Michael D. Trudeau

Endoscopic and stroboscopic description of adults with paradoxical vocal fold dysfunction

The purpose of this study was to determine if endoscopic and stroboscopic parameters of voice were normal between attacks of paradoxical vocal fold dysfunction (PVFD). Fifty adults (38 females, 12 males) and 54 adult controls (40 females, 14 males) were examined via endoscopy with and without stroboscopy. Endoscopy indicated paradoxical adduction of the folds during the respiratory cycle of all 50 participants with PVFD, although they were asymptomatic. Atypical laryngeal configurations were observed including abnormality of the anterior-posterior dimension and ventricular fold medialization in both groups of subjects. Stroboscopy demonstrated abnormalities including unstable zero phase, decreased amplitude of vibration, decreased mucosal waves, and phase asymmetry primarily for the PVFD subjects alone. Results indicate that persons with PVFD demonstrate subtle laryngeal abnormality endoscopically and stroboscopically when dyspnea is not reported. This supports the hypothesis that PVFD is not episodic but exists as a continuum of laryngeal instability that may, due to various precipitating factors, be exacerbated to breathing attacks.

Vocal restorative surgery: why wait?

The case histories of 36 laryngectomees with vocal restorative surgery from the Department of Otolaryngology were reviewed to determine the patients current mode of speech and number and type of complications to recovery and rehabilitation. The patients comprised two groups: 21 with tracheoesophageal fistula (tef) at the time of laryngectomy (primary) and 15 with tef subsequent to laryngectomy (secondary). Results of the review indicated that while approximately 10% fewer patients in the primary group were using a surgically restored voice, none of the surviving primary group remained aphonic. In contrast, 27% of the surviving secondary group failed to develop some form of verbal communication. When the complication rate is identified, vocal restorative surgery at the time of laryngectomy appeared to be very successful in initiating the rehabilitation process without

Changes in sustained production tasks among women with bilateral vocal nodules before and after voice therapy.

The purpose of the current study was to determine how maximum phonation duration (MPD) of five notes (C4, D4, E4, F4, G4) sustained on /o/, sustained vowels (/i/, /ae/, /a/, /u/), and s/z ratio (sustained /s/ and /z/) changed during voice therapy for vocal nodules. Voices of adult females before treatment and after resolution of vocal nodules were analyzed via the PM Pitch Analyzer. Treatment included tension reduction, abuse identification and elimination, laryngeal strengthening, and home exercises. Results indicate there was no significant difference in maximum phonation duration or S/Z ratio before and after treatment. Results revealed that females with vocal nodules demonstrate measurements before therapy similar to measures considered to be normal in persons without vocal nodules. Application of findings to clinical practice is discussed.

A comparison of the speech acceptibility of good and excellent esophageal and tracheoesophageal speakers

Thirteen esophageal speakers (8 male, 5 female) and 12 tracheoesophageal (t-e) speakers (7 male, 5 female) were placed into eight groups based on gender, voice type, and speaking proficiency (excellent or good). Audio recordings of each speaker reading the Rainbow Passage (Fairbanks, 1960) were made. The resultant samples were judged for acceptability of speech by 25 naive listeners trained in use of a five-point equal-appearing-interval scale. An analysis of variance of the listener data indicated that speaker proficiency but not voice type had a significant effect on judgments of acceptability, indicating that the listeners perceived no difference in the acceptability of esophageal and t-e speech.

A Multidimensional Scaling Study of Esophageal Vowels

A multidimensional scaling experiment was conducted to determine the perceptual structure of 11 American English vowels produced by a competent esophageal speaker. Estimates of perceptual distance among these vowels were obtained using a 9-point similarity/dissimilarity scale and were analyzed using an individual differences scaling algorithm (INDSCAL). A three-dimensional perceptual space was produced. The three perceptual dimensions corresponded to tongue advancement, vowel height, and rhotacization. These three dimensions were then correlated with selected bark scale transformed acoustic vowel measurements. The perceptual dimensions 1-3 corresponded most closely to F3-F2, F1-F0, and F3, respectively. Little difference was found between the perceptual structure of esophageal vowels and laryngeal vowels, although it is suggested that the correlation between some of the acoustic measures (such as F0) and the perceptual dimensions may change as a function of individual speaker differences due to postsurgical capabilities (anatomical and physiological) and/or method of voice restoration.

