Average Ambulatory Measures of Sound Pressure Level, Fundamental Frequency, and Vocal Dose Do Not Differ Between Adult Females With Phonotraumatic Lesions and Matched Control Subjects

Abstract

Objectives Clinical management of phonotraumatic vocal fold lesions (nodules, polyps) is based largely on assumptions that abnormalities in habitual levels of sound pressure level (SPL), fundamental frequency (f0), and/or amount of voice use play a major role in lesion development and chronic persistence. This study used ambulatory voice monitoring to evaluate if significant differences in voice use exist between patients with phonotraumatic lesions and normal matched controls. Methods Subjects were 70 adult females: 35 with vocal fold nodules or polyps and 35 age-, sex-, and occupation-matched normal individuals. Weeklong summary statistics of voice use were computed from anterior neck surface acceleration recorded using a smartphone-based ambulatory voice monitor. Results Paired t-tests and Kolmogorov-Smirnov tests resulted in no statistically significant differences between patients and matched controls regarding average measures of SPL, f0, vocal dose measures, and voicing/voice rest periods. Paired t-tests comparing f0 variability between the groups resulted in statistically significant differences with moderate effect sizes. Conclusions Individuals with phonotraumatic lesions did not exhibit differences in average ambulatory measures of vocal behavior when compared with matched controls. More refined characterizations of underlying phonatory mechanisms and other potentially contributing causes are warranted to better understand risk factors associated with phonotraumatic lesions.

Screening value of V-RQOL in the evaluation of occupational voice disorders

“…It is obvious that vocal nodules could have detrimental effect on quality of voice (e.g., in the case of singers they may cause loss of the higher frequencies), which is important for vocal performers [25]. However, they tend to have a lesser impact on vocal efficiency [26] which is important in spoken voice professions e.g., teachers, clerks, telemarketers, and the representatives of the above mentioned professional groups in particular have been examined in the study.…”

Accuracy of Self-Reported Estimates of Daily Voice Use in Adults With Normal and Disordered Voices

“…The results of the present study also cast doubt on the accuracy with which patients might be able to self-assess or self-monitor these parameters during activities of daily living, which is often required as part of the voice assessment and therapy process. Ambulatory voice monitors that have the capability to objectively measure multiple vocal parameters (e.g., phonation duration, intensity, and fundamental frequency) and provide real-time feedback have the potential to significantly improve the clinical management of behavior-based voice disorders (Llico et al, 2015;Van Stan, Mehta, Zeitels, et al, 2015). This would include defining or establishing safe limits for healthy voice use that are based on the types of quantitative or cumulative measures of daily phonatory behavior that ambulatory monitoring can provide Titze & Hunter, 2015).…”

Estimating Subglottal Pressure From Neck-Surface Acceleration During Normal Voice Production

“…This degree of uncertainty can be problematic, because SPL estimates obtained from ACC data are often used to derive higherlevel voice-use parameters, such as long-term vocal-dose measures (Titze, Švec, & Popolo, 2003). Vocal-dose measures have been thought to be clinically important and are applied to the assessment of individuals in high-voice-use occupations (Bottalico & Astolfi, 2012;Lindstrom, Waye, Södersten, McAllister, & Ternström, 2011;Titze & Hunter, 2015) as well as individuals diagnosed with behaviorally based voice disorders Nacci et al, 2013;Van Stan et al, 2015). Thus, improving the accuracy of ACC-based estimates of vocal parameters would have a positive impact on voice research and ultimately on the application of this technology to enhance clinical practice.…”