Expert validation of prediction models for a clinical decision-support system in audiology.

For supporting clinical decision-making in audiology, Common Audiological Functional Parameters (CAFPAs) were suggested as an interpretable intermediate representation of audiological information taken from various diagnostic sources within a clinical decision-support system (CDSS). Ten different CAFPAs were proposed to represent specific functional aspects of the human auditory system, namely hearing threshold, supra-threshold deficits, binaural hearing, neural processing, cognitive abilities, and a socio-economic component. CAFPAs were established as a viable basis for deriving audiological findings and treatment recommendations, and it has been demonstrated that model-predicted CAFPAs, with machine learning models trained on expert-labeled patient cases, are sufficiently accurate to be included in a CDSS, but it requires further validation by experts.

Development of a time-dependent numerical model for the assessment of non-stationary pharyngoesophageal tissue vibrations after total laryngectomy.

Laryngeal cancer due to, e.g., extensive smoking and/or alcohol consumption can necessitate the excision of the entire larynx.

Preliminary results on the influence of engineered artificial mucus layer on phonation.

PURPOSE Previous studies have confirmed the influence of dehydration and an altered mucus (e.g., due to pathologies) on phonation.

Spatiotemporal analysis of high-speed videolaryngoscopic imaging of organic pathologies in males.

Purpose: The aim of this study was to identify parameters that would differentiate healthy from pathological organic-based vocal fold vibrations to emphasize clinical usefulness of high-speed imaging.

Method: Fifty-five men (M age = 36 years, SD = 20 years) were examined and separated into 4 groups: 1 healthy (26 individuals) and 3 pathological (10 individuals with contact granuloma, 12 with polyps, and 7 with cysts). Vocal fold vibrations were recorded using a high-speed camera during sustained phonation.

Quantitative analysis of organic vocal fold pathologies in females by high-speed endoscopy.

Objectives/hypothesis: Quantitative analysis of endoscopic high-speed video recordings of vocal fold vibrations has been growing in importance in recent years. The videos have mainly been analyzed using subjective evaluation, but this is examiner dependent, and the results show inadequate interobserver agreement. The aims of this study were therefore to identify appropriate objective parameters for analyzing high-speed recordings to differentiate healthy voice production from organic disorders.

Analysis of vocal fold function from acoustic data simultaneously recorded with high-speed endoscopy.

Summary: Acoustic and endoscopic voice assessments are routinely performed to determine the vocal fold vibratory function as part of the voice assessment protocol in clinics. More often than not these data are separately recorded, resulting in information being obtained from two different phonation segments and an increase of time for the voice evaluation process. This study explores the use of acoustic data, simultaneously recorded during high-speed endoscopy (HSE), for the evaluation of vocal fold function.

Sentence repetition and digit span: potential markers of bilingual children with suspected SLI?

Purpose: Digit span and sentence repetition are identified as potential markers for specific language impairment (SLI). We investigated if language learning of bilingual children with suspected language impairment (biSLI) was also influenced and led by memory constraints.

Method: In a retrospective study, 19 children with SLI and 25 controls (ages 4;9-5;9), as well as 15 biSLI children and 14 controls (ages 5;1-8;9) were compared with regard to their performance on a digit span and sentence repetition task.

Vowel- and text-based cepstral analysis of chronic hoarseness.

Objectives/hypothesis: Automatic voice evaluation is usually performed on stable sections of sustained vowels, which often cannot capture hoarseness properly. The measures cepstral peak prominence (CPP) and smoothed CPP (CPPS) do not require exact determination of the cycles of fundamental frequency like established perturbation-based measures. They can also be applied to text recordings.

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

With the use of an endoscopic, high-speed camera, vocal fold dynamics may be observed clinically during phonation. However, observation and subjective judgment alone may be insufficient for clinical diagnosis and documentation of improved vocal function, especially when the laryngeal disease lacks any clear morphological presentation. In this study, biomechanical parameters of the vocal folds are computed by adjusting the corresponding parameters of a three-dimensional model until the dynamics of both systems are similar.

Automatic intelligibility assessment of pathologic speech over the telephone.

Objective assessment of intelligibility on the telephone is desirable for voice and speech assessment and rehabilitation. A total of 82 patients after partial laryngectomy read a standardized text which was synchronously recorded by a headset and via telephone. Five experienced raters assessed intelligibility perceptually on a five-point scale.

Automatic intelligibility assessment of speakers after laryngeal cancer by means of acoustic modeling.

Objective: One aspect of voice and speech evaluation after laryngeal cancer is acoustic analysis. Perceptual evaluation by expert raters is a standard in the clinical environment for global criteria such as overall quality or intelligibility. So far, automatic approaches evaluate acoustic properties of pathologic voices based on voiced/unvoiced distinction and fundamental frequency analysis of sustained vowels.

Effects of consonant-vowel transitions in speech stimuli on cortical auditory evoked potentials in adults.

We examined the neural activation to consonant-vowel transitions by cortical auditory evoked potentials (AEPs). The aim was to show whether cortical response patterns to speech stimuli contain components due to one of the temporal features, the voice-onset time (VOT). In seven normal-hearing adults, the cortical responses to four different monosyllabic words were opposed to the cortical responses to noise stimuli with the same temporal envelope as the speech stimuli.

Substitute voice production: quantification of PE segment vibrations using a biomechanical model.

