children (6-9 years), two adult male and three adult female participants without voice disorders, and one child (10 years) with bilateral vocal fold nodules during modal phonation. Independent measurements made on the glottal length of a vocal fold phantom demonstrated a 0.13mm bias error with a standard deviation of 0.23mm, indicating adequate precision and accuracy for measuring vocal fold structures and displacement. First, in vivo measurements of amplitude-to-length ratio, peak closing velocity, and impact velocity during phonation in pediatric population and a child with vocal fold nodules are reported. The proposed laser projection system can be used to obtain in vivo measurements of absolute length and vibratory features in children and adults. Children have large amplitude-to-length ratio compared with typically developing adults, whereas nodules result in larger peak amplitude, amplitude-to-length ratio, average closing velocity, and impact velocity compared with typically developing children. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  3. [Voice classification in professional singers: the influence of vocal fold length, vocal tract length and body measurements].

    Science.gov (United States)

    Mürbe, D; Roers, F; Sundberg, J

    2011-06-01

    Professional voice performance is strongly affected by the functional adjustments of the structures involved in voice production. Generally, these functional skills are required by means of intensive training. On the other hand, the individual morphology of the larynx and vocal tract limits this functional variability. Thus, to neglect morphological conditions might result in voice problems. The present paper summarizes investigations on the influence of morphological measurements on the voice classification of professional singers. Vocal fold length, vocal tract length and body height have been found to differ systematically between sopranos, mezzosopranos, altos, tenors, baritones and basses. Although the knowledge of morphological measures does not permit a definite assignment or prediction of the individual voice classification, the data are valuable for counseling by voice teachers and phoniatricians. This might contribute to the prevention of voice disorders.

  4. Using image processing technology combined with decision tree algorithm in laryngeal video stroboscope automatic identification of common vocal fold diseases.

    Science.gov (United States)

    Jeffrey Kuo, Chung-Feng; Wang, Po-Chun; Chu, Yueng-Hsiang; Wang, Hsing-Won; Lai, Chun-Yu

    2013-10-01

    This study used the actual laryngeal video stroboscope videos taken by physicians in clinical practice as the samples for experimental analysis. The samples were dynamic vocal fold videos. Image processing technology was used to automatically capture the image of the largest glottal area from the video to obtain the physiological data of the vocal folds. In this study, an automatic vocal fold disease identification system was designed, which can obtain the physiological parameters for normal vocal folds, vocal paralysis and vocal nodules from image processing according to the pathological features. The decision tree algorithm was used as the classifier of the vocal fold diseases. The identification rate was 92.6%, and the identification rate with an image recognition improvement processing procedure after classification can be improved to 98.7%. Hence, the proposed system has value in clinical practices. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. Vocal tract analysis in patients with vocal fold nodules, clefts and cysts.

    Science.gov (United States)

    Nunes, Raquel Buzelin; Souza, Andrea Moreira Veiga de; Duprat, Andre de Campos; Silva, Marta Assumpção de Andrade E; Costa, Rejane Cardoso; Paulino, Juliana Gomes

    2009-01-01

    The supraglottic plan represents an important dimension in vocal production, and its characterization is very important in the evaluation and treatment approach of dysphonic individuals. To check if certain glottic configurations are related to specific adjustments in the vocal tract. To use nasal and laryngeal fibroscopy to assess the frequency of supraglottic vocal tract adjustments in dysphonic women with nodules, clefts and cysts. We assessed 31 dysphonic women, with age ranging between 18 and 45 years, with vocal alteration and a diagnosis of nodules, middle-posterior cleft and cyst, and we carried out a summarized evaluation of the sensory-motor and oral systems and the patients were submitted to video-laryngostroboscopy and nasal and laryngeal fibroscopy. Three distinct groups were selected: patients with bilateral nodules, clefts and cysts, with similar glottic configuration. Their vocal tracts were visually analyzed through exams of nasal and laryngeal fibroscopy, by speech and hearing therapists and otorhinolaryngologists, checking the following parameters: supraglottic constriction, larynx vertical mobility, pharyngeal constriction and tongue mobility. The data was statistically described and treated. During visual analysis we did not find statistically significant differences which would separate the glottic alterations groups. There was no correlation between supraglottic tract adjustments with any particular type of glottic alteration. These are individual behaviors that generate adjustments and justify the different vocal qualities in patients with the same type of laryngeal alteration.

  6. Long-term results of surgical treatment of vocal fold nodules.

    Science.gov (United States)

    Béquignon, Emilie; Bach, Christine; Fugain, Claude; Guilleré, Lia; Blumen, Marc; Chabolle, Frédéric; Wagner, Isabelle

    2013-08-01

    To evaluate the long-term outcome of patients with vocal fold nodules treated by surgery alone, or by a combination of surgery and voice therapy and to identify factors associated with long-term recurrent dysphonia. Retrospective study. All patients who had undergone surgery for vocal fold nodules in a tertiary care hospital between 1996 and 2006 were contacted. After giving their consent, they were evaluated by videostroboscopic examination of vocal fold nodules and by a subjective questionnaire including the Voice Handicap Index (VHI). Sixty-two out of 90 patients (69%) (60 women, 2 men with a mean age of 33 years) answered the questionnaire at a mean interval of 9.5 years after surgery. Recurrent dysphonia was observed in 19 patients (30%) at a mean interval of 5.2 years after surgery and new benign vocal fold lesions (nodules or Reinke's edema) were observed in 11 patients (18%). Absence of postoperative voice therapy was significantly associated with a higher recurrence rate (P = 0.02) (56% of recurrent dysphonia without voice therapy versus 22% with voice therapy). Postoperative voice therapy decreases the risk of recurrence. Vocal fold nodules can recur over a period of 5 years, consequently requiring follow-up for at least 5 years in clinical practice and in future prospective studies. © 2012 The American Laryngological, Rhinological and Otological Society, Inc.

  7. Nonsurgical Treatment for Vocal Fold Leukoplakia: An Analysis of 178 Cases

    Directory of Open Access Journals (Sweden)

    Min Chen

    2017-01-01

    Full Text Available Objective. To assess the effectiveness and identify vocal fold leukoplakia types appropriate for nonsurgical treatment. Methods. The vocal fold leukoplakia in 178 patients was divided by gross appearance into three subtypes: flat and smooth, elevated and smooth, and rough. All patients received nonsurgical treatment including smoking and drinking cessation, voice rest, omeprazole, and Chinese medication therapy. The clinical response of three subtypes was assessed after a 6-month follow-up. Results. Vocal fold leukoplakia subtypes included flat and smooth (n=66; 37.1%, elevated and smooth (n=103; 57.9%, and rough (n=9; 5.0%. The rate of complete response was 80.3%, 66.0%, and 0.0% for the 3 lesion types, respectively (rough versus flat and smooth, P<0.001; rough versus elevated and smooth, P<0.001, Fisher’s exact test. The incidence of carcinoma in rough leukoplakia was significantly higher than that in smooth leukoplakia (44.4% versus 2.4%, P=0.002, Fisher’s exact test. Clinical type was the only significant factor for clinical response of nonsurgical treatment (P=0.005, ordinal logistic regression. Conclusions. The effectiveness of nonsurgical treatment for smooth vocal fold leukoplakia is better in comparison to rough vocal fold leukoplakia. Smooth leukoplakia could be managed with nonsurgical treatment; more aggressive treatments should be considered for rough leukoplakia.

  8. Nonsurgical Treatment for Vocal Fold Leukoplakia: An Analysis of 178 Cases

    Science.gov (United States)

    Chen, Min; Cheng, Lei; Li, Chang-jiang; Chen, Jian

    2017-01-01

    Objective To assess the effectiveness and identify vocal fold leukoplakia types appropriate for nonsurgical treatment. Methods The vocal fold leukoplakia in 178 patients was divided by gross appearance into three subtypes: flat and smooth, elevated and smooth, and rough. All patients received nonsurgical treatment including smoking and drinking cessation, voice rest, omeprazole, and Chinese medication therapy. The clinical response of three subtypes was assessed after a 6-month follow-up. Results Vocal fold leukoplakia subtypes included flat and smooth (n = 66; 37.1%), elevated and smooth (n = 103; 57.9%), and rough (n = 9; 5.0%). The rate of complete response was 80.3%, 66.0%, and 0.0% for the 3 lesion types, respectively (rough versus flat and smooth, P leukoplakia was significantly higher than that in smooth leukoplakia (44.4% versus 2.4%, P = 0.002, Fisher's exact test). Clinical type was the only significant factor for clinical response of nonsurgical treatment (P = 0.005, ordinal logistic regression). Conclusions The effectiveness of nonsurgical treatment for smooth vocal fold leukoplakia is better in comparison to rough vocal fold leukoplakia. Smooth leukoplakia could be managed with nonsurgical treatment; more aggressive treatments should be considered for rough leukoplakia. PMID:28695129

  9. Vocal fold nodules in school age children: attention deficit hyperactivity disorder as a potential risk factor.

    Science.gov (United States)

    D'Alatri, Lucia; Petrelli, Livia; Calò, Lea; Picciotti, Pasqualina Maria; Marchese, Maria Raffaella; Bussu, Francesco

    2015-05-01

    To evaluate the presence of symptoms of inattention and hyperactivity/impulsivity in a population of school age children affected by vocal fold nodules. Parents and teachers of 18 children with vocal fold nodules (10 males, eight females; aged between 6 and 12 years) and 20 matched controls without dysphonia and/or vocal fold diseases (11 males, nine females; aged between 6 and 12 years) completed Attention-Deficit/Hyperactivity Disorder (ADHD) rating scale for parents (SDAG [Scala per i Disturbi di Attenzione/Iperattività per Genitori]) and teachers (SDAI [Scala per i Disturbi di Attenzione/Iperattività per Insegnanti) rating scales containing in two subscales items that specifically evaluate the symptoms of ADHD according to the DSM-IV. All children were subjected to videolaryngoscopy. The group with vocal fold nodules scored significantly higher than the controls; the difference between the two groups was statistically significant for both the subscales of both questionnaires (SDAG and SDAI) (P childhood. SDAG and SDAI rating scales may supplement the diagnostic assessment of children with vocal fold nodules. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  10. Structural Fat Grafting to Improve Outcomes of Vocal Folds' Fat Augmentation: Long-term Results.

    Science.gov (United States)

    Cantarella, Giovanna; Mazzola, Riccardo F; Gaffuri, Michele; Iofrida, Elisabetta; Biondetti, Pietro; Forzenigo, Laura V; Pignataro, Lorenzo; Torretta, Sara

    2018-01-01

    Objective Evaluating the long-term outcomes of vocal fold structural fat grafting. Study Design Case series with chart review. Setting University hospital. Subjects and Methods Seventy-nine dysphonic patients (16-82 years; 55 with unilateral laryngeal paralysis and 24 with vocal fold scarring) underwent vocal fold fat injection. Fat was harvested by low-pressure liposuction and then processed by centrifugation. Refined fat aliquots were placed in the vocal fold and paraglottic space in multiple tunnels to enhance graft neovascularization. All patients were followed for 12 months, 15 for 3 years, and 5 for 10 years with videolaryngostroboscopy, maximal phonation time (MPT) measurement, Voice Handicap Index (VHI) questionnaire, and GRBAS (grade, roughness, breathiness, asthenia, strain) perceptual evaluation. Laryngeal computed tomography (CT) and/or magnetic resonance imaging (MRI) studies were performed in 16 patients 3 to 28 months postoperatively; MRI was repeated in 5 cases 12 to 18 months after the first radiological study. Results The voice quality of all patients improved after surgery, and long-term stability was confirmed by MPT, GRBAS, and VHI ( P ranging between .004 and fat resorption. CT and MRI demonstrated survival of the fat grafts in all of the 16 examined cases. Serial MRI scans showed no change in graft size over time. Conclusions The reported clinical and radiological data demonstrate that fat is an effective filler for permanent vocal fold augmentation if the refined micro-aliquots are placed in multiple tunnels.

  11. [Vocal fold nodules. Risk factors in teachers. A case control study design].

    Science.gov (United States)

    Pérez Fernández, C A; Preciado López, J

    2003-04-01

    Vocal nodules are structural lesions very common amongst professional voice users such as teachers. We have studied the risk factors that predispose the development of vocal nodules in teachers. Two hundred and forty-two teachers were selected: 120 with vocal nodules and 120 with normal vocal folds. Professional and personal factors as well as classroom environment were studied. A complete evaluation of the voice was performed, aerodynamic measures, tone and extension of the voice, acoustic analysis, perceptual evaluation of the voice as well as a videolaryngostroboscopy which was definitive in the diagnosis. Younger teachers with less years of teaching experience a greater have tendency to develop vocal nodules than the rest. Class-room's dryness, loudness and echo are correlated with the pathological group. The most relevant personal factors in the pathological group were previous vocal pathology, laryngeal surgery, nasal surgery and gastroesophageal reflux. Vocal intensity and vocal frequency ranks were shorter in the pathological group. We could also see that, fonatory flow was less effective in the pathological group.

  12. Long-term effects of an intensive voice treatment for vocal fold nodules.

    Science.gov (United States)

    Fu, Sherry; Theodoros, Deborah; Ward, Elizabeth C

    2016-02-01

    The purpose of the current study was to examine the long-term effects of intensive voice treatment for vocal fold nodules, compared to outcomes for patients treated with traditional voice therapy. It was hypothesised that intensive treatment would provide comparable maintenance of vocal function, voice quality, and patients' perception of quality-of-life when compared with traditional treatment at 6 month follow-up. Thirty-six women diagnosed with bilateral vocal fold nodules who were treated with either traditional (n = 20; once a week for 8 weeks) or intensive (n = 16; eight sessions within 3 weeks) therapy. Each participant completed voice, stroboscopic, and acoustic assessments and the Voice Handicap Index before, immediately post and 6 months post-treatment. Results revealed most improved perceptual, stroboscopic and acoustic parameters were maintained in both groups at 6 months post-treatment, with no significant differences between the two groups. In addition, both groups maintained satisfaction on their perception of vocal function, with no significant difference between the two groups. The investigation provided further evidence that individuals with vocal fold nodules are able to maintain improved voice quality and vocal health following intensive voice treatment to a similar degree to traditional voice treatment.

  13. The effect of retinyl palmitate on healing of benign vocal fold lesions.

    Science.gov (United States)

    Okur, Erdogan; Kahveci, Orhan Kemal; Aycicek, Abdullah; Altuntaş, Ali

    2013-01-01

    The leading cause of vocal fold lesions such as nodules and polyps is phonotrauma, which causes microhematoma formation in the vocal fold cover that can initiate an inflammatory process. Vitamin A (Vit A) is essential for immunity, cellular differentiation and maintenance of respiratory epithelium. The aim of this study is to investigate the effect of Vit A (retinyl palmitate) on healing of vocal fold lesions, including vocal polyps and nodules. Eighteen patients with vocal fold lesions were included in the study. Of the patients, 13 had vocal polyps and 5 had vocal nodules. Patients received 90,000 IU oral Vit A in palmitate form daily for 2 months. In addition to Vit A treatment, only vocal hygiene recommendations were given to the patients, without any other medication or specific voice therapy. Pre- and post-treatment acoustic analysis [jitter % (jitt %), shimmer % (shim %), normalized noise energy (NNE), maximum phonation time (MPT), etc.] were performed. Lesion dimensions and stroboscopic findings were evaluated. Voice handicap index (VHI) was applied. Statistical analysis was performed between pre- and post-treatment measurements. Of the 18 patients, 8 had immature lesions (6 polyp-like lesions and 2 immature nodules) and 10 had mature lesion (7 polyps and 3 nodules). None of the patients showed complete healing. Partial response was seen in four patients with immature lesions. There were minimal changes in lesion dimensions, but this difference did not reach statistical significance. MPT of patients with immature lesions were close to significance level but overall MPT revealed no significant improvement (p = 0.051). Jitt %, shim % and NNE did not change significantly. In this study, the only statistically significant finding was VHI of the patients with immature lesions. Three of the patients complained of weight gain. Our data showed that Vit A at a given level of dose and duration seems to be ineffective in the treatment of benign vocal fold lesions. On

  14. [Vocal fold paralysis in children: diagnostic and management from a case report].

    Science.gov (United States)

    Tiago, Romualdo Suzano Louzeiro; Patrocínio, Sandra Jager; dos Anjos, Patricya Santos Figueiredo; Ribeiro, Juparethan Trento; Gil, Fábio Marangoni; Denunci, Flávia Villin

    2005-01-01

    The vocal fold paralysis accounts for 10% of the larynx congenital abnormality, being the second most common cause of laryngeal stridor in childhood. In case the unilateral vocal fold paralysis is considered, the main cause is left-sided iatrogenic injury to the recurrent laryngeal nerve, secondary to surgery to correct the patent ductus arteriosus. In this study we reviewed the literature, reporting a case of a child who, after having undergone surgery to close the patent ductus arteriosus, evolved with breathing difficulty and dysphonia. We suggest that flexible fiberoptic laryngoscopy is carried out pre- and post surgery of children for whom heart surgery to correct congenital abnormalities is indicated, thus allowing for early diagnosis of vocal fold paralysis and therefore to define as soon as possible the conduct to be followed.

  15. An optical flow-based state-space model of the vocal folds.

    Science.gov (United States)

    Granados, Alba; Brunskog, Jonas

    2017-06-01

    High-speed movies of the vocal fold vibration are valuable data to reveal vocal fold features for voice pathology diagnosis. This work presents a suitable Bayesian model and a purely theoretical discussion for further development of a framework for continuum biomechanical features estimation. A linear and Gaussian nonstationary state-space model is proposed and thoroughly discussed. The evolution model is based on a self-sustained three-dimensional finite element model of the vocal folds, and the observation model involves a dense optical flow algorithm. The results show that the method is able to capture different deformation patterns between the computed optical flow and the finite element deformation, controlled by the choice of the model tissue parameters.

  16. Granuloma of the membranous vocal fold: an unusual complication of microlaryngoscopic surgery.

    Science.gov (United States)

    Sulica, Lucian; Simpson, C Blake; Branski, Ryan; McLaurin, Colby

    2007-05-01

    We describe the clinical features of granuloma of the membranous vocal fold (as opposed to granuloma of the vocal process, or "contact granuloma"), a poorly recognized sequela of microlaryngoscopic surgery. Membranous vocal fold granuloma may mimic the initial lesion in appearance, and thus be mistaken for recurrence. We performed a retrospective review of cases from 2 institutions. Fifteen cases of membranous vocal fold granuloma from 2 institutions were identified. In all but 1 case, granuloma developed in the early postoperative period, within 8 weeks. Of the 15 cases, 10 followed laser resection of carcinoma. Five were noted following cold steel resection of benign lesions (2 papillomas, 2 cysts, 1 Reinke's edema). Technical aspects of these cases suggest that membranous vocal fold granulomas result from surgical violation of deep tissue planes and/or epithelial defects. All patients were treated with proton pump inhibitors. In 12 cases, the granulomas proved self-limited, resolving over weeks to months following surgery. Three patients underwent surgical removal of the lesion, which confirmed the diagnosis. One of these cases recurred and was treated nonsurgically. Granuloma should be suspected when a mass lesion appears at the surgical site early in the postoperative course. Surgical excision is generally not necessary and may provoke further growth of granulation tissue.

  17. Kymographic characterization of vibration in human vocal folds with nodules and polyps.

    Science.gov (United States)

    Chodara, Ann M; Krausert, Christopher R; Jiang, Jack J

    2012-01-01

    Digital kymography (DKG) can provide objective quantitative data about vocal fold vibration, which may help distinguish normal from pathological vocal folds as well as nodules from polyps. Case-control study. There were 87 subjects who were separated into three groups: control, nodules, and unilateral polyps, and examined using a high-speed camera attached to an endoscope. Videos were analyzed using a custom MATLAB program, and three DKG line-scan positions (25%, 50%, and 75% of vocal fold length) were used in statistical analyses to compare vocal fold vibrational frequency, amplitude symmetry index (ASI), amplitude order, and vertical and lateral phase difference (VPD and LPD, respectively). Significant differences among groups were found in all vibrational parameters except frequency. Polyps and nodules groups exhibited greater ASI values (less amplitude symmetry) than the control group. Although the control group consistently showed its largest amplitudes at the midline, the polyps group showed larger amplitudes toward the posterior end of the vocal folds. A significant anterior-posterior pattern in amplitude was not found in the nodules group. LPD values were usually largest (most symmetrical) in the control group, followed by nodules and polyps. LPD at the 25% position allowed for differentiation between polyp and nodule groups. The largest VPD (more pronounced mucosal wave) values were usually found in the control group. Vibratory characteristics of normal and pathological vocal folds were quantitatively examined and compared using multiline DKG. These findings may allow for better characterization of pathologies and eventually assist in improving the clinical utility of DKG. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  18. Characteristics of Vocal Fold Vibrations in Vocally Healthy Subjects: Analysis with Multi-Line Kymography

    Science.gov (United States)

    Yamauchi, Akihito; Imagawa, Hiroshi; Sakakibara, Ken-Ichi; Yokonishi, Hisayuki; Nito, Takaharu; Yamasoba, Tatsuya; Tayama, Niro

    2014-01-01

    Purpose: In this study, the authors aimed to analyze longitudinal data from high-speed digital images in normative subjects using multi-line kymography. Method: Vocally healthy subjects were divided into young (9 men and 17 women; M[subscript age] = 27 years) and older groups (8 men and 12 women; M[subscript age] = 73 years). From high-speed…

  19. Vocal folds disorder detection using pattern recognition methods.

    Science.gov (United States)

    Wang, Jianglin; Jo, Cheolwoo

    2007-01-01

    Diagnosis of pathological voice is one of the most important issues in biomedical applications of speech technology. This study focuses on the classification of pathological voice using the HMM(Hidden Markov Model), the GMM(Gaussian Mixture Model) and a SVM (Support Vector Machine), and then compares the results to work done previously using an ANN (Artificial Neural Network). Speech data were collected from those without and those with vocal disorders. Normal and pathological speech data were mixed in out experiment. Six characteristic parameters (Jitter, Shimmer, NHR, SPI, APQ and RAP) were chosen. Then the pattern recognition methods (HMM, GMM and SVM) were used to distinguish the mixed data into categories of normal and pathological speech. We found that the GMM-based method can give us superior classification rates compared to the other classification methods.

  20. Transnasal endoscopic steroid injection: a practical and effective alternative treatment for benign vocal fold disorders.

    Science.gov (United States)

    Wang, Chi-Te; Lai, Mei-Shu; Liao, Li-Jen; Lo, Wu-Chia; Cheng, Po-Wen

    2013-06-01

    Emerging literature has documented the effectiveness of intralesional steroid injection as an alternative treatment for benign vocal fold disorders. However, clinical application is frequently limited by the associated technical demands for adequate anesthesia and precise needle placement. This study investigated the applicability and effectiveness of the more practical and less technically demanding method of transnasal endoscopic steroid injection (TESI). Prospective case series. This study recruited 30 patients with vocal nodules and polyps. Dexamethasone was injected into the Reinke's space under local anesthesia via the operating channel of a transnasal flexible laryngoscope in an office setting. Treatment outcome were measured before, 1 month after, and 3 months after the injection, using videolaryngostroboscopy (VLS), maximal phonation time (MPT), 10-item voice handicap index (VHI-10), acoustic analysis, and perceptual evaluation. VLS examinations at 3 months post-treatment demonstrated that vocal lesions of 10 and 19 patients were resolved or reduced, respectively. Objective measurements showed increased MPT and decreased VHI-10 (P vocal nodules and polyps (P > .05). Mild vocal hematoma occurred in three patients following TESI, but resolved spontaneously within 1 month. TESI is a simple and practical office-based treatment modality for benign vocal fold lesions, suitable for most otolaryngologists. Treatment outcomes showed significant subjective and objective improvements that were comparable to the results of other injection procedures reported in the literature. 4. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  1. Computation of physiological human vocal fold parameters by mathematical optimization of a biomechanical model

    Science.gov (United States)

    Yang, Anxiong; Stingl, Michael; Berry, David A.; Lohscheller, Jörg; Voigt, Daniel; Eysholdt, Ulrich; Döllinger, Michael

    2011-01-01

    With the use of an endoscopic, high-speed camera, vocal fold dynamics may be observed clinically during phonation. However, observation and subjective judgment alone may be insufficient for clinical diagnosis and documentation of improved vocal function, especially when the laryngeal disease lacks any clear morphological presentation. In this study, biomechanical parameters of the vocal folds are computed by adjusting the corresponding parameters of a three-dimensional model until the dynamics of both systems are similar. First, a mathematical optimization method is presented. Next, model parameters (such as pressure, tension and masses) are adjusted to reproduce vocal fold dynamics, and the deduced parameters are physiologically interpreted. Various combinations of global and local optimization techniques are attempted. Evaluation of the optimization procedure is performed using 50 synthetically generated data sets. The results show sufficient reliability, including 0.07 normalized error, 96% correlation, and 91% accuracy. The technique is also demonstrated on data from human hemilarynx experiments, in which a low normalized error (0.16) and high correlation (84%) values were achieved. In the future, this technique may be applied to clinical high-speed images, yielding objective measures with which to document improved vocal function of patients with voice disorders. PMID:21877808

  2. Determination of strain field on the superior surface of excised larynx vocal folds using DIC.

    Science.gov (United States)

    Bakhshaee, Hani; Young, Jonathan; Yang, Justin C W; Mongeau, Luc; Miri, Amir K

    2013-11-01

    The objective of the present study was to quantify the mechanical strain and stress in excised porcine larynges during self-oscillation using digital image correlation (DIC) method. The use of DIC in the excised larynx setup may yield accurate measurements of the vocal fold displacement field. Ex vivo animal larynx. Measurements were performed using excised porcine larynges on a humidified flow bench, equipped with two high-speed cameras and a commercially available DIC software. Surface deformations were calculated from digital images recorded at 3000 frames per second during continuous self-oscillation for four excised porcine larynges. Larynx preparation consisted of removing the supraglottal wall and the false folds. DIC yielded the deformation field on the superior visible surface of the vocal folds. Measurement data for adducted and freely suspended vocal folds were also used to estimate the distribution of the initial prephonatory strain field. An isotropic constitutive law, the polymer eight-chain model, was used to estimate the surface distributions of planar stresses from the strain data. The Lagrangian normal strain values were between ∼16% and ∼29% along the anterior-posterior direction. The motion of material points on the vocal fold surface described an elliptical trajectory during oscillation. A phase difference was observed between the anterior-posterior and the medial-lateral component of the displacement. The strain data and eight-chain model yielded a maximum stress of ∼4 kPa along the medial-lateral direction on the superior surface. DIC allowed the strain field over the superior surface of an excised porcine larynx to be quantified during self-oscillation. The approach allowed the determination of the trajectory of specific points on the vocal fold surface. The results for the excised larynx were found to be significantly different than previous results obtained using synthetic replicas. The present study provides suggestions for future

  3. Aerodynamically and acoustically driven modes of vibration in a physical model of the vocal folds.

    Science.gov (United States)

    Zhang, Zhaoyan; Neubauer, Juergen; Berry, David A

    2006-11-01

    In a single-layered, isotropic, physical model of the vocal folds, distinct phonation types were identified based on the medial surface dynamics of the vocal fold. For acoustically driven phonation, a single, in-phase, x-10 like eigenmode captured the essential dynamics, and coupled with one of the acoustic resonances of the subglottal tract. Thus, the fundamental frequency appeared to be determined primarily by a subglottal acoustic resonance. In contrast, aerodynamically driven phonation did not naturally appear in the single-layered model, but was facilitated by the introduction of a vertical constraint. For this phonation type, fundamental frequency was relatively independent of the acoustic resonances, and two eigenmodes were required to capture the essential dynamics of the vocal fold, including an out-of-phase x-11 like eigenmode and an in-phase x-10 like eigenmode, as described in earlier theoretical work. The two eigenmodes entrained to the same frequency, and were decoupled from subglottal acoustic resonances. With this independence from the acoustic resonances, vocal fold dynamics appeared to be determined primarily by near-field, fluid-structure interactions.

  4. Localization of Label-Retaining Cells in Murine Vocal Fold Epithelium

    Science.gov (United States)

    Leydon, Ciara; Bartlett, Rebecca S.; Roenneburg, Drew A.; Thibeault, Susan L.

    2011-01-01

    Purpose: Epithelial homeostasis is critical for vocal fold health, yet little is known about the cells that support epithelial self-renewal. As a known characteristic of stem cells is that they are slow-cycling in vivo, the purpose of this prospective controlled study was to identify and quantify slow-cycling cells or putative stem cells in murine…

  5. Vocal fold hyalinosis in Urbach-Wiethe disease, a rare cause of hoarseness

    NARCIS (Netherlands)

    Honings, J.; Rossum, M.M. van; Hoogen, F.J.A. van den

    2015-01-01

    BACKGROUND: Lipoid proteinosis is an autosomal recessive disorder characterized by hyalin deposits in the skin and mucosa of the upper aerodigestive tract; currently, no treatment exists. Nearly all patients experience hoarseness and speech difficulties, due to hyalin deposition in the vocal folds

  6. An automatic method to quantify the vibration properties of human vocal folds via videokymography

    NARCIS (Netherlands)

    Qiu, QJ; Schutte, HK; Gu, L; Yu, QL

    2003-01-01

    The study offers an automatical quantitative method to obtain vibration properties of human vocal folds via videokymography. The presented method is based on image processing, which combines an active contour model with a genetic algorithm to improve detecting precision and processing speed, can

  7. Real-time kymographic imaging for visualizing human vocal-fold vibratory function

    NARCIS (Netherlands)

    Qiu, Qingjun; Schutte, Harm K.

    A stand-alone kymographic system for visualizing human vocal-fold vibration in real time is presented. By using a dual charge-coupled-device construction, the system not only provides kymographic images but also simultaneously presents structural images for navigating the endoscope to a desired

  8. Pathogenesis of vocal fold nodules: new insights from a modelling approach.

    Science.gov (United States)

    Dejonckere, Philippe H; Kob, Malte

    2009-01-01

    To give new insights into the pathogenesis of vocal fold nodules: (a) why the female/male ratio is so extreme, (b) how an hourglass-shaped vibration pattern - eliciting a localized microtrauma - originates, and (c) what the roles of muscular tension imbalance and of behavioral aspects are. Simulations with a 3-dimensional computer model of the vibrating vocal folds. (1) A slightly incomplete dorsal vocal fold adduction is a first condition for inducing an hourglass vibration pattern. (2) A limited collision zone is only possible with a small degree of curving of the rest position of the vocal fold edges in their ventral portion. This is an anatomical characteristic of the adult female larynx. Muscular fatigue and resulting hypotonia seem to enhance this curving. (3) If both these conditions are fulfilled, a sufficient vibration amplitude is required to achieve a localized impact. (4) This third condition can be obtained by an increased subglottal pressure and/or by a decrease in active stress of the tension forces between the neighboring vocalis masses. These last aspects incorporate muscular tension imbalance (dyskinesia) and behavioral aspects in the modelling process. Decrease in active stress is a possible effect of fatigue, and increase in subglottal pressure a result of effort compensation. Copyright 2009 S. Karger AG, Basel.

  9. Magnetic Resonance Imaging of the Vocal Folds in Women with Congenital Adrenal Hyperplasia and Virilized Voices

    Science.gov (United States)

    Nygren, Ulrika; Isberg, Bengt; Arver, Stefan; Hertegård, Stellan; Södersten, Maria; Nordenskjöld, Agneta

    2016-01-01

    Purpose: Women with congenital adrenal hyperplasia (CAH) may develop a virilized voice due to late diagnosis or suboptimal suppression of adrenal androgens. Changes in the vocal folds due to virilization have not been studied in vivo. The purpose was to investigate if the thyroarytenoid (TA) muscle is affected by virilization and correlate…

  10. Neck ultrasonography for the evaluation of the etiology of adult unilateral vocal fold paralysis.

    Science.gov (United States)

    Wang, Cheng-Ping; Chen, Tseng-Cheng; Lou, Pei-Jen; Yang, Tsung-Lin; Hu, Ya-Ling; Shieh, Ming-Jium; Ko, Jenq-Yuh; Hsiao, Tzu-Yu

    2012-05-01

    An extralaryngeal neoplasm involving the vagus nerve and recurrent laryngeal nerve must be excluded when adult unilateral vocal fold paralysis is diagnosed. Between 2004 and 2009, 53 adult patients with unilateral vocal fold paralysis received neck ultrasonography. Patients with laryngeal/hypopharyngeal cancer or with previously known cancers of the head and neck, thyroid, esophagus or lung, or with known etiology or trauma were excluded from this study. We included 26 men and 27 women. Ultrasonography revealed 16 patients (30%) having subclinical tumors, including thyroid papillary carcinoma in 7 patients, vagus nerve schwannoma in 2 patients, nodular goiter in 2 patients, malignant nodes in the lower neck in 4 patients, which were metastasized from lung cancer in 3 patients, esophageal cancer in 1 patient, and cervical esophageal cancer in 1 patient. Neck ultrasonography is useful to detect subclinical neoplasia, causing unilateral vocal fold paralysis. Thyroid cancer is the most common neoplastic etiology of adult unilateral vocal fold paralysis. Copyright © 2011 Wiley Periodicals, Inc.

  11. Combining multiobjective optimization and cluster analysis to study vocal fold functional morphology.

    Science.gov (United States)

    Palaparthi, Anil; Riede, Tobias; Titze, Ingo R

    2014-07-01

    Morphological design and the relationship between form and function have great influence on the functionality of a biological organ. However, the simultaneous investigation of morphological diversity and function is difficult in complex natural systems. We have developed a multiobjective optimization (MOO) approach in association with cluster analysis to study the form-function relation in vocal folds. An evolutionary algorithm (NSGA-II) was used to integrate MOO with an existing finite element model of the laryngeal sound source. Vocal fold morphology parameters served as decision variables and acoustic requirements (fundamental frequency, sound pressure level) as objective functions. A two-layer and a three-layer vocal fold configuration were explored to produce the targeted acoustic requirements. The mutation and crossover parameters of the NSGA-II algorithm were chosen to maximize a hypervolume indicator. The results were expressed using cluster analysis and were validated against a brute force method. Results from the MOO and the brute force approaches were comparable. The MOO approach demonstrated greater resolution in the exploration of the morphological space. In association with cluster analysis, MOO can efficiently explore vocal fold functional morphology.

  12. SUSPENSION MICROLARYNGOSCOPIC SURGERY AND INDIRECT MICROLARYNGOSTROBOSCOPIC SURGERY FOR BENIGN LESIONS OF THE VOCAL FOLDS

    NARCIS (Netherlands)

    DIKKERS, FG; SULTER, AM

    1994-01-01

    A prospective study was designed to compare the effects on voice capacities after either suspension microlaryngoscopic surgery or indirect microlaryngostroboscopic surgery. Patients where the clinical diagnosis 'dysphonia due to a benign lesion of the vocal fold' was made, and who could be operated

  13. Deformation analysis of the vocal folds from videostroboscopic image sequences of the larynx.

    Science.gov (United States)

    Saadah, A K; Galatsanos, N P; Bless, D; Ramos, C A

    1998-06-01

    Videostroboscopy is an examination which yields a permanent record of the moving vocal folds. Thus, it allows the diagnosis of abnormalities which contribute to voice disorders. In this paper, in order to find and quantify the deformation of the vocal folds in videostroboscopic recordings, an active contours- (snakes) based approach is used to delineate the vocal folds in each frame of the videostroboscopic image sequence. After this delineation, a new elastic registration algorithm is used to register the vocal fold contours between adjacent frames of the video sequence. This algorithm is based on the regularization principle and is very effective when large deformations are present. A least-squares approach is used to fit an affine model to the displacement vectors found by elastic registration. The parameters of this model, rotation, translation, and deformation along two principle axes, quantify the deformation and allow the succinct characterization of the videostroboscopic recordings based on the deformations that occurred. Experiments are shown with synthetic and real videostroboscopic data that demonstrate the value of the proposed approach.

  14. Ex vivo canine vocal fold lamina propria rehydration after varying dehydration levels

    Science.gov (United States)

    Hanson, Kevin P.; Zhang, Yu; Jiang, Jack J.

    2010-01-01

    Objectives To examine the recoverability of canine vocal fold lamina propria upon rehydration from varying dehydration levels. Study Design Open controlled experimental trial Methods The vocal fold lamina propria was excised en block using a scalpel from ten canine larynges, providing twenty tissue samples. The initial volume of each sample was measured. Ten samples were dehydrated to 30% by mass, and the other ten samples to 70%. Each sample was rehydrated in 0.9% saline until the mass stabilized. The liquid mass and volume fractions, liquid:solid mass and volume ratios, and the fractions of the original tissue masses and volumes were calculated. Results All calculated parameters were significantly different between 30% and 70% dehydration recovery, with all parameters lesser in the 70% dehydration treatment group. Half of the tissue samples subjected to 30% dehydration fully recovered to their original volumes, while only 1 of the 10 samples subjected to 70% dehydration fully recovered its volume. Conclusions The level of attainable rehydration recovery of vocal fold lamina propria tissue in an ex vivo setting depends on the level of dehydration. The results correspond with the biphasic theory and may be used to help model the biomechanical and physiological properties of vocal fold lamina propria tissue during rehydration. PMID:20951551

  15. Multidimensional effects of voice therapy in patients affected by unilateral vocal fold paralysis due to cancer.

    Science.gov (United States)

    Barcelos, Camila Barbosa; Silveira, Paula Angélica Lorenzon; Guedes, Renata Lígia Vieira; Gonçalves, Aline Nogueira; Slobodticov, Luciana Dall'Agnol Siqueira; Angelis, Elisabete Carrara-de

    2017-08-24

    Patients with unilateral vocal fold paralysis may demonstrate different degrees of voice perturbation depending on the position of the paralyzed vocal fold. Understanding the effectiveness of voice therapy in this population may be an important coefficient to define the therapeutic approach. To evaluate the voice therapy effectiveness in the short, medium and long-term in patients with unilateral vocal fold paralysis and determine the risk factors for voice rehabilitation failure. Prospective study with 61 patients affected by unilateral vocal fold paralysis enrolled. Each subject had voice therapy with an experienced speech pathologist twice a week. A multidimensional assessment protocol was used pre-treatment and in three different times after voice treatment initiation: short-term (1-3 months), medium-term (4-6 months) and long-term (12 months); it included videoendoscopy, maximum phonation time, GRBASI scale, acoustic voice analysis and the portuguese version of the voice handicap index. Multiple comparisons for GRBASI scale and VHI revealed statistically significant differences, except between medium and long term (pOtorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  16. Influence of Embedded Fibers and an Epithelium Layer on the Glottal Closure Pattern in a Physical Vocal Fold Model

    Science.gov (United States)

    Xuan, Yue; Zhang, Zhaoyan

    2014-01-01

    Purpose: The purpose of this study was to explore the possible structural and material property features that may facilitate complete glottal closure in an otherwise isotropic physical vocal fold model. Method: Seven vocal fold models with different structural features were used in this study. An isotropic model was used as the baseline model, and…

  17. Use Videostrobokymography to Quantitatively Analyze the Vibratory Characteristics Before and After Conservative Medical Treatment of Vocal Fold Leukoplakia.

    Science.gov (United States)

    Gao, Xiao-Wei; Huang, Yong-Wang; Liu, Li-Yan; Ouyang, Jie

    2016-03-01

    To quantitatively analyze the vibratory characteristics of vocal folds before and after conservative treatments to evaluate the outcomes of conservative treatments for vocal fold leukoplakia using videostrobokymography (VSK). This is a prospective study. Twenty patients and 20 controls were enrolled into the study. All patients received conservative treatments for 3 weeks and received VSK examination before and 3 weeks after the treatments. All controls only received VSK examination once. Vocal fold lengths of 25%, 50%, and 75% were chosen as the line-scan positions to evaluate the vocal fold vibration. Open quotient (OQ) and asymmetry index (AI) were obtained using VSK. Significant improvements in the main symptoms including voice hoarseness were found. Videostroboscopic findings showed that the white lesions on the vocal folds almost completely disappeared in all patients, and the vocal fold flexibility returned to normal. All OQs and AIs at each line-scan position in patients before the treatments were larger than those in controls (P  0.017). VSK could quantitatively evaluate the vibratory characteristics of vocal folds before and after the treatments, and conservative treatment could improve VSK measurements to normal control values, suggesting that VSK is a tool to assess the outcomes of the conservative treatments for vocal fold leukoplakia. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. The Cystic Fibrosis Transmembrane Conductance Regulator and Chloride-Dependent Ion Fluxes of Ovine Vocal Fold Epithelium

    Science.gov (United States)

    Leydon, Ciara; Fisher, Kimberly V.; Lodewyck-Falciglia, Danielle

    2009-01-01

    Purpose: Ion-driven transepithelial water fluxes participate in maintaining superficial vocal fold hydration, which is necessary for normal voice production. The authors hypothesized that Cl[superscript -] channels are present in vocal fold epithelial cells and that transepithelial Cl[superscript -] fluxes can be manipulated pharmacologically.…

  19. Difficulty Systematized Evaluation of Vocal Folds Exposure in Microsurgery of the Larynx

    Directory of Open Access Journals (Sweden)

    Ballin, Annelyse Cristine

    2010-09-01

    Full Text Available Introduction: Several studies addressing preoperative factors that predict difficulty of endotracheal intubation graduated by anesthesiologists, for the scale of the Cormack-Lehane. These parameters were evaluated for the difficulty of location of the laryngoscope in microsurgery of the larynx. There is not a standard scale of difficulty targeted to surgeons of the larynx. Objective: Create a standard scale of difficulty leasing the laryngoscope during microsurgery of the larynx, with a focus on exposure of the vocal folds (vocal cords to evaluate which clinical parameters predict difficulty of exposure of their vocal folds and verify the improvement of laryngeal exposure with the hanger of the laryngoscope. Method: A prospective randomized study, 57 patients undergoing laryngeal microsurgery. The preoperative parameters were evaluated: three epidemiological data, two of history and 13 physical examination. Intraoperatively: the anesthesiologist evaluated the Cormack-Lehane score and the surgeon evaluated according to the proposed scale, before and after placement of the hanger. Results and Conclusion: Several parameters showed sensitivity, specificity, positive predictive value for high inadequate exposure of the larynx. But only distance hiomentual <6.05 cm (p = 0.003 and 2 classes of Cormack-Lehane (p = 0.04 with statistical significance and high sensitivity of 100% and 81% respectively. The use of the hanger of laryngoscope laryngeal exposure improved significantly (p = 0.04. The proposed scale standardizes the visualization and grades the difficulty of exposure of their vocal folds, facilitating comparisons between studies and communication between otolaryngologists.

  20. Effects of the epilarynx area on vocal fold dynamics and the primary voice signal.

    Science.gov (United States)

    Döllinger, Michael; Berry, David A; Luegmair, Georg; Hüttner, Björn; Bohr, Christopher

    2012-05-01

    For the analysis of vocal fold dynamics, sub- and supraglottal influences must be taken into account, as recent studies have shown. In this work, we analyze the influence of changes in the epilaryngeal area on vocal fold dynamics. We investigate two excised female larynges in a hemilarynx setup combined with a synthetic vocal tract consisting of hard plastic and simulating the vowel /a/. Eigenmodes, amplitudes, and velocities of the oscillations, the subglottal pressures (P(sub)), and sound pressure levels (SPLs) of the generated signal are investigated as a function of three distinctive epilaryngeal areas (28.4 mm(2), 71.0 mm(2), and 205.9 mm(2)). The results showed that the SPL is independent of the epilarynx cross section and exhibits a nonlinear relation to the insufflated airflow. The P(sub) decreased with an increase in the epilaryngeal area and displayed linear relations to the airflow. The principal eigenfunctions (EEFs) from the vocal fold dynamics exhibited lateral movement for the first EEF and rotational motion for the second EEF. In total, the first two EEFs covered a minimum of 60% of the energy, with an average of more than 50% for the first EEF. Correlations to the epilarynx areas were not found. Maximal values for amplitudes (up to 2.5 mm) and velocities (up to 1.57 mm/ms) changed with varying epilaryngeal area but did not show consistent behavior for both larynges. We conclude that the size of the epilaryngeal area has significant influence on vocal fold dynamics but does not significantly affect the resultant SPL. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  1. [Observation of clinicopathological characteristics of vocal fold leukoplakia and laryngopharyngeal reflux].

    Science.gov (United States)

    Zhu, Hong; Xu, Wen; Li, Yun; Cheng, Liyu

    2014-05-01

    To investigate the correlation between clinicopathological characteristics of vocal fold leukoplakia and laryngopharyngeal reflux (LRP). One hundred and thirty-eight patients with vocal leukoplakia who received laryngeal microsurgeries under suspension laryngoscope were recruited in this study. Reflux symptom index (RSI) and reflux finding score (RFS) were measured. The clinical features, pathological characteristics were collected. There were 129 males and 9 females with a mean age of (53.4 ± 11.5) years. The mean age of patients with severe dysplasia/carcinoma and invasive carcinoma was significantly older than that of inflammation/hyperplasia (F = 6.773, P 13 or RFS > 7 was 54.3 %, while the positive rate of RSI was 21.7% and that of RFS was 43.5%. There was no significant differences of the positive rates of RSI and RFS among different pathological types (χ² values 3.537 and 7.619 respectively with both P > 0.05). According to RSI evaluation, the most common reflux symptoms were hoarseness (94.9%), throat clearing (68.8%) and globus sensation (62.3%). The most common RFS findings were posterior commissure hypertrophy (79.7%), thick endolaryngeal mucus (77.5%) and vocal fold edema (70.3%). The vocal fold leukoplakia consisted of various pathological types including benign, dysplasia and malignancy. There was a correlation between pathological types and the extent of mucosal waves. About half of the patients with vocal fold leukoplakia existed LPR using RFS and RSI evaluation, but no significant difference of LPR positive rates were observed among different pathological types.

  2. Differential diagnosis in paradoxical vocal fold movement (PVFM): an interdisciplinary task.

    Science.gov (United States)

    Franca, Maria Claudia

    2014-12-01

    The objective of this study was to contribute to the discussion of differential diagnosis in paradoxical vocal fold movement (PVFM), a disorder frequently associated with episodes of breathing difficulty and stridor. Because of analogous respiratory symptoms, PVFM is often misdiagnosed as asthma. Additional evidence suggests the association of factors such as respiratory struggle during physical exertion, digestive reflux, and respiratory allergies with PVFM, particularly in athletes and young females. Interdisciplinary attention is warranted to avoid unnecessary utilization of medical resources and potential delay in the application of proper treatment. A description of critical points in PVFM differential diagnosis is proposed, featuring the assessment of a seven-year-old female with a history of behaviors considered to exacerbate voice fatigue symptoms. Noticeably, the child has consistently demonstrated tiredness and respiratory difficulties during physical education classes. Past use of oral steroids to reduce respiratory problems was applied with no improvement; short-acting beta 2-agonists have been also tried with mild improvement. Indications of instability and effort associated with respiratory-phonatory functions were demonstrated. Furthermore, there was evidence of GERD and seasonal allergies. The literature suggests an association of factors such as respiratory struggle during physical exertion, unwanted vocal effort, GERD, and respiratory allergies in individuals with PVFM, particularly in young females. A diagnosis of PVFM was suggested, in association with paradoxical vocal folds motion caused by respiratory difficulties verified by laryngeal examination. In PVFM, the vocal folds adduct during inhalation, thereby restricting the airway opening. Inconsistent vocal folds movement during phonation may also lead to PVFM symptoms. Acute bronchospasm/asthma-like symptoms, as well as additional morbidity may impact accuracy of diagnosis, leading to

  3. Effects of the epi-larynx area on vocal fold dynamics and the primary voice signal✩

    Science.gov (United States)

    Döllinger, Michael; Berry, David A.; Luegmair, Georg; Hüttner, Björn; Bohr, Christopher

    2011-01-01

    For the analysis of vocal fold dynamics, sub- and supra glottal influences must be taken into account, as recent studies have shown. In this work, we analyze the influence of changes in the epi-laryngeal area on vocal fold dynamics. We investigate two excised female larynges in a hemi-larynx set-up combined with a synthetic vocal tract consisting of hard plastic and simulating the vowel /a/. Eigenmodes, amplitudes, and velocities of the oscillations, the sub-glottal pressures and sound pressure levels of the generated signal are investigated as function of three distinctive epi-laryngeal areas (28.4 mm2, 71.0 mm2 and 205.9 mm2). The results showed that the sound-pressure level is independent of the epi-larynx cross-section and exhibits a non-linear relation to the insufflated air flow. The sub-glottal pressure decreased with an increase in the epi-laryngeal area and displayed linear relations to the air flow. The principal eigenfunctions from the vocal fold dynamics exhibited lateral movement for the first Eigenfunction and rotational motion for the second Eigenfunction. In total, the first two Eigenfunctions (EEF) covered a minimum of 60% of the energy, with an average of more than 50% for the first Eigenfunction. Correlations to epilarynx areas were not found. Maximal values for amplitudes (up to 2.5 mm) and velocities (up to 1.57 mm/ms) changed with varying epilaryngeal area, but did not show consistent behaviour for both larynges. We conclude that the size of the epi-laryngeal area has significant influence on vocal fold dynamics, but does not significantly affect the resultant sound-pressure level. PMID:21708451

  4. The natural history of recoverable vocal fold paralysis: Implications for kinetics of reinnervation.

    Science.gov (United States)

    Mau, Ted; Pan, Hao-Min; Childs, Lesley F

    2017-11-01

    Patients with unilateral vocal fold paralysis (UVFP) are commonly told to wait 12 months for spontaneous recovery. This study aims to 1) determine the time to vocal recovery in UVFP, 2) use that data to develop a neurophysiologically plausible model for recovery, and 3) use the model to generate meaningful predictions for patient counseling. Case series with de novo mathematical modeling. Patients with UVFP who could pinpoint a discrete onset of vocal improvement were identified. The time-to-recovery data were modeled by assuming an "early" recovery group with neuropraxia and a "late" recovery group with more severe nerve injury. For the late group, a two-stage model was developed to explain the time to recovery: regenerating axons must cross the site of injury in stage 1 (probabilistic), followed by unimpeded regrowth to the larynx in stage 2 (deterministic). Of 727 cases of UVFP over a 7-year period, 44 reported spontaneous recovery with a discrete onset of vocal improvement. A hybrid distribution incorporating the two stages (exponentially modified Gaussian) accurately modeled the time-to-recovery data (R2 = 0.918). The model predicts 86% of patients with recoverable UVFP will recover within 6 months, with 96% recovering within 9 months. Earlier vocal recovery is associated with recovery of vocal fold motion and younger age. Waiting 12 months for spontaneous recovery is probably too conservative. Repair across the site of injury, and not regrowth to larynx, is likely the rate-determining step in reinnervation, consistent with other works on peripheral nerve regeneration. 4. Laryngoscope, 127:2585-2590, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Validation of a pediatric vocal fold nodule rating scale based on digital video images.

    Science.gov (United States)

    Nuss, Roger C; Ward, Jessica; Recko, Thomas; Huang, Lin; Woodnorth, Geralyn Harvey

    2012-01-01

    We sought to create a validated scale of vocal fold nodules in children, based on digital video clips obtained during diagnostic fiberoptic laryngoscopy. We developed a 4-point grading scale of vocal fold nodules in children, based upon short digital video clips. A tutorial for use of the scale, including schematic drawings of nodules, static images, and 10-second video clips, was presented to 36 clinicians with various levels of experience. The clinicians then reviewed 40 short digital video samples from pediatric patients evaluated in a voice clinic and rated the nodule size. Statistical analysis of the ratings provided inter-rater reliability scores. Thirty-six clinicians with various levels of experience rated a total of 40 short video clips. The ratings of experienced raters (14 pediatric otolaryngology attending physicians and pediatric otolaryngology fellows) were compared with those of inexperienced raters (22 nurses, medical students, otolaryngology residents, physician assistants, and pediatric speech-language pathologists). The overall intraclass correlation coefficient for the ratings of nodule size was quite good (0.62; 95% confidence interval, 0.52 to 0.74). The p value for experienced raters versus inexperienced raters was 0.1345, indicating no statistically significant difference in the ratings by these two groups. The intraclass correlation coefficient for intra-rater reliability was very high (0.89). The use of a dynamic scale of pediatric vocal fold nodule size most realistically represents the clinical assessment of nodules during an office visit. The results of this study show a high level of agreement between experienced and inexperienced raters. This scale can be used with a high level of reliability by clinicians with various levels of experience. A validated grading scale will help to assess long-term outcomes of pediatric patients with vocal fold nodules.

  6. Quantitative Study for the Surface Dehydration of Vocal Folds Based on High-Speed Imaging.

    Science.gov (United States)

    Li, Lin; Zhang, Yu; Maytag, Allison L; Jiang, Jack J

    2015-07-01

    From the perspective of the glottal area and mucosal wave, quantitatively estimate the differences of vocal fold on laryngeal activity during phonation at three different dehydration levels. Controlled three sets of tests. A dehydration experiment for 10 excised canine larynges was conducted at 16 cm H2O. According to the dehydration cycle time (H), dehydration levels were divided into three degrees (0% H, 50% H, 75% H). The glottal area and mucosal wave under three dehydration levels were extracted from high-speed images and digital videokymography (DKG) image sequences. Direct and non-direct amplitude components were derived from glottal areas. The amplitude and frequency of mucosal wave were calculated from DKG image sequences. These parameters in condition of three dehydration levels were compared for statistical analysis. The results showed a significant difference in direct (P = 0.001; P = 0.005) and non-direct (P = 0.005; P = 0.016) components of glottal areas between every two different dehydration levels. Considering the right-upper, right-lower, left-upper, and left-lower of vocal fold, the amplitudes of mucosal waves consistently decreased with increasing of dehydration levels. But, there was no significant difference in frequency. Surface dehydration could give rise to complex variation of vocal fold on tissues and vibratory mechanism, which should need analyzing from multiple perspectives. The results suggested that the combination of glottal area and mucosal wave could be better to research the change of vocal fold at different dehydrations. It would become a better crucial research tool for the clinical treatment of dehydration-induced laryngeal pathologies. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  7. High-speed image analysis reveals chaotic vibratory behaviors of pathological vocal folds

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Yu, E-mail: yuzhang@xmu.edu.c [Key Laboratory of Underwater Acoustic Communication and Marine Information Technology of the Ministry of Education, Xiamen University, Xiamen Fujian 361005 (China); Shao Jun [Shanghai EENT Hospital of Fudan University, Shanghai (China); Krausert, Christopher R. [Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792-7375 (United States); Zhang Sai [Key Laboratory of Underwater Acoustic Communication and Marine Information Technology of the Ministry of Education, Xiamen University, Xiamen Fujian 361005 (China); Jiang, Jack J. [Shanghai EENT Hospital of Fudan University, Shanghai (China); Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792-7375 (United States)

    2011-01-15

    Research highlights: Low-dimensional human glottal area data. Evidence of chaos in human laryngeal activity from high-speed digital imaging. Traditional perturbation analysis should be cautiously applied to aperiodic high speed image signals. Nonlinear dynamic analysis may be helpful for understanding disordered behaviors in pathological laryngeal systems. - Abstract: Laryngeal pathology is usually associated with irregular dynamics of laryngeal activity. High-speed imaging facilitates direct observation and measurement of vocal fold vibrations. However, chaotic dynamic characteristics of aperiodic high-speed image data have not yet been investigated in previous studies. In this paper, we will apply nonlinear dynamic analysis and traditional perturbation methods to quantify high-speed image data from normal subjects and patients with various laryngeal pathologies including vocal fold nodules, polyps, bleeding, and polypoid degeneration. The results reveal the low-dimensional dynamic characteristics of human glottal area data. In comparison to periodic glottal area series from a normal subject, aperiodic glottal area series from pathological subjects show complex reconstructed phase space, fractal dimension, and positive Lyapunov exponents. The estimated positive Lyapunov exponents provide the direct evidence of chaos in pathological human vocal folds from high-speed digital imaging. Furthermore, significant differences between the normal and pathological groups are investigated for nonlinear dynamic and perturbation analyses. Jitter in the pathological group is significantly higher than in the normal group, but shimmer does not show such a difference. This finding suggests that the traditional perturbation analysis should be cautiously applied to high speed image signals. However, the correlation dimension and the maximal Lyapunov exponent reveal a statistically significant difference between normal and pathological groups. Nonlinear dynamic analysis is capable of

  8. Resolution of vocal fold leukoplakia during erlotinib treatment for lung cancer.

    Science.gov (United States)

    Francis, David O; Misono, Stephanie; Somerville, Jessica; McWhorter, Andrew; Garrett, C Gaelyn

    2016-02-01

    Treatment of vocal fold leukoplakia is complicated because it is associated with a high rate of recurrence after excision and it has the potential for progression to malignancy. Authors have presented different approaches to management, one of which is directed serial excisional biopsies. Ideally, a topical or systemic agent could be administered to eradicate this troublesome condition. We present the case of a patient with an 8-year history of vocal fold leukoplakia treated with directed serial biopsies who was subsequently diagnosed with non-small-cell lung cancer and treated with erlotinib. He experienced a complete resolution after 2 months of erlotinib therapy for his lung cancer. Immunohistochemistry confirmed that his lesion exhibited a much higher than normal expression of epidermal growth factor receptor (EGFR), which supports the idea that EGFR antagonism may combat EGFR-avid leukoplakia. However, we caution that the clinical observation made herein is an association and should not be misconstrued as a recommendation regarding the safety, efficacy, or economy of using erlotinib for the treatment of vocal fold leukoplakia.

