Effects of intracordal trafermin injection on mutational voice disorder.

INTRODUCTION: Mutational voice disorder is the inability of the voice to adjust to the changes in the larynx during puberty, resulting in the speaking fundamental frequency failing to decrease. Standard treatments for mutational voice disorder are voice therapy and thyroplasty. However, voice therapy takes time to show its effects, and thyroplasty is highly invasive. Herein, we present a case of mutational voice disorder successfully treated with intracordal trafermin injection. CASE SUMMARY: A 31-year-old male patient was diagnosed with mutational voice disorder and offered standard treatment, but he requested a less invasive treatment with early effects. We performed intracordal trafermin injection with his consent. Two months after the procedure, the speaking fundamental frequency decreased from 155.5 Hz to 93.0 Hz, and the voice handicap index decreased from 14 to 2. DISCUSSION: This case suggests that intracordal trafermin injection is an effective treatment option for mutational voice disorder. Furthermore, compared with the standard treatment methods, it is less invasive and provides effects shortly with only one injection.

One Year Outcomes and Longitudinal Changes in Voice Improvement With Single High Dose Intracordal Trafermin Injections for Age-Related Vocal Fold Atrophy.

OBJECTIVE: Although intracordal trafermin injection has been performed in the treatment of age-related vocal fold atrophy, the effects of single high dose trafermin injections are unknown. In this study, we examined the 1 year outcomes and longitudinal changes in voice improvement with single high dose intracordal trafermin injections. STUDY DESIGN: Retrospective study with approval by our Ethics Committee. METHODS: The medical records of 34 patients who underwent single high dose (50ug per side) intracordal trafermin injections under local anesthesia for vocal fold atrophy were retrospectively reviewed at 1 month pre-injection and 1 month, 6 months and 1 year post injection. RESULTS: Maximum phonation time (MPT), pitch range (PR), Japanese version of voice handicap index (VHI), grade of GRBAS evaluation, and jitter% improved significantly at 1-year post-injection compared to 1-month pre-injection. MPT and PR improved as early as 1-month post-injection and continued to improve most at 1-year post-injection. VHI showed negative progression from 6-months to 1-year post-injection, during which time the speaking fundamental frequency (SFF) changed to the high pitch in men. CONCLUSIONS: Single high dose intracordal trafermin injections can be expected to improve voice in the early post-injection period and to maintain its effect for 1 year. SFF may play a role in worsening VHI in men. LEVEL OF EVIDENCE: level 4.

Speaking Fundamental Frequencies of Adult Speakers of Australian English and Effects of Sex, Age, and Geographical Location.

AIMS: The aim of this study was to provide a description of normative speaking fundamental frequency (fos) characteristics for adult speakers of Australian English. The effects of age, sex, and geographical location on fos were also examined to assess whether variations existed. METHODS: fos data for 244 female and 135 male speakers aged 18-60 years from a recent large-scale corpus of Australian English were analyzed on a passage reading task. Creak phonation frequencies were first separated from the modal phonation frequencies algorithmically. Descriptive statistics were then generated for modal voice. RESULTS: The mixed effects linear regression model suggested that geographical location had no effect on fos (P = 0.0677). The multiple linear regression model suggested that both sex (P = 0.000) and age (P = 0.000) significantly predicted fos. fos of the female speakers was greater than males by 76 Hz, when accounted for by age, and for every increase in age by one year, fos decreased by 0.37 Hz. Normative data on fos were therefore provided with reference to speaker sex and age only. CONCLUSION: Both clinicians and researchers are provided with normative fos data for 18-60 year-old speakers of Australian English. These updated data have increased internal and external validity relative to previous literature. These increases were achieved by having a larger sample size, systematically sampling speakers of different age groups and geographical locations, sampling contemporary speakers of Australian English and excluding speakers with known concomitant factors that affect fos.

Multiparametric Analysis of Speaking Fundamental Frequency in Genetically Related Speakers Using Different Speech Materials: Some Forensic Implications.

