Efecto inmediato de dos ejercicios con tracto vocal semiocluido en el contacto glótico de usuarios ocupacionales de la voz / Immediate effect of two semi-occluded vocal tract exercises in glottal contact of occupational voice users

Introducción. Los docentes son usuarios ocupacionales de la voz con alto riesgo de desarrollar patologías vocales a causa de su labor. Para enfrentar esta proble-mática, suelen usarse ejercicios con tracto vocal semiocluido (TVSO), estrategia de educación/rehabilitación empleada para generar un cambio en el patrón de vibración de los pliegues vocales, minimizando el riesgo de lesión vocal al reducir el estrés de colisión al que se someten los tejidos. Diversos reportes han indicado que este tratamiento tiene efectos en el cociente de cierre (CQ), medida indirecta del estrés de colisión.Objetivo. Examinar el efecto fisiológico de dos ejercicios con TVSO en la actividad laríngea de profesores con esfuerzo vocal constante pero sin patología vocal. Metodología. Se registraron muestras de 43 profesores antes, durante y después de la realización de dos ejercicios con TVSO (vibración lingual y fonación en tubos). Las muestras de electroglotografía se analizaron para obtener el CQ. Resultados y conclusión. Se observó una diferencia significativa al comparar los valores del CQ antes y durante la realización de ambos ejercicios. No se encontraron cambios en este parámetro después de ejecutar la actividad. Estos hallazgos concuer-dan con reportes previos en los cuales el CQ tiende a aumentar durante la fonación en tubos; contrariamente, la realización de la vibración lingual tiende a decrecer el valor del CQ. Es posible que este comportamiento se deba a los mecanismos biome-cánicos particulares de cada ejercicio

Introduction. Teachers are occupational voice users with high risk of developing vocal pathologies due to their work. To face this situation, it is common the use of semi-occluded vocal tract (SOVT) exercises, a strategy of voice education/rehabil-itation implemented to induce a change in the vibration pattern of the vocal folds, mitigating, therefore, the risk of vocal lesion by reducing the collision stress applied to tissues. A variety of reports have indicated that this treatment has effects in the closed quotient (CQ), an indirect measure of collision stress. Aim. The purpose of this study was to examine the physiological effect of two dif-ferent SOVT exercises in larynx activity of teachers with constant vocal effort but without vocal pathology. Methods. 43 samples of teachers were recorded before, during and after executing two SOVT exercises (tongue trill and tube phonation). Electroglottographic samples were analyzed in order to obtain CQ. Results and conclusion. Both exercises had a significant difference of CQ scores when before and during conditions were compared. Any difference was found on this parameter after executing the activity. These findings agree with previous reports where CQ tends to increase during phonation through resonance tubes; on the con-trary, execution of tongue trill tends to decrease CQ values. This behavior might be because of the particular biomechanical mechanisms of each exercise

Vocal tract physiology and its MRI evaluation / Fisiología del tracto vocal y su evaluación por resonancia magnética

Introduction. The rapid technological evolution in Magnetic Resonance Imaging (MRI) has recently offered a great opportunity for the analysis of voice production.Objectives. This article is aimed to describe main physiological principles at the base of voice production (in particular of vocal tract), and an overview about liter-ature on MRI of the vocal tract. This is presented in order to analyze both present results and future perspectives.Method. A narrative review was performed by searching the MeSH terms "vocal tract" and "MRI" in Pub Med database. Then, the obtained studies were subse-quently selected by relevancy.Results. Main fields described in literature concern technical feasibility and op-timization of MRI sequences, modifications of vocal tract in vowel or articulatory phonetics, modifications of vocal tract in singing, 3D reproduction of vocal tract and segmentation, and describing vocal tract in pathological conditions.Conclusions. MRI is potentially the best method to study the vocal tract physi-ology during voice production. Most recent studies have achieved good results in representation of changes in the vocal tract during emission of vowels and singing. Further developments in MR technique are necessary to allow an equally detailed study of faster movements that participate in the articulation of speaking, which will allow fascinating perspectives in clinical use.