  9. Treatment Outcomes of In-Office KTP Ablation of Vocal Fold Granulomas.

    Science.gov (United States)

    Dominguez, Laura M; Brown, Raymond J; Simpson, C Blake

    2017-12-01

    To determine the effectiveness of in-office potassium-titanyl-phosphate (KTP) treatment of vocal fold granulomas and identify any predictors of complete lesion resolution. A retrospective review of patients who underwent in-office KTP ablation of vocal fold granulomas between 2007 and 2016 was performed. Medical records were reviewed for use of acid suppression medication, prior surgical treatment, voice therapy, laser settings, number of treatments, follow-up time, and Voice Handicap Index-10 (VHI-10) scores. Twenty-six patients underwent a total of 43 laser treatments. Eighty percent of patients were previously on acid suppression medication, and 42.3% had failed previous endoscopic treatments. Patients underwent a mean number of 1.65 ± 1.16 in-office treatments with decrease in size in 96.2% of cases. The VHI-10 was not significantly affected. Complete resolution occurred in 73.1% of cases with follow-up time ranging from 1 to 86 months (median = 9.5 months). No recurrences occurred in patients with complete resolution. Other than undergoing a single KTP treatment, no variable was found to be predictive of complete lesion resolution. Granuloma etiology was not predictive of lesion resolution but did correlate with symptom improvement. In-office pulsed KTP laser is an effective treatment option for vocal fold granulomas as the lesion resolves in the majority of cases.

  10. Towards A Simulation-Based Tool for the Treatment of Vocal Fold Paralysis

    Directory of Open Access Journals (Sweden)

    Rajat eMittal

    2011-05-01

    Full Text Available Advances in high-performance computing are enabling a new generation of software tools that employ computational modeling for surgical planning. Surgical management of laryngeal paralysis is one area where such computational tools could have a significant impact. The current paper describes a comprehensive effort to develop a software tool for planning medialization laryngoplasty where a prosthetic implant is inserted into the larynx in order to medialize the paralyzed vocal-fold. While this is one of the most common procedures used to restore voice in patients with vocal-fold paralysis, it has a relatively high revision rate, and the tool being developed is expected to improve surgical outcomes. This software tool models the biomechanics of airflow-induced vibration in the human larynx and incorporates sophisticated approaches for modeling the turbulent laryngeal flow, the complex dynamics of the vocal folds, as well as the production of voiced sound. The current paper describes the key elements of the modeling approach, presents computational results that demonstrate the utility of the approach and also describes some of the limitations and challenges.

  11. War, politics, and voice: the vocal fold paralysis of George Orwell.

    Science.gov (United States)

    Sulica, Lucian

    2007-02-01

    In 1936, like many individuals who felt the menace of fascism, George Orwell traveled to Spain to lend his support to the cause of the Republic, battling a right-wing coup. Spain, during its Civil War, was an eye-opening experience for him, yielding insights that allowed, and even compelled him to write Animal Farm and 1984. Spain was also a close brush with death. In May of 1937, in a trench on a windswept ridge near Huesca, Orwell was shot through the neck by a sniper, leaving him with a paralyzed vocal fold. A thorough review of firsthand accounts of Orwell's injury and subsequent care was made. These are presented in the context of current knowledge of ballistics, penetrating neck trauma, and vocal fold paralysis. Orwell survived largely because of the nature of his wounding with a high-velocity jacketed military round. His recovery followed a course in many ways typical for patients with vocal fold paralysis. His writings leave us a unique and extraordinary account of the experience of being shot, of the medical care of the day, of the handicap of paralytic dysphonia, and of survival and heroism under extraordinary circumstances.

  12. Effects of Vocal Fold Nodules on Glottal Cycle Measurements Derived from High-Speed Videoendoscopy in Children.

    Directory of Open Access Journals (Sweden)

    Rita R Patel

    Full Text Available The goal of this study is to quantify the effects of vocal fold nodules on vibratory motion in children using high-speed videoendoscopy. Differences in vibratory motion were evaluated in 20 children with vocal fold nodules (5-11 years and 20 age and gender matched typically developing children (5-11 years during sustained phonation at typical pitch and loudness. Normalized kinematic features of vocal fold displacements from the mid-membranous vocal fold point were extracted from the steady-state high-speed video. A total of 12 kinematic features representing spatial and temporal characteristics of vibratory motion were calculated. Average values and standard deviations (cycle-to-cycle variability of the following kinematic features were computed: normalized peak displacement, normalized average opening velocity, normalized average closing velocity, normalized peak closing velocity, speed quotient, and open quotient. Group differences between children with and without vocal fold nodules were statistically investigated. While a moderate effect size was observed for the spatial feature of speed quotient, and the temporal feature of normalized average closing velocity in children with nodules compared to vocally normal children, none of the features were statistically significant between the groups after Bonferroni correction. The kinematic analysis of the mid-membranous vocal fold displacement revealed that children with nodules primarily differ from typically developing children in closing phase kinematics of the glottal cycle, whereas the opening phase kinematics are similar. Higher speed quotients and similar opening phase velocities suggest greater relative forces are acting on vocal fold in the closing phase. These findings suggest that future large-scale studies should focus on spatial and temporal features related to the closing phase of the glottal cycle for differentiating the kinematics of children with and without vocal fold nodules.

  13. Effects of Vocal Fold Nodules on Glottal Cycle Measurements Derived from High-Speed Videoendoscopy in Children.

    Science.gov (United States)

    Patel, Rita R; Unnikrishnan, Harikrishnan; Donohue, Kevin D

    2016-01-01

    The goal of this study is to quantify the effects of vocal fold nodules on vibratory motion in children using high-speed videoendoscopy. Differences in vibratory motion were evaluated in 20 children with vocal fold nodules (5-11 years) and 20 age and gender matched typically developing children (5-11 years) during sustained phonation at typical pitch and loudness. Normalized kinematic features of vocal fold displacements from the mid-membranous vocal fold point were extracted from the steady-state high-speed video. A total of 12 kinematic features representing spatial and temporal characteristics of vibratory motion were calculated. Average values and standard deviations (cycle-to-cycle variability) of the following kinematic features were computed: normalized peak displacement, normalized average opening velocity, normalized average closing velocity, normalized peak closing velocity, speed quotient, and open quotient. Group differences between children with and without vocal fold nodules were statistically investigated. While a moderate effect size was observed for the spatial feature of speed quotient, and the temporal feature of normalized average closing velocity in children with nodules compared to vocally normal children, none of the features were statistically significant between the groups after Bonferroni correction. The kinematic analysis of the mid-membranous vocal fold displacement revealed that children with nodules primarily differ from typically developing children in closing phase kinematics of the glottal cycle, whereas the opening phase kinematics are similar. Higher speed quotients and similar opening phase velocities suggest greater relative forces are acting on vocal fold in the closing phase. These findings suggest that future large-scale studies should focus on spatial and temporal features related to the closing phase of the glottal cycle for differentiating the kinematics of children with and without vocal fold nodules.

  14. Long-term Surveillance Following Intralesional Steroid Injection for Benign Vocal Fold Lesions.

    Science.gov (United States)

    Wang, Chi-Te; Lai, Mei-Shu; Cheng, Po-Wen

    2017-06-01

    The short-term outcomes of vocal fold steroid injection (VFSI) are well documented. However, few studies have reported the long-term outcomes following VFSI. To investigate the incidence rates of symptom recurrence and secondary interventions following VFSI for benign vocal fold lesions. This prospective cohort study was conducted at a tertiary referral medical center in Taipei, Taiwan. The cohort included 189 patients with vocal fold lesions who had received VFSI as the primary treatment between August 2011 and September 2013. All participants underwent VFSI. Long-term surveillance was conducted through structured telephonic interviews and by reviewing medical charts every 6 months over a 2-year period. We assessed the 10-item voice handicap index, dysphonic symptoms, and whether the patients had received any additional interventions after the initial VFSI. The 189 participants (32 men and 157 women; mean [SD] age, 39 [10] years [range, 20-74 years] included patients who had undergone VFSI for vocal fold nodules (n = 72), polyps (n = 72), or mucus-retention cysts (n = 45). Following VFSI, 141 patients (74.6%; 23 men and 118 women; mean age, 39 years [range, 20-70 years]) showed positive response (ie, clinically significant symptom resolution without the need for additional procedures) and received long-term surveillance. The median follow-up period was 19.4 months, and 2 patients were lost to follow-up postoperatively within 1 year. The cumulative failure rates (subjective symptom recurrence plus secondary treatments) at 6, 12, 18, and 24 months after VFSI were 12%, 17%, 24%, and 32%, respectively. When the initial response rate to VFSI (141 of 189, 74.6%) was considered altogether, VFSI remained effective after 2 years in 50% of the initially recruited 189 patients. The highest rate of long-term effectiveness of VFSI occurred in vocal polyps (54%), followed by nodules (49%) and cysts (43%). This study demonstrates that VFSI can be beneficial in

  15. A cervid vocal fold model suggests greater glottal efficiency in calling at high frequencies.

    Directory of Open Access Journals (Sweden)

    Ingo R Titze

    2010-08-01

    Full Text Available Male Rocky Mountain elk (Cervus elaphus nelsoni produce loud and high fundamental frequency bugles during the mating season, in contrast to the male European Red Deer (Cervus elaphus scoticus who produces loud and low fundamental frequency roaring calls. A critical step in understanding vocal communication is to relate sound complexity to anatomy and physiology in a causal manner. Experimentation at the sound source, often difficult in vivo in mammals, is simulated here by a finite element model of the larynx and a wave propagation model of the vocal tract, both based on the morphology and biomechanics of the elk. The model can produce a wide range of fundamental frequencies. Low fundamental frequencies require low vocal fold strain, but large lung pressure and large glottal flow if sound intensity level is to exceed 70 dB at 10 m distance. A high-frequency bugle requires both large muscular effort (to strain the vocal ligament and high lung pressure (to overcome phonation threshold pressure, but at least 10 dB more intensity level can be achieved. Glottal efficiency, the ration of radiated sound power to aerodynamic power at the glottis, is higher in elk, suggesting an advantage of high-pitched signaling. This advantage is based on two aspects; first, the lower airflow required for aerodynamic power and, second, an acoustic radiation advantage at higher frequencies. Both signal types are used by the respective males during the mating season and probably serve as honest signals. The two signal types relate differently to physical qualities of the sender. The low-frequency sound (Red Deer call relates to overall body size via a strong relationship between acoustic parameters and the size of vocal organs and body size. The high-frequency bugle may signal muscular strength and endurance, via a 'vocalizing at the edge' mechanism, for which efficiency is critical.

  16. The impact of phonation mode and vocal technique on vocal fold closure in young females with normal voice quality.

    Science.gov (United States)

    De Bodt, Marc S; Clement, Gregory; Wuyts, Floris L; Borghs, Cindy; Van Lierde, Kristiane M

    2012-11-01

    Because voice quality depends substantially on vocal fold closure (VFC), voice therapists try to modify VFC by specific voice techniques or adjustments in phonation mode. This study demonstrates the impact of six different phonation modes on VFC in healthy subjects. For this study, 21 female subjects with normal voice quality were selected. The impact of different phonation modes and voice techniques was examined by fiberoptic laryngovideoendoscopy during different modes of phonation: habitual phonation, high pitch, low pitch, resonance on /m/, Coblenzer's "abspannen," and chant talk. The video recordings were judged by three experienced professionals (two Speech and Language Pathologist and one laryngologist) by means of a visual analog scale. Statistical analysis showed that only resonance on /m/ significantly improved VFC compared with habitual phonation. All other phonation modes and techniques, except low-pitched phonation, led to a significant worse closure in comparison with the closure at normal pitch. The glottic closure observed by low-pitched phonation was not significantly different than the closure at habitual pitch. Interrater agreement was moderate to very good, depending on the mode of phonation. The results of this study allow a better understanding of the impact of phonation mode and vocal therapy techniques on VFC in healthy subjects and give an indication about the impact of these methods to influence VFC. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  17. Vocal fold scars : current concepts and future directions. Consensus report of the phonosurgery committee of the European laryngological society

    NARCIS (Netherlands)

    Friedrich, G.; Dikkers, F. G.; Arens, C.; Remacle, M.; Hess, M.; Giovanni, A.; Duflo, S.; Hantzakos, A.; Bachy, V.; Gugatschka, M.

    Scarring of the vocal folds leads to a deterioration of the highly complex micro-structure with consecutively impaired vibratory pattern and glottic insufficiency. The resulting dysphonia is predominantly characterized by a reduced vocal capacity. Despite the considerable progress in understanding

  18. Two-dimensional model of vocal fold vibration for sound synthesis of voice and soprano singing

    Science.gov (United States)

    Adachi, Seiji; Yu, Jason

    2005-05-01

    Voiced sounds were simulated with a computer model of the vocal fold composed of a single mass vibrating both parallel and perpendicular to the airflow. Similarities with the two-mass model are found in the amplitudes of the glottal area and the glottal volume flow velocity, the variation in the volume flow waveform with the vocal tract shape, and the dependence of the oscillation amplitude upon the average opening area of the glottis, among other similar features. A few dissimilarities are also found in the more symmetric glottal and volume flow waveforms in the rising and falling phases. The major improvement of the present model over the two-mass model is that it yields a smooth transition between oscillations with an inductive load and a capacitive load of the vocal tract with no sudden jumps in the vibration frequency. Self-excitation is possible both below and above the first formant frequency of the vocal tract. By taking advantage of the wider continuous frequency range, the two-dimensional model can successfully be applied to the sound synthesis of a high-pitched soprano singing, where the fundamental frequency sometimes exceeds the first formant frequency. .

  19. [Vocal fold paralysis in the Medical University of Warsaw's Ambulatory of Phoniatry in years 2000-2011].

    Science.gov (United States)

    Sielska-Badurek, Ewelina; Domeracka-Kołodziej, Anna; Zawadzka, Renata; Dębowska-Jarzębska, Ewa

    2012-01-01

    Vocal fold paralysis it is an important problem in Phoniatrics' Ambulatory. There are a lot of difficulties in estimation a precise incidence of vocal fold paralysis in the population. As many as 50% of cases with paralysis might present nonspecific symptoms. The aim of the research it was to determine a vocal fold paralysis' epidemiology and etiology in material of the Medical University of Warsaw's Ambulatory of Phoniatry. Authors present a group of 593 patients with vocal cord paralysis who were diagnosed and treated in The Ambulatory of Phoniatry from 2000 to 2011. The paralysis was observed in 439 women and in 154 men. In 488 patients paralysis was unilateral and in 105 - bilateral. In the study, surgery was responsible for most vocal fold paralysis (79.0%). In 357 patients, paralysis was caused by thyroid surgery. Other surgical causes of the paralysis there were: endarterectomy, thoracic surgery and skull base surgery. Of the total group, 1.2% of cases were diagnosed after intubation. In the review, in another 19.8% cases, paralysis was caused by thoracic, neck or brain tumors, by traumas and in 21 patients there was no obvious reason (idiopathic cases). Etiology of vocal fold paralysis seems to be affected by a character of institutions or hospitals who make a study and by geographic location. The most common etiology of vocal cord paralysis is iatrogenic. 2012 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o.

  20. Delivery of Intensive Voice Therapy for Vocal Fold Nodules Via Telepractice: A Pilot Feasibility and Efficacy Study.

    Science.gov (United States)

    Fu, Sherry; Theodoros, Deborah G; Ward, Elizabeth C

    2015-11-01

    This pilot study examined voice outcomes and patient perceptions after intensive voice therapy for vocal fold nodules via telepractice. Pilot, within-subjects experimental trial. Participants included 10 women diagnosed with bilateral vocal fold nodules who received intensive voice treatment via a free videoconferencing platform Skype, (Microsoft Corp., Redmond, WA). All participants completed one vocal hygiene session in person, followed by eight sessions of therapy via telepractice over 3 weeks. Before and immediately after treatment, patients attended a clinic in person to complete perceptual, stroboscopic, acoustic, and physiological assessments of vocal function. Analyses were performed by a speech-language pathologist and an otolaryngologist independent to and blinded to the study. Participants also completed the Voice Handicap Index and a telepractice satisfaction questionnaire, or an anticipated satisfaction questionnaire, before and after the treatment. Significant improvements were found in perceptual, vocal fold function, acoustic, and physiological parameters as well as nodule sizes and patient perceptions of voice-related quality of life post-treatment. Participants were highly positive about their first experience with telepractice. Results were similar to those from a separate study investigating the effects of an intensive voice therapy delivered in conventional face-to-face (FTF) format. This study is consistent with possible benefits of telepractice in the delivery of intensive treatment for vocal fold nodules. Pending final verification with a FTF comparison group, telepractice could be recommended as an alternate treatment modality for patients with vocal fold nodules. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  1. Laryngeal muscle activity and vocal fold adduction during chest, chestmix, headmix, and head registers in females.

    Science.gov (United States)

    Kochis-Jennings, Karen Ann; Finnegan, Eileen M; Hoffman, Henry T; Jaiswal, Sanyukta

    2012-03-01

    Commercial singers produce chestmix register by maintaining or increasing adduction of the vocal processes (VPs) and by engaging the thyroarytenoid (TA) muscle to a greater degree than they would to produce head register. Prospective cohort study. Simultaneous recordings of TA and cricothyroid (CT) muscle activity, videonasendoscopy, and audio were obtained from seven female singers during production of a variety of midrange pitches in chest, chestmix, headmix, and head registers. Fast Fourier transforms were performed to measure the energy in the fundamental frequency and in mid and upper frequency harmonics to determine if the productions that were judged as perceptually distinct registers also showed distinctive acoustic characteristics. Then, measures of TA and CT muscle activity and vocal fold adduction ratings were obtained to determine how these varied as a function of pitch and register. Spectral tilt increased as subjects shifted from chest to chestmix to headmix and finally into head register. For same pitch phonation, subjects increased TA muscle activity and vocal fold adduction as they shifted register from head to headmix to chestmix to chest, particularly during production of higher frequencies. CT activity appeared to be more related to pitch rather than register control. Nonclassically trained singers were able to produce pitches at the high end of the midrange in chestmix register by increasing TA muscle activity and adduction of the VPs. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  2. Detection of the Vibration Signal from Human Vocal Folds Using a 94-GHz Millimeter-Wave Radar

    Science.gov (United States)

    Chen, Fuming; Li, Sheng; Zhang, Yang; Wang, Jianqi

    2017-01-01

    The detection of the vibration signal from human vocal folds provides essential information for studying human phonation and diagnosing voice disorders. Doppler radar technology has enabled the noncontact measurement of the human-vocal-fold vibration. However, existing systems must be placed in close proximity to the human throat and detailed information may be lost because of the low operating frequency. In this paper, a long-distance detection method, involving the use of a 94-GHz millimeter-wave radar sensor, is proposed for detecting the vibration signals from human vocal folds. An algorithm that combines empirical mode decomposition (EMD) and the auto-correlation function (ACF) method is proposed for detecting the signal. First, the EMD method is employed to suppress the noise of the radar-detected signal. Further, the ratio of the energy and entropy is used to detect voice activity in the radar-detected signal, following which, a short-time ACF is employed to extract the vibration signal of the human vocal folds from the processed signal. For validating the method and assessing the performance of the radar system, a vibration measurement sensor and microphone system are additionally employed for comparison. The experimental results obtained from the spectrograms, the vibration frequency of the vocal folds, and coherence analysis demonstrate that the proposed method can effectively detect the vibration of human vocal folds from a long detection distance. PMID:28282892

  3. The relation of vocal fold lesions and voice quality to voice handicap and psychosomatic well-being.

    Science.gov (United States)

    Smits, R; Marres, H; de Jong, Felix

    2012-07-01

    Voice disorders have a multifactorial genesis and may be present in various ways. They can cause a significant communication handicap and impaired quality of life. To assess the effect of vocal fold lesions and voice quality on voice handicap and psychosomatic well-being. Female patients, aged 18-65 years, who were referred to the outpatient clinic with voice problems were subsequently assessed. Laryngostroboscopic examination and acoustic voice analysis were carried out, and the patients were asked to fill in the Voice Handicap Index (VHI) and Symptom Check List-90 questionnaires. Eighty-two patients were included. In 43 patients (52.4%), a vocal fold lesion was observed. The VHI and psychosomatic well-being did not differ significantly between patients with and without a vocal fold lesion. The patients with a vocal fold lesion showed lower scores on the Dysphonia Severity Index (DSI) compared with those without a vocal fold lesion. However, the DSI was not correlated with voice handicap and psychosomatic well-being, except for the VHI physical subscale. Objective measurement does not necessarily correlate with the subjective appraisal of the patient's voice handicap and psychosomatic well-being. Furthermore, the criterion of the presence of a vocal fold lesion as the base of indemnity that is applied by health insurance institutions should be questioned. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  4. Long-term efficacy of percutaneous steroid injection for treating benign vocal fold lesions: A prospective study.

    Science.gov (United States)

    Lee, Seung Won; Park, Ki Nam

    2016-10-01

    This study assessed the long-term efficacy and recurrence rates of percutaneous steroid injections (PSIs) for benign vocal fold lesions. Prospective clinical study. A prospective human clinical trial was performed from October 2008 to September 2014 at Soonchunhyang University Hospital, Bucheon, Korea. Percutaneous steroid injection was performed in 84 consecutive patients with small benign vocal fold lesions, such as vocal fold nodules, polyps, and Reinke's edema, who could not be treated with voice therapy or surgery. Patients had acoustic aerodynamic, perceptual, stroboscopic, and voice handicap index evaluations before PSI and also 3, 6, 12, and 24 months after PSI. Of the 84 patients, 37 (44.0%) showed complete remission; 22 (26.2%) showed partial remission; five (6%) had no response; and 20 (23.8%) developed recurrences after PSI. Most of the objective and subjective parameters that improved statistically (P vocal fold hematomas in 2.4% (2 of 84) and mild vocal fold atrophy in 1.2% (1 of 84). Percutaneous steroid injection is a useful alternative modality for treating benign vocal fold lesions without morbidity. However, recurrence rates were higher with voice abuse after PSI and professional voice users. 4. Laryngoscope, 126:2315-2319, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Detection of the Vibration Signal from Human Vocal Folds Using a 94-GHz Millimeter-Wave Radar

    Directory of Open Access Journals (Sweden)

    Fuming Chen

    2017-03-01

    Full Text Available The detection of the vibration signal from human vocal folds provides essential information for studying human phonation and diagnosing voice disorders. Doppler radar technology has enabled the noncontact measurement of the human-vocal-fold vibration. However, existing systems must be placed in close proximity to the human throat and detailed information may be lost because of the low operating frequency. In this paper, a long-distance detection method, involving the use of a 94-GHz millimeter-wave radar sensor, is proposed for detecting the vibration signals from human vocal folds. An algorithm that combines empirical mode decomposition (EMD and the auto-correlation function (ACF method is proposed for detecting the signal. First, the EMD method is employed to suppress the noise of the radar-detected signal. Further, the ratio of the energy and entropy is used to detect voice activity in the radar-detected signal, following which, a short-time ACF is employed to extract the vibration signal of the human vocal folds from the processed signal. For validating the method and assessing the performance of the radar system, a vibration measurement sensor and microphone system are additionally employed for comparison. The experimental results obtained from the spectrograms, the vibration frequency of the vocal folds, and coherence analysis demonstrate that the proposed method can effectively detect the vibration of human vocal folds from a long detection distance.

  6. Acoustic and electroglottographic voice characteristics in chronic cough and paradoxical vocal fold movement.

    Science.gov (United States)

    Vertigan, Anne E; Theodoros, Deborah G; Winkworth, Alison L; Gibson, Peter G

    2008-01-01

    Chronic cough (CC) and paradoxical vocal fold movement (PVFM) may be associated with voice problems. Objective acoustic and electroglottographic (EGG) measures have the capacity to delineate these vocal characteristics. This study investigated acoustic and EGG voice features of CC and PVFM. Acoustic and EGG findings were compared among 5 groups of participants. The first 3 groups, CC (n = 56), PVFM (n = 8) and combined CC-PVFM (n = 55), included individuals with cough and respiratory symptoms that persisted despite medical treatment. Groups 4 and 5 included individuals with muscle tension dysphonia (n = 25) and healthy controls (n = 27). Participants with CC/PVFM recorded reduced phonation times (p voice features in CC and PVFM. Copyright 2008 S. Karger AG, Basel.

  7. Dysphonia secondary to traumatic avulsion of the vocal fold in infants.

    Science.gov (United States)

    Bray, D; Cavalli, L; Eze, N; Mills, N; Hartley, B E J

    2010-11-01

    Airway compromise due to paediatric intubation injuries is well documented; however, intubation injuries may also cause severe voice disorders. We report our experience and review the world literature on the voice effects of traumatic paediatric intubation. We report five cases of children referred to Great Ormond Street Hospital for Children who suffered traumatic avulsion of the vocal fold at the time of, or secondary to, endotracheal intubation. All children had significant dysphonia and underwent specialist voice therapy. The mechanisms of injury, risk factors and management of the condition are discussed. Children suffering traumatic intubation require follow up throughout childhood and beyond puberty as their vocal needs and abilities change. At the time of writing, none of the reported patients had yet undergone reconstructive or medialisation surgery. However, regular specialist voice therapy evaluation is recommended for such patients, with consideration of phonosurgical techniques including injection laryngoplasty or thyroplasty.

  8. Pediatric Vocal Fold Nodule Etiology: What Are Its Usual Causes in Children?

    Science.gov (United States)

    Tuzuner, Arzu; Demirci, Sule; Oguz, Haldun; Ozcan, Kursat Murat

    2017-07-01

    In this study, the relation between phonotrauma and presence of siblings and social activities was investigated, and the incidence of voice disorders in the mothers of children with vocal fold nodules was studied with objective (clinical voice analysis) and subjective (laryngostroboscopy, Voice Handicap Index) methods. Twenty-nine children with vocal fold nodules (age range 5-14 years), 45 age-matched children without any voice disorders as a control group, and their mothers were included in the study. All patients had laryngostroboscopy and clinical voice analysis, and their mothers filled out the Pediatric Voice Handicap Index. We noted the most common place or situation where children used their voice in excessively high volume according to their mothers, including home, school, sportive activities, and singing or reciting poem activities, to recognize the major cause of phonotrauma. In addition, presence of siblings was recorded. It was found that 15 patients (51.7%) had younger siblings, seven patients (24.1%) had older siblings, five patients (17.2%) had both younger and older siblings, and two patients (6.8%) did not have any siblings. It was seen that excessive usage of high-volume voice at home had a correlation with presence of only younger siblings, and both younger and older siblings tended to cause phonotrauma at home (86.7%). Additionally, eight boys (44.4%) reported presence of sportive activities, whereas none of the girls had such an activity (P = 0.012). Presence of siblings seems to be an important factor for vocal nodule formation. Maternal relationship does not seem to be a major factor for vocal misuse. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  9. Computerized Analysis of Vocal Folds Vibration From Laryngeal Videostroboscopy.

    Science.gov (United States)

    Gora, Silvia; Yavin, Noy; Elad, David; Wolf, Michael; Primov-Fever, Adi

    2016-07-01

    To develop an objective analysis of laryngeal videostroboscopy (VSS) movies in the space-time domain for quantitative determination of the true vocal folds (TVFs) vibratory pattern to allow for detection of local pathologies at early stages of development. Contours of the TVF and false vocal folds (FVFs) were tracked on each frame of a VSS movie. A registration algorithm was used with respect to the centerline of the FVF to eliminate movements not related to TVF vibration. The registered contours of the TVF were analyzed in time and frequency domains. The TVF vibration demonstrated a sinusoidal pattern with the same fundamental frequency at every section along the folds of healthy subjects, as well as detection of an abnormal area with a different fundamental frequency in TVF with local pathologies. Analysis of the TVF vibration time delay of healthy subject revealed a posterior-to-anterior longitudinal wave that was not detected by visual observation. An objective analysis of laryngeal VSS movies was developed for quantitative determination of the TVF vibration. This analysis was able to detect and quantify TVF characteristics in normal subjects as well as in patients with pathologies beyond the ability of examinee's naked eyes. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  10. Laryngoscopic and stroboscopic signs in the diagnosis of vocal fold paresis.

    Science.gov (United States)

    Estes, Christine; Sadoughi, Babak; Mauer, Elizabeth; Christos, Paul; Sulica, Lucian

    2017-09-01

    To identify strobolaryngoscopic findings significant in the diagnosis of paresis. Retrospective cohort study. Fellowship-trained laryngologists reviewed 34 videostroboscopic examinations (24 with paresis, eight without paresis, two repeat). They indicated presence or absence of paresis, including side and type, degree of confidence in diagnosis, and ranked clinical findings that influenced diagnosis by order of importance. Fleiss's κ was used to assess inter-rater agreement for paresis presence, side, and type. Clinical findings compelling in diagnosis were tabulated and described. Confidence levels for side and type were compared by analysis of variance/Kruskal-Wallis tests and post hoc pairwise comparisons. Thirty-one laryngologists completed the review. Inter-rater agreement on presence or absence of paresis was fair at 0.334 (Fleiss's κ). Fourteen examinations were diagnosed with paresis by >70% of raters and considered strong paresis-candidate exams. Diagnosis of paresis side and type were inconsistent, although with statistically significant differences in confidence ratings (unilateral vs. bilateral, recurrent laryngeal nerve [RLN] vs. superior laryngeal nerve [SLN], RLN vs. mixed RLN/SLN). Laryngoscopic and stroboscopic findings with the strongest association with paresis were vocal fold motion anomalies, vocal fold degeneration, glottic insufficiency, and mucosal wave anomalies. Most laryngologists use strobolaryngoscopy for diagnosis of paresis. Although certain clinical findings were found to be associated with diagnosis, most commonly vocal fold motion anomalies, these varied among raters, especially when determining sidedness and nerve involvement. Future studies should expand the discussion and consideration of strobolaryngoscopic factors and adjunct functional and objective measures to develop a heuristic algorithm for diagnosis of paresis. 4. Laryngoscope, 127:2100-2105, 2017. © 2017 The American Laryngological, Rhinological and Otological

  11. Factors associated with tracheotomy and decannulation in pediatric bilateral vocal fold immobility.

    Science.gov (United States)

    Funk, Ryan T; Jabbour, Jad; Robey, Thomas

    2015-06-01

    Describe the natural history of all-cause bilateral vocal fold immobility (BVFI) in pediatric patients and analyze factors associated with tracheotomy and subsequent decannulation. This is a retrospective review of all patients diagnosed with complete or partial BVFI at a metropolitan private pediatric otolaryngology practice between 2001 and 2012. Records were reviewed for data on demographics, etiologies, vocal fold position, and BVFI resolution. Patients requiring tracheotomy were further investigated for tracheotomy duration and associated complications and procedures. One hundred two patients were included, with a median (range) follow-up of 32.9 (0.3-124.2) months. Of these, 68.6% required tracheotomy. Tracheotomies were more likely in those with concomitant airway disease (p = 0.005) and paramedian vocal fold position compared to lateral position (p = 0.02). Among patients requiring tracheotomy, 64.3% underwent decannulation during follow up. Decannulation was more likely in those who demonstrated VFI resolution (p = 0.002) and those with idiopathic compared to neurogenic etiologies (p = 0.003). Median duration of cannulation was 30.6 (0.5-297.3) months. The most common tracheotomy-related complication requiring medical attention was tracheal and stomal granuloma formation (77.1%), while the most frequent associated procedures included granuloma excision (47.1%) and airway reconstruction (31.4%). Of those who avoided tracheotomy, 40.6% did not demonstrate BVFI resolution during median follow up of 13.4 (0.6-44.4) months. Most pediatric BVFI patients require tracheotomy, with the majority of those undergoing eventual decannulation. A better understanding of the factors associated with tracheotomy and subsequent decannulation improves the otolaryngologist's ability to counsel parents and caregivers of children with BVFI. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Persistent Vocal Fold Granuloma Following Superficial PAAG Injection Laryngoplasty: A Case Report.

    Science.gov (United States)

    Kang, Kyung Yun; Lee, Se A; Lee, Sang Kuk; Seon, Sang Woo; Jung, Jae Hyun; Park, Ki Nam; Kwak, Jeong Ja; Lee, Seung Won

    2016-11-01

    The injection material polyacrylamide hydrogel (PAAG; Ferrosan, Søborg, Denmark) is often used as space filler for soft-tissue defects. PAAG is a suitable alternative to the materials used for injection laryngoplasty. Over the past decade, 427 patients have undergone injection laryngoplasty in our clinic using PAAG, and no major complications, such as material migration or foreign body granuloma, were identified. Here, we report the case of the first woman to undergo laryngomicrosurgery to remove a vocal fold granuloma that developed after a superficial injection laryngoplasty performed 4 years previously. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  13. Evaluation of Synthetic Self-Oscillating Models of the Vocal Folds

    Science.gov (United States)

    Hubler, Elizabeth P.; Weiland, Kelley S.; Hancock, Adrienne B.; Plesniak, Michael W.

    2013-11-01

    Approximately 30% of people will suffer from a voice disorder at some point in their lives. The probability doubles for those who rely heavily on their voice, such as teachers and singers. Synthetic vocal fold (VF) models are fabricated and evaluated experimentally in a vocal tract simulator to replicate physiological conditions. Pressure measurements are acquired along the vocal tract and high-speed images are captured at varying flow rates during VF oscillation to facilitate understanding of the characteristics of healthy and damaged VFs. The images are analyzed using a videokymography line-scan technique that has been used to examine VF motion and mucosal wave dynamics in vivo. Clinically relevant parameters calculated from the volume-velocity output of a circumferentially-vented mask (Rothenberg mask) are compared to patient data. This study integrates speech science with engineering and flow physics to overcome current limitations of synthetic VF models to properly replicate normal phonation in order to advance the understanding of resulting flow features, progression of pathological conditions, and medical techniques. Supported by the GW Institute for Biomedical Engineering (GWIBE) and GW Center for Biomimetics and Bioinspired Engineering (COBRE).

  14. Learning to detect vocal hyperfunction from ambulatory neck-surface acceleration features: Initial results for vocal fold nodules

    OpenAIRE

    Ghassemi, Marzyeh; Van Stan, Jarrad H.; Mehta, Daryush D.; Zañartu, Matías; Cheyne, Harold A.; Hillman, Robert E.; Guttag, John V.

    2014-01-01

    Voice disorders are medical conditions that often result from vocal abuse/misuse which is referred to generically as vocal hyperfunction. Standard voice assessment approaches cannot accurately determine the actual nature, prevalence, and pathological impact of hyperfunctional vocal behaviors because such behaviors can vary greatly across the course of an individual's typical day and may not be clearly demonstrated during a brief clinical encounter. Thus, it would be clinically valuable to dev...

  15. Unilateral Vocal Fold Paralysis: A Systematic Review of Speech-Language Pathology Management.

    Science.gov (United States)

    Walton, Chloe; Conway, Erin; Blackshaw, Helen; Carding, Paul

    2017-07-01

    Dysphonia due to unilateral vocal fold paralysis (UVFP) can be characterized by hoarseness and weakness, resulting in a significant impact on patients' activity and participation. Voice therapy provided by a speech-language pathologist is designed to maximize vocal function and improve quality of life. The purpose of this paper is to systematically review literature surrounding the effectiveness of speech-language pathology intervention for the management of UVFP in adults. This is a systematic review. Electronic databases were searched using a range of key terms including dysphonia, vocal fold paralysis, and speech-language pathology. Eligible articles were extracted and reviewed by the authors for risk of bias, methodology, treatment efficacy, and clinical outcomes. Of the 3311 articles identified, 12 met the inclusion criteria: seven case series and five comparative studies. All 12 studies subjectively reported positive effects following the implementation of voice therapy for UVFP; however, the heterogeneity of participant characteristics, voice therapy, and voice outcome resulted in a low level of evidence. There is presently a lack of methodological rigor and clinical efficacy in the speech-language pathology management of dysphonia arising from UVFP in adults. Reasons for this reduced efficacy can be attributed to the following: (1) no standardized speech-language pathology intervention; (2) no consistency of assessment battery; (3) the variable etiology and clinical presentation of UVFP; and (4) inconsistent timing, frequency, and intensity of treatment. Further research is required to develop the evidence for the management of UVFP incorporating controlled treatment protocols and more rigorous clinical methodology. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  16. Timing of nimodipine therapy for the treatment of vocal fold paralysis.

    Science.gov (United States)

    Sridharan, Shaum S; Rosen, Clark A; Smith, Libby J; Young, VyVy N; Munin, Michael C

    2015-01-01

    To retrospectively determine optimal timing for initiation of nimodipine within a cohort of patients with acute vocal fold paralysis (VFP). Retrospective patient review. Subjects were divided into three groups: initiation within 15 days postinjury (n = 19), between 15 and 30 days postinjury (n = 23), or greater than 30 days postinjury (n = 11). Fifty-one patients (53 paralyzed vocal folds [VFs]) met entrance criteria and were offered and started off-label nimodipine treatment. Thirty-six of 53 VFs recovered purposeful motion (67.9%). There was no significant difference in the rate of VF recovery among patients who began nimodipine within 15 days (68.4%), patients who started nimodipine between 15 and 30 days (73.9%) of nerve injury (P = .1405), and patients who initiated nimodipine after 30 days postinjury (54.5%). Nimodipine treatment for acute VFP yielded equal VF motion recovery rates regardless of when the medication was initiated. Time to recovery of motion was not different between groups studied. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Quantifying the effects of altering ambient humidity on ionic composition of vocal fold surface fluid.

    Science.gov (United States)

    Sivasankar, M Preeti; Carroll, Thomas L; Kosinski, Aaron M; Rosen, Clark A

    2013-07-01

    Vocal fold surface fluid (VFSF) is important in hydration and defense of underlying epithelial cells. The objective of this study was to quantify changes in the ionic composition of VFSF after altering the humidity of inhaled air. We tested the hypothesis that low humidity exposure would increase the concentration of VFSF sodium (Na(+)) and chloride (Cl(-)) ions but that high humidity exposure would decrease the concentration of VFSF Na(+) and Cl(-) ions as compared to the low humidity challenge. Prospective design. Eighteen healthy adults participated in this study. VFSF was collected from each subject at baseline and following exposure to low humidity and high humidity environments. VFSF Na(+) concentration was assessed using inductively coupled plasma mass spectrometry. VFSF Cl(-) concentration was measured with indirect potentiometry. All analyses were completed by personnel blinded to the hypothesis being tested. The low humidity environment increased Na(+) concentration in the majority of the subjects. Data for changes in Cl(-) concentrations were variable. Overall the data did not reach statistical significance (P > .05). Subjective impressions suggested that VFSF collection was more difficult in low humidity as compared to the high humidity and baseline conditions. This study is the first attempt to measure the ionic concentration of VFSF. The results from the current study have important implications for future programmatic research quantifying the effects of pollutants and laryngopharyngeal reflux on VFSF composition, epithelial hydration, and vocal fold defense. Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Aerodynamic measures and biofeedback as management in persistent paradoxical vocal fold motion and reverse phonation.

    Science.gov (United States)

    Carroll, Linda M; Tan, Melin

    2015-03-01

    Paradoxical vocal fold motion (PVFM) and reverse phonation are characterized by aberrant vocal fold adduction. To date, there have been no studies examining the aerodynamic events during reverse phonation. We present an unusual case of persistent reverse phonation secondary to respiratory distress associated with PVFM. Case report. We present the case of a 42-year-old female with sudden onset of respiratory distress associated with PVFM and persistent reverse phonation. She underwent baseline aerodynamic measurements followed by trial therapy. Through the use of instrumental and tactile aerodynamic biofeedback, the patient was able to coordinate exhalatory breath pressure flow during phonation, which resulted in immediately improved voice quality from highly dysphonic to nearly normal voice quality. Patients with reverse phonation seldom undergo aerodynamic testing as part of the initial diagnostic and management program. Our case study demonstrates the effectiveness of aerodynamic technology to enable a patient with aberrant glottic function to recognize inspiratory phonation events and to reestablish consistent expiratory flow/pressure egress in speech tasks. Instrumental and tactile biofeedback is effective for reinforcement of normal flow patterns during speech tasks. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  19. The nonlinear aeroelastic characteristics of a folding wing with cubic stiffness

    Science.gov (United States)

    Hu, Wei; Yang, Zhichun; Gu, Yingsong; Wang, Xiaochen

    2017-07-01

    This paper focuses on the nonlinear aeroelastic characteristics of a folding wing in the quasi-steady condition (namely at fixed folding angles) and during the morphing process. The structure model of the folding wing is formulated by the Lagrange equations, and the constraint equation is used to describe the morphing strategy. The aerodynamic influence coefficient matrices at several folding angles are calculated by the Doublet Lattice method, and described as rational functions in the Laplace domain by the rational function approximation, and then the Kriging agent model technique is adopted to interpolate the coefficient matrices of the rational functions, and the aerodynamics model of the folding wing during the morphing process is built. The aeroelastic responses of the folding wing with cubic stiffness are simulated, and the results show that the motion types of aeroelastic responses in the quasi-steady condition and during the morphing process are all sensitive to the initial condition and folding angle. During the morphing process, the transition of the motion types is observed. And apart from the period of transition, the aeroelastic response at some folding angles may exhibit different motion types, which can be found from the results in the quasi-steady condition.

  20. Configuração das pregas vestibulares em laringes de pacientes com nódulo vocal Vestibular folds configuration in vocal nodule

    Directory of Open Access Journals (Sweden)

    Juliane Tuma

    2005-10-01

    physiological role of the vocal folds as the glottic sound source is evident, however, there is no consensus regarding the vestibular folds' participation/influence in phonation. AIM: To verify if there is difference in the bidimensional configuration of the vestibular folds between two distinct groups of women, one with the diagnosis of vocal nodules and the other without vocal complaints and vocal fold lesions. STUDY DESIGN: clinical with transversal cohort. MATERIAL AND METHOD: Ninety-six laryngeal images were evaluated, 48 from individuals without vocal complaints and 48 from patients with the diagnosis of vocal nodules. Angles were obtained and bilaterally measured in single frames of the vestibular folds during sustained phonation and those structures were morphologically classified as concave, linear or convex. RESULTS: Among the 96 vestibular folds evaluated in each group, there was predominance of the concave form, followed by the linear and the convex ones. In the control group, there was a single convex vestibular fold, 27 were linear and 68 were concave folds. In the group of vocal nodules, 8 were convex, 15 were linear and 73 were concave folds. However, the differences among groups were not statistically significant as well as those among the angles, whose average measures were proven quite similar. CONCLUSION: In the female gender, the vestibular folds presented similar behavior regarding the morphology in both patients with vocal nodules and women without vocal complaints.

  1. Making a diagnosis of different lesions of vocal fold mucosa by contact endoscopy: The first usage in our clinical practice

    Directory of Open Access Journals (Sweden)

    Jovanović Milan B.

    2005-01-01

    Full Text Available During laryngomicroscopy, the superficial layers of vocal fold epithelium can be examined in vivo and in situ by contact endoscopy. Methylene blue is applied initially to stain the epihelial cells of the vocal folds. When in contact with mucosal tissue, this endoscope provides 60 and 150 times magnification and clear visualization of cellular patterns of the superficial epithelial layers. For the first time in our laryngological clinical practice, we confirmed a number of previously established parametars such as regularity and arrangement of the epithelium, nucleus contour, and nucleus-cytoplasm ratio, what all enable recognition and easy evaluation of different clinical conditions such as chronic laryngitis, Reinke.s edema, papiloma dyspiasia or vocal fold carcinoma. The advantage of con- tact endoscopy in vivo and in situ allows for detailed scan and mapping of all cell changes of the whole mucosa surface. All these features definitely classify the contact endoscopy into additional diagnostic methods in laryngology.

  2. Medialization thyroplasty in glottis insufficiency due to unilateral vocal fold paralysis and after laser cordectomies - preliminary report.

    Science.gov (United States)

    Rzepakowska, Anna; Osuch-Wójcikiewicz, Ewa; Sielska-Badurek, Ewelina; Niemczyk, Kazimierz

    2017-02-28

    Medialization thyroplasty (type I) is surgical procedure performed on the thyroid cartilage. The major indication for this surgery is significant glottis insufficiency due to unilateral vocal fold paresis. However the proce¬dure is also performed after vocal fold resections during cordectomy. The evaluation of voice results in patients after medialisation throplasty. In Otolaryngology Department of Medical University of Warsaw there were performed so far 8 thyroplasty procedures under local anaesthesia with implantation of medical silicon protesis. 6 patients had unilat¬eral vocal fold paresis and the rest two underwent in the past laser cordectomy due to T1a vocal carcinoma. There were no complications during and post the surgery. The follow up examination in 1st , 3rd, 6th i 12th months postoperatively revealed for all patients significant improvement of glottal closure in laryngeal videostrobos¬copy. The voice quality improved both in perceptual evaluation (GRBAS scale) and acoustic analysis (F0, jitter, shim¬mer, NHR) in both patients groups. However the rate of improvement was much more significant in group with uni¬lateral vocal fold paresis. In all patients the maximum phonation time (MPT) increased. The self-evaluation of voice quality with Voice Handicap Index questionnaire confirmed also individual improvement. The speech rehabilitations is not successful in each patient with glottis insufficiency. The medialisation thyroplasty remains the standard procedure for permanent improvement of voice quality in those cases.

  3. The nasal provocation test combined with spirometry establishes paradoxical vocal fold motion in allergic subjects.

    Science.gov (United States)

    Olivier, Celso Eduardo; Argentão, Daiana Guedes Pinto; Lima, Regiane Patussi dos Santos; da Silva, Mariana Dias; dos Santos, Raquel Acácia Pereira Gonçalves

    2013-01-01

    Vocal cord dysfunction (also called paradoxical vocal cord motion) or paradoxical vocal fold motion (PVFM) is an event elicited by specific and nonspecific triggers in which its diagnosis is limited by the restricted number of available functional tests. This study was designed to appreciate the contribution of the spirometric changes elicited by the allergen-specific nasal provocation test (NPT) performed with Dermatophagoides pteronyssinus for the diagnosis of PVFM in subjects with known sensitization to this allergen. In total, 63 subjects with allergic rhinitis who had previously been shown to be sensitized to D. pteronyssinus and who had experienced one or more episodes of inspiratory shortness of breath underwent two spirometric tests, one before (pre-NPT) and another 15 minutes after the allergen-specific NPT (post-NPT). The forced inspiratory vital capacity (FIVC), forced inspiratory volume in 2 seconds (FIV2), and the ratio between the FIV in 1 second and FIVC (FIV1/FIVC) were measured by spirometry. The morphology of the post-NPT inspiratory loop was compared with the pre-NPT inspiratory loop. We found that 18 subjects (28.5%) showed alterations suggestive of PVFM on post-NPT spirometry (e.g., truncation and/or flattening of the inspiratory loop). The mean differences between the pre-NPT and post-NPT values for the whole group were significant using a two-tailed paired t-test for the FIVC (4.1; 95% confidence interval [CI95%], 1.4-6.8), FIV1/FIVC ratio (2.7; CI95%, 0.05-5.3), and FIV2 (7.2; CI95%, 3.4-11). Allergen-specific NPT combined with spirometry is useful to show allergen-specific laryngeal hyperresponsiveness in allergic subjects with PVFM. Brazilian clinical trial registry platform (Plataforma Brasil, CAAE 07971212.0.0000.5480).

  4. Drug delivery system of basic fibroblast growth factor using gelatin hydrogel for restoration of acute vocal fold scar.

    Science.gov (United States)

    Kobayashi, Toshiki; Mizuta, Masanobu; Hiwatashi, Nao; Kishimoto, Yo; Nakamura, Tatsuo; Kanemaru, Shin-Ichi; Hirano, Shigeru

    2017-02-01

    There continue to be therapeutic challenges in the management of vocal fold scarring. We previously showed that basic fibroblast growth factor (bFGF) injection has therapeutic potential for vocal fold scarring. However, the working time of bFGF is relatively short, and multiple injections were required in many cases to obtain the regenerative effect. An efficacious delivery system for bFGF has yet to be established. We designed a method of sustained drug delivery system (DDS) of bFGF by using a gelatin hydrogel. Hydrogel has been developed for targeted delivery and controlled release of bFGF. Hydrogel of the particle type is also injectable and commercially available. The current study aims to investigate the effects of a single injection of bFGF-DDS on acute vocal fold scarring using a canine model. Vocal folds from eight beagles were unilaterally scarred by stripping the lamina propria. One month later, hydrogels (0.5ml) containing 10μg of bFGF were injected into the scarred vocal folds of four beagles (FGF-hydrogel group). Saline (0.5ml) was injected into the other four beagles (sham group). Vibratory and histological examination of excised larynges was performed 5 months after treatment. Comparative analysis between the current data and our previous data with repeated injection of bFGF solution was also completed. Vibratory examination demonstrated significantly improved vibration in the bFGF hydrogel-treated group. Histological examination of the bFGF hydrogel group showed restoration of hyaluronic acid in the lamina propria as compared to sham. Comparison between the DDS system and our previous bFGF solution injection indicated better effects of the DDS system on vibratory amplitude. A single injection of bFGF hydrogel has regenerative effects on acute vocal fold scarring, which is at least similar to repeated injection of bFGF solution. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Voice Range Change After Injection Laryngoplasty for Unilateral Vocal Fold Paralysis.

    Science.gov (United States)

    Pei, Yu-Cheng; Chuang, Hsiu-Feng; Chang, Chia-Fen; Chang, Tzu-Ling; Chiang, Hui-Chen; Fang, Tuan-Jen

    2017-12-13

    Patients with unilateral vocal fold paralysis (UVFP) caused by nerve injury manifest with voice changes. This study investigated vocal performance measured by voice range profile (VRP) in patients with UVFP and changes in VRP in response to intracordal hyaluronate injection. Eighty-five patients with UVFP were enrolled prospectively, among whom 68 received intracordal hyaluronate injections. The outcome measurements included VRP, acoustic and aerodynamic analyses, peak turn frequency of thyroarytenoid-lateral cricoarytenoid muscle complex (TA-LCA) measured by laryngeal electromyography, and normalized glottal gap area by videolaryngostroboscopy. The peak turn frequency of the paralyzed TA-LCA showed a modest correlation with max fundamental frequency (F0) and F0 range. Closed-phase normalized glottal gap area showed modest negative correlations with max F0 and F0 semitone range. Regarding conventional acoustic and aerodynamic analyses, the paralyzed TA-LCA peak turn frequency was only correlated with maximal phonation time. Intracordal hyaluronate injection improved VRP performance by increasing max F0, decreasing min F0, increasing F0 range, and increasing semitone range (all P VRP provides a more sensitive reflection of the severity of neuromuscular impairment, compared with conventional voice analysis. The validity of VRP is further supported by a robust response to voice improvements following injection laryngoplasty. Copyright © 2017. Published by Elsevier Inc.

  6. Numerical simulation of airflow through the model of oscillating vocal folds

    Directory of Open Access Journals (Sweden)

    Prokopová J.

    2010-12-01

    Full Text Available This work deals with numerical simulation of flow in time-dependent 2D domains with a special interest in medical applications to airflow in human vocal folds. The mathematical model of this process is described by the compressible Navier-Stokes equations. For the treatment of the time-dependent domain, the Arbitrary Lagrangian-Eulerian (ALE method is used. The discontinuous Galerkin finite element method (DGFEM is used for the space semidiscretization of the governing equations in the ALE formulation. The time discretization is carried out with the aid of a linearized semi-implicit method with good stability properties. We present some computational results for flow in a channel with a prescribed periodic motion of a part of the channel walls.

  7. Parallel CFD simulation of flow in a 3D model of vibrating human vocal folds

    Czech Academy of Sciences Publication Activity Database

    Šidlof, Petr; Horáček, Jaromír; Řidký, V.

    2013-01-01

    Roč. 80, č. 1 (2013), s. 290-300 ISSN 0045-7930 R&D Projects: GA ČR(CZ) GAP101/11/0207 Institutional research plan: CEZ:AV0Z20760514 Keywords : numerical simulation * vocal folds * glottal airflow * inite volume method * parallel CFD Subject RIV: BI - Acoustics Impact factor: 1.532, year: 2013 http://www.sciencedirect.com/science?_ob=ArticleListURL&_method=list&_ArticleListID=-268060849&_sort=r&_st=13&view=c&_acct=C000034318&_version=1&_urlVersion=0&_userid=640952&md5=7c5b5539857ee9a02af5e690585b3126&searchtype=a

  8. Long-term results of autologous fascia in unilateral vocal fold paralysis.

    Science.gov (United States)

    Reijonen, Petri; Tervonen, Hanna; Harinen, Kirsi; Rihkanen, Heikki; Aaltonen, Leena-Maija

    2009-08-01

    The objective of this retrospective clinical review was to evaluate the long-term results of injection laryngoplasty with autologous fascia as a single, primary procedure in unilateral vocal fold paralysis. Forty-three patients who had undergone injection laryngoplasty between 1996 and 2003 entered the study. Clinical examination and videostroboscopy were performed and the voice handicap index was analyzed postoperatively. Pre- and post-operative evaluation included computerized acoustic analysis and perceptual evaluation. The results remained stable 3-10 years and were not affected by the length of follow-up, the delay from paralysis to surgery, or the age of the patient. Although most mean values of voice parameters were significantly improved, results in individual patients were difficult to predict. Poor results were especially related to cases caused by intrathoracic lesions. Wide glottal gaps should not be treated with fascia injection. Fascia is a stable graft and most suitable for cases with less severe glottal insufficiency.

  9. Climate, vocal folds, and tonal languages: Connecting the physiological and geographic dots.

    Science.gov (United States)

    Everett, Caleb; Blasi, Damián E; Roberts, Seán G

    2015-02-03

    We summarize a number of findings in laryngology demonstrating that perturbations of phonation, including increased jitter and shimmer, are associated with desiccated ambient air. We predict that, given the relative imprecision of vocal fold vibration in desiccated versus humid contexts, arid and cold ecologies should be less amenable, when contrasted to warm and humid ecologies, to the development of languages with phonemic tone, especially complex tone. This prediction is supported by data from two large independently coded databases representing 3,700+ languages. Languages with complex tonality have generally not developed in very cold or otherwise desiccated climates, in accordance with the physiologically based predictions. The predicted global geographic-linguistic association is shown to operate within continents, within major language families, and across language isolates. Our results offer evidence that human sound systems are influenced by environmental factors.

  10. Clinically silent subdural hemorrhage causes bilateral vocal fold paralysis in newborn infant.

    Science.gov (United States)

    Alshammari, Jaber; Monnier, Yan; Monnier, Philippe

    2012-10-01

    Bilateral congenital vocal fold paralysis (BVFP) may result from multiple etiologies or remain idiopathic when no real cause can be identified. If obstructive dyspnea is significant and requires urgent stabilization of the airway, then intubation is performed first and an MRI of the brain is conducted to rule out an Arnold-Chiari malformation that can benefit from a shunt procedure and thus alleviate the need for a tracheostomy. Clinically silent subdural hemorrhage without any birth trauma represents another cause of neonatal BVFP that resolves spontaneously within a month. It is of clinical relevance to recognize this potential cause of BVFP as its short duration may alleviate the need for a tracheostomy. In this article, we present such a case and review the literature to draw the otolaryngologist's attention to this possible etiology. Copyright © 2012. Published by Elsevier Ireland Ltd.

