Cepstral Peak Prominence Smoothed - CPPS and Acoustic Voice Quality Index - AVQI in healthy and altered children's voices: comparation, relationship with auditory-perceptual judgment and cut-off points. / Cepstral Peak Prominence Smoothed - CPPS e Acoustic Voice Quality Index - AVQI em vozes infantis saudáveis e alteradas: comparação, relação com julgamento perceptivo-auditivo e pontos de corte.

PURPOSE: To compare the acoustic measurements of Cepstral Peak Prominence Smoothed (CPPS) and Acoustic Voice Quality Index (AVQI) of children with normal and altered voices, to relationship with auditory-perceptual judgment (APJ) and to establish cut-off points. METHODS: Vocal recordings of the sustained vowel and number counting tasks of 185 children were selected from a database and submitted to acoustic analysis with extraction of CPPS and AVQI measurements, and to APJ. The APJ was performed individually for each task, classified as normal or altered, and for the tasks together defining whether the child would pass or fail in a situation of vocal screening. RESULTS: Children with altered APJ and who failed the screening had lower CPPS values and higher AVQI values, than those with normal APJ and who passed the screening. The APJ of the sustained vowel task was related to CPPS and AVQI, and APJ of the number counting task was related only to AVQI and CPPS numbers. The cut-off points that differentiate children with and without vocal deviation are 14.07 for the vowel CPPS, 7.62 for the CPPS numbers and 2.01 for the AVQI. CONCLUSION: Children with altered voices, have higher AVQI values and lower CPPS values, when detected in children with voices within the normal range. The acoustic measurements were related to the auditory perceptual judgment of vocal quality in the sustained vowel task, however, the number counting task was related only to the AVQI and CPPS. The cut-off points that differentiate children with and without vocal deviation are 14.07 for the CPPS vowel, 7.62 for the CPPS numbers and 2.01 for the AVQI. The three measures were similar in identifying voices without deviation and dysphonic voices.

OBJETIVO: Comparar as medidas acústicas de Cepstral Peak Prominence Smoothed (CPPS) e Acoustic Voice Quality Index (AVQI) de crianças com vozes normais e alteradas, relacionar com o julgamento perceptivo-auditivo (JPA) da voz e estabelecer pontos de corte. MÉTODO: Gravações vocais das tarefas de vogal sustentada e contagem de números de 185 crianças foram selecionadas em um banco de dados e submetidas a análise acústica com extração das medidas de CPPS e AVQI, e ao JPA. O JPA foi realizado individualmente para cada tarefa e as amostras foram classificadas posteriormente como normal ou alterada, e para as tarefas em conjunto definindo-se se a criança passaria ou falharia em uma situação de triagem vocal. RESULTADOS: Crianças com JPA alterado e que falharam na triagem apresentaram valores menores de CPPS e maiores de AVQI, do que as com JPA normal e que passaram na triagem. O JPA da tarefa de vogal sustentada se relacionou ao CPPS e AVQI, e da tarefa de contagem de números relacionou-se apenas ao AVQI e CPPS números. Os pontos de corte que diferenciam crianças com e sem desvio vocal são 14,07 para o CPPS vogal, 7,62 para o CPPS números e 2,01 para o AVQI. CONCLUSÃO: Crianças com JPA alterado apresentaram maiores valores de AVQI e menores valores de CPPs. O JPA da tarefa de vogal previu todas as medidas acústicas, porém, de contagem previu apenas as medidas extraídas dela. As três medidas foram semelhantes na identificação de vozes sem desvio e vozes disfônicas.

Effects of Speech Characteristics on Electroglottographic and Instrumental Acoustic Voice Analysis Metrics in Women With Structural Dysphonia Before and After Treatment.

PURPOSE: Literature suggests a dependency of the acoustic metrics, smoothed cepstral peak prominence (CPPS) and harmonics-to-noise ratio (HNR), on human voice loudness and fundamental frequency (F0). Even though this has been explained with different oscillatory patterns of the vocal folds, so far, it has not been specifically investigated. In the present work, the influence of three elicitation levels, calibrated sound pressure level (SPL), F0 and vowel on the electroglottographic (EGG) and time-differentiated EGG (dEGG) metrics hybrid open quotient (OQ), dEGG OQ and peak dEGG, as well as on the acoustic metrics CPPS and HNR, was examined, and their suitability for voice assessment was evaluated. METHOD: In a retrospective study, 29 women with a mean age of 25 years (± 8.9, range: 18-53) diagnosed with structural vocal fold pathologies were examined before and after voice therapy or phonosurgery. Both acoustic and EGG signals were recorded simultaneously during the phonation of the sustained vowels /ɑ/, /i/, and /u/ at three elicited levels of loudness (soft/comfortable/loud) and unconstrained F0 conditions. RESULTS: A linear mixed-model analysis showed a significant effect of elicitation effort levels on peak dEGG, HNR, and CPPS (all p < .01). Calibrated SPL significantly influenced HNR and CPPS (both p < .01). Furthermore, F0 had a significant effect on peak dEGG and CPPS (p < .0001). All metrics showed significant changes with regard to vowel (all p < .05). However, the treatment had no effect on the examined metrics, regardless of the treatment type (surgery vs. voice therapy). CONCLUSIONS: The value of the investigated metrics for voice assessment purposes when sampled without sufficient control of SPL and F0 is limited, in that they are significantly influenced by the phonatory context, be it speech or elicited sustained vowels. Future studies should explore the diagnostic value of new data collation approaches such as voice mapping, which take SPL and F0 effects into account.

