[Dynamic palatography: Diagnostic tool for dysfunc­tional swallowing? Feasibility study].

Objective: Dysfunctional swallowing may cause transverse occlusal disorders. The speech re-education of dysfunctional swallowing aims to correct or prevent the recurrence of occlu­sal disorders. The main objective was to test the dynamic palato­graphy as a diagnosis and quantification tool of the dysfunctional swallowing. Material and methods: The study was prospective and descriptive. Twelve average 23.5 years old women with a clinical dysfunctional swallowing have been included between January and May 2014. None was aware of presenting an atypical swallowing or dento-facial dysmorphism of class II. The dynamic palatography device measured the pressure force of the language on the palate during the lingual rest, swallowing saliva and water. Parameters measured were the duration and magnitude of support of the tongue on the palate. Results: Dynamic palatography showed a trend to predominant anterior contact during rest position (25%), and lower position of the language with little contact during swallo­wing of saliva and water. Discussion: Palatography results are consistent with the clinical diagnostic criteria of atypical swallo­wing. Our palatography tool has the advantage of being unobtrusive in the mouth compared to other pre existing systems. This device should be tested on larger patient popu­la­tions and could enable monitore atypical swallowing rehabili­ta­tion efficiency. The palatography could complete the swallo­wing assessment and be a monitoring and rehabilitation tool in real time.

[Study of tongue pressure on the hard palate during exercises of swallowing rehabilitation]. / Etude de la pression de la langue sur le palais osseux au cours desexercices de rééducation de la déglutition.

INTRODUCTION: The exercises performed during the reeducation of swallowing seek to improve forces of propulsion of the bolus and airway protection during the course of swallowing. The objective of this study was to objectify the effect of pronunciation praxis of posterior phonemes /aka/ and /akra/, and swallowing maneuvers (super-supraglottic swallow with or without superimposed effort swallowing effort) on the time of the oral swallowing. MATERIALS AND METHODS: Four healthy volunteers participated in the experiment. They are called "experts" because they have a good knowledge of physiology and rehabilitation of swallowing. The dynamic palatography setup measured continuously the different pressures from the tongue on the hard palate through three force sensors arranged in a sagittal plane during the implementation of articulatory and swallowing tasks. RESULTS: Articulatory praxis created significant pressure on the posterior sensor for 2 of the 4 subjects. All the swallowing maneuvers increased the contact pressure and the contact duration compared to the control swallowing for the anterior and posterior pressure sensor. A large inter-individual variability was found. CONCLUSION: The complexity of instruction, the inter-individual variability in their performance, and the non-invasive nature of the instrument make the dynamic palatography a potentially useful tool in routine practice of swallowing reeducation.

[Preliminary experimental studies of whispered voice: subglottal pressure and postural aspects]. / Etudes expérimentales préiminaires de la voix chuchotée: pression sous-glottique et étude posturale.

OBJECTIVES: Whispered voice is investigated from the energetic point of view. Our hypothese is that whispered voice, and mainly the forced whispers are very similar to vocal effort, for non acoustic vocal parameters, and body movements. DESIGN: Two experiments are combined. The first experiment focused on the laryngeal aspects, mainly the subglottal pressure, and also the electroglottography. The second experiment analyzed the body movements associated with loud whispered voice. RESULTS: No electroglottograhic wave was observed during the two experiments. The vocal intensity was always lower during whispered voice than during comfortable voice (p < 0.001). In experiment 1, subglottal pressure was significantly higher during forced whisper than during the other conditions (p < 0.001). In experiment 2, the amplitude of the trunk movements in the sagittal plane were greater during loud whisper than during comfortable voice (p < 0.001). CONCLUSION: Whispered voice can be close to vocal loading, especially the loud whispered voice.

[Postural study on healthy subjects during experimental vocal effort]. / Etude posturale de sujets normaux en situation expérimentale d'effort vocal.

INTRODUCTION: The objective of the study was to assess how posture and vocal acoustics are modified when one needs to communicate despite environmental obstacles (i.e. vocal effort performance). METHOD: 20 healthy young women participated to this study. They had to communicate numbers to a listener. Environmental obstacles were the distance between the subject and the auditor, and the noise. Segmental posture modifications were recorded and analyzed using the numerical infra-red system for movement analysis SMART. Vocal acoustics and electroglottography were also recorded and analyzed using the EVA system. RESULTS: The study showed the presence of objective postural modifications during vocal effort. Their amplitude increased when the environmental obstacles to communications increased, and they anticipated the vocal production. DISCUSSION: The vocal effort concept and its relation with the posture, the voice and the subject's feeling are reviewed on the basis of these results. Laryngeal effort is not isolated, but belongs to a global behavioral strategy which aims to improving the efficiency of the communication.

Acoustic correlates of vocal effort: External factors and personality traits.

OBJECTIVES: To develop an experimental protocol to study the vocal effort generated by introducing barriers to communication, and its relationship with certain personality traits. MATERIAL AND METHODS: The experimental protocol consisted of an interactive game in which the subject gave an investigator instructions to adopt various body positions (semi-directed communication situation). The Control situation included no constraints on communication. Then a Distance Constraint (increased distance between subject and investigator) and a Time Constraint (generation of performance stress by putting the subject in competition with others) were introduced. The vocal parameters studied comprised vocal intensity and fundamental frequency in the middle of the vowel of 3 target phonemes. Subjects also took the NEO FFI-R personality test. RESULTS: The study included 41 women aged between 18 and 52 years. Vocal intensity and fundamental frequency increased significantly with the introduction of the constraints (P<0.05), intensity passing from 75.5dB to 81.8dB and frequency from 249.4Hz to 335.8Hz. No correlations were found between these changes and results for the various personality traits. CONCLUSIONS: This ecological protocol enables the impact of both physical and emotional obstacles to communication to be studied. No correlations between vocal effort and personality traits emerged. A larger-scale study would be necessary to analyze the continuum between vocal effort and vocal forcing, to improve speech therapy for dysfunctional dysphonia.