  11. Real-time dual visualization of two different modalities for the evaluation of vocal fold vibration - Laryngeal videoendoscopy and 2D scanning videokymography: Preliminary report.

    Science.gov (United States)

    Kim, Geun-Hyo; Wang, Soo-Geun; Lee, Byung-Joo; Park, Hee-June; Kim, Yong-Cheol; Kim, Hyung-Soon; Sohn, Keon-Tae; Kwon, Soon-Bok

    2017-04-01

    Currently, various tools have been introduced for the assessment of vocal fold vibration: laryngeal videolaryngoscopy (LV), videokymography (VKG), high speed videoendoscopy (HSV), digital videokymography (DKG), and 2D scanning videokymography (2D VKG). Among these, the authors have recently designed a dual modality examination system using LV and 2D VKG for more detailed information regarding the vibrations of the vocal folds. The clinical availability of this hybrid system offers medical imaging departments a range of potential advantages in the evaluation of vocal fold vibration. The obvious benefit of simultaneous acquisition is the improved integration of information that allows not only optimal anatomic localization, but also physical movement patterns. Other advantages include the lessened inconvenience to patients due to no longer requiring repeated examinations and shortening the examination time, and increased profitability. The purpose of study was to identify the efficacy of real-time dual examination of two different modalities for the evaluation of vocal fold vibration in human subjects and vocal fold vibration simulator. One vocally healthy subject and three patients with vocal fold nodules, a vocal cyst, and vocal fold paralysis took part in this study. The vibratory patterns of the vocal folds were visualized using simultaneous real-time examination of two different modalities. Additionally, qualitative and quantitative analyses of the dual LV and 2D VKG images were performed. Real-time dual examination using a two modality system provided high definition images of the vibratory movements of the vocal folds. By assessing the obtained images, we confirmed that the dual modality examination method was useful in the evaluation of pathologic vibratory patterns, even in non-periodic phonation. The present system might improve the understanding of the processes of vocal fold vibration and make a contribution to pathologic voice research, as well as

  12. Quantitative Evaluation of the In Vivo Vocal Fold Medial Surface Shape.

    Science.gov (United States)

    Vahabzadeh-Hagh, Andrew M; Zhang, Zhaoyan; Chhetri, Dinesh K

    2017-07-01

    Glottal insufficiency is a common clinical problem in otolaryngology and medialization laryngoplasty (ML) procedures remain the primary treatment modality. Although the goal of ML is to restore physiologic glottal posture and achieve optimal phonation, this posture has not been directly measured. In this study, we assessed glottal medial surface contour changes with selective activation of the intrinsic laryngeal muscles (ILMs). Basic science study using an in vivo canine hemilarynx model. In an in vivo canine hemilarynx, India ink was used to mark fleshpoints in a grid-like fashion along the medial surface of the vocal fold and ILMs were activated in a graded manner. A right-angled prism provided two views of the medial surface, which were recorded using a high-speed camera and used to reconstruct the 3D posture deformations of the medial surface. Thyroarytenoid (TA) muscle activation results in initial inferomedial bulging and increased glottal channel thickness and then glottal adduction with a final rectangular glottal channel shape. Lateral cricoarytenoid (LCA) activation closes the posterior glottis but final posture remains slightly convergent. Together, TA + LCA forms a rectangular glottis with an increased glottal vertical thickness. Posterior cricoarytenoid activation results in abduction and a slightly divergent glottis, whereas cricothyroid activation elongates the glottis and reduces the glottal channel vertical thickness. A quantitative analysis of in vivo canine vocal fold medial surface upon activation of selective ILMs is provided. This may guide our therapeutic efforts during medialization laryngoplasty, as well as computational modeling of laryngeal physiology. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  13. Voice outcomes following treatment of benign midmembranous vocal fold lesions using a nomenclature paradigm.

    Science.gov (United States)

    Akbulut, Sevtap; Gartner-Schmidt, Jackie L; Gillespie, Amanda I; Young, VyVy N; Smith, Libby J; Rosen, Clark A

    2016-02-01

    Benign midmembranous vocal fold lesions (BMVFLs) are common voice disorders, but interpretation of outcomes following treatment is difficult due to the lack of a standardized nomenclature system for these lesions. Outcome results are increasingly important to third party payers. This study aimed to investigate the outcomes of patients with BMVFLs using a previously validated nomenclature, and to provide incidences and outcome results for each diagnosis. A retrospective chart review of BMVFL patients was performed. Treatment was individualized but typically involved implementation of nonsurgical therapy followed by phonomicrosurgery as needed. A previously reported BMVFL stratification system was used. A total of 224 patients with BMVFLs were studied. Sixty-seven percent of all patients with a BMVFL underwent phonomicrosurgery. The most common BMVFL types were polyp and nonspecific vocal fold lesion. Pseudocyst represented 0.9% of the cohort. The Voice Handicap Index-10 (VHI-10) and acoustic data demonstrate a high degree of treatment success. The mean change in VHI-10 was greatest for cyst-subepithelial and polyp. Fibrous mass-ligamentous patients had the smallest mean change in VHI-10. Mean post-treatment VHI-10 scores of all the lesions except fibrous mass-ligamentous were within normal limits (<11). This study represents the first outcomes-based report of BMVFLs using a strictly defined nomenclature system for stratification of lesions. Ligamentous fibrous mass lesions have a decreased response to treatment compared to all other lesions. This study demonstrates the ability to return most BMVFL patients to normal speaking voice capabilities following treatment. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Laryngopharyngeal dysfunction independent of vocal fold palsy in infants after aortic arch interventions.

    Science.gov (United States)

    Davies, Ryan R; Carver, Stephanie W; Schmidt, Richard; Keskeny, Heather; Hoch, Jeanine; Pizarro, Christian

    2014-08-01

    Laryngopharyngeal dysfunction contributes significantly to morbidity, length of stay, and increased resource utilization after aortic arch interventions in infants. Previous studies have focused on postoperative evaluation of selected symptomatic patients with vocal fold palsy (VFP). A prospective evaluation of laryngopharyngeal function was undertaken to assess and determine its importance in perioperative management. A routine preoperative and postoperative assessment was done by flexible fiber optic laryngoscopy, oral feeding evaluation (OFE), and modified barium swallow (mBS) on 101 infants undergoing 113 procedures on the aortic arch (2003 to 2011). The primary outcome was the ability to take full nutrition orally at discharge. Preoperative OFE was abnormal in 33.3% of patients. VFP occurred in 39.3%, 30 of 57 patients had an abnormal OFE. Factors predictive of abnormal postoperative feeding evaluation included genetic syndromes (odds ratio [OR], 5.1; confidence interval [CI], 1.1-23.2) and preoperative mechanical ventilation (OR, 24.1; 95% CI, 2.5-226.6). An abnormal postoperative OFE was highly predictive (OR, 7.0; 95% CI, 1.8-27.1) of an abnormal postoperative mBS. There was a trend toward decreased long-term survival among patients who were intubated or had an abnormal preoperative feeding evaluation (P = .07). Postoperative laryngopharyngeal dysfunction is common among infants undergoing aortic arch interventions, and is largely independent of vocal fold function. Preoperative evaluation demonstrates significant intrinsic abnormalities in sensory and motor function. Routine, comprehensive, multimodality preoperative and postoperative evaluation is required to identify at-risk children and reduce morbidity and resource utilization. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  15. Serial full-thickness excision of dysplastic vocal fold leukoplakia: Diagnostic or therapeutic?

    Science.gov (United States)

    Ahn, Annie; Wang, Li; Slaughter, James C; Nguyen, Amy M; Ossoff, Robert H; Francis, David O

    2016-04-01

    A previous study proposed that serial full-thickness excisional biopsies of vocal fold leukoplakia therapeutically decreased dysplasia grade. The current investigation aimed to 1) analyze the pathological evolution and natural history of these lesions and 2) re-examine the role of serial excisions in dysplasia grade regression in long-term follow-up. Retrospective case series. Patients treated for vocal fold dysplasia (1994-2013) with serial full-thickness microflap-type excisions were identified and followed longitudinally. Excluded were those with one excision, invasive cancer at initial excision, or history of laryngeal cancer or radiation. Data from surgical procedures, associated pathology, and patient characteristics were recorded. Weighted repeated measures ordinal logistic regression measured associations with pathology findings. Of 55 patients (median age = 65 years, interquartile range = 54-73 years, 89% male, 63% ever smokers, 27% alcohol users), 31 met inclusion criteria. During the study period, patients had two to 44 excisions, with a median time between excisions of 4.0 months. Each additional excision increased odds of higher-grade pathology by 4% (odds ratio = 1.04, 95% confidence interval = 1.01-1.06; P = .007). A transition model demonstrated that patients with moderate dysplasia, severe dysplasia, or carcinoma in situ on a prior biopsy had 2.64-, 5.64-, and 8.73-times increased odds of the same or higher pathology grade at the next excision, respectively. Data do not support the hypothesis that serial full-thickness excisions decrease dysplasia grade. Progression of dysplasia appears to be nonlinear, but higher-grade dysplasia is more likely to progress to malignancy. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Feasibility of vocal fold abduction and adduction assessment using cine-MRI.

    Science.gov (United States)

    Baki, Marina Mat; Menys, Alex; Atkinson, David; Bassett, Paul; Morley, Simon; Beale, Timothy; Sandhu, Guri; Naduvilethil, Georgekutty; Stevenson, Nicola; Birchall, Martin A; Punwani, Shonit

    2017-02-01

    Determine feasibility of vocal fold (VF) abduction and adduction assessment by cine magnetic resonance imaging (cine-MRI) METHODS: Cine-MRI of the VF was performed on five healthy and nine unilateral VF paralysis (UVFP) participants using an axial gradient echo acquisition with temporal resolution of 0.7 s. VFs were continuously imaged with cine-MRI during a 10-s period of quiet respiration and phonation. Scanning was repeated twice within an individual session and then once again at a 1-week interval. Asymmetry of VF position during phonation (VF phonation asymmetry, VFPa) and respiration (VF respiration asymmetry, VFRa) was determined. Percentage reduction in total glottal area between respiration and phonation (VF abduction potential, VFAP) was derived to measure overall mobility. An un-paired t-test was used to compare differences between groups. Intra-session, inter-session and inter-reader repeatability of the quantitative metrics was evaluated using intraclass correlation coefficient (ICC). VF position asymmetry (VFPa and VFRa) was greater (p=0.012; p=0.001) and overall mobility (VFAP) was lower (p=0.008) in UVFP patients compared with healthy participants. ICC of repeatability of all metrics was good, ranged from 0.82 to 0.95 except for the inter-session VFPa (0.44). Cine-MRI is feasible for assessing VF abduction and adduction. Derived quantitative metrics have good repeatability. • Cine-MRI is used to assess vocal folds (VFs) mobility: abduction and adduction. • New quantitative metrics are derived from VF position and abduction potential. • Cine-MRI able to depict the difference between normal and abnormal VF mobility. • Cine-MRI derived quantitative metrics have good repeatability.

  17. Quantification of vocal fold motion using echography: application to recurrent nerve paralysis detection

    Science.gov (United States)

    Cohen, Mike-Ely; Lefort, Muriel; Bergeret-Cassagne, Héloïse; Hachi, Siham; Li, Ang; Russ, Gilles; Lazard, Diane; Menegaux, Fabrice; Leenhardt, Laurence; Trésallet, Christophe; Frouin, Frédérique

    2015-03-01

    Recurrent nerve paralysis (RP) is one of the most frequent complications of thyroid surgery. It reduces vocal fold mobility. Nasal endoscopy, a mini-invasive procedure, is the conventional way to detect RP. We suggest a new approach based on laryngeal ultrasound and a specific data analysis was designed to help with the automated detection of RP. Ten subjects were enrolled for this feasibility study: four controls, three patients with RP and three patients without RP according to nasal endoscopy. The ultrasound protocol was based on a ten seconds B-mode acquisition in a coronal plane during normal breathing. Image processing included three steps: 1) automated detection of two consecutive closing and opening images, corresponding to extreme positions of vocal folds in the sequence of B-mode images, using principal component analysis of the image sequence; 2) positioning of three landmarks and robust tracking of these points using a multi-pyramidal refined optical flow approach; 3) estimation of quantitative parameters indicating left and right fractions of mobility, and motion symmetry. Results provided by automated image processing were compared to those obtained by an expert. Detection of extreme images was accurate; tracking of landmarks was reliable in 80% of cases. Motion symmetry indices showed similar values for controls and patients without RP. Fraction of mobility was reduced in cases of RP. Thus, our CAD system helped in the detection of RP. Laryngeal ultrasound combined with appropriate image processing helped in the diagnosis of recurrent nerve paralysis and could be proposed as a first-line method.

  18. Measuring Quality of Life in Pediatric Paradoxical Vocal Fold Motion Using the SF-36v2.

    Science.gov (United States)

    Liao, Kershena S; Kwak, Paul E; Hewitt, Hazel; Hollas, Sarah; Ongkasuwan, Julina

    2017-07-01

    Paradoxical vocal fold motion (PVFM) consists of intermittent adduction of the vocal folds during inspiration, resulting in stridor and worsened by anxiety and stress. The purpose of this study was to assess the impact of PVFM on quality of life in our pediatric patient population. This is a prospective, descriptive survey study. Thirty-nine consecutive patients (ages 12-17 years) presenting with a PVFM diagnosis for respiratory retraining sessions with speech-language pathology were recruited. Patients completed a brief demographic questionnaire and the Short Form 36, version 2, a validated tool for measuring health-related quality of life. There were 31 (79%) girls and 8 (21%) boys with a mean age of 15.5 years. Subjects reported regular participation in competitive extracurricular activities, including track or cross country (30.8%), swimming (17.9%), and cheerleading or dancing (15.4%). Of the patients in the study, 46.2% were straight-A students. On the SF-36 (population averages normalized to a score of 50), the general health of patients with PVFM was better than that of the general population (53.27); however, their physical health limited their role activities more severely (42.82). In addition, a greater proportion of the group with PVFM was at risk for first-stage depression screening when compared with the general population (28% versus 18%). We demonstrate a measurable detrimental impact of PVFM on health-related quality of life. This is consistent with previously published literature showing a preponderance of females with PVFM, most of whom are high achievers academically and athletically. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  19. Predicted singers' vocal fold lengths and voice classification-a study of x-ray morphological measures.

    Science.gov (United States)

    Roers, Friederike; Mürbe, Dirk; Sundberg, Johan

    2009-07-01

    Students admitted to the solo singing education at the University of Music Dresden, Germany have been submitted to a detailed physical examination of a variety of factors with relevance to voice function since 1959. In the years 1959-1991, this scheme of examinations included X-ray profiles of the singers' vocal tracts. This material of 132 X-rays of voice professionals was used to investigate different laryngeal morphological measures and their relation to vocal fold length. Further, the study aimed to investigate if there are consistent anatomical differences between singers of different voice classifications. The study design used was a retrospective analysis. Vocal fold length could be measured in 29 of these singer subjects directly. These data showed a strong correlation with the anterior-posterior diameter of the subglottis and the trachea as well as with the distance from the anterior contour of the thyroid cartilage to the anterior contour of the spine. These relations were used in an attempt to predict the 132 singers' vocal fold lengths. The results revealed a clear covariation between predicted vocal fold length and voice classification. Anterior-posterior subglottic-tracheal diameter yielded mean vocal fold lengths of 14.9, 16.0, 16.6, 18.4, 19.5, and 20.9mm for sopranos, mezzo-sopranos, altos, tenors, baritones, and basses, respectively. The data support the assumption that there are consistent anatomical laryngeal differences between singers of different voice classifications, which are of relevance to pitch range and timbre of the voice.

  20. Incidência de alterações estruturais das pregas vocais associadas ao pólipo de prega vocal Incidence of structural vocal fold abnormalities associated with vocal fold polyps

    Directory of Open Access Journals (Sweden)

    Claudia Alessandra Eckley

    2008-08-01

    Full Text Available A etiologia mais aceita para pólipos de pregas vocais é o fonotrauma. Imaginamos que possa existir alguma alteração anatômica prévia nas pregas vocais que predisponha indivíduos a apresentarem lesões fonotraumáticas. OBJETIVO: O presente estudo retrospectivo procura encontrar correlação entre os pólipos de prega vocal e alterações estruturais da prega vocais. MATERIAL E MÉTODO: Foi realizado trabalho retrospectivo a partir da descrição cirúrgica de 33 pacientes submetidos a exérese de pólipo de prega vocal no período de três anos em hospital universitário. RESULTADOS: Trinta e um pacientes apresentaram pólipos unilaterais e 2 bilaterais. Foram encontradas 27 lesões associadas: 10 lesões reacionais, 12 sulcos, 3 cistos e 2 ectasia capilars. Foram 14 lesões contralaterais e 13 ipsilaterais. DISCUSSÃO E CONCLUSÕES: Encontrou-se uma forte correlação entre a presença de uma lesão de base influindo como co-fator de fragilização da prega vocal ao fonotrauma, pois das 27 lesões encontradas 17 foram consideradas pré-existentes (63%. As lesões poderiam interferir na coaptação das pregas vocais, gerando uma onda mucosa irregular durante a fonação, expondo o espaço de Reinke a uma agressão estrutural. Apesar do caráter preliminar do trabalho os achados sugerem íntima correlação entre o pólipo e lesões estruturais mínimas das pregas vocais.Phonotrauma is considered the main cause of vocal fold polyps (VFP. However, the authors believe that an underlying anatomical deviation could render the vocal folds more susceptible to such trauma. AIM: To prove this hypothesis a retrospective chart review was carried out to correlate the surgical findings of patients with VFP. MATERIAL AND METHODS: The charts of thirty-three patients who underwent surgery for excision of VFP were reviewed: 21 had right VFP, 10 had left VFP and 2 had bilateral lesions. RESULTS: Associated lesions were reported in 27 patients (14 lesions

  1. Correlation of the Vocal Fold Vibratory Pattern to the Post-Operative Surgical Wound in the Porcine Model.

    Science.gov (United States)

    1992-02-15

    sections were embedded in paraffin and sectioned at 6 microns. The samples were stained with hematoxylin and eosin, Massons Trichrome and Verhoff’s elastic...AT 20X MAGNIFICATION). VIEW B IS A CROSS-SECTION OF THE INJURED RIGHT TRUE VOCAL FOLD ( MASSONS TRICHROME AT 20X MAGNIFICATION). THE ARCHITECTURAL

  2. The relation of vocal fold lesions and voice quality to voice handicap and psychosomatic well-being

    NARCIS (Netherlands)

    Smits, R.; Marres, H.A.; Jong, F. de

    2012-01-01

    BACKGROUND: Voice disorders have a multifactorial genesis and may be present in various ways. They can cause a significant communication handicap and impaired quality of life. OBJECTIVE: To assess the effect of vocal fold lesions and voice quality on voice handicap and psychosomatic well-being.

  3. 3D synthetic aperture PIV measurements from artificial vibrating vocal folds

    CERN Document Server

    Daily, Jesse; Belden, Jesse; Thomson, Scott; Truscott, Tadd

    2011-01-01

    During speech, air from the lungs is forced past the vocal folds which vibrate, producing sound. A pulsatile jet of air is formed downstream of the vibrating folds which interacts with the various structures in the airway. Currently, it is postulated that the way this jet interacts with the downstream structures in the airway directly affects the quality of human speech. In order to better understand this jet, it is desirable to visualize the jet in three dimensions. We present the results of a method that reconstructs the three dimensional velocity field using Synthetic aperture PIV (SAPIV) \\cite{Belden:2010}. SAPIV uses an array of high-speed cameras to artificially create a single camera with a variable focal length. This is accomplished by overlapping the images from the array to create a "focal stack". As the images are increasingly overlapped, more distant image planes come into focus. 3D PIV is then performed on the "refocused" focal stack to reconstruct the flow field in three dimensions. SAPIV has th...

  4. Voice Outcomes of Adults Diagnosed with Pediatric Vocal Fold Nodules and Impact of Speech Therapy.

    Science.gov (United States)

    Song, Brian H; Merchant, Maqdooda; Schloegel, Luke

    2017-08-01

    Objective To evaluate the voice outcomes of adults diagnosed with vocal fold nodules (VFNs) as children and to assess the impact of speech therapy on long-term voice outcomes. Study Design Prospective cohort study. Setting Large health care system. Subjects and Methods Subjects diagnosed with VFNs as children between the years 1996 and 2008 were identified within a medical record database of a large health care system. Included subjects were 3 to 12 years old at the time of diagnosis, had a documented laryngeal examination within 90 days of diagnosis, and were ≥18 years as of December 31, 2014. Qualified subjects were contacted by telephone and administered the Vocal Handicap Index-10 (VHI-10) and a 15-item questionnaire inquiring for confounding factors. Results A total of 155 subjects were included, with a mean age of 21.4 years (range, 18-29). The male:female ratio was 2.3:1. Mean VHI-10 score for the entire cohort was 5.4. Mean VHI-10 scores did not differ between those who received speech therapy (6.1) and those who did not (4.5; P = .08). Both groups were similar with respect to confounding risk factors that can contribute to dysphonia, although the no-therapy group had a disproportionately higher number of subjects who consumed >10 alcoholic drinks per week ( P = .01). Conclusion The majority of adults with VFNs as children will achieve a close-to-normal voice quality when they reach adulthood. In our cohort, speech therapy did not appear to have an impact on the long-term voice outcomes.

  5. Serial in-office laser treatment of vocal fold leukoplakia: Disease control and voice outcomes.

    Science.gov (United States)

    Koss, Shira L; Baxter, Peter; Panossian, Haig; Woo, Peak; Pitman, Michael J

    2017-07-01

    Although vocal fold (VF) leukoplakia is commonly treated with in-office laser, there is no data on its long-term effectiveness. This study hypothesizes that VF leukoplakia treated by serial in-office laser results in long-term disease control with maintenance of voice and minimal morbidity. Retrospective review (2008-2015). Forty-six patients with VF leukoplakia treated by in-office KTP (potassium titanyl phosphate) or PDL (pulsed dye laser) were included. Median follow-up from final laser treatment was 19.6 months. Main outcomes included: 1) rate of disease control, 2) percentage of disease regression using ImageJ analysis. Secondary outcomes included vocal assessment using the Voice Handicap Index-10 (VHI-10). Patients underwent a median of 2 (range: 1-6) in-office laser treatments. Time between treatments was median 7.6 months. After final treatment, 19 patients (41.3%) had no disease; two patients (4.3%) progressed to invasive cancer; overall disease regression was median 77.1% (P office treatment only); failures were 13 patients (28.3%) who required operative intervention and two patients (4%) who underwent radiation. Compared to responders, failures demonstrated significantly shorter duration between treatments (median 2.3 vs. 8.9 months, P = 0.038) and significantly less regression (median 49.3% vs. 100%, P = 0.006). Serial outpatient KTP or PDL treatment of VF leukoplakia is effective for disease control with minimal morbidity and preservation of voice quality. We suggest that patients requiring repeated in-office treatment every 6 months may benefit from earlier operative intervention; other factors associated with in-office success remain unclear. 4. Laryngoscope, 127:1644-1651, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  6. Perceptual voice characteristics in chronic cough and paradoxical vocal fold movement.

    Science.gov (United States)

    Vertigan, Anne E; Theodoros, Deborah G; Winkworth, Alison L; Gibson, Peter G

    2007-01-01

    Voice problems have been reported in chronic cough (CC) and paradoxical vocal fold movement (PVFM), however, there is a lack of a systematic description of voice characteristics in these conditions. This study examined the perceptual voice characteristics of 56 individuals with CC, 8 with PVFM and 55 with both CC and PVFM, compared to 25 people with muscle tension dysphonia (MTD) and 27 healthy controls. There was a high prevalence of abnormal voice quality in the CC and PVFM groups compared with healthy controls. More than one third of participants with CC and PVFM demonstrated strained, rough and/or breathy voices to a moderate or severe degree. The perceptual features in CC and PVFM were similar to those in MTD with greater severity evident in MTD. Possible mechanisms for abnormalities in voice quality include the presence of muscle tension and the frequency of coughing. These results have implications for the identification and management of voice disorders in CC and PVFM and suggest that clinicians should be alert to the incidence of voice abnormalities in these populations. Copyright 2007 S. Karger AG, Basel.

  7. Attention deficit hyperactivity disorder symptoms in children with vocal fold nodules.

    Science.gov (United States)

    Erdur, Omer; Herguner, Arzu; Ozturk, Kayhan; Kibar, Ertugrul; Elsurer, Cagdas; Bozkurt, Mete Kaan; Herguner, Sabri

    2016-06-01

    The aim of this case-control study was to investigate the symptoms of attention-deficit/hyperactivity disorder (ADHD) in children with vocal fold nodules (VNs). Study group (SG) included children between 4 and 12 years. As a control group (CG), children between 4 and 12 years without VNs were included in the study. Parents of the participants completed the Conners' Parent Rating Scale-Revised: Short Form (CPRS-RS) which was used to analyze the symptoms of ADHD. Forty-five children (30 boys and 15 girls) with VNs and 45 controls (30 boys and 15 girls) were enrolled in the study. Multivariate analysis of variance revealed that the CPRS-RS Hyperactivity and Oppositional Subscales were significantly higher in the SG than the CG (p < .05), after controlling the effects of age and gender. Our findings suggest associations between VNs and hyperactivity and oppositional behaviors in children. Clinicians should be aware of ADHD symptoms in children with VNs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. The management of vocal fold nodules in children: a national survey of speech-language pathologists.

    Science.gov (United States)

    Signorelli, Monique E; Madill, Catherine J; McCabe, Patricia

    2011-06-01

    The purpose of this study was to determine the management options and voice therapy techniques currently being used by practicing speech-language pathologists (SLPs) to treat vocal fold nodules (VFNs) in children. The sources used by SLPs to inform and guide their clinical decisions when managing VFNs in children were also explored. Sixty-two SLPs completed a 23-item web-based survey. Data was analysed using frequency counts, content analyses, and supplementary analyses. SLPs reported using a range of management options and voice therapy techniques to treat VFNs in children. Voice therapy was reportedly the most frequently used management option across all respondents, with the majority of SLPs using a combination of indirect and direct voice therapy techniques. When selecting voice therapy techniques, the majority of SLPs reported that they did not use the limited external evidence available to guide their clinical decisions. Additionally, the majority of SLPs reported that they frequently relied on lower levels of evidence or non-evidence-based sources to guide clinical practice both in the presence and absence of higher quality evidence. Further research needs to investigate strategies to remove the barriers that impede SLPs use of external evidence when managing VFNs in children.

  9. A retrospective review of the progression of pediatric vocal fold nodules.

    Science.gov (United States)

    Nardone, Heather C; Recko, Thomas; Huang, Lin; Nuss, Roger C

    2014-03-01

    To our knowledge, the rate of change in the size of pediatric vocal fold nodules (VFNs) has not been investigated. Improved understanding of the factors that affect change in VFN size may help to better guide treatment decisions and counselling of families. To characterize the rate of change in the size of pediatric VFNs over time and to identify which factors affect increased rates of improvement. Retrospective review of 67 children evaluated in a voice clinic between 2002 and 2011 with a primary diagnosis of VFNs. No treatment or behavioral modification only (n = 19) vs targeted voice therapy with or without the treatment of associated conditions (gastroesophageal reflux and allergic rhinitis) (n = 45) vs surgical intervention (n = 3). Change in VFN grade (graded according to a previously validated scale based on size) over time. Sixty-seven patients with a median (range) age of 6.0 (3.8-20.6) years were analyzed. Median (range) follow-up was 25 (1-119) months. The rate of change in VFN grade over time was significantly associated with large baseline VFN size (P nodule size over time. Rate of change in VFN size is a gradual decrease that is steady over time. This information can be used to help guide treatment decisions and counsel families of children with VFNs regarding expectations for improvement. Additional study is needed to evaluate whether the same factors that influence nodule size similarly influence parental perception of voice and expert perceptual voice analysis.

  10. Feasibility of vocal fold abduction and adduction assessment using cine-MRI

    Energy Technology Data Exchange (ETDEWEB)

    Baki, Marina Mat [National University of Malaysia, Faculty of Medicine, Kuala Lumpur (Malaysia); Menys, Alex; Morley, Simon; Beale, Timothy [University College London, Centre for Medical Imaging, London (United Kingdom); Atkinson, David; Punwani, Shonit [University College London, Centre for Medical Imaging, London (United Kingdom); Royal National Throat Nose Ear Hospital, University College London Hospital NHS Trust, London (United Kingdom); Bassett, Paul [University College London, London (United Kingdom); Sandhu, Guri [Charing Cross Hospital, Imperial College Healthcare NHS Trust, London (United Kingdom); Naduvilethil, Georgekutty; Stevenson, Nicola [Royal National Throat Nose Ear Hospital, University College London Hospital NHS Trust, London (United Kingdom); Birchall, Martin A. [Royal National Throat Nose Ear Hospital, University College London Hospital NHS Trust, London (United Kingdom); University of California, Davis, Department of Otolaryngology, Davis, CA (United States); University College London, Ear Institute, London (United Kingdom)

    2017-02-15

    Determine feasibility of vocal fold (VF) abduction and adduction assessment by cine magnetic resonance imaging (cine-MRI) Cine-MRI of the VF was performed on five healthy and nine unilateral VF paralysis (UVFP) participants using an axial gradient echo acquisition with temporal resolution of 0.7 s. VFs were continuously imaged with cine-MRI during a 10-s period of quiet respiration and phonation. Scanning was repeated twice within an individual session and then once again at a 1-week interval. Asymmetry of VF position during phonation (VF phonation asymmetry, VFPa) and respiration (VF respiration asymmetry, VFRa) was determined. Percentage reduction in total glottal area between respiration and phonation (VF abduction potential, VFAP) was derived to measure overall mobility. An un-paired t-test was used to compare differences between groups. Intra-session, inter-session and inter-reader repeatability of the quantitative metrics was evaluated using intraclass correlation coefficient (ICC). VF position asymmetry (VFPa and VFRa) was greater (p=0.012; p=0.001) and overall mobility (VFAP) was lower (p=0.008) in UVFP patients compared with healthy participants. ICC of repeatability of all metrics was good, ranged from 0.82 to 0.95 except for the inter-session VFPa (0.44). Cine-MRI is feasible for assessing VF abduction and adduction. Derived quantitative metrics have good repeatability. (orig.)

  11. Quantitative laryngeal electromyography assessment of cricothyroid function in patients with unilateral vocal fold paralysis.

    Science.gov (United States)

    Fang, Tuan-Jen; Pei, Yu-Cheng; Hsin, Li-Jen; Lin, Wan-Ni; Lee, Li-Ang; Li, Hsueh-Yu; Wong, Alice M K

    2015-11-01

    Determination of superior laryngeal nerve (SLN) involvement in addition to recurrent laryngeal nerve (RLN) paralysis in patients with unilateral vocal fold paralysis (UVFP) relies on traditional, qualitative laryngeal electromyography (LEMG) examination. It is necessary to develop a quantitative measurement that reflects the degree of denervation of the cricothyroid (CT) muscle. The present study aimed to establish a standard quantitative assessment of CT function in patients with UVFP by measuring the turn frequency. Case series study performed in an otolaryngology outpatient clinic. Twenty healthy subjects and 103 patients with UVFP were recruited. The main outcome measures for the patients included acoustic analysis using traditional LEMG examination, quantitative LEMG analysis, and acoustic analysis based on fundamental frequency contours. Acoustic reliability was examined in the healthy subjects, and the peak fundamental frequency in an upward glissando showed good test-retest reliability, especially for the offset fundamental frequency. LEMG indicated that 33 patients had RLN and SLN lesions (RLN+SLN group) and 70 had only RLN lesions (RLN group). When patients produced a standard upward glissando sound, the peak turn frequency reflecting the recruitment of the CT muscle was significantly lower in the RLN+SLN group compared with the RLN group (406±256 vs. 778±238 Hz; P<.001). We conclude that quantitative measurement of the interference pattern when voicing a standard upward glissando sound may provide a feasible reflection of the degree of a SLN injury. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Self-oscillating Vocal Fold Model Mechanics: Healthy, Diseased, and Aging

    Science.gov (United States)

    Hiubler, Elizabeth P.; Pollok, Lucas F. E.; Apostoli, Adam G.; Hancock, Adrienne B.; Plesniak, Michael W.

    2014-11-01

    Voice disorders have been estimated to have a substantial economic impact of 2.5 billion annually. Approximately 30% of people will suffer from a voice disorder at some point in their lives. Life-sized, self-oscillating, synthetic vocal fold (VF) models are fabricated to exhibit material properties representative of human VFs. These models are created both with and without a polyp-like structure, a pathology that has been shown to produce rich viscous flow structures not normally observed for healthy VFs during normal phonation. Pressure measurements are acquired upstream of the VFs and high-speed images are captured at varying flow rates during VF oscillation to facilitate an understanding of the characteristics of healthy and diseased VFs. The images are analyzed using a videokymography line-scan technique. Clinically-relevant parameters calculated from the volume-velocity output of a circumferentially-vented mask (Rothenberg mask) are compared to human data collected from two groups of males aged 18-30 and 60-80. This study extends the use of synthetic VF models by assessing their ability to replicate behaviors observed in human subject data to advance a means of investigating changes associated with normal, pathological, and the aging voice. Supported by the GWU Institute for Biomedical Engineering (GWIBE) and GWU Center for Biomimetics and Bioinspired Engineering (COBRE).

  13. Wavelet analysis of hemispheroid flow separation toward understanding human vocal fold pathologies

    Science.gov (United States)

    Plesniak, Daniel H.; Carr, Ian A.; Bulusu, Kartik V.; Plesniak, Michael W.

    2014-11-01

    Physiological flows observed in human vocal fold pathologies, such as polyps and nodules, can be modeled by flow over a wall-mounted protuberance. The experimental investigation of flow separation over a surface-mounted hemispheroid was performed using particle image velocimetry (PIV) and measurements of surface pressure in a low-speed wind tunnel. This study builds on the hypothesis that the signatures of vortical structures associated with flow separation are imprinted on the surface pressure distributions. Wavelet decomposition methods in one- and two-dimensions were utilized to elucidate the flow behavior. First, a complex Gaussian wavelet was used for the reconstruction of surface pressure time series from static pressure measurements acquired from ports upstream, downstream, and on the surface of the hemispheroid. This was followed by the application of a novel continuous wavelet transform algorithm (PIVlet 1.2) using a 2D-Ricker wavelet for coherent structure detection on instantaneous PIV-data. The goal of this study is to correlate phase shifts in surface pressure with Strouhal numbers associated with the vortex shedding. Ultimately, the wavelet-based analytical framework will be aimed at addressing pulsatile flows. This material is based in part upon work supported by the National Science Foundation under Grant Number CBET-1236351, and GW Center for Biomimetics and Bioinspired Engineering (COBRE).

  14. Vocal fold vibratory characteristics of healthy geriatric females--analysis of high-speed digital images.

    Science.gov (United States)

    Ahmad, Kartini; Yan, Yuling; Bless, Diane

    2012-11-01

    A high proportion of the geriatric population suffers from presbylaryngis and presbyphonia; however, our knowledge of vibratory patterns in this population is almost nonexistent. In this study, we investigate the vocal fold vibratory patterns of healthy elderly females to determine which features or combination of them could best describe the geriatric voices. Cross-sectional study with 20 elderly healthy females with no history of voice problems. Hilbert transformed glottal area waveforms (GAWs) from serial high-speed digital imaging of sustained phonation are used to provide quantitative measures of glottal vibratory characteristics and perturbations; open quotient, jitter, and shimmer. Nyquist plots provide interpretable patterns to portray the vibratory characteristics as clear, pressed, breathy, and atypical patterns. The GAW from most elderly speakers (50%) showed vibratory characteristics associated with a more pressed voice and higher glottal perturbation values: their Nyquist plot patterns show wide scatterings around the rim of the plot reflecting a much-reduced ability in sustaining vibratory oscillation; these were distinct differences from previously reported data on younger speakers. Qualitative examination revealed more anteriorly placed glottal gaps in the geriatric females. These findings have important implications in understanding voice production in the geriatric population and in helping to establish normal perturbation references among female speakers across age. Copyright © 2012 The Voice Foundation. All rights reserved.

  15. The role of laryngeal electromyography in vagus nerve stimulation-related vocal fold dysmotility.

    Science.gov (United States)

    Saibene, Alberto M; Zambrelli, Elena; Pipolo, Carlotta; Maccari, Alberto; Felisati, Giovanni; Felisati, Elena; Furia, Francesca; Vignoli, Aglaia; Canevini, Maria Paola; Alfonsi, Enrico

    2017-03-01

    Vagus nerve stimulation (VNS) is a useful tool for drug-resistant epilepsy, but it induces known laryngeal side effects, with a significant role on patients' quality of life. VNS patients may show persistent left vocal fold (LVF) palsy at rest and/or recurrent LVF adduction during stimulation. This study aims at electromyographically evaluating laryngeal muscles abnormalities in VNS patients. We compared endoscopic laryngeal evaluation data in six VNS patients with laryngeal muscle electromyography (LMEMG) carried out on the thyroarytenoid, cricothyroid, posterior cricoarytenoid, and cricopharyngeal muscles. Endoscopy showed LVF palsy at rest in 3/6 patients in whom LMEMG documented a tonic spastic activity with reduced phasic modulation. In four out of six patients with recurrent LVF adduction during VNS activation, LMEMG showed a compound muscle action potential persisting for the whole stimulation. This is the first LMEMG report of VNS-induced motor unit activation via recurrent laryngeal nerve and upper laryngeal nerve stimulation. LMEMG data were could, therefore, be considered consistent with the endoscopic laryngeal examination in all patient.

  16. Verification of two minimally invasive methods for the estimation of the contact pressure in human vocal folds during phonation.

    Science.gov (United States)

    Chen, Li-Jen; Mongeau, Luc

    2011-09-01

    The contact pressure on the vocal fold surface during high pitch or amplitude voice production is believed to be one major source of phonotrauma. Models for the quantitative estimate of the contact pressure may be valuable for prevention and treatment. Various indirect and minimally invasive approaches have been purported to estimate contact pressure. But the accuracy of these methods has not yet been objectively verified in controlled laboratory settings. In the present study, two indirect approaches for the estimation of the contact pressure were investigated. One is based on a Hertzian impact model, and the other on a finite element model. A probe microphone was used for direct measurements of the contact pressure and verifications of the indirect approaches. A silicone replica of human vocal folds was used as a test bed. Consistent contact pressure estimations were obtained using all three methods. The advantages and disadvantages of each approach for eventual clinical applications are described. © 2011 Acoustical Society of America

  17. Effect of intralaryngeal muscle synkinesis on perception of voice handicap in patients with unilateral vocal fold paralysis.

    Science.gov (United States)

    Lin, R Jun; Munin, Michael C; Rosen, Clark A; Smith, Libby J

    2017-07-01

    Intralaryngeal muscle synkinesis associated with unilateral vocal fold paralysis (UVFP) is thought to preserve thyroarytenoid-lateral cricoarytenoid muscle complex tone, resulting in a better voice despite the presence of vocal fold paralysis (VFP). This study compares voice handicap in patients with unilateral VFP (UVFP) with and without evidence of adductory synkinesis on laryngeal electromyography (LEMG). Retrospective review of LEMG data and Voice Handicap Index-10 (VHI-10) scores of patients diagnosed with permanent UVFP. LEMG was performed within 1 to 6 months post onset of UVFP. Patients were stratified into two groups: 1) recurrent laryngeal nerve (RLN) neuropathy with synkinesis and 2) RLN neuropathy without synkinesis. Synkinesis was diagnosed when the sniff to phonation maximum amplitude ratio was ≥0.65. VHI-10 scores at 6-month follow-up were recorded. Four hundred forty-nine patients with UVFP and who had an LEMG were reviewed. Eighty-three patients met the inclusion criteria, with 16 in group 1 and 67 in group 2. There was no significant difference between the groups with regard to age, timing of LEMG from onset of VFP, number of patients undergoing temporary vocal fold injection or use of off-label nimodipine. Average VHI-10 scores at 6 months post onset of VFP were 14.4 ± 10.6 for patients with LEMG-identified synkinesis (group 1) and 21.0 ± 10.1 for patients with no LEMG evidence of synkinesis (group 2). This was statistically significant (P = .02). Patients with unilateral vocal fold paralysis and LEMG evidence of laryngeal synkinesis are more likely to have less perceived voice handicap than those without synkinesis. 4. Laryngoscope, 127:1628-1632, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Narrow-band imaging (NBI for improving the assessment of vocal fold leukoplakia and overcoming the umbrella effect.

    Directory of Open Access Journals (Sweden)

    H Klimza

    Full Text Available It is crucial to find a balance between functional and oncological outcome when choosing an adequate method for the management of vocal fold leukoplakia. Therefore, a detailed examination is a milestone in the decision-making process.To examine whether narrow-band imaging (NBI can be helpful in vocal fold assessment in the case of leukoplakia and how to overcome the "umbrella effect"- understood as the submucosal vascular pattern hidden under the plaque.Prospective cohort of 41 consecutive patients. Inclusion criteria: vocal fold leukoplakia, no previous procedures (surgery, radiotherapy, and preoperative endoscopy with an optical filter for NBI. Two groups: "suspicious" and "normal", according to the submucosal microvascular pattern of peripheral regions of the mucosa surrounding the plaque, were distinguished. Patients were qualified for a full-thickness or partial-thickness biopsy, respectively. Criteria defining suspected characters were well-demarcated brownish areas with scattered brown spots corresponding to type IV, Va, Vb, and Vc NI classifications.In 22/41 (53.7% patients with "suspected" microvascular pattern, full-thickness biopsy was performed. Moderate and severe dysplasia was revealed in 15 type IV and 7 type Va NI patients. In 19/41 (46.3% patients with proper NBI vessel pattern treated by partial-thickness biopsy, hyperkeratosis was diagnosed. There was a strong correlation between the NBI pattern and final histology: Chi2 (2 = 41.0 (p = 0.0000.The results demonstrate that NBI endoscopic assessment of the submucosal microvascular pattern of mucosa surrounding the plaque can be an effective method to categorise the risk in vocal fold leukoplakia prior to treatment.

  19. Narrow-band imaging (NBI) for improving the assessment of vocal fold leukoplakia and overcoming the umbrella effect

    Science.gov (United States)

    Tokarski, M.; Piersiala, K.; Wierzbicka, M.

    2017-01-01

    Background It is crucial to find a balance between functional and oncological outcome when choosing an adequate method for the management of vocal fold leukoplakia. Therefore, a detailed examination is a milestone in the decision-making process. Aim To examine whether narrow-band imaging (NBI) can be helpful in vocal fold assessment in the case of leukoplakia and how to overcome the “umbrella effect”- understood as the submucosal vascular pattern hidden under the plaque. Material and methods Prospective cohort of 41 consecutive patients. Inclusion criteria: vocal fold leukoplakia, no previous procedures (surgery, radiotherapy), and preoperative endoscopy with an optical filter for NBI. Two groups: “suspicious” and “normal”, according to the submucosal microvascular pattern of peripheral regions of the mucosa surrounding the plaque, were distinguished. Patients were qualified for a full-thickness or partial-thickness biopsy, respectively. Criteria defining suspected characters were well-demarcated brownish areas with scattered brown spots corresponding to type IV, Va, Vb, and Vc NI classifications. Results In 22/41 (53.7%) patients with “suspected” microvascular pattern, full-thickness biopsy was performed. Moderate and severe dysplasia was revealed in 15 type IV and 7 type Va NI patients. In 19/41 (46.3%) patients with proper NBI vessel pattern treated by partial-thickness biopsy, hyperkeratosis was diagnosed. There was a strong correlation between the NBI pattern and final histology: Chi2 (2) = 41.0 (p = 0.0000). Conclusion The results demonstrate that NBI endoscopic assessment of the submucosal microvascular pattern of mucosa surrounding the plaque can be an effective method to categorise the risk in vocal fold leukoplakia prior to treatment. PMID:28662209

  20. Pleomorphic Rhabdomyosarcoma Arising from True Vocal Fold of Larynx: Report of a Rare Case and Literature Review

    Directory of Open Access Journals (Sweden)

    Sevdegül Mungan

    2016-01-01

    Full Text Available We present an extremely rare case of a pleomorphic rhabdomyosarcoma of the true vocal fold. The histopathological diagnosis was confirmed by immunohistochemistry. The patient was treated with radical surgery including total laryngectomy and radical neck dissection followed by postoperative radiotherapy. The clinicopathologic features of this rare malignancy are discussed together with a review of the literature. This case report and literature review highlights the more favorable prognosis of pleomorphic rhabdomyosarcoma in the larynx than in other locations.

  1. Laser bonding with ICG-infused chitosan patches: preliminary experiences in suine dura mater and vocal folds

    Science.gov (United States)

    Rossi, Francesca; Matteini, Paolo; Ratto, Fulvio; Pini, Roberto; Iacoangeli, Maurizio; Giannoni, Luca; Fortuna, Damiano; Di Cicco, Emiliano; Corbara, Sylwia; Dallari, Stefano

    2014-05-01

    Laser bonding is a promising minimally invasive approach, emerging as a valid alternative to conventional suturing techniques. It shows widely demonstrated advantages in wound treatment: immediate closuring effect, minimal inflammatory response and scar formation, reduced healing time. This laser based technique can overcome the difficulties in working through narrow surgical corridors (e.g. the modern "key-hole" surgery as well as the endoscopy setting) or in thin tissues that are impossible to treat with staples and/or stitches. We recently proposed the use of chitosan matrices, stained with conventional chromophores, to be used in laser bonding of vascular tissue. In this work we propose the same procedure to perform laser bonding of vocal folds and dura mater repair. Laser bonding of vocal folds is proposed to avoid the development of adhesions (synechiae), after conventional or CO2 laser surgery. Laser bonding application in neurosurgery is proposed for the treatment of dural defects being the Cerebro Spinal Fluid leaks still a major issue. Vocal folds and dura mater were harvested from 9-months old porks and used in the experimental sessions within 4 hours after sacrifice. In vocal folds treatment, an IdocyanineGreen-infused chitosan patch was applied onto the anterior commissure, while the dura mater was previously incised and then bonded. A diode laser emitting at 810 nm, equipped with a 600 μm diameter optical fiber was used to weld the patch onto the tissue, by delivering single laser spots to induce local patch/tissue adhesion. The result is an immediate adhesion of the patch to the tissue. Standard histology was performed, in order to study the induced photothermal effect at the bonding sites. This preliminary experimental activity shows the advantages of the proposed technique in respect to standard surgery: simplification of the procedure; decreased foreign-body reaction; reduced inflammatory response; reduced operating times and better handling in

  2. Laryngeal chondrosarcoma of the arytenoid cartilage presenting as bilateral vocal fold immobility: a case report and literature review.

    Science.gov (United States)

    Hu, Rong; Xu, Wen; Liu, Honggang; Chen, Xuejun

    2014-01-01

    To describe an atypical case of laryngeal chondrosarcoma of arytenoid cartilage presenting as bilateral vocal fold immobility and to avoid potential missed diagnosis. Our case study included a detail history, physical and radiological examination, laryngeal electromyography (LEMG), and surgical treatment and pathology analysis. We compared it with the previously discussed cases of chondrosarcoma of arytenoid cartilage in the literature. Chondrosarcomas of the arytenoid cartilage is rare, and to date only approximately 10 cases have been reported. We reported a case of a 51-year-old man with 1 month of persistent dyspnea presenting with bilateral vocal fold immobility without neoplasms in larynx. The LEMG showed no obvious abnormality. The cervical-enhanced computed tomography (CT) found no significant signs of a mass except for localized high-density areas in arytenoid cartilage. Right arytenoidectomy and biopsy were performed under general anesthesia with CO2 laser with the pathological diagnosis of chondroma. A total laryngectomy was performed 2 years later, and low-grade chondrosarcoma was the final diagnosis. Laryngeal chondrosarcomas of the arytenoid cartilage are rare. It is easily neglected, especially in those cases presenting with idiopathic vocal fold immobility without any obvious signs of neoplasms. The LEMG and laryngeal CT are necessary. Sometimes, a biopsy of the arytenoid cartilage is essential. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  3. Voice and upper airway symptoms in people with chronic cough and paradoxical vocal fold movement.

    Science.gov (United States)

    Vertigan, Anne E; Theodoros, Deborah G; Gibson, Peter G; Winkworth, Alison L

    2007-05-01

    Chronic cough (CC) and paradoxical vocal fold movement (PVFM) share several common features; however, there has been no systematic comparison of these two conditions. The aims of this study were to contrast and compare the symptom profiles of CC and PVFM, to clarify the relationship between the two conditions, and to explore how symptom characteristics could be used to design an individualized treatment program. Participants included 55 people with a combination of PVFM and CC that was refractory to medical treatment, 8 people with PVFM alone, 56 people with CC alone, 25 people with voice disorders, and 27 normal controls. Symptoms and descriptive features of CC, PVFM, and voice disorders were assessed via structured case history interview, symptom frequency, and severity ratings, ratings of activity limitation, and anxiety/depression ratings. Results indicated consistent overlap in the symptom profile between people with CC and those presenting with a combination of CC and PVFM. Participants with PVFM without cough and those with voice disorders overlapped with the participants with CC on some dimensions; however, there were still some significant differences between them. These data suggest that CC and PVFM are related and manifestations of a common underlying condition but that voice disorders are a discrete entity. Most participants had normal ratings on screening for anxiety and depression. Results indicated that there were no consistent psychiatric symptoms in any of the groups studied, and they do not support the label of psychogenic cough for CC that is refractory to medical treatment. Characteristics of CC such as nature and timing of the cough provide important information for developing behavioral treatment programs for individual patients who have exhausted medical options. A template has been provided that is a practical method of designing an integrated behavioral treatment program based on those individual patient characteristics.

  4. Flexible Fiber-Optic High-Speed Imaging of Vocal Fold Vibration: A Preliminary Report.

    Science.gov (United States)

    Woo, Peak; Baxter, Peter

    2017-03-01

    High-speed video (HSV) imaging of vocal fold vibration has been possible only through the rigid endoscope. This study reports that a fiberscope-based high-speed imaging system may allow HSV imaging of naturalistic voicing. Twenty-two subjects were recorded using a commercially available black and white high-speed camera (Photron Motion Tools, 256 × 120 pixel, 2000 frames per second, 8 second acquisition time). The camera gain is set to +6 db. The camera is coupled to a standard fiber-optic laryngoscope (Olympus ENF P-4) with a 300-W Xenon light. Image acquisition was done by asking the subject to perform repeated phonation at modal phonation. Video images were processed using commercial video editing and video noise reduction software (After effects, Magix, and Neat Video 4.1). After video processing, the video images were analyzed using digital kymography (DKG). The HSV black and white video acquired by the camera is gray and lacks contrast. By adjustment of image contrast, brightness, and gamma and using noise reduction software, the flexible laryngoscopy image can be converted to video image files suitable for DKG and waveform analysis. The increased noise still makes edge tracking for objective analysis difficult, but subjective analysis of DKG plot is possible. This is the first report of HSV acquisition in an unsedated patient using a fiberscope. Image enhancement and noise reduction can enhance the HSV to allow extraction of the digital kymogram. Further image enhancement may allow for objective analysis of the vibratory waveform. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  5. Unilateral Vocal Fold Paralysis and Risk of Pneumonia: A Nationwide Population-Based Cohort Study.

    Science.gov (United States)

    Tsai, Ming-Shao; Yang, Yao-Hsu; Liu, Chia-Yen; Lin, Meng-Hung; Chang, Geng-He; Tsai, Yao-Te; Li, Hsueh-Yu; Tsai, Ying-Huang; Hsu, Cheng-Ming

    2018-01-01

    Objective To investigate pneumonia risk among patients with unilateral vocal fold paralysis (UVFP). Study Design Retrospective population-based cohort study. Setting This study used data from the National Health Insurance Research Database of Taiwan, a nationwide population-based database. Subjects and Methods A total of 419 patients newly diagnosed with UVFP between January 1, 1997, and December 31, 2013, were identified from the Longitudinal Health Insurance Database 2000, a nationally representative database of 1 million randomly selected patients. Moreover, 1676 patients without UVFP were matched to patients with UVFP at a 1:4 ratio based on age, sex, socioeconomic status, urbanization level, and site-specific cancers. Patients were followed up until death or the end of the study period (December 31, 2013). The primary outcome was the occurrence of pneumonia. Results The cumulative incidence of pneumonia was significantly higher for patients with UVFP than those without UFVP ( P < .001). The adjusted Cox proportional hazard model showed that UVFP was significantly associated with a higher incidence of pneumonia (hazard ratio, 1.97; 95% CI, 1.35-2.86; P < .001). Subgroup analyses demonstrated that UVFP was an independent risk factor of pneumonia for 4 subgroups: young (18-50 years), older (≥51 years), male, and cancer. Conclusion This is the first nationwide population-based cohort study to investigate the association between UVFP and pneumonia. The findings indicate that UVFP is an independent risk factor of pneumonia. Given the study results, physicians should be aware of the potential for pneumonia occurrence following UVFP.

  6. The 3D Printing of the Paralyzed Vocal Fold: Added Value in Injection Laryngoplasty.

    Science.gov (United States)

    Hamdan, Abdul-Latif; Haddad, Ghassan; Haydar, Ali; Hamade, Ramsey

    2017-08-18

    Three-dimensional (3D) printing has had numerous applications in various disciplines, especially otolaryngology. We report the first case of a high-fidelity 3D-printed model of the vocal cords of a patient with unilateral vocal cord paralysis in need of injection laryngoplasty. A case report was carried out. A tailored 3D-printed anatomically precise models for injection laryngoplasty has the potential to enhance preoperative planning, resident teaching, and patient education. A 3D printing model of the paralyzed vocal cord has an added value in the preoperative assessment of patients undergoing injection laryngoplasty. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  7. Coordination of respiration and swallowing: functional pattern and relevance of vocal folds closure

    Directory of Open Access Journals (Sweden)

    Milton Melciades Barbosa Costa

    2010-03-01

    Full Text Available CONTEXT: Breathing and swallowing coordination, despite the expressive number of study, remain as theme deserving further research. OBJECTIVE: To identify a coordination pattern between swallowing and the natural breathing pause that occur in association with it (swallowing apnea and also the relevance of the vocal folds closure in this process. METHODS: Sixty-six adults, male and female, including normal health people, post-laryngectomy individuals and patients with digestive complaints without dysphagia were analyzed. The respiratory air flux interruptions produced by wet requested swallows and dry, requested and spontaneous swallows, were registered using thermo and piezoelectric receptors coupled to synectics medical manometry equipment, using Polygram upper 4.21 software. The results were analyzed with the Chi-square (3×2 and (2×2 nonparametric independency test with P = 0.05. RESULTS: Swallowing apnea is a preventive breathing stop that start just before and stay present during all deglutition pharyngeal phase. It is a well coordinated phenomena that occur as pattern in association with low elastic resistance of the lung, on the expiratory final phase until inspiration initial phase. This breathing stoppage it is usually followed by a short expiraton preceding a new breathing cycle. The swallow apnea and vocal folds closure are both independents mechanisms. CONCLUSION: It is possible to suppose that in the subconscious condition, swallowing apnea is integrated under coordination of the same control mechanism that also involves the elastic resistance of the lung.CONTEXTO: Apesar do expressivo número de estudos sobre a coordenação da respiração com a deglutição, o tema permanece aberto à pesquisa. OBJETIVO: Identificar um padrão de coordenação entre a pausa respiratória e a deglutição que ocorre em associação a esta usual apneia (apneia de deglutição e estabelecer a importância do fechamento das pregas vocais que ocorre

  8. In situ vocal fold properties and pitch prediction by dynamic actuation of the songbird syrinx

    DEFF Research Database (Denmark)

    Düring, Daniel N; Knörlein, Benjamin J; Elemans, Coen P H

    2017-01-01

    , forces and torques exerted on, and motion of the syringeal skeleton during song. Here, we present a novel marker-based 3D stereoscopic imaging technique to reconstruct 3D motion of servo-controlled actuation of syringeal muscle insertions sites in vitro and focus on two muscles controlling sound pitch...... motion and forces, acoustic effects of muscle recruitment, and calibration of computational birdsong models, enabling experimental access to the entire neuromechanical control loop of vocal motor control....