Introducción. La rápida evolución tecnológica en la resonancia magnética (MRI) ha ofrecido recientemente una gran oportunidad para el análisis de la producción de voz.Objetivos. Este artículo tiene como objetivo describir los principales principios fisiológicos en la base de la producción de la voz (en particular, del tracto vocal) y una descripción general de la literatura sobre resonancia magnética del tracto vocal. Esto se presenta con el fin de analizar tanto los resultados actuales como las perspectivas futuras.Método. Se realizó una revisión narrativa mediante la búsqueda de los términos MeSH "tracto vocal" y "MRI" en la base de datos PubMed. Los estudios obtenidos se seleccionaron posteriormente por relevancia.Resultados. Los campos principales descritos en la literatura se refieren a la viabi-lidad técnica y optimización de secuencias de resonancia magnética, modificaciones del tracto vocal en una vocal o fonética articulatoria, modificaciones del tracto vocal en el canto, reproducción 3D del tracto vocal y segmentación y descripción del tracto vocal en condiciones patológicas.Conclusiones. La resonancia magnética es potencialmente el mejor método para estudiar la fisiología del tracto vocal en el momento de la producción de la voz. Los estudios más recientes han obtenido buenos resultados en la representación de cambios en el tracto vocal durante la emisión de vocales y el canto. Se necesitan más desarrollos en la técnica de RM para permitir un estudio igualmente detallado de los movimientos más rápidos que participan en la articulación del habla, lo que permi-tirá perspectivas fascinantes en el uso clínico.

Rehabilitación vocal fisiológica con ejercicios de tracto vocal semiocluido / Physiologic voice rehabilitation with semi-occluded vocal tract exercises

Introducción. Los ejercicios de tracto vocal semiocluido (ETVSO) son herramien-tas utilizadas en la rehabilitación fisiológica de la voz. Los ETVSO son ejercicios vocales producidos por la semioclusión del tracto vocal, a través de una serie de posturas que buscan alargar y/o ocluir el tracto vocal, generando un cambio en el patrón vibratorio de los pliegues vocales, grado de aducción y el patrón respiratorio. Los ETVSO pueden dividirse, según el tipo de semioclusión, en sostenida, transitoria y oscilatoria, así como en ejercicios de mayor resistencia a menor resistencia.Objetivo. Describir los diferentes tipos de ejercicios de tracto vocal semiocluido, el tipo de semioclusión, el grado de resistencia y sus efectos en los pliegues vocales, patrón respiratorio y configuración del tracto vocal. Metodología. Se realizó una revisión de la literatura en las bases de datos PubMed, Medline y Science Direct, usando los siguientes términos: "Semi-Occluded Vocal Tract Postures", "tract vocal semiocclude" y "ejercicios de tracto vocal semiocluido". Se utilizaron operadores booleanos "AND" y "OR" para especificar la búsqueda.Resultados. Los beneficios de estos ejercicios impactan positivamente en variables aerodinámicas, en la función glótica y en la configuración del tracto vocal. Conclusiones. Los ejercicios de tracto vocal semiocluido son una familia de ejerci-cios vocales producidos por semioclusión sostenida, transitoria y oscilatoria del tracto vocal, a través de una serie de posturas que buscan alargar y/o ocluir el tracto vocal, cuyos beneficios impactan positivamente los pliegues vocales y el tracto vocal

