The interference of voice change on structural vocal cords lesions.
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A longitudinal cohort study Introduction: Voice change may be defined as a group of changes in voice pattern that take place between childhood and puberty. During this period some vocal cord lesions (specifically cysts and nodules) may undergo transformation. AIM: To evaluate changes in vocal cord structural lesions following voice changes. MATERIAL AND METHOD: All laringoscopic exams made at the Sao Paulo Santa Casa de Misericordia between 1997 and 2002 of children aged below 10 years with structural lesions were reevaluated. Children whose voice had already changed repeated the exam and answered a questionary about voice change. RESULTS: Eleven children were studied. Observation showed that hoarseness was significantly decreased after voice change, and that lesions revealed modifications. Thickened-like lesions were reabsorved, and protrusion-like lesions underwent modification but did not disappear. CONCLUSION: The definition of lesions and subsequent modifications after voice change are important to define the correct approach to children presenting hoarseness. (+info)
Reverse phonation--physiologic and clinical aspects of this speech voice therapy modality.
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Reverse phonation is the voice production during inspiration, accomplished spontaneously in situations such as when a person sighs. AIM: to do a literature review, describing discoveries related to the use of the reverse phonation in the clinical practice, the anatomy and physiology of its production and its effects in vocal treatments; and moreover, indications and problems of the technique for speech disorders treatment and voice enhancement. RESULTS: there were reports of significant changes in vocal treatment during with the use of reverse phonation: ventricular distention, ventricular folds separation, increase in the fundamental frequency, mucous wave inverse movement; and it also facilitates the dynamic study of the larynx when associated with endoscopy, making it possible to have a better definition of lesion localization in vocal folds superficial lamina propria layers. CONCLUSION: There are few studies describing larynx behavior during reverse phonation and, for this technique to be used in a more precise and objective way, more studies are necessary in order to prove its effectiveness in practical matters. (+info)
Infant-directed speech produced by fathers with symptoms of depression: effects on infant associative learning in a conditioned-attention paradigm.
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Infant-directed (ID) speech produced by fathers who varied in their number of self-reported symptoms of depressed was analyzed for differences its ability to promote infant voice-face associative learning. Infants of fathers with elevated scores on the Beck Depression Inventory-II (BDI-II) showed significantly poorer learning than did infants of fathers with non-elevated BDI-II scores when their fathers' ID speech served as a conditioned stimulus for a face reinforcer in a conditioned-attention paradigm. Fathers with elevated BDI-II scores produced ID speech with marginally significantly lower F0 variability than fathers with non-elevated BDI-II scores. However, F0-related cues were uncorrelated with infant learning. Overall, fathers' ID speech contained significantly less F0 modulation than did mothers' ID speech. These findings show that paternal depression, like maternal depression, adversely affects infant learning in a conditioned-attention paradigm. (+info)
The voice of emotion: an FMRI study of neural responses to angry and happy vocal expressions.
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The human voice is one of the principal conveyers of social and affective communication. Yet relatively little is known about the neural circuitry that supports the recognition of different vocally expressed emotions. We conducted an FMRI study to examine the brain responses to vocal expressions of anger and happiness, and to test whether specific brain regions showed preferential engagement in the processing of one emotion over the other. We also tested the extent to which simultaneously presented facial expressions of the same or different emotions would enhance brain responses, and to what degree such responses depend on attention towards the vocal expression. Forty healthy individuals were scanned while listening to vocal expressions of anger or happiness, while at the same time watching congruent or discrepant facial expressions. Happy voices elicited significantly more activation than angry voices in right anterior and posterior middle temporal gyrus (MTG), left posterior MTG and right inferior frontal gyrus. Furthermore, for the left MTG region, happy voices were related to higher activation only when paired with happy faces. Activation in the left insula, left amygdala and hippocampus, and rostral anterior cingulate cortex showed an effect of selectively attending to the vocal stimuli. Our results identify a network of regions implicated in the processing of vocal emotion, and suggest a particularly salient role for vocal expressions of happiness. (+info)
Airway involvement and obstruction from granulomas in African-American patients with sarcoidosis.