  9. Characteristics of phonatory function in singers and nonsingers with vocal fold nodules.

    Science.gov (United States)

    Stepp, Cara E; Heaton, James T; Stadelman-Cohen, Tara K; Braden, Maia N; Jetté, Marie E; Hillman, Robert E

    2011-11-01

    The goals of this study were to determine if there were significant differences between singers and nonsingers in the morphology of vocal nodules and the associated impact on vocal function. Participants were 10 professionally trained singers with nodules, eight nonsingers with nodules, and 10 individuals with healthy normal voice (controls). Surface electromyography (sEMG) from three anterior neck locations and acoustic rise times for vowels /a/ and /i/ were measured in all the participants. In individuals with nodules, dB SPL/cm H(2)O, glottal airflow, and nodule location and size were also measured. There were no significant differences between singers and nonsingers with nodules in terms of airflow, dB SPL/cm H(2)O, nodule size, or nodule location. In nonsingers with nodules, airflow and nodule size were significantly correlated, but were not significantly correlated in singers. Vowel rise times and sEMG during vocal tasks did not differentiate among nodule and control groups. Sternocleidomastoid sEMG during initiation of the vowel /a/ was statistically significantly stronger in nonsingers with nodules relative to singers with nodules and controls. Nodule morphology did not differ between singers and nonsingers, although some behavioral aspects of phonation differed between the groups. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  10. Characteristics of phonatory function in singers and non-singers with vocal fold nodules

    Science.gov (United States)

    Stepp, Cara E.; Heaton, James T.; Stadelman-Cohen, Tara K.; Braden, Maia N.; Jetté, Marie E.; Hillman, Robert E.

    2010-01-01

    Purpose The goal of this study was to determine if there were significant differences between singers and non-singers in the morphology of vocal nodules and associated impact on vocal function. Method Participants were 10 professionally trained singers with nodules, 8 non-singers with nodules, and 10 individuals with healthy normal voice (controls). Surface electromyography (sEMG) from three anterior neck locations and acoustic rise times for vowels /a/ and /i/ were measured in all participants. In individuals with nodules, dB SPL / cm H2O, glottal airflow, and nodule location and size were also measured. Results There were no significant differences between singers and non-singers with nodules in terms of airflow, dB SPL / cm H2O, nodule size, or nodule location. In non-singers with nodules, airflow and nodule size were significantly correlated, but were not significantly correlated in singers. Vowel rise times and sEMG during vocal tasks did not differentiate among nodule and control groups. Sternocleidomastoid sEMG during initiation of the vowel /a/ was statistically significantly stronger in non-singers with nodules relative to singers with nodules and controls. Conclusions Nodule morphology did not differ between singers and non-singers, although some behavioral aspects of phonation differed between the groups. PMID:21216129

  11. The effects of the false vocal fold gaps on intralaryngeal pressure distributions and their effects on phonation.

    Science.gov (United States)

    Li, Sheng; Wan, Mingxi; Wang, Supin

    2008-11-01

    Human phonation does not merely depend on the vibration of the vocal folds. Research by clinical and computer simulations has demonstrated that the false vocal fold (FVF) is an important laryngeal constriction that plays a vital role during human voice production. This study explored the effects of the FVF gaps using both the three-dimensional Plexiglas model and the numerical computation methods. Twelve FVF gaps (ranging from 0.02 to 2.06 cm) were used in this study at three glottal angles (uniform and convergent/divergent 40 degrees ), two minimal glottal diameters (D (g)) (0.04 cm and 0.06 cm) separately, and the constant subglottal pressure (8 cm H(2)O). The results suggested that (1) the intralaryngeal pressure was the lowest and the flow was the highest (least flow resistance) when the FVF gap was 1.5-2 times greater than D (g); (2) the divergent glottal angle gave lower pressure and greater flow than the convergent and uniform glottal angle as there were no FVF conditions; (3) the presence of the FVF decreased the effects of the glottal angle to a certain extent; and more importantly, (4) the presence of the FVF also moved the separation points downstream, straightened the glottal jet for a longer distance, decreased the overall laryngeal resistance, and reduced the energy dissipation, suggesting the significance of FVF in efficient voice production. These results may be incorporated in the phonatory models (physical or computational) for better understanding of vocal mechanics. The results might also be helpful in exploring the surgical and rehabilitative intervention of related voice problems.

  12. Correlation between functional MRI and voice improvement following Type I thyroplasty in unilateral vocal fold paralysis--a case study.

    Science.gov (United States)

    Galgano, Jessica F; Peck, Kyung K; Branski, Ryan C; Bogomolny, Dmitry; Mener, David; Ho, Margaret; Holodny, Andrei I; Kraus, Dennis H

    2009-09-01

    The objectives of this study are to describe central nervous system modulation associated with voice improvement following Type I thyroplasty in a patient with glottic insufficiency secondary to unilateral vocal fold paralysis. Serial functional magnetic resonance imaging scans were performed before as well as one and six months after thyroplasty. Paradigms consisting of four voice production tasks and a motor control task were completed. Volumes of activation within regions activated during each task were measured. Acoustic and aerodynamic measures were also obtained. A widespread network of neural activations was shown for all tasks. Differences in volumes of activation 1-month postsurgery positively correlated with acoustic and aerodynamic improvements. Sixth months following medialization, lesser volumes of activation were observed in all regions. Prior to this session, however, the patient's mediastinal disease progressed, leading to a significant deterioration in voice. Functional differences between patient brain maps yield new information about the central nervous system's ability to reorganize sensorimotor representations associated with voice improvement following Type I thyroplasty in a patient with glottic insufficiency secondary to unilateral vocal fold paralysis (UVFP).

  13. Preliminary study of a novel transfection modality for in vivo siRNA delivery to vocal fold fibroblasts.

    Science.gov (United States)

    Kraja, Iv; Bing, Renjie; Hiwatashi, Nao; Rousseau, Bernard; Nalband, Danielle; Kirshenbaum, Kent; Branski, Ryan C

    2017-07-01

    An obstacle to clinical use of RNA-based gene suppression is instability and inefficiency of current delivery modalities. Nanoparticle delivery likely holds great promise, but the kinetics and transfection conditions must be optimized prior to in vivo utility. We investigated a RNA nanoparticle complex incorporating a lipitoid transfection reagent in comparison to a commercially available reagent. In vitro. We investigated which variables influence transfection efficiency of lipitoid oligomers and a commercially available reagent across species, in vitro. These variables included duration, dose, and number of administrations, as well as serum and media conditions. The target gene was Smad3, a signaling protein in the transforming growth factor-β cascade implicated in fibroplasia in the vocal folds and other tissues. The two reagents suppressed Smad3 mRNA for up to 96 hours; lipitoid performed favorably and comparably. Both compounds yielded 60% to 80% mRNA knockdown in rat, rabbit, and human vocal fold fibroblasts (P transfection conditions. These preliminary data are encouraging, and lipitoid warrants further investigation with the goal of clinical utility. NA. Laryngoscope, 127:E231-E237, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Lesões de borda de pregas vocais e tempos máximos de fonação Vocal folds edge lesions and maximum phonation times

    Directory of Open Access Journals (Sweden)

    Bárbara Costa Beber

    2009-03-01

    Full Text Available OBJETIVO: comparar o diagnóstico otorrinolaringológico de lesão de borda de prega vocal e seus Tempos Máximos de Fonação em adultos e crianças de ambos os sexos; verificar a frequência dos tipos de TMF (reduzido, normal ou aumentado nas patologias de borda de pregas vocais e a frequência dessas patologias em indivíduos com pregas vocais maduras (adultos e imaturas (crianças, em ambos os sexos. MÉTODOS: resgate no banco de dados de pacientes com queixas de voz, atendidos em um serviço de atendimento fonoaudiológico universitário, com diagnóstico médico de patologia de borda de prega vocal. Entre os 152 registros apresentados pelo banco de dados, 54 passaram pelos critérios de inclusão, sendo oito casos de cisto vocal e 46 de nódulo vocal. RESULTADOS: os nódulos vocais foram as lesões mais frequentes em adultos e crianças, com maior parcela em mulheres adultas e crianças do sexo masculino. Os cistos vocais ocorreram em maior parcela no sexo feminino tanto em crianças como em adultos. Houve redução nos tempos máximos de fonação de crianças de ambos os sexos e de mulheres adultas. CONCLUSÃO: as lesões de borda de pregas vocais, por dificultarem o adequado fechamento glótico, tendem a causar redução nos valores de Tempos Máximos de Fonação.PURPOSE: to compare the otorhinolaryngologic diagnosis of vocal folds edge lesions and their Maximum Phonation Times in adults and children of both genders; to check the frequency of the Maximum Phonation Times types (reduced, normal or increased in the pathologies of vocal folds edge and the frequency of these pathologies in individuals with mature vocal fold edge (adults and immature vocal fold edge (children in both genders. METHODS: to recover the database of the patients that have complained about voice. They have been attended in a phonological university service office, with a medical diagnosis of the edge pathology of vocal fold. Among the 152 records displayed by the

  15. [Making a diagnosis of different lesions of vocal fold mucosa by contact endoscopy--the first usage in our clinical practice].

    Science.gov (United States)

    Jovanović, Milan B; Perović-Jovanović, Jelena; Milenkovć, Sanja

    2005-01-01

    During laryngomicroscopy, the superficial layers of vocal fold epithelium can be examined in vivo and in situ by contact endoscopy. Methylene blue is applied initially to stain the epihelial cells of the vocal folds. When in contact with mucosal tissue, this endoscope provides 60 and 150 times magnification and clear visualization of cellular patterns of the superficial epithelial layers. For the first time in our laryngological clinical practice, we confirmed a number of previosly established parametars such as regularity and arrangement of the epithelium, nucleus contour, and nucleus-cytoplasm ratio, what all enable recognition and easy evaluation of different clinical conditions such as chronic laryngitis, Reinke's edema, papiloma dysplasia or vocal fold carcinoma. The advantage of contact endoscopy in vivo and in situ allows for detailed scan and mapping of all cell changes of the whole mucosa surface. All these features definitely classify the contact endoscopy into additional diagnostic methods in laryngology.

  16. Examination of the vocal fold activity using ultra high speed filming: archival recordings by Paul Moore and Hans von Leden

    Science.gov (United States)

    Izdebski, Krzysztof; Vaughan, Laura

    2012-02-01

    We present excerpts from three archival ultra high-speed films on the function of the human larynx by Paul Moore, Ph. D. and Hans von Leden, M.D. The films received two awards for best scientific cinematography from two different international film festivals in Italy in 1957. These films present ultra high-speed cinematographic accounts on the workings of the human vocal folds during various phonatory and ventilatory activities. These films were captured at speeds of 2000 to 5000 frames-per-second via an ingeniously arranged laryngeal mirror viewing device. Such speeds were revolutionary six decades ago. Technology currently allows us to film laryngeal behavior at speeds of up to 16,000 frames-per-second using digital recordings. However, the ultra high-speed films by Paul and Hans remain a beacon for anyone sincerely interested in how the smallest instrument of sound production works, and how it is subjected to failure by intrinsic or extrinsic factors.

  17. Análise do trato vocal em pacientes com nódulos, fendas e cisto de prega vocal Vocal tract analysis in patients with vocal fold nodules, clefts and cysts

    OpenAIRE

    Raquel Buzelin Nunes; Andrea Moreira Veiga de Souza; Andre de Campos Duprat; Marta Assumpção de Andrade e Silva; Rejane Cardoso Costa; Juliana Gomes Paulino

    2009-01-01

    O plano supraglótico representa uma importante dimensão na produção vocal, sendo de grande relevância sua caracterização na avaliação e conduta terapêutica de indivíduos disfônicos. OBJETIVO: Verificar se determinadas configurações glóticas se relacionam com ajustes específicos de trato vocal. Avaliar por meio da nasofibrolaringoscopia a freqüência dos ajustes do trato vocal supraglótico em mulheres disfônicas com nódulos, fendas e cistos. MÉTODO: Foram avaliadas 31 mulheres disfônicas, faixa...

  18. Análise do trato vocal em pacientes com nódulos, fendas e cisto de prega vocal Vocal tract analysis in patients with vocal fold nodules, clefts and cysts

    Directory of Open Access Journals (Sweden)

    Raquel Buzelin Nunes

    2009-04-01

    Full Text Available O plano supraglótico representa uma importante dimensão na produção vocal, sendo de grande relevância sua caracterização na avaliação e conduta terapêutica de indivíduos disfônicos. OBJETIVO: Verificar se determinadas configurações glóticas se relacionam com ajustes específicos de trato vocal. Avaliar por meio da nasofibrolaringoscopia a freqüência dos ajustes do trato vocal supraglótico em mulheres disfônicas com nódulos, fendas e cistos. MÉTODO: Foram avaliadas 31 mulheres disfônicas, faixa etária entre 18 e 45 anos, com alteração vocal e diagnóstico de nódulos, fenda médioposterior e cisto e realizada avaliação resumida do sistema sensório-motor e oral e exames de videolaringoestroboscopia e nasofibrolaringoscopia. Três grupos distintos foram selecionados: pacientes com nódulos bilaterais, com fenda e com cisto, com configurações glóticas semelhantes. Foi realizada, por fonoaudiólogas e otorrinolaringologistas, a análise visual do trato vocal dos exames de nasofibrolaringoscopia, verificando os parâmetros de: constrição supraglótica, mobilidade vertical da laringe, constrição faríngea e mobilidade de língua. Os dados foram descritos e tratados estatisticamente. RESULTADOS: Na análise visual não foi encontrada diferença estatística significante que separasse os grupos das alterações glóticas. CONCLUSÃO: Não houve correlação dos ajustes do trato supraglótico com determinado tipo de alteração glótica. São comportamentos individuais que geram os ajustes e justificam as diferentes qualidades vocais em pacientes com mesmo tipo de alteração laríngea.The supraglottic plan represents an important dimension in vocal production, and its characterization is very important in the evaluation and treatment approach of dysphonic individuals. AIM: to check if certain glottic configurations are related to specific adjustments in the vocal tract. To use nasal and laryngeal fibroscopy to assess

  19. Finite element modeling of the vocal folds with deformable interface tracking

    DEFF Research Database (Denmark)

    Granados Corsellas, Alba; Brunskog, Jonas; Misztal, Marek Krzysztof

    2014-01-01

    Continuous and prolonged use of the sp eaking voice may lead to functional sp eech disorders that are not apparent for voice clinicians from high-sp eed imaging of the vo cal folds' vibration. However, it is hyp othesized that time dep endent tissue prop erties provide some insight into the injur...

  20. Detecção de receptor de ácido hialurônico em prega vocal humana por método imunohistoquímico Detection of hyaluronic acid receptor in human vocal folds by immunohistochemistry

    Directory of Open Access Journals (Sweden)

    Luiz Henrique Fonseca Barbosa

    2008-04-01

    Full Text Available O receptor do ácido Hialurônico é uma glicoproteína da membrana plasmática, sendo o principal o CD44, e está expresso em vários tipos de células onde possui a função de adesão celular. OBJETIVO: Estudar a possibilidade de empregar o método imunohistoquímico para identificar a distribuição dos receptores de ácido hialurônico ao longo da prega vocal humana. MATERIAL E MÉTODOS: Foram ressecadas as pregas vocais normais de um indivíduo de 23 anos, sexo masculino, cor negra. As lâminas foram analisadas por meio de estudo histomorfométrico, comparando-se a intensidade das cores nas camadas superficial, média e profunda da lâmina própria. Nas lâminas silanizadas foi utilizado método imunohistoquímico, sendo avaliadas através de microscopia óptica com aumento 40 vezes, obtendo coloração marrom onde houve a reação com receptor para ácido hialurônico. RESULTADOS: Os achados imunohistoquímicos mostraram presença de receptores para ácido hialurônico no epitélio de cobertura da prega vocal tendo maior concentração na região central da prega vocal. CONCLUSÃO: A técnica de imunohistoquímica, utilizada para avaliar a distribuição dos receptores para ácido hialurônico na pregas vocais humanas, mostrou sua disposição em epitélio da prega vocal e predomínio no terço médio, em relação às demais regiões na prega vocal estudada.Hyaluronic acid receptor is a glycoprotein of the plasmatic membrane, and the CD44 is its representative, expressed in many cell types where it has the task of cell adhesion. AIM: the goal of the present experimental study is to investigate the possibility of using immunohistochemistry to identify the distribution of hyaluronic acid along the vocal fold. MATERIALS AND METHODS: We resected the normal vocal folds from a normal 23 year-old male black individual. The slides were analyzed by means of a histomorphometric study, comparing the color intensity in the superficial, middle and

  1. Paralisia de prega vocal em crianças: diagnóstico e conduta a partir de relato de caso Vocal fold paralysis in children: diagnostic and management from a case report

    Directory of Open Access Journals (Sweden)

    Romualdo Suzano Louzeiro Tiago

    2005-06-01

    Full Text Available A paralisia de pregas vocais representa 10% das anomalias congênitas da laringe, sendo a segunda causa mais comum de estridor laríngeo na infância. Quando considerada a paralisia de prega vocal unilateral, a principal causa é a lesão iatrogênica do nervo laríngeo recorrente esquerdo secundária à cirurgia para correção da persistência do canal arterial. Nesse trabalho fazemos uma revisão da literatura e relatamos um caso de uma criança que após a cirurgia de fechamento da persistência do canal arterial evoluiu com dificuldade respiratória e disfonia. Sugerimos o uso da fibronasofaringolaringoscopia flexível no pré e pós-operatório de crianças com indicação de cirurgia cardíaca para correção de anomalias congênitas, permitindo deste modo o diagnóstico precoce de paralisia de prega vocal e a definição de conduta o mais rápido possível.Vocal fold paralysis accounts for 10% of the larynx congenital abnormality, being the second most common cause of laryngeal stridor in childhood. As to unilateral vocal fold paralysis, the main cause is left-sided iatrogenic injury to the recurrent laryngeal nerve, secondary to surgery to correct the patent ductus arteriosus. In this study we reviewed the literature, reporting a case of a child who, after having undergone surgery to close the patent ductus arteriosus, evolved with breathing difficulty and dysphonia. We suggest that flexible fiberoptic laryngoscopy is carried out pre- and post surgery in children for whom heart surgery to correct congenital abnormalities is indicated, thus allowing for early diagnosis of vocal fold paralysis and the selection of the best management approach.

  2. Imunohistoquímica como método de estudo das fibras elásticas em prega vocal humana Immunohistochemistry as a method to study elastic fibers of human vocal fold

    Directory of Open Access Journals (Sweden)

    Hugo Valter Lisboa Ramos

    2005-08-01

    Full Text Available OBJETIVO: O objetivo deste trabalho é o de verificar a aplicabilidade do método imunohistoquímico na quantificação das diferentes formas das fibras elásticas em prega vocal humana. FORMA DE ESTUDO: coorte transversal. MATERIAL E MÉTODO: Foram seguidos os seguintes critérios de inclusão: idade entre 25 e 40 anos, gênero masculino, cor branca, morte causada por ferimento de arma de fogo, menos de doze horas de morte, ausência de intubação traqueal e de trauma na região cervical e que, por análise microscópica, não apresentassem qualquer alteração da mucosa das pregas vocais. Por estes critérios dez pregas vocais foram obtidas e selecionou-se, aleatoriamente, uma prega vocal que pertencia a um indivíduo de 28 anos. A prega vocal foi transversalmente seccionada em nove regiões e três cortes de cada fragmento foram utilizados para a realização das colorações Verhoeff e resorcina-fuchsina de Weighert e para a realização do estudo imunohistoquímico. Realizou-se quantificação colorimétrica das fibras elásticas. RESULTADO: As camadas intermediária e profunda da prega vocal apresentam valores muito superiores aos da camada superficial, nas colorações histológicas. A quantidade de tropoelastina identificada pelos anticorpos não apresentou grandes diferenças entre os valores da camada superficial e os da camada intermediária e profunda. CONCLUSÃO: A imunohistoquímica é uma técnica que identifica, em prega vocal humana, todas as formas de fibras elásticas e que também possibilita a realização de medidas objetivas.AIM: Verify the use of immunohistochemistry as a method to measure all forms of elastic fibers at human vocal folds. STUDY DESIGN: transversal cohort. MATERIAL AND METHOD: We collected vocal folds following these criterion: age between 25 and 40, Caucasian men, dead by gun shot, within 12 hours of death, without instrumentation of the larynx or suspicion of neck injury and without mucosal lesions

  3. The role of sensory dysfunction in the development of voice disorders, chronic cough and paradoxical vocal fold movement.

    Science.gov (United States)

    Vertigan, Anne E; Gibson, Peter G; Theodoros, Deborah G; Winkworth, Alison L

    2008-01-01

    Sensory function may be important in the pathogenesis of Chronic Cough (CC) and Paradoxical Vocal Fold Movement (PVFM). This paper aims to explore sensory issues related to the pathogenesis, classification, assessment and management of these conditions. Sensory disruption of the vagus nerve can occur through neural plasticity whereby a change occurs in the way a central neuron reacts to an incoming stimulus. Such disruption can be demonstrated through assessment of cough reflex sensitivity and extrathoracic airway hyperresponsiveness both of which may be increased in CC and PVFM. In addition, sensory function may be determined by measuring the laryngeal adductor reflex, however this phenomenon is yet to be explored in CC and PVFM. The similarity in sensory dysfunction between CC and PVFM provides support for a link between the two conditions. There are also similarities in underlying medical conditions and symptom profiles between CC/PVFM and voice disorders such as muscle tension dysphonia. Although coughing and throat clearing may be contributing factors in the development and maintenance of voice disorders, they may occur in response to extrathoracic airway hyperresponsiveness. Dysphonia can occur in CC/PVFM and may improve following behavioural treatment of CC.

  4. Interspecies comparison of stellate cell-containing macula flavae and vitamin A storage in vocal fold mucosa.

    Science.gov (United States)

    Toya, Yutaka; Riabroy, Napaporn; Davis, Christopher R; Kishimoto, Yo; Tanumihardjo, Sherry A; Bless, Diane M; Welham, Nathan V

    2014-09-01

    The macula flavae (MF), populated by vitamin A-storing stellate cells (SCs), are believed to play a fundamental role in development, maintenance and repair of the vocal fold (VF) mucosa; however, to date, they have mostly been examined in observational human cadaver studies. Here, we conducted an interspecies comparison of MF and SC phenotype, as well as vitamin A quantification and localization, in human, pig, dog, rabbit and rat VF mucosae. MF containing vitamin A-positive SCs were only identified in human and rat specimens. Pig, dog and rabbit VF mucosae contained no discernable MF, but rather exhibited preferential vitamin A localization to mucous (pig), serous (dog) or mixed (rabbit) glands. This glandular vitamin A storage corresponded to exceedingly high concentrations of retinol in pig and dog mucosae, and retinyl ester in dog mucosa. These findings have significant implications for the presumed role of the MF and SCs in VF biology, the nature of vitamin A storage within the VF mucosa, and the selection of an appropriate animal model for future experimental studies. © 2014 Anatomical Society.

  5. Integration of Motor Learning Principles Into Real-Time Ambulatory Voice Biofeedback and Example Implementation Via a Clinical Case Study With Vocal Fold Nodules.

    Science.gov (United States)

    Van Stan, Jarrad H; Mehta, Daryush D; Petit, Robert J; Sternad, Dagmar; Muise, Jason; Burns, James A; Hillman, Robert E

    2017-02-01

    Ambulatory voice biofeedback (AVB) has the potential to significantly improve voice therapy effectiveness by targeting one of the most challenging aspects of rehabilitation: carryover of desired behaviors outside of the therapy session. Although initial evidence indicates that AVB can alter vocal behavior in daily life, retention of the new behavior after biofeedback has not been demonstrated. Motor learning studies repeatedly have shown retention-related benefits when reducing feedback frequency or providing summary statistics. Therefore, novel AVB settings that are based on these concepts are developed and implemented. The underlying theoretical framework and resultant implementation of innovative AVB settings on a smartphone-based voice monitor are described. A clinical case study demonstrates the functionality of the new relative frequency feedback capabilities. With new technical capabilities, 2 aspects of feedback are directly modifiable for AVB: relative frequency and summary feedback. Although reduced-frequency AVB was associated with improved carryover of a therapeutic vocal behavior (i.e., reduced vocal intensity) in a patient post-excision of vocal fold nodules, causation cannot be assumed. Timing and frequency of AVB schedules can be manipulated to empirically assess generalization of motor learning principles to vocal behavior modification and test the clinical effectiveness of AVB with various feedback schedules.

  6. Efeito da mitomicina C tópica na cicatrização de prega vocal em modelo suíno Topical mitomycin C effect on swine vocal folds healing

    Directory of Open Access Journals (Sweden)

    Paulo Antônio Monteiro Camargo

    2006-10-01

    Full Text Available Várias terapias adjuvantes à cirurgia vêm sendo usadas para modular o processo cicatricial nas pregas vocais, entre elas a Mitomicina tópica (MTC. OBJETIVOS: Avaliar os efeitos da MTC no processo de cicatrização de pregas vocais de suínos 30 dias após exérese de fragmento de mucosa com laser de CO2 mediante a mensuração da deposição de colágeno. FORMA DE ESTUDO: Experimental em suínos. MATERIAIS E MÉTODOS: Dois grupos de 6 suínos cada foram avaliados após exérese de fragmento de mucosa de prega vocal a laser de CO2 (grupo controle sem uso e grupo experimento com uso de MTC tópica. Após 30 dias os animais foram submetidos à eutanásia, sendo coletadas amostras das pregas vocais para análise histológica, a fim de quantificar a deposição de colágeno mediante coloração de Picrosirius Red. RESULTADOS: A média da área do colágeno total das pregas vocais do grupo controle foi de 2648,03 µm2, enquanto a média do colágeno total das pregas vocais do grupo experimento foi de 2200,30 µm2 (p = 0,0043. CONCLUSÃO: A MTC usada topicamente após a exérese de fragmento de mucosa da prega vocal a laser de CO2 em suínos, diminui, significativamente, a deposição do colágeno total.several adjuvant therapies to surgery have been used to modulate the healing process of vocal folds, including topic mitomycin (MTC. AIM: to evaluate the effect of topical MTC in the healing process of vocal folds 30 days after the exeresis of a mucosal fragment with CO2 laser in a swine model (control group without mitomycin and study group with topical MTC, with collagen deposition measurement. STUDY TYPE: prospective experimental in swine. METHODS: two groups of 6 swine each were subjected to exeresis of a mucosal fragment of the vocal fold with CO2 laser. Immediately after the procedure MTC was applied topically for three minutes on the study group. Thirty days later the animals were slaughtered and samples of the vocal folds were collected for

  7. Investigation of the Viability, Adhesion, and Migration of Human Fibroblasts in a Hyaluronic Acid/Gelatin Microgel-Reinforced Composite Hydrogel for Vocal Fold Tissue Regeneration.

    Science.gov (United States)

    Heris, Hossein K; Daoud, Jamal; Sheibani, Sara; Vali, Hojatollah; Tabrizian, Maryam; Mongeau, Luc

    2016-01-21

    The potential use of a novel scaffold biomaterial consisting of cross-linked hyaluronic acid (HA)-gelatin (Ge) composite microgels is investigated for use in treating vocal fold injury and scarring. Cell adhesion integrins and kinematics of cell motion are investigated in 2D and 3D culture conditions, respectively. Human vocal fold fibroblast (hVFF) cells are seeded on HA-Ge microgels attached to a HA hydrogel thin film. The results show that hVFF cells establish effective adhesion to HA-Ge microgels through the ubiquitous expression of β1 integrin in the cell membrane. The microgels are then encapsulated in a 3D HA hydrogel for the study of cell migration. The cells within the HA-Ge microgel-reinforced composite hydrogel (MRCH) scaffold have an average motility speed of 0.24 ± 0.08 μm min(-1) . The recorded microscopic images reveal features that are presumably associated with lobopodial and lamellipodial cell migration modes within the MRCH scaffold. Average cell speed during lobopodial migration is greater than that during lamellipodial migration. The cells move faster in the MRCH than in the HA-Ge gel without microgels. These findings support the hypothesis that HA-Ge MRCH promotes cell adhesion and migration; thereby they constitute a promising biomaterial for vocal fold repair. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Nonlinear dynamic-based analysis of severe dysphonia in patients with vocal fold scar and sulcus vocalis

    Science.gov (United States)

    Choi, Seong Hee; Zhang, Yu; Jiang, Jack J.; Bless, Diane M.; Welham, Nathan V.

    2011-01-01

    Objective The primary goal of this study was to evaluate a nonlinear dynamic approach to the acoustic analysis of dysphonia associated with vocal fold scar and sulcus vocalis. Study Design Case-control study. Methods Acoustic voice samples from scar/sulcus patients and age/sex-matched controls were analyzed using correlation dimension (D2) and phase plots, time-domain based perturbation indices (jitter, shimmer, signal-to-noise ratio [SNR]), and an auditory-perceptual rating scheme. Signal typing was performed to identify samples with bifurcations and aperiodicity. Results Type 2 and 3 acoustic signals were highly represented in the scar/sulcus patient group. When data were analyzed irrespective of signal type, all perceptual and acoustic indices successfully distinguished scar/sulcus patients from controls. Removal of type 2 and 3 signals eliminated the previously identified differences between experimental groups for all acoustic indices except D2. The strongest perceptual-acoustic correlation in our dataset was observed for SNR; the weakest correlation was observed for D2. Conclusions These findings suggest that D2 is inferior to time-domain based perturbation measures for the analysis of dysphonia associated with scar/sulcus; however, time-domain based algorithms are inherently susceptible to inflation under highly aperiodic (i.e., type 2 and 3) signal conditions. Auditory-perceptual analysis, unhindered by signal aperiodicity, is therefore a robust strategy for distinguishing scar/sulcus patient voices from normal voices. Future acoustic analysis research in this area should consider alternative (e.g., frequency- and quefrency-domain based) measures alongside additional nonlinear approaches. PMID:22516315

  9. Induced unilateral vocal fold paralysis and recovery rapidly modulate brain areas related to phonatory behavior: a case study.

    Science.gov (United States)

    Joshi, Ashwini; Jiang, Yang; Stemple, Joseph C; Archer, Sanford M; Andreatta, Richard D

    2011-03-01

    Peripheral and behavioral effects of voice disorders are well documented in the literature; yet, there is little information regarding the central neural biomarkers and mechanisms underlying these disorders. Understanding the details of brain function changes in disordered voice production is a critical factor for developing better treatment strategies that result in more robust patient outcomes. To examine a model of induced unilateral vocal fold paralysis (iUVFP) to demonstrate and characterize the form of activity changes within central mappings of the larynx to the induced paralysis. The induced paralysis model allowed the participant to serve as his or her own control when comparing baseline results of normal voice with results during the paralysis and subsequent recovery. Prospective, case-study design. Functional magnetic resonance imaging was used to examine central laryngeal representations during three time points: pre-iUVFP, during iUVFP, and postrecovery from iUVFP. iUVFP was induced using a lidocaine with epinephrine nerve block unilaterally. Percent changes in blood oxygenation level-dependent (BOLD) activity served as the dependent variable. Results indicated an overall reduced activity level in sensorimotor, subcortical, and cerebellar regions during paralysis. Recovery from paralysis led to augmented responses, particularly in sensory, association, and cerebellar zones. The decrease in activity during iUVFP and the significantly increased activity during the recovery phase likely represent immediate neuroplastic events occurring within minutes of nerve blockade. Recovery-related changes in the BOLD response are hypothesized to be associated with a recalibration of the system after return of normal laryngeal function. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  10. Correlation among the dysphonia severity index (DSI), the RBH voice perceptual evaluation, and minimum glottal area in female patients with vocal fold nodules.

    Science.gov (United States)

    Hussein Gaber, Ammar Gaber; Liang, Fa-Ya; Yang, Jin-Shan; Wang, Ya-Jing; Zheng, Yi-Qing

    2014-01-01

    To investigate the clinical significance and correlation of the dysphonia severity index (DSI), the RBH (roughness [R]; breathiness [B]; hoarseness [H]) perceptual voice quality evaluation, and minimum glottal area (MGA) in patients with vocal fold nodules and validate the practicality of the DSI further. The DSI evaluation, the voice RBH perceptual evaluation, and the MGA were performed on 30 female patients with vocal fold nodules (the patient group) and 30 female volunteers with normal voices (the control group). The DSI determination was calculated using the following formula: DSI = 0.13 × MPT + 0.0053 × F(0)-High - 0.26 × I-Low - 1.18 × Jitter(%) + 12.4. The RBH evaluation was graded according to four scales. The MGA was measured by KayPENTAX Kips (7105) software. The differences among the DSI, the RBH grade, and MGA of the patients were compared. The median DSI values of the patient group and the control group were -0.81 and 3.79, respectively, and the difference was statistically significant (P vocal nodules has significant clinical application and good correlation with MGA measurement. Copyright © 2014 The Voice Foundation. All rights reserved.

  11. Fatores associados a patologias de pregas vocais em professores Factores asociados a patologías de cuerdas vocales en profesores Factors associated with vocal fold pathologies in teachers

    Directory of Open Access Journals (Sweden)

    Carla Lima de Souza

    2011-10-01

    édico referido de patologías de las cuerdas vocales y las independientes, características sociodemográficas, actividad profesional, organización del trabajo/relaciones interpersonales, características físicas del ambiente de trabajo, frecuencia de trastornos mentales comunes, medida por el Self-Reporting Questionnaire-20 (SRQ-20>7 y condiciones de salud general. Se aplicaron técnicas de análisis estadístico descriptivo, bivariada y regresión logística múltiple. RESULTADOS: La prevalencia de diagnóstico médico referido de patologías de las cuerdas vocales fue de 18,9%. En el análisis de regresión logística, las variables que permanecieron asociadas al diagnóstico médico de patología de las cuerdas vocales fueron: sexo femenino, trabajar como profesor por más de siete años, uso intensivo de la voz, referir más de cinco características desfavorables del ambiente físico de trabajo, una o más enfermedades del tracto respiratorio, pérdida auditiva, y presentar trastornos mentales comunes. CONCLUSIONES: La presencia de patologías de las cuerdas vocales referidas se asoció a factores que indican la necesidad de acciones de promoción de la salud vocal del profesor y modificaciones en la organización y estructura del trabajo docente.OBJECTIVE: To analyze factors associated with the prevalence of the medical diagnosis of vocal fold pathologies in teachers. METHODS: A census-based epidemiological, cross-sectional study was conducted with 4,495 public primary and secondary school teachers in the city of Salvador, Northeastern Brazil, between March and April 2006. The dependent variable was the self-reported medical diagnosis of vocal fold pathologies and the independent variables were sociodemographic characteristics; professional activity; work organization/interpersonal relationships; physical work environment characteristics; frequency of common mental disorders, measured by the Self-Reporting Questionnaire-20 (SRQ-20 >7; and general health conditions

  12. Extension and Application of High-Speed Digital Imaging Analysis Via Spatiotemporal Correlation and Eigenmode Analysis of Vocal Fold Vibration Before and After Polyp Excision.

    Science.gov (United States)

    Wang, Jun-Sheng; Olszewski, Emily; Devine, Erin E; Hoffman, Matthew R; Zhang, Yu; Shao, Jun; Jiang, Jack J

    2016-08-01

    To evaluate the spatiotemporal correlation of vocal fold vibration using eigenmode analysis before and after polyp removal and explore the potential clinical relevance of spatiotemporal analysis of correlation length and entropy as quantitative voice parameters. We hypothesized that increased order in the vibrating signal after surgical intervention would decrease the eigenmode-based entropy and increase correlation length. Prospective case series. Forty subjects (23 males, 17 females) with unilateral (n = 24) or bilateral (n = 16) polyps underwent polyp removal. High-speed videoendoscopy was performed preoperatively and 2 weeks postoperatively. Spatiotemporal analysis was performed to determine entropy, quantification of signal disorder, correlation length, size, and spatially ordered structure of vocal fold vibration in comparison to full spatial consistency. The signal analyzed consists of the vibratory pattern in space and time derived from the high-speed video glottal area contour. Entropy decreased (Z = -3.871, P < .001) and correlation length increased (t = -8.913, P < .001) following polyp excision. The intraclass correlation coefficients (ICC) for correlation length and entropy were 0.84 and 0.93. Correlation length and entropy are sensitive to mass lesions. These parameters could potentially be used to augment subjective visualization after polyp excision when evaluating procedural efficacy. © The Author(s) 2016.

  13. Microarray-driven validation of reference genes for quantitative real-time polymerase chain reaction in a rat vocal fold model of mucosal injury.

    Science.gov (United States)

    Chang, Zhen; Ling, Changying; Yamashita, Masaru; Welham, Nathan V

    2010-11-15

    Relative quantification by normalization against a stably expressed reference gene is a widely used data analysis method in microarray and quantitative real-time polymerase chain reaction (qRT-PCR) platforms; however, recent evidence suggests that many commonly utilized reference genes are unstable in certain experimental systems and situations. The primary aim of this study, therefore, was to screen and identify stably expressed reference genes in a well-established rat model of vocal fold mucosal injury. We selected and evaluated the expression stability of nine candidate reference genes. Ablim1, Sptbn1, and Wrnip1 were identified as stably expressed in a model-specific microarray dataset and were further validated as suitable reference genes in an independent qRT-PCR experiment using 2(-DeltaCT) and pairwise comparison-based (geNorm) analyses. Parallel analysis of six commonly used reference genes identified Sdha as the only stably expressed candidate in this group. Sdha, Sptbn1, and the geometric mean of Sdha and Sptbn1 each provided accurate normalization of target gene Tgfb1; Gapdh, the least stable candidate gene in our dataset, provided inaccurate normalization and an invalid experimental result. The stable reference genes identified here are suitable for accurate normalization of target gene expression in vocal fold mucosal injury experiments. Copyright 2010 Elsevier Inc. All rights reserved.

  14. Does laryngeal reinnervation or type I thyroplasty give better voice results for patients with unilateral vocal fold paralysis (VOCALIST): study protocol for a feasibility randomised controlled trial.

    Science.gov (United States)

    Blackshaw, Helen; Carding, Paul; Jepson, Marcus; Mat Baki, Marina; Ambler, Gareth; Schilder, Anne; Morris, Stephen; Degun, Aneeka; Yu, Rosamund; Husbands, Samantha; Knowles, Helen; Walton, Chloe; Karagama, Yakubu; Heathcote, Kate; Birchall, Martin

    2017-09-29

    A functioning voice is essential for normal human communication. A good voice requires two moving vocal folds; if one fold is paralysed (unilateral vocal fold paralysis (UVFP)) people suffer from a breathy, weak voice that tires easily and is unable to function normally. UVFP can also result in choking and breathlessness. Current treatment for adults with UVFP is speech therapy to stimulate recovery of vocal fold (VF) motion or function and/or injection of the paralysed VF with a material to move it into a more favourable position for the functioning VF to close against. When these therapies are unsuccessful, or only provide temporary relief, surgery is offered. Two available surgical techniques are: (1) surgical medialisation; placing an implant near the paralysed VF to move it to the middle (thyroplasty) and/or repositioning the cartilage (arytenoid adduction) or (2) restoring the nerve supply to the VF (laryngeal reinnervation). Currently there is limited evidence to determine which surgery should be offered to adults with UVFP. A feasibility study to test the practicality of running a multicentre, randomised clinical trial of surgery for UVFP, including: (1) a qualitative study to understand the recruitment process and how it operates in clinical centres and (2) a small randomised trial of 30 participants recruited at 3 UK sites comparing non-selective laryngeal reinnervation to type I thyroplasty. Participants will be followed up for 12 months. The primary outcome focuses on recruitment and retention, with secondary outcomes covering voice, swallowing and quality of life. Ethical approval was received from National Research Ethics Service-Committee Bromley (reference 11/LO/0583). In addition to dissemination of results through presentation and publication of peer-reviewed articles, results will be shared with key clinician and patient groups required to develop the future large-scale randomised controlled trial. ISRCTN90201732; 16 December 2015. © Article

  15. Effects of laryngeal manual therapy (LMT) and transcutaneous electrical nerve stimulation (TENS) in vocal folds diadochokinesis of dysphonic women: a randomized clinical trial.

    Science.gov (United States)

    Siqueira, Larissa Thaís Donalonso; Silverio, Kelly Cristina Alves; Brasolotto, Alcione Ghedini; Guirro, Rinaldo Roberto de Jesus; Carneiro, Christiano Giácomo; Behlau, Mara

    2017-05-15

    To verify and compare the effect of transcutaneous electrical nerve stimulation (TENS) and laryngeal manual therapy (LMT) on laryngeal diadochokinesis (DDK) of dysphonic women. Twenty women with bilateral vocal nodules participated and were equally divided into: LMT Group - LMT application; TENS Group - TENS application; both groups received 12 sessions of treatment, twice a week, with a duration of 20 minutes each, applied by the same therapist. The women were evaluated as to laryngeal DDK at three moments: diagnostic, pre-treatment, and post-treatment, which produced three groups of measurements. The DDK recording was performed with intersected repetition of vowels /a/ and / i/. The analysis of vowels was performed by the program Motor Speech Profile Advanced (MSP)-KayPentax. The DDK parameters of the three evaluations were compared by means of the paired t-test (p≤0.05). The measurements of laryngeal DDK parameters were similar in the phase without treatment, indicating no individual variability over time. There was no change with respect to the speed of DDK after intervention, but after LMT, DDK of the vowel /i/ was more stable in terms of the duration of the emissions and intensity of emissions repeated. These results show improved coordination of vocal folds movement during phonation. There were no changes in the DDK parameters following TENS. LMT provides greater regularity of movement during laryngeal diadochokinesis in dysphonic women, which extends knowledge on the effect of rebalancing the larynx muscles during phonation, although TENS does not impact laryngeal diadochokinesis.

  16. Pesquisa de estrógeno e progesterona no epitélio das pregas vocais de mulheres por imunohistoquímica Immunohistochemical searching for estrogen and progesterone receptors in women vocal fold epithelia

    Directory of Open Access Journals (Sweden)

    Oswaldo Angel Bellido Rios

    2008-08-01

    Full Text Available A laringe é extremamente sensível a mudanças endocrinológicas. A maioria das alterações da mucosa das pregas vocais é causada por modificações do conteúdo líquido das pregas vocais e das suas modificações epiteliais. O estrógeno e a progesterona interferem e modificam esse conteúdo líquido das pregas vocais. O objetivo deste trabalho é verificar a presença de receptores de estrógeno e progesterona no epitélio das pregas vocais de mulheres. MATERIAL E MÉTODO: Estudo de casos prospectivos. Foram realizados exames de imunohistoquímica para receptores de estrógeno e progesterona em 19 espécimes de epitélio de pregas vocais que não apresentavam quaisquer indícios de afecção, inclusive inflamatória. Foram descartados casos de pacientes com idade superior a 40 anos e inferior a 15 anos. RESULTADOS: Foram encontrados receptores para progesterona em 18 de 19 pacientes. Os receptores de progesterona estão localizados tanto no núcleo quanto no citoplasma e principalmente na camada basal. Não houve nenhum caso de receptores de estrógeno nas pregas vocais. CONCLUSÃO: O epitélio das pregas vocais apresenta receptores para progesterona, tanto no citoplasma quanto no núcleo. Não foram encontrados receptores para estrógeno no epitélio das pregas vocais estudadas.Larynx is extremely sensitive to endocrinologic changes. Most vocal fold mucosa alterations are caused by changes in vocal fold liquid content and its epithelial changes. Estrogen and progesterone interfere and change this liquid content in the vocal folds. Our goal with the present paper is to study the presence of estrogen and progesterone receptors on vocal fold epithelium in 19 vocal fold epithelium specimens that did not present any indication of disease, especially inflammatory disease. We discarded those cases of patients above 40 years of age and those below 15. RESULTS: we found progesterone receptors in 18 of the 19 patients. The progesterone receptors

  17. Vocal process granuloma.

    Science.gov (United States)

    al-Dousary, S

    1997-06-01

    Vocal process granuloma or contact ulcer is uncommon disease in which there is chronic irritation and granulation tissue formation at the posterior third of the vocal folds. Thirteen patients (11 men and two women) with vocal process granuloma were enrolled in this study; cases of intubation granuloma were excluded. The most frequent complaints were throat irritation, frequent throat clearing and voice change. Forty-seven percent of patients had a recurrence two to four months after surgery. Computed tomography (CT) of the larynx in four patients showed arytenoid sclerosis on the involved side and disclosed moderate enhancement of the vocal fold granuloma after contrast injection in one. Three patients had hyperacidity and four had hyperfunctioning granulomas: two used their voices excessively and the other two had bilateral sulcus vocalis. To our knowledge this is the first report of sulcus vocalis with vocal process granuloma, and of enhanced vocal process granuloma.

  18. [Phonosurgery of chronic vocal cord edema].

    Science.gov (United States)

    Milutinović, A

    1997-01-01

    Chronic (Reinke's) oedema of the vocal folds is a frequent and declicate objective of phonosurgery. It is characterized by a marked bilateral subepithelial oedema, which develops by degrees, as a non-specific reaction of the vocal folds to various irritative noxious agents (especially smoking), in patients with some predisposition. It is found, by the light and electron microscopes and immunohistochemistry, that oedema is characterized by subepithelial fissure-like spaces, which accumulate a protein-rich fluid, and develops like neobursae. Therefore, mechanical factors and functional influences may also contribute to the development of Reinke's oedema. The voice is low pitched and with various degrees of hoarseness. Reinke's oedema alters the mechanical properties of the cover, which becomes very pliable and with reduced stiffness, incapacitating the vocal fold for production of high tones. Hoarseness is induced in subject with associated laryngitis, or disbalance in mechanical properties of the vocal folds. Hyperkinetic pattern of voice production can often be seen in patients with Reinke's oedema, which is a compensatory results of reduced functional capability of the vocal folds. Stroboscopy reveals a prolonged closed phase of the vibratory cycles and strikingly marked mucosal waves. A series of 371 patients with Reinke's oedema was operated by direct microlaryngoscopy, under the general anaesthesia. The "excessive" mucosa was removed by bimanual micro-procedure, while the care was not taken to severe layers deeper than a superficial part of the intermediate layer of the vocal fold (Reinke's space). In this procedure we used the micro-forceps and scissors, to detach oedema parallel to the free edge of the vocal fold, at its upper and lower demarcation lines, beginning from the posterior part of oedema. Another 27 patients were operated by indirect procedures. Microstroboscopy (IMS) was used in subjects, while videostroboscopy (IVS) was carried out in another 18

  19. Early hyaluronate injection improves quality of life but not neural recovery in unilateral vocal fold paralysis: an open-label randomized controlled study.

    Science.gov (United States)

    Pei, Yu-Cheng; Fang, Tuan-Jen; Hsin, Li-Jen; Li, Hsueh-Yu; Wong, Alice Mk

    2015-01-01

    To investigate the neurologic and functional effect of intracordal hyaluronate injections in acute unilateral vocal fold paralysis (UVFP) in a randomized controlled trial. In this open-label, randomized controlled study, 29 patients with UVFP were recruited within 6 months of their first outpatient visit and were randomized to receive either single hyaluronate injection (HI group) or conservative management (CM group). Quantitative laryngeal electromyography, videolaryngostroboscopy, UVFP-related quality of life (Voice Outcomes Survey, VOS), laboratory voice analysis, and health-related quality of life (SF-36) were evaluated at baseline, and at 1, 3 and 6 months post-injection in the HI group, and at baseline and 6 months in the CM group. Improvements in most quality of life domains and other assessments were comparable between the HI and CM groups; however, the HI group had a greater improvement in the mental health domain of quality of life at the end of follow-up. Early hyaluronate injection cannot improve nerve regeneration but can result in long-lasting improvements in patients' psychosocial well-being, thus highlighting the importance of early intervention for patients with UVFP.

  20. Structural changes and immunohistochemical localisation of epidermal growth factor receptor in the true vocal fold of female albino rats administered anabolic, androgenic steroids, and effects of anti-androgen therapy.

    Science.gov (United States)

    Amer, H E; Asker, S A; Mazroa, S A

    2011-08-01

    Anabolic steroid abuse by women is associated with a number of adverse effects, including laryngeal changes. The epidermal growth factor receptor is related to regulation of the cell life cycle. This study aimed to investigate the structural changes and immunohistochemical localisation of epidermal growth factor receptor in rat vocal folds following anabolic steroid administration, and also to assess the effect of anti-androgens. Thirty-two adult female albino rats were divided into: group I (controls), group II (receiving anabolic steroids for two months) or group III (receiving anabolic steroids plus anti-androgen for two months). Group II rat true vocal folds showed thicker epithelial layers with many mitotic figures, thicker lamina propria and thicker muscle fibres; epithelial cells were also immunohistochemically positive for epidermal growth factor receptor. Group III rats showed similar changes, but thin muscle fibres and extravasated red blood cells within the lamina propria. Anabolic steroids caused structural and immunohistochemical changes within the female rat true vocal fold. Co-administration of anti-androgens did not prevent these changes, suggesting that anti-androgens have a limited role in the management of such changes in humans.

  1. Injeção de gordura na prega vocal: efeitos do local de injeção sobre a configuração glótica e a distribuição espacial da gordura injetada Fat injection into the vocal fold: effects of the place of injection on the configuration of the glottis and the spatial distribution of the fat

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    Rui Imamura

    2003-08-01

    Full Text Available A injeção intracordal de gordura tem sido utilizada para medializar a prega vocal em casos de paralisia laríngea, com resultados variáveis. A ausência de consenso entre os autores em relação a diversos aspectos técnicos, como o local de injeção, pode contribuir, em parte, para essa variação. OBJETIVO: Estudar o efeito do local de injeção em relação à distribuição espacial da gordura dentro da prega vocal e à configuração glótica após essas injeções. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Seis laringes adultas excisadas foram utilizadas. Gordura colhida por lipoaspiração foi injetada, por meio de uma seringa de pressão, no ponto médio da prega vocal em três laringes e lateralmente ao processo vocal da aritenóide em outras três. Fotografias digitais em vista cranial da glote foram obtidas antes e após as injeções. Após fixação e descalcificação, as laringes foram cortadas no plano frontal nos terços anterior, médio e posterior da prega vocal e no nível da cartilagem aritenóide, para estudar a distribuição da gordura. RESULTADOS: Somente a injeção de gordura lateralmente ao processo vocal da aritenóide permitiu o fechamento da glote posterior. A gordura tendeu a ocupar um espaço cilíndrico dentro do músculo tireoaritenóideo, ao longo do maior eixo da prega vocal, mesmo quando injetada próximo ao processo vocal. CONCLUSÕES: O local de injeção da gordura teve influência sobre a configuração glótica após a injeção, apesar da gordura tender a ocupar um espaço cilíndrico ao longo da prega vocal em ambos os grupos.Intracordal fat injection has been used for vocal fold medialization in cases of laryngeal paralysis with variable results. A lack of consensus among the authors concerning various technical aspects, such as the site of injection, may contribute, in part, to this variation. AIM: To study the effects of the place of fat injection on the spatial distribution of fat and

  2. Paralisia unilateral de prega vocal: associação e correlação entre tempos máximos de fonação, posição e ângulo de afastamento Unilateral vocal fold paralysis: association and correlation between maximum phonation time, position and displacement angle

    Directory of Open Access Journals (Sweden)

    Luciane M. Steffen

    2004-08-01

    Full Text Available A paralisia de prega vocal (PPV decorre da lesão do nervo vago ou de seus ramos, podendo levar a alterações das funções que requerem o fechamento glótico. O tempo máximo de fonação (TMF é um teste aplicado rotineiramente em pacientes disfônicospara avaliar a eficiência glótica e freqüentemente utilizado em casos de PPV, cujos valores encontram-se diminuídos. A classificação clínica clássica da posição da prega vocal paralisada em mediana, para-mediana, intermediária e em abdução ou cadavérica tem sido objeto de controvérsias. OBJETIVO: Verificar a associação e correlação entre os TMF e posição da prega vocal paralisada (PVP, TMF e ângulo de afastamento da PVP, medir o ângulo de afastamento da linha média das diferentes posições da PVP e correlacioná-lo com a sua classificação clínica FORMA DE ESTUDO: Clínico retrospectivo. MATERIAL E MÉTODO: Foram revisados os prontuários e analisados os exames videoendoscópicos de 86 indivíduos com paralisia de prega vocal unilateral e medido o ângulo de afastamento da PVP por meio de um programa computadorizado. RESULTADOS: A associação e correlação entre os TMF em cada posição assumida pela PVP têm significância estatística somente para /z/ na posição mediana. A associação e correlação entre TMF com ângulo de afastamento da PVP guardam relação para /i/, /u/. Ao associar e correlacionar medidas de ângulo com posição observa-se significância estatística em posição de abdução. CONCLUSÕES: Neste estudo não foi possível determinar as posições assumidas pela PVP por meio dos TMF nem correlacioná-las com medidas do ângulo.Vocal fold paralysis (VFP is due to an injury of the vagus nerve or one of its branches and may cause dysfunctions in the glottic competence. The Maximum Phonation Time (MPT is a test usually applied on dysphonic patients to assess glottic efficiency, mainly in patients with VFP and a decreased phonation time. The

  3. Paralisia de prega vocal em crianças: diagnóstico e conduta a partir de relato de caso Vocal fold paralysis in children: diagnostic and management from a case report

    OpenAIRE

    Romualdo Suzano Louzeiro Tiago; Sandra Jager Patrocínio; Patricya Santos Figueiredo dos Anjos; Juparethan Trento Ribeiro; Fábio Marangoni Gil; Flávia Villin Denunci

    2005-01-01

    A paralisia de pregas vocais representa 10% das anomalias congênitas da laringe, sendo a segunda causa mais comum de estridor laríngeo na infância. Quando considerada a paralisia de prega vocal unilateral, a principal causa é a lesão iatrogênica do nervo laríngeo recorrente esquerdo secundária à cirurgia para correção da persistência do canal arterial. Nesse trabalho fazemos uma revisão da literatura e relatamos um caso de uma criança que após a cirurgia de fechamento da persistência do canal...

  4. Assessment of vocal cord nodules: a case study in speech processing by using Hilbert-Huang Transform

    Science.gov (United States)

    Civera, M.; Filosi, C. M.; Pugno, N. M.; Silvestrini, M.; Surace, C.; Worden, K.

    2017-05-01

    Vocal cord nodules represent a pathological condition for which the growth of unnatural masses on vocal folds affects the patients. Among other effects, changes in the vocal cords’ overall mass and stiffness alter their vibratory behaviour, thus changing the vocal emission generated by them. This causes dysphonia, i.e. abnormalities in the patients’ voice, which can be analysed and inspected via audio signals. However, the evaluation of voice condition through speech processing is not a trivial task, as standard methods based on the Fourier Transform, fail to fit the non-stationary nature of vocal signals. In this study, four audio tracks, provided by a volunteer patient, whose vocal fold nodules have been surgically removed, were analysed using a relatively new technique: the Hilbert-Huang Transform (HHT) via Empirical Mode Decomposition (EMD); specifically, by using the CEEMDAN (Complete Ensemble EMD with Adaptive Noise) algorithm. This method has been applied here to speech signals, which were recorded before removal surgery and during convalescence, to investigate specific trends. Possibilities offered by the HHT are exposed, but also some limitations of decomposing the signals into so-called intrinsic mode functions (IMFs) are highlighted. The results of these preliminary studies are intended to be a basis for the development of new viable alternatives to the softwares currently used for the analysis and evaluation of pathological voice.

