Asymmetry of Occupational Noise Induced Hearing Loss: An Electrophysiological Approach.

 The question as to whether occupational noise exposure causes symmetrical or asymmetrical hearing loss is still controversial and incompletely understood.  Two electrophysiological methods (cortical evoked response audiometry: CERA and auditory steady state responses: ASSR) were used to address this issue.  156 subjects with a well-documented history of noise exposure, a wide range of noise induced hearing loss (NIHL) and without middle ear pathology underwent both a CERA and an ASSR examination in the context of an exhaustive medicolegal expert assessment intended for possible compensation.

Vocal Fold Collision Speed in vivo: The Effect of Loudness.

Mechanical impact stress on the vocal fold surface, particularly when excessive, has been postulated to cause the so-called phonotraumatic tissue lesions, such as nodules and polyps. The collision stress between the vocal folds depends on the vocal fold velocity at the time of impact. Hence this vocal fold collision speed is a relevant parameter when considering biomechanical economy of phonation, especially in voice professionals needing a louder voice than normal.

In Vivo Quantification of the Intraglottal Pressure: Modal Phonation and Voice Onset.

Intraglottal pressure is the driving force of vocal fold vibration. Its time course during the open phase of the vibratory cycle is essential in the mechanics of phonation, but measuring it directly is difficult and may hinder spontaneous voicing. However, it can be computed from the in vivo measured transglottal flow and glottal area (hence the air particle velocity) on the basis of the Bernoulli energy law and the interaction with the inertance of the vocal tract.

Speech Therapy as Treatment for Supragastric Belching.

The purpose of this study was to describe a newly developed speech therapy program as an innovating therapeutic approach and to assess the results of this intervention in patients with supragastric belching. This is a retrospective analysis of prospectively gathered data from 73 patients with supragastric belching who were treated with speech therapy between 2007 and 2017. Of these, 48 were included for evaluation of therapy.

Dynamics of the Driving Force During the Normal Vocal Fold Vibration Cycle.

Intraglottal pressure is the driving force of vocal fold vibration. Theoretically, simultaneous quantification of glottal area and transglottal airflow allows the calculation of the intraglottal pressure waveform during a single vibration cycle. In this study, we show that, by combining photoglottography (transglottal light transmission) and airflow (Rothenberg mask) measurements during sustained vocal emissions in vivo, the intraglottal pressure wave can be approximated in a way similar to what has been done in models.

Physiology and Acoustics of Inspiratory Phonation.

Introduction: Inspiratory phonation (IP) means phonating with inspiratory airflow. Some vocalists remarkably master this technique, to such an extent that it offers new dramatic, aesthetic, and functional possibilities in singing specific contemporary music. The present study aims to a better understanding of the physiological backgrounds of IP.

Automatic Assessment of Acoustic Parameters of the Singing Voice: Application to Professional Western Operatic and Jazz Singers.

Introduction: The obvious perceptual differences between various singing styles like Western operatic and jazz rely on specific dissimilarities in vocal technique. The present study focuses on differences in vibrato acoustics and in singer's formant as analyzed by a novel software tool, named BioVoice, based on robust high-resolution and adaptive techniques that have proven its validity on synthetic voice signals.

Material And Methods: A total of 48 professional singers were investigated (29 females; 19 males; 29 Western operatic; and 19 jazz).

Voice dosimetry and monitoring, with emphasis on professional voice diseases: Critical review and framework for future research.

Professional voice has become an important issue in the field of occupational health. Similarly, voice diseases related to occupations gain interest in insurance medicine, particularly within the frame of specific insurance systems for occupational diseases. Technological developments have made possible dosimetry of voice loading in the work-place, as well as long-term monitoring of relevant voice parameters during professional activities.

Automated tracking of quantitative parameters from single line scanning of vocal folds: a case study of the 'messa di voce' exercise.

This article presents a novel application of the 'single line scanning' of the vocal fold vibrations (kymography) in singing pedagogy, particularly in a specific technical voice exercise: the 'messa di voce'. It aims at giving the singer relevant and valid short-term feedback. A user-friendly automatic analysis program makes possible a precise, immediate quantification of the essential physiological parameters characterizing the changes in glottal impedance, concomitant with the progressive increase and decrease of the lung pressure.

Therapeutic consequences from changing voice ideals (clear to harsh, pleasant to jarring): summarizing report on a round-table discussion at the 5th World Voice Congress, Luxor, Egypt, 27-31 October 2012.

Starting out with an attempt to define an 'ideal voice', the discussion moved on to the hazards of pop singing, followed by the topics of harsh voices (from the desired effects in modern singing expression to devastating clinical cases), phoniatric targets (aesthetics and fitness), and, finally, the phoniatricians' attitudes comprising acceptance, neglect, and rejection. Therapy should aim at a resilient and effective voice regardless of the mere sound, unless the perfection of the vocal sound is the ultimate goal. In addition, the panellists agreed that voice specialists and all friends of healthy and efficient voices are obliged permanently to engage in voice care.

Long-term effects of previous oxandrolone treatment in adult women with Turner syndrome.

Objective: Short stature is a prominent feature of Turner syndrome (TS), which is partially overcome by GH treatment. We have previously reported the results of a trial on the effect of oxandrolone (Ox) in girls with TS. Ox in a dose of 0.