OBJECTIVE: To assess the speaker-discriminatory potential of a set of fundamental frequency estimates in intraidentical twin pair comparisons and cross-pair comparisons (i.e., among all speakers). PARTICIPANTS: A total of 20 Brazilian Portuguese speakers of the same dialect, namely 10 male identical twin pairs aged between 19 and 35, were recruited. METHOD: the participants were recorded directly through professional microphones while taking part in a spontaneous dialogue over mobile phones. Acoustic measurements were performed in connected speech samples, and in lengthened vowels, at least 160 ms long produced during spontaneous speech. RESULTS: f0 baseline, central tendency, and extreme values were found mostly discriminatory in intra-twin pair and cross-pair comparisons. These were also the estimates displaying the largest effect sizes. Overall, only three identical twins were found statistically different regarding their f0 patterns in connected speech, but not for lengthened vowel-based f0 metrics. Estimates of f0 variation and modulation were found the least discriminatory across speakers, which may signal the control of speaking style and dialect on dynamic patterns of f0. Concerning system performance, the base value of f0 (f0 baseline) was found the most reliable metric, displaying the lowest equal error rate (EER). CONCLUSIONS: the outcomes suggest that, although identical twins were very closely related regarding their f0 patterns, some pairs could still be differentiated acoustically, only in connected speech. Such findings reinforce the relevance of analyzing long-term f0 metrics for speaker comparison purposes, with particular consideration to f0 baseline. Furthermore, f0 differences across subjects were suggested as more expressive in connected speech than in lengthened vowels.

Unintended imitation of fundamental frequency in female speakers.

Objective: Former studies have shown that humans unintentionally adopt speech characteristics from their conversation partners, a phenomenon known as speech convergence. This study investigated imitation of fundamental frequency (Fo) in nine healthy females in a repetition task.Method: The design included two conditions; loud reading (baseline) and repetition after a model talker. The model talker was a female with a high-pitched voice and stimuli included both words and nonwords. All productions were analyzed with regard to mean and SD of Fo and compared between conditions and word types.Results: The participants showed different patterns regarding the effect on Fo, thus indicating that some individuals are more likely to change their speaking Fo in a repetition task than others. Group results showed somewhat but not significantly higher mean Fo in the repetition task as compared to baseline (reading). Moreover, nonwords were produced with a significantly higher mean Fo than real words, in both reading and repetition conditions. No interaction effect between condition and word type was found.

Mean fundamental frequency in connected speech and sustained vowel with and without a sentence-frame.

Introduction: Sustained vowel phonation is a common patient task in the assessment of voice disorders. Free from articulatory influence, it allows for acoustic voice analyses unfeasible for connected speech. Previous research indicates that the fundamental frequency (fo) of a self-chosen vowel is not necessarily representative to mean fo of the same subject's connected speech.Objective: The purpose was to examine mean fo in text reading and to compare it with sustained vowel phonation with and without a sentence-frame. It was hypothesized, that a short phrase of context embedding the prolonged vowel would affect mean fo of the vowel to be closer to that of text reading.Method: Thirteen vocally healthy women, age 22-27 was audio recorded during three tasks: reading of a standard text, producing an isolated, sustained /a/ and repeating three times a frame sentence with an imbedded /a/ and the third time to sustain the /a/. Mean fo of the three conditions was analyzed by means of the Praat computer program.Results: The isolated vowel condition differed significantly from the mean fo of the sentence-framed one, the latter being closest to mean fo of the reading task. The isolated vowel condition also differed significantly from text reading. The difference in mean fo between sentence-framed vowel and text reading was not significant.Conclusion: Data support that the use of a sentence-frame is helpful to get a client's fo elicited from sustained vowel production in voice assessments more representative to that of text reading as compared to an isolated vowel.

F0 Characteristics of Newsreaders on Varied Emotional Texts in Tamil Language.

OBJECTIVE: The objective of this study was to profile speaking F0 and its variations in newsreaders on varied emotional texts. STUDY DESIGN: This study has a prospective, case-control study design. METHODS: Fifteen professional newsreaders and 15 non-newsreaders were the participants. The participants read the news bulletin that conveyed different emotions (shock, neutral, happy, and sad) in a habitual and "newsreading" voice. Speaking fundamental frequency (SFF) and F0 variations were extracted from 1620 tokens using Praat software (version 5.2.32) on the opening lines, headlines, news stories, and closing lines of each news item. Paired t test, independent t test, and Friedman test were used for statistical analysis. RESULTS: Both male and female newsreaders had significantly (P ≤ 0.05) higher SFFs and standard deviations (SDs) of SFF in newsreading voice than speaking voice. Female non-newsreaders demonstrated significantly higher SFF and SD of SFF in newsreading voice, whereas no significant differences were noticed in the frequency parameters for male non-newsreaders. No significant difference was noted in the frequency parameters of speaking and newsreading voice between male newsreaders and male non-newsreaders. A significant difference in the SD of SFF was noticed between female newsreaders and female non-newsreaders in newsreading voice. Female newsreaders had a higher frequency range in both speaking voice and newsreading voice when compared with non-newsreaders. CONCLUSIONS: F0 characteristics and frequency range determine the amount of frequency changes exercised by newsreaders while reading bulletins. This information is highly pedagogic for training voices in this profession.