  5. Tempos máximos de fonação e características vocais acústicas de mulheres com nódulos vocais Maximum phonation time and vocal acoustic characteristics for women with vocal fold nodule

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    Carla Aparecida Cielo

    2011-06-01

    Full Text Available OBJETIVO: descrever os tempos máximos de fonação (TMF e características vocais acústicas de mulheres adultas jovens com nódulos vocais. MÉTODOS: coleta dos TMF das vogais /a/, /i/ e /u/; da relação s/z e medidas acústicas da fonte glótica (Multi Dimensional Voice Program Advanced da Kay PENTAX de 20 sujeitos do sexo feminino, com faixa etária entre 20 e 40 anos, dez com laudo otorrinolaringológico de nódulos vocais e dez com laudo de laringe normal. RESULTADOS: quanto aos TMF, o grupo sem nódulos (GSN apresentou 90% dos resultados normais e 10% diminuídos, e o grupo com nódulos (GCN apresentou 70% dos resultados normais e 30% diminuídos; na relação s/z, todo o GSN apresentou resultados dentro dos padrões da normalidade e o GCN apresentou 70% de resultados normais e 30% aumentados; ambos os grupos apresentaram todas as medidas vocais acústicas dentro da normalidade, com exceção do GSN que apresentou vf0 aumentada. CONCLUSÃO: as mulheres jovens com nódulos vocais apresentaram medidas de TMF e de relação s/z sem diferenças significativas em relação às mesmas medidas de mulheres sem afecção laríngea. As medidas acústicas da fonte glótica foram semelhantes e dentro da normalidade para ambos os grupos, com exceção da medida do cociente de variação de frequência fundamental (vf0 que foi elevada no GSN, sugerindo incoordenação penumofonoarticulatória. As medidas de TMF e da relação s/z, mesmo sem diferenças significativas, pareceram mais sensíveis à presença do predomínio aerodinâmico dos nódulos vocais do que as medidas acústicas.PURPOSE: to describe maximum phonation time (MPT and vocal acoustic characteristics for young adult women with vocal fold nodules. METHODS: collection of MPT of the vowels /a/, /i/ and /u/; s/z ratio and acoustic measures of the glottal source (Multi Dimensional Voice Program Advanced from Kay PENTAX of 20 female subjects, aged between 20 and 40 year old, being ten with

  6. Injeção de corticosteróide em patologias vocais inflamatórias crônicas, revisão da literatura Steroid injection in chronic inflammatory vocal fold disorders, literature review

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    Andrea Maria Campagnolo

    2008-12-01

    these situations: 1 acute inflammatory diseases, mainly when edema compromises the airways; 2 auto- immune disease with laryngeal involvement; 3 laryngeal stenosis; 4 benign lesions of the vocal folds, e.g., nodules, polyps and Reinke's edema, to reduce the inflammatory reactions before phonosurgery or in an attempt to avoid surgery; 5 In phonosurgery, aiming to reduce scarring. In this case, it could be used as a preventive measure in vocal fold scarring, or for scar treatment. CONCLUSION: Steroids may be considered an important therapeutic option in the management of many diseases, specially the inflammatory ones, associated with vocal changes.

  7. Predicting Achievable Fundamental Frequency Ranges in Vocalization Across Species.

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    Ingo Titze

    2016-06-01

    Full Text Available Vocal folds are used as sound sources in various species, but it is unknown how vocal fold morphologies are optimized for different acoustic objectives. Here we identify two main variables affecting range of vocal fold vibration frequency, namely vocal fold elongation and tissue fiber stress. A simple vibrating string model is used to predict fundamental frequency ranges across species of different vocal fold sizes. While average fundamental frequency is predominantly determined by vocal fold length (larynx size, range of fundamental frequency is facilitated by (1 laryngeal muscles that control elongation and by (2 nonlinearity in tissue fiber tension. One adaptation that would increase fundamental frequency range is greater freedom in joint rotation or gliding of two cartilages (thyroid and cricoid, so that vocal fold length change is maximized. Alternatively, tissue layers can develop to bear a disproportionate fiber tension (i.e., a ligament with high density collagen fibers, increasing the fundamental frequency range and thereby vocal versatility. The range of fundamental frequency across species is thus not simply one-dimensional, but can be conceptualized as the dependent variable in a multi-dimensional morphospace. In humans, this could allow for variations that could be clinically important for voice therapy and vocal fold repair. Alternative solutions could also have importance in vocal training for singing and other highly-skilled vocalizations.

  8. Vocal Cord Paralysis

    Science.gov (United States)

    ... therapy can sometimes be an option. Symptoms Vocal cords open and closed Vocal cords open and closed Your vocal cords are two ... Cardiovascular and Thoracic Research. 2014;6:47. Vocal cord paralysis Symptoms & causes Diagnosis & treatment Doctors & departments Advertisement ...

  9. Improvement of vocal pathologies diagnosis using high-speed videolaryngoscopy.

    Science.gov (United States)

    Tsuji, Domingos Hiroshi; Hachiya, Adriana; Dajer, Maria Eugenia; Ishikawa, Camila Cristina; Takahashi, Marystella Tomoe; Montagnoli, Arlindo Neto

    2014-07-01

    Introduction The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV) has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution. Objective To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies. Methods We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia). The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases) were assessed. Results Differences in the vocal vibration parameters were observed and correlated with the pathophysiology. Conclusion HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation.

  10. Improvement of Vocal Pathologies Diagnosis Using High-Speed Videolaryngoscopy

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    Tsuji, Domingos Hiroshi

    2014-04-01

    Full Text Available Introduction The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution. Objective To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies. Methods We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia. The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases were assessed. Results Differences in the vocal vibration parameters were observed and correlated with the pathophysiology. Conclusion HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation.

  11. Nonlinear phenomena in contemporary vocal music.

    Science.gov (United States)

    Neubauer, Jürgen; Edgerton, Michael; Herzel, Hanspeter

    2004-03-01

    Complex and multiphonic voice signals of vocal improvisors are analyzed within the framework of nonlinear dynamics. Evidence is given that nonlinear phenomena are extensively used by performers associated with contemporary music. Narrow-band spectrograms of complex vocalizations are used to visualize the appearance of nonlinear phenomena (spectral bifurcation diagrams). Possible production mechanisms are discussed in connection with previous research, personal performance and pedagogical experience. Examples for period doubling, biphonation and irregular aperiodic phonation in vocal sonorities of contemporary vocal improvisors are given, and glottal whistle production encompassed with biphonation and triphonation is shown. Furthermore, coincidences of harmonics-formant matching associated with abrupt transitions to subharmonics and biphonation in the vocal output are provided. This also shows the recurrent use of nonlinear phenomena by performers. It is argued that mechanisms such as source-tract coupling or vocal fold desynchronization due to asymmetry are used in a reproducible way for musical tasks.

  12. An Investigation of Vocal Tract Characteristics for Acoustic Discrimination of Pathological Voices

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    Jung-Won Lee

    2013-01-01

    Full Text Available This paper investigates the effectiveness of measures related to vocal tract characteristics in classifying normal and pathological speech. Unlike conventional approaches that mainly focus on features related to the vocal source, vocal tract characteristics are examined to determine if interaction effects between vocal folds and the vocal tract can be used to detect pathological speech. Especially, this paper examines features related to formant frequencies to see if vocal tract characteristics are affected by the nature of the vocal fold-related pathology. To test this hypothesis, stationary fragments of vowel /aa/ produced by 223 normal subjects, 472 vocal fold polyp subjects, and 195 unilateral vocal cord paralysis subjects are analyzed. Based on the acoustic-articulatory relationships, phonation for pathological subjects is found to be associated with measures correlated with a raised tongue body or an advanced tongue root. Vocal tract-related features are also found to be statistically significant from the Kruskal-Wallis test in distinguishing normal and pathological speech. Classification results demonstrate that combining the formant measurements with vocal fold-related features results in improved performance in differentiating vocal pathologies including vocal polyps and unilateral vocal cord paralysis, which suggests that measures related to vocal tract characteristics may provide additional information in diagnosing vocal disorders.

  13. Voice therapy and vocal nodules in adults.

    Science.gov (United States)

    Leonard, Rebecca

    2009-12-01

    This review considers recent and significant information pertinent to voice therapy for vocal nodules. Available evidence suggests that voice therapy directed to excessive, hyperfunctional and maladaptive vocal practices can be effective in improving voice quality and reducing size/extent of pathology. However, there is also a growing literature suggesting that behavioral approaches may not be sufficient to permanently heal tissue changes in some patients, regardless of compliance with treatment aims, due to lasting structural damage in the vocal fold cover. This evidence underscores the need for early identification and education in individuals at risk for nodules. The relationship between vocal nodules and excessive, phonotraumatic voice use is well established. Voice therapy typically consists of education regarding vocal fold mechanics and etiological factors, as well as modification of specific vocal practices that either cause, exacerbate or result from inappropriate voice production. Therapy can be effective in improving voice quality and tissue health but does not necessarily result in complete resolution of pathology. It should always be considered as a part of the treatment regimen for patients with vocal nodules.

  14. Laryngeal and vocal alterations after thyroidectomy.

    Science.gov (United States)

    Iyomasa, Renata Mizusaki; Tagliarini, José Vicente; Rodrigues, Sérgio Augusto; Tavares, Elaine Lara Mendes; Martins, Regina Helena Garcia

    2017-09-21

    Dysphonia is a common symptom after thyroidectomy. To analyze the vocal symptoms, auditory-perceptual and acoustic vocal, videolaryngoscopy, the surgical procedures and histopathological findings in patients undergoing thyroidectomy. Prospective study. Patients submitted to thyroidectomy were evaluated as follows: anamnesis, laryngoscopy, and acoustic vocal assessments. Moments: pre-operative, 1st post (15 days), 2nd post (1 month), 3rd post (3 months), and 4th post (6 months). Among the 151 patients (130 women; 21 men). Type of surgery: lobectomy+isthmectomy n=40, total thyroidectomy n=88, thyroidectomy+lymph node dissection n=23. Vocal symptoms were reported by 42 patients in the 1st post (27.8%) decreasing to 7.2% after 6 months. In the acoustic analysis, f0 and APQ were decreased in women. Videolaryngoscopies showed that 144 patients (95.3%) had normal exams in the preoperative moment. Vocal fold palsies were diagnosed in 34 paralyzes at the 1st post, 32 recurrent laryngeal nerve (lobectomy+isthmectomy n=6; total thyroidectomy n=17; thyroidectomy+lymph node dissection n=9) and 2 superior laryngeal nerve (lobectomy+isthmectomy n=1; Total thyroidectomy+lymph node dissection n=1). After 6 months, 10 patients persisted with paralysis of the recurrent laryngeal nerve (6.6%). Histopathology and correlation with vocal fold palsy: colloid nodular goiter (n=76; palsy n=13), thyroiditis (n=8; palsy n=0), and carcinoma (n=67; palsy n=21). Vocal symptoms, reported by 27.8% of the patients on the 1st post decreased to 7% in 6 months. In the acoustic analysis, f0 and APQ were decreased. Transient paralysis of the vocal folds secondary to recurrent and superior laryngeal nerve injury occurred in, respectively, 21% and 1.3% of the patients, decreasing to 6.6% and 0% after 6 months. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  15. What's the Difference Between Vocal Cord Dysfunction and Asthma?

    Science.gov (United States)

    ... may involve special breathing exercises called panting maneuvers, speech therapy, biofeedback and avoidance of irritants. With James T C Li, M.D., Ph.D. References Vocal Cord Dysfunction (VCD) or Paradoxical Vocal Fold Movement (PVFM). American Academy of Allergy Asthma and Immunology. ...

  16. Vocal Imitations of Non-Vocal Sounds.

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    Guillaume Lemaitre

    Full Text Available Imitative behaviors are widespread in humans, in particular whenever two persons communicate and interact. Several tokens of spoken languages (onomatopoeias, ideophones, and phonesthemes also display different degrees of iconicity between the sound of a word and what it refers to. Thus, it probably comes at no surprise that human speakers use a lot of imitative vocalizations and gestures when they communicate about sounds, as sounds are notably difficult to describe. What is more surprising is that vocal imitations of non-vocal everyday sounds (e.g. the sound of a car passing by are in practice very effective: listeners identify sounds better with vocal imitations than with verbal descriptions, despite the fact that vocal imitations are inaccurate reproductions of a sound created by a particular mechanical system (e.g. a car driving by through a different system (the voice apparatus. The present study investigated the semantic representations evoked by vocal imitations of sounds by experimentally quantifying how well listeners could match sounds to category labels. The experiment used three different types of sounds: recordings of easily identifiable sounds (sounds of human actions and manufactured products, human vocal imitations, and computational "auditory sketches" (created by algorithmic computations. The results show that performance with the best vocal imitations was similar to the best auditory sketches for most categories of sounds, and even to the referent sounds themselves in some cases. More detailed analyses showed that the acoustic distance between a vocal imitation and a referent sound is not sufficient to account for such performance. Analyses suggested that instead of trying to reproduce the referent sound as accurately as vocally possible, vocal imitations focus on a few important features, which depend on each particular sound category. These results offer perspectives for understanding how human listeners store and access

  17. Vocal Imitations of Non-Vocal Sounds

    Science.gov (United States)

    Houix, Olivier; Voisin, Frédéric; Misdariis, Nicolas; Susini, Patrick

    2016-01-01

    Imitative behaviors are widespread in humans, in particular whenever two persons communicate and interact. Several tokens of spoken languages (onomatopoeias, ideophones, and phonesthemes) also display different degrees of iconicity between the sound of a word and what it refers to. Thus, it probably comes at no surprise that human speakers use a lot of imitative vocalizations and gestures when they communicate about sounds, as sounds are notably difficult to describe. What is more surprising is that vocal imitations of non-vocal everyday sounds (e.g. the sound of a car passing by) are in practice very effective: listeners identify sounds better with vocal imitations than with verbal descriptions, despite the fact that vocal imitations are inaccurate reproductions of a sound created by a particular mechanical system (e.g. a car driving by) through a different system (the voice apparatus). The present study investigated the semantic representations evoked by vocal imitations of sounds by experimentally quantifying how well listeners could match sounds to category labels. The experiment used three different types of sounds: recordings of easily identifiable sounds (sounds of human actions and manufactured products), human vocal imitations, and computational “auditory sketches” (created by algorithmic computations). The results show that performance with the best vocal imitations was similar to the best auditory sketches for most categories of sounds, and even to the referent sounds themselves in some cases. More detailed analyses showed that the acoustic distance between a vocal imitation and a referent sound is not sufficient to account for such performance. Analyses suggested that instead of trying to reproduce the referent sound as accurately as vocally possible, vocal imitations focus on a few important features, which depend on each particular sound category. These results offer perspectives for understanding how human listeners store and access long

  18. Vocal efficiency measurements in subjects with vocal polyps and nodules: a preliminary report.

    Science.gov (United States)

    Jiang, Jack; Stern, Jennifer; Chen, Hui-Jun; Solomon, Nancy Pearl

    2004-04-01

    Vocal efficiency is a quantitative measure of the ability of the larynx to convert subglottal power to acoustic power. On the basis of the scant previous literature and clinical intuition, we tested the hypothesis that vocal efficiency, as an indicator of the functional status of the larynx, is abnormally reduced in persons with vocal nodules and polyps. Because the most difficult aspect of obtaining measures of vocal efficiency has been the determination of subglottal pressure, we applied a noninvasive airflow interruption technique for this purpose. Subjects with normal voices (n = 22), vocal polyps (n = 14), and vocal nodules (n = 16) phonated at different intensities into a mask connected by way of piping to a flow meter, a pressure transducer, and an acoustic microphone. Inflation of a balloon-type valve located within the piping provided interruption of phonation. The intraoral pressure plateau occurring during flow interruption was used to estimate subglottal pressure. Subglottal power and acoustic power were determined, and their quotient provided a measure of vocal efficiency. The vocal efficiency in the normal subjects averaged 1.15 x 10(-5) at 70 dB, 3.17 x 10(-5) at 75 dB, 7.52 x 10(-5) at 80 dB, and 1.41 x 10(-4) at 85 dB. The vocal efficiency in the patients with vocal polyps averaged 3.62 x 10(-6) at 70 dB, 8.34 x 10(-6) at 75 dB, 2.10 x 10(-5) at 80 dB, and 4.26 x 10(-5) at 85 dB. The vocal efficiency in the patients with vocal nodules averaged 4.32 x 10(-6) at 70 dB, 1.57 x 10(-5) at 75 dB, 4.26 x 10(-5) at 80 dB, and 8.34 x 10(-5) at 85 dB. As compared to the normal subjects, the patients with laryngeal polyps or vocal nodules had significantly reduced vocal efficiency. These results provide quantitative verification of the clinical impression of inefficient phonation in patients with mass lesions of the vocal folds.

  19. Fat augmentation following microsurgical removal of the vocal nodules.

    Science.gov (United States)

    Hsiung, Ming-Wang; Chen, Yen-Yu; Pai, Lu; Lin, Yaoh-Shiang; Kang, Bor-Hwang; Wang, Hsing-Won

    2002-08-01

    Autogenous fat augmentation has been used as a treatment for glottic insufficiency. However, no information is available on the effectiveness of fat injection in patients with vocal nodules or recurrent vocal nodules after surgery. The retrospective study reviews the efficiency of fat injection after surgery in patients with vocal nodules (n = 18) and recurrent vocal nodules (n = 5). The perceptual acoustic, phonatory function, and video laryngostroboscopic data were evaluated before and after surgery in 23 patients. Mean follow-up time was 7.5 months. Nineteen patients had excellent results. Two patients had improvement, and no change was observed in two patients. Phonatory function showed significant improvement in shimmer, harmonic-to-noiseratio (P vocal fold edge, amplitude of vocal fold vibration, and excursion of the mucosal wave (P vocal nodules than in nonrecurrent vocal nodules. Fat injection is an effective autogenous implant and may be considered as an option in management of patients with vocal nodules after surgery. Recurrence of nodules is a problem, but the procedure may be repeated.

  20. Arterial stiffness

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    Ursula Quinn

    2012-09-01

    Full Text Available Measurements of biomechanical properties of arteries have become an important surrogate outcome used in epidemiological and interventional cardiovascular research. Structural and functional differences of vessels in the arterial tree result in a dampening of pulsatility and smoothing of blood flow as it progresses to capillary level. A loss of arterial elastic properties results a range of linked pathophysiological changes within the circulation including increased pulse pressure, left ventricular hypertrophy, subendocardial ischaemia, vessel endothelial dysfunction and cardiac fibrosis. With increased arterial stiffness, the microvasculature of brain and kidneys are exposed to wider pressure fluctuations and may lead to increased risk of stroke and renal failure. Stiffening of the aorta, as measured by the gold-standard technique of aortic Pulse Wave Velocity (aPWV, is independently associated with adverse cardiovascular outcomes across many different patient groups and in the general population. Therefore, use of aPWV has been proposed for early detection of vascular damage and individual cardiovascular risk evaluation and it seems certain that measurement of arterial stiffness will become increasingly important in future clinical care. In this review we will consider some of the pathophysiological processes that result from arterial stiffening, how it is measured and factors that may drive it as well as potential avenues for therapy. In the face of an ageing population where mortality from atheromatous cardiovascular disease is falling, pathology associated with arterial stiffening will assume ever greater importance. Therefore, understanding these concepts for all clinicians involved in care of patients with cardiovascular disease will become vital.

  1. Effects of Voice Therapy on Vocal Acoustic Characteristics in Patients With Vocal Cord Nodules

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    Yunos Amiri Shavaki

    2011-09-01

    Full Text Available Background and Aim: Vocal cord nodule is one of the voice disorders causes hoarseness and breathy voice. Voice therapy is one of the treatment approaches. We aimed to find out the effects of voice therapy on vocal acoustic characteristics in these patients.Methods: In this case series, five women with vocal nodule (14 to 45-year-old participated in a 9-week voice therapy program developed by Boone. Vocal hygiene and voice practices were measured every day using a questionnaire. Moreover, structure and movements of vocal folds were examined using videolaryngostroboscope by a laryngologist before and after voice therapy to evaluate the effectiveness of program. For collecting voice samples we used sustained /æ/ in comfortable loudness for all patients and data were analyzed using Speech Studio.Results: After voice therapy, fundamental frequency in four of five subjects were decreased but it was not significant (p=0.225. However, jitter in all of five subjects was significantly decreased (p=0.043. After voice therapy, shimmer in three of five subjects were decreased that was not significant (p=0.345.Conclusion: Voice therapy can be used for the remedy of acoustic vocal characteristics and elimination or contraction of vocal cord nodule.

  2. Avaliação videoquimográfica da vibração de pregas vocais no pré e pós hidratação Videokymography assessment of vocal fold vibration before and after hydration

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    Reginaldo Fujita

    2004-12-01

    Full Text Available Manter o corpo hidratado é um dos fatores que contribuem para a saúde orgânica e funcional da laringe, principalmente nos profissionais da voz. Sabe-se que a hidratação é considerada fator muito importante na prevenção e tratamento de disfonias, porém não existem formas objetivas e não-invasivas de avaliação da quantidade de água nos tecidos da prega vocal. OBJETIVO: Avaliar as modificações na vibração da onda mucosa nas pregas vocais com o uso da videoquimografia após hidratação interna e externa em profissionais da voz. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Seis profissionais da voz, do sexo masculino, após a jornada de seis horas de trabalho sem ingestão de líquidos por um período de 4 horas, foram avaliados pelo médico otorrinolaringologista, utilizando-se a laringoscopia com e sem estroboscopia e videoquimografia. Os indivíduos foram avaliados antes e após terem sido submetidos à hidratação laríngea interna (ingestão de 300 ml de solução aquosa com eletrólitos, em temperatura ambiente e externa (com inalação de solução salina a 0,9% durante 10 minutos. Com o uso do videoquimógrafo, avaliamos o tempo de fase aberta e fechada durante fonação fazendo um quociente entre estes dois parâmetros. RESULTADOS: Encontramos cinco indivíduos com quociente reduzido e um aumentado. CONCLUSÃO: A videoquimografia foi capaz de detectar diferenças nas características vibratórias na onda mucosa das pregas vocais após hidratação da laringe.Keeping the body hydrated is one of the factors that contribute to organic and functional laryngeal health, especially for professional voice users. Hydration is considered an important factor for the prevention and treatment of dysphonias. There is no objective evaluation that quantifies water present in the vocal fold tissue. AIM: To evaluate changes in vocal folds investigated through videokymography after internal and external hydration of voice

  3. Angyomatous vocal polypus: a complete spontaneous regression

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    Edmir Américo Lourenço

    Full Text Available The authors describe a male patient who had malignant lymphoma seven years ago which remitted with chemotherapy.Two years ago he developed dysphonia. An unilateral, pediculate smooth red lesion on the right vocal fold was later discovered. Even without benefit of medicamentosus treatment, the patient refused surgery. In a reevaluation using rigid telescopy of the larynx two years later, the lesion had disappeared, completely and spontaneously. As there are no existing publications on this topic, this case report is an alert that surgery should be recommended with extreme caution in this type of vocal disease.

  4. Reinforcement of Infant Vocalizations through Contingent Vocal Imitation

    Science.gov (United States)

    Pelaez, Martha; Virues-Ortega, Javier; Gewirtz, Jacob L.

    2011-01-01

    Maternal vocal imitation of infant vocalizations is highly prevalent during face-to-face interactions of infants and their caregivers. Although maternal vocal imitation has been associated with later verbal development, its potentially reinforcing effect on infant vocalizations has not been explored experimentally. This study examined the…

  5. Vocal cord hemangioma in an adult

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    Muzaffer Kanlıkama

    2011-09-01

    Full Text Available Hemangioma is one of the most common benign tumors in the head and neck region. Laryngeal hemangiomas are benign vascular tumors of unknown etiology that arise from subglottic region with stridor in infants. This type also known as congenital laryngeal hemangioma, is the more common. Congenital hemangiomas occur usually in subglottic region and more frequent in girls. Laryngeal hemangioma in adults is a very rare condition and main symptom is hoarseness and breathing difficulties. Adult hemangiomas can be seen in different locations such as the epiglottis, aryepiglottic folds, arytenoids and false and true vocal cords. They are more often of cavernous form and cause hoarseness. In this report we present an adult patient with hemangioma of the left vocal fold and review the literature. Diagnostic investigation revealed a pink-purple mass which was extended from the anterior comissure to the posterior part of true vocal cord and false vocal cord, filling the ventricule and extending to supraglottic region. Direct laryngoscopy was performed, but the lesion was not excised because of its widespread extension in the larynx. J Clin Exp Invest 2010; 2(3: 323-326.

  6. A study of vocal nonlinearities in humpback whale songs: from production mechanisms to acoustic analysis

    Science.gov (United States)

    Cazau, Dorian; Adam, Olivier; Aubin, Thierry; Laitman, Jeffrey T.; Reidenberg, Joy S.

    2016-10-01

    Although mammalian vocalizations are predominantly harmonically structured, they can exhibit an acoustic complexity with nonlinear vocal sounds, including deterministic chaos and frequency jumps. Such sounds are normative events in mammalian vocalizations, and can be directly traceable to the nonlinear nature of vocal-fold dynamics underlying typical mammalian sound production. In this study, we give qualitative descriptions and quantitative analyses of nonlinearities in the song repertoire of humpback whales from the Ste Marie channel (Madagascar) to provide more insight into the potential communication functions and underlying production mechanisms of these features. A low-dimensional biomechanical modeling of the whale’s U-fold (vocal folds homolog) is used to relate specific vocal mechanisms to nonlinear vocal features. Recordings of living humpback whales were searched for occurrences of vocal nonlinearities (instabilities). Temporal distributions of nonlinearities were assessed within sound units, and between different songs. The anatomical production sources of vocal nonlinearities and the communication context of their occurrences in recordings are discussed. Our results show that vocal nonlinearities may be a communication strategy that conveys information about the whale’s body size and physical fitness, and thus may be an important component of humpback whale songs.

  7. Analysis of hyaluronic acid concentration in rat vocal folds during estral and gravidic puerperal cycles Análise da concentração do ácido hialurônico nas pregas vocais de ratas durante o ciclo estral e ciclo gravídico-puerperal

    Directory of Open Access Journals (Sweden)

    José Eduardo de Sá Pedroso

    2009-10-01

    Full Text Available Hormone plays an important role in the larynx. Among other substances, vocal folds contain hyaluronic acid, which tissue concentration may vary according to hormone action. AIM: the objective of this study is to analyze hyaluronic acid concentration in the vocal folds during estral and gravidic-puerperal cycles. MATERIALS AND METHODS: Experimental study. 40 adult rats were divided into two groups. In the first group we used 20 rats to establish the concentration of hyaluronic acid during the estral cycle and in the second group, 20 animals were submitted to the same procedure but during the gravidic-puerperal cycle. RESULTS: Variations in hyaluronic acid concentration was not observed during the estral cycle. In the gravidic puerperal cycle group, an increase in hyaluronic acid concentration was observed in the puerperal subgroup. Comparing the two groups of estral and gravidic-puerperal cycles, no difference was observed. CONCLUSIONS: In comparing all subgroups of estral and gravidic-puerperal cycles, an increase in hyaluronic acid concentration was noticed only in the puerperal phase.Os hormônios exercem importante influência sobre a laringe. A prega vocal contém, entre outras substâncias, o ácido hialurônico, cuja concentração nos tecidos pode variar com a ação dos hormônios. OBJETIVO: O objetivo deste trabalho é analisar comparativamente a concentração do ácido hialurônico nas pregas vocais de ratas durante o ciclo estral e ciclo gravídico-puerperal. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Foram utilizadas 40 ratas adultas, divididas em dois grupos, no primeiro grupo utilizamos 20 ratas para determinação da concentração do ácido hialurônico no ciclo estral, no segundo grupo, também de 20 animais, foi realizado o mesmo experimento no ciclo gravídico-puerperal. RESULTADOS: No grupo do ciclo estral não observou-se variação da concentração do ácido hialurônico. No grupo do ciclo grav

  8. A Systematic Review of Psychological Interventions for Adult and Pediatric Patients with Vocal Cord Dysfunction

    OpenAIRE

    Guglani, Loveleen; Atkinson, Sarah; Hosanagar, Avinash; Guglani, Lokesh

    2014-01-01

    Background: Vocal Cord Dysfunction (VCD) or Paradoxical Vocal Fold Motion (PVFM) is a functional disorder of the vocal cords that requires multidisciplinary treatment. Besides relaxation techniques, the use of psychological interventions can help treat the underlying psychological co-morbidities. There is currently no literature that examines the effectiveness of psychological interventions for VCD/PVFM. Objectives: To review the evidence for psychological interventions used for the treatment...

  9. The Anatomy of Vocal Divergence in North American Elk and European Red Deer

    Science.gov (United States)

    Frey, Roland; Riede, Tobias

    2014-01-01

    Loud and frequent vocalizations play an important role in courtship behavior in Cervus species. European red deer (Cervus elaphus) produce low-pitched calls, whereas North American elk (Cervus canadensis) produce high-pitched calls, which is remarkable for one of the biggest land mammals. Both species engage their vocal organs in elaborate maneuvers but the precise mechanism is unknown. Vocal organs were compared by macroscopic and microscopic dissection. The larynx is sexually dimorphic in red deer but not in elk. The laryngeal lumen is more constricted in elk, and narrows further during ontogeny. Several elements of the hyoid skeleton and two of four vocal tract segments are longer in red deer than in elk allowing greater vocal tract expansion and elongation. We conclude that elk submit the larynx and vocal tract to much higher tension than red deer, whereby, enormously stressed vocal folds of reduced effective length create a high resistance glottal source. The narrow, high impedance laryngeal vestibulum matches glottal and vocal tract impedance allowing maximum power transfer. In red deer longer and relaxed vocal folds create a less resistant glottal source and a wider vestibulum matches the low glottal impedance to the vocal tract, thereby also ensuring maximum power transfer. PMID:23225193

  10. Impacto vocal de professores Teachers' vocal impact

    Directory of Open Access Journals (Sweden)

    Adriana Ricarte

    2011-08-01

    Full Text Available OBJETIVO: analisar o impacto vocal nas atividades diárias em professores do ensino médio. Correlacionar os achado da auto-percepção do problema vocal com os aspectos: efeitos no trabalho, na comunicação diária, na comunicação social e na sua emoção. MÉTODOS: a amostra foi constituída por 107 professores, sendo 86 com queixa e 21 sem queixa, selecionados em escolas da rede particular de ensino de Maceió-AL. Cada professor respondeu individualmente o protocolo Perfil Participação em Atividades Vocais na presença da pesquisadora, assinalando suas respostas em uma escala visual que varia de 0 a 10. O protocolo é composto por 28 questões com a presença integrada em cinco aspectos englobados para avaliar a qualidade de vida e o resultado de tratamentos vocais. O protocolo oferece, ainda, dois escores adicionais: pontuação de limitação nas atividades (PLA e de restrição de participação (PRP. RESULTADOS: na comparação dos grupos com e sem queixa vocal foram verificados que todos os resultados foram estatisticamente significantes (pPURPOSE: to analyze the vocal impact in the daily activities on high-school teachers. Correlate the finding of the auto-perception on the vocal problem with the following aspects: effects in the work, daily communication, social communication and, its emotion METHODS: the sample consisted of 107 teachers, 86 with and 21 with no complaint, selected from private teaching schools in Maceió-AL. Each teacher answered individually the Protocol for Voice Activity Participation Profile in the presence of the researcher, noting their responses on a visual scale ranging from 0 to 10. The protocol is composed of 28 questions with the presence integrated in five aspects to evaluate the quality of life and the result of vocal treatments. The protocol offers, still, two additional scores: punctuation of limitation in the activities (PLA and restriction of participation (PRP. RESULTS: comparing the groups with

  11. Vocal Cord Nodules, Polyps, and Cysts

    Science.gov (United States)

    ... in three forms; nodules, polyps, and cysts. Vocal Cord Nodules (also called Singer's Nodes, Screamer's Nodes) Vocal ... when overuse of the area is stopped. Vocal Cord Polyp A vocal cord polyp typically occurs only ...

  12. Pediatric vocal nodules: correlation with perceptual voice analysis.

    Science.gov (United States)

    Shah, Rahul K; Woodnorth, Geralyn Harvey; Glynn, Amy; Nuss, Roger C

    2005-07-01

    To present the epidemiology and correlation with perceptual analysis of vocal nodules in pediatric patients. Retrospective review of patients seen in a tertiary care pediatric hospital's voice center from 1996 to 2003. Six hundred and forty-six patients were evaluated with videostroboscopic examinations and perceptual analysis of voice characteristics by speech pathologists. Appropriate treatment was based on the pathology identified. Two hundred and fifty-four patients (40%) with an average age of 7.7 years (range 0.1-19.3 years) were identified as having vocal nodules. Of these, 72% were male. Six patients (2%) were under the age of 7 months. Nodules were most commonly found in males, aged 3-10 years old. Evidence of gastro-esophageal reflux disease was found in one-quarter of patients; hyperfunction of the larynx was seen in three-fourths. Hyperfunction of the larynx correlates with the size of vocal nodules. Distortion of the vocal fold mucosal wave was not present. Perceptual analysis revealed positive correlation of the severity of hoarseness, breathiness, straining and aphonia with the size of vocal nodules. The epidemiology and correlation with perceptual voice analysis in pediatric patients with vocal nodules is presented. Hyperfunction of the larynx correlates with nodule size, while the presence of reflux disease does not. The severity of hoarseness, breathiness, straining and aphonia correlates with the size of vocal nodules.

  13. Do Talkativeness and Vocal Loudness Correlate With Laryngeal Pathology? A Study of the Vocal Overdoer/Underdoer Continuum.

    Science.gov (United States)

    Bastian, Robert W; Thomas, James P

    2016-09-01

    Assess the correlation between self-rating scales of talkativeness and loudness with various types of voice disorders. This is a retrospective study. A total of 974 patients were analyzed. The cohort study included 430 consecutive patients presenting to the senior author with voice complaints from December 1995 to December 1998. The case-control study added 544 consecutive patients referred to the same examiner from January 1988 to December 1998 for vocal fold examination before thyroid, parathyroid, and carotid surgery. Patient responses on seven-point Likert self-rating scales of talkativeness and loudness were compared with laryngeal disease. Mucosal lesions clearly associated with vibratory trauma are strongly associated with a high self-rating of talkativeness. Laryngeal deconditioning disorders were associated with a low self-rating of talkativeness. Use of a simple self-rating scale of vocal loudness and talkativeness during history taking can reliably orient the examiner to the types of voice disorders likely to be diagnosed subsequently during vocal capability testing and visual laryngeal examination. The high degree of talkativeness and loudness seen in vocal overdoers correlates well with mucosal disorders such as nodules, polyps, capillary ectasia, epidermoid inclusion cysts, and hemorrhage. A lower degree of talkativeness correlates with muscle deconditioning disorders such as vocal fold bowing, atrophy, presbyphonia, and vocal fatigue syndrome. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  14. Vocal Characteristics and Laryngoscopic Findings in Future Musical Theater Performers.

    Science.gov (United States)

    D'haeseleer, Evelien; Claeys, Sofie; Meerschman, Iris; Bettens, Kim; Degeest, Sofie; Dijckmans, Caroline; De Smet, Joke; Luyten, Anke; Van Lierde, Kristiane

    2017-07-01

    Musical theater performers are a special group of elite vocal performers with a high vocal load as they combine singing, acting, and physical performance. As they are absolutely depending on their voice quality and vocal capacities for their studies and their future profession, an optimal voice production is very important. The purpose of this study was to determine the voice quality of musical theater students. The voice quality of seven students was then reevaluated 1 year after the first assessment. Observational study. Thirty-one musical students (7 men and 24 women) with a mean age of 20 years participated in the study. To determine the voice quality, objective (aerodynamic measurements, voice range profile, acoustic analysis, and Dysphonia Severity Index) and subjective (videolaryngostroboscopy, Voice Handicap Indexes, and questionnaires regarding voice symptoms and risk factors) voice measurements were performed. The median Dysphonia Severity Index in male and female musical students was respectively 5.3 and 5.7, both corresponding with an overall good voice quality. The questionnaires revealed the presence of vocal fatigue, dryness of the throat, vocal tract discomfort, and harmful vocal habits in the majority of students. In 45% of the subjects, videolaryngostroboscopic evaluation of the vocal folds showed an organic lesion. The majority of these lesions are inflammatory lesions (26%). In 68% of the subjects, a certain degree of supraglottic constriction was observed. Despite the overall good voice quality, videolaryngostroboscopy showed a high presence of vocal fold lesions and supraglottic constriction during phonation. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  15. Vocal Qualities in Music Theater Voice: Perceptions of Expert Pedagogues.

    Science.gov (United States)

    Bourne, Tracy; Kenny, Dianna

    2016-01-01

    To gather qualitative descriptions of music theater vocal qualities including belt, legit, and mix from expert pedagogues to better define this voice type. This is a prospective, semistructured interview. Twelve expert teachers from United States, United Kingdom, Asia, and Australia were interviewed by Skype and asked to identify characteristics of music theater vocal qualities including vocal production, physiology, esthetics, pitch range, and pedagogical techniques. Responses were compared with published studies on music theater voice. Belt and legit were generally described as distinct sounds with differing physiological and technical requirements. Teachers were concerned that belt should be taught "safely" to minimize vocal health risks. There was consensus between teachers and published research on the physiology of the glottis and vocal tract; however, teachers were not in agreement about breathing techniques. Neither were teachers in agreement about the meaning of "mix." Most participants described belt as heavily weighted, thick folds, thyroarytenoid-dominant, or chest register; however, there was no consensus on an appropriate term. Belt substyles were named and generally categorized by weightedness or tone color. Descriptions of male belt were less clear than for female belt. This survey provides an overview of expert pedagogical perspectives on the characteristics of belt, legit, and mix qualities in the music theater voice. Although teacher responses are generally in agreement with published research, there are still many controversial issues and gaps in knowledge and understanding of this vocal technique. Breathing techniques, vocal range, mix, male belt, and vocal registers require continuing investigation so that we can learn more about efficient and healthy vocal function in music theater singing. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  16. Practical management: vocal cord dysfunction in athletes.

    Science.gov (United States)

    Wilson, John J; Wilson, Erin M

    2006-07-01

    Vocal cord dysfunction (VCD) is characterized by paradoxical adduction of the vocal folds during inhalation, and occasionally upon exhalation, resulting in extrathoracic airflow obstruction. Sports medicine professionals must have a high index of suspicion for VCD when acute respiratory symptoms occur so that prompt evaluation and use of appropriate specialists results in an accurate and timely diagnosis. Many factors have been implicated in the pathophysiology of VCD, including laryngeal irritants, psychogenic and neurogenic causes. The diagnosis and management of VCD involves a variety of specialties including pulmonology, otolaryngology, speech-language pathology, allergy and immunology, and psychologic management as appropriate. The mainstay of treatment remains behavioral management guided by a medical speech-language pathologist, as well as pharmacologic management for VCD triggers.

  17. Vocal tract dynamics in an adult stutterer

    Directory of Open Access Journals (Sweden)

    Lesley Wolk

    1981-08-01

    Full Text Available The present study was motivated by the clinical observation of "laryngeal spasms" during dysfluency in an adult female  stutterer. The flexible fiberoptic nasolaryngoscope was employed in an attempt to assess this phenomenon objectively. Findings from fiberscopic and spectrographic investigations provided evidence for a disturbance in laryngeal behaviour, and in turn served to determine the nature of the treatment programme. Asymmetry of the vocal folds  and partial abductory laryngeal behaviour, reflecting  a conflict between adductory and abductory forces, characterized the dysfluency  in this patient. A subjective evaluation after treatment revealed a reduction in both severity and frequency of stuttering behaviour. Furthermore, fiberscopic examination carried out after treatment revealed an absence of the laryngeal disturbances noted previously. Results are considered in terms of vocal tract dynamics in stuttering and its clinical applicability.

  18. Vocal tract dynamics in an adult stutterer

    Directory of Open Access Journals (Sweden)

    Lesley Wolk

    1981-11-01

    Full Text Available The present study was motivated by the clinical observation of "laryngeal spasms" during dysfluency in an adult female  stutterer. The flexible fiberoptic nasolaryngoscope was employed in an attempt to assess this phenomenon objectively. Findings from fiberscopic and spectrographic investigations provided evidence for a disturbance in laryngeal behaviour, and in turn served to determine the nature of the treatment programme. Asymmetry of the vocal folds  and partial abductory laryngeal behaviour, reflecting  a conflict between adductory and abductory forces, characterized the dysfluency  in this patient. A subjective evaluation after treatment revealed a reduction in both severity and frequency of stuttering behaviour. Furthermore, fiberscopic examination carried out after treatment revealed an absence of the laryngeal disturbances noted previously. Results are considered in terms of vocal tract dynamics in stuttering and its clinical applicability.

  19. Vocal cord paralysis.

    Science.gov (United States)

    Grundfast, K M; Harley, E

    1989-06-01

    The information presented in this article demonstrates that unilateral or bilateral vocal cord paresis or paralysis in infants and children is difficult to diagnose and difficult to manage. In an attempt to provide the otolaryngologist with a concise set of relevant guidelines, the following rules for management are presented here. 1. Suspect bilateral abductor vocal cord paralysis (BAVP) when a neonate or infant presents with high-pitched inspiratory stridor and evidence of airway compromise. Factors that should increase the suspicion of BAVP include associated Arnold-Chiari malformation; congenital anatomic abnormality involving the mediastinum (for example, tracheoesophageal fistula, vascular ring, other vascular anomalies); dysmorphic syndromes, especially those involving brainstem dysfunction; and manifest findings indicative of neuromuscular disorder. The neonate or infant with Arnold-Chiari malformation and inspiratory stridor has bilateral abductor vocal cord paralysis until proven otherwise. 2. Suspect unilateral vocal cord paresis or paralysis in an infant or child with hoarse voice, low-pitched cry, or breathy cry or voice. The infant who develops mild stridor and hoarse cry following surgical repair of a patent ductus arteriosus or tracheoesophageal fistula has a unilateral vocal cord paralysis until proven otherwise. 3. Direct laryngoscopy with the flexible fiberoptic nasopharyngolaryngoscope and photodocumentation using a videocassette recorder offers the best method for diagnosis of vocal cord paresis or paralysis. Additional diagnostic studies that may be helpful include radiographic studies, CT scan, MRI scan, electromyography of the larynx, and, in older children, stroboscopy. 4. In using a flexible direct laryngoscope be careful not to interpret all motions of the vocal cords or arytenoids as evidence to preclude the diagnosis of vocal cord paralysis or paresis and be careful not to mistake the anterior intraluminal portion of a normal cricoid

  20. Computer simulation of mucosal waves on vibrating human vocal folds

    Czech Academy of Sciences Publication Activity Database

    Vampola, T.; Horáček, Jaromír; Klepáček, I.

    2016-01-01

    Roč. 36, č. 3 (2016), s. 451-465 ISSN 0208-5216 R&D Projects: GA ČR GA16-01246S; GA ČR(CZ) GAP101/12/1306 Institutional support: RVO:61388998 Keywords : biomechanics of human voice * 3D FE model of human larynx * finite element method * proper orthogonal decomposition analysis Subject RIV: BI - Acoustics Impact factor: 1.031, year: 2016 http://ac.els-cdn.com/S0208521616300298/1-s2.0-S0208521616300298-main.pdf?_tid=e0b15360-28a9-11e6-9119-00000aab0f27&acdnat=1464862256_9ef3bcd835b40b3ce495106c65295508

  1. A subharmonic vibratory pattern in normal vocal folds

    NARCIS (Netherlands)

    Svec, JG; Schutte, HK; Miller, DG

    This study observes in detail an F-0/2 (sounding an octave below an original tone) subharmonic vibratory pattern produced in a normal larynx. Simultaneous electroglottographic and photoglottographic measurements reveal two different open phases within a subharmonic cycle-the first shorter with a

  2. Estimating Gear Teeth Stiffness

    DEFF Research Database (Denmark)

    Pedersen, Niels Leergaard

    2013-01-01

    The estimation of gear stiffness is important for determining the load distribution between the gear teeth when two sets of teeth are in contact. Two factors have a major influence on the stiffness; firstly the boundary condition through the gear rim size included in the stiffness calculation...... and secondly the size of the contact. In the FE calculation the true gear tooth root profile is applied. The meshing stiffness’s of gears are highly non-linear, it is however found that the stiffness of an individual tooth can be expressed in a linear form assuming that the contact length is constant....

  3. Sleep disordered breathing as a delayed complication of iatrogenic vocal cord trauma

    Science.gov (United States)

    Faiz, Saadia A.; Bashoura, Lara; Kodali, Lavanya; Hessel, Amy C.; Evans, Scott E.; Balachandran, Diwakar

    2017-01-01

    A case of a 55 year old woman with iatrogenic vocal cord trauma and sleep related symptoms is reported. In particular this case highlights sleep disordered breathing as a delayed complication after iatrogenic vocal cord trauma. The patient developed acute stridor from a contralateral vocal cord hematoma following vocal fold injection for right vocal cord paralysis. Acute respiratory symptoms resolved with oxygen, steroids and nebulized therapy, but nocturnal symptoms persisted and polysomnography revealed sleep-related hypoventilation and mild obstructive sleep apnea. Positive pressure therapy was successfully used to ameliorate her symptoms and treat sleep disordered breathing until her hematoma resolved. In addition to the typically acute respiratory symptoms that may result from vocal cord dysfunction, sleep disordered breathing may also present as a significant sub-acute or chronic problem. Management of the acute respiratory symptoms is relatively well established, but clinicians should be alert for more subtle nocturnal symptoms that may require further study with polysomnography. PMID:27544828

  4. Gastroesophageal reflux disease and vocal disturbances

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Coelho de Arruda Henry

    2011-06-01

    Full Text Available CONTEXT: Gastroesophageal reflux disease is a chronic disease in which gastroduodenal contents reflux into the esophagus. The clinical picture of gastroesophageal reflux disease is usually composed by heartburn and regurgitation (typical manifestations. Atypical manifestations (vocal disturbances and asthma may also be complaint. OBJECTIVE: To analyse the clinical, endoscopic, manometric and pHmetric aspects of patients suffering from gastroesophageal reflux disease associated with vocal disturbances. METHODS: Fifty patients with gastroesophageal reflux disease were studied, including 25 with vocal disturbances (group 1 - G1 and 25 without these symptoms (group 2 - G2. All patients were submitted to endoscopy, manometry and esophageal pHmetry (2 probes. The group 1 patients were submitted to videolaryngoscopy. RESULTS: Endoscopic findings: non-erosive reflux disease was observed in 95% of G1 patients and 88% of G2. Videolaryngoscopy: vocal fold congestion, asymmetry, nodules and polyps were observed in G1 patients. Manometric findings: pressure in the lower esophageal sphincter (mm Hg: 11.6 ± 5.2 in G1 and 14.0 ± 6.2 in G2 (P = 0.14; pressure in the upper esophageal sphincter (mm Hg: 58.4 ± 15.9 in G1 and 69.5 ± 30.7 in the controls. pHmetric findings: De Meester index: 34.0 ± 20.9 in G1 and 15.4 ± 9.4 in G2 (P<0.001; number of reflux episodes in distal probe: 43.0 ± 20.4 in G1 and 26.4 ± 17.2 in G2 (P = 0.003; percentage of time with esophageal pH value lower than 4 units (distal sensor: 9.0% ± 6.4% in G1 and 3.4% ± 2.1% in G2 (P<0.001; number of reflux episodes in proximal probe: 7.5 ± 10.9 in G1 and 5.3 ± 5.7 in G2 (P = 0.38; percentage of time with esophageal pH values lower than 4 units (Proximal probe: 1.2 ± 2.7 in G1 and 0.5 ± 0.7 in G2 (P = 0.21. CONCLUSIONS: 1 The clinical, endoscopic, and manometric findings observed in patients with vocal disturbance do not differ from those without these symptoms; 2 gastroesophageal

  5. Vocal nodules and edema may be due to vibration-induced rises in capillary pressure.

    Science.gov (United States)

    Czerwonka, Lukasz; Jiang, Jack J; Tao, Chao

    2008-04-01

    Vocal fold vibration may physically raise intravascular pressure to levels high enough to damage capillaries and result in leakage of erythrocytes. This type of injury is commonly seen in benign vocal fold lesions and is not well explained. Theoretical, retrospective. The relationship of intravascular pressure to vibration frequency and amplitude is derived and confirmed with a physical blood vessel model, then applied to published human measurements to estimate human intravascular pressures. Vocal fold intravascular pressure is predicted to have a quadratic dependence on both frequency and amplitude. During speaking, the pressure may rise to over 20 cmH2O, and may reach levels far higher for screaming and singing. Such pressure magnitudes are known to trigger inflammatory cascades and can lead to fluid leakage. They also have the potential for pharmacologic control with beta-agonists. Intravascular pressure likely rises significantly during vocal fold vibration and may lead to the type of injury seen in benign vocal fold lesions. The results support voice therapy aimed at reducing vibratory amplitude. More vibratory amplitude measurements need to be performed in a wider range of subjects before the full range of human vocal fold vascular pressures can be estimated.

  6. 'Stiff-person'-syndroom

    NARCIS (Netherlands)

    Vogels, R. L.; van Orshoven, N. P.; de Koning-Tijssen, M. A.; Wouda, E. J.

    2003-01-01

    In two patients, a man aged 54 years and a woman aged 49 years, stiff-person syndrome was diagnosed. This is a rare disorder of the central nervous system, with signs of an autoimmune pathogenesis. Patients present with pain and stiffness of the lower back, a complaint that is regularly seen in

  7. Effect of pneumotach on measurement of vocal function

    Science.gov (United States)

    Walters, Gage; McPhail, Michael; Krane, Michael

    2017-11-01

    Aerodynamic and acoustic measurements of vocal function were performed in a physical model of the human airway with and without a pneumotach (Rothenberg mask), used by clinicians to measure vocal volume flow. The purpose of these experiments was to assess whether the device alters acoustic and aerodynamic conditions sufficiently to change phonation behavior. The airway model, which mimics acoustic behavior of an adult human airway from trachea to mouth, consists of a 31.5cm long straight duct with a 2.54cm square cross section. Model vocal folds comprised of molded silicone rubber were set into vibration by introducing airflow from a compressed air source. Measurements included transglottal pressure difference, mean volume flow, vocal fold vibratory motion, and sound pressure measured at the mouth. The experiments show that while the pneumotach imparted measurable aerodynamic and acoustic loads on the system, measurement of mean glottal resistance was not affected. Acoustic pressure levels were attenuated, however, suggesting clinical acoustic measurements of vocal function need correction when performed in conjunction with a pneumotach Acknowledge support from NIH DC R01005642-11.

  8. Numerical simulation of deformation of dynamic mesh in the human vocal tract model

    Directory of Open Access Journals (Sweden)

    Řidký Václav

    2015-01-01

    Full Text Available Numerical simulation of the acoustic signal generation in the human vocal tract is a very complex problem. The computational mesh is not static; it is deformed due to vibration of vocal folds. Movement of vocal folds is in this case prescribed as function of translation and rotation. A new boundary condition for the 2DOF motion of the vocal folds was implemented in OpenFOAM, an open-source software package based on finite volume method Work is focused on the dynamic mesh and deformation of structured meshes in the computation a package OpenFOAM. These methods are compared with focus onquality of the mesh (non-orthogonality, aspect ratio and skewness.

  9. Numerical simulation of deformation of dynamic mesh in the human vocal tract model

    Science.gov (United States)

    Řidký, Václav; Šidlof, Petr

    2015-05-01

    Numerical simulation of the acoustic signal generation in the human vocal tract is a very complex problem. The computational mesh is not static; it is deformed due to vibration of vocal folds. Movement of vocal folds is in this case prescribed as function of translation and rotation. A new boundary condition for the 2DOF motion of the vocal folds was implemented in OpenFOAM, an open-source software package based on finite volume method Work is focused on the dynamic mesh and deformation of structured meshes in the computation a package OpenFOAM. These methods are compared with focus onquality of the mesh (non-orthogonality, aspect ratio and skewness).

  10. Acoustic analysis of primate air sacs and their effect on vocalization

    NARCIS (Netherlands)

    de Boer, B.

    2009-01-01

    This paper presents an analysis of the acoustic impedance of primate air sacs and their interaction with the vocal tract. A lumped element model is derived and it is found that the inertance of the neck and the volume of the air sac are relevant, as well as the mass and stiffness of the walls

  11. Efeito imediato de técnicas vocais em mulheres sem queixa vocal Immediate effect of vocal techniques in women without vocal complaint

    Directory of Open Access Journals (Sweden)

    Eliane Cristina Pereira

    2011-10-01

    Full Text Available OBJETIVO: verificar o efeito imediato das técnicas vocais vibração, som nasal e sobrearticulação na voz e na laringe de mulheres sem queixas vocais. MÉTODO: participaram da pesquisa 32 sujeitos do sexo feminino, com idades entre 20 e 45 anos, sem queixas vocais, com qualidade vocal avaliada entre normal e alteração de grau leve Os sujeitos foram submetidos à análise perceptivo-auditiva pela escala visual analógica da vogal /ε/ e fala espontânea, análise acústica e laringoestroboscopia antes e após a realização das técnicas. RESULTADOS: a análise perceptivo-auditiva revelou melhora significante dos parâmetros impressão global da voz, rouquidão e estabilidade na vogal /ε/ e articulação na fala espontânea. A análise acústica evidenciou melhora significante do jitter e shimmer. A laringoestroboscopia evidenciou significante melhora no fechamento glótico e melhora na movimentação muco-ondulatória das pregas vocais. CONCLUSÃO: as técnicas vocais estudadas são capazes de proporcionar melhora imediata significante da qualidade vocal e da configuração laríngea.PURPOSE: to check the immediate effect of vocal techniques: vibration, nasal sound and overarticulation. METHOD: 32 female subjects with normal to mild dysphonia took part in the study, with ages from 20 to 45 years. Subjects were submitted to perceptual analysis and laryngostroboscopic exams before and after the use of vocal techniques. RESULTS: subjects' vocal classification in perceptual analysis after accomplishing the vocal techniques showed significant improvement on parameters voice global impression, hoarseness and stability; and, in spontaneous speech, one showed a significant improvement on the parameter articulation. The acoustic analysis evidenced significant improvement of the jitter and shimmer. Laryngostroboscopic examination evidenced a significant increase in the glottic closing and an increase in the mucondulatory movement of the vocal folds

  12. Vocally disruptive behavior.

    Science.gov (United States)

    White, M K; Kaas, M J; Richie, M F

    1996-11-01

    Vocally disruptive behavior (VDB) is intelligible or unintelligible noise making that may be goal-directed or purposeless. VDB can be conceptualized as a cyclic phenomenon. VDB has been linked to cognitive impairment, poor sleep, requiring assistance with ADLs, and being at high risk for falling. General nursing interventions for VDB include remaining calm, using gentle touch, creating a familiar, home-like environment, and using diversions during ADLs.

  13. The Relationship between Relative Fundamental Frequency and a Kinematic Estimate of Laryngeal Stiffness in Healthy Adults

    Science.gov (United States)

    McKenna, Victoria S.; Heller Murray, Elizabeth S.; Lien, Yu-An S.; Stepp, Cara E.

    2016-01-01

    Purpose: This study examined the relationship between the acoustic measure relative fundamental frequency (RFF) and a kinematic estimate of laryngeal stiffness. Method: Twelve healthy adults (mean age = 22.7 years, SD = 4.4; 10 women, 2 men) produced repetitions of /ifi/ while varying their vocal effort during simultaneous acoustic and video…

  14. Vocal Body, Gender and Performance

    Directory of Open Access Journals (Sweden)

    Daiane Dordete Steckert Jacobs

    2017-05-01

    Full Text Available The text discusses scientific and artistic discourses from the perspective of vocalities gendering, which assigns specific and binary gender marks to bodies. For this, it contextualizes the territory of Feminist Critique and Gender Theories, mainly based on the thoughts of the feminist philosopher Judith Butler, who approaches sex and gender as naturalized cultural constructions. It points, in this context, to a view of biological determinism implied in these discourses concerning the voice, which naturalizes vocal production from physiological aspects of vocal bodies, limiting the understanding of training and vocal creation in the arts.