Voice aspects in children with precocious puberty.

PURPOSE: In this prospective study, we aimed to investigate the difference in voice acoustic parameters between girls with idiopathic central precocious puberty (ICPP) and those who developed normally during prepuberty. MATERIALS AND METHODS: Our study recruited 54 girls diagnosed with ICPP and randomly sampled 51 healthy prepubertal girls as the control. Tanner stages, circulating hormone levels and bone ages of the girls with ICPP and the age and body mass index (BMI) of all participants were recorded. Acoustic analyses were performed using PRAAT computer-based voice analysis software and the mean pitch (F0), jitter, shimmer, noise-to harmonic-ratio (NHR) and harmonic-to-noise ratio (HNR) values were compared in the patient and control groups. RESULTS: The two groups did not significantly differ in age or BMI. In the evaluation of the F0 and jitter values, we were found to be lower in the control group than in the patient group. However, we did not find a statistical significance. The mean shimmer values of the patient group were significantly higher than those of the control group. In addition, a statistically significant difference was noted for the mean HNR and NHR values (P < 0.001). A moderate negative correlation was found between shimmer and hormone levels in the patient group. CONCLUSIONS: Voice acoustic parameters one of the defining features of girls with ICPP. Voice changes in acoustic parameters could reflect hormonal changes during puberty. Clinicians should suspect ICPP when there is a change in the voice.

A Retrospective Study of Acoustic Measures of Glottal Stop Production to Assess Vocal Function in Unilateral Vocal Fold Paresis/Paralysis Patients.

PURPOSE: The aim of this study was to determine (a) diagnostic accuracy of acoustic measures of glottal stop production (GSP; intensity differences, slopes, complete voicing cessation) to distinguish between unilateral vocal fold paresis/paralysis (UVFP) patients and controls; (b) if acoustic measures of GSP significantly correlated with an acoustic measure of voice disorder severity, acoustic voice quality index (AVQI); and (c) if acoustic measures from another type of voicing cessation, voiceless consonant production, also significantly differed between groups. METHOD: Ninety-seven patients with unilateral paresis/paralysis and 35 controls with normal laryngostroboscopic signs produced two sets of five repeated [i] and four repeated [isi]. Tokens were randomized by type between groups and analyzed blinded using a customized Praat program that computed intensity differences and slopes between vowel maxima and glottal stop minima for inter-[i] tokens and vowel maxima and voiceless consonant minima for intra-[isi] tokens. The number of voicing cessations for inter-[i] tokens was obtained. RESULTS: Onset and offset intensity differences and number of voicing cessations from inter-[i] tokens had the greatest areas under the curve (.854, .856, and .835, respectively). Correlation coefficients were significant (p < .01) between AVQI and all GSP acoustic measures with weak/medium effect sizes. No significant differences were found between controls and participants with UVFP for acoustic measures from intra-[isi]. CONCLUSIONS: Acoustic GSP measures demonstrated good diagnostic accuracy and some relationship to severity of voice disorder. No significant differences in acoustic measures for medial voiceless fricative consonants between controls and participants with UVFP suggested that voicing cessation for voiceless fricatives differs from voicing cessation for GSP.

Zoom in: factors affecting vocal habits during online meetings, a prospective trial on 40 subjects.

PURPOSE: To identify factors that influence vocal habits during online meetings (OMs). METHODS: A prospective trial of forty participants without any known hearing or vocal cord disorders. Subjects participated in an OM divided into six randomly ordered sections, with alterations in audio/speaking equipment and language: the computer's speaker-microphone, a single earbud, two-earbuds or headphones; with/without video, native-language-speaking (Hebrew) versus second language-speaking (English). Each section included free speech, sustained phonation, and a standardized passage. Participants ranked their vocal-effort for each section. Three blinded raters independently scored the voice using the GRBAS scale, and acoustic analyses were performed. RESULTS: No significant difference in self-reported vocal effort was demonstrated between sections. Second-language speaking resulted in significantly increased intensity (p < 0.0001), frequency (p = 0.015), GRBAS (p = 0.008), and strain (p < 0.0001) scores. Using the computer's speaker/microphone resulted in significantly higher strain (p < 0.0001). Using headphones, single or two earbuds resulted in lower intensity and a lower strain score. No differences were detected between OMs with or without video. CONCLUSIONS: Using the computer's microphone/speaker or speaking in a second language during OMs, may result in vocal habits associated with vocal trauma.