New Vocal Fold-shortening Procedure: External Approach to Anterior Vocal Fold Plication.

INTRODUCTION: We believe that our new procedure offers a useful external approach to anterior vocal fold plication. Vocal cord shortening by laryngomicrosurgery (LMS) involves plication of the anterior commissure, but this difficult procedure requires high-level skills. Dehiscence of the plicated location may occur postoperatively. METHODS: In the present case, we applied an innovative procedure combining vocal cord shortening by LMS with cervical incision. This facilitated plication, and no postoperative dehiscence was encountered. RESULTS: Speaking fundamental frequency (SFF) was 110 Hz at the first visit, 170 Hz after type 4 thyroplasty, 167 Hz after thyroarytenoid muscle myectomy, and 208 Hz after the present procedure, representing a good outcome. CONCLUSIONS: This procedure could be useful when the SFF is not sufficiently raised by existing procedures. The risk of postoperative dehiscence of the plicated location is low compared with LMS. CASE DETAILS: The patient consulted with a major complaint of low vocal pitch. At the first visit, SFF was 110 Hz, suggesting a male voice. In April 201X, type 4 thyroplasty was performed and successfully raised SFF to 170 Hz. As the patient did not readily pass as a woman, thyroarytenoid muscle myectomy was performed in February 201X +1 but only achieved an SFF of 167 Hz, which was considered unsatisfactory. As a result, the procedure was performed again in September 201X +1.

Influence of Glottal Fry on Acoustic Voice Assessment: A Preliminary Study.

PURPOSE: This preliminary study examined the influence of glottal fry on measurement of speaking fundamental frequency (SF0) and whether sex differences influence the impact glottal fry has on SF0 and cepstral peak prominence (CPP). It was hypothesized that SF0 and CPP would decrease as percent glottal fry in the sample increased, with larger changes observed in the female voice. METHODS: Twenty-six participants (13 men, 13 women) completed the study. Participants were recorded reading the Rainbow Passage. SF0 and CPP were determined from the original sample. Percent glottal fry SF0 was determined and semitone change was recalculated after removal of glottal fry from the sample. Regression analysis was used to determine the impact of glottal fry and sex on semitone change and CPP differences in SF0. RESULTS: Significant differences were found for both sex and percent glottal fry on semitone change in SF0. A significant relationship was not found between CPP and semitone change when sex was accounted for. CONCLUSIONS: Findings from this study indicate that the measurement of SF0 for women will decline as percent of glottal fry increases. These findings have clinical implications for interpretation of SF0 measurement and evidence-based outcomes for voice therapy.

Freddie Mercury-acoustic analysis of speaking fundamental frequency, vibrato, and subharmonics.

Freddie Mercury was one of the twentieth century's best-known singers of commercial contemporary music. This study presents an acoustical analysis of his voice production and singing style, based on perceptual and quantitative analysis of publicly available sound recordings. Analysis of six interviews revealed a median speaking fundamental frequency of 117.3 Hz, which is typically found for a baritone voice. Analysis of voice tracks isolated from full band recordings suggested that the singing voice range was 37 semitones within the pitch range of F#2 (about 92.2 Hz) to G5 (about 784 Hz). Evidence for higher phonations up to a fundamental frequency of 1,347 Hz was not deemed reliable. Analysis of 240 sustained notes from 21 a-cappella recordings revealed a surprisingly high mean fundamental frequency modulation rate (vibrato) of 7.0 Hz, reaching the range of vocal tremor. Quantitative analysis utilizing a newly introduced parameter to assess the regularity of vocal vibrato corroborated its perceptually irregular nature, suggesting that vibrato (ir)regularity is a distinctive feature of the singing voice. Imitation of subharmonic phonation samples by a professional rock singer, documented by endoscopic high-speed video at 4,132 frames per second, revealed a 3:1 frequency locked vibratory pattern of vocal folds and ventricular folds.