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Sarcoidosis is a global disorder whose breadth of organ involvement can often be underappreciated. Head and neck manifestations include involvement of the skin, salivary glands, sinonasal cavity, and larynx. Of cases of upper airway sarcoidosis, laryngeal sarcoidosis and airway compromise portend a greater risk of fatal outcomes. People representing all racial groups have been diagnosed with sarcoidosis. Although many studies have evaluated incidence and manifestations of sarcoidosis in multiple ethnicities, few studies have explored racial predilection for laryngeal involvement. However, assertions that disease severity and poor outcome may be tied to the African diaspora as well as related socio-economic and cultural realities have been recognized. We present our case series of six African-American patients diagnosed with sarcoidosis and presented with complaints of voice change and increased shortness of breath. Four of them required expeditious, surgical management of the airway. Two had limited supraglottic involvement and have avoided tracheotomy with aggressive and timely pharmacotherapeutic intervention and close clinical surveillance. Early recognition of laryngeal manifestations of sarcoidosis and airway compromise is essential to provide patients with conservative management without the need for aggressive surgical intervention. (+info)
Posterior glottic stenosis in adults.
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BACKGROUND: Posterior glottic stenosis is a complication of prolonged intubation, manifesting as airway stenosis that may mimic bilateral vocal cord paralysis. It presents a variety of features that mandate specific surgical interventions. OBJECTIVES: To summarize our experience with PSG and its working diagnosis. METHODS: We conducted a retrospective review of a cohort of adult patients with PGS operated at the Sheba Medical Center between 1994 and 2006. RESULTS: Ten patients were diagnosed with PGS, 6 of whom also had stenosis at other sites of the larynx and trachea. Since 2000, all patients underwent laryngeal electromyographic studies and direct laryngoscopy prior to surgery. Surgical interventions included endoscopic laser procedures (in 2 patients), laryngofissure and scar incision (in 1), laryngofissure with buccal mucosa grafting (in 3) or with costal cartilage grafting (in 1) and laryngofissure with posterior cricoid split and stenting (in 1); one patient was not suitable for surgery. Postoperative follow-up included periodic fiberoptic endoscopies. Voice analysis was evaluated by the GRBAS grading. Seven patients were successfully decannulated within one to three procedures. Voice quality was defined as good in 7 patients, serviceable in 2 and aphonic in 1. CONCLUSIONS: Posterior glottic stenosis may be isolated or part of complex laryngotracheal pathologies. Electromyographic studies and direct laryngoscopy must be included in the diagnostic workup. Costal cartilage or buccal mucosa grafts are reliable, safe and successful with respect to graft incorporation and subglottic remodeling. (+info)
Predicting phonetic transcription agreement: insights from research in infant vocalizations.
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The purpose of this study is to provide new perspectives on correlates of phonetic transcription agreement. Our research focuses on phonetic transcription and coding of infant vocalizations. The findings are presumed to be broadly applicable to other difficult cases of transcription, such as found in severe disorders of speech, which similarly result in low reliability for a variety of reasons. We evaluated the predictiveness of two factors not previously documented in the literature as influencing transcription agreement: canonicity and coder confidence. Transcribers coded samples of infant vocalizations, judging both canonicity and confidence. Correlation results showed that canonicity and confidence were strongly related to agreement levels, and regression results showed that canonicity and confidence both contributed significantly to explanation of variance. Specifically, the results suggest that canonicity plays a major role in transcription agreement when utterances involve supraglottal articulation, with coder confidence offering additional power in predicting transcription agreement. (+info)
Usefulness of three-dimensional computed tomography of the larynx for evaluation of unilateral vocal fold paralysis before and after treatment: technique and clinical applications.
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Laryngoplasty is well-known technique for unilateral vocal fold paralysis (UVFP). However, operation result are sometimes not as good as expected before surgery. Three-dimensional Computed tomography (3DCT) is useful for visualizing complicated intralaryngeal structures. Moreover, 3DCT is suited for analyzing the movement of the vocal fold and arytenoid cartilage because the technique is based on actual data from live patients. We have been used 3DCT of the Larynx for evaluation of UVFP before and after treatment. We uncovered some new findings about UVFP and reasons of unsatisfactory outcomes after operation. Technique and clinical applications of 3DCT for UVFP are outlined in this paper. (+info)