Vocal Fold Dissipated Power in Females with Hyperfunctional Voice Disorders.

Objective: Phonotrauma has been hypothesized to be associated with prolonged and/or accumulated biomechanical stress on vocal fold tissue. This hypothesis can be tested using ambulatory monitoring of vocal fold dissipated power, which requires a reliable method for its noninvasive estimation during the activity of daily living. The first aim of this study was to show that a laboratory-based estimate of vocal fold dissipated power computed from intraoral pressure (IOP) has significant discriminative power in individuals with phonotraumatic vocal hyperfunction (PVH).

Innovative Approach to Accelerate Wound Healing: Synthesis and Validation of Enzymatically Cross-Linked COL-rGO Biocomposite Hydrogels.

In this study, an innovative conductive hybrid biomaterial was synthetized using collagen (COL) and reduced graphene oxide (rGO) in order for it to be used as a wound dressing. The hydrogels were plasticized with glycerol and enzymatically cross-linked with horseradish peroxidase (HRP). A successful interaction among the components was demonstrated by FTIR, XRD, and XPS.

Spectral features related to the auditory perception of twang-like voices.

Background: To the best of our knowledge, studies on the relationship between spectral energy distribution and the degree of perceived voices are still sparse. Through an auditory-perceptual test we aimed to explore the spectral features that may relate with the auditory-perception of voices.

Methods: Ten judges who were blind to the test's tasks and stimuli rated the amount of twang perceived on seventy-six audio samples.

Ambulatory Monitoring of Subglottal Pressure Estimated from Neck-Surface Vibration in Individuals with and without Voice Disorders.

The aerodynamic voice assessment of subglottal air pressure can discriminate between speakers with typical voices from patients with voice disorders, with further evidence validating subglottal pressure as a clinical outcome measure. Although estimating subglottal pressure during phonation is an important component of a standard voice assessment, current methods for estimating subglottal pressure rely on non-natural speech tasks in a clinical or laboratory setting. This study reports on the validation of a method for subglottal pressure estimation in individuals with and without voice disorders that can be translated to connected speech to enable the monitoring of vocal function and behavior in real-world settings.

Kalman Filter Implementation of Subglottal Impedance-Based Inverse Filtering to Estimate Glottal Airflow during Phonation.

Subglottal Impedance-Based Inverse Filtering (IBIF) allows for the continuous, non-invasive estimation of glottal airflow from a surface accelerometer placed over the anterior neck skin below the larynx. It has been shown to be advantageous for the ambulatory monitoring of vocal function, specifically in the use of high-order statistics to understand long-term vocal behavior. However, during long-term ambulatory recordings over several days, conditions may drift from the laboratory environment where the IBIF parameters were initially estimated due to sensor positioning, skin attachment, or temperature, among other factors.

Home Away From Home: Mentorship and Research in Private Practices for Students Without Home Programs.

As the competitiveness of matching to an otolaryngology residency continues to climb, students are encouraged to seek mentorship and research within their home institution. This notion, however, does not account for students without a home otolaryngology program or department. Here, we present a research model where medical students conduct clinical research and gain experience and mentorship within a local otolaryngology private practice.

Lombard Effect in Individuals With Nonphonotraumatic Vocal Hyperfunction: Impact on Acoustic, Aerodynamic, and Vocal Fold Vibratory Parameters.

Purpose: This exploratory study aims to investigate variations in voice production in the presence of background noise (Lombard effect) in individuals with nonphonotraumatic vocal hyperfunction (NPVH) and individuals with typical voices using acoustic, aerodynamic, and vocal fold vibratory measures of phonatory function.

Method: Nineteen participants with NPVH and 19 participants with typical voices produced simple vocal tasks in three sequential background conditions: baseline (in quiet), Lombard (in noise), and recovery (5 min after removing the noise). The Lombard condition consisted of speech-shaped noise at 80 dB SPL through audiometric headphones.

Tissue Mobilization During Double Source of Vibration Semioccluded Vocal Tract Exercises: A Neck and Face Surface Acceleration Study.

Purpose This study primarily aimed at observing the possible tissue mobilization on facial, neck, and chest tissues caused by different double source of vibration semioccluded vocal tract exercises (DSV-SOVTEs). Another goal was to inspect the degree of self-perceived sensation of a massage-like sensation. Method Fifty-five participants engaged in a set of several DSV-SOVTEs: (a) phonation with a silicone tube submerged 2 and 8 cm below water surface, (b) Acapella Choice device, (c) lip trills, and (d) tongue trills.

Estimation of Subglottal Pressure, Vocal Fold Collision Pressure, and Intrinsic Laryngeal Muscle Activation From Neck-Surface Vibration Using a Neural Network Framework and a Voice Production Model.

The ambulatory assessment of vocal function can be significantly enhanced by having access to physiologically based features that describe underlying pathophysiological mechanisms in individuals with voice disorders. This type of enhancement can improve methods for the prevention, diagnosis, and treatment of behaviorally based voice disorders. Unfortunately, the direct measurement of important vocal features such as subglottal pressure, vocal fold collision pressure, and laryngeal muscle activation is impractical in laboratory and ambulatory settings.

Does Mask Usage Worsen Symptoms in Patients With Rhinosinusitis Balloon Sinuplasty Amid the COVID-19 Pandemic?

With the onset of the COVID-19 pandemic, social distancing guidelines have reshaped the way that we live our lives. Perhaps the most common and strictly adopted measure has been mask wearing. Mask wearing, whether it be cloth, surgical, or N95, has quickly become the new norm in the ongoing struggle against this pandemic and has been proven to be effective in curbing its high infection rate.