Analysis of the relationship between emotion intensity and electrophysiology parameters during a voice examination of opera singers.

OBJECTIVES: Emotions and stress affect voice production. There are only a few reports in the literature on how changes in the autonomic nervous system affect voice production. The aim of this study was to examine emotions and measure stress reactions during a voice examination procedure, particularly changes in the muscles surrounding the larynx. MATERIAL AND METHODS: The study material included 50 healthy volunteers (26 voice workers - opera singers, 24 control subjects), all without vocal complaints. All subjects had good voice quality in a perceptual assessment. The research procedure consisted of 4 parts: an ear, nose, and throat (ENT)­phoniatric examination, surface electromyography, recording physiological indicators (heart rate and skin resistance) using a wearable wristband, and a psychological profile based on questionnaires. RESULTS: The results of the study demonstrated that there was a relationship between positive and negative emotions and stress reactions related to the voice examination procedure, as well as to the tone of the vocal tract muscles. There were significant correlations between measures describing the intensity of experienced emotions and vocal tract muscle maximum amplitude of the cricothyroid (CT) and sternocleidomastoid (SCM) muscles during phonation and non-phonation tasks. Subjects experiencing eustress (favorable stress response) had increased amplitude of submandibular and CT at rest and phonation. Subjects with high levels of negative emotions, revealed positive correlations with SCMmax during the glissando. The perception of positive and negative emotions caused different responses not only in the vocal tract but also in the vegetative system. Correlations were found between emotions and physiological parameters, most markedly in heart rate variability. A higher incidence of extreme emotions was observed in the professional group. CONCLUSIONS: The activity of the vocal tract muscles depends on the type and intensity of the emotions and stress reactions. The perception of positive and negative emotions causes different responses in the vegetative system and the vocal tract. Int J Occup Med Environ Health. 2024;37(1):84-97.

Direct subthalamic nucleus stimulation influences speech and voice quality in Parkinson's disease patients.

BACKGROUND: DBS of the subthalamic nucleus (STN) considerably ameliorates cardinal motor symptoms in PD. Reported STN-DBS effects on secondary dysarthric (speech) and dysphonic symptoms (voice), as originating from vocal tract motor dysfunctions, are however inconsistent with rather deleterious outcomes based on post-surgical assessments. OBJECTIVE: To parametrically and intra-operatively investigate the effects of deep brain stimulation (DBS) on perceptual and acoustic speech and voice quality in Parkinson's disease (PD) patients. METHODS: We performed an assessment of instantaneous intra-operative speech and voice quality changes in PD patients (n = 38) elicited by direct STN stimulations with variations of central stimulation features (depth, laterality, and intensity), separately for each hemisphere. RESULTS: First, perceptual assessments across several raters revealed that certain speech and voice symptoms could be improved with STN-DBS, but this seems largely restricted to right STN-DBS. Second, computer-based acoustic analyses of speech and voice features revealed that both left and right STN-DBS could improve dysarthric speech symptoms, but only right STN-DBS can considerably improve dysphonic symptoms, with left STN-DBS being restricted to only affect voice intensity features. Third, several subareas according to stimulation depth and laterality could be identified in the motoric STN proper and close to the associative STN with optimal (and partly suboptimal) stimulation outcomes. Fourth, low-to-medium stimulation intensities showed the most optimal and balanced effects compared to high intensities. CONCLUSIONS: STN-DBS can considerably improve both speech and voice quality based on a carefully arranged stimulation regimen along central stimulation features.

Singing in different performance spaces: The effect of room acoustics on singers' perception.

Classical singers' performances vary across different acoustic environments. The changes in the delivery are influenced by the singer's perception of the venue's acoustics. This study investigated these relationships using nine professional or semi-professional classical singers. Participants performed Giordani's "Caro mio ben" aria in five venues, and the acoustic parameters reverberance (T30 and EDT), clarity (C80), early vocal support (STv), and tonal color (EDTf) were measured. From a factor analysis of the subjective analysis three major factors emerged that, we propose, would represent three generalized percepts of Room Supportiveness, Room Noiselessness, and Room Timbre. These percepts correlated significantly with objective acoustic parameters traditionally linked to vocal support, reverberation, and timbre. Room Supportiveness and Room Noiselessness significantly contributed to the singers' likability of the acoustic environment, while Room Timbre did not. This indicates that singers' perceptual preference for a performance space may be influenced by factors affecting both auditory feedback and vocal function. These findings underscore the need for performing space designers to consider the unique needs of all stakeholders, including listeners and performers. The study contributes to the bridging of the gap between subjective perceptions and objective measurements, providing valuable insights for acoustic design considerations.

