Vocal Impact of a Prolonged Reading Task in Dysphonic Versus Normophonic Female Teachers

in Journal of Voice (2012), 26(6), 8201-82013

OBJECTIVES: This study evaluates the impact on voice of a 2-hour reading task between 70-75 dB(A) in 16 normophonic and 16 dysphonic female teachers with vocal nodules. METHODS: Objective measurements ... [more ▼]

OBJECTIVES: This study evaluates the impact on voice of a 2-hour reading task between 70-75 dB(A) in 16 normophonic and 16 dysphonic female teachers with vocal nodules. METHODS: Objective measurements (acoustic analysis, voice range measurements, aerodynamic measurements) and subjective self-ratings were collected before the task and every 30 minutes during the reading to determine the voice evolution in both groups. RESULTS: Fundamental frequency, lowest frequency, highest frequency (F-High), highest intensity and intensity range increase through the reading, whereas Shimmer decreases. Maximum phonation time decreases after 30 minutes. Estimated subglottal pressure (ESP) and sound pressure level increase during the first hour. Afterwards, ESP decreases. Self-ratings worsen through time. When comparing the normophonic and the dysphonic teachers, self-ratings reveal more complaints in the dysphonic group. Few differences in objective measurements are found between both groups: normophonic teachers show lower ESP, higher F-High and greater frequency range. CONCLUSIONS: Frequency modifications from acoustic analysis and voice range measurements suggest an increased laryngeal tension during vocal load, while subjects perceive a worsening of voice. Aerodynamic parameters depict first a deterioration of voice efficiency and then an adaptation to the prolonged reading. The comparison between both groups shows a discrepancy between objective measurements and self-ratings, suggesting that both approaches are necessary to have a complete view of vocal load effects. Surprisingly, both groups behave similarly through vocal load, without more or quicker deterioration of voice in the dysphonic group. [less ▲]

Vocal Impact of a Prolonged Reading Task at Two Intensity Levels: Objective Measurements and Subjective Self-Ratings

in Journal of Voice (2012), 26(4), 177-186

Objectives: The objectives of this study are to evaluate the impact on voice of both duration and intensity level of 2 hours of continuous oral reading. Voice modifications accompanying changes in ... [more ▼]

Objectives: The objectives of this study are to evaluate the impact on voice of both duration and intensity level of 2 hours of continuous oral reading. Voice modifications accompanying changes in intensity level during prolonged reading tasks are analyzed. Methods: Fifty normophonic women undergo two sessions of voice loading in which the required intensity level of voice varied between 60–65 dB(A) for the first session and 70–75 dB(A) for the second session. The effects of loading on objective data (average fundamental frequency [F0], jitter%, shimmer%, noise-to-harmonic ratio, maximum phonation time, lowest frequency [F-Low], highest frequency [F-High], frequency range [Range], lowest intensity [I-Low] level, and highest intensity level) and self-ratings (voice quality, phonation effort, vocal fatigue, and laryngeal discomfort) are assessed every 30 minutes during the loading tasks. Results: Results indicate that average F0, F-Low, I-Low, maximum phonation time, feeling of phonation effort, vocal fatigue, and laryngeal discomfort increase during prolonged reading, whereas shimmer% and self-rating of voice quality decrease. Average F0, F-High, and Range are the only parameters influenced by the required intensity of vocal load; they are significantly higher in the 70- to 75-dB session compared with the 60- to 65-dB session. Concerning the subjective self-ratings, similar results for the four ratings used suggest that only one would suffice in future studies. Conclusions: These results confirm the importance of both duration and intensity level as loading factors, even if intensity level affects fewer variables than duration. [less ▲]

Glottoplasty for Male-to-Female Transsexualism: Voice Results

in Journal of Voice (2010), 25(1), 120-3

Summary: Objectives. The aim of this study was to evaluate the objective voice results ofWendler’s glottoplasty in male-to-female transsexuals. Method. We retrospectively reviewed our patients treated ... [more ▼]

Summary: Objectives. The aim of this study was to evaluate the objective voice results ofWendler’s glottoplasty in male-to-female transsexuals. Method. We retrospectively reviewed our patients treated with Wendler’s technique with minor modifications. Glottoplasty consisted in CO2-laser epithelial ablation of the anterior commissure and the two vocal folds in anterior third, suturing of the two vocal folds with two stitches of 3.0 resorbable thread, and application of fibrin sealant to strengthen the suture. Voice assessment was based mainly on fundamental frequency (F0), frequency range, jitter, maximum phonation time, phonation quotient, estimated subglottic pressure (ESGP) grade of dysphonia (G), and voice handicap index (VHI). These measures were taken before surgery and on the last follow-up visit. Results. Our series included 15 patients with a mean age of 36 years. The mean follow-up period was 7.2 months.We did not observe any early complications related to the technique. The comparison between the preoperative and the postoperative measurements, using Wilcoxon signed rank test, showed a significant improvement of median F0 from 139 to 191 Hz (P ¼ 0.006) with an increase in the grade of dysphonia (Gpre ¼ 0.2, Gpost ¼ 1, P ¼ 0.013) and ESGP (ESGPpre ¼ 8.1 ± 3.2, ESGPpost ¼ 12.0 ± 3.8, P ¼ 0.002). Other measurements, including VHI, did not show any significant differences pre- and postoperatively. Conclusion. Wendler’s glottoplasty can contribute to feminize the voice. [less ▲]

