Effect of Voice Reinforcement Method for Treatment of Vocal Nodules: Preliminary Study

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Objectives: The purpose of this study is to investigate the characteristics of vocal fold vibration during sustained vowel /a/ phonation and various semi-occluded vocal tract exercise (SOVTEs) using a vibration simulator and digital kymography (DKG).Methods: A total of 12 normal young speakers (6 males, 6 females) aged 20-30 years participated in the study. They phonated a sustained /a/ vowel and performed SOVTE. The vocal fold vibration characteristics were measured according to the number of vibration sources (single vs. double), and vocal tract occlusion degree using a vibration simulator and DKG. Glottal gap quotient (GQ, %), speed quotient (SQ, %) and amplitude (pixel) were estimated quantitatively from the DKG image.Results: The results showed that significantly higher GQ (p = .000) and SQ (p = .000) were observed in the humming and bilabial fricative /β/ compared to open vowels. The amplitude was significantly higher in the open vowel /a/ than in humming (p = .018) and bilabial fricative /β/ (p = .003). Also, when comparing the vocal fold vibration parameters according to vibration type (single source: straw phonation vs. double source: straw phonation with water), the double source presented a significantly higher GQ (p = .000) as well as SQ (p = .008) in comparison with a single source.Conclusion: SOVTE showed a glottal gap that is different from the opened vowel /a/. It also had a longer opening of the vocal fold and a smaller amplitude than the vowel. This suggests that SOVTE may be helpful for facilitating vocal fold vibration and good voice quality in clinical practice. The current study can be meaningful in providing theoretical and clinical evidence for SOVTE.

Vocal Fold Vibration Characteristics during SOVTE using a Vibration Simulator and Digital Kymography

Kim¹,

Choi²,

Lee³

et al. 2021

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Usefulness of Water-Resistance Straw Phonation in Discrimination of Adductor-Type Spasmodic Dysphonia and Muscle Tension Dysphonia

Kim¹

2022

Objectives: Although Adductor-type spasmodic dysphonia (AdSD) and Muscle tension dysphonia (MTD) show similar phonetic symptoms, the causes and treatment methods are different. Therefore, discrimination is necessary for the proper treatment of the two diseases. The purpose of this study is to investigate the usefulness of Water-resistance straw phonation (WSP) as a diagnostic therapy for the differentiation of AdSD and MTD. To that end, Both patients with AdSD and MTD performed WSP, and their voices was measured before and after diagnostic therapy.Methods: A total of 27 (18 MTD, 9 AdSD) individuals participated in this study. The MTD group (4 male, 14 female) mean age was 30.01 years and the AdSD (2 male, 7 female) group mean age was 31.03. Both groups were treated with diagnostic therapy using WSP which took approximately 90 seconds. The acoustic analysis and auditory–perceptual assessment were completed after diagnostic therapy.Results: The MTD group was significantly lower in Jitter Percent (Jitter) (p= .003), Pitch Perturbation Quotient (PPQ) (p= .007), Fundamental Frequency Variation (vF0) (p= .004), Shimmer Percent (Shimmer) (p= .010), Amplitude Perturbation Quotient (APQ) (p= .012), Peak to Peak Amplitude Variation (vAm) (p= .005) and auditory–perceptual grade (p= .007). However, the AdSD group was not significantly different for all variables after performing the WSP.Conclusion: WSP is one of the methods that relieve laryngeal hypertension. In this study, the voice improvement of the MTD group after diagnostic therapy using WSP meant that the laryngeal hypertension was relieved. This change indicates a high probability of MTD as opposed to AdSD. Whereas, no improvement or worsening of the voice problem suggests neither the probability of MTD nor no confirmation of AdSD. Therefore, a diagnostic therapy using WSP may be useful as one of the evaluation methods for discrimination between AdSD and MTD.

Clinical Applications of Facial Sensor Biofeedback: Implications for Voice Therapy or Vocal Training

An¹,

Choi²,

Lee³

et al. 2022

Objectives: Biofeedback therapy is a training technique that has a positive effect on the voice. In order to conduct resonant voice therapy or tube phonation more effectively, it is important for the patient to feel the vibration sensation in a specific part of the facial structures. Therefore, in this study, the clinical basis for facial vibration was presented by quantifying the vibration site and magnitude using vibration sensors during various semi-occluded vocal tract phonations.Methods: A total of 38 normal young adults without dysphonia participated in this study. Recording was performed a total of 6 times for each type of phonation, in the order of /a/ phonation, Kazoo, lip trill, humming, straw phonation, and tube phonation in water at the comfortable level using newly developed facial vibration sensor.Results: There was a significant difference in the magnitude of vibration according to body parts (cheek, nose, neck) during resonant voice or tube phonation; the largest amplitude presented in the nose during humming whereas lip trill, straw, kazoo, and tube phonation in water presented in the cheek. There were also significant differences in the magnitude of vibration among the voice therapy exercises or vocal training techniques (/a/ phonation, Kazoo, lip trill, humming, straw phonation, and tube phonation in water; with greater amplitude in dual sources such as lip trill and water resistance phonation than in single source phonations.Conclusion: The facial vibration sensor could provide clinical evidence for facial vibration sensation during semi-occluded vocal tract phonation. It can also provide biofeedback and monitor whether patients can perform semi-occluded vocal tract phonation properly.