An experimental model of the pharyngoesophageal segment in tracheoesophageal phonation.

Tracheoesophageal (TE) speech is an important method of speech rehabilitation for those who undergo a total laryngectomy. Despite the many advantages over other methods, there is still room for improvement in terms of the overall quality of the TE voice as well as its success rate. These points could be greatly assisted by an improved knowledge on the mechanics of TE speech. Here, an experimental model of the pharyngoesophageal segment (PES), based on the idea of a collapsible tube, is proposed. To implement the model, considerable simplifications had to be made, most notably in the use of a thin flexible tube to represent the PES. The model was used to assess the minimum amount of tonicity required for the onset of phonation in terms of the flow rate and longitudinal tension. Additionally, comparisons with a mathematical model [Tourinho, da Silva, dos Santos, Thomaz, and Vieira, J. Acoust. Soc. Am. 149, 1979-1988 (2021)] have been made, yielding similar trends for sufficiently large flow rates. The measurements also suggest that the phonation frequency is most affected by the tonicity of the PES, which highlights the question of which physiological mechanism is responsible for the control of the fundamental frequency of phonation.

Normative Voice Range Profile of the Young Female Voice.

OBJECTIVES: Normative data are important in the clinical setting of Speech and Language Pathology. The purpose of this study was to develop a normative reference dataset of voice range profiles from young females. STUDY DESIGN: Descriptive study including a prospective collection of voice range profile data. METHODS: Voice range profile recordings from 39 females with healthy voices aged 18 to 28 years were conducted. Seven voice range profile variables were analyzed: minimum and maximum fundamental frequency and intensity, semitone and intensity ranges, and voice range profile area. Descriptive statistical methods were applied. RESULTS: An age-specific voice range profile normative dataset was established. The mean values and standard deviations were as follows: semitone range 34.7 ± 3.9 ST, minimum fundamental frequency 143.6 ± 21.7 hertz, maximum fundamental frequency 1063.5 ± 160 hertz, intensity range 65.6 ± 5.0 dB, minimum intensity 43.2 ± 2.5 dB SPL, maximum SPL 108.9 ± 5.1 dB SPL, and voice range profile area 1346 ± 222 cells. CONCLUSION: A normative dataset usable for optimization of future voice assessments has been established. It may especially benefit evaluation and treatment planning for younger females suffering from vocal fold nodules.

The effect of type 1 diabetes mellitus on voice in pediatric patients.

PURPOSE: The aim of this prospective case-control study was to determine the effect on the voice of type 1 diabetes mellitus (T1DM) in paediatric patients. MATERIALS AND METHODS: The study included patients aged 6-18 years followed up for at least 1 year because of T1DM, and a control group of age and gender-matched healthy volunteers. Following an Ear, Nose, and Throat (ENT) examination, all subjects underwent flexible endoscopic laryngeal examination. Fasting venous blood samples were taken in the morning for the examination of fasting blood glucose (FBG), HgbA1C, and kidney, liver, and thyroid function tests. Data were recorded from the patient files of age, gender, comorbidities, and the development of diabetes-related complications. Voice recordings were taken and the Voice Handicap Index (VHI)-10 form was completed. The patients and control group were compared in respect of the parameters of fundamental frequency, jitter, shimmer, and acoustic voice quality index (AVQI). RESULTS: Evaluation was made of 64 children and adolescents as 32 in the patient group (Group 1) and 32 healthy control subjects (Group 2). Group 1 comprised 17 females and 15 males with a mean age of 12.75 ± 3.23 years. Group 2 comprised 17 females and 15 males with a mean age of 12.75 ± 3.33 years. In Group 1, mean disease duration was 5.21 ± 3.17 years (range, 1-13 years), the FBG value was mean 216.6 ± 122.3 mg/dl, mean HgbA1c was 10.7 ± 2.8, as ≤ 7 in 4 patients, 7-9 in 4, and > 9 in 24. Maximum phonation time (MPT) was determined as 10.66 ± 3.6 secs in Group 1 and 12.11 ± 4.43 in Group 2. VHI was determined as 2.33 ± 3 in Group 1 and 2.31 ± 2.77 in Group 2. No statistically significant difference was determined between the groups was determined in respect of acoustic analysis, perturbation parameters, AVQI and body mass index. CONCLUSIONS: This study is the first to have investigated the effects of T1DM on the voice in paediatric patients. The study results showed that the AVQI value was higher in the patient group but not to a statistically significant level. Therefore, there is a need for further studies with larger samples. The current study can be of guidance for further studies in this field.