Introduction. Semi-occluded vocal tract exercises (SOVTE) are tools used in physiologic voice rehabilitation. Semi-occluded vocal tract exercises are vocal exer-cises produced by the semi-occlusion of the vocal tract through a series of postures that seek to lengthen and/or occlude the vocal tract, generating a change in the vibratory pattern of vocal folds, degree of vocal folds adduction, and the respira-tory pattern. SOVTE can be divided, according to the type of semi-occlusion, into sustained, transient and oscillatory, as well as exercises with high and low degree of airflow resistance.Objective. To describe the different types of semi-occluded vocal tract exercises, the type of semi-occlusion, the type of resistance, and their effects on the vocal folds, respiratory pattern, and configuration of the vocal tract.Methodology. A literature review was performed in the PubMed, Medline, and Science Direct databases, using the following terms: "Semi-occluded vocal tract pos-tures", "Semi-occluded vocal tract" and "Semi-occluded vocal tract exercises". Boo-lean operators "AND" and "OR" were used to specify the search.Results. The benefits of these exercises positively impact aerodynamic variables, glottal function, and configuration of the vocal tract.Conclusions. The semi-occluded vocal tract exercises are a family of vocal exerci-ses produced by the sustained, transitory, and oscillatory semi-occlusion of the vocal tract, through a series of postures that seek to lengthen and/or occlude the vocal tract, whose benefits positively impact on vocal folds and vocal tract.

Prevención de Alteraciones Vocales con Ejercicios de Tubos de Resonancia en un Grupo de Docentes / Prevention of Vocal Alterations Through Exercises with Resonance Tubes in a Teaching Group

En múltiples estudios se ha determinado la importancia de la voz en aquellos profesionales que la utilizan como su herramienta principal de trabajo. Dentro de este grupo se encuentran locutores, agentes de call center, profesores, entre otros; la población objeto de estudio en esta investigación son los profesores universitarios, ellos trabajan durante varias horas al día usando su voz para transmitir el conocimiento dentro del aula de clase, muchas veces en condiciones poco óptimas para un desempeño laboral efectivo. Además, están expuestos a diversos factores de riesgos ambientales y organizacionales lo cual los predispone y pueden generar sintomatología vocal asociada a su ocupación. Los participantes pertenecen a un programa de conservación de la voz. El diseño de investigación preexperimental, cuantitativo, utilizando pre-test y pos-test en una misma población, descriptivo transversal, bajo un enfoque epidemiológico. Se aplicó una encuesta de autopercepción vocal como pre-test, con el fin de identificar la percepción que tenían estos profesionales acerca de sus características vocales. Posterior a esto, se les realizó una serie de ejercicios con tubos de resonancia basados en la técnica de Tracto Vocal Semi Ocluido (TVSO) y finalmente, se le reaplicó la encuesta de autopercepción vocal como post-test para determinar los efectos y cambios fisiológicos de estos ejercicios sobre los parámetros acústicos de la voz y las características del habla tales como: inteligibilidad, naturalidad y audibilidad; logrando un efecto fisiológico terapéutico inmediato y una percepción subjetiva de mejoría posterior a la terapia, generando un cambio en el patrón vibratorio de sus pliegues vocales, minimizando el abuso y mal uso vocal, creando conciencia del cuidado que se debe tener con la voz cuando se utiliza de manera profesional por ser la herramienta principal de su trabajo.

Multiple studies have determined the importance of voice in those professionals who use it as their main work tool. Within this group are announcers, call center agents, teachers, among others; this research will deepen the professors, these are found for several hours a day using their voice to transmit knowledge within the classroom, often in poor conditions for effective work performance. In addition, they are exposed to various environmental and organizational risk factors which predispose them and generate a diversity of laryngeal pathologies characteristic of their occupation. Participants belong to a voice conservation program. The design of pre- experimental, quantitative research, using pre-test and post-test in the same population, cross- sectional descriptive, under an epidemiological approach. A vocal self-perception survey was applied as a pre-test, in order to identify the perception that these professionals had about their vocal characteristics. After this, they performed a series of exercises with resonance tubes based on the Semi-Occluded Vocal Tract (TVSO) technique and finally, the vocal self- perception survey was reapplied as a post-test to determine the physiological effects and changes of these exercises on the acoustic parameters of voice and speech characteristics such as: intelligibility, naturalness and audibility; achieving an immediate therapeutic physiological effect and a subjective perception of improvement after therapy, generating a change in the vibratory pattern of your vocal folds, minimizing abuse and vocal misuse, creating awareness of the care that should be taken with the voice when Professionally used as the main tool of his work.

