Lateral Phase Mucosal Wave Asymmetries in the Clinical Voice Laboratory

Haben, C. Michael; Kost, Karen; Papagiannis, George

doi:10.1016/s0892-1997(03)00032-8

Cited by 25 publications

(31 citation statements)

References 19 publications

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“…The findings of this study are consistent with other studies which identify individuals with normal laryngeal structure and function showing characteristics of vocal hyperfunction regardless of any perceptual characteristics of abnormal voice [6,7,8,9]. These findings raise concerns that individuals with normal laryngeal function may be misdiagnosed with ‘muscle tension dysphonia' or the degree of vocal hyperfunction diagnosed may be inaccurate.…”

Section: Discussionsupporting

confidence: 89%

“…Interestingly, increased supraglottic activity such as ventricular fold medialization and A-P compression is evident even in individuals with normal vocal fold mucosa, laryngeal structures and perceptually normal vocal quality [6]. Other diagnostic parameters such as phase asymmetry, atypical mucosal wave, glottal width irregularity and periodicity irregularity are also evident in normal participants [7,8,9]. Ng and Bailey [10] reported higher than normal acoustic measures such as percent jitter values, relative average perturbation for shimmer, and noise-to-harmonic ratios due to the presence of a rigid endoscope in the mouth and the requisite tongue anchoring.…”

Section: Introductionmentioning

confidence: 99%

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Participant Anxiety and Presence of Hyperfunction in Stroboscopy

Kelkar¹,

Cox²,

Hough³

et al. 2013

Folia Phoniatr Logop

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Objective: Excessive supraglottic and abnormal fine vibratory characteristics associated with vocal hyperfunction are identified even in individuals with normal laryngeal structure, function and vocal quality when they undergo stroboscopy, possibly due to anxiety. The purpose of this study is to (a) test for vocal hyperfunction in individuals with normal laryngeal structure and function and if present, (b) to track changes in vocal hyperfunction associated with anxiety when stroboscopy is repeated within 24-48 h. Participants and Methods: Thirty participants, naïve to stroboscopy, underwent the procedure and completed the State-Trait Anxiety Inventory 3 times over 24-48 h. Results: 41.4% of participants demonstrated vocal hyperfunction in supraglottic and fine vibratory characteristics after the first trial. Vocal hyperfunction decreased to 27.6% after the third trial. Results showed a significant main effect of time indicating that vocal hyperfunction decreased as participants repeated stroboscopy. Although the average anxiety score decreased across trials, state (anxiety) had no significant effect on change in vocal hyperfunction. Conclusions: In the real world, true representation of vocal function can be achieved by getting a patient acquainted to the presence of strobe in the oral cavity and practice the tasks that will be attempted during the procedure without introducing vocal hyperfunction and most importantly, without the use of a topical anesthetic.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Participant Anxiety and Presence of Hyperfunction in Stroboscopy

Kelkar¹,

Cox²,

Hough³

et al. 2013

Folia Phoniatr Logop

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“…Vibratory phase asymmetries between the left and right vocal folds have been observed in speakers with normal voices and with voice disorders (Haben et al, 2003;Bonilha et al, 2008Bonilha et al, , 2011, with various factors purported to influence asymmetry within speakers, including subglottal pressure (Berry et al, 1996;Maunsell et al, 2006;Murugappan et al, 2009), fundamental frequency (Maunsell et al, 2006), vocal fold mass and stiffness (Steinecke and Herzel, 1995), and vocal loading (Lohscheller et al, 2008a).…”

Section: Introductionmentioning

confidence: 99%

“…Voice specialists make critical diagnostic, medical, therapeutic, and surgical decisions based on coupling visual observations of vocal fold tissue motion with auditory-perceptual assessments of voice quality (Zeitels et al, 2007). Although clinical experience indicates that this approach is generally applicable, it is inherently limited to case-by-case observations, and visual judgments of vocal fold vibratory patterns might not adequately reflect changes in objective measures of the acoustic signal (Haben et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Investigating acoustic correlates of human vocal fold vibratory phase asymmetry through modeling and laryngeal high-speed videoendoscopy

Mehta

Zañartu

Quatieri

et al. 2011

The Journal of the Acoustical Society of America

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Vocal fold vibratory asymmetry is often associated with inefficient sound production through its impact on source spectral tilt. This association is investigated in both a computational voice production model and a group of 47 human subjects. The model provides indirect control over the degree of left-right phase asymmetry within a nonlinear source-filter framework, and high-speed videoendoscopy provides in vivo measures of vocal fold vibratory asymmetry. Source spectral tilt measures are estimated from the inverse-filtered spectrum of the simulated and recorded radiated acoustic pressure. As expected, model simulations indicate that increasing left-right phase asymmetry induces steeper spectral tilt. Subject data, however, reveal that none of the vibratory asymmetry measures correlates with spectral tilt measures. Probing further into physiological correlates of spectral tilt that might be affected by asymmetry, the glottal area waveform is parameterized to obtain measures of the open phase (open=plateau quotient) and closing phase (speed=closing quotient). Subjects' left-right phase asymmetry exhibits low, but statistically significant, correlations with speed quotient (r ¼ 0.45) and closing quotient (r ¼ À0.39). Results call for future studies into the effect of asymmetric vocal fold vibration on glottal airflow and the associated impact on voice source spectral properties and vocal efficiency.

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“…Subharmonics present a periodically occurring ''irregularity'' (as opposed to randomly occurring irregularity measured by jitter and shimmer) that rarely persists throughout the duration of the vowel. [1][2][3] Up to three subharmonics can be distinguished between two consecutive harmonic traces. 2 Subharmonics, which have often been observed in connection with asymmetric vocal fold vibrations because of differences in mechanical properties of the vocal folds, 4 have been implicated as acoustic property of pathologic voices.…”

Section: Introductionmentioning

confidence: 99%