Effects of Cognitive Stress on Voice Acoustics in Individuals With Hyperfunctional Voice Disorders.

PURPOSE: Autonomic nervous system dysfunction has been implicated in the development and persistence of hyperfunctional voice disorders (HVDs). The purpose of this study was to determine the effects of cognitive stress, which is known to arouse the autonomic nervous system, on voice acoustics in female speakers with and without HVDs. METHOD: Adult female speakers-66 with HVDs, 66 without-were recorded while speaking with and without a cognitive stressor. Root-mean-square (RMS) of amplitude, fundamental frequency (f o), low-to-high spectral energy ratio (L/H ratio), cepstral peak prominence (CPP), and relative f o (RFF) were measured for each speaker and cognitive stress condition. Mixed-model analyses of variance and post hoc t tests were conducted to determine if cognitive stress affected voice acoustics and whether voice changes were greater for those with HVDs. RESULTS: All measures differed significantly under cognitive stress for speakers with and without HVDs. RMS and CPP increased whereas f o, CPP, and RFF decreased under cognitive stress. Changes in these measures were not greater in those with HVDs. CONCLUSION: Cognitive stress and presumed autonomic arousal affect voice similarly in female speakers with and without HVDs.

Interactions Between Breathy and Rough Voice Qualities and Their Contributions to Overall Dysphonia Severity.

PURPOSE: Dysphonic voices typically present multiple voice quality dimensions. This study investigated potential interactions between perceived breathiness and roughness and their contributions to overall dysphonia severity. METHOD: Synthetic stimuli based on four talkers were created to systematically map out potential interactions. For each talker, a stimulus matrix composed of 49 stimuli (seven breathiness steps × seven roughness steps) was created by varying aspiration noise and open quotient to manipulate breathiness and superimposing amplitude modulation of varying depths to simulate roughness. One-dimensional matching (1DMA) and magnitude estimation (1DME) tasks were used to measure perceived breathiness, roughness, their potential interactions, and overall dysphonia severity. Additional 1DME tasks were used to assess a set of natural stimuli that varied along both breathiness and roughness. RESULTS: For the synthetic stimuli, the 1DMA task indicated little interaction between the two voice qualities. For the 1DME task, breathiness magnitude was influenced by roughness step to a greater extent than roughness magnitude was influenced by breathiness step. The additive contributions of breathiness and roughness to overall severity gradually diminished with increasing breathiness and roughness steps, possibly reflecting a ceiling effect in the 1DME task. For the natural stimuli, little consistent interaction was observed between breathiness and roughness. CONCLUSIONS: The matching task revealed minimal interaction between perceived breathiness and roughness, whereas the magnitude estimation task revealed some interaction between the two qualities and their cumulative contributions to overall dysphonia severity. Task differences are discussed in terms of differences in response bias and the role of perceptual anchors. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21313701.

Reducing the GAP between science and clinic: lessons from academia and professional practice - part A: perceptual-auditory judgment of vocal quality, acoustic vocal signal analysis and voice self-assessment. / Reduzindo o GAP entre a ciência e a clínica: lições da academia e da prática profissional ­ parte A: julgamento perceptivo-auditivo da qualidade vocal, análise acústica do sinal vocal e autoavaliação em voz.

During the XXVIII Brazilian Congress of SBFa, 24 specialists met and, from a leading position on scientific research as a tool for connecting laboratory and clinic, five fronts of knowledge of the voice specialty were discussed as following: Perceptual-auditory judgment of vocal quality; 2. Acoustic analysis of the vocal signal; 3. Voice self-assessment; 4. Traditional techniques of therapy; 5. Modern techniques of electrostimulation and photobiomodulation (PBMT) in voice. Part "a" of this publication was associated with the consolidation of the analyses of the first three aspects. The trend in the perceptual-auditory judgment of vocal quality was related to the use of standard protocols. The acoustic evaluation of the vocal signal is accessible and can be done descriptively or by extraction of parameters, thus preferring multiparametric measures. Finally, the analysis of the individual himself closes this triad of voice documentation, which will be the basis for the conclusion of the evaluation, reference for monitoring progress, and evaluation of treatment results.

