Melda Kunduk

Investigation of voice initiation and voice offset characteristics with high-speed digital imaging

This study involves preliminary investigation of the characteristics of the voice initiation period (VIP) and voice offset period (VOP) using high-speed digital imaging. The goals of the study were to develop a methodology to objectively analyze these periods of phonation and to explore the feasibility of studying the effects of aging on these phonation segments. Results of the analysis of the data from two female subjects, one younger and one older, with the developed methodology, demonstrated that the older subjects VIP was characterized by a slow and irregular increase in glottal area waveform (GAW) until reaching 90% of the maximum opening of the glottis at 244 frames or 122 ms. The younger subject demonstrated a sharp increase in GAW during VIP, taking only 155 frames or 77.5 ms to reach the 90% mark. Also, the older subject took a greater number of frames for the vocal fold vibration to come to a complete stop than the younger subject during the VOP; 275 frames and 150 frames respectively.

Variability of normal vocal fold dynamics for different vocal loading in one healthy subject investigated by phonovibrograms.

We investigate the potential of high-speed digital imaging technique (HSI) and the phonovibrogram (PVG) analysis in normal vocal fold dynamics by studying the effects of continuous voice use (vocal loading) during the workday. One healthy subject was recorded at sustained phonation 13 times within 2 consecutive days in the morning before and in the afternoon after vocal loading, respectively. Vocal fold dynamics were extracted and visualized by PVGs. The characteristic PVG patterns were extracted representing vocal fold vibration types. The parameter values were then analyzed by statistics regarding vocal load, left-right PVG asymmetries, anterior-posterior PVG asymmetries, and opening-closing differences. For the first time, the direct impact of vocal load could be determined by analyzing vocal fold dynamics. For same vocal loading conditions, equal dynamical behavior of the vocal folds were confirmed. Comparison of recordings performed in the morning with the recordings after work revealed significant changes in vibration behavior, indicating impact of occurring vocal load. Left-right asymmetries in vocal fold dynamics were found confirming earlier assumptions. Different dynamics between opening and closing procedure as well as for anterior and posterior parts were found. Constant voice usage stresses the vocal folds even in healthy subjects and can be detected by applying the PVG technique. Furthermore, left-right PVG asymmetries do occur in healthy voice to a certain extent. HSI in combination with PVG analysis seems to be a promising tool for investigation of vocal fold fatigue and pathologies resulting in small forms of dynamical changes.

Vocal Warm-Up Practices and Perceptions in Vocalists: A Pilot Survey

OBJECTIVES Investigated in a pilot study the type, duration, and frequency of vocal warm-up regimens in the singing community using a survey. METHODS One hundred seventeen participants completed an online survey. Participants included voice students from undergraduate, masters, and doctoral music programs and professional singers. RESULTS Fifty-four percent of participants reported always using vocal warm-up before singing. Twenty-two percent of the participants used vocal cool down. The most preferred warm-up duration was of 5-10 minutes in duration. Despite using vocal warm-up, 26% of the participants reported experiencing voice problems. Females tended to use vocal warm-up more frequently than males. Females also tended to use longer warm-up sessions than males. Education of the participants did not appear to have any noticeable effect on the vocal warm-up practices. The most commonly used singing warm-up exercises were ascending/descending five-note scales, ascending/descending octave scales, legato arpeggios, and glissandi.

Effects of 2 different swallowing exercise regimens during organ-preservation therapies for head and neck cancers on swallowing function.

This study investigated the effects of 2 different swallowing exercise regimens performed during radiation therapy with/without chemotherapy on swallowing function.

Assessment of the variability of vocal fold dynamics within and between recordings with high-speed imaging and by phonovibrogram†‡§

The goal of the study was to assess the variability of healthy vocal fold dynamics. Quantitative parameters describing mean regularity and vibration characteristics of vocal fold dynamics along the entire glottal axis were analyzed.

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. Patients and Methods HSE and acoustic data were recorded from the subjects simultaneously during sustained phonation. The data included voices of 73 healthy subjects, 148 paresis, 210 functional dysphonias, and 119 benign lesions of vocal folds. For this study, only acoustic data were analyzed using Dr. Speech software (Tiger electronics Inc., MA). Twelve parameters were computed; 82% of the acoustic voice recordings could be analyzed. Statistical analysis was performed with SPSS 17.0. Results Acoustic data was easily recorded simultaneously allowing analyses of the same phonation segment to determine vocal fold function and therefore eliminating the need for another voice recording. The acoustic voice parameters differed between genders in the healthy voice group. Most of the parameters showed significant differences between healthy and pathological groups. Conclusion Simultaneously recorded endoscopic and acoustic data is valuable. Differentiation between healthy and pathological groups was possible using acoustic data only. We suggest that the synchronously recorded acoustic signal is of sufficient quality for objective analysis yielding reduced examination time.