Implantation of Esterified Hyaluronic Acid in Microdissected Reinke's Space After Vocal Fold Microsurgery: Short- and Long-Term Results.

in Journal of Voice (2010)

In this study are reported the laryngeal and vocal results obtained after a microflap excision of benign vocal fold (VF) lesions and immediate implantation of esterified hyaluronic acid (EHA) in the ... [more ▼]

In this study are reported the laryngeal and vocal results obtained after a microflap excision of benign vocal fold (VF) lesions and immediate implantation of esterified hyaluronic acid (EHA) in the surgical wound. In a previous pilot study on 11 cases, we have shown an excellent tolerance of this bioimplant. The objectives are to confirm the innocuity of the technique, to demonstrate the laryngeal and vocal evolution at short and long term, and to evaluate the eventual positive impact of EHA implantation on the pliability of the superficial layer of the lamina propria (SLLP) and on voice. This is a prospective and comparative study on 83 patients suffering from various benign VF lesions. Thirty-three patients were implanted with EHA, whereas 50 patients did not undergo implantation at the end of the microsurgical procedure.All patients undergo rigid laryngoscopy and microflap excision procedure under general anesthesia. After freeing up of the Reinke's space and creation of a mucosal microflap, a few fibers of EHA are inserted in the surgical wound, before closure of the incision with fibrin glue. Serial laryngeal and vocal assessments are performed in all patients using videostroboscopy (Wolff and Xion), perceptual and objective voice evaluation (MDVP software, Kay Elemetrics), and phonatory function measurements (Aerophone II). Pre- and early postoperative means are compared by analysis of variance. Delayed and long-term evolution of laryngeal and vocal data are compared by means of nonparametric statistical methods. The longest follow-up in the implanted group is 4 years. Early postoperative results are similar in both groups: a significant improvement of a majority of laryngeal and vocal data is observed after microsurgery. In the long term, the two groups exhibit a different behavior: further improvement of voice, as an ongoing process, is only observed in the EHA implanted group, together with improvement of some videostroboscopic characteristics. The nonimplanted group remains stable, with no further improvement of the voice quality obtained after microsurgery. Excellent short- and long-term tolerance of EHA implantation is confirmed by this larger series. The use of EHA implant in microdissected SLLP is safe and leads to good laryngeal and vocal outcomes in the treated patients. More interestingly, treated cases exhibit a continuous improvement over a long period of time. [less ▲]

Implantation of esterified hyaluronic acid in microdissected Reinke's space after vocal fold microsurgery: short and long-term results

in Journal of Voice (2010), (24( 5)), 626-635

laryngeal and vocal results obtained after microflap excision of benign vocal fold lesions and immediate implantation of esterified hyaluronic acid(EHA) in the surgical wound are described in this study ... [more ▼]

laryngeal and vocal results obtained after microflap excision of benign vocal fold lesions and immediate implantation of esterified hyaluronic acid(EHA) in the surgical wound are described in this study.Prospective and comparative study on 83 patients ( 33 implanted with EHA and 50 not implanted). Longest follow up is 4 years. The objectives are to confirm the innocuity of the technique, to demonstrate the laryngeal and vocal evolution at short and long term, and to evaluate the eventual positive impact of EHA implantation on the pliability of the superficial layer of the lamina propria (SLLP) and on voice. The use of EHA implant in microdissected SLLP is safe and leads to good laryngeal and vocal outcomes in the treated patients. [less ▲]

Voice Feminization in case of gender reassignment: effect of Wendler glottopasty

in Journal of Voice (2009, July 04)

Summary: Objectives. The aim of this study was to evaluate the objective voice results ofWendler’s glottoplasty in male-to-female transsexuals. Method. We retrospectively reviewed our patients treated ... [more ▼]

Summary: Objectives. The aim of this study was to evaluate the objective voice results ofWendler’s glottoplasty in male-to-female transsexuals. Method. We retrospectively reviewed our patients treated with Wendler’s technique with minor modifications. Glottoplasty consisted in CO2-laser epithelial ablation of the anterior commissure and the two vocal folds in anterior third, suturing of the two vocal folds with two stitches of 3.0 resorbable thread, and application of fibrin sealant to strengthen the suture. Voice assessment was based mainly on fundamental frequency (F0), frequency range, jitter, maximum phonation time, phonation quotient, estimated subglottic pressure (ESGP) grade of dysphonia (G), and voice handicap index (VHI). These measures were taken before surgery and on the last follow-up visit. Results. Our series included 15 patients with a mean age of 36 years. The mean follow-up period was 7.2 months.We did not observe any early complications related to the technique. The comparison between the preoperative and the postoperative measurements, using Wilcoxon signed rank test, showed a significant improvement of median F0 from 139 to 191 Hz (P ¼ 0.006) with an increase in the grade of dysphonia (Gpre ¼ 0.2, Gpost ¼ 1, P ¼ 0.013) and ESGP (ESGPpre ¼ 8.1 ± 3.2, ESGPpost ¼ 12.0 ± 3.8, P ¼ 0.002). Other measurements, including VHI, did not show any significant differences pre- and postoperatively. Conclusion. Wendler’s glottoplasty can contribute to feminize the voice. [less ▲]