No XXVIII Congresso Brasileiro da SBFa, 24 especialistas reuniram-se e, a partir de um posicionamento condutor sobre pesquisa científica como ferramenta de conexão entre laboratório e clínica, cinco frentes de conhecimento da especialidade de voz foram discutidas: 1. Julgamento perceptivo-auditivo da qualidade vocal; 2. Análise acústica do sinal vocal; 3. Autoavaliação em voz; 4. Técnicas tradicionais de terapia; 5. Técnicas modernas de eletroestimulação e fotobiomodulação em voz. A parte "a" desta publicação é a consolidação das análises dos três primeiros aspectos. A tendência no julgamento perceptivo-auditivo da qualidade vocal é o uso de protocolos padrão. A avaliação acústica do sinal vocal é acessível e pode ser feita de modo descritivo ou por extração de parâmetros, preferindo-se medidas multiparamétricas. Finalmente, a análise do próprio indivíduo fecha essa tríade de documentação fonoaudiológica, que será base para a conclusão da avaliação, referência para monitoramento do progresso e avaliação de resultado de tratamento.

O uso da voz nos rituais indígenas Pankararu / The use of voice in Pankararu indigenous rituals / El uso de la voz en los rituales indígenas Pankararu

Introdução: a voz é essencial para preservação e manutenção da cultura de grupos sociais. O povo Pankararu, vincula sua língua-mãe aos rituais religiosos. A principal forma de transmitir a tradição oral é através dos cantos nos rituais dos Praiás. Objetivo: resgatar o uso de voz pelos cantadores Pankararu no ritual dos Praiás, à luz do saber tradicional e científico. Método: estudo qualitativo, do tipo história de vida, autobiográfica, no qual foram acessadas memórias individuais e coletivas da comunidade Pankararu, considerando a caracterização do povo, do ambiente e o uso de voz nos rituais. Resultados: os cantadores utilizam a voz de maneira intensa e contínua, sem hidratação, e fumam cachimbo durante o ritual. O local onde cantam é um terreiro, espaço aberto, exposto às intempéries da natureza, com presença de poeira. Para cuidar da voz, baseiam-se no saber tradicional, apresentando uma visão distinta do conhecimento científico, no qual a voz representa sua cultura e identidade. Nesta perspectiva, hábitos descritos pela literatura como deletérios, são considerados saudáveis, demonstrando uma concepção singular de saúde. Conclusão: o conhecimento científico, paralelamente ao tradicional, poderá contribuir para estabelecimento de cuidados que visem à saúde vocal dos Pankararus.  Poderei oferecer ao meu povo, o qual apresenta demandas de saúde, conhecimentos científicos proporcionando uma melhor qualidade de voz e vida.

Introduction: The voice is essential for the preservation and maintenance of the culture of social groups. The Pankararu people link their mother language to religious rituals. The main way of transmitting the oral tradition is through singing in the rituals of Praiás. Objective: To rescue the use of voice by Pankararu singers in the Praiás ritual, considering the traditional and scientific knowledges. Method: Qualitative study, history life, autobiography design, which individual and collective memories of the Pankararu community were accessed, considering the characterization of the people, environment, and voice use in the rituals. Results: The singers use their voices intensely and continuously, without hydration, and smoking pipes during the ritual. The "terreiro" is the place where they sing, an open space, exposed to wuthering and dust. They are based on traditional knowledge for taking care of their voices, in a different view of scientific knowledge, in which voice represents their culture and identity. In this perspective, habits described in the literature as harmful are considered healthy, demonstrating a unique conception of health. Conclusion: Scientific knowledge, in parallel with the traditional one, can contribute to establish care aimed at the vocal health of the Pankararus. I will be able to offer to my people, who have health demands, scientific knowledge providing a better quality of voice and life.

Introducción: la voz es fundamental para la preservación y mantenimiento de la cultura de los grupos sociales. La gente de Pankararu, vincula su lengua materna a los rituales religiosos. La principal forma de transmitir la tradición oral es a través del canto en los rituales de Praiás. Objetivo: rescatar el uso de la voz de los cantantes de Pankararu en el ritual Praiás, a la luz de los conocimientos tradicionales y científicos. Método: estudio cualitativo, del tipo de historia de vida; Se accedió a las memorias individuales y colectivas de la comunidad Pankararu, considerando la caracterización de las personas, el entorno y el uso de la voz en los rituales. Resultados: los cantantes utilizan sus voces de forma intensa y continua, sin hidratarse, pipas de humo durante el ritual. El lugar donde canta el terreiro, un espacio abierto, expuesto a la intemperie de la naturaleza, con presencia de polvo. Para cuidar la voz, se basan en los conocimientos tradicionales, presentan una visión diferente del conocimiento científico, donde la voz representa la cultura y la identidad. En esta perspectiva, los hábitos descritos en la literatura como nocivos, se consideran saludables, demostrando una concepción única de la salud. Conclusión: El conocimiento científico, además del conocimiento tradicional, puede contribuir al establecimiento de cuidados dirigidos a la salud vocal de los Pankararus. Podré ofrecer a mi gente, que tiene demandas de salud, conocimientos científicos que brinden una mejor calidad de vida.

