This study investigated the perceptual and cepstral/spectral characteristics of phonation and their relationships in dysarthria in connected speech. Twenty-two participants were divided into two groups; the eleven dysarthric speakers were paired with matching age and gender healthy control participants. A perceptual evaluation was performed by three speech pathologists using the GRBAS scale to measure the cepstrual/spectral characteristics of phonation between the two groups' connected speech. Correlations showed dysarthric speakers scored significantly worse (with a higher rating) with severities in G (overall dysphonia grade), B (breathiness), and S (strain), while the smoothed prominence of the cepstral peak (CPPs) was significantly lower. The CPPs were significantly correlated with the perceptual ratings, including G, B, and S. The utility of CPPs is supported by its high relationship with perceptually rated dysphonia severity in dysarthric speakers. The receiver operating characteristic (ROC) analysis showed that the threshold of 5.08 dB for the CPPs achieved a good classification for dysarthria, with 63.6% sensitivity and the perfect specificity (100%). Those results indicate the CPPs reliably distinguished between healthy controls and dysarthric speakers. However, the CPP frequency (CPP F0) and low-high spectral ratio (L/H ratio) were not significantly different between the two groups.
ObjectiveTo investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI).MethodsEighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated.ResultsThere were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks.ConclusionThe results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI.
Voice change is a common complaint after thyroid surgery and has significant impacts on quality of life. The Korean Society of Laryngology, Phoniatrics, and Logopedics set up a task force team to establish guideline recommendations on education, care, and management related to thyroid surgery. The guideline recommendations include preoperative voice education, management of anticipated voice change during surgery, and comprehensive voice care after thyroid surgery, including in-depth information and up-to-date knowledge based on validated literature. The committee constructed 14 key questions (KQ) in three categories: preoperative (KQ1–2), intraoperative (KQ 3–8), and postoperative (KQ 9–14) management and developed 18 evidence-based recommendations. The Delphi survey reached an agreement on each recommendation. Detailed evidence profiles are presented for each recommendation. The level of evidence for each recommendation is classified into high, moderate, and low-quality. The recommendation
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