Allergic rhinitis and voice change.

The aim of this study was to investigate voice function in patients with birch pollen allergy. Voice recordings for acoustic analysis were performed during pollen season and non-pollen season, with 30 patients and 30 controls, and all participants answered a questionnaire about voice symptoms. The results show that the patients reported more voice symptoms than controls during both seasons. In the non-pollen season the symptoms were decreased in the patient group but not in the controls. Speaking fundamental frequency was lower in patients compared to controls during both seasons. The results suggest chronic edema of the vocal folds in the patients. Laryngeal examination with stroboscope was not performed but is recommended for future patients diagnosed with an air-borne allergy.

Is the speaking fundamental frequency in females related to body height?

The aim of the study was to determine the impact of body height on speaking fundamental frequency (SF0) while controlling for as many as possible influencing factors such as habits, biophysical conditions, medication, diseases, and others. Fifty-eight females were analyzed during spontaneous speech (i.e. explaining driving directions or a cooking recipe) of at least 60 seconds at comfortable pitch and loudness. The subjects showed a moderate negative and significant correlation between body height and SF0 (r = -0.40, P = 0.002). With r(2) = 0.16, however, a reasonable portion (16%) of the variance in SF0 is explained by the variance in body height. In comparison with other factors for which a correlation with SF0 was mentioned in literature (hypothyrodism, hemodialysis, auditory-maleness after female-to-male transsexualism, body weight, body mass index, and body fat), body height accounted for most of the proportion of SF0 in females. It is therefore possible to validate body height as a factor to account for in clinical F0 measurement.

Clinical Utility of CAPE-V Sentences for Determination of Speaking Fundamental Frequency.

OBJECTIVES/HYPOTHESIS: Sentence stimuli from the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) were compared with standard speaking fundamental frequency (SF0) tasks to establish clinical utility of the sentence stimuli for standardized assessment of SF0. STUDY DESIGN: Using a within-participant repeated measures design, 60 consented participants (30 males and 30 females) completed the study. METHODS: Participants provided 10 acoustic samples (six CAPE-V sentences and four additional standard tasks), counterbalanced for order effect, for determining SF0. A within-participant repeated measures analysis of variance was used in a 2 (males vs females) by 11 (10 tasks and CAPE-V sentence average) design to determine significant differences in SF0 with significance set at α < .05. RESULTS: Significant differences were found for the CAPE-V sentences "Peter will keep at the peak" and "How hard did he hit him" with seven of the remaining tasks and the CAPE-V average determined to be statistically similar in female participants. No significant differences were found for male participants. CONCLUSIONS: Findings from this study indicate that taken individually, four of the CAPE-V sentences and the average of the six CAPE-V sentences may be used instead of longer tasks to determine SF0 in nonvoice-disordered individuals. This may streamline clinical service by using the CAPE-V sentences for both standardized acoustic and perceptual voice assessments.

Speaking fundamental frequency and vowel formant frequencies: effects on perception of gender.

OBJECTIVES/HYPOTHESIS: The purpose of the present study was to investigate the contribution of vowel formant frequencies to gender identification in connected speech, the distinctiveness of vowel formants in males versus females, and how ambiguous speaking fundamental frequencies (SFFs) and vowel formants might affect perception of gender. STUDY DESIGN: Multivalent experimental. METHODS: Speakers subjects (eight tall males, eight short females, and seven males and seven females of "middle" height) were recorded saying two carrier phrases to elicit the vowels /i/ and /α/ and a sentence. The gender/height groups were selected to (presumably) maximize formant differences between some groups (tall vs short) and minimize differences between others (middle height). Each subjects' samples were digitally altered to distinct SFFs (116, 145, 155, 165, and 207 Hz) to represent SFFs typical of average males, average females, and in an ambiguous range. Listeners judged the gender of each randomized altered speech sample. RESULTS: Results indicated that female speakers were perceived as female even with an SFF in the typical male range. For male speakers, gender perception was less accurate at SFFs of 165 Hz and higher. Although the ranges of vowel formants had considerable overlap between genders, significant differences in formant frequencies of males and females were seen. CONCLUSIONS: Vowel formants appeared to be important to perception of gender, especially for SFFs in the range of 145-165 Hz; however, formants may be a more salient cue in connected speech when compared with isolated vowels or syllables.