Effects of Laryngeal Vibratory Asymmetry and Neuromuscular Compensation on Voice Quality.

INTRODUCTION: Vibratory asymmetry and neuromuscular compensation are often seen in laryngeal neuromuscular pathology. However, the ramifications of these findings on voice quality are unclear. This study investigated the effects of varying levels of vibratory asymmetry and neuromuscular compensation on cepstral peak prominence (CPP), an analog of voice quality. STUDY DESIGN: In vivo canine phonation model. METHODS: Varying degrees of vocal fold vibratory asymmetry were achieved by stimulating one recurrent laryngeal nerve (RLN) over 11 levels from threshold to maximal muscle activation. For each of these levels, phonation was induced at systematically varied combinations of neuromuscular compensation: three levels each of contralateral RLN stimulation (80%, 90%, and 100% of maximal), superior laryngeal nerve (SLN) activation (0%, 50%, and 100% of maximal), and airflow levels (500, 700, and 900 mL/s). Vocal fold symmetry was determined by assessing the opening phase of the vibratory cycle in high-speed video recordings. Voice quality was estimated acoustically by calculating CPP for each voice sample. RESULTS: Eight hundred twenty-two phonatory conditions with varying degrees of vibratory asymmetry were evaluated. CPP was highest at vibratory symmetry. Increasing levels of asymmetry resulted in significant decreases in CPP. CPP increased significantly with increasing contralateral RLN activation. CPP was significantly higher at 50% SLN activation than 0% or 100% SLN activation. CONCLUSION: Voice quality, as approximated by CPP, is best at vibratory symmetry and deteriorates with increasing degrees of asymmetry. Voice quality may be improved with neuromuscular compensation by increased adduction of the contralateral vocal fold or increased vocal fold tension at mid-levels of SLN activation. LEVEL OF EVIDENCE: NA, Basic Science Laryngoscope, 132:130-134, 2022.

Dermatoglifia e condição vocal de professores universitários / Dermatoglyphy and vocal condition of professors

RESUMO Objetivo Investigar a associação entre o perfil dermatoglífico e a condição vocal dos professores de uma instituição pública de ensino superior. Métodos Participaram do estudo 49 docentes. Foram utilizados os seguintes instrumentos de coleta: questionário sociodemográfico e Índice de Triagem para Distúrbios da Voz (ITDV). As impressões digitais foram coletadas por meio do scanner Watson Mini da Integrated Biometric e a análise realizada por meio do protocolo de Cummins e Midlo. Os resultados foram expostos em frequência absoluta. Foi realizado o teste Qui-Quadrado, com nível de significância de 5%, para verificação da associação dos sintomas vocais do ITDV com o perfil dermatoglífico. Resultados houve prevalência do gênero feminino entre os docentes universitários estudados. Quanto à classificação do perfil dermatoglífico, a maioria apresentou perfil anaeróbico. Observou-se associação estatisticamente significativa apenas entre perfil dermatoglífico e carga horária semanal. Conclusão a maioria dos sujeitos de perfil anaeróbico teve maior frequência de sintomas vocais. Observou-se associação estatisticamente significativa entre carga horária semanal e perfil dermatoglífico.

ABSTRACT Purpose To investigate the association between the dermatoglyphic profile and the vocal condition of teachers at a public higher education institution. Methods 49 professors participated in the study. After signing the Informed Consent Form, the following instruments were used: sociodemographic questionnaire and Voice Disorder Screening Index (ITDV). Fingerprints were collected using the Integrated Biometric Watson Mini scanner and analysis performed using the Cummins and Midlo protocol. The results were presented in absolute frequency. The Chi-Square Test was performed, with a significance level of 5%, to verify the association of ITDV vocal symptoms with a dermatoglyphic profile. This study was approved by the Research Ethics Committee of a public higher education institution under protocol number 3,372.226. Results There was a prevalence of females among the university professors studied. As for the classification of the dermatoglyphic profile , most had an anaerobic profile. There was a statistically significant association only between dermatoglyphic profile and weekly workload. Conclusion Most subjects with an anaerobic profile had more frequency of vocal symptoms. There was a statistically significant association between weekly working hours and dermatoglyphic profile.

The Normative Study of Acoustic and Aerodynamic Characteristics of Voice among Healthy Adult Turkish Speaker Population.

