Seishi Hibi

Sulcus Vocalis: Functional Aspects

The vocal function of 126 patients with sulcus vocalis was evaluated with the use of a test battery of multidimensional evaluation items. Of the 126 patients, 31 had a unilateral sulcus and 95, bilateral lesions. The results were as follows. 1) The majority of the patients had a mild degree of hoarseness with a breathy quality. 2) An incomplete glottic closure, a small vibratory amplitude, and a small mucosal wave were frequently observed in the stroboscopic examination. 3) The maximum phonation time, fundamental frequency range, and sound pressure level range of phonation were decreased, whereas the airflow during phonation was increased. 4) The pitch perturbation quotient, amplitude perturbation quotient, and normalized noise energy were increased. 5) Abnormal test results were more frequent and more marked for bilateral lesions than for unilateral lesions.

Acoustic Analysis of Pathological Voice: Some Results of Clinical Application

Tape-recorded voices of 30 patients were acoustically analysed: 10 had glottic Tla carcinoma, 10 unilateral vocal fold polyp and 10 unilateral recurrent laryngeal nerve paralysis. The carcinoma cases were treated with laser surgery with/without radiotherapy, the polyp cases with endolaryngeal microsurgery and the paralysis cases with intrafold silicone injection. The acoustic analysis was conducted before and after the treatment for each patient. Three acoustic parameters, viz. pitch perturbation quotient (PPQ), amplitude perturbation quotient (APQ) and normalized noise energy (NNE), were employed. The results were as follows: (1) PPQ and APQ were greater in paralysis cases than in carcinoma and polyp cases; (2) none of the parameters was useful in differentiating the three disease groups investigated; (3) all three parameters proved to be useful in monitoring the effects of treatments; (4) all three parameters were positively correlated to the grade of hoarseness, rough and breathy quality of hoarseness, mean airflow rate and regularity of vocal fold vibration viewed under stroboscopy; (5) PPQ, APQ and NNE were positively related to each other.

Asymmetry of the Laryngeal Framework: A Morphologic Study of Cadaver Larynges

Asymmetry of the laryngeal framework was investigated with 50 excised human larynges, ten from newborns (five males, five females), 20 from adults in their 20s (ten males, ten females), and 20 from adults in their 50s (ten males, ten females). All adults were right-handed. The results are summarized as follows. 1) The laryngeal framework was asymmetric to a greater or lesser extent in all larynges. 2) The degree of asymmetry did not differ among different age groups or between sexes. 3) In newborns, there was no directional preponderance in asymmetry. 4) In older adults, there was a directional preponderance in asymmetry. The right thyroid lamina tended to tilt laterally whereas the left lamina showed a tendency to tilt medially. The right cricoarytenoid joint tended to be located slightly more laterally, posteriorly, and inferiorly than the left joint. The longitudinal axis of the thyroid cartilage was inclined to shift to the right posteriorly against the axis of the cricoid cartilage. The thyroid cartilage as a whole tended to tilt to the right against the cricoid cartilage. 5) There must be some compensatory mechanisms for the asymmetric framework to keep the vocal fold edges relatively symmetric.

Transcutaneous Intrafold Injection for Unilateral Vocal Fold Paralysis: Functional Results

This paper presents the technique of transcutaneous intrafold silicone injection and the functional results of 44 procedures in 42 patients. The injection is given under local anesthesia with the patient in a supine position. The needle is inserted through the cricothyroid space. The location of the needle as well as the effect of injection is monitored by means of a fiberscope connected to a television camera and screen. The preoperative and postoperative vocal function was multidimensionally evaluated with the use of a test battery consisting of the maximum phonation time (MPT), mean airflow rate (MFRc), fundamental frequency (FO) range and sound pressure level (SPL) range of phonation, pitch perturbation quotient (PPQ), amplitude perturbation quotient (APQ), and normalized noise energy (NNEa). In the majority of the patients, MPT, FO range, and SPL range increased and MFRc, PPQ, APQ, and NNEa decreased postoperatively. In the overall evaluation based on the test values of these parameters, the result was excellent for 16 procedures, good for 16, fair for 7, and poor for 5. The most frequent cause of failure was an insufficient amount injected.

Acoustic measurements and perceptual evaluation of hoarseness in children's voices

According to a previous investigation of childrens voices hoarseness was found to be a stable concept consisting of three main predictors: hyperfunction, breathiness, and roughness. The present investigation analyzes the relation between these perceptual voice characteristics, complemented by instability and gratings (high pitched roughness) on the one hand and four acoustic measures: pitch perturbation quotient, amplitude perturbation quotient and two types of normalized noise energy measures on the other. The analysis was carried out on a sample of vowels sustained by 50 ten-year-old school children representing different degrees of hoarseness. Significant correlations were found between hoarseness, breathiness, and roughness, and two acoustic measures, namely a frequency perturbation quotient and one harmonics-to-noise measure.

Distortions of videofiberoscopy imaging: Reconsideration and correction**

Summary An analysis was made of the optical distortion of a lens system of a fiberscope and the distortion related to lens-object angles and lens-object distances used in laryngeal flexible endoscopic examinations. The optical distortion was systematic and, therefore, could be corrected through computer processing once the calibration was made. Similarly, the distortion related to the lens-object angle and distance varied systematically depending on distance and angle and, therefore, could be predicted if those parameters were measured simultaneously. The correction of those distortions of videofiberoscopic image is demonstrated, and a procedure for recording and measuring laryngeal images that minimizes measurement error due to those distortions is suggested.

Falsetto, head/chest, and speech mode: An acoustic study with three tenors

Summary An acoustic analysis of voices in falsetto, head/chest, and speech mode produced by three tenor singers was conducted. The three different modes of phonation were produced at a fairly high pitch in five Japanese vowels. The results were as follows: (a) pitch period perturbation quotient was smaller in speech than in head/chest and falsetto, (b) amplitude perturbation quotient was smaller in speech than in falsetto, (c) normalized noise energy was smallest in falsetto and greatest in head/chest, (d) gross spectral decay between 0 and 4.5 kHz was greatest in falsetto and smallest in head/chest, (e) singing formant was remarkable both in head/chest and speech, and (6) the speech mode was associated with relatively strong harmonics in high-frequency range between 3.5 and 4.5 kHz.