Effects of Semi-Occluded Vocal Tract Exercise in Patients with Functional Aphonia

BACKGROUND AND OBJECTIVES: Functional aphonia is characterized by incomplete closure of the vocal folds. Semi-occluded vocal tract exercise (SOVTE) allows smoothly vocal folds collision without damage to the vocal folds tissues to produce normal vocal intensity. The purpose of this study is to report the effect of SOVTE in patients with functional aphonia. MATERIALS AND METHOD: Seven patients diagnosed with functional aphonia were treated with 1-3 voice therapy sessions using voiced lip-trill, humming, Lax Vox in SOVTE. To assess the effectiveness of semi-occluded vocal tract exercise, cepstral analysis and auditory perceptual assessment were performed before and after voice therapy. RESULTS: F0 (fundamental frequency), CPP (cepstral peak prominence) and L/H ratio (low/high spectral ratio) were significantly increased, while CPP Standard deviation, L/H ratio Standard deviation were decreased. In addition, ‘Grade’, ‘Breathiness’ and ‘Asthenia’ were significantly decreased in the GRBAS scale after SOVTE (p<0.05). CONCLUSIONS: In our study, SOVTE seemed to be effective to elicit voice quickly and promote vocal folds vibration without muscular effort in patients with functional aphonia.

Terapia con tracto vocal semi-ocluido: un estudio de caso / Voice therapy with semi-occluded vocal tract: a case study

Introducción: Los ejercicios de tracto vocal semi-ocluido hacen referencia a una serie de posturas que buscan alargar u ocluir el tracto vocal, generando de esta forma un cambio en el patrón vibratorio de los pliegues vocales. El mecanismo que explicaría los efectos percibidos después y durante el uso de estos ejercicios es el incremento de la inertancia del tracto vocal. Objetivo: El propósito de este trabajo es mostrar la aplicación de una secuencia de ejercicios de tracto vocal semi-ocluido como parte de un programa de tratamiento vocal y su efecto terapéutico en la fatiga vocal. Método: Estudiante de canto diagnosticado con fatiga vocal, presenta en el examen laringoscópico acumulación de mucus espeso en la glotis fonatoria y contracción laríngea antero-posterior. El plan terapéutico incluyó una secuencia de tareas fonatorias utilizando tubos de resonancia, programa de hidratación laríngea y eliminación del hábito de carraspeo. Resultados: Después de un mes se observa eliminación de la fatiga vocal, eliminación de la dificultad en los extremos de la tesitura, disminución de la mucosidad en la laringe y necesidad de aclarar la voz. Conclusiones: Los ejercicios con tracto vocal semi-ocluido pueden ser una herramienta efectiva en sujetos que presentan fatiga vocal. Estos ejercicios minimizan.

Introduction: Semi-occluded vocal tract exercises, involve a series of postures with extended and/or occluded vocal tract, producing a change in the vibration pattern of the vocal folds. The mechanism that explains the perceived effects during and after using these exercises is the increased vocal tract inertance. Objective: The purpose of this work is to show the application of a semi-occluded vocal tract exercise sequence as part of a voice treatment program and its therapeutic effect on vocal fatigue. Method: Singing student diagnosed with vocal fatigue presents mucus accumulation in phonatory glottis and antero-posterior contraction during a laringoscopy examination. The treatment plan included a phonatory sequence with resonance tubes, laryngeal hydration program and elimination of the clearing throat habit. Results: After one month of treatment, elimination of vocal fatigue, elimination of the difficulty production in the high vocal range, decreased mucus in the larynx and decreased clearing throat habit is observed. Conclusion: Semi-occluded vocal tract exercises can be an effective tool in subjects with vocal fatigue. These exercises minimize laryngeal muscular effort to promote vocal economy.