After total larynx excision due to laryngeal cancer, the tracheoesophageal substitute tissue vibrations at the intersection between the pharynx and the esophagus [pharyngoesophageal segment (PE segment)] serve as voice generator. The quality of the substitute voice significantly depends on the vibratory characteristics of the PE segment. For improving voice rehabilitation, the relationship between the PE dynamics and the resulting substitute voice quality is a matter of particular interest.

Optical reconstruction of high-speed surface dynamics in an uncontrollable environment.

The ability to communicate with our voice can be regarded as the concatenation of the two processes "phonation" and "modulation." These take place in the larynx and palatal and oral region, respectively. During phonation the audible primary voice signal is created by mutual reaction of vocal folds with the exhaled air stream of the lungs.

Objective detection and quantification of mucosal wave propagation.

In this work a detection algorithm for mucosal wave propagation is presented. By incorporating physiological knowledge of mucosal wave properties and taking the segmented lateral movement of both vocal fold edges as a basis, the spatio-temporal position of the traveling mucosal wave is identified and quantitatively captured. The course of mucosal wave propagation can be successfully detected and analyzed with regard to discriminating different types of mucosal wave activity (in terms of spread velocity and symmetry).

Multiparametric analysis of vocal fold vibrations in healthy and disordered voices in high-speed imaging.

Objectives: The aim of this study was to look for visual subjective and objective parameters of vocal fold dynamics being capable of differentiating healthy from pathologic voices in daily clinical practice applying endoscopic high-speed digital imaging (HSI).

Study Design And Methods: Four hundred ninety-six datasets containing 80 healthy and 416 pathologic subjects (232 functional dysphonia (FD), 13 bilateral, and 171 unilateral vocal fold nerve paralysis) were analyzed retrospectively. Videos at 4000Hz (256×256 pixel) were recorded during sustained phonation.

Clinical value of acoustic voice measures: a retrospective study.

Within this study a retrospective analysis of clinical voice perturbation measures, Dysphonia Severity Index and subjective perceived hoarseness was performed to determine their value under clinical aspects. The study included the data of 580 healthy and 1,700 pathologic voices, which were investigated under the following aspects. The relevant parameters were identified and their interrelation determined.

Voice function and voice-related quality of life in the elderly.

Background: Many studies have referred to the effects of age on voice and the consequences of these changes. However, only little is known about the adverse effects of voice changes on quality of life in the elderly.

Objective: This study focuses on self-perception of voice in seniors as assessed by the Voice-Related Quality of Life (V-RQOL) questionnaire, on voice quality as measured by the Dysphonia Severity Index (DSI) and on the correlation between these parameters.

Voice- and health-related quality of life in the elderly.

Objective: Restrictions of verbal communication and high prevalence of voice disorders in the elderly are suspected to influence the quality of life. For assessment, both voice-specific and unspecific methods are already established and fundamental components of clinical diagnostics, but the question of correlation between voice-related and general health-related quality of life is still open in this subpopulation.

Methods: One hundred and seven socially active persons aged 65+ years were recruited and asked to complete Voice-Related Quality of Life (V-RQOL) and Short Form (SF)-36 questionnaires.

Classification of functional voice disorders based on phonovibrograms.

Objective: This work presents a computer-aided method for automatically and objectively classifying individuals with healthy and dysfunctional vocal fold vibration patterns as depicted in clinical high-speed (HS) videos of the larynx.

Methods: By employing a specialized image segmentation and vocal fold movement visualization technique - namely phonovibrography - a novel set of numerical features is derived from laryngeal HS videos capturing the dynamic behavior and the symmetry of oscillating vocal folds. In order to assess the discriminatory power of the features, a support vector machine is applied to the preprocessed data with regard to clinically relevant diagnostic tasks.

Automatic diagnosis of vocal fold paresis by employing phonovibrogram features and machine learning methods.

The clinical diagnosis of voice disorders is based on examination of the rapidly moving vocal folds during phonation (f0: 80-300Hz) with state-of-the-art endoscopic high-speed cameras. Commonly, analysis is performed in a subjective and time-consuming manner via slow-motion video playback and exhibits low inter- and intra-rater reliability. In this study an objective method to overcome this drawback is presented being based on Phonovibrography, a novel image analysis technique.

Biomechanical modeling of the three-dimensional aspects of human vocal fold dynamics.

Human voice originates from the three-dimensional (3D) oscillations of the vocal folds. In previous studies, biomechanical properties of vocal fold tissues have been predicted by optimizing the parameters of simple two-mass-models to fit its dynamics to the high-speed imaging data from the clinic. However, only lateral and longitudinal displacements of the vocal folds were considered.

Automatic evaluation of tracheoesophageal substitute voice: sustained vowel versus standard text.

Objective: The Hoarseness Diagram, a program for voice quality analysis used in German-speaking countries, was compared with an automatic speech recognition system with a module for prosodic analysis. The latter computed prosodic features on the basis of a text recording. We examined whether voice analysis of sustained vowels and text analysis correlate in tracheoesophageal speakers.

Application of automatic speech recognition to quantitative assessment of tracheoesophageal speech with different signal quality.

Objective: Tracheoesophageal voice is state-of-the-art in voice rehabilitation after laryngectomy. Intelligibility on a telephone is an important evaluation criterion as it is a crucial part of social life. An objective measure of intelligibility when talking on a telephone is desirable in the field of postlaryngectomy speech therapy and its evaluation.