  15. Effect of performance time of the high-pitched blowing vocal exercise in the voice of women.

    Science.gov (United States)

    Moreira, Fabíola Santos; Gama, Ana Cristina Côrtes

    2017-02-16

    To analyze the results of the runtimes of one, three, five, and seven minutes of the high-pitched blowing vocal exercise in women without voice complaints and with dysphonia and vocal nodules. This is an experimental study with a consecutive and convenience sample of 60 women divided into two groups: 30 participants with dysphonia caused by vocal fold nodules (study group - SG) and 30 participants without vocal complaints (control group - CG). All participants performed the high-pitched blowing vocal exercise for one, three, five, and seven minutes. Sustained vowels /a/ and counting from one to ten were recorded before and after each exercise runtime. The recordings were randomized and evaluated by comparison task by four speech-language pathologists using the parameters grade of vocal deviation, roughness, breathiness, asthenia, strain and instability (GRBASI). The acoustic parameters analyzed were fundamental frequency, jitter, shimmer, period perturbation quotient, amplitude perturbation quotient, and harmonics-to-noise ratio. After each vocal exercise runtime, the participants responded whether they had felt vocal discomfort using a visual analogue scale. Auditory-perceptual analysis in the SG showed improved overall severity of dysphonia and breathiness after three minutes and worsening of these acoustic parameters after seven minutes of exercise performance. Participants in the SG reported self-perception of vocal discomfort after seven minutes of exercise performance. The ideal prescription time for the high-pitched blowing vocal exercise in dysphonic women is three minutes; worsening of voice quality and perception of vocal discomfort occurs after seven minutes.

  16. Surgical versus non-surgical interventions for vocal cord nodules.

    Science.gov (United States)

    Pedersen, Mette; McGlashan, Julian

    2012-06-13

    This is an update of a Cochrane review first published in The Cochrane Library in Issue 2, 2001 and previously updated in 2007 and 2009.Vocal cord nodules are bilateral, benign, callous-like growths of the mid-portion of the membranous vocal folds. They are of variable size and are characterised histologically by thickening of the epithelium with a variable degree of inflammation in the underlying superficial lamina propria. They characteristically produce hoarseness, discomfort and an unstable voice when speaking or singing. To assess the effectiveness of surgery versus non-surgical interventions for vocal cord nodules. We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the most recent search was 9 April 2012. Randomised and quasi-randomised trials comparing any surgical intervention for vocal cord nodules with non-surgical treatment or no treatment. No suitable trials were identified. No studies fulfilled the inclusion criteria. There is a need for high-quality randomised controlled trials to evaluate the effectiveness of surgical and non-surgical treatment of vocal cord nodules.

  17. Effect of Vocal Fry on Voice and on Velopharyngeal Sphincter

    Directory of Open Access Journals (Sweden)

    Elias, Vanessa Santos

    2016-01-01

    Full Text Available Introduction It is known that the basal sound promotes shortening and adduction of the vocal folds and leaves the mucosa looser. However there are few studies that address the supralaryngeal physiological findings obtained using the technique. Objective To check the effectiveness of using vocal fry on the voice and velopharingeal port closure of five adult subjects, whose cleft palate has been corrected with surgery. Methods Case study with five subjects who underwent otolaryngology examination by means of nasopharyngoscopy for imaging and measurement of the region of velopharyngeal port closure before and after using the vocal fry technique for three minutes. During the exam, the subjects sustained the isolated vowel /a:/ in their usual pitch and loudness. The emission of the vowel /a:/ was also used for perceptual analysis and spectrographic evaluation of their voices. Results Four subjects had an improvement in the region of velopharyngeal port closure; the results of the spectrographic evaluation were indicative of decreased hypernasality, and the results of the auditory-perceptual analysis suggested improved overall vocal quality, adequacy of loudness, decreased hypernasality, improvement of type of voice and decreased hoarseness. Conclusion This study showed a positive effect of vocal fry on voice and greater velopharyngeal port closure.

  18. Computational acoustic modeling of cetacean vocalizations

    Science.gov (United States)

    Gurevich, Michael Dixon

    A framework for computational acoustic modeling of hypothetical vocal production mechanisms in cetaceans is presented. As a specific example, a model of a proposed source in the larynx of odontocetes is developed. Whales and dolphins generate a broad range of vocal sounds, but the exact mechanisms they use are not conclusively understood. In the fifty years since it has become widely accepted that whales can and do make sound, how they do so has remained particularly confounding. Cetaceans' highly divergent respiratory anatomy, along with the difficulty of internal observation during vocalization have contributed to this uncertainty. A variety of acoustical, morphological, ethological and physiological evidence has led to conflicting and often disputed theories of the locations and mechanisms of cetaceans' sound sources. Computational acoustic modeling has been used to create real-time parametric models of musical instruments and the human voice. These techniques can be applied to cetacean vocalizations to help better understand the nature and function of these sounds. Extensive studies of odontocete laryngeal morphology have revealed vocal folds that are consistently similar to a known but poorly understood acoustic source, the ribbon reed. A parametric computational model of the ribbon reed is developed, based on simplified geometrical, mechanical and fluid models drawn from the human voice literature. The physical parameters of the ribbon reed model are then adapted to those of the odontocete larynx. With reasonable estimates of real physical parameters, both the ribbon reed and odontocete larynx models produce sounds that are perceptually similar to their real-world counterparts, and both respond realistically under varying control conditions. Comparisons of acoustic features of the real-world and synthetic systems show a number of consistencies. While this does not on its own prove that either model is conclusively an accurate description of the source, it

  19. Local steroid injection via the cricothyroid membrane in patients with a vocal nodule.

    Science.gov (United States)

    Lee, Sang-Hyuk; Yeo, Jang-Ok; Choi, Jeong-Im; Jin, Hee-Jin; Kim, Jin-Pyeong; Woo, Seung-Hoon; Jin, Sung-Min

    2011-10-01

    To analyze the usefulness and safety of a steroid injection into vocal nodules via the cricothyroid membrane. Local administration of steroid directly into the larynx has been reported in many laryngeal diseases with different methods. Prospective case series at an academic tertiary care hospital. Eighty patients with vocal nodules were enrolled between December 2008 and May 2010. Triamcinolone acetonide was injected through the cricothyroid membrane with a transnasal flexible laryngoscope to patients in a sitting position. Vocal nodules were evaluated before and 2 and 4 weeks after the injection; improvement was assessed both objectively and subjectively. The nodules disappeared in 35 patients by the fourth week after the injection (44%), and 39 patients showed improvement (49%). Jitter, shimmer, maximum phonation time, and mean voice handicap index also improved significantly after the steroid injection (P nodules had recurred after 4 weeks. Four patients experienced mild vocal fold atrophy, and 2 patients showed a white plaque formation on the vocal fold that resolved spontaneously 1 to 2 months after the injection. A local steroid injection via the cricothyroid membrane is a useful and safe treatment option for vocal nodules. However, vocal nodules are caused mainly by excessive voice use; therefore, nodules can recur unless the voice use pattern changes. Further study of this treatment technique, including long-term follow-up, is needed.

  20. Stiff quantum polymers

    OpenAIRE

    Kleinert, H.

    2009-01-01

    At ultralow temperatures, polymers exhibit quantum behavior, which is calculated here for the second and fourth moments of the end-to-end distribution in the large-stiffness regime. The result should be measurable for polymers in wide optical traps.

  1. Vocal therapy of hyperkinetic dysphonia

    Directory of Open Access Journals (Sweden)

    Mumović Gordana

    2014-01-01

    Full Text Available Introduction. Hyperkinetic (hyperfunctional dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. Objective. The objective of this study was to evaluate the effects of vocal therapy on voice condition characterized by hyperkinetic dysphonia with prenodular lesions and soft nodules. Methods. The study included 100 adult patients and 27 children aged 4-16 years with prenodular lesions and soft nodules. A subjective acoustic analysis using the GIRBAS scale was performed prior to and after vocal therapy. Twenty adult patients and 10 children underwent objective acoustic analysis including several acoustic parameters. Pathological vocal qualities (hoarse, harsh and breathy voice were also obtained by computer analysis. Results. The subjective acoustic analysis revealed a significant (p<0.01 reduction in all dysphonia parameters after vocal treatment in adults and children. After treatment, all levels of dysphonia were lowered in 85% (85/100 of adult patients and 29% (29/100 had a normal voice. Before vocal therapy 9 children had severe, 13 had moderate and 8 slight dysphonia. After vocal therapy only 1 child had severe dysphonia, 7 had moderate, 10 had slight levels of dysphonia and 9 were without voice disorder. The objective acoustic analysis in adults revealed a significant improvement (p≤0.025 in all dysphonia parameters except SD F0 and jitter %. In children, the acoustic parameters SD F0, jitter % and NNE (normal noise energy were significantly improved (p=0.003-0.03. Pathological voice qualities were also improved in adults and children (p<0.05. Conclusion. Vocal therapy effectively improves the voice in hyperkinetic dysphonia with prenodular lesions and soft nodules in both adults and children, affecting diverse acoustic parameters.

  2. Physiologically driven avian vocal synthesizer

    Science.gov (United States)

    Sitt, Jacobo D.; Arneodo, Ezequiel M.; Goller, Franz; Mindlin, Gabriel B.

    2010-03-01

    In this work, we build an electronic syrinx, i.e., a programmable electronic device capable of integrating biomechanical model equations for the avian vocal organ in order to synthesize song. This vocal prosthesis is controlled by the bird’s neural instructions to respiratory and the syringeal motor systems, thus opening great potential for studying motor control and its modification by sensory feedback mechanisms. Furthermore, a well-functioning subject-controlled vocal prosthesis can lay the foundation for similar devices in humans and thus provide directly health-related data and procedures.

  3. On gear tooth stiffness evaluation

    DEFF Research Database (Denmark)

    Pedersen, Niels Leergaard; Jørgensen, Martin Felix

    2014-01-01

    The estimation of gear stiffness is important for determining the load distribution between the gear teeth when two sets of teeth are in contact. Two factors have a major influence on the stiffness; firstly the boundary condition through the gear rim size included in the stiffness calculation...

  4. Epidemiological study on vocal disorders in paediatric age.

    Science.gov (United States)

    Angelillo, N; Di Costanzo, B; Angelillo, M; Costa, G; Barillari, M R; Barillari, U

    2008-03-01

    Few studies analyzed the diffusion of vocal alterations especially in childhood. Aim of our study was to quantify the numbers of subjects, in paediatric age, in which dysphonia was diagnosed in our department of Phoniatrics, during a period of 5 years, (January 2002-December 2006), and also to evaluate the influence of some potential risk factors. In the considered period it emerged that the diagnosis of dysphonia was made in 312 children (17.2% of the patients affected from dysphonia), aged between 2 and 16-years-old, with a major prevalence amongst males (57%) than females (43%). On the contrary in the adult population the prevalence was: 23% in males and 77% in females. In paediatric population, the most affected range of age is the one between 8 and 14, in both male and female gender (59.6%). In 82.4% of the cases there were vocal fold lesions. The 90.3% of children with vocal fold alterations presented lesions secondary to vocal abuse and misuse and classifiable as functional dysphonia. The proportion of functional dysphonia in our sample was 92%. The 65% of children belonged to large families with more than two children, and the 30% had a family history of dysphonia (brothers, parents). The study of the behavioural characteristics has shown aggressive and hyperactive attitudes in 83% of the cases. Since in the ethiopathogenesis of the childhood dysphonia the tendency to vocal abuse has a predominant role, it would be useful to encourage the diffusion of programmes of information to show the risks linked to this abuse in children, in order to prevent the development of dysphonia in paediatric age.

  5. The Effects of Amplification on Vocal Dose in Teachers with Dysphonia.

    Science.gov (United States)

    Assad, Joana Perpetuo; Gama, Ana Cristina Côrtes; Santos, Juliana Nunes; de Castro Magalhães, Max

    2017-11-06

    The purpose of this study was to determine if voice amplification influenced vocal dose in female teachers with dysphonia. This was an experimental study with comparative intrasubjects in which 15 individuals were compared in two different moments: condition 1 (C1) without voice amplification and condition 2 (C2) with voice amplification. All of them were female, kindergarten and elementary school teachers who presented organic or functional dysphonia. The search was carried out at the school where the teachers work. The professional voice use was considered the teachers' activity for a continuous period of two classes (average recording time of 96 minutes, with no difference in time between C1 and C2). To measure the dose we used the vocal dosimeter composed of a microphone, an accelerometer fixed to the neck, and a portable unit that stores the vocal data. The phonation data (intensity, fundamental frequency, phonation percentage, cycle dose, and distance dose) were analyzed by the equipment software (VoxLog). The use of vocal amplification in teachers promotes a reduction of the fundamental frequency (295.6-267.7 Hz), the voice intensity (96.2-93.3 dB sound pressure level), the cycle doses (489.4-345.2 thousand cycles per second), and distance doses (3,800-2,300 m). The vocal amplification allows the teacher to maintain the same phonation time (phonation percentage) but decreases the number of vocal fold oscillations (cycle dose) and the total distance traveled by the vocal fold tissue during phonation (distance dose), reducing the exposure of the vocal folds to voice trauma. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  6. Vocal therapy of hyperkinetic dysphonia.

    Science.gov (United States)

    Mumović, Gordana; Veselinović, Mila; Arbutina, Tanja; Škrbić, Renata

    2014-01-01

    Hyperkinetic (hyperfunctional) dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. The objective of this study was to evaluate the effects of vocal therapy on voice condition characterized by hyperkinetic dysphonia with prenodular lesions and soft nodules. The study included 100 adult patients and 27 children aged 4-16 years with prenodular lesions and soft nodules. A subjective acoustic analysis using the GIRBAS scale was performed prior to and after vocal therapy. Twenty adult patients and 10 children underwent objective acoustic analysis including several acoustic parameters. Pathological vocal qualities (hoarse, harsh and breathy voice) were also obtained by computer analysis. The subjective acoustic analysis revealed a significant (pvocal treatment in adults and children. After treatment, all levels of dysphonia were lowered in 85% (85/100) of adult patients and 29% (29/100) had a normal voice. Before vocal therapy 9 children had severe, 13 had moderate and 8 slight dysphonia. After vocal therapy only 1 child had severe dysphonia, 7 had moderate, 10 had slight levels of dysphonia and 9 were without voice disorder. The objective acoustic analysis in adults revealed a significant improvement (p≤0.025) in all dysphonia parameters except SD FO and jitter %. In children, the acoustic parameters SD FO, jitter % and NNE (normal noise energy) were significantly improved (p=0.003-0.03). Pathological voice qualities were also improved in adults and children (pVocal therapy effectively improves the voice in hyperkinetic dysphonia with prenodular lesions and soft nodules in both adults and children, affectinq diverse acoustic parameters.

  7. Elasticity of Stiff Biopolymers

    OpenAIRE

    Ghosh, Abhijit; Samuel, Joseph; Sinha, Supurna

    2007-01-01

    We present a statistical mechanical study of stiff polymers, motivated by experiments on actin filaments and the considerable current interest in polymer networks. We obtain simple, approximate analytical forms for the force-extension relations and compare these with numerical treatments. We note the important role of boundary conditions in determining force-extension relations. The theoretical predictions presented here can be tested against single molecule experiments on neurofilaments and ...

  8. Vocal differentiation parallels development of auditory saccular sensitivity in a highly soniferous fish.

    Science.gov (United States)

    Vasconcelos, Raquel O; Alderks, Peter W; Ramos, Andreia; Fonseca, Paulo J; Amorim, M Clara P; Sisneros, Joseph A

    2015-09-01

    Vocal differentiation is widely documented in birds and mammals but has been poorly investigated in other vertebrates, including fish, which represent the oldest extant vertebrate group. Neural circuitry controlling vocal behaviour is thought to have evolved from conserved brain areas that originated in fish, making this taxon key to understanding the evolution and development of the vertebrate vocal-auditory systems. This study examines ontogenetic changes in the vocal repertoire and whether vocal differentiation parallels auditory development in the Lusitanian toadfish Halobatrachus didactylus (Batrachoididae). This species exhibits a complex acoustic repertoire and is vocally active during early development. Vocalisations were recorded during social interactions for four size groups (fry: 25 cm, standard length). Auditory sensitivity of juveniles and adults was determined based on evoked potentials recorded from the inner ear saccule in response to pure tones of 75-945 Hz. We show an ontogenetic increment in the vocal repertoire from simple broadband-pulsed 'grunts' that later differentiate into four distinct vocalisations, including low-frequency amplitude-modulated 'boatwhistles'. Whereas fry emitted mostly single grunts, large juveniles exhibited vocalisations similar to the adult vocal repertoire. Saccular sensitivity revealed a three-fold enhancement at most frequencies tested from small to large juveniles; however, large juveniles were similar in sensitivity to adults. We provide the first clear evidence of ontogenetic vocal differentiation in fish, as previously described for higher vertebrates. Our results suggest a parallel development between the vocal motor pathway and the peripheral auditory system for acoustic social communication in fish. © 2015. Published by The Company of Biologists Ltd.

  9. Vocal power and pressure-flow relationships in excised tiger larynges.

    Science.gov (United States)

    Titze, Ingo R; Fitch, W Tecumseh; Hunter, Eric J; Alipour, Fariborz; Montequin, Douglas; Armstrong, Douglas L; McGee, Joann; Walsh, Edward J

    2010-11-15

    Despite the functional importance of loud, low-pitched vocalizations in big cats of the genus Panthera, little is known about the physics and physiology of the mechanisms producing such calls. We investigated laryngeal sound production in the laboratory using an excised-larynx setup combined with sound-level measurements and pressure-flow instrumentation. The larynges of five tigers (three Siberian or Amur, one generic non-pedigreed tiger with Bengal ancestry and one Sumatran), which had died of natural causes, were provided by Omaha's Henry Doorly Zoo over a five-year period. Anatomical investigation indicated the presence of both a rigid cartilaginous plate in the arytenoid portion of the glottis, and a vocal fold fused with a ventricular fold. Both of these features have been confusingly termed 'vocal pads' in the previous literature. We successfully induced phonation in all of these larynges. Our results showed that aerodynamic power in the glottis was of the order of 1.0 W for all specimens, acoustic power radiated (without a vocal tract) was of the order of 0.1 mW, and fundamental frequency ranged between 20 and 100 Hz when a lung pressure in the range of 0-2.0 kPa was applied. The mean glottal airflow increased to the order of 1.0 l s(-1) per 1.0 kPa of pressure, which is predictable from scaling human and canine larynges by glottal length and vibrational amplitude. Phonation threshold pressure was remarkably low, on the order of 0.3 kPa, which is lower than for human and canine larynges phonated without a vocal tract. Our results indicate that a vocal fold length approximately three times greater than that of humans is predictive of the low fundamental frequency, and the extraordinarily flat and broad medial surface of the vocal folds is predictive of the low phonation threshold pressure.

  10. Vocal power and pressure–flow relationships in excised tiger larynges

    Science.gov (United States)

    Titze, Ingo R.; Fitch, W. Tecumseh; Hunter, Eric J.; Alipour, Fariborz; Montequin, Douglas; Armstrong, Douglas L.; McGee, JoAnn; Walsh, Edward J.

    2010-01-01

    Despite the functional importance of loud, low-pitched vocalizations in big cats of the genus Panthera, little is known about the physics and physiology of the mechanisms producing such calls. We investigated laryngeal sound production in the laboratory using an excised-larynx setup combined with sound-level measurements and pressure–flow instrumentation. The larynges of five tigers (three Siberian or Amur, one generic non-pedigreed tiger with Bengal ancestry and one Sumatran), which had died of natural causes, were provided by Omaha's Henry Doorly Zoo over a five-year period. Anatomical investigation indicated the presence of both a rigid cartilaginous plate in the arytenoid portion of the glottis, and a vocal fold fused with a ventricular fold. Both of these features have been confusingly termed ‘vocal pads’ in the previous literature. We successfully induced phonation in all of these larynges. Our results showed that aerodynamic power in the glottis was of the order of 1.0 W for all specimens, acoustic power radiated (without a vocal tract) was of the order of 0.1 mW, and fundamental frequency ranged between 20 and 100 Hz when a lung pressure in the range of 0–2.0 kPa was applied. The mean glottal airflow increased to the order of 1.0 l s–1 per 1.0 kPa of pressure, which is predictable from scaling human and canine larynges by glottal length and vibrational amplitude. Phonation threshold pressure was remarkably low, on the order of 0.3 kPa, which is lower than for human and canine larynges phonated without a vocal tract. Our results indicate that a vocal fold length approximately three times greater than that of humans is predictive of the low fundamental frequency, and the extraordinarily flat and broad medial surface of the vocal folds is predictive of the low phonation threshold pressure. PMID:21037066

  11. Effectiveness of laryngostroboscopy for monitoring the evolution of vocal nodules after rehabilitator treatment.

    Science.gov (United States)

    Halawa, Wasim Elhendi; García, Antonio Caravaca; Pérez, Sofía Santos

    2013-04-01

    The aim of this study is to evaluate the effectiveness of the laryngostroboscopy for monitoring the evolution of patients with vocal nodules before and after the logopedic vocal treatment. We performed a prospective observational study of 97 dysphonic patients diagnosed of vocal nodules, where we analyzed four stroboscopic parameters (glottal closure, vocal fold vibration, mucosal wave and phase symmetry) by a protocol based on systematic subjective evaluation of the stroboscopic images before and after the rehabilitator vocal treatment; and the results were stratified according to the clinical course. All patients, before the treatment, had some abnormality in at least one of the four analyzed aspects. After the vocal treatment, we found improvement of the four parameters in different degrees. Also, we found a statistically significant relationship between the evolution of each parameter and the clinical course. We believe that the laryngostroboscopy, systematized through a protocol, is a useful technique for the diagnosis of structural abnormalities in patients with vocal nodules and is a useful technique for evaluating the results after the rehabilitator treatment, as there is a statistically significant relationship between clinical course and the change in the stroboscopic findings. However it should not be the only technique used for these proposes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. Identifying Knowledge Gaps in Clinicians Who Evaluate and Treat Vocal Performing Artists in College Health Settings.

    Science.gov (United States)

    McKinnon-Howe, Leah; Dowdall, Jayme

    2017-07-28

    The goal of this study was to identify knowledge gaps in clinicians who evaluate and treat performing artists for illnesses and injuries that affect vocal function in college health settings. This pilot study utilized a web-based cross-sectional survey design incorporating common clinical scenarios to test knowledge of evaluation and management strategies in the vocal performing artist. A web-based survey was administered to a purposive sample of 28 clinicians to identify the approach utilized to evaluate and treat vocal performing artists in college health settings, and factors that might affect knowledge gaps and influence referral patterns to voice specialists. Twenty-eight clinicians were surveyed, with 36% of respondents incorrectly identifying appropriate vocal hygiene measures, 56% of respondents failing to identify symptoms of vocal fold hemorrhage, 84% failing to identify other indications for referral to a voice specialist, 96% of respondents acknowledging unfamiliarity with the Voice Handicap Index and the Singers Voice Handicap Index, and 68% acknowledging unfamiliarity with the Reflux Symptom Index. The data elucidated specific knowledge gaps in college health providers who are responsible for evaluating and treating common illnesses that affect vocal function, and triaging and referring students experiencing symptoms of potential vocal emergencies. Future work is needed to improve the standard of care for this population. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  13. Self-folding origami at any energy scale

    Science.gov (United States)

    Pinson, Matthew B.; Stern, Menachem; Carruthers Ferrero, Alexandra; Witten, Thomas A.; Chen, Elizabeth; Murugan, Arvind

    2017-05-01

    Programmable stiff sheets with a single low-energy folding motion have been sought in fields ranging from the ancient art of origami to modern meta-materials research. Despite such attention, only two extreme classes of crease patterns are usually studied; special Miura-Ori-based zero-energy patterns, in which crease folding requires no sheet bending, and random patterns with high-energy folding, in which the sheet bends as much as creases fold. We present a physical approach that allows systematic exploration of the entire space of crease patterns as a function of the folding energy. Consequently, we uncover statistical results in origami, finding the entropy of crease patterns of given folding energy. Notably, we identify three classes of Mountain-Valley choices that have widely varying `typical' folding energies. Our work opens up a wealth of experimentally relevant self-folding origami designs not reliant on Miura-Ori, the Kawasaki condition or any special symmetry in space.

  14. Vocal tract resonances in oscine bird sound production: evidence from birdsongs in a helium atmosphere.

    Science.gov (United States)

    Nowicki, S

    The complexity and dependence on learning of many bird sounds have suggested parallels between birdsong and human speech, but the mechanisms by which each is produced have been supposed to differ markedly. In human speech, resonances of the vocal tract are thought to modulate in complex ways the sound produced by vibration of the vocal folds. The current theory of birdsong production holds that all variation in sound quality arises from the primary sound-producing organ, the syrinx, and that resonances of the vocal tract play no part. Here I present evidence, obtained from acoustic analyses of birdsongs recorded in a helium atmosphere, which contradicts this hypothesis. Not only does the songbird's vocal tract act as an acoustic filter, but its filter characteristics are actively coordinated with the output of the syrinx. Songbird and human phonation are thus more analogous than previously thought, in that both require coordination of an array of diverse motor systems.

  15. Mice produce ultrasonic vocalizations by intra-laryngeal planar impinging jets

    DEFF Research Database (Denmark)

    Mahrt, Elena; Agarwal, Anurag; Perkel, David

    2016-01-01

    Rodent ultrasonic vocalizations (USVs) are a vital tool for linking gene mutations to behavior in mouse models of communication disorders, such as autism [1]. However, we currently lack an understanding of how physiological and physical mechanisms combine to generate acoustic features of the voca......Rodent ultrasonic vocalizations (USVs) are a vital tool for linking gene mutations to behavior in mouse models of communication disorders, such as autism [1]. However, we currently lack an understanding of how physiological and physical mechanisms combine to generate acoustic features...... of the vocalizations, and thus cannot meaningfully relate those features to experimental treatments. Here we test and provide evidence against the two leading hypotheses explaining USV production: superficial vocal fold vibrations [2], and a hole-tone whistle [3]. Instead, we propose and provide theoretical...

  16. Stiffness, resilience, compressibility

    Energy Technology Data Exchange (ETDEWEB)

    Leu, Bogdan M. [Argonne National Laboratory, Advanced Photon Source (United States); Sage, J. Timothy, E-mail: jtsage@neu.edu [Northeastern University, Department of Physics and Center for Interdisciplinary Research on Complex Systems (United States)

    2016-12-15

    The flexibility of a protein is an important component of its functionality. We use nuclear resonance vibrational spectroscopy (NRVS) to quantify the flexibility of the heme iron environment in the electron-carrying protein cytochrome c by measuring the stiffness and the resilience. These quantities are sensitive to structural differences between the active sites of different proteins, as illustrated by a comparative analysis with myoglobin. The elasticity of the entire protein, on the other hand, can be probed quantitatively from NRVS and high energy-resolution inelastic X-ray scattering (IXS) measurements, an approach that we used to extract the bulk modulus of cytochrome c.

  17. The vocal monotony of monogamy

    Science.gov (United States)

    Thomas, Jeanette

    2003-04-01

    There are four phocids in waters around Antarctica: Weddell, leopard, crabeater, and Ross seals. These four species provide a unique opportunity to examine underwater vocal behavior in species sharing the same ecosystem. Some species live in pack ice, others in factice, but all are restricted to the Antarctic or sub-Antarctic islands. All breed and produce vocalizations under water. Social systems range from polygyny in large breeding colonies, to serial monogamy, to solitary species. The type of mating system influences the number of underwater vocalizations in the repertoire, with monogamous seals producing only a single call, polygynous species producing up to 35 calls, and solitary species an intermediate number of about 10 calls. Breeding occurs during the austral spring and each species carves-out an acoustic niche for communicating, with species using different frequency ranges, temporal patterns, and amplitude changes to convey their species-specific calls and presumably reduce acoustic competition. Some species exhibit geographic variations in their vocalizations around the continent, which may reflect discrete breeding populations. Some seals become silent during a vulnerable time of predation by killer whales, perhaps to avoid detection. Overall, vocalizations of these seals exhibit adaptive characteristics that reflect the co-evolution among species in the same ecosystem.

  18. Vocal Frequency Measures in Normal Speaking Children and Children with Vocal Deviations. Final Report.

    Science.gov (United States)

    Leeper, Herbert A., Jr.; Iverson, Rachel L.

    The report examines vocal frequency differences between normal speaking children and 65 children (mean age 9-years) with vocal nodules and accompanying vocal quality disturbances. In part I of the study children were screened by a physician and their voices were recorded and analyzed by a digitizer-computer system for mean vocal frequency,…

  19. University Vocal Training and Vocal Health of Music Educators and Music Therapists

    Science.gov (United States)

    Baker, Vicki D.; Cohen, Nicki

    2017-01-01

    The purpose of this study was to describe the university vocal training and vocal health of music educators and music therapists. The participants (N = 426), music educators (n = 351) and music therapists (n = 75), completed a survey addressing demographics, vocal training, voice usage, and vocal health. Both groups reported singing at least 50%…

  20. Disabled Vocal Cords: An Occupational Hazard.

    Science.gov (United States)

    Kahn, Norma B.

    1987-01-01

    A teacher points out the occupational hazard that can result from the misuse of the voice and ensuing vocal cord damage. Presents discussion of ways to avoid misusing the voice and prevent vocal cord damage. (MD)

  1. The Folded t Distribution

    OpenAIRE

    Psarakis, Stelios; Panaretos, John

    1990-01-01

    Measurements are frequently recorder without their algebraic sign. As a consequence the underlying distribution of measurements is replaced by a distribution of absolute measurements. When the underlying distribution is t the resulting distribution is called the “folded-t distribution”. Here we study this distribution, we find the relationship between the folded-t distribution and a special case of the folded normal distribution and we derive relationships of the folded-t distribution to othe...

  2. Pharmacological modulation of arterial stiffness.

    LENUS (Irish Health Repository)

    Boutouyrie, Pierre

    2011-09-10

    Arterial stiffness has emerged as an important marker of cardiovascular risk in various populations and reflects the cumulative effect of cardiovascular risk factors on large arteries, which in turn is modulated by genetic background. Arterial stiffness is determined by the composition of the arterial wall and the arrangement of these components, and can be studied in humans non-invasively. Age and distending pressure are two major factors influencing large artery stiffness. Change in arterial stiffness with drugs is an important endpoint in clinical trials, although evidence for arterial stiffness as a therapeutic target still needs to be confirmed. Drugs that independently affect arterial stiffness include antihypertensive drugs, mostly blockers of the renin-angiotensin-aldosterone system, hormone replacement therapy and some antidiabetic drugs such as glitazones. While the quest continues for \\'de-stiffening drugs\\

  3. Clinical practice: vocal nodules in dysphonic children.

    Science.gov (United States)

    Martins, Regina Helena Garcia; Branco, Anete; Tavares, Elaine Lara Mendes; Gramuglia, Andrea Cristina Jóia

    2013-09-01

    Common among children, vocal symptoms are a cause of concern for parents who seek elucidation of their diagnosis and treatment. Vocal nodules are the major cause of dysphonias in children and are related to vocal abuse. We conducted a literature review considering clinical, physiopathological, epidemiological, and histological aspects of vocal nodules, as well as diagnostic methods, highlighting the main studies addressing this issue. The controversial points of treatments were also discussed.

  4. Vocal Nodules: Their Cause and Treatment

    Science.gov (United States)

    Teter, Darrel L.

    1977-01-01

    Provides knowledge about the workings of the vocal apparatus, the scientific basis of certain vocal problems, and what to do to overcome those problems. Specifically discusses the occurrence of nodules on the vocal cords and how to treat them, a subject of interest to both singers and nonsingers. (Editor/RK)

  5. Effects of Social Games on Infant Vocalizations

    Science.gov (United States)

    Hsu, Hui-Chin; Iyer, Suneeti Nathani; Fogel, Alan

    2014-01-01

    The aim of the present study was to examine the contextual effects of social games on prelinguistic vocalizations. The two main goals were to (1) investigate the functions of vocalizations as symptoms of affective arousal and symbols of social understanding, and (2) explore form-function (de)coupling relations between vocalization types and game…

  6. An Investigation of Extinction-Induced Vocalizations

    Science.gov (United States)

    Valentino, Amber L.; Shillingsburg, M. Alice; Call, Nathan A.; Burton, Britney; Bowen, Crystal N.

    2011-01-01

    Children with autism have significant communication delays. Although some children develop vocalizations through shaping and differential reinforcement, others rarely exhibit vocalizations, and alternative methods are targeted in intervention. However, vocal language often remains a goal for caregivers and clinicians. Thus, strategies to increase…

  7. Dynamic stiffness of suction caissons

    DEFF Research Database (Denmark)

    Ibsen, Lars Bo; Liingaard, Morten; Andersen, Lars

    The purpose of this report is to evaluate the dynamic soil-structure interaction of suction caissons for offshore wind turbines. The investigation is limited to a determination of the vertical dynamic stiffness of suction caissons. The soil surrounding the foundation is homogenous with linear...... viscoelastic properties. The dynamic stiffness of the suction caisson is expressed by dimensionless frequency-dependent dynamic stiffness coefficients corresponding to the vertical degree of freedom. The dynamic stiffness coefficients for the foundations are evaluated by means of a dynamic three...

  8. Trabecular meshwork stiffness in glaucoma.

    Science.gov (United States)

    Wang, Ke; Read, A Thomas; Sulchek, Todd; Ethier, C Ross

    2017-05-01

    Alterations in stiffness of the trabecular meshwork (TM) may play an important role in primary open-angle glaucoma (POAG), the second leading cause of blindness. Specifically, certain data suggest an association between elevated intraocular pressure (IOP) and increased TM stiffness; however, the underlying link between TM stiffness and IOP remains unclear and requires further study. We here first review the literature on TM stiffness measurements, encompassing various species and based on a number of measurement techniques, including direct approaches such as atomic force microscopy (AFM) and uniaxial tension tests, and indirect methods based on a beam deflection model. We also briefly review the effects of several factors that affect TM stiffness, including lysophospholipids, rho-kinase inhibitors, cytoskeletal disrupting agents, dexamethasone (DEX), transforming growth factor-β2 (TGF-β2), nitric oxide (NO) and cellular senescence. We then describe a method we have developed for determining TM stiffness measurement in mice using a cryosection/AFM-based approach, and present preliminary data on TM stiffness in C57BL/6J and CBA/J mouse strains. Finally, we investigate the relationship between TM stiffness and outflow facility between these two strains. The method we have developed shows promise for further direct measurements of mouse TM stiffness, which may be of value in understanding mechanistic relations between outflow facility and TM biomechanical properties. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Limit cycles and stiffness control with variable stiffness actuators

    NARCIS (Netherlands)

    Carloni, Raffaella; Marconi, Lorenzo

    2012-01-01

    Variable stiffness actuators realize highly dynamic systems, whose inherent mechanical compliance can be properly exploited to obtain a robust and energy-efficient behavior. The paper presents a control strategy for variable stiffness actuators with the primarily goal of tracking a limit cycle

  10. Investigation of the Effects of Speech Signal Length on Vocal Disorder Sorting Done Via Dynamic Pattern Modeling.

    Science.gov (United States)

    Mehdizadehfar, Vida; Almasganj, Farshad; Torabinezhad, Farhad

    2017-07-01

    Development of a noninvasive method for separating different vocal fold diseases is an important issue concerning vocal analysis. Due to the time variations along a pathologic vocal signal, application of dynamic pattern modeling tools is expected to help in the detection of defects that occur in the speech production mechanism. In the present study, the hidden Markov model, which is a state space model, is employed to sort some of the vocal diseases. Moreover, this research mainly investigates the effects of the processed vocal signal lengths on the mentioned sorting task. To this end, the signal lengths of 1, 3, and 5 seconds of different disorders are used. The experimental results show that some pathologic conditions in vocal folds such as cyst, false vocal cord, and mass are more evident in continued voice production, and the recognition accuracies gained via dynamic modeling of pathologic voice signals with more lengths are considerably improved. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  11. The posttraumatic stiff elbow.

    Science.gov (United States)

    Morrey, Bernard F

    2005-02-01

    The development of joint contracture is a well-recognized complication of elbow injury. Precise causes of the propensity of this joint for ankylosis are understood poorly. Yet, treatment is emerging and therefore the indications and willingness on the part of the surgeon to address this problem is improving. Limited open procedures have emerged during the past several years that are safe and effective by improving arcs of motion of 50-70 degrees in approximately 80-90% of patients. For severe injuries that involve the articular surface, interposition arthroplasty is less documented but has been shown to be effective but constitutes one of the most challenging technical procedures. Joint replacement arthroplasty generally should not be considered as a treatment for posttraumatic stiffness unless the patient is older than 65 years. The experience with this procedure indicates that with linked semiconstrained implants, approximately 80% of patients will achieve a near functional arc of motion. Arthroscopic intervention shows the greatest activity of investigation and clinical expansion. The learning curve is defined by a concern of complications to the neural structures and the fear of this complication has limited the application but the emerging documentation of the safeness of this option also has been associated with improved effectiveness. Therefore, arthroscopic intervention for the stiff elbow, particularly those with soft tissue extrinsic involvement, is emerging as the treatment of choice in many instances. The investigation regarding the medical treatment of altering the tendency of the soft tissue to go through such intense contracture is in its infancy but suggests that this could be a long-term solution at least for many patients.

  12. Vocal Health for Physical Educators

    Science.gov (United States)

    Trout, Josh; McColl, Douglas

    2007-01-01

    Evidence suggests that teachers are often at risk for vocal disease and are more likely to change occupations because of their voice problems compared to non-teachers. Physical educators are especially at risk for voice problems due to the intense daily demands of voice projection. Chronic abuse can cause swelling and inflammation of the…

  13. Producing song: the vocal apparatus.

    Science.gov (United States)

    Suthers, Roderick A; Zollinger, Sue Anne

    2004-06-01

    In order to achieve the goal of understanding the neurobiology of birdsong, it is necessary to understand the peripheral mechanisms by which song is produced. This paper reviews recent advances in the understanding of syringeal and respiratory motor control and how birds utilize these systems to create their species-typical sounds. Songbirds have a relatively homogeneous duplex vocal organ in which sound is generated by oscillation of a pair of thickened labia on either side of the syrinx. Multiple pairs of syringeal muscles provide flexible, independent control of sound frequency and amplitude, and each side of the syrinx exhibits a degree of acoustic specialization. This is in contrast to many non-songbirds, including vocal learners such as parrots, which have fewer syringeal muscles and use syringeal membranes to generate sound. In doves, at least, these membranes generate a harmonic signal in which the fundamental frequency is regulated by respiratory pressure in the air sac surrounding the syrinx and the overtones are filtered out by the vocal tract. The songs of adult songbirds are generally accompanied by precisely coordinated respiratory and syringeal motor patterns that, despite their relative stereotypy, are modulated in real time by somatosensory feedback. Comparative studies indicate songbirds have evolved species-specific motor patterns that utilize the two sides of the syrinx in specific ways and enhance the particular acoustic effects characterizing the species song. A vocal mimic tutored with heterospecific song uses the same motor pattern as the tutor species when he accurately copies the song, suggesting that physical or physiological constraints on sound production have had a prominent role in the evolution of species-specific motor patterns. An understanding of the relationship between the central processing and peripheral performance of song motor programs is essential for an understanding of the development, function, and evolution of these

  14. Fast protein folding kinetics

    Science.gov (United States)

    Gelman, Hannah; Gruebele, Martin

    2014-01-01

    Fast folding proteins have been a major focus of computational and experimental study because they are accessible to both techniques: they are small and fast enough to be reasonably simulated with current computational power, but have dynamics slow enough to be observed with specially developed experimental techniques. This coupled study of fast folding proteins has provided insight into the mechanisms which allow some proteins to find their native conformation well less than 1 ms and has uncovered examples of theoretically predicted phenomena such as downhill folding. The study of fast folders also informs our understanding of even “slow” folding processes: fast folders are small, relatively simple protein domains and the principles that govern their folding also govern the folding of more complex systems. This review summarizes the major theoretical and experimental techniques used to study fast folding proteins and provides an overview of the major findings of fast folding research. Finally, we examine the themes that have emerged from studying fast folders and briefly summarize their application to protein folding in general as well as some work that is left to do. PMID:24641816

  15. Laryngeal microweb and vocal nodules. Clinical study in a Brazilian population.

    Science.gov (United States)

    Ruiz, Daniela Maria Cury Ferreira; Pontes, Paulo; Behlau, Mara; Richieri-Costa, A

    2006-01-01

    The etiology and pathogenesis of laryngeal microwebs are heterogeneous, and in most cases they are an incidental finding. It has also been suggested that microwebs could be a familial trait, representing a postblastogenic embryonic vestigial structure that might alter the biomechanical and vibratory properties of the vocal fold. Vocal nodules are small benign swellings along the margins of the vocal cords, with preferential location at the junction of the anterior and middle thirds, and usually resulting from mechanical trauma. The authors studied a sample of 107 patients with vocal nodules, looking for a possible correlation with microwebs due to the predicted involvement in the vibration of vocal cord margins. Glottic proportion, type of glottic closure, nodule location and the main complaints in patients with microwebs were compared with those in a sample of patients without microwebs. In the present study, microwebs were found in 9.4% of the patients, who showed much smaller glottic proportion than patients with micronodules only. Furthermore, vocal nodule location was not related to the presence and/or absence of laryngeal microwebs. Copyright 2006 S. Karger AG, Basel.

  16. Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series.

    Science.gov (United States)

    Martins, Regina Helena Garcia; Tavares, Elaine Lara Mendes; Ranalli, Paula Ferreira; Branco, Anete; Pessin, Adriana Bueno Benito

    2014-01-01

    Psychogenic dysphonia is a functional disorder with variable clinical manifestations. To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings. 28 patients (26 women and 2 men) were assessed. Their occupations included: housekeeper (n=17), teacher (n=4), salesclerk (n=4), nurse (n=1), retired (n=1), and psychologist (n=1). Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms. In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  17. Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series

    Directory of Open Access Journals (Sweden)

    Regina Helena Garcia Martins

    2014-12-01

    Full Text Available Introduction: Psychogenic dysphonia is a functional disorder with variable clinical manifestations. Objective: To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. Methods: The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings. Results: 28 patients (26 women and 2 men were assessed. Their occupations included: housekeeper (n = 17, teacher (n = 4, salesclerk (n = 4, nurse (n = 1, retired (n = 1, and psychologist (n = 1. Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms. Conclusions: In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed.

  18. Wound-healing effect of acupuncture for treating phonotraumatic vocal pathologies: A cytokine study.

    Science.gov (United States)

    Yiu, Edwin M L; Chan, Karen M K; Li, Nicole Y K; Tsang, Raymond; Verdolini Abbott, Katherine; Kwong, Elaine; Ma, Estella P M; Tse, Fred W; Lin, Zhixiu

    2016-01-01

    Acupuncture is a less-invasive procedure when compared with surgical treatment for benign vocal pathologies caused by vocal overuse. This study aimed to determine the wound-healing effect of acupuncture in treating phonotraumatic vocal fold lesions. Two-way, mixed-model, between- and within-subjects, prospective randomized, placebo-controlled, blinded group design. Seventeen dysphonic individuals with vocal nodules were recruited from a university clinic in Hong Kong. Each participant was randomly assigned to receive one session of either genuine or sham acupuncture. The genuine acupuncture group (n = 9) received needles puncturing nine voice-related acupoints for 30 minutes, whereas the sham acupuncture group (n = 8) received blunted needles stimulating the skin surface of the nine acupoints for the same frequency and duration. Laryngeal secretions were suctioned from the surface of the vocal folds immediately before, immediately after, and 24 hours after the acupuncture. The protein concentration levels of wound-healing-related cytokines (interleukin [IL]-1β and IL-10) in these secretion samples were measured. Following acupuncture, a significant increase in the anti-inflammatory cytokine IL-10 was found in the genuine acupuncture group (n = 9) but not in the sham acupuncture group (n = 8). The findings showed that acupuncture of voice-related acupoints facilitated an anti-inflammatory process in phonotraumatic vocal pathologies. This could be considered as supporting evidence to consider acupuncture as a less-invasive alternative option, when compared to surgery, for treating phonotraumatic vocal pathologies. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  19. On Safe Folding

    NARCIS (Netherlands)

    Bossi, Annalisa; Bruynooghe, Maurice; Cocco, Nicoletta; Wirsing, Martin; Etalle, Sandro

    In [3] a general fold operation has been introduced for definite programs wrt computed answer substitution semantics. It differs from the fold operation defined by Tamaki and Sato in [26,25] because its application does not depend on the transformation history. This paper extends the results in [3

  20. Arterial stiffness and cognitive impairment.

    Science.gov (United States)

    Li, Xiaoxuan; Lyu, Peiyuan; Ren, Yanyan; An, Jin; Dong, Yanhong

    2017-09-15

    Arterial stiffness is one of the earliest indicators of changes in vascular wall structure and function and may be assessed using various indicators, such as pulse-wave velocity (PWV), the cardio-ankle vascular index (CAVI), the ankle-brachial index (ABI), pulse pressure (PP), the augmentation index (AI), flow-mediated dilation (FMD), carotid intima media thickness (IMT) and arterial stiffness index-β. Arterial stiffness is generally considered an independent predictor of cardiovascular and cerebrovascular diseases. To date, a significant number of studies have focused on the relationship between arterial stiffness and cognitive impairment. To investigate the relationships between specific arterial stiffness parameters and cognitive impairment, elucidate the pathophysiological mechanisms underlying the relationship between arterial stiffness and cognitive impairment and determine how to interfere with arterial stiffness to prevent cognitive impairment, we searched PUBMED for studies regarding the relationship between arterial stiffness and cognitive impairment that were published from 2000 to 2017. We used the following key words in our search: "arterial stiffness and cognitive impairment" and "arterial stiffness and cognitive impairment mechanism". Studies involving human subjects older than 30years were included in the review, while irrelevant studies (i.e., studies involving subjects with comorbid kidney disease, diabetes and cardiac disease) were excluded from the review. We determined that arterial stiffness severity was positively correlated with cognitive impairment. Of the markers used to assess arterial stiffness, a higher PWV, CAVI, AI, IMT and index-β and a lower ABI and FMD were related to cognitive impairment. However, the relationship between PP and cognitive impairment remained controversial. The potential mechanisms linking arterial stiffness and cognitive impairment may be associated with arterial pulsatility, as greater arterial pulsatility

  1. Stiffness of desiccating insect wings

    Energy Technology Data Exchange (ETDEWEB)

    Mengesha, T E; Vallance, R R [Department of Mechanical Engineering, The George Washington University, 738 Phillips Hall, 801 22nd St NW, Washington, DC 20052 (United States); Mittal, R, E-mail: vallance@gwu.edu [Department of Mechanical Engineering, Johns Hopkins University, 126 Latrobe Hall, 3400 N Charles Street, Baltimore, MD 21218 (United States)

    2011-03-15

    The stiffness of insect wings is typically determined through experimental measurements. Such experiments are performed on wings removed from insects. However, the wings are subject to desiccation which typically leads to an increase in their stiffness. Although this effect of desiccation is well known, a comprehensive study of the rate of change in stiffness of desiccating insect wings would be a significant aid in planning experiments as well as interpreting data from such experiments. This communication presents a comprehensive experimental analysis of the change in mass and stiffness of gradually desiccating forewings of Painted Lady butterflies (Vanessa cardui). Mass and stiffness of the forewings of five butterflies were simultaneously measured every 10 min over a 24 h period. The averaged results show that wing mass declined exponentially by 21.1% over this time period with a time constant of 9.8 h, while wing stiffness increased linearly by 46.2% at a rate of 23.4 {mu}N mm{sup -1} h{sup -1}. For the forewings of a single butterfly, the experiment was performed over a period of 1 week, and the results show that wing mass declined exponentially by 52.2% with a time constant of 30.2 h until it reached a steady-state level of 2.00 mg, while wing stiffness increased exponentially by 90.7% until it reached a steady-state level of 1.70 mN mm{sup -1}. (communication)

  2. Comportamento vocal de cantores populares Vocal behavior of popular singers

    Directory of Open Access Journals (Sweden)

    Valquíria Zimmer

    2012-04-01

    Full Text Available OBJETIVO: investigar aspectos do histórico, hábitos e comportamentos vocais de cantores populares, conforme o sexo e as categorias profissional e amador. MÉTODO: entrevista com 47 cantores, 25 homens e 22 mulheres. RESULTADOS: significância estatística nos seguintes achados: MASCULINO - microfone nos ensaios, ausência de problemas vocais diagnosticados, ausência de orientações sobre higiene vocal, dor ou desconforto após cantar, ausência de alergias e problemas respiratórios; FEMININO - aulas de canto e conhecimento sobre postura; AMADOR - não cantar dançando, não imitar vozes, ausência de avaliação otorrinolaringológica, ausência de problemas vocais diagnosticados, ausência de terapia fonoaudiológica, ausência de orientações de anatomofisiologia vocal e não utilização de álcool nos ensaios; PROFISSIONAL - rouquidão, conhecimento sobre articulação, álcool durante os shows, "garganta suja" ou pigarro, dor após cantar. CONCLUSÕES: a comparação entre os sexos evidenciou que os homens utilizavam microfone no ensaio, não apresentavam problemas alérgicos ou respiratórios, nem problemas vocais diagnosticados, mas apresentavam sensação de dor ou desconforto após o canto e não possuíam noções sobre higiene vocal; e que as mulheres realizavam aulas de canto e possuíam orientações de postura. A comparação entre amadores e profissionais mostrou que os amadores não cantavam dançando, não imitavam vozes, não utilizavam álcool nos ensaios, e não apresentavam problemas vocais diagnosticados, mas não possuíam avaliação otorrinolaringológica, não realizavam terapia fonoaudiológica, e não possuíam conhecimento sobre anatomofisiologia vocal; e os profissionais apresentavam queixa de rouquidão, de "garganta suja" ou pigarro e de dor após cantar, e usavam álcool durante os shows, apesar de possuir conhecimento sobre articulação.PURPOSE: to investigate aspects of vocal history, vocal habits and

  3. Postlaryngectomy vocal rehabilitation in Albania.

    Science.gov (United States)

    Boci, B; Isufi, R; Thomai, K

    2012-01-01

    To assess short and midterm results with consistent use of indwelling voice prostheses (Provox 1 and Provox 2 valves) for vocal rehabilitation after total laryngectomy. From May 2008 to June 2010 106 patients (104 men, 2 women, median age 62.32 years) with total laryngectomy underwent vocal prosthesis insertion and replacement procedures as needed. Patients were prosthesized primarily or secondarily and follow-up was performed monthly. Median patient-device follow-up was 279 days (range 184-995). Leakage through the prosthesis, mainly caused by Candida deposits on the valve, was the most common cause of failure of the Provox valves. Compared to other European countries, like the Netherlands (100 days) and France (150 days) Albania has the longest device half life. This relatively long prosthesis' lifetime in our country is perhaps related with the use of spicy food (a common custom in our country), and the use of antifungal and antacid agents.

  4. Recording vocalizations with Bluetooth technology.

    Science.gov (United States)

    Gaona-González, Andrés; Santillán-Doherty, Ana María; Arenas-Rosas, Rita Virginia; Muñoz-Delgado, Jairo; Aguillón-Pantaleón, Miguel Angel; Ordoñez-Gómez, José Domingo; Márquez-Arias, Alejandra

    2011-06-01

    We propose a method for capturing vocalizations that is designed to avoid some of the limiting factors found in traditional bioacoustical methods, such as the impossibility of obtaining continuous long-term registers or analyzing amplitude due to the continuous change of distance between the subject and the position of the recording system. Using Bluetooth technology, vocalizations are captured and transmitted wirelessly into a receiving system without affecting the quality of the signal. The recordings of the proposed system were compared to those obtained as a reference, which were based on the coding of the signal with the so-called pulse-code modulation technique in WAV audio format without any compressing process. The evaluation showed p < .05 for the measured quantitative and qualitative parameters. We also describe how the transmitting system is encapsulated and fixed on the animal and a way to video record a spider monkey's behavior simultaneously with the audio recordings.

  5. Vocal communication of wild parrots

    Science.gov (United States)

    Bradbury, Jack

    2004-05-01

    Field studies of four sympatric parrot species in Costa Rica are revealing several possible functions for the well-known ability of parrots to mimic new sounds throughout life. Despite earlier suggestions that this might facilitate exchanges of environmental information, all data so far suggest that vocal mimicry in the wild is associated with mediation of the fission/fusion of groups of parrots and/or of conflicts between mated pairs. Recent results using array recording and interactive playback will be summarized, and several technical problems created by the mechanisms of parrot vocal signal production discussed. [Research supported by NSF Grant IBN-022927 and by continued encouragement and logistics provided by the staff of the Area Conservacion Guanacaste (Costa Rica).

  6. To assemble or fold?

    Science.gov (United States)

    Das, Anindita; Ghosh, Suhrit

    2014-10-11

    This communication reports an elegant structure formation by an amide functionalized donor (D)-acceptor (A) dyad by stepwise folding and assembly. It adopts a folded conformation by intra-chain CT-interaction that subsequently dimerizes by inter-molecular H-bonding to produce a folded dimer (FD) with a DAAD stacking sequence. Incompatibility of the aromatic stacked face with MCH triggers macroscopic assembly by solvophobically driven edge-to-edge stacking of the FD with concomitant growth in the orthogonal direction by D-D π-stacking leading to the formation of a reverse-vesicle.

  7. Nonlinear acoustics in the pant-hoot vocalization of common chimpanzees (Pan troglodytes)

    Science.gov (United States)

    Riede, Tobias; Arcadi, Adam Clark; Owren, Michael J.

    2003-04-01

    Pant-hoots produced by chimpanzees are multi-call vocalizations. While predominantly harmonically structured, pant-hoots can exhibit acoustic complexity that has recently been found to result from inherent nonlinearity in the vocal-fold dynamics. This complexity reflects abrupt shifts between qualitatively distinct vibration patterns (known as modes), which include but are not limited to simple, synchronous movements by the two vocal folds. Studies with humans in particular have shown that as the amplitude and vibration rate increase, vocal-fold action becomes increasingly susceptible to higher-order synchronizations, desynchronized movements, and irregular behavior. We examined the occurrence of these sorts of nonlinear phenomena in pant-hoots, contrasting quieter and lower-pitched introduction components with loud and high-pitched climax calls in the same sounds. Spectrographic evidence revealed four classic kinds of nonlinear phenomena, including discrete frequency jumps, subharmonics, biphonation, and deterministic chaos. While these events were virtually never found in the introduction, they occurred in more than half of the climax calls. Biphonation was by far the most common. Individual callers varied in the degree to which their climax calls exhibited nonlinear phenomena, but we are consistent in showing more biphonation than any of the other forms. These outcomes demonstrate that understanding these calls requisitely requires an understanding of such events.

  8. Universal vocal signals of emotion

    OpenAIRE

    Sauter, D.; Eisner, F; Ekman, P.; Scott, S

    2009-01-01

    Emotional signals allow for the sharing of important information with conspecifics, for example to warn them of danger. Humans use a range of different cues to communicate to others how they feel, including facial, vocal, and gestural signals. Although much is known about facial expressions of emotion, less research has focused on affect in the voice. We compare British listeners to individuals from remote Namibian villages who have had no exposure to Western culture, and examine recognition ...