IMPORTANCIA DE LAS FRECUENCIAS DE RESONANCIA DEL TRACTO VOCAL EN LA ESTIMACIÓN DE POSICIONES ARTICULATORIAS / IMPORTANCE OF THE RESONANCE FREQUENCIES OF THE VOCAL TRACT IN ESTIMATING ARTICULATORY POSITIONS

La inversión articulatoria, cuyo objetivo es estimar la posición de los órganos articuladores a partir de la información contenida en la señal de voz, ofrece una variedad de potenciales aplicaciones en el campo de la voz; sin embargo, este es un problema aún por resolver. En este sentido, buscar representaciones con la capacidad de incrementar el desempeño de los sistemas de inversión articulatoria es una tarea importante. El presente trabajo analiza la relevancia de los formantes como entrada para los sistemas de inversión articulatoria. Para ello se implementa un análisis analítico y estadístico. En el caso analítico se utiliza un sintetizador articulario, el cual simula la ecuación de tubos concatenados que modelan el tracto vocal. Para el análisis estadístico se estudian datos reales provenientes de un articulógrafo electromagnético para los cuales se estima la asociación entre las características acústicas y los movimientos de los órganos articuladores. A modo de medida de asociación estadística se utiliza la medida de información . Los resultados entregados por el análisis son corroborados en un sistema de inversión articulatoria basado en redes neuronales. Se observa una mejora en el valor de error cuadrático medio del 2,2% y para el caso de la medida de desempeño de la correlación, una mejora del 2,8%.

Acoustic-to-Articulatory inversion, which seeks to estimate an articulator position using the acoustic information in the speech signal, offers several potential applications in the field of speech processing. In this context, it is important to use acoustic parameters with the ability to increase the performance of acoustic-to-articulatory inversion systems. This paper analyzes the importance of formants as inputs to such inversion systems from an analytical and a statistical perspective. The former is based on an articulatory synthesizer that simulates the voice signal from the vocal tract. The statistical analysis is based on real data provided by an electromagnetic articulograph, for which we estimate the statistical association between acoustic features and articulator movement. As a measure of statistical association, the information measure is utilized. The results are tested on a neuralnetwork- based Acoustic-to-Articulatory inversion system. The use of formants as inputs led to an improvement of 2.2% and 2.8% in the root-mean-square error and correlation values, respectively.

Perception of Hypernasality and its Physical Correlates / Oral Science International

To clarify the relationship between the perceptual diagnoses of hypernasality and its physical correlates, we conducted three experiments using the Japanese vowel /i/. We performed a spectral analysis of hypernasality on five cleft palate patients and six velum resection patients to investigate the spectral features related to hypernasality (experiment 1). Psychoacoustic experiments were conducted using various spectrally modified vowels to investigate the relationships between the spectral features and auditory perceptions of hypernasality (experiment 2). We analyzed the estimated spectral envelopes using an articulatory speech synthesis model to clarify the relationship between the spectral features and the velopharyngeal opening (experiment 3). Experiments 1 and 2 suggested four spectral features as the characteristics of hypernasality: (1) broadening of the F1 bandwidth, (2) an additional peak at around 1 kHz [P1], (3)^* a decrease in the magnitude of F2, and (4)^* a dip between F2 and F3 [D2]. In particular, the simultaneous modification of the decrease in the magnitudes of F2 and D2 is a very important cue for the auditory perception of hypernasality. Experiment 3 showed that the dips caused by nasal coupling resulted in the spectral modifications. In addition, the dip regions appeared to spread from the low-frequency region (around F1) to the high-frequency region (above F2), as the velopharyngeal opening enlarged. This suggests that the decrease in the magnitude of F2 and the dip between F2 and F3 [D2] are related to excessive acoustic coupling of the nasal cavity.^* New findings.