Phonatory Aerodynamic System (PAS Model 6600) is an evaluation instrument that assesses the effectiveness of surgical interventions, treatments, and therapy for voice disorders. It can be used for the assessment of voice disorders by supporting other perceptual and instrumental methods. It is important to establish normative data, because the use of appropriate norms is necessary for diagnostic and descriptive accuracy. Therefore, this study is aimed primarily at establishing adult normative databases for phonatory aerodynamic measures obtained with the KayPENTAX PAS Model 6600 among healthy adult Turkish speakers and then examining the effect of age, gender, and age-gender interaction variables on these measures. The contribution of the study is considered so important since it will generate normative data for all measurements-except the mean pitch-by the five protocols of PAS for the first time. Two hundred and six healthy Turkish speakers with normal voice (106 women and 100 men) were included in the study and stratified into three age groups. Forty-five phonatory aerodynamic measures across five PAS protocols (vital capacity, maximum sustained phonation, comfortable sustained phonation, variation in sound pressure level, and voicing efficiency) were collected. Age, gender, and age-gender interaction variables were analyzed for 45 PAS parameters. Significant gender and age effect was found for 30 and 19 variables, respectively. Gender-age interaction together was observed for only 6 parameters. Significant differences were not found for the remaining 10 parameters. Significant age and gender effects were observed for 35 phonatory and aerodynamic measures which are essential part of the objective clinical assessment of voice. Consequently, normative data used as reference in voice assessment should be generated according to age and gender differences.

Enlarging the spectrum of cluster headache: Extracranial autonomic involvement revealed by voice analysis.

BACKGROUND: People with cluster headache (CH) are frequently burdened by misdiagnosis or diagnostic delay. The peculiar somatic and behavioral changes characterizing patients with CH are not useful to improve diagnostic accuracy. In our clinical experience, we noticed a typical voice quality with low and croaking tone in patients with CH. In this cross-sectional study, we evaluated, by digital voice analysis, whether it is possible to identify typical voice quality characterizing patients with CH compared with healthy controls (HCs). Furthermore, to investigate whether putative differences in voice characteristics could be underpinned by constitutional aspects or pathological processes of vocal cords, subjects underwent a videolaryngostroboscopy. Smoking habits and alcohol consumption were specifically investigated. METHODS: After conducting digital recording of the voices from both patients with CH and HCs in a soundproof insulated cabin in the laboratory of the Audiology Department, a set of voice parameters was analyzed. We included the measures of fundamental frequency, calculations of jitter and shimmer, and noise-to-harmonics ratios as well as quantities related to the spectral tilt (i.e., H1-H2, H1-A1, H1-A2, and H1-A3) in 20 patients with CH and in 13 HCs. A videolaryngostroboscopy was performed in all subjects. RESULTS: Patients with CH, explored during the cluster bout period, showed significantly lower second harmonic (H1-H2) values compared with HCs (-6.9 ± 7.6 vs. 2.1 ± 6.7, p = 0.002), usually characterizing the so-called creaky voice. By using a laryngoscopy investigation, a significantly higher prevalence of mild to moderate vocal cord edema and laryngopharyngeal reflux signs were found in patients with CH (100% of patients with CH vs. 15% of HC, p < 0.001). CONCLUSION: Creaky phonation is a "physiological mode of laryngeal operation" usually underpinned by shortened and thickened vocal folds. Creaky voice phonation can be due to a vocal fold's reduced capability to become slack or flaccid secondary to vocal cord edema underpinned by laryngopharyngeal reflux affecting the phonatory mechanisms in patients with CH. The laryngopharyngeal reflux may represent a dysautonomic sign related to the increased parasympathetic tone during in-bout period, reinforcing the hypothesis of an extracranial autonomic dysfunction as part of CH clinical picture.

OpenHSV: an open platform for laryngeal high-speed videoendoscopy.

High-speed videoendoscopy is an important tool to study laryngeal dynamics, to quantify vocal fold oscillations, to diagnose voice impairments at laryngeal level and to monitor treatment progress. However, there is a significant lack of an open source, expandable research tool that features latest hardware and data analysis. In this work, we propose an open research platform termed OpenHSV that is based on state-of-the-art, commercially available equipment and features a fully automatic data analysis pipeline. A publicly available, user-friendly graphical user interface implemented in Python is used to interface the hardware. Video and audio data are recorded in synchrony and are subsequently fully automatically analyzed. Video segmentation of the glottal area is performed using efficient deep neural networks to derive glottal area waveform and glottal midline. Established quantitative, clinically relevant video and audio parameters were implemented and computed. In a preliminary clinical study, we recorded video and audio data from 28 healthy subjects. Analyzing these data in terms of image quality and derived quantitative parameters, we show the applicability, performance and usefulness of OpenHSV. Therefore, OpenHSV provides a valid, standardized access to high-speed videoendoscopy data acquisition and analysis for voice scientists, highlighting its use as a valuable research tool in understanding voice physiology. We envision that OpenHSV serves as basis for the next generation of clinical HSV systems.