  9. Angiogenesis, fibrinogenesis and presence of synechiae after exeresis of a swine vocal fold mucosal microflap and use of topical mitomycin-C Estudo da angiogênese, fibrogênese e presença de sinéquias após exérese de fragmento de mucosa de pregas vocais de suínos utilizando instrumental frio e mitomicina-C tópica

    Directory of Open Access Journals (Sweden)

    Vinicius Ribas de Carvalho Duarte Fonseca

    2010-02-01

    Full Text Available PURPOSE: To evaluate swine vocal fold healing in a period of 30 days after topical mitomycin-C application. METHODS: Twelve swine underwent exeresis of mucosal flaps from the free edge of the anterior third of both vocal folds with a cold instrument (laryngeal scissors. The animals were divided into two groups: EG (Experimental Group, consisting of 6 animals undergoing topical MMC application (4 mg/dL on the operated area for 4 minutes; CG (Control Group, 6 animals undergoing topical saline solution application on the operated area for 4 minutes. After 30 days, the animals were sacrificed and the larynges were collected and examined for the presence of synechiae as well as a histological immunohistochemical assessment of immature and mature collagen deposition, number of blood vessels and myofibroblasts. RESULTS: Mature collagen deposition in the EG was 452.12 μm² and 1332.31μm² in the CG; immature collagen deposition was 1511.73μm² in the EG and 1020.61μm² in the CG. The number of myofibroblasts was 1.556 in the EG and 3.583 in the CG. The number of blood vessels was 2.565 in EG and 6.917 in the CG. There were no synechiae in the two studied groups. CONCLUSIONS: There was an increase in immature collagen deposition in the experimental group when compared with the control group. There was a decrease in mature collagen deposition in the experimental group when compared with the control group. There was a decrease in the number of myofibroblasts in the experimental group when compared with the control group. A decrease in blood vessels was observed in the experimental group when compared with the control group. There was no synechia formation in either studied group.OBJETIVO: Avaliar a cicatrização de pregas vocais de suínos utilizando mitomicina-C tópica, em 30 dias. MÉTODOS: Doze suínos foram submetidos à exérese de mucosa do bordo livre do terço anterior de ambas as pregas vocais com instrumental frio (tesoura curva e divididos

  10. Integrating perspectives on vocal performance and consistency

    OpenAIRE

    Sakata, Jon T.; Vehrencamp, Sandra L.

    2012-01-01

    Recent experiments in divergent fields of birdsong have revealed that vocal performance is important for reproductive success and under active control by distinct neural circuits. Vocal consistency, the degree to which the spectral properties (e.g. dominant or fundamental frequency) of song elements are produced consistently from rendition to rendition, has been highlighted as a biologically important aspect of vocal performance. Here, we synthesize functional, developmental and mechanistic (...

  11. Path Models of Vocal Emotion Communication

    National Research Council Canada - National Science Library

    Bänziger, Tanja; Hosoya, Georg; Scherer, Klaus R

    2015-01-01

    We propose to use a comprehensive path model of vocal emotion communication, encompassing encoding, transmission, and decoding processes, to empirically model data sets on emotion expression and recognition...

  12. Considerações sobre modificações vocais e laríngeas ocasionadas pelo som basal em mulheres sem queixa vocal Considerations regarding vocal and laryngeal modifications caused by vocal fry in women without voice complaints

    Directory of Open Access Journals (Sweden)

    Débora Meurer Brum

    2010-01-01

    vowel /a/ and the videostroboscopic examination of the larynx. Both laryngeal and vocal data found prior to and after the vocal fry technique were submitted to acoustic, auditory-perceptive, and videostroboscopic analyses. The acoustic analysis was generated by the Multi Speech program. Analyses showed the following effects of the vocal fry: increase of the vibration of the vocal folds mucosa; alteration or maintenance of voice type and pitch; decrease or maintenance of measures related to jitter and shimmer, as well as the index that suggests glottic noise; decrease of the soft phonation index; maintenance or alteration of the vocal quality and resonance focus, with laryngopharyngeal prevalence; decrease of the fundamental frequency; and increase of frequency and width variations. The study allowed the conclusion that vocal fry had a positive effect on the vibration of the vocal folds mucosa as well as on voice noise, and a negative effect on voice resonance and stability.

  13. Biomaterial stiffness determines stem cell fate.

    Science.gov (United States)

    Lv, Hongwei; Wang, Heping; Zhang, Zhijun; Yang, Wang; Liu, Wenbin; Li, Yulin; Li, Lisha

    2017-06-01

    Stem cells have potential to develop into numerous cell types, thus they are good cell source for tissue engineering. As an external physical signal, material stiffness is capable of regulating stem cell fate. Biomaterial stiffness is an important parameter in tissue engineering. We summarize main measurements of material stiffness under different condition, then list and compare three main methods of controlling stiffness (material amount, crosslinking density and photopolymeriztion time) which interplay with one another and correlate with stiffness positively, and current advances in effects of biomaterial stiffness on stem cell fate. We discuss the unsolved problems and future directions of biomaterial stiffness in tissue engineering. Copyright © 2017. Published by Elsevier Inc.

  14. Ultra structure of the denervated vocal muscle mechanically in hogs (sus scrofa domestica

    Directory of Open Access Journals (Sweden)

    Leão, Henrique Zaquia

    2010-03-01

    Full Text Available Introduction: The literature is not clear in the ultra-structural manifestations of the vocal wrinkles after neural wound. Objective: To verify the alterations that occur in a vocal fold mechanically denervated. Method: In this prospective study, it were utilized 15 hogs of commercial race (Sus scrofa domesticates, with age of 4 to 12 weeks. The animals were distributed in three groups, chosen at random. Everybody was submitted to the denervation of the right vocal fold, with surgical removal of a segment with three centimeters of the recurring right laryngeal nerve. After 45, 90 and 180 days of the operations, it was proceeded the biopsy of the vocal muscles, it was prosecuted the samples for transmission electron microscopy and, for the ultra-structural study, utilized the transmission electron microscopy Philips, model EM208S. Results: The biopsied groups with 45 and 90 days after operation of mechanical denervation, presented disorganization miofibrilar, only vestigial lines Z in many samples, as well like altered mithochondrions presenting limited sizes, and matrix mithocondrial rarefied with rare mithocondrial cristae present. The biopsied group with 180 days after operation of denervation, presented regular sarcomeres, mithocondrions with sizes and regular number with correct positioning between the sarcomerical units. Conclusion: The finds in the ultra-structure of the vocal muscles suggest to re enervation of the muscle being that the muscular mithochondrions were the most sensible structures to the denervated condition, successions by the cytoarchiteture of the miofibrilas; the finds in the ultra-structure of the vocal muscles suggests to reinervation of the muscle in the period of approximately six months.

  15. Folded waveguide resonator

    DEFF Research Database (Denmark)

    2013-01-01

    A waveguide resonator comprising a number of side walls defining a cavity enclosed by said sidewalls defining the cavity; and two or more conductive plates extending into the cavity, each conductive plate having a first side and a second side opposite the first side, and wherein the conductive...... plates are adapted to cause a standing electromagnetic wave to fold around the conductive plates along at least a first and a second direction and to extend on both sides of each of the conductive plates; wherein the conductive plates are adapted to cause the standing electromagnetic wave to fold...

  16. Avian vocal production beyond low dimensional models

    Science.gov (United States)

    Mindlin, Gabriel B.

    2017-02-01

    Birdsong is an active field of research in neuroscience, since songbirds learn their songs through a process similar to that followed by humans during vocal learning. Moreover, many of the vocalizations produced by birds are quite complex. Since the avian vocal organ is nonlinear, it is sensible to explore how much of that complexity is due to the neural instructions controlling the vocal organ, and how much to its nonlinear nature. In this work we first review some of the work carried out in the last years to address this problem, and then we discuss the existence of noisy sound sources in the avian vocal organ. We show that some spectral features of the song produced by the Zebra finch (one of the most widely studied species) can only be explained when vortex sound is taken into account.

  17. HIV infection and aortic stiffness.

    Science.gov (United States)

    Leite, Luisa Helena Maia; Cohen, Ariel; Boccara, Franck

    People living with human immunodeficiency virus (HIV) infection and receiving antiretroviral therapy now have the same life expectancy as the general population. However, they have a higher risk of atherosclerotic cardiovascular events because of a complex and polyfactorial vasculopathy, combining the effects of antiretroviral therapy, the HIV virus itself, immune activation, chronic inflammation and metabolic disturbances. Whether people living with HIV infection experience increased vascular aging compared with the general population remains controversial. To summarize current knowledge of the association between HIV infection and aortic stiffness as a marker of vascular aging. This review included 18 clinical studies in adult populations, published between 2009 and 2016, and identified on PubMed/MEDLINE or other databases. Search terms were aortic stiffness, arterial stiffness, vascular aging, pulse wave velocity and HIV. All 18 studies were observational, and compared groups infected (HIV+) and not infected (HIV-) with HIV. Ten studies (55%) reported no significant differences in aortic stiffness between HIV+ groups and age-matched HIV- control groups. The main reported determinants of aortic stiffness were age, blood pressure, smoking, metabolic syndrome and HIV-related variables, including CD4/CD8 ratio, current T-CD4 count < 200/mm 3 and nadir T-CD4+ count < 200/mm 3 . We found discordant results regarding whether HIV+ patients had increased aortic stiffness compared with HIV- controls. However, HIV-related conditions were associated with vascular health. This association has been confirmed in recent prospective studies. There is emerging evidence that HIV itself and immune activity affect vascular health and the large arteries. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. Folding worlds between pages

    CERN Multimedia

    Meier, Matthias

    2010-01-01

    "We all remember pop-up books form our childhood. As fascinated as we were back then, we probably never imagined how much engineering know-how went into these books. Pop-up engineer Anton Radevsky has even managed to fold a 27-kilometre particle accelerator into a book" (4 pages)

  19. Lase Ultrasonic Web Stiffness tester

    Energy Technology Data Exchange (ETDEWEB)

    Tim Patterson, Ph.D., IPST at Ga Tech

    2009-01-12

    The objective is to provide a sensor that uses non-contact, laser ultrasonics to measure the stiffness of paper during the manufacturing process. This will allow the manufacturer to adjust the production process in real time, increase filler content, modify fiber refining and as result produce a quality product using less energy. The sensor operates by moving back and forth across the paper web, at pre-selected locations firing a laser at the sheet, measuring the out-of-plane velocity of the sheet then using that measurement to calculate sheet stiffness.

  20. Association of Gastrocnemius Muscle Stiffness With Passive Ankle Joint Stiffness and Sex-Related Difference in the Joint Stiffness.

    Science.gov (United States)

    Chino, Kintaro; Takashi, Hideyuki

    2017-11-15

    Passive ankle joint stiffness is affected by all structures located within and over the joint, and is greater in men than in women. Localized muscle stiffness can be assessed by ultrasound shear wave elastography, and muscle architecture such as fascicle length and pennation angle can be measured by B-mode ultrasonography. Thus, we assessed localized muscle stiffness of the medial gastrocnemius (MG) with consideration of individual variability in the muscle architecture, and examined the association of the muscle stiffness with passive ankle joint stiffness and the sex-related difference in the joint stiffness. Localized muscle stiffness of the MG in 16 men and 17 women was assessed at 10° and 20° plantar flexion, neutral anatomical position, 10° and 20° dorsiflexion. Fascicle length and pennation angle of the MG were measured at these joint positions. Passive ankle joint stiffness was determined by the ankle joint angle-torque relationship. Localized MG muscle stiffness was not significantly correlated with passive ankle joint stiffness, and did not show significant sex-related difference, even when considering the muscle architecture. This finding suggest that muscle stiffness of the MG would not be a prominent factor to determine passive ankle joint stiffness and the sex-related difference in the joint stiffness.

  1. Force induced conformational transition in a system of interacting stiff polymer: Application to unfolding

    OpenAIRE

    Kumar, Sanjay; Giri, Debaprasad

    2007-01-01

    We consider a stiff polymer chain in poor solvent and apply a force at one end of the chain. We find that by varying the stiffness parameter, polymer undergoes a transition from the globule state to the folded like state. The conformation of folded state mimics the $\\beta$-sheet as seen in titin molecule. Using exact enumeration technique, we study the extension-force and force-temperature diagrams of such a system. Force-temperature diagram shows the re-entrance behaviour for flexible chain....

  2. Detecting Depression Severity from Vocal Prosody.

    Science.gov (United States)

    Yang, Ying; Fairbairn, Catherine; Cohn, Jeffrey F

    2013-01-01

    To investigate the relation between vocal prosody and change in depression severity over time, 57 participants from a clinical trial for treatment of depression were evaluated at seven-week intervals using a semi-structured clinical interview for depression severity (Hamilton Rating Scale for Depression: HRSD). All participants met criteria for Major Depressive Disorder at week 1. Using both perceptual judgments by naive listeners and quantitative analyses of vocal timing and fundamental frequency, three hypotheses were tested: 1) Naive listeners can perceive the severity of depression from vocal recordings of depressed participants and interviewers. 2) Quantitative features of vocal prosody in depressed participants reveal change in symptom severity over the course of depression. And 3) Interpersonal effects occur as well; such that vocal prosody in interviewers shows corresponding effects. These hypotheses were strongly supported. Together, participants' and interviewers' vocal prosody accounted for about 60% of variation in depression scores, and detected ordinal range of depression severity (low, mild, and moderate-to-severe) in 69% of cases (kappa = 0.53). These findings suggest that analysis of vocal prosody could be a powerful tool to assist in depression screening and monitoring over the course of depressive disorder and recovery.

  3. Vocal Loading in Speaking a Foreign Language.

    Science.gov (United States)

    Järvinen, Kati; Laukkanen, Anne-Maria

    2015-01-01

    This study investigated whether speaking a foreign language affects the subjective notions of vocal fatigue, and whether acoustic measurements reveal a higher vocal loading. The speech samples of 20 native Finnish-speaking and 23 native English-speaking subjects were recorded in Finnish and in English. From the speech samples, fundamental frequency, equivalent sound level, total duration of voiced speech, speech rate, alpha ratio and L1-L0 level difference were analyzed. Vocal doses were calculated. According to subjective notions, the voice gets tired more quickly when speaking a foreign language. The mean fundamental frequency increased but the speech rate and total duration of voiced speech decreased significantly when speaking a foreign language. Thus, the vocal doses decreased. The subjective sensations of increased vocal fatigue may be due to increased mental stress rather than to higher vocal loading. However, a trend that speaking a foreign language may involve more loading was found in L1-L0 level difference and in the doses normalized to time dose. Longer speech samples should be studied. Voice quality-based indicators of vocal loading are worth testing in addition to the measures based on the amount of voicing in speech. © 2015 S. Karger AG, Basel.

  4. Aerodynamic and acoustic features of vocal effort.

    Science.gov (United States)

    Rosenthal, Allison L; Lowell, Soren Y; Colton, Raymond H

    2014-03-01

    The purpose of this study was to determine the aerodynamic and acoustic features of speech produced at comfortable, maximal and minimal levels of vocal effort. Prospective, quasi-experimental research design. Eighteen healthy participants with normal voice were included in this study. After task training, participants produced repeated syllable combinations at comfortable, maximal and minimal levels of vocal effort. A pneumotachometer and vented (Rothenberg) mask were used to record aerodynamic data, with simultaneous recording of the acoustic signal for subsequent analysis. Aerodynamic measures of subglottal pressure, translaryngeal airflow, maximum flow declination rate (MFDR), and laryngeal resistance were analyzed, along with acoustic measures of cepstral peak prominence (CPP) and its standard deviation (SD). Participants produced significantly greater subglottal pressure, translaryngeal airflow, and MFDR during maximal effort speech as compared with comfortable vocal effort. When producing speech at minimal vocal effort, participants lowered subglottal pressure, MFDR, and laryngeal resistance. Acoustic changes associated with changes in vocal effort included significantly higher CPP during maximal effort speech and significantly lower CPP SD during minimal effort speech, when each was compared with comfortable effort. For healthy speakers without voice disorders, subglottal pressure, translaryngeal airflow, and MFDR may be important factors that contribute to an increased sense of vocal effort. Changes in the cepstral signal also occur under conditions of increased or decreased vocal effort relative to comfortable effort. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  5. Coordination between posture and phonation in vocal effort behavior.

    Science.gov (United States)

    Lagier, Aude; Vaugoyeau, Marianne; Ghio, Alain; Legou, Thierry; Giovanni, Antoine; Assaiante, Christine

    2010-01-01

    Postural correlates of vocal effort are rarely described in the literature, while they are extensively dealt with in speech therapy. This study aims at determining whether body movement is a side effect of vocal effort or an integral part of communication effort behavior. The answer to this question is mainly based on correlations between posture and phonation. Twenty healthy subjects participated in this study. They had to communicate with a listener under 3 conditions requiring different levels of vocal effort. The vocal parameters increased and confirmed that the subjects had made a vocal effort. The kinematic parameters (amplitude and duration of body movement) increased with vocal effort. Lastly, vocal and kinematic characteristics were significantly correlated. The close correlation of posture with vocal production shows that movement is not a mere consequence of vocal effort. Posture and voice are coordinated in communication behavior, and each body segment plays its specific role in the vocal effort behavior. (c) 2010 S. Karger AG, Basel.

  6. Vocal ontogeny in neotropical singing mice (Scotinomys.

    Directory of Open Access Journals (Sweden)

    Polly Campbell

    Full Text Available Isolation calls produced by dependent young are a fundamental form of communication. For species in which vocal signals remain important to adult communication, the function and social context of vocal behavior changes dramatically with the onset of sexual maturity. The ontogenetic relationship between these distinct forms of acoustic communication is surprisingly under-studied. We conducted a detailed analysis of vocal development in sister species of Neotropical singing mice, Scotinomys teguina and S. xerampelinus. Adult singing mice are remarkable for their advertisement songs, rapidly articulated trills used in long-distance communication; the vocal behavior of pups was previously undescribed. We recorded 30 S. teguina and 15 S. xerampelinus pups daily, from birth to weaning; 23 S. teguina and 11 S. xerampelinus were recorded until sexual maturity. Like other rodent species with poikilothermic young, singing mice were highly vocal during the first weeks of life and stopped vocalizing before weaning. Production of first advertisement songs coincided with the onset of sexual maturity after a silent period of ≧2 weeks. Species differences in vocal behavior emerged early in ontogeny and notes that comprise adult song were produced from birth. However, the organization and relative abundance of distinct note types was very different between pups and adults. Notably, the structure, note repetition rate, and intra-individual repeatability of pup vocalizations did not become more adult-like with age; the highly stereotyped structure of adult song appeared de novo in the first songs of young adults. We conclude that, while the basic elements of adult song are available from birth, distinct selection pressures during maternal dependency, dispersal, and territorial establishment favor major shifts in the structure and prevalence of acoustic signals. This study provides insight into how an evolutionarily conserved form of acoustic signaling provides

  7. Vocal learning beyond imitation: mechanisms of adaptive vocal development in songbirds and human infants.

    Science.gov (United States)

    Tchernichovski, Ofer; Marcus, Gary

    2014-10-01

    Studies of vocal learning in songbirds typically focus on the acquisition of sensory templates for song imitation and on the consequent process of matching song production to templates. However, functional vocal development also requires the capacity to adaptively diverge from sensory templates, and to flexibly assemble vocal units. Examples of adaptive divergence include the corrective imitation of abnormal songs, and the decreased tendency to copy over-abundant syllables. Such frequency-dependent effects might mirror tradeoffs between the assimilation of group identity (culture) while establishing individual and flexibly expressive songs. Intriguingly, although the requirements for vocal plasticity vary across songbirds, and more so between birdsong and language, the capacity to flexibly assemble vocal sounds develops in a similar, stepwise manner across species. Therefore, universal features of vocal learning go well beyond the capacity to imitate. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Vocal Cord Actinomycosis Mimicking a Laryngeal Tumor

    Directory of Open Access Journals (Sweden)

    Keisuke Yoshihama

    2013-01-01

    Full Text Available Laryngeal carcinoma and laryngeal papilloma are the most commonly encountered tumorous lesions in the larynx. Herein, we report a case of the mass arising from the left vocal cord in a 49-year-old Japanese man. Endoscopic examination suggested that the mass is a tumor such as carcinoma and papilloma. Pathological examination showed that the specimen demonstrated actinomycosis in the left vocal cord. Although vocal cord actinomycosis is extremely rare, the otolaryngologist should recognize this condition during the inspection of the larynx.

  9. Vocal Cord Actinomycosis Mimicking a Laryngeal Tumor

    Science.gov (United States)

    Yoshihama, Keisuke; Kato, Yasumasa; Baba, Yuh

    2013-01-01

    Laryngeal carcinoma and laryngeal papilloma are the most commonly encountered tumorous lesions in the larynx. Herein, we report a case of the mass arising from the left vocal cord in a 49-year-old Japanese man. Endoscopic examination suggested that the mass is a tumor such as carcinoma and papilloma. Pathological examination showed that the specimen demonstrated actinomycosis in the left vocal cord. Although vocal cord actinomycosis is extremely rare, the otolaryngologist should recognize this condition during the inspection of the larynx. PMID:23573444

  10. [From stiff man syndrome to stiff person spectrum disorders].

    Science.gov (United States)

    Meinck, H-M; Balint, B

    2018-02-01

    The identification of new variants of the stiff man syndrome (SMS) and of new, probably pathogenic neuronal autoantibodies has led to the concept of stiff man (or person) spectrum disorders (SPSD). This is an expanding group of rare chronic autoimmune inflammatory diseases of the central nervous system (CNS) that have in common the main symptoms of fluctuating rigidity and spasms with pronounced stimulus sensitivity. These core symptoms are mandatory and can be accompanied by a wide variety of other neurological signs. The SPSDs are associated with autoantibodies directed against neuronal proteins that attenuate excitability. Neither clinical phenotypes nor the course of SPSD correlate closely with the antibody status. The treatment of these diseases aims at maintaining mobility and is pragmatically oriented to the degree of impediment and comprises antispastic, anticonvulsant and immunomodulating or immunosuppressive medication strategies.

  11. Vocal Cord Paralysis and its Etiologies: A Prospective Study

    OpenAIRE

    Seyed Javad Seyed Toutounchi; Mahmood Eydi; Samad EJ Golzari; Mohammad Reza Ghaffari; Nashmil Parvizian

    2014-01-01

    Introduction: Vocal cord paralysis is a common symptom of numerous diseases and it may be due to neurogenic or mechanical fixation of the cords. Paralysis of the vocal cords is just a symptom of underlying disease in some cases; so, clinical diagnosis of the underlying cause leading to paralysis of the vocal cords is important. This study evaluates the causes of vocal cord paralysis. Methods: In a prospective study, 45 patients with paralyzed vocal cord diagnosis were examined by tests such a...

  12. Retinal folds in Terson syndrome.

    Science.gov (United States)

    Keithahn, M A; Bennett, S R; Cameron, D; Mieler, W F

    1993-08-01

    Perimacular retinal folds have been reported in the shaken baby syndrome, but have not been described in adults with Terson syndrome. The authors present two patients with perimacular retinal folds in adults with Terson syndrome. In one patient, electron microscopy was used to examine the membrane spanning the fold. The membrane spanning the perimacular fold was found to be internal limiting membrane. The pathogenesis of these perimacular folds found in adults sustaining direct head trauma is probably different from that previously described for folds seen in infant eyes with shaken baby syndrome. Retinal folds occurring in Terson syndrome are clinically similar to those seen in the shaken baby syndrome.

  13. Actions in vocal health: a proposal for improving the vocal profile of teachers.

    Science.gov (United States)

    Silverio, Kelly Cristina Alves; Gonçalves, Claudia Giglio de Oliveira; Penteado, Regina Zanella; Vieira, Tais Pichirilli Guilherme; Libardi, Aline; Rossi, Daniele

    2008-01-01

    several authors have pointed to the urgent need of researches and actions involving teachers, in the school environment, that have a preventive and vocal health promotion character with the purpose of improving work conditions. to analyze the vocal complaints, laryngeal symptoms, vocal habits and vocal profile of teachers of a public school before and after their participation in voice workshops. the study was divided in different steps: 1st step - closed interview, larynx and perceptive-auditory assessment in which 42 teachers were evaluated; 2nd step - voice workshops; 3rd step - perceptive-auditory reassessment in which 13 teachers were evaluated. 73% of the subjects presented vocal complaints; 57.14% presented mild to moderate hoarseness, 78.57% presented breathiness and 52.38% vocal tension. Evaluation of the larynx indicated that 75.86% of the subjects presented glottal gaps and 34.48% mucous thickening. After the voice workshops a significant difference was observed in the level of vocal tension, both in the analysis of the /e/ vowel and in the analysis of Spontaneous Speech (p = 0.0277 for p > 0.05 for both). Improvement was observed in vocal care and in the understanding of intervening and determinant factors for vocal alterations, which are present in the teaching environment. health actions, such as voice workshops, are important to trigger changes in the work environment as well as in the health of teachers.

  14. Nocturnal "humming" vocalizations: adding a piece to the puzzle of giraffe vocal communication.

    Science.gov (United States)

    Baotic, Anton; Sicks, Florian; Stoeger, Angela S

    2015-09-09

    Recent research reveals that giraffes (Giraffa camelopardalis sp.) exhibit a socially structured, fission-fusion system. In other species possessing this kind of society, information exchange is important and vocal communication is usually well developed. But is this true for giraffes? Giraffes are known to produce sounds, but there is no evidence that they use vocalizations for communication. Reports on giraffe vocalizations are mainly anecdotal and the missing acoustic descriptions make it difficult to establish a call nomenclature. Despite inconclusive evidence to date, it is widely assumed that giraffes produce infrasonic vocalizations similar to elephants. In order to initiate a more detailed investigation of the vocal communication in giraffes, we collected data of captive individuals during day and night. We particularly focussed on detecting tonal, infrasonic or sustained vocalizations. We collected over 947 h of audio material in three European zoos and quantified the spectral and temporal components of acoustic signals to obtain an accurate set of acoustic parameters. Besides the known burst, snorts and grunts, we detected harmonic, sustained and frequency-modulated "humming" vocalizations during night recordings. None of the recorded vocalizations were within the infrasonic range. These results show that giraffes do produce vocalizations, which, based on their acoustic structure, might have the potential to function as communicative signals to convey information about the physical and motivational attributes of the caller. The data further reveal that the assumption of infrasonic communication in giraffes needs to be considered with caution and requires further investigations in future studies.

  15. Microscopie non-lineaire pour l'imagerie des cordes vocales

    Science.gov (United States)

    Deterre, Romain

    The vocal cords are two folds of epithelial tissues located in the larynx and are involved in production of the human voice. Despite their apparent simplicity, their internal structure is complex. Each fold can be divided into several layers with different mechanical properties. The gold standard for studying their structure - histology - has the inconvenience of being very invasive. Non-linear microscopy is an optical imaging technique which allows images to be taken in depth within samples in a non invasive manner. It also offers intrinsic contrasts, allowing the identification of certain fibrous proteins - elastin and collagen - which are responsible for the mechanical properties of epithelious tissues. The main goal of this research project was to assess nonlinear microscopy's performances for vocal fold imaging. The study has been broken down in two separate tasks. The first one was to evaluate the nonlinear modalities contrast against histology. For that purpose, we chose to first take images of thin samples and compare them to the corresponding histological slides. The second task was to make tests to transcribe the results obtained to in vivo imaging. A custom-built nonlinear imaging system was used for these experiments. It was developed to allow acquisition of wide-field images. A C++ based software was developped to control the microscope and allow treatment and visualization of the images. After being built, the system was further tested to check its performances in comparison with the theoretical limit as described in the literature. Thin slices of vocal folds were obtained from the team of Pr Christopher J. Hartnick from Massachusetts Eye and Ear Infirmary, Harvard Medical School. Specialists from his team analysed the histological samples to extract structural data from the vocal folds. A good correlation was measured between histological and nonlinear data. A first step in evaluating the possibility for translating these results towards in vivo

  16. Energy-Efficient Variable Stiffness Actuators

    NARCIS (Netherlands)

    Visser, L.C.; Carloni, Raffaella; Stramigioli, Stefano

    2011-01-01

    Variable stiffness actuators are a particular class of actuators that is characterized by the property that the apparent output stiffness can be changed independent of the output position. To achieve this, variable stiffness actuators consist of a number of elastic elements and a number of actuated

  17. Shoulder Stiffness : Current Concepts and Concerns

    NARCIS (Netherlands)

    Itoi, Eiji; Arce, Guillermo; Bain, Gregory I.; Diercks, Ronald L.; Guttmann, Dan; Imhoff, Andreas B.; Mazzocca, Augustus D.; Sugaya, Hiroyuki; Yoo, Yon-Sik

    Shoulder stiffness can be caused by various etiologies such as immobilization, trauma, or surgical interventions. The Upper Extremity Committee of ISAKOS defined the term "frozen shoulder" as idiopathic stiff shoulder, that is, without a known cause. Secondary stiff shoulder is a term that should be

  18. Cepstral analysis of voice in persons with vocal nodules.

    Science.gov (United States)

    Radish Kumar, B; Bhat, Jayashree S; Prasad, Neitica

    2010-11-01

    Traditional measures of dysphonia were reported to be unreliable, and the measurements of cepstral peak prominence (CPP) have been shown to correlate well with perceptions of breathiness. Hence, the present study was hypothesized that there would be abnormal reduction of the cepstral peak in the speakers with vocal nodules relative to the normal controls as they are characterized by hoarse and breathy voice due to inadequate closure of vocal folds. Phonation of sustained vowel /a/ was subjected to acoustic analysis using Computerized Speech Lab (CSL model 4150) software. The vowels were analyzed acoustically with the measurement of CPP. Independent t test was employed to compare the significant differences between the clinical and the control groups in both males and females. The results revealed significant differences across the two groups at Pvocal nodules. Cepstral deviations in the clinical group are explained due to the presence of laryngeal pathology leading to the lower values of CPP. Copyright © 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  19. Information from folds: A review

    Science.gov (United States)

    Hudleston, Peter J.; Treagus, Susan H.

    2010-12-01

    Folds are spectacular geological structures that are seen in layered rock on many different scales. To mark 30 years of the Journal of Structural Geology, we review the information that can be gained from studies of folds in theory, experiment and nature. We first review theoretical considerations and modeling, from classical approaches to current developments. The subject is dominated by single-layer fold theory, with the assumption of perfect layer-parallel shortening, but we also review multilayer fold theory and modeling, and folding of layers that are oblique to principal stresses and strains. This work demonstrates that viscosity ratio, degree of non-linearity of the flow law, anisotropy, and the thickness and spacing distribution of layers of different competence are all important in determining the nature and strength of the folding instability. Theory and modeling provide the basis for obtaining rheological information from natural folds, through analysis of wavelength/thickness ratios of single layer folds, and fold shapes. They also provide a basis for estimating the bulk strain from folded layers. Information about folding mechanisms can be obtained by analysis of cleavage and fabric patterns in folded rocks, and the history of deformation can be revealed by understanding how asymmetry can develop in folds, by how folds develop in shear zones, and how folds develop in more complex three-dimensional deformations.

  20. Functional flexibility in wild bonobo vocal behaviour

    National Research Council Canada - National Science Library

    Clay, Zanna; Archbold, Jahmaira; Zuberbühler, Klaus

    2015-01-01

    ... independently of context and biological function. Functional flexibility has recently been demonstrated in the vocalisations of pre-linguistic human infants, which has been contrasted to the functionally fixed vocal behaviour of non-human primates...

  1. Dynamic stiffness of suction caissons

    DEFF Research Database (Denmark)

    Ibsen, Lars Bo; Liingaard, Morten; Andersen, Lars

    This report concerns the dynamic soil-structure interaction of steel suction caissons applied as foundations for offshore wind turbines. An emphasis is put on torsional vibrations and coupled sliding/rocking motion, and the influence of the foundation geometry and the properties of the surrounding...... soil is examined. The soil is simplified as a homogenous linear viscoelastic material and the dynamic stiffness of the suction caisson is expressed in terms of dimensionless frequency-dependent coefficients corresponding to the different degrees of freedom. The dynamic stiffness coefficients...... for the skirted foundation are evaluated by means of a three-dimensional coupled boundary element/finite element model. Comparisons with known analytical and numerical solutions indicate that the static and dynamic behaviour of the foundation are predicted accurately with the applied model. The analysis has been...

  2. Coping strategies in teachers with vocal complaint.

    Science.gov (United States)

    Zambon, Fabiana; Moreti, Felipe; Behlau, Mara

    2014-05-01

    To understand the coping strategies used by teachers with vocal complaints, compare the differences between those who seek and those who do not seek voice therapy, and investigate the relationships among coping and voice perceptual analysis, coping and signs and symptoms of voice, and coping and participation restrictions and limitations in vocal activities. Cross-sectional nonrandomized prospective study with control group. Ninety female teachers participated in the study, of similar ages, divided into three groups: group 1 (G1) comprised 30 teachers with vocal complaints who sought voice therapy, group 2 (G2) comprised 30 teachers with vocal complaints who never sought voice therapy, and group 3 (G3) comprised 30 teachers without vocal complaints. The following analysis were conducted: identification and characterization questionnaire, addressing personal and occupational description, recording speech material for voice perceptual analysis, Voice Signs and Symptoms Questionnaire, Voice Activity and Participation Profile (VAPP), and Voice Disability Coping Questionnaire (VDCQ)-Brazilian Version. In relation to the voice perceptual analysis, there was statistically significant difference between the groups with vocal complaint (G1+G2), which had showed voices with mild-to-moderate deviation, and the group without vocal complaint (G1), which showed voices within the normal variability of voice quality (mean for G1 = 49.9, G2 = 43.7, and G3 = 32.3, P vocal complaints who looked for voice therapy (G1) tended to use more problem-focused strategies and had higher scores in VDCQ (G1 = 45.4, G2 = 38.5, and G3 = 9.5, P vocal deviation, VAPP total score, VAPP partial scores of self-perceived severity of voice problem, effect on daily communication, effect on emotion, and participation restriction for G1; VAPP total score and partial score of effect on daily communication for G2; and all VAPP scores for G3. No correlation was found between voice signs and

  3. Integration of acoustic radiation force and optical imaging for blood plasma clot stiffness measurement.

    Directory of Open Access Journals (Sweden)

    Caroline W Wang

    Full Text Available Despite the life-preserving function blood clotting serves in the body, inadequate or excessive blood clot stiffness has been associated with life-threatening diseases such as stroke, hemorrhage, and heart attack. The relationship between blood clot stiffness and vascular diseases underscores the importance of quantifying the magnitude and kinetics of blood's transformation from a fluid to a viscoelastic solid. To measure blood plasma clot stiffness, we have developed a method that uses ultrasound acoustic radiation force (ARF to induce micron-scaled displacements (1-500 μm on microbeads suspended in blood plasma. The displacements were detected by optical microscopy and took place within a micro-liter sized clot region formed within a larger volume (2 mL sample to minimize container surface effects. Modulation of the ultrasound generated acoustic radiation force allowed stiffness measurements to be made in blood plasma from before its gel point to the stage where it was a fully developed viscoelastic solid. A 0.5 wt % agarose hydrogel was 9.8-fold stiffer than the plasma (platelet-rich clot at 1 h post-kaolin stimulus. The acoustic radiation force microbead method was sensitive to the presence of platelets and strength of coagulation stimulus. Platelet depletion reduced clot stiffness 6.9 fold relative to platelet rich plasma. The sensitivity of acoustic radiation force based stiffness assessment may allow for studying platelet regulation of both incipient and mature clot mechanical properties.

  4. Negative stiffness in gear contact

    Directory of Open Access Journals (Sweden)

    Půst L.

    2015-12-01

    Full Text Available The tooth contact stiffness is very often included in dynamic mathematical models of gear drives. It is an important value for calculation of torsion eigenfrequencies as well as the dynamic properties of the whole transmission systems. Planetary gear drives have several advantages over simple parallel axis gears, especially due to theirs compact design and great torque-to-weight ratio caused by multiple parallel paths. However, the dimensional or mounting errors can cause that some planets have the tendency to take more load than the others. One of the ways how to improve load sharing is the application of flexible planetary pins or by using a free central wheel. However in such cases, the wheels motion is defined in one rotation coordinate and two translation coordinates — tangential and radial. The reaction force at radial change of axis distance is usually neglected. The focus of this contribution is to derive the stiffness of this radial connection and to analyse the influence of radial stiffness on planetary gear dynamics.

  5. Vocal health fitness to different music styles

    Directory of Open Access Journals (Sweden)

    Maria Cláudia Mendes Caminha Muniz

    2010-09-01

    Full Text Available Objective: To present genres and styles currently running on western music scene, focusing on the practice of singing voice. Methods: An observational and documental study for which were selected sound sources presenting musical genres and styles that are part of the experience of the researchers, which were analyzed considering origins, formative elements and vocal features. Alongside we carried out a review of literature grounded in databases research and free review of websites and classical books of the area. Results: The selected styles (Rock and Roll, Heavy Metal, Trash Metal, Grunge, Gothic Metal, Rap, Funk, Blues, R&B – Rhythm and Blues, Soul, Gospel, MPB, Samba, Forro, Sertanejo, Bossa Nova, Opera and Chamber Music were described, pointing the reasons for the speech therapist to be informed about them and about singing voice aspects. His guidance may minimize possible vocal damage caused by each style, since each of them carries its own patterns to which the interpreter must submit. Conclusions: We conclude that the singer will use a specific vocal pattern that resembles the musical style he intends to sing, regardless of any harm it may or may not cause to vocal health. When choosing a musical style, it is important that the singer has the knowledge and understanding of how the use of his vocal apparatus will cause or not cause injury to his voice. Also be aware that the technique in singing is necessary for vocal longevity.

  6. Shoulder stiffness and rotator cuff repair.

    Science.gov (United States)

    Papalia, Rocco; Franceschi, Francesco; Vasta, Sebastiano; Gallo, Andrea; Maffulli, Nicola; Denaro, Vincenzo

    2012-01-01

    Shoulder stiffness is a frequent complication of surgical repair of rotator cuff tears. Post-operative stiffness negatively affects surgical outcomes leading to a substantial comorbidity and to the failure of surgical treatment. Also, a stiff shoulder could commonly be concomitant with an rotator cuff tear (RCT). We performed a comprehensive search of CINAHL, Embase, Medline and the Cochrane Central Registry of Controlled Trials, from inception of the database to 31 July 2011. Sixteen articles published in peer-reviewed journals were included in this comprehensive review. The management of shoulder stiffness is still controversial. The role of rehabilitation programs (standard versus early passive mobilization) after RCT repair on the development of stiffness is not clear, while the role of arthroscopic capsular release for post-operative stiffness is better defined, although a threshold of decreased the range of movement for which capsular release is advised has not been identified. Several factors have been identified to predispose the development of shoulder stiffness. There is also evidence in favor of surgical management of RCTs even when accompanied by shoulder stiffness, and there are strong evidences that arthroscopic capsular release is reliable and effective in managing shoulder stiffness. The post-operative rehabilitation protocol remains controversial. We are still far from definitive guidelines for the management of pre- and post-operative stiffness, and prospective double-blinded randomized clinical trials are needed to obtain evidence allowing to establish a reliable and effective management plan for shoulder stiffness.

  7. Frustration, function and folding.

    Science.gov (United States)

    Ferreiro, Diego U; Komives, Elizabeth A; Wolynes, Peter G

    2017-11-01

    Natural protein molecules are exceptional polymers. Encoded in apparently random strings of amino-acids, these objects perform clear physical tasks that are rare to find by simple chance. Accurate folding, specific binding, powerful catalysis, are examples of basic chemical activities that the great majority of polypeptides do not display, and are thought to be the outcome of the natural history of proteins. Function, a concept genuine to Biology, is at the core of evolution and often conflicts with the physical constraints. Locating the frustration between discrepant goals in a recurrent system leads to fundamental insights about the chances and necessities that shape the encoding of biological information. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Folding, Tiling, and Multidimensional Coding

    OpenAIRE

    Etzion, Tuvi

    2009-01-01

    Folding a sequence $S$ into a multidimensional box is a method that is used to construct multidimensional codes. The well known operation of folding is generalized in a way that the sequence $S$ can be folded into various shapes. The new definition of folding is based on lattice tiling and a direction in the $D$-dimensional grid. There are potentially $\\frac{3^D-1}{2}$ different folding operations. Necessary and sufficient conditions that a lattice combined with a direction define a folding a...

  9. Force-induced conformational transition in a system of interacting stiff polymers: application to unfolding.

    Science.gov (United States)

    Kumar, Sanjay; Giri, Debaprasad

    2005-11-01

    We consider a stiff polymer chain in poor solvent and apply a force at one end of the chain. We find that by varying the stiffness parameter, the polymer undergoes a transition from the globule state to the foldedlike state. The conformation of the folded state mimics the beta sheet as seen in the titin molecule. Using the exact enumeration technique, we study the extension-force and force-temperature diagrams of such a system. The force-temperature diagram shows the re-entrance behavior for a flexible chain. However, for a stiff chain this re-entrance behavior is absent and there is an enhancement in theta temperature with the rise of stiffness. We further propose that the internal information about the frozen structure of a polymer can be read from the distribution of end-to-end distance which shows a sawtoothlike behavior.

  10. Afferents from vocal motor and respiratory effectors are recruited during vocal production in juvenile songbirds.

    Science.gov (United States)

    Bottjer, Sarah W; To, Michelle

    2012-08-08

    Learned behaviors require coordination of diverse sensory inputs with motivational and motor systems. Although mechanisms underlying vocal learning in songbirds have focused primarily on auditory inputs, it is likely that sensory inputs from vocal effectors also provide essential feedback. We investigated the role of somatosensory and respiratory inputs from vocal effectors of juvenile zebra finches (Taeniopygia guttata) during the stage of sensorimotor integration when they are learning to imitate a previously memorized tutor song. We report that song production induced expression of the immediate early gene product Fos in trigeminal regions that receive hypoglossal afferents from the tongue and syrinx (the main vocal organ). Furthermore, unilateral lesion of hypoglossal afferents greatly diminished singing-induced Fos expression on the side ipsilateral to the lesion, but not on the intact control side. In addition, unilateral lesion of the vagus reduced Fos expression in the ipsilateral nucleus of the solitary tract in singing birds. Lesion of the hypoglossal nerve to the syrinx greatly disrupted vocal behavior, whereas lesion of the hypoglossal nerve to the tongue exerted no obvious disruption and lesions of the vagus caused some alterations to song behavior. These results provide the first functional evidence that somatosensory and respiratory feedback from peripheral effectors is activated during vocal production and conveyed to brainstem regions. Such feedback is likely to play an important role in vocal learning during sensorimotor integration in juvenile birds and in maintaining stereotyped vocal behavior in adults.

  11. Loud voice during environmental noise exposure in patients with vocal nodules.

    Science.gov (United States)

    Aronsson, Carina; Bohman, Mikael; Ternström, Sten; Södersten, Maria

    2007-01-01

    The aim was to investigate how female patients with vocal nodules use their voices when trying to make themselves heard over background noise. Ten patients with bilateral vocal fold nodules and 23 female controls were recorded reading a text in four conditions, one without noise and three with noise from cafés/pubs, played over loudspeakers at 69, 77 and 85 dBA. The noise was separated from the voice signal using a high-resolution channel estimation technique. Both patients and controls increased voice sound pressure level (SPL), fundamental frequency (F0), subglottal pressure (Ps) and their subjective ratings of strain significantly as a main effect of the increased background noise. The patients used significantly higher Ps in all four conditions. Despite this they did not differ significantly from the controls in voice SPL, F0 or perceived strain. It was concluded that speaking in background noise is a risk factor for vocal loading. Vocal loading tests in clinical settings are important and further development of assessment methods is needed.

  12. Changes after voice therapy in objective and subjective voice measurements of pediatric patients with vocal nodules.

    Science.gov (United States)

    Tezcaner, Ciler Zahide; Karatayli Ozgursoy, Selmin; Ozgursoy, Selmin Karatayli; Sati, Isil; Dursun, Gursel

    2009-12-01

    The aim of this study was to analyze the efficiency of the voice therapy in children with vocal nodules by using the acoustic analysis and subjective assessment. Thirty-nine patients with vocal fold nodules, aged between 7 and 14, were included in the study. Each subject had voice therapy led by an experienced voice therapist once a week. All diagnostic and follow-up workouts were performed before the voice therapy and after the third or the sixth month. Transoral and/or transnasal videostroboscopic examination and acoustic analysis were achieved using multi-dimensional voice program (MDVP) and subjective analysis with GRBAS scale. As for the perceptual assessment, the difference was significant for four parameters out of five. A significant improvement was found in the acoustic analysis parameters of jitter, shimmer, and noise-to-harmonic ratio. The voice therapy which was planned according to patients' needs, age, compliance and response to therapy had positive effects on pediatric patients with vocal nodules. Acoustic analysis and GRBAS may be used successfully in the follow-up of pediatric vocal nodule treatment.

  13. Determining the shape of a human vocal tract from pressure measurements at the lips

    Science.gov (United States)

    Aktosun, Tuncay; Machuca, Alicia; Sacks, Paul

    2017-11-01

    The inverse problem of determining the cross-sectional area of a human vocal tract during the utterance of a vowel is considered in terms of the data consisting of the absolute value of sound pressure at the lips. If the upper lip is curved downward during the utterance, it is shown that there may be up to an M-fold nonuniqueness in the determination, where M is the maximal number of eligible resonances associated with a related Schrödinger operator. Each of the M such distinct candidates for the vocal-tract area corresponding to the same absolute pressure is uniquely determined. The mathematical theory is presented for the recovery of each candidate for the vocal-tract area, and the admissibility criterion for each of the M candidates to be a vocal-tract radius is specified. On the other hand, if the upper lip is horizontal or curved upward during the utterance, then the inverse problem has a unique solution. The theory developed is illustrated with some examples.

  14. Simultaneous optimisation of earwig hindwings for flight and folding

    Directory of Open Access Journals (Sweden)

    Julia Deiters

    2016-05-01

    Full Text Available Earwig wings are highly foldable structures that lack internal muscles. The behaviour and shape changes of the wings during flight are yet unknown. We assume that they meet a great structural challenge to control the occurring deformations and prevent the wing from collapsing. At the folding structures especially, the wing could easily yield to the pressure. Detailed microscopy studies reveal adaptions in the structure and material which are not relevant for folding purposes. The wing is parted into two structurally different areas with, for example, a different trend or stiffness of the wing veins. The storage of stiff or more flexible material shows critical areas which undergo great changes or stress during flight. We verified this with high-speed video recordings. These reveal the extent of the occurring deformations and their locations, and support our assumptions. The video recordings reveal a dynamical change of a concave flexion line. In the static unfolded state, this flexion line blocks a folding line, so that the wing stays unfolded. However, during flight it extends and blocks a second critical folding line and prevents the wing from collapsing. With these results, more insight in passive wing control, especially within high foldable structures, is gained.

  15. Stuttering: A novel bullfrog vocalization

    Science.gov (United States)

    Simmons, Andrea; Suggs, Dianne

    2004-05-01

    The advertisement call of male bullfrogs (Rana catesbeiana) consists of a series of individual croaks, each of which contains multiple harmonics with a missing or attenuated fundamental frequency of approximately 100 Hz. The envelope of individual croaks has typically been represented in the literature as smooth and unmodulated. From an analysis of 5251 advertisement calls from 17 different choruses over two mating seasons, we show that males add an extra modulation (around 4 Hz) to the envelope of individual croaks, following specific rules. We term these extra modulations stutters. Neither single croak calls nor the first croak in multiple croak calls contains stutters. When stuttering begins, it does so with a croak containing a single stutter, and the number of stutters increases linearly (plus or minus 1 stutter, up to 4 stutters) with the number of croaks. This pattern is stable across individual males (N=10). Playback experiments reveal that vocal responses to stuttered and nonstuttered calls vary with proximity to the stimulus. Close males respond with nonstuttered calls, while far males respond with stuttered calls. The data suggest that nonstuttered calls are used for aggressive or territorial purposes, while stuttered calls are used to attract females.

  16. Origami tubes assembled into stiff, yet reconfigurable structures and metamaterials

    Science.gov (United States)

    Filipov, Evgueni T.; Tachi, Tomohiro; Paulino, Glaucio H.

    2015-01-01

    Thin sheets have long been known to experience an increase in stiffness when they are bent, buckled, or assembled into smaller interlocking structures. We introduce a unique orientation for coupling rigidly foldable origami tubes in a “zipper” fashion that substantially increases the system stiffness and permits only one flexible deformation mode through which the structure can deploy. The flexible deployment of the tubular structures is permitted by localized bending of the origami along prescribed fold lines. All other deformation modes, such as global bending and twisting of the structural system, are substantially stiffer because the tubular assemblages are overconstrained and the thin sheets become engaged in tension and compression. The zipper-coupled tubes yield an unusually large eigenvalue bandgap that represents the unique difference in stiffness between deformation modes. Furthermore, we couple compatible origami tubes into a variety of cellular assemblages that can enhance mechanical characteristics and geometric versatility, leading to a potential design paradigm for structures and metamaterials that can be deployed, stiffened, and tuned. The enhanced mechanical properties, versatility, and adaptivity of these thin sheet systems can provide practical solutions of varying geometric scales in science and engineering. PMID:26351693

  17. Vocal effort and voice handicap among teachers.

    Science.gov (United States)

    Sampaio, Márcio Cardoso; dos Reis, Eduardo José Farias Borges; Carvalho, Fernando Martins; Porto, Lauro Antonio; Araújo, Tânia Maria

    2012-11-01

    The relationship between voice handicap and professional vocal effort was investigated among teachers in a cross-sectional study of census nature on 4496 teachers within the public elementary education network in Salvador, Bahia, Brazil. Voice handicap (the outcome of interest) was evaluated using the Voice Handicap Index 10. The main exposure, the lifetime vocal effort index, was obtained as the product of the number of years working as a teacher multiplied by the mean weekly working hours. The prevalence of voice handicap was 28.8% among teachers with high professional vocal effort and 21.3% among those with acceptable vocal effort, thus yielding a crude prevalence ratio (PR) of 1.36 (95% confidence interval [CI]=1.14-1.61). In the final logistic model, the prevalence of voice handicap was statistically associated with the professional vocal effort index (PR=1.47; 95% CI=1.19-1.82), adjusted according to sex, microphone availability in the classroom, excessive noise, pressure from the school management, heartburn, and rhinitis. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  18. Vascular Aging and Arterial Stiffness

    Directory of Open Access Journals (Sweden)

    Luana de Rezende Mikael

    Full Text Available Abstract Cardiovascular diseases (CVD account annually for almost one third of all deaths worldwide. Among the CVD, systemic arterial hypertension (SAH is related to more than half of those outcomes. Type 2 diabetes mellitus is an independent risk factor for SAH because it causes functional and structural damage to the arterial wall, leading to stiffness. Several studies have related oxidative stress, production of free radicals, and neuroendocrine and genetic changes to the physiopathogenesis of vascular aging. Indirect ways to analyze that aging process have been widely studied, pulse wave velocity (PWV being considered gold standard to assess arterial stiffness, because there is large epidemiological evidence of its predictive value for cardiovascular events, and it requires little technical knowledge to be performed. A pulse wave is generated during each cardiac contraction and travels along the arterial bed until finding peripheral resistance or any bifurcation point, determining the appearance of a reflected wave. In young individuals, arteries tend to be more elastic, therefore, the reflected wave occurs later in the cardiac cycle, reaching the heart during diastole. In older individuals, however, the reflected wave occurs earlier, reaching the heart during systole. Because PWV is an important biomarker of vascular damage, highly valuable in determining the patient’s global cardiovascular risk, we chose to review the articles on vascular aging in the context of cardiovascular risk factors and the tools available to the early identification of that damage.

  19. The Influence of Vowels on Vocal Fold Dynamics in the Tenor's Passaggio.

    Science.gov (United States)

    Echternach, Matthias; Burk, Fabian; Köberlein, Marie; Burdumy, Michael; Döllinger, Michael; Richter, Bernhard

    2017-07-01

    The influence of vowels on the frequency region where registration events in male voices usually occur (passaggio) has not yet been clarified. Particularly, for tenors who frequently have to sing across the passaggio, it might be assumed that the vowel quality has an influence on the stability of phonation. In this investigation, six professionally trained Western classical tenors performed a glide from A3 (220 Hz) to A4 (440 Hz) and were recorded using high-speed videoendoscopy at 20,000 fps via transnasal flexible endoscopy. The participants produced transitions (1) from modal register to falsetto and (2) from modal register to stage voice above the passaggio on the vowels [aː], [iː], and [uː]. Simultaneously, acoustic and electroglottographic (EGG) signals were recorded. The glottal area waveform (GAW) open quotient (OQ), the EGG OQ, and the sample entropy derived from the EGG were calculated and phonovibrograms were established. In comparison to [iː] and [uː], vowel [aː] showed lower values regarding the sample entropy and greater periodicity in the phonovibrograms during the passaggio. For [iː] and [uː], the falsetto showed greater GAW OQ than the stage voice above the passaggio but no great difference for vowel [aː]. There was a good agreement between GAW OQ and EGG OQ for GAW OQ values below .65. However, for values greater than .65, the EGG OQ showed greater disagreement. The data support the hypothesis that the vowel condition influences the phonatory stability concerning the passaggio, suggesting that vowel [aː] is associated with greater phonation stability. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  20. Gradual stiffness versus magnetic imaging-guided variable stiffness colonoscopes: A randomized noninferiority trial.

    Science.gov (United States)

    Garborg, Kjetil; Wiig, Håvard; Hasund, Audun; Matre, Jon; Holme, Øyvind; Noraberg, Geir; Løberg, Magnus; Kalager, Mette; Adami, Hans-Olov; Bretthauer, Michael

    2017-02-01

    Colonoscopes with gradual stiffness have recently been developed to enhance cecal intubation. We aimed to determine if the performance of gradual stiffness colonoscopes is noninferior to that of magnetic endoscopic imaging (MEI)-guided variable stiffness colonoscopes. Consecutive patients were randomized to screening colonoscopy with Fujifilm gradual stiffness or Olympus MEI-guided variable stiffness colonoscopes. The primary endpoint was cecal intubation rate (noninferiority limit 5%). Secondary endpoints included cecal intubation time. We estimated absolute risk differences with 95% confidence intervals (CIs). We enrolled 475 patients: 222 randomized to the gradual stiffness instrument, and 253 to the MEI-guided variable stiffness instrument. Cecal intubation rate was 91.7% in the gradual stiffness group versus 95.6% in the variable stiffness group. The adjusted absolute risk for cecal intubation failure was 4.3% higher in the gradual stiffness group than in the variable stiffness group (upper CI border 8.1%). Median cecal intubation time was 13 minutes in the gradual stiffness group and 10 minutes in the variable stiffness group (p < 0.001). The study is inconclusive with regard to noninferiority because the 95% CI for the difference in cecal intubation rate between the groups crosses the noninferiority margin. (ClinicalTrials.gov identifier: NCT01895504).

  1. Research on Detection of Machine Stiffness

    OpenAIRE

    Wang Li-Jie; Shi Wei-Chao; Xu De-Kai

    2015-01-01

    Machine tool stiffness is a principal factor affecting machine tool precision, traditional methods can only be used to detect limited categories of machine tools. The paper introduces a new scheme to detect machine tool stiffness on the basis of dynamic detection of machine tool stiffness considering its characteristics and stress state during processing. An experiment conducted in turn-milling machining center CH7516GS indicated by comparison that statics analysis of finite elements matched ...

  2. Effects of speech style, room acoustics, and vocal fatigue on vocal effort.

    Science.gov (United States)

    Bottalico, Pasquale; Graetzer, Simone; Hunter, Eric J

    2016-05-01

    Vocal effort is a physiological measure that accounts for changes in voice production as vocal loading increases. It has been quantified in terms of sound pressure level (SPL). This study investigates how vocal effort is affected by speaking style, room acoustics, and short-term vocal fatigue. Twenty subjects were recorded while reading a text at normal and loud volumes in anechoic, semi-reverberant, and reverberant rooms in the presence of classroom babble noise. The acoustics in each environment were modified by creating a strong first reflection in the talker position. After each task, the subjects answered questions addressing their perception of the vocal effort, comfort, control, and clarity of their own voice. Variation in SPL for each subject was measured per task. It was found that SPL and self-reported effort increased in the loud style and decreased when the reflective panels were present and when reverberation time increased. Self-reported comfort and control decreased in the loud style, while self-reported clarity increased when panels were present. The lowest magnitude of vocal fatigue was experienced in the semi-reverberant room. The results indicate that early reflections may be used to reduce vocal effort without modifying reverberation time.