An Acoustic and Radiologic Study on Voice Change after Laser Assisted Uvulopalatoplasty / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Many people have been concerned about voice change after laser assisted uvulopalatoplasty (LAUP). A number of studies reported acoustic changes after uvulopalatopharyngoplasty (UPPP) and LAUP. However, there have not been any reports on the association between anatomic change and acoustic results after LAUP. The purpose of this study is to analyze changes in the voice and changes in the vocal tract after LAUP and to evaluate whether the anatomical changes of vocal tract have an effect on the voice change or not. SUBJECTS AND METHOD: By using CSL, we analyzed fourteen LAUP cases on the formant frequencies of six vowels (/a/, /i/, /u/, /=, /o/, /e/) and four nasal consonants (/hana/, /eomma/, /eoungga/, /chiken/). By using MR image, we analyzed changes in the vocal tract eight weeks after LAUP with preoperative findings in three cases. RESULTS: In acoustic analysis, the second formant frequencies of /u/ and /= phonation were significantly reduced postoperatively compared to those of preoperative status. In imaging study of /u/ and /=, the uvula and soft palate were contracted, so coupling was occurred between nasal cavity and oropharynx in /u/ and /= phonation and the tongue was shifted toward posterior pharyngeal wall to compensate coupling. CONCLUSION: LAUP reduced the second formant of /u/ and /=, which did not result in serious voice changes.

The Vocal Tract and Speech Intelligibility of Tracheoesophageal Shunt Patients after Total Laryngectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In this paper, rehabilitation of voice after total laryngectomy has been suggested through the correct estimation and simulation of patients' vocal tract. Material and Methods: The author studied the shape of vocal tract during the phonation of five Korean vowels /u, o, a, e, i/ in tracheoesophageal shunt patients by magnetic resonance images (MRI). The same vocal tract was determined in each vowels from MRI. First, speech data produced by them were analyzed and also checked for speech intelligibility. Then the author tried to synthesize vowels from the vocal tract area of each vowels and from the expanded pharyngeal section of the vocal tract. RESULTS: The obtained results were as follows: 1) The sounds of /a/, /e/, /i/ were similar to natural sounds in actual patients' speech. The sound of /o/ was heard as /sigma/. The sound of /u/ was heard as strained /u/. 2) The synthesized vowels of /a/, /e/ from MRI were heard as natural sounds. The sounds of /u/, /o/, /i/ were heard as other sounds. 3) The synthesized vowel by the expanded pharyngeal section of 3 times in vowel /o/ was more naturally heard than that of 2 times. The synthesized vowel from Formfrek was more naturally heard than that from AreatoFormant. CONCLUSION: In conclusion, some of the synthesized sounds from MRI disagrees with the actual sounds produced by the subjects. This could be best identified by the synthesis from the area data. Future MRI studies should consider this problem for more accurate measurements. Also, pharyngeal areas with varied sizes should be experimented to secure better speech output because the correct shapes of vocal tract ensures correct vowel pronunciation.

An Acoustic and Radiologic Study on Voice Change after Tonsillectomy and Adenotonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Some patients who have undergone tonsillectomy complain of voice change, but few studies for the mechanism of voice change were found. To solve this problem, study of voice change after tonsillectomy and adenotonsillectomy was done. MATERIALS AND METHODS: We analyzed voice change of 22 patients who underwent tonsillectomy and 15 patients who underwent adenotonsillectomy at CSL (computerized speech laboratory), St. Benedict Hospital. With the measured cross sectional area of vocal tract and its length from the glottis on MR images, we presented the change of cross sectional area schematically after tonsillectomy. RESULTS: Acoustically, the frequencies of the second formant of /e/ and /i/ increased and that of the first formant of /u/ decreased significantly after tonsillectomy and the frequency of the second formant of /o/ and those of the second and third formants of /i/ and /u/ increased significantly after adenotonsillectomy. It was also showed acoustically that the formant bandwidths of /a/ and /hana/ after tonsillectomy and those of /e/ and /hana/ after adenotonsillectomy increased due to nasalization. Anatomically, it was showed that the cross sectional area of oropharyngeal cavity increased and coupling effect of vocal tract happened after tonsillectomy. CONCLUSION: This study showed that acoustic characteristics and vocal tract shapes of the patients did change following tonsillectomy and adenotonsillectomy. It is imperative that we explain to patients about the postoperative voice change. Research should also be done to find ways to induce better voice changes following the operations.