Voice quality after thyroplasty type I using a silicone block.

AIM: The aim of the work was to evaluate the voice quality of 10 adult patients after thyroplasty type I using a silicone block. Preoperatively patients suffered from unilateral vocal fold paralysis. MATERIAL AND METHODS: We evaluated selected preoperative and postoperative patient findings (RBH according to Wendler classification, videolaryngostroboscopy and maximum phonation time MPT). The evaluation was performed by a phoniatrician and clinical speech therapist, using patient medical records and the Lingwaves and Glottis Analysis Tools (GAT) programs. RESULTS: Preoperatively we identified R1B1H1 - R3B3H3, postoperatively R0B0H0 - R3B3H2. In six cases the paralysed vocal cord was preoperatively in a paramedian position, twice in intermediate position and twice in a lateral position. In the case of 6 patients presbyphonic changes were present. Motility of the healthy vocal cord was within the norm. Postoperatively, the paretic vocal cord was medialised. We assessed the MPT value: preoperatively 3‒10 seconds, postoperatively 9‒17 seconds. Postoperatively we measured jitter (%), shimmer (%) and closing quotient values. In comparison with healthy subjects (Inwald et al. 2011), jitter and shimmer values were higher and closing quotient values after thyroplasty type I close to normal values (Tab.1). CONCLUSIONS: The postoperative voice quality was significantly better in comparison with the preoperative state; though, it never achieved the parameters of a normal voice. We confirmed the significant contribution of TPL I for the patients´ quality of life through partial rehabilitation of their voices.

Control of Fundamental Frequency in Dysphonic Patients During Phonation and Speech.

PURPOSE: The pitch-shift reflex (PSR) is the adaptation of the fundamental frequency during phonation and speech and describes the auditory feedback control. Speakers without voice and speech disorders mostly show a compensation of the pitch change in the auditory feedback and adapt their fundamental frequency to the opposite direction. Dysphonic patients often display problems with the auditory perception and control of their voice during therapy. Our study focuses on the auditory and kinesthetic control mechanisms of patients with muscle tension dysphonia (MTD) and speakers without voice and speech problems. Main purpose of the study is the analysis of the functionality of the control mechanisms within phonation and speech between patients with MTD and normal speakers. METHOD: Sixty-one healthy subjects (17 male, 44 female) and 22 patients with MTD (7 male, 15 female) participated following two paradigms including a sustained phonation (vowel /a/) and speech (['mama]). Within both paradigms the fundamental frequency of the auditory feedback was increased synthetically. For the analysis of the PSR the electroencephalogram, electroglottography, the voice signal, and the high-speed endoscopy data were recorded simultaneously. The PSR in the electroencephalogram was detected via the N100 and the mismatch negativity. Statistical tests were applied for the detection of the PSR in the physiological response within the electroglottography, voice, and high-speed endoscopy signals. The results were compared between both groups. RESULTS: No differences were found between the controls and patients with MTD regarding latency and magnitude of the perception of the pitch shift in both paradigms, but for the magnitude of the behavioral response. Differences also could be found for both groups between the "no pitch" and "pitch" condition of the two paradigms regarding vocal fold dynamics and voice quality. Patients with MTD showed more vibrational irregularities during the PSR than the controls, especially regarding the symmetry of vocal fold dynamics. CONCLUSION: Patients with MTD seem to have a disturbed interaction between the auditory and kinesthetic feedback inducing the execution of an overriding behavioral response.

[Validation of an automatic speech analysis in children with isolated cleft palate]. / Validierung einer automatischen Analyse der Sprechproben von Kindern mit isolierter Gaumenspalte.

BACKGROUND: Following surgical repair of cleft lip and palate, hearing and speech and language development are important issues for the continued care of affected childhood and adolescent patients. Therefore, PEAKS (Program for Evaluation and Analysis of all Kinds of Speech Disorders) was developed in order to rate speech intelligibility automatically and reduce the time required for diagnostics. PEAKS is based on a speech recognition system and was extended to incorporate a speaker model. This investigation validated PEAKS for isolated cleft palate. METHODS: From each of the 39 children with isolated cleft palate (3.1-14.5 years), 99 word productions were recorded digitally and analyzed-once "subjectively" by five experts and five nonexperts; once "objectively" using PEAKS. RESULTS: The automatic speech recognition system and the experts arrive at similar results with regard to speech intelligibility. The expert and nonexpert ratings differ significantly from each other. Within the group of nonexperts, a weak interrater reliability demonstrates the uncertainty associated with their ratings. CONCLUSION: PEAKS delivers reliable and representative results with regard to speech intelligibility among children and adolescents with isolated cleft palate. The automatic measurement of speech quality in children and adolescents with isolated cleft palate is possible.

[Evaluation of 2 German Parental Questionnaires: a comparative analysis of the FRAKIS questionnaire for early speech development and the early lexical development inventory ELAN for 2-year-olds]. / Validität der Elternfragebögen FRAKIS und ELAN bei der Vorsorgeuntersuchung U7.

OBJECTIVE: The German parental questionnaires FRAKIS and ELAN are 2 screening instruments, usable in the German preventive paediatric examinations for 2-year-olds. This study investigates the difference between the questionnaires with regard to validity, reliability, time and cost-efficiency and usability in daily clinical practice. METHOD: The parents of 25 children filled in the questionnaires FRAKIS and ELAN. As a reference test, the German speech development test 2 (SETK-2, Grimm 2000) was applied. Vocabulary results were compared with SETK-2 subtest production I (word production). RESULTS: Both parental questionnaires correlated significantly with the SETK-2 subtest production I. ELAN and FRAKIS showed equal results in classifying patients as "critical-below average" or "uncritical-indifferent". CONCLUSION: The ELAN as well as FRAKIS are both appropriate screening tools for identifying language developmental delay in 2-year-olds.

[Perceptual and automatic voice and speech analysis of chronic laryngitis and T1 vocal cord cancer]. / Perzeptive und maschinelle Stimm- und Sprechanalyse bei chronischer Laryngitis und T1-Stimmlippenkarzinom.

BACKGROUND: Patients with chronic laryngitis and T1 vocal cord cancer were compared using perceptual and text-based objective voice and speech analyses in order to determine which group is more affected in its ability to communicate and whether a distinction between the two pathologies is possible. PATIENTS AND METHODS: In all, 13 patients with histologically proven chronic laryngitis and 13 patients with T1 vocal cord cancer were compared perceptually by five speech therapists on the basis of seven criteria and objectively by a speech recognition system and prosodic analysis. RESULTS: Both, the data of the five speech therapists and the results of the automatic analysis revealed no significant differences between the two patient groups. CONCLUSION: A distinction between chronic laryngitis and T1 vocal cord carcinoma by mere voice and speech analysis is not possible, because the patient groups do not show significant differences in their voice quality.