  3. Contemporary Commercial Music Singing Students-Voice Quality and Vocal Function at the Beginning of Singing Training.

    Science.gov (United States)

    Sielska-Badurek, Ewelina M; Sobol, Maria; Olszowska, Katarzyna; Niemczyk, Kazimierz

    2017-10-03

    The purpose of this study was to assess the voice quality and the vocal tract function in popular singing students at the beginning of their singing training at the High School of Music. This is a retrospective cross-sectional study. The study consisted of 45 popular singing students (35 females and 10 males, mean age: 19.9 ± 2.8 years). They were assessed in the first 2 months of their 4-year singing training at the High School of Music, between 2013 and 2016. Voice quality and vocal tract function were evaluated using videolaryngostroboscopy, palpation of the vocal tract structures, the perceptual speaking and singing voice assessment, acoustic analysis, maximal phonation time, the Voice Handicap Index, and the Singing Voice Handicap Index (SVHI). Twenty-two percent of Contemporary Commercial Music singing students began their education in the High School, with vocal nodules. Palpation of the vocal tract structure showed in 50% correct motions and tension in speaking and in 39.3% in singing. Perceptual voice assessment showed in 80% proper speaking voice quality and in 82.4% proper singing voice quality. The mean vocal fundamental frequency while speaking in females was 214 Hz and in males was 116 Hz. Dysphonia Severity Index was at the level of 2, and maximum phonation time was 17.7 seconds. The Voice Handicap Index and the SVHI remained within the normal range: 7.5 and 19, respectively. Perceptual singing voice assessment correlated with the SVHI (P = 0.006). Twenty-two percent of the Contemporary Commercial Music singing students began their education in the High School, with organic vocal fold lesions. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  4. RNA folding: structure prediction, folding kinetics and ion electrostatics.

    Science.gov (United States)

    Tan, Zhijie; Zhang, Wenbing; Shi, Yazhou; Wang, Fenghua

    2015-01-01

    Beyond the "traditional" functions such as gene storage, transport and protein synthesis, recent discoveries reveal that RNAs have important "new" biological functions including the RNA silence and gene regulation of riboswitch. Such functions of noncoding RNAs are strongly coupled to the RNA structures and proper structure change, which naturally leads to the RNA folding problem including structure prediction and folding kinetics. Due to the polyanionic nature of RNAs, RNA folding structure, stability and kinetics are strongly coupled to the ion condition of solution. The main focus of this chapter is to review the recent progress in the three major aspects in RNA folding problem: structure prediction, folding kinetics and ion electrostatics. This chapter will introduce both the recent experimental and theoretical progress, while emphasize the theoretical modelling on the three aspects in RNA folding.

  5. Automatic Classification of Cetacean Vocalizations Using an Aural Classifier

    Science.gov (United States)

    2013-09-30

    the Gulf of Mexico . A set of pre-recorded bowhead and humpback whale vocalizations and a set of synthetic bowhead and humpback vocalizations were...vocalizations primarily from four1 cetacean species – the sperm whale , northern right whale , the bowhead whale and the humpback whale . These species...with the classifier as time permits. For example, Minke whale vocalizations, available on the Mobysound website, were the focal topic for the 5th

  6. Vocal Hygiene Habits and Vocal Handicap Among Conservatory Students of Classical Singing.

    Science.gov (United States)

    Achey, Meredith A; He, Mike Z; Akst, Lee M

    2016-03-01

    This study sought to assess classical singing students' compliance with vocal hygiene practices identified in the literature and to explore the relationship between self-reported vocal hygiene practice and self-reported singing voice handicap in this population. The primary hypothesis was that increased attention to commonly recommended vocal hygiene practices would correlate with reduced singing voice handicap. This is a cross-sectional, survey-based study. An anonymous survey assessing demographics, attention to 11 common vocal hygiene recommendations in both performance and nonperformance periods, and the Singing Voice Handicap Index 10 (SVHI-10) was distributed to classical singing teachers to be administered to their students at two major schools of music. Of the 215 surveys distributed, 108 were returned (50.2%), of which 4 were incomplete and discarded from analysis. Conservatory students of classical singing reported a moderate degree of vocal handicap (mean SVHI-10, 12; range, 0-29). Singers reported considering all 11 vocal hygiene factors more frequently when preparing for performances than when not preparing for performances. Of these, significant correlations with increased handicap were identified for consideration of stress reduction in nonperformance (P = 0.01) and performance periods (P = 0.02) and with decreased handicap for consideration of singing voice use in performance periods alone (P = 0.02). Conservatory students of classical singing report more assiduous attention to vocal hygiene practices when preparing for performances and report moderate degrees of vocal handicap overall. These students may have elevated risk for dysphonia and voice disorders which is not effectively addressed through common vocal hygiene recommendations alone. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  7. Vocal Health Education and Medical Resources for Graduate-Level Vocal Performance Students.

    Science.gov (United States)

    Latham, Katherine; Messing, Barbara; Bidlack, Melissa; Merritt, Samantha; Zhou, Xian; Akst, Lee M

    2017-03-01

    Most agree that education about vocal health and physiology can help singers avoid the development of vocal disorders. However, little is known about how this kind of education is provided to singers as part of their formal training. This study describes the amount of instruction in these topics provided through graduate-level curricula, who provides this instruction, and the kinds of affiliations such graduate singing programs have with medical professionals. This is an online survey of music schools with graduate singing programs. Survey questions addressed demographics of the programs, general attitudes about vocal health instruction for singers, the amount of vocal health instruction provided and by whom it was taught, perceived barriers to including more vocal health instruction, and any affiliations the voice program might have with medical personnel. Eighty-one survey responses were received. Instruction on vocal health was provided in 95% of the schools. In 55% of the schools, none of this instruction was given by a medical professional. Limited time in the curriculum, lack of financial support, and lack of availability of medical professional were the most frequently reported barriers to providing more instruction. When programs offered more hours of instruction, they were more likely to have some of that instruction given by a medical professional (P = 0.008) and to assess the amount of instruction provided positively (P = 0.001). There are several perceived barriers to incorporating vocal health education into graduate singing programs. Opportunity exists for more collaboration between vocal pedagogues and medical professionals in the education of singers about vocal health. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  8. Measurement and Treatment of Passive Muscle Stiffness

    DEFF Research Database (Denmark)

    Kirk, Henrik

    This PhD thesis is based on research conducted at the University of Copenhagen and Helene Elsass Center from 2012 to 2015. Measurements and treatment of passive muscle stiffness in people with cerebral palsy (CP) comprise the focus of the thesis. The thesis summarizes the results from four studies...... stiffness. I introduce how to evaluate and distinguish between passive muscle stiffness and reflex-mediated stiffness in research and in clinical practice. Furthermore, I present ”the Portable Spasticity Assessment Device”, which was developed as a part of the PhD study. I discuss the validity...

  9. A new approach to determine press stiffness

    DEFF Research Database (Denmark)

    Arentoft, Mogens; Wanheim, Tarras

    2004-01-01

    A new procedure is proposed for measuring press stiffness, including separated horizontal and vertical loading of the press frame. The load can be eccentrically positioned for measuring rotational stiffnesses. Two loading devices and corresponding measuring equipment for registration of press...... deflections are designed. The press stiffness is presented as a 6 by 6 flexibility matrix. The approach has been tested by measuring the stiffness of a 5000 kN O-frame, ring element, hydraulic press, a 10000 kN O-frame, pillar element, hydraulic press and a 10000 kN O-frame, ring element mechanical press...

  10. Evolutionary optimization of protein folding.

    Directory of Open Access Journals (Sweden)

    Cédric Debès

    Full Text Available Nature has shaped the make up of proteins since their appearance, [Formula: see text]3.8 billion years ago. However, the fundamental drivers of structural change responsible for the extraordinary diversity of proteins have yet to be elucidated. Here we explore if protein evolution affects folding speed. We estimated folding times for the present-day catalog of protein domains directly from their size-modified contact order. These values were mapped onto an evolutionary timeline of domain appearance derived from a phylogenomic analysis of protein domains in 989 fully-sequenced genomes. Our results show a clear overall increase of folding speed during evolution, with known ultra-fast downhill folders appearing rather late in the timeline. Remarkably, folding optimization depends on secondary structure. While alpha-folds showed a tendency to fold faster throughout evolution, beta-folds exhibited a trend of folding time increase during the last [Formula: see text]1.5 billion years that began during the "big bang" of domain combinations. As a consequence, these domain structures are on average slow folders today. Our results suggest that fast and efficient folding of domains shaped the universe of protein structure. This finding supports the hypothesis that optimization of the kinetic and thermodynamic accessibility of the native fold reduces protein aggregation propensities that hamper cellular functions.

  11. Check Vocal: A program to facilitate checking the accuracy and response time of vocal responses from DMDX

    National Research Council Canada - National Science Library

    Protopapas, Athanassios

    2007-01-01

    CheckVocal is a Windows application that facilitates checking the accuracy and response time of recorded vocal responses in naming and other experimental tasks using the DMDX display and response collection software...

  12. CheckVocal: a program to facilitate checking the accuracy and response time of vocal responses from DMDX

    National Research Council Canada - National Science Library

    Protopapas, Athanassios

    2007-01-01

    CheckVocal is a Windows application that facilitates checking the accuracy and response time of recorded vocal responses in naming and other experimental tasks using the DMDX display and response collection software...

  13. Automated Assessment of Child Vocalization Development Using LENA

    Science.gov (United States)

    Richards, Jeffrey A.; Xu, Dongxin; Gilkerson, Jill; Yapanel, Umit; Gray, Sharmistha; Paul, Terrance

    2017-01-01

    Purpose: To produce a novel, efficient measure of children's expressive vocal development on the basis of automatic vocalization assessment (AVA), child vocalizations were automatically identified and extracted from audio recordings using Language Environment Analysis (LENA) System technology. Method: Assessment was based on full-day audio…

  14. [Functional dysphonia and vocal cord nodules in teachers in Navarra, Spain].

    Science.gov (United States)

    Palomino Moreno, María Prado; Hoyo Rodríguez, Asier; García López, Vega; Losantos Martínez, Juan Tomás

    2013-01-01

    To describe teachers treated for dysphonia and vocal cord nodules by the public health system in Navarra (Spain), to describe associated factors and to identify the proportion of these cases registered as occupational diseases. Cases of dysphonia occurring in persons between the age of 18 and 65 years, registered between May 2010 and June 2011, and treated in a specific unit (Speech Unit) of Otorhinolaryngology Services were identified. Information on occupation, sex and clinical diagnosis was collected. For teachers, additional information was obtained on smoking habits, teaching level and prior training in speech disorders and their prevention. Cases declared as occupational diseases were identified from the official Register of Occupational Diseases of Navarra. 135 teachers (18% of all dysphonia patients in the sample) were treated for dysphonia in the Speech Unit (87% women). Being female was 3-fold higher among teachers than other occupations (crude prevalence odds ratio = 3.5; 95% confidence interval, 95%CI, 2.1-5.9). Female teachers were also 6.5 years (95%CI, 1.7-11.4) younger than male teachers. No association was found between smoking and risk of vocal cord nodules or dysphonia. Only 20% of teachers treated had received training on speech disorders and their prevention. Nine out of 83 cases of vocal cord nodules diagnosed in professional voice users were officially declared as occupational diseases; in all cases, these were teachers. Dysphonia in teachers is a frequent reason for visiting a specialty clinic. Among these professionals, women showed a higher risk of suffering from vocal cord nodules. Most cases of vocal cord nodules in our sample were not reported as occupational diseases. Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.

  15. The Importance of Vocal Parameters Correlation

    Directory of Open Access Journals (Sweden)

    Valentin Ghisa

    2016-06-01

    Full Text Available To analyze communication we need to study the main parameters that describe the vocal sounds from the point of view of information content transfer efficiency. In this paper we analyze the physical quality of the “on air" information transfer, according to the audio streaming parameters and from the particular phonetic nature of the human factor. Applying this statistical analysis we aim to identify and record the correlation level of the acoustical parameters with the vocal ones and the impact which the presence of this cross-correlation can have on communication structures’ improvement.

  16. VOCAL SEGMENT CLASSIFICATION IN POPULAR MUSIC

    DEFF Research Database (Denmark)

    Feng, Ling; Nielsen, Andreas Brinch; Hansen, Lars Kai

    2008-01-01

    This paper explores the vocal and non-vocal music classification problem within popular songs. A newly built labeled database covering 147 popular songs is announced. It is designed for classifying signals from 1sec time windows. Features are selected for this particular task, in order to capture...... both the temporal correlations and the dependencies among the feature dimensions. We systematically study the performance of a set of classifiers, including linear regression, generalized linear model, Gaussian mixture model, reduced kernel orthonormalized partial least squares and {K-}means on cross...

  17. Meaning and emotion in animal vocalizations.

    Science.gov (United States)

    Seyfarth, Robert M; Cheney, Dorothy L

    2003-12-01

    Historically, a dichotomy has been drawn between the semantic communication of human language and the apparently emotional calls of animals. Current research paints a more complicated picture. Just as scientists have identified elements of human speech that reflect a speaker's emotions, field experiments have shown that the calls of many animals provide listeners with information about objects and events in the environment. Like human speech, therefore, animal vocalizations simultaneously provide others with information that is both semantic and emotional. In support of this conclusion, we review the results of field experiments on the natural vocalizations of African vervet monkeys, diana monkeys, baboons, and suricates (a South African mongoose). Vervet and diana monkeys give acoustically distinct alarm calls in response to the presence of leopards, eagles, and snakes. Each alarm call type elicits a different, adaptive response from others nearby. Field experiments demonstrate that listeners compare these vocalizations not just according to their acoustic properties but also according to the information they convey. Like monkeys, suricates give acoustically distinct alarm calls in response to different predators. Within each predator class, the calls also differ acoustically according to the signaler's perception of urgency. Like speech, therefore, suricate alarm calls convey both semantic and emotional information. The vocalizations of baboons, like those of many birds and mammals, are individually distinctive. As a result, when one baboon hears a sequence of calls exchanged between two or more individuals, the listener acquires information about social events in its group. Baboons, moreover, are skilled "eavesdroppers:" their response to different call sequences provides evidence of the sophisticated information they acquire from other individuals' vocalizations. Baboon males give loud "wahoo" calls during competitive displays. Like other vocalizations, these

  18. Multi-stability and variable stiffness of cellular solids designed based on origami patterns

    Science.gov (United States)

    Sengupta, Sattam; Li, Suyi

    2017-04-01

    The application of origami-inspired designs to engineered structures and materials has been a subject of much research efforts. These structures and materials, whose mechanical properties are directly related to the geometry of folding, are capable of achieving a host of unique adaptive functions. In this study, we investigate a three-dimensional multistability and variable stiffness function of a cellular solid based on the Miura-Ori folding pattern. The unit cell of such a solid, consisting of two stacked Miura-Ori sheets, can be elastically bistable due to the nonlinear relationship between rigid-folding deformation and crease material bending. Such a bistability possesses an unorthodox property: the critical, unstable configuration lies on the same side of two stable ones, so that two different force-deformation curves co-exist within the same range of deformation. By exploiting such unique stability properties, we can achieve a programmable stiffness change between the two elastically stable states, and the stiffness differences can be prescribed by tailoring the crease patterns of the cell. This paper presents a comprehensive parametric study revealing the correlations between such variable stiffness and various design parameters. The unique properties stemming from the bistability and design of such a unit cell can be advanced further by assembling them into a solid which can be capable of shape morphing and programmable mechanical properties.

  19. Load to Failure and Stiffness

    Science.gov (United States)

    Esquivel, Amanda O.; Duncan, Douglas D.; Dobrasevic, Nikola; Marsh, Stephanie M.; Lemos, Stephen E.

    2015-01-01

    Background: Rotator cuff tendinopathy is a frequent cause of shoulder pain that can lead to decreased strength and range of motion. Failures after using the single-row technique of rotator cuff repair have led to the development of the double-row technique, which is said to allow for more anatomical restoration of the footprint. Purpose: To compare 5 different types of suture patterns while maintaining equality in number of anchors. The hypothesis was that the Mason-Allen–crossed cruciform transosseous-equivalent technique is superior to other suture configurations while maintaining equality in suture limbs and anchors. Study Design: Controlled laboratory study. Methods: A total of 25 fresh-frozen cadaveric shoulders were randomized into 5 suture configuration groups: single-row repair with simple stitch technique; single-row repair with modified Mason-Allen technique; double-row Mason-Allen technique; double-row cross-bridge technique; and double-row suture bridge technique. Load and displacement were recorded at 100 Hz until failure. Stiffness and bone mineral density were also measured. Results: There was no significant difference in peak load at failure, stiffness, maximum displacement at failure, or mean bone mineral density among the 5 suture configuration groups (P sutures in the repair should be considered to judge the strength of the repair. Clinical Relevance: Previous in vitro studies have shown the double-row rotator cuff repair to be superior to the single-row repair; however, clinical research does not necessarily support this. This study found no difference when comparing 5 different repair methods, supporting research that suggests the number of sutures and not the pattern can affect biomechanical properties. PMID:26665053

  20. The ribosome regulates flavodoxin folding

    OpenAIRE

    Houwman, Joseline A.

    2017-01-01

    During and after their translation by the ribosome, folding of polypeptides to biologically active proteins is of vital importance for all living organisms. Gaining knowledge about nascent chain folding is required to enhance our understanding of protein folding in the cell. This in turn allows us to obtain insights into factors responsible for protein misfolding, aggregation, and, potentially, for numerous devastating pathologies. In Chapter 1 the model protein flavodoxin is introduced. Also...

  1. Discrimination of ultrasonic vocalizations by CBA/CaJ mice (Mus musculus is related to spectrotemporal dissimilarity of vocalizations.

    Directory of Open Access Journals (Sweden)

    Erikson G Neilans

    Full Text Available The function of ultrasonic vocalizations (USVs produced by mice (Mus musculus is a topic of broad interest to many researchers. These USVs differ widely in spectrotemporal characteristics, suggesting different categories of vocalizations, although this has never been behaviorally demonstrated. Although electrophysiological studies indicate that neurons can discriminate among vocalizations at the level of the auditory midbrain, perceptual acuity for vocalizations has yet to be determined. Here, we trained CBA/CaJ mice using operant conditioning to discriminate between different vocalizations and between a spectrotemporally modified vocalization and its original version. Mice were able to discriminate between vocalization types and between manipulated vocalizations, with performance negatively correlating with spectrotemporal similarity. That is, discrimination performance was higher for dissimilar vocalizations and much lower for similar vocalizations. The behavioral data match previous neurophysiological results in the inferior colliculus (IC, using the same stimuli. These findings suggest that the different vocalizations could carry different meanings for the mice. Furthermore, the finding that behavioral discrimination matched neural discrimination in the IC suggests that the IC plays an important role in the perceptual discrimination of vocalizations.

  2. Synthesis, Characterization, and Modeling of Nanotube Materials with Variable Stiffness Tethers

    Science.gov (United States)

    Frankland, S. J. V.; Herzog, M. N.; Odegard, G. M.; Gates, T. S.; Fay, C. C.

    2004-01-01

    Synthesis, mechanical testing, and modeling have been performed for carbon nanotube based materials. Tests using nanoindentation indicated a six-fold enhancement in the storage modulus when comparing the base material (no nanotubes) to the composite that contained 5.3 wt% of nanotubes. To understand how crosslinking the nanotubes may further alter the stiffness, a model of the system was constructed using nanotubes crosslinked with a variable stiffness tether (VST). The model predicted that for a composite with 5 wt% nanotubes at random orientations, crosslinked with the VST, the bulk Young's modulus was reduced by 30% compared to the noncrosslinked equivalent.

  3. Curvature dependent modulation of fish fin stiffness

    Science.gov (United States)

    Nguyen, Khoi; Yu, Ning; Bandi, Mahesh; Venkadesan, Madhusudhan; Mandre, Shreyas

    Propulsion and maneuvering ability of fishes depends on the stiffness of their fins. However, increasing stiffness by simply adding material to thicken the fin would incur a substantial energetic cost associated with flapping the fin. We propose that fishes increase stiffness of the fin not by building thicker fins, but by geometrically coupling out-of-plane bending of the fin's rays with in-plane stretching of a stiff membrane that connects the rays. We present a model of fin elasticity for ray-finned fish, where we decompose the fin into a series of elastic beams (rays) with springy interconnections (membrane). In one limit, where the membranes are infinitely extensible, the fin's stiffness is no more than the sum of the stiffness of individual rays. At the other limit of an inextensible membrane, fin stiffness reaches an asymptotic maximum. The asymptote value increases monotonically with curvature. We propose that musculature at the base of the fin controls fin curvature, and thereby modulates stiffness.

  4. Embodying Desired Behavior in Variable Stiffness Actuators

    NARCIS (Netherlands)

    Visser, L.C.; Stramigioli, Stefano; Bicchi, Antonio

    2011-01-01

    Variable stiffness actuators are a class of actuators with the capability of changing their apparent output stiffness independently from the actuator output position. This is achieved by introducing internally a number of compliant elements, and internal actuated degrees of freedom that determine

  5. Stiffness and damping in mechanical design

    National Research Council Canada - National Science Library

    Rivin, Eugene I

    1999-01-01

    ... important conceptual issues are stiffness of mechanical structures and their components and damping in mechanical systems sensitive to and/or generating vibrations. Stiffness and strength are the most important criteria for many mechanical designs. However, although there are hundreds of books on various aspects of strength, and strength issues ar...

  6. [A case of vocal cord contact granuloma after vocal cord polyp surgery].

    Science.gov (United States)

    Qiu, Zhili; Jiang, Xiaoping; Yuan, Xiaodong

    2016-01-01

    The vocal cord polyp is easy to relapse after surgery, but if the patient has recurrence in a short term, it is necessary to consider it as postoperative vocal cord contact granuloma. If the patients with contact granuloma after surgical treatment had severe impact on the pronunciation, it is necessary to be operated and confirmed by pathology and given the treatment of acid suppression, in order to avoid postoperative recurrence.

  7. Foil Bearing Stiffness Estimation with Pseudospectral Scheme

    Directory of Open Access Journals (Sweden)

    Sankar Balaji

    2016-01-01

    Full Text Available Compliant foil gas lubricated bearings are used for the support of light loads in the order of few kilograms at high speeds, in the order of 50,000 RPM. The stiffness of the foil bearings depends both on the stiffness of the compliant foil and on the lubricating gas film. The stiffness of the bearings plays a crucial role in the stable operation of the supported rotor over a range of speeds. This paper describes a numerical approach to estimate the stiffness of the bearings using pseudo spectral scheme. Methodology to obtain the stiffness of the foil bearing as a function of weight of the shaft is given and the results are presented.

  8. Stiffness Control of Surgical Continuum Manipulators.

    Science.gov (United States)

    Mahvash, Mohsen; Dupont, Pierre E

    2011-04-01

    This paper introduces the first stiffness controller for continuum robots. The control law is based on an accurate approximation of a continuum robot's coupled kinematic and static force model. To implement a desired tip stiffness, the controller drives the actuators to positions corresponding to a deflected robot configuration that produces the required tip force for the measured tip position. This approach provides several important advantages. First, it enables the use of robot deflection sensing as a means to both sense and control tip forces. Second, it enables stiffness control to be implemented by modification of existing continuum robot position controllers. The proposed controller is demonstrated experimentally in the context of a concentric tube robot. Results show that the stiffness controller achieves the desired stiffness in steady state, provides good dynamic performance, and exhibits stability during contact transitions.

  9. Determination of 6 stiffnesses for a press

    DEFF Research Database (Denmark)

    Arentoft, Mogens; Eriksen, Morten; Wanheim, Tarras

    2000-01-01

    the workpiece will result in deflections of the press, which will decrease the tolerances of the component. At present, it is possible to measure the reaction forces from the workpiece, for instance by use of the model material technique as described in [1-2]. If the stiffness and clearances of the press...... is known too, the final dimensions can be predicted by divide the force by the stiffness and add the clearance. If the stiffness of the press is known, it is possible to optimize the orientation of the workpiece too, so the direction, in which the best tolerances is demanded, is equal to the direction...... in which the press has the highest stiffness. Furthermore, knowledge about the stiffnesses of all presses in a production system makes it possible to choose the press which best fit to a specific process....

  10. The Tufts Non-Vocal Communication Program.

    Science.gov (United States)

    Foulds, Richard A.; And Others

    Described are the efforts of the Biomedical Engineering Center in developing devices, particularly the Tufts Interactive Communicator (TIC) for the non-vocal severely physically disabled individual. It is noted that research has been conducted in the following areas: dictionary development, anticipatory communication, symbol communication, symbol…

  11. Music Education Intervention Improves Vocal Emotion Recognition

    Science.gov (United States)

    Mualem, Orit; Lavidor, Michal

    2015-01-01

    The current study is an interdisciplinary examination of the interplay among music, language, and emotions. It consisted of two experiments designed to investigate the relationship between musical abilities and vocal emotional recognition. In experiment 1 (N = 24), we compared the influence of two short-term intervention programs--music and…

  12. Path Models of Vocal Emotion Communication.

    Directory of Open Access Journals (Sweden)

    Tanja Bänziger

    Full Text Available We propose to use a comprehensive path model of vocal emotion communication, encompassing encoding, transmission, and decoding processes, to empirically model data sets on emotion expression and recognition. The utility of the approach is demonstrated for two data sets from two different cultures and languages, based on corpora of vocal emotion enactment by professional actors and emotion inference by naïve listeners. Lens model equations, hierarchical regression, and multivariate path analysis are used to compare the relative contributions of objectively measured acoustic cues in the enacted expressions and subjective voice cues as perceived by listeners to the variance in emotion inference from vocal expressions for four emotion families (fear, anger, happiness, and sadness. While the results confirm the central role of arousal in vocal emotion communication, the utility of applying an extended path modeling framework is demonstrated by the identification of unique combinations of distal cues and proximal percepts carrying information about specific emotion families, independent of arousal. The statistical models generated show that more sophisticated acoustic parameters need to be developed to explain the distal underpinnings of subjective voice quality percepts that account for much of the variance in emotion inference, in particular voice instability and roughness. The general approach advocated here, as well as the specific results, open up new research strategies for work in psychology (specifically emotion and social perception research and engineering and computer science (specifically research and development in the domain of affective computing, particularly on automatic emotion detection and synthetic emotion expression in avatars.

  13. Patterns of Vocalization and Impression Formation

    Science.gov (United States)

    Hayes, Donald P.; Bouma, Gary D.

    1975-01-01

    This article discusses the interactive behavior that accompanies verbal exchange. It specifically describes a set of experiments designed to isolate an important subset of interactive behavior, the vocal (as opposed to the verbal) and to relate this information to a wide range of social impressions resulting from verbal exchange. (Available from…

  14. Modelling vocal anatomy's significant effect on speech

    NARCIS (Netherlands)

    de Boer, B.

    2010-01-01

    This paper investigates the effect of larynx position on the articulatory abilities of a humanlike vocal tract. Previous work has investigated models that were built to resemble the anatomy of existing species or fossil ancestors. This has led to conflicting conclusions about the relation between

  15. Enhanced Processing of Vocal Melodies in Childhood

    Science.gov (United States)

    Weiss, Michael W.; Schellenberg, E. Glenn; Trehub, Sandra E.; Dawber, Emily J.

    2015-01-01

    Music cognition is typically studied with instrumental stimuli. Adults remember melodies better, however, when they are presented in a biologically significant timbre (i.e., the human voice) than in various instrumental timbres (Weiss, Trehub, & Schellenberg, 2012). We examined the impact of vocal timbre on children's processing of melodies.…

  16. Functional flexibility in wild bonobo vocal behaviour

    Directory of Open Access Journals (Sweden)

    Zanna Clay

    2015-08-01

    Full Text Available A shared principle in the evolution of language and the development of speech is the emergence of functional flexibility, the capacity of vocal signals to express a range of emotional states independently of context and biological function. Functional flexibility has recently been demonstrated in the vocalisations of pre-linguistic human infants, which has been contrasted to the functionally fixed vocal behaviour of non-human primates. Here, we revisited the presumed chasm in functional flexibility between human and non-human primate vocal behaviour, with a study on our closest living primate relatives, the bonobo (Pan paniscus. We found that wild bonobos use a specific call type (the “peep” across a range of contexts that cover the full valence range (positive-neutral-negative in much of their daily activities, including feeding, travel, rest, aggression, alarm, nesting and grooming. Peeps were produced in functionally flexible ways in some contexts, but not others. Crucially, calls did not vary acoustically between neutral and positive contexts, suggesting that recipients take pragmatic information into account to make inferences about call meaning. In comparison, peeps during negative contexts were acoustically distinct. Our data suggest that the capacity for functional flexibility has evolutionary roots that predate the evolution of human speech. We interpret this evidence as an example of an evolutionary early transition away from fixed vocal signalling towards functional flexibility.

  17. Production, Usage, and Comprehension in Animal Vocalizations

    Science.gov (United States)

    Seyfarth, Robert M.; Cheney, Dorothy L.

    2010-01-01

    In this review, we place equal emphasis on production, usage, and comprehension because these components of communication may exhibit different developmental trajectories and be affected by different neural mechanisms. In the animal kingdom generally, learned, flexible vocal production is rare, appearing in only a few orders of birds and few…

  18. Audiovisual vocal outburst classification in noisy conditions

    NARCIS (Netherlands)

    Eyben, Florian; Petridis, Stavros; Schuller, Björn; Pantic, Maja

    2012-01-01

    In this study, we investigate an audiovisual approach for classification of vocal outbursts (non-linguistic vocalisations) in noisy conditions using Long Short-Term Memory (LSTM) Recurrent Neural Networks and Support Vector Machines. Fusion of geometric shape features and acoustic low-level

  19. Phonetic characteristics of vocalizations during pain

    DEFF Research Database (Denmark)

    Niebuhr, Oliver; Lautenbacher, Stefan; Salinas-Ranneberg, Melissa

    2017-01-01

    ” (central vowel, sounding like a darker “e” as in hesitations like “ehm”)—as experimental approximations to natural vocalizations. Methods: In 50 students vowel production and self-report ratings were assessed during painful and nonpainful heat stimulation (hot water immersion) as well as during baseline...

  20. Path Models of Vocal Emotion Communication

    Science.gov (United States)

    Bänziger, Tanja; Hosoya, Georg; Scherer, Klaus R.

    2015-01-01

    We propose to use a comprehensive path model of vocal emotion communication, encompassing encoding, transmission, and decoding processes, to empirically model data sets on emotion expression and recognition. The utility of the approach is demonstrated for two data sets from two different cultures and languages, based on corpora of vocal emotion enactment by professional actors and emotion inference by naïve listeners. Lens model equations, hierarchical regression, and multivariate path analysis are used to compare the relative contributions of objectively measured acoustic cues in the enacted expressions and subjective voice cues as perceived by listeners to the variance in emotion inference from vocal expressions for four emotion families (fear, anger, happiness, and sadness). While the results confirm the central role of arousal in vocal emotion communication, the utility of applying an extended path modeling framework is demonstrated by the identification of unique combinations of distal cues and proximal percepts carrying information about specific emotion families, independent of arousal. The statistical models generated show that more sophisticated acoustic parameters need to be developed to explain the distal underpinnings of subjective voice quality percepts that account for much of the variance in emotion inference, in particular voice instability and roughness. The general approach advocated here, as well as the specific results, open up new research strategies for work in psychology (specifically emotion and social perception research) and engineering and computer science (specifically research and development in the domain of affective computing, particularly on automatic emotion detection and synthetic emotion expression in avatars). PMID:26325076

  1. Brown meagre vocalization rate increases during repetitive boat noise exposures: a possible case of vocal compensation.

    Science.gov (United States)

    Picciulin, Marta; Sebastianutto, Linda; Codarin, Antonio; Calcagno, Giuliana; Ferrero, Enrico A

    2012-11-01

    This study investigated whether or not boat noise causes variations in brown meagre (Sciaena umbra) vocalizations recorded in a nearshore Mediterranean marine reserve. Six nocturnal experimental sessions were carried out from June to September 2009. In each of them, a recreational boat passed over vocalizing fish 6 times with 1 boat passage every 10 min. For this purpose three different boats were used in random order: an 8.5-m cabin-cruiser (CC), a 5-m fiberglass boat (FB), and a 7-m inflatable boat (INF). In situ continuous acoustic recordings were collected using a self-standing sonobuoy. Because boat noise levels largely exceeded both background noise and S. umbra vocalizations in the species' hearing frequency range, masking of acoustic communication was assumed. Although no immediate effect was observed during a single boat passage, the S. umbra mean pulse rate increased over multiple boat passages in the experimental condition but not in the control condition, excluding that the observed effect was due to a natural rise in fish vocalizations. The observed vocal enhancement may result either from an increased density of callers or from an increased number of pulses/sounds produced by already acoustically active individuals, as a form of vocal compensation. These two explanations are discussed.

  2. Auditory lateralization of conspecific and heterospecific vocalizations in cats.

    Science.gov (United States)

    Siniscalchi, Marcello; Laddago, Serena; Quaranta, Angelo

    2016-01-01

    Auditory lateralization in response to both conspecific and heterospecific vocalizations (dog vocalizations) was observed in 16 tabby cats (Felis catus). Six different vocalizations were used: cat "purring," "meowing" and "growling" and dog typical vocalizations of "disturbance," "isolation" and "play." The head-orienting paradigm showed that cats turned their head with the right ear leading (left hemisphere activation) in response to their typical-species vocalization ("meow" and "purring"); on the other hand, a clear bias in the use of the left ear (right hemisphere activation) was observed in response to vocalizations eliciting intense emotion (dogs' vocalizations of "disturbance" and "isolation"). Overall these findings suggest that auditory sensory domain seems to be lateralized also in cat species, stressing the role of the left hemisphere for intraspecific communication and of the right hemisphere in processing threatening and alarming stimuli.

  3. Vocal learning in elephants: neural bases and adaptive context.

    Science.gov (United States)

    Stoeger, Angela S; Manger, Paul

    2014-10-01

    In the last decade clear evidence has accumulated that elephants are capable of vocal production learning. Examples of vocal imitation are documented in African (Loxodonta africana) and Asian (Elephas maximus) elephants, but little is known about the function of vocal learning within the natural communication systems of either species. We are also just starting to identify the neural basis of elephant vocalizations. The African elephant diencephalon and brainstem possess specializations related to aspects of neural information processing in the motor system (affecting the timing and learning of trunk movements) and the auditory and vocalization system. Comparative interdisciplinary (from behavioral to neuroanatomical) studies are strongly warranted to increase our understanding of both vocal learning and vocal behavior in elephants. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Problem Solving through Paper Folding

    Science.gov (United States)

    Wares, Arsalan

    2014-01-01

    The purpose of this article is to describe a couple of challenging mathematical problems that involve paper folding. These problem-solving tasks can be used to foster geometric and algebraic thinking among students. The context of paper folding makes some of the abstract mathematical ideas involved relatively concrete. When implemented…

  5. Teaching computers to fold proteins

    DEFF Research Database (Denmark)

    Winther, Ole; Krogh, Anders Stærmose

    2004-01-01

    A new general algorithm for optimization of potential functions for protein folding is introduced. It is based upon gradient optimization of the thermodynamic stability of native folds of a training set of proteins with known structure. The iterative update rule contains two thermodynamic average...

  6. Validity and reliability of three methods of stiffness assessment

    National Research Council Canada - National Science Library

    Elizabeth C.Pruyn Mark L.Watsford Aron J.Murphy

    2016-01-01

    ... and reliability of 3 in vivo methods of stiffness assessment using 1 cohort of participants.Methods:To determine inter-day reliability,15 female netballers were assessed for stiffness twice within 1 week using unilateral hopping(vertical stiffness...

  7. Ideal Particle Sizes for Inhaled Steroids Targeting Vocal Granulomas: Preliminary Study Using Computational Fluid Dynamics.

    Science.gov (United States)

    Perkins, Elizabeth L; Basu, Saikat; Garcia, Guilherme J M; Buckmire, Robert A; Shah, Rupali N; Kimbell, Julia S

    2017-11-01

    Objectives Vocal fold granulomas are benign lesions of the larynx commonly caused by gastroesophageal reflux, intubation, and phonotrauma. Current medical therapy includes inhaled corticosteroids to target inflammation that leads to granuloma formation. Particle sizes of commonly prescribed inhalers range over 1 to 4 µm. The study objective was to use computational fluid dynamics to investigate deposition patterns over a range of particle sizes of inhaled corticosteroids targeting the larynx and vocal fold granulomas. Study Design Retrospective, case-specific computational study. Setting Tertiary academic center. Subjects/Methods A 3-dimensional anatomically realistic computational model of a normal adult airway from mouth to trachea was constructed from 3 computed tomography scans. Virtual granulomas of varying sizes and positions along the vocal fold were incorporated into the base model. Assuming steady-state, inspiratory, turbulent airflow at 30 L/min, computational fluid dynamics was used to simulate respiratory transport and deposition of inhaled corticosteroid particles ranging over 1 to 20 µm. Results Laryngeal deposition in the base model peaked for particle sizes 8 to 10 µm (2.8%-3.5%). Ideal sizes ranged over 6 to 10, 7 to 13, and 7 to 14 µm for small, medium, and large granuloma sizes, respectively. Glottic deposition was maximal at 10.8% for 9-µm-sized particles for the large posterior granuloma, 3 times the normal model (3.5%). Conclusion As the virtual granuloma size increased and the location became more posterior, glottic deposition and ideal particle size generally increased. This preliminary study suggests that inhalers with larger particle sizes, such as fluticasone propionate dry-powder inhaler, may improve laryngeal drug deposition. Most commercially available inhalers have smaller particles than suggested here.

  8. Dynamic stiffness of suction caissons - vertical vibrations

    Energy Technology Data Exchange (ETDEWEB)

    Ibsen, Lars Bo; Liingaard, M.; Andersen, Lars

    2006-12-15

    The dynamic response of offshore wind turbines are affected by the properties of the foundation and the subsoil. The purpose of this report is to evaluate the dynamic soil-structure interaction of suction caissons for offshore wind turbines. The investigation is limited to a determination of the vertical dynamic stiffness of suction caissons. The soil surrounding the foundation is homogenous with linear viscoelastic properties. The dynamic stiffness of the suction caisson is expressed by dimensionless frequency-dependent dynamic stiffness coefficients corresponding to the vertical degree of freedom. The dynamic stiffness coefficients for the foundations are evaluated by means of a dynamic three-dimensional coupled Boundary Element/Finite Element model. Comparisons are made with known analytical and numerical solutions in order to evaluate the static and dynamic behaviour of the Boundary Element/Finite Element model. The vertical frequency dependent stiffness has been determined for different combinations of the skirt length, Poisson's ratio and the ratio between soil stiffness and skirt stiffness. Finally the dynamic behaviour at high frequencies is investigated. (au)

  9. Observer-Based Human Knee Stiffness Estimation.

    Science.gov (United States)

    Misgeld, Berno J E; Luken, Markus; Riener, Robert; Leonhardt, Steffen

    2017-05-01

    We consider the problem of stiffness estimation for the human knee joint during motion in the sagittal plane. The new stiffness estimator uses a nonlinear reduced-order biomechanical model and a body sensor network (BSN). The developed model is based on a two-dimensional knee kinematics approach to calculate the angle-dependent lever arms and the torques of the muscle-tendon-complex. To minimize errors in the knee stiffness estimation procedure that result from model uncertainties, a nonlinear observer is developed. The observer uses the electromyogram (EMG) of involved muscles as input signals and the segmental orientation as the output signal to correct the observer-internal states. Because of dominating model nonlinearities and nonsmoothness of the corresponding nonlinear functions, an unscented Kalman filter is designed to compute and update the observer feedback (Kalman) gain matrix. The observer-based stiffness estimation algorithm is subsequently evaluated in simulations and in a test bench, specifically designed to provide robotic movement support for the human knee joint. In silico and experimental validation underline the good performance of the knee stiffness estimation even in the cases of a knee stiffening due to antagonistic coactivation. We have shown the principle function of an observer-based approach to knee stiffness estimation that employs EMG signals and segmental orientation provided by our own IPANEMA BSN. The presented approach makes realtime, model-based estimation of knee stiffness with minimal instrumentation possible.

  10. Interplay of matrix stiffness and protein tethering in stem cell differentiation.

    Science.gov (United States)

    Wen, Jessica H; Vincent, Ludovic G; Fuhrmann, Alexander; Choi, Yu Suk; Hribar, Kolin C; Taylor-Weiner, Hermes; Chen, Shaochen; Engler, Adam J

    2014-10-01

    Stem cells regulate their fate by binding to, and contracting against, the extracellular matrix. Recently, it has been proposed that in addition to matrix stiffness and ligand type, the degree of coupling of fibrous protein to the surface of the underlying substrate, that is, tethering and matrix porosity, also regulates stem cell differentiation. By modulating substrate porosity without altering stiffness in polyacrylamide gels, we show that varying substrate porosity did not significantly change protein tethering, substrate deformations, or the osteogenic and adipogenic differentiation of human adipose-derived stromal cells and marrow-derived mesenchymal stromal cells. Varying protein-substrate linker density up to 50-fold changed tethering, but did not affect osteogenesis, adipogenesis, surface-protein unfolding or underlying substrate deformations. Differentiation was also unaffected by the absence of protein tethering. Our findings imply that the stiffness of planar matrices regulates stem cell differentiation independently of protein tethering and porosity.

  11. Research on Detection of Machine Stiffness

    Directory of Open Access Journals (Sweden)

    Wang Li-Jie

    2015-01-01

    Full Text Available Machine tool stiffness is a principal factor affecting machine tool precision, traditional methods can only be used to detect limited categories of machine tools. The paper introduces a new scheme to detect machine tool stiffness on the basis of dynamic detection of machine tool stiffness considering its characteristics and stress state during processing. An experiment conducted in turn-milling machining center CH7516GS indicated by comparison that statics analysis of finite elements matched the experimental result well, which provided precise original data for design of improved machine tool precision and access to design of precision detection equipment for other types of machine tools.

  12. Voice parameters and videonasolaryngoscopy in children with vocal nodules: a longitudinal study, before and after voice therapy.

    Science.gov (United States)

    Valadez, Victor; Ysunza, Antonio; Ocharan-Hernandez, Esther; Garrido-Bustamante, Norma; Sanchez-Valerio, Araceli; Pamplona, Ma C

    2012-09-01

    Vocal Nodules (VN) are a functional voice disorder associated with voice misuse and abuse in children. There are few reports addressing vocal parameters in children with VN, especially after a period of vocal rehabilitation. The purpose of this study is to describe measurements of vocal parameters including Fundamental Frequency (FF), Shimmer (S), and Jitter (J), videonasolaryngoscopy examination and clinical perceptual assessment, before and after voice therapy in children with VN. Voice therapy was provided using visual support through Speech-Viewer software. Twenty patients with VN were studied. An acoustical analysis of voice was performed and compared with data from subjects from a control group matched by age and gender. Also, clinical perceptual assessment of voice and videonasolaryngoscopy were performed to all patients with VN. After a period of voice therapy, provided with visual support using Speech Viewer-III (SV-III-IBM) software, new acoustical analyses, perceptual assessments and videonasolaryngoscopies were performed. Before the onset of voice therapy, there was a significant difference (p<0.05) in mean FF, S and J, between the patients with VN and subjects from the control group. After the voice therapy period, a significant improvement (p<0.05) was found in all acoustic voice parameters. Moreover, perceptual voice analysis demonstrated improvement in all cases. Finally, videonasolaryngoscopy demonstrated that vocal nodules were no longer discernible on the vocal folds in any of the cases. SV-III software seems to be a safe and reliable method for providing voice therapy in children with VN. Acoustic voice parameters, perceptual data and videonasolaryngoscopy were significantly improved after the speech therapy period was completed. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Vocal quality in university teachers: a pilot study.

    Science.gov (United States)

    D'haeseleer, E; Claeys, S; Wuyts, F; Van Lierde, K M

    2009-01-01

    The main purpose of this study was to determine the vocal quality of 20 male and 9 female university teachers using a multi-parameter approach. Secondly, the effect of an academic lecture on the voice profiles of the university teachers was measured. All groups underwent subjective voice evaluations (perceptual evaluation, Voice Handicap Index, anamnesis of vocal complaints and vocal abuse) and objective voice evaluations (aerodynamic and acoustic parameters, vocal performance, and the Dysphonia Severity Index). The same voice assessment was performed after an academic lecture with a mean length of one and a half hours. The mean DSI score was + 2.2 for the male teachers and + 4.0 for the female teachers. The mean VHI score was 13. Perceptually, all voice parameters were rated as normal. The questionnaire revealed a relatively high amount of vocal abuse. No changes in the objective vocal parameters were found after the lecture. Perceptually, however, the voices of the university teachers were significantly less instable after the lecture. Although no negative changes in objective vocal quality were observed, 48% of the university teachers experienced subjective vocal changes. The authors concluded that university teachers are professional voice users with good vocal quality who suffer no handicapping effect from possible voice disorders. No important changes in the vocal profile after a teaching activity of one and a half hours were found, despite the high prevalence of voice complaints.

  14. Vocal tract discomfort in teachers after teaching activity.

    Science.gov (United States)

    Amaral, Amanda Corrêa do; Zambon, Fabiana; Moreti, Felipe; Behlau, Mara

    2017-01-01

    Purpose To evaluate the vocal tract discomfort (VTD) reported by teachers, comparing their vocal self-assessment at three different times: before teaching, after four hours of teaching, and after eight hours of teaching. Methods The study sample was composed of 50 teachers: 42 women and eight men. The participating teachers were divided into two groups according to the cutoff value of the Voice Symptom Scale (VoiSS): Vocal Risk Group (VRG) and Vocally Healthy Group (VHG). The List of Vocal Signs and Symptoms (LVSS) was used to identify the number of vocal symptoms in each group. The groups were evaluated at three specific moments (before (BT) and after four (4HT) and eight (8HT) hours of teaching) by means of the Vocal Tract Discomfort Scale (VTD scale) and vocal self-assessment. Results The VRG presented more vocal signs and symptoms of the LVSS than the VHG (total: VHG=0.56/VRG=1.60, pBT=0.67; 4HT=0.96; 8HT=0.96, p=0.007). However, the VRG presented vocal tract discomfort after four and eight hours of teaching for both frequency (BT=1.60; 4HT=2.49; 8HT=2.95, pBT=1.79; 4HT=2.52; 8HT=3.12, pBT=2.00; 4HT=2.42; 8HT=3.00, p<0.001). Conclusion Teachers at vocal risk present worse vocal self-assessment and increased vocal tract discomfort throughout the teaching working day.

  15. On the Folded Normal Distribution

    Directory of Open Access Journals (Sweden)

    Michail Tsagris

    2014-02-01

    Full Text Available The characteristic function of the folded normal distribution and its moment function are derived. The entropy of the folded normal distribution and the Kullback–Leibler from the normal and half normal distributions are approximated using Taylor series. The accuracy of the results are also assessed using different criteria. The maximum likelihood estimates and confidence intervals for the parameters are obtained using the asymptotic theory and bootstrap method. The coverage of the confidence intervals is also examined.

  16. Equi-Gaussian curvature folding

    Indian Academy of Sciences (India)

    Figure 10. Note that the graph Gf of any equi-Gaussian curvature of #nT 2 is a regular graph of valency 4. 2. References. [1] Farran H R, El-Kholy E and Robertson S A, Folding a surface to a polygon, Geometric. Dedicatiae 33 (1996) 255–266. [2] Zeen El-Deen M R, Cellular and fuzzy folding, Ph.D. thesis (Egypt: Tanta Univ.) ...

  17. Desvantagem vocal em cantores de igreja Vocal handicap of church singers

    Directory of Open Access Journals (Sweden)

    Tatiane Prestes

    2012-10-01

    Full Text Available OBJETIVO: avaliar a desvantagem vocal de cantores amadores de coros de igreja. MÉTODO: participaram 42 cantores de coros amadores de igrejas, sendo 20 homens e 22 mulheres, com idades entre 18 e 59 anos. Todos responderam a um questionário contendo perguntas sobre autopercepção vocal e práticas de canto, e ao protocolo Índice de Desvantagem para o Canto Moderno (IDCM, composto por 30 questões referentes às subescalas incapacidade, desvantagem e defeito. Foi realizada triagem perceptivo-auditiva para classificação das vozes em adaptadas ou alteradas e mensuração dos graus De alteração. RESULTADOS: a pontuação total média obtida no IDCM foi 23 pontos. Os maiores escores foram obtidos na subescala "defeito" (10,9, seguido por "incapacidade" (7,6 e "desvantagem" (4,5, com diferença entre elas (p= 0,001. Cantores que nunca realizaram aula de canto apresentaram maiores escores no domínio "desvantagem" (p=0,003. À medida que o escore total do IDCM aumentou, a nota atribuída pelo cantor em relação à própria voz diminuiu (p= 0,046. Participantes com qualidade vocal alterada apresentaram maiores escores nas subescalas incapacidade e desvantagem e no domínio total do IDCM quando comparados aos que apresentavam qualidade vocal adaptada (p=0,012, p=0,049 e p=0,015, respectivamente. Além disso, quanto maior o grau de alteração vocal, maiores foram os escores referentes à subescala incapacidade (p=0,022. CONCLUSÃO: cantores de igreja apresentam desvantagem vocal importante. Quando apresentam alterações vocais, esta desvantagem é ainda maior. Quanto maior o grau de alteração vocal, maiores as limitações referentes à voz cantada. Aulas de canto parecem minimizar a desvantagem vocal nessa população.PURPOSE: to evaluate the vocal handicap of amateur singers of church choirs. METHOD: we interviewed 42 amateur singers from church choirs, 20 men, and 22 women, between 18 and 59 year old. Everybody answered a questionnaire

  18. Protein folding by motion planning.

    Science.gov (United States)

    Thomas, Shawna; Song, Guang; Amato, Nancy M

    2005-11-09

    We investigate a novel approach for studying protein folding that has evolved from robotics motion planning techniques called probabilistic roadmap methods (PRMs). Our focus is to study issues related to the folding process, such as the formation of secondary and tertiary structures, assuming we know the native fold. A feature of our PRM-based framework is that the large sets of folding pathways in the roadmaps it produces, in just a few hours on a desktop PC, provide global information about the protein's energy landscape. This is an advantage over other simulation methods such as molecular dynamics or Monte Carlo methods which require more computation and produce only a single trajectory in each run. In our initial studies, we obtained encouraging results for several small proteins. In this paper, we investigate more sophisticated techniques for analyzing the folding pathways in our roadmaps. In addition to more formally revalidating our previous results, we present a case study showing that our technique captures known folding differences between the structurally similar proteins G and L.

  19. Protein folding by motion planning

    Science.gov (United States)

    Thomas, Shawna; Song, Guang; Amato, Nancy M.

    2005-12-01

    We investigate a novel approach for studying protein folding that has evolved from robotics motion planning techniques called probabilistic roadmap methods (PRMs). Our focus is to study issues related to the folding process, such as the formation of secondary and tertiary structures, assuming we know the native fold. A feature of our PRM-based framework is that the large sets of folding pathways in the roadmaps it produces, in just a few hours on a desktop PC, provide global information about the protein's energy landscape. This is an advantage over other simulation methods such as molecular dynamics or Monte Carlo methods which require more computation and produce only a single trajectory in each run. In our initial studies, we obtained encouraging results for several small proteins. In this paper, we investigate more sophisticated techniques for analyzing the folding pathways in our roadmaps. In addition to more formally revalidating our previous results, we present a case study showing that our technique captures known folding differences between the structurally similar proteins G and L. This research was supported in part by NSF CAREER Award CCR-9624315, NSF Grants ACI-9872126, EIA-9975018, EIA-0103742, EIA-9805823, ACR-0113971, CCR-0113974, EIA-9810937, EIA-0079874 and the Texas Higher Education Coordinating Board grant ATP-000512-0261-2001. ST was supported in part by an NSF Graduate Research Fellowship. GS was supported in part by an IBM PhD Fellowship.

  20. Four-dimensional CT analysis of vocal cords mobility for highly focused single vocal cord irradiation.

    Science.gov (United States)

    Osman, Sarah O S; de Boer, Hans C J; Heijmen, Ben J M; Levendag, Peter C

    2008-10-01

    To quantify respiratory motion of the vocal cords during normal respiration using 4D-CT. The final goal is to develop a technique for single vocal cord irradiation (SVCI) in early glottic carcinoma. Sparing the non-involved cord and surrounding structures has the potential to preserve voice quality and allow re-irradiation of recurrent and second primary tumors. Four-dimensional CTs of 1mm slice thickness from 10 early glottic carcinoma patients were acquired. The lateral dimensions of the air gap separating the vocal cords were measured anteriorly, at mid-level and posteriorly at each phase of the 4D-CTs. The corresponding anterior-posterior gaps were similarly measured. Cranio-caudal vocal cords movements during breathing were derived from the shifts of the arythenoids. The population-averaged mean gap size+/-the corresponding standard deviation due to breathing (SD(B)) for the lateral gaps was 5.8+/-0.7mm anteriorly, 8.7+/-0.9mm at mid-level, and 11.0+/-1.3mm posteriorly. Anterior-posterior gap values were 21.7+/-0.7mm, while cranio-caudal shift SD(B) was 0.8mm. Vocal cords breathing motions were found to be small relative to their separation. Hence, breathing motion does not seem to be a limiting factor for SVCI.

  1. The Vocal Tract Organ: A New Musical Instrument Using 3-D Printed Vocal Tracts.

    Science.gov (United States)

    Howard, David M

    2017-10-27

    The advent and now increasingly widespread availability of 3-D printers is transforming our understanding of the natural world by enabling observations to be made in a tangible manner. This paper describes the use of 3-D printed models of the vocal tract for different vowels that are used to create an acoustic output when stimulated with an appropriate sound source in a new musical instrument: the Vocal Tract Organ. The shape of each printed vocal tract is recovered from magnetic resonance imaging. It sits atop a loudspeaker to which is provided an acoustic L-F model larynx input signal that is controlled by the notes played on a musical instrument digital interface device such as a keyboard. The larynx input is subject to vibrato with extent and frequency adjustable as desired within the ranges usually found for human singing. Polyphonic inputs for choral singing textures can be applied via a single loudspeaker and vocal tract, invoking the approximation of linearity in the voice production system, thereby making multiple vowel stops a possibility while keeping the complexity of the instrument in reasonable check. The Vocal Tract Organ offers a much more human and natural sounding result than the traditional Vox Humana stops found in larger pipe organs, offering the possibility of enhancing pipe organs of the future as well as becoming the basis for a "multi-vowel" chamber organ in its own right. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  2. Programmable variable stiffness 2D surface design

    Science.gov (United States)

    Trabia, Sarah; Hwang, Taeseon; Yim, Woosoon

    2014-03-01

    Variable stiffness features can contribute to many engineering applications ranging from robotic joints to shock and vibration mitigation. In addition, variable stiffness can be used in the tactile feedback to provide the sense of touch to the user. A key component in the proposed device is the Biased Magnetorheological Elastomer (B-MRE) where iron particles within the elastomer compound develop a dipole interaction energy. A novel feature of this device is to introduce a field induced shear modulus bias via a permanent magnet which provides an offset with a current input to the electromagnetic control coil to change the compliance or modulus of a base elastomer in both directions (softer or harder). The B-MRE units can lead to the design of a variable stiffness surface. In this preliminary work, both computational and experimental results of the B-MRE are presented along with a preliminary design of the programmable variable stiffness surface design.

  3. Stiff Neck, Torticollis, and Pseudotumor Cerebri

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-05-01

    Full Text Available Three prepubertal children diagnosed with pseudotumor cerebri and presenting with stiff neck and torticollis are reported from Schneider Children’s Medical Center, Sackler School of Medicine, Tel Aviv, Israel.

  4. Strength and stiffness of engineering systems

    CERN Document Server

    Leckie, Frederick A

    2009-01-01

    This book on the stiffness and strength of engineering systems integrates a wide array of topics into a unified text, including plasticity, fracture, composite materials, energy approaches, and mechanics of microdevices (MEMs)..

  5. Macroscopic stiffness of breast tumors predicts metastasis.

    Science.gov (United States)

    Fenner, Joseph; Stacer, Amanda C; Winterroth, Frank; Johnson, Timothy D; Luker, Kathryn E; Luker, Gary D

    2014-07-01

    Mechanical properties of tumors differ substantially from normal cells and tissues. Changes in stiffness or elasticity regulate pro-metastatic behaviors of cancer cells, but effects have been documented predominantly in isolated cells or in vitro cell culture systems. To directly link relative stiffness of tumors to cancer progression, we combined a mouse model of metastatic breast cancer with ex vivo measurements of bulk moduli of freshly excised, intact tumors. We found a high, inverse correlation between bulk modulus of resected tumors and subsequent local recurrence and meta