The Contributions of Phonatory Volume and Transglottal Airflow to the S/Z Ratio

This investigation tested two underlying premises of the s/z ratio. Interpretation of the ratio rests on the assumptions of equal phonatory volumes in producing both consonants and of increased air...

Mechanisms for Vocal Communication Following Total Laryngectomy

Effective speech relies on the successful coordination of four motor processes: respiration, phonation, resonation and articulation. Impairment of any of these processes results in decrements in the intelligibility and/or prosody of speech. The obvious communicative sequela to total laryngectomy is aphonia, arising not simply from loss of the phonatory organ, but as well from diversion of respiratory flow (the power source for speech) from the vocal tract. Rehabilitation of speech rests, therefore, on identifying a secondary source of phonation and a means of energizing that source into vibration.

Temporal speech characteristics and vocal pleasantness in the aging voice

Previous work by the authors emphasized temporal characteristics of speech as critical cues in age estimation. The present study assessed the role of the same temporal cues in listener perception of vocal pleasantness (PL). Twenty‐four speakers (12 male), ages 41–82 years, read the passage “My Grandfather” and prolonged /aeiou/. With the first two sentences of “My Grandfather” as the stimulus, 22 college‐age naive listeners (11 male) judged speaker PL on a five point scale. The times to initiate and to terminate /aeiou/, the time to articulate /maɪ gnaendfðɚ/, reading rate, pause time within the passage, and speaker sex were regressed against PL. The single best predictor for PL was reading rate (R‐square = 0.48) and the best significant model (12 variables) for PL yielded R‐square = 0.77. Similar to age estimation, the perception of PL appeared to be strongly influenced by temporal characteristics of speech. While the contributions of individual variables differ, the results suggest that estimations of ag...

Effects of Respiratory Muscle Strength Training in Classically Trained Singers

Many voice pedagogy practices revolve around the notion of controlling airflow and lung volumes and focus heavily on the concepts of breath support and breath control. Despite this emphasis, the effects of increased respiratory muscle strength on airflow and phonation patterns in trained singers remain unknown. This study addressed whether singers could increase respiratory muscle strength with progressive threshold training and whether respiratory muscle strength increases had measurable effect on voice outcomes. A single-subject design was used to answer the research questions. Improved breath support was hypothesized to manifest in differences in airflow and phonetogram characteristics. Six graduate-level singing students were recruited to complete the protocol, which consisted of a baseline phase followed by either inspiratory muscle strength training followed by expiratory muscle strength training or vice versa. Results showed that these singers had increased respiratory muscle strength after completing the training program. Consistent changes in measures of aerodynamics and voice were not present among subjects, although some individual changes were noted. Future research may focus on the effects of respiratory muscle strength training in less advanced singers.

Prosodic differences in tracheoesophageal speech: Perception and production

Prosody plays an important but often unrecognized role in a listeners interpretation of an utterance. The potential for significant prosodic limitations is often found in speakers who use tracheoesophageal speech due to extirpation of the larynx from cancer. This is because many prosodic features in the normal speaker are controlled by the use of laryngeal muscles [Kent, The Speech Sciences (1997)]. Previous studies showed inconsistencies in intonation and word stress perception and production levels regarding tracheoesophageal speech [Gandour and Weinberg, J. Speech Hear. Res. 26, 142–148; Trudeau et al., J. Commun. Dis. 21, 21–31]. The present study was designed to reevaluate listeners perceptions of tracheoesophageal speech and then describe the production components or limitations leading to these perceptions. Listeners unfamiliar with tracheoesophageal speech listened to normal and tracheoesophageal speakers saying the sentence Put the dishes away as a declarative, query, and exclamation—both in and ...