Glottal Aerodynamics Estimated From Neck-Surface Vibration in Women With Phonotraumatic and Nonphonotraumatic Vocal Hyperfunction.

Purpose The purpose of this study was to determine whether estimates of glottal aerodynamic measures based on neck-surface vibration are comparable to those previously obtained using oral airflow and air pressure signals (Espinoza et al., 2017) in terms of discriminating patients with phonotraumatic and nonphonotraumatic vocal hyperfunction (PVH and NPVH) from vocally healthy controls. Method Consecutive /pae/ syllables at comfortable and loud level were produced by 16 women with PVH (organic vocal fold lesions), 16 women with NPVH (primary muscle tension dysphonia), and 32 vocally healthy women who were each matched to a patient according to age and occupation.

Telemedicine in Minority and Socioeconomically Disadvantaged Communities Amidst COVID-19 Pandemic.

In the wake of the COVID-19 pandemic, many otolaryngology practices worldwide have chosen to shift their consultations from in-person to telemedicine. The addition of the telemedicine model has allowed many physicians to resume their clinical duties while maintaining social distancing. Access to telemedicine generally relies on the patient's ability to obtain and use technology-factors that are usually dictated by age, education, and socioeconomic status.

How Do Tube Diameter and Vocal Tract Configuration Affect Oral Pressure Oscillation Characteristics Caused by Bubbling During Water Resistance Therapy?

Purpose: The present study aimed at observing the effect of tube diameter and vocal tract configuration on frequency, amplitude, and regularity of Poral oscillation caused by bubbling during water resistance therapy (WRT). A secondary objective was to examine the degree of self-perceived sensation of massage-like effect produced by bubbles during WRT.

Methods: Forty-two participants were included in this study.

Improved subglottal pressure estimation from neck-surface vibration in healthy speakers producing non-modal phonation.

Subglottal air pressure plays a major role in voice production and is a primary factor in controlling voice onset, offset, sound pressure level, glottal airflow, vocal fold collision pressures, and variations in fundamental frequency. Previous work has shown promise for the estimation of subglottal pressure from an unobtrusive miniature accelerometer sensor attached to the anterior base of the neck during typical modal voice production across multiple pitch and vowel contexts. This study expands on that work to incorporate additional accelerometer-based measures of vocal function to compensate for non-modal phonation characteristics and achieve an improved estimation of subglottal pressure.

The difference between first and second harmonic amplitudes correlates between glottal airflow and neck-surface accelerometer signals during phonation.

Miniature high-bandwidth accelerometers on the anterior neck surface are used in laboratory and ambulatory settings to obtain vocal function measures. This study compared the widely applied L-L measure (historically, H1-H2)-the difference between the log-magnitude of the first and second harmonics-computed from the glottal airflow waveform with L-L derived from the raw neck-surface acceleration signal in 79 vocally healthy female speakers. Results showed a significant correlation (r = 0.

Estimating Vocal Fold Contact Pressure from Raw Laryngeal High-Speed Videoendoscopy Using a Hertz Contact Model.

The development of trauma-induced lesions of the vocal folds (VFs) has been linked to a high collision pressure on the VF surface. However, there are no direct methods for the clinical assessment of VF collision, thus limiting the objective assessment of these disorders. In this study, we develop a video processing technique to directly quantify the mechanical impact of the VFs using solely laryngeal kinematic data.

Ambulatory assessment of phonotraumatic vocal hyperfunction using glottal airflow measures estimated from neck-surface acceleration.

Phonotraumatic vocal hyperfunction (PVH) is associated with chronic misuse and/or abuse of voice that can result in lesions such as vocal fold nodules. The clinical aerodynamic assessment of vocal function has been recently shown to differentiate between patients with PVH and healthy controls to provide meaningful insight into pathophysiological mechanisms associated with these disorders. However, all current clinical assessment of PVH is incomplete because of its inability to objectively identify the type and extent of detrimental phonatory function that is associated with PVH during daily voice use.

Glottal Aerodynamic Measures in Women With Phonotraumatic and Nonphonotraumatic Vocal Hyperfunction.

Purpose: The purpose of this study was to determine the validity of preliminary reports showing that glottal aerodynamic measures can identify pathophysiological phonatory mechanisms for phonotraumatic and nonphonotraumatic vocal hyperfunction, which are each distinctly different from normal vocal function.

Method: Glottal aerodynamic measures (estimates of subglottal air pressure, peak-to-peak airflow, maximum flow declination rate, and open quotient) were obtained noninvasively using a pneumotachograph mask with an intraoral pressure catheter in 16 women with organic vocal fold lesions, 16 women with muscle tension dysphonia, and 2 associated matched control groups with normal voices. Subjects produced /pae/ syllable strings from which glottal airflow was estimated using inverse filtering during /ae/ vowels, and subglottal pressure was estimated during /p/ closures.

Using Ambulatory Voice Monitoring to Investigate Common Voice Disorders: Research Update.

Many common voice disorders are chronic or recurring conditions that are likely to result from inefficient and/or abusive patterns of vocal behavior, referred to as vocal hyperfunction. The clinical management of hyperfunctional voice disorders would be greatly enhanced by the ability to monitor and quantify detrimental vocal behaviors during an individual's activities of daily life. This paper provides an update on ongoing work that uses a miniature accelerometer on the neck surface below the larynx to collect a large set of ambulatory data on patients with hyperfunctional voice disorders (before and after treatment) and matched-control subjects.