Empirical Distribution of Glottal Edges (EDGE): A Statistical Assessment of Vocal Fold Kinematics Using High-Speed Videoendoscopy.

Although laryngeal high-speed videoendoscopy (HSV) is crucial for studying vocal fold vibrations, its translation to clinical practice has been hindered by the large volume of data it produces and the difficulty in interpreting current analysis methods. Although image processing techniques have been developed to map spatial-temporal data into two-dimensional representations, they alter the geometrical construction of the glottis and do not provide standard quantitative features, thus challenging clinical interpretation. In response, we propose a new visualization and analysis framework for assessing the dynamics of vocal folds based on the empirical distribution of the glottal edge using HSV. This procedure analyzes vocal fold oscillations by preserving the shape of the glottis and quantifying the asymmetry between right and left vocal fold displacements along the anterior-posterior axis. This method was evaluated on four groups of participants: ten with normal voices, ten with vocal fold nodules, ten with muscle tension dysphonia, and two with unilateral vocal fold paralysis. The proposed method produces distinct representations for normal and pathological vocal fold vibratory behaviors and derived features based on amplitude and phase asymmetry metrics that show statistically significant differences between normal and pathological groups. Comparative analysis with state-of-the-art techniques indicates that our proposed method can complement the assessment of vocal fold vibration and enhance the clinical translation of HSV.

Lombard Effect in Individuals With Nonphonotraumatic Vocal Hyperfunction: Impact on Acoustic, Aerodynamic, and Vocal Fold Vibratory Parameters.

PURPOSE: This exploratory study aims to investigate variations in voice production in the presence of background noise (Lombard effect) in individuals with nonphonotraumatic vocal hyperfunction (NPVH) and individuals with typical voices using acoustic, aerodynamic, and vocal fold vibratory measures of phonatory function. METHOD: Nineteen participants with NPVH and 19 participants with typical voices produced simple vocal tasks in three sequential background conditions: baseline (in quiet), Lombard (in noise), and recovery (5 min after removing the noise). The Lombard condition consisted of speech-shaped noise at 80 dB SPL through audiometric headphones. Acoustic measures from a microphone, glottal aerodynamic parameters estimated from the oral airflow measured with a circumferentially vented pneumotachograph mask, and vocal fold vibratory parameters from high-speed videoendoscopy were analyzed. RESULTS: During the Lombard condition, both groups exhibited a decrease in open quotient and increases in sound pressure level, peak-to-peak glottal airflow, maximum flow declination rate, and subglottal pressure. During the recovery condition, the acoustic and aerodynamic measures of individuals with typical voices returned to those of the baseline condition; however, recovery measures for individuals with NPVH did not return to baseline values. CONCLUSIONS: As expected, individuals with NPVH and participants with typical voices exhibited a Lombard effect in the presence of elevated background noise levels. During the recovery condition, individuals with NPVH did not return to their baseline state, pointing to a persistence of the Lombard effect after noise removal. This behavior could be related to disruptions in laryngeal motor control and may play a role in the etiology of NPVH. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20415600.

Laryngeal and pharyngeal activity during semioccluded vocal tract postures in subjects diagnosed with hyperfunctional dysphonia.

High vertical laryngeal position (VLP), pharyngeal constriction, and laryngeal compression are common features associated with hyperfunctional voice disorders. The present study aimed to observe the effect on these variables of different semioccluded vocal tract postures in 20 subjects diagnosed with hyperfunctional dysphonia. During observation with flexible endoscope, each participant was asked to produce eight different semioccluded exercises: lip trills, hand-over-mouth technique, phonation into four different tubes, and tube phonation into water using two different depth levels. Participants were required to produce each exercise at three loudness levels: habitual, soft, and loud. To determine the VLP, anterior-to-posterior (A-P) compression, and pharyngeal width, a human evaluation test with three blinded laryngologists was conducted. Judges rated the three endoscopic variables using a five-point Likert scale. An intraclass correlation coefficient to assess intrarater and interrater agreement was performed. A multivariate linear regression model considering VLP, pharyngeal width, and A-P laryngeal compression as outcomes and phonatory tasks and intensity levels as predictive variables were carried out. Correlation analysis between variables was also conducted. Results indicate that all variables differ significantly. Therefore, VLP, A-P constriction, and pharyngeal width changed differently throughout the eight semioccluded postures. All semioccluded techniques produced a lower VLP, narrower aryepiglottic opening, and a wider pharynx than resting position. More prominent changes were obtained with a tube into the water and narrow tube into the air. VLP significantly correlated with pharyngeal width and A-P laryngeal compression. Moreover, pharyngeal width significantly correlated with A-P laryngeal compression.

Hábitos musicales de la juventud y daño auditivo / Musical habits in youth and hearing damage

Se efectuaron diversas investigaciones con el fin de determinar la presencia de daño auditivo en relación a la exposición a música ambiental en jóvenes y músicos profesionales, las que comprendieron: a) encuesta sobre los hábitos de audición musical. b) mediciones de intensidad sonora de Personal Stereos y lugares donde se escucha música a gran volúmen. c) estudios de fatiga auditiva durante la utilización normal de Personal Stereo. d) evaluación audiométrica a una población de jóvenes y a otra de músicos profesionales. Los resultados sugieren que existe un daño auditivo pesquisable en jóvenes al compararlos con las curvas normales para su edad y tanto la encuesta de hábitos de audición como las mediciones técnicas efectuadas en las fuentes sonoras y el estudio de fatiga auditiva, podrían explicar este deterioro. Igualmente se pesquisaron signos de daño auditivo en músicos profesionales

Tratamiento del mucocele frontal mediante marsupialización / Frontal mucocele treatment by marsupialization

Los autores presentan su experiencia de un tratamiento quirúrgico conservador del mucocele frontal en un período de cuatro años. Se describe la técnica quirúrgica de la marsupialización del seno frontal y sus ventajas estéticas. Se discute y compara con otras técnicas más radicales. Esta es una técnica simple con excelentes resultados cosméticos y un período post operatorio breve y buena tolerancia