Children with specific language impairment show difficulties in sensory modulation.

The purpose of this study is to investigate whether a group of 116 Dutch children with specific language impairment (SLI) shows differences in sensory processing when compared to a control group of age-matched 4-7-year-old typical peers. The Sensory Profile-NL-a standardized questionnaire of 125 items-was completed by caregivers of children in both groups. Children with SLI differed significantly from the control group on all 14 section scores and 4 quadrant scores of the Sensory Profile-NL.

The effect of oxandrolone on voice frequency in growth hormone-treated girls with Turner syndrome.

Objectives/hypothesis: Oxandrolone (Ox) increases height gain but may also cause voice deepening in growth hormone (GH)-treated girls with Turner syndrome (TS). We assessed the effect of Ox on objective and subjective speaking voice frequency in GH-treated girls with TS.

Study Design: A multicenter, randomized, placebo (Pl)-controlled, double-blind study was conducted.

Efficacy and safety of oxandrolone in growth hormone-treated girls with turner syndrome.

Context And Objective: GH therapy increases growth and adult height in Turner syndrome (TS). The benefit to risk ratio of adding the weak androgen oxandrolone (Ox) to GH is unclear.

Design And Participants: A randomized, placebo-controlled, double-blind, dose-response study was performed in 10 centers in The Netherlands.

Language development before and after temporal surgery in children with intractable epilepsy.

Purpose: To obtain systematic knowledge of language development before and after epilepsy surgery in regions that, if damaged, are known to entail language impairment in adults.

Methods: Twenty-four children (mean age 11 years; range 5.8-15.

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

Objective: 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.

Materials And Methods: Simulations with a 3-dimensional computer model of the vibrating vocal folds.

Results And Conclusion: (1) A slightly incomplete dorsal vocal fold adduction is a first condition for inducing an hourglass vibration pattern.

Experience with a medicolegal decision-making system for occupational hearing loss-related tinnitus.

Owing to an increasing number of requests for compensation, a medicolegal decision-making system for tinnitus related to noise-induced hearing loss (NIHL) has been elaborated at the Federal Belgian Institute of Occupational Diseases. Experience with 113 patients, all of them claiming compensation for NIHL and tinnitus, is now available. The patients underwent an exhaustive audiological investigation, and their professional career and noise exposure were carefully and objectively documented.

Laryngeal electroglottography as a predictor of laryngeal electromyography.

We evaluate a group of patients who have mobile vocal folds, but have flexible laryngeal examinations suspicious for mild vocal fold paresis. The purpose of this retrospective study is to evaluate if electroglottography (EGG) can predict the probability of having an abnormal laryngeal electromyography (LEMG). Charts of patients evaluated and suspected of having mild vocal fold paresis between August 1, 2004 and March 30, 2006 were reviewed.

The effect of visible speech in the perceptual rating of pathological voices.

Objective: To test a simple method for improving consistency among raters for the perceptual evaluation of pathological voice quality by providing visible speech (spectrogram) as additional information because, to date, the interrater variability still limits the widespread clinical use of the best available rating system.

Design: Experimental comparison between 2 different ways (with and without the addition of visible speech) of perceptual rating by trained professionals of recorded pathological voices. Furthermore, the correlation between acoustical (jitter, shimmer, and noise-harmonic ratio) and perceptual parameters was investigated in both rating conditions.

Medicolegal decision making in noise-induced hearing loss-related tinnitus.

In some patients with occupational noise-induced hearing loss, a significant aspect of the handicap concerns the concomitant tinnitus; thus, this disorder must be considered in evaluating a disability percentage in the insurance context. The main difficulty comes from the lack of objective measures for tinnitus. To reach a maximum of medicolegal objectivity, a system was developed within the Belgian Institute of Occupational Disorders (Brussels) in the form of a four-level decision structure, after exhaustive but noninvasive assessment of patients.

Accuracy of measurements on digital videostroboscopic images of the vocal folds.

Objectives: The reliability of objective measurements on digital laryngeal images was investigated.

Methods: The magnitude of the error of measurement of surface areas by visually tracing the outline was determined for three different areas: the area of the lesion and, during vibration, the glottal area on maximal opening of the vocal folds and the glottal area on maximal closing of the vocal folds.

Results: The errors in these areas were 10% to 30%.

Objectivating nasality in healthy and velopharyngeal insufficient children with the Nasalance Acquisition System (NasalView). Defining minimal required speech tasks assessing normative values for Dutch language.

Objectives: (1) To define normative nasalance data for Dutch language with "the NasalView System", and obtain a reference for normality when nasality is evaluated in children. (2) To investigate the minimal number of required speech tasks for a reliable nasalance measurement.

Methods: 55 children (30 normal and 25 velopharyngeal insufficient), aged between 4 and 11 were included.

Correlation between the perceptual rating of speech in Dutch patients with velopharyngeal insufficiency and composite measures derived from mean nasalance scores.

Objective: To evaluate the potential clinical use of composite measures derived from mean nasalance scores.

Procedure: Speech samples with a normal distribution of phonemes (normal text, NT) and speech samples free of nasal consonants (denasal text, DT) of 43 patients with perceived hypernasality were used. The overall grade of severity, hyperrhinophonia, audible nasal emission, misarticulations associated with velopharyngeal insufficiency and intelligibility were perceptually rated on separate visual analog scales.