Objective Quantification of Pre- and Postphonosurgery Vocal Fold Vibratory Characteristics Using High-Speed Videoendoscopy and a Harmonic Waveform Model

PURPOSE The model-based quantitative analysis of high-speed videoendoscopy (HSV) data at a low frame rate of 2,000 frames per second was assessed for its clinical adequacy. Stepwise regression was employed to evaluate the HSV parameters using harmonic models and their relationships to the Voice Handicap Index (VHI). Also, the model-based HSV parameters were compared with those using conventional analysis techniques. METHOD Eight pairs of HSV recordings of vocal folds before and after surgery for benign lesions were investigated. Five glottal area waveform features-fundamental frequency (F0), open quotient (OQ), speed index (SI), relative glottal gap (RGG), and harmonics-to-noise ratio (HNR)-were measured using model-based and conventional approaches. The statistical analyses were conducted on the mean (M) and standard deviation (SD) of the feature measurements over 1 s during sustained phonation. RESULTS Two model-based HSV parameters, OQ M (ρ = .67) and HNR M (ρ = -.56), were selected and explained 55% of the VHI variation. The conventional techniques yielded a regression model with OQ SD (ρ = -.60) and F0 SD (ρ = .44), explaining 61% of the VHI variation. CONCLUSIONS Although the selected model-based HSV parameters explained less variation in the VHI than the conventionally computed HSV parameters, the behaviors of the model-based parameters were more consistent with expectations and theory than the conventional analysis techniques.

True vocal fold nodules: the role of differential diagnosis.

Purpose of reviewThe present article aims to discuss the current reviews and the literature published regarding the differential diagnosis of vocal fold nodules with emphasis on diagnosis and nomenclature. Recent findingsBenign lesions of the vocal folds, including nodules, continue to challenge practitioners in nomenclature uniformity and even histologic diagnosis. Utilization of molecular techniques is helping to better understand Reinkes space and to better differentiate these lesions. This more accurate diagnosis may help guide appropriate treatment indicating behavioral versus surgical therapy. SummaryFurther study with the application of new technology in the laboratory and clinic will continue to refine our differential diagnosis and understanding of vocal fold nodules.

Vocal Fold Vibratory Behavior Changes following Surgical Treatment of Polyps Investigated with High-Speed Videoendoscopy and Phonovibrography

Objectives: The goal of this study was to objectively quantify the changes in vocal fold vibratory characteristics before and after surgery with high-speed videoendoscopy and the image analysis tool phonovibrography. Methods: High-speed videoendoscopic data, audio recordings, and Voice Handicap Index scores were collected from 8 subjects with a diagnosis of unilateral vocal fold polyps, before operation and at 1 week and 1 to 3 months after operation. We then analyzed the objective phonovibrographic patterns and parameters describing the vocal fold vibratory behavior. Results: On phonovibrography, the visual representations of the vocal fold vibratory characteristics, from both the individual and the group data, demonstrated very different patterns before surgery and both 1 week and 1 to 3 months after surgery. The individual phonovibrograms obtained from the left and right true vocal folds clearly demonstrated the lesion site and its effects on the vocal fold vibratory characteristics for each subject. The improvements in amplitude and symmetry (relative vibratory amplitude and vibration amplitude symmetry) of vocal fold vibration were quantified; the difference was greatest between data from before surgery and data from 1 week after surgery. Conclusions: The visual phonovibrographic patterns and quantitative data revealed marked changes in vocal fold vibratory patterns after operation and continued improvement at 1 to 3 months.

Preprocessing techniques for high-speed videoendoscopy analysis.

One of the critical requirements for high-speed videoendoscopy (HSV) to become a clinically useful tool is to pair it with a technique, which provides a quick overview of the vast amount of HSV data and rapidly identifies the best video segments for subjective and objective analyses. This article proposes intensity-based representations that are easily computed from the HSV data and can be used to identify the HSV features quickly. The first representation-termed the Quick Vibratory Profile (QVP)-is an HSV-based one-dimensional waveform that captures the vocal fold vibration as well as nonglottic activities. The QVP can be used in a wide range of experimental and clinical studies to select appropriate HSV recording segments quickly without extensive review of the actual video frames. Moreover, this article proposes a pair of spatial profiles to locate the vibrating vocal folds within the HSV frames. These profiles are useful in automation of objective assessments as their use together with the QVP are demonstrated in a proposed cyclewise three-dimensional glottal area segmentation. The article illustrates the usefulness of these proposed representations with examples.