FORMANT CHARACTERISTICS OF ENGLISH-SPEAKING LEBANESE MEN.

OBJECTIVE: To report the formant characteristics of English-speaking Lebanese men during steady prolongation of vowels /a/ and /i/. DESIGN: Cross-sectional study involving volunteer participants. PARTICIPANTS: Fifty healthy English-speaking males with a mean age of 32 ± 4.027 years and a range of 42 years (18-60). MATERIALS AND METHODS: A total of 50 healthy males between the age of 18 and 60 were recruited for the study. Each subject was asked to phonate a sustained /a/ and /i/ sound at a comfortable pitch and intensity level. Measures were made in real-time and formant frequencies across F1, F2, F3 and F4 were determined using the Real-time Spectrogram VP 3950 (Kay Elemetrics, New Jersey). MAIN OUTCOME MEASURES: The formant frequencies across F1, F2, F3 and F4 were recorded. RESULTS: For the vowel /a/, the mean values of F1, F2, F3 and F4 were 622.86 ± 61.293 Hz, 1264 ± 78.602 Hz, 2610.90 ± 206.359 Hz and 3483.56 ± 206.833 Hz, respectively. For the vowel /i/, the corresponding values were 378.88 ± 51.825 Hz, 2210.34 ± 124.077 Hz, 2847 ± 168.770 Hz and 3576.82 ± 242.760 Hz, respectively. CONCLUSION: Formant characteristics vary among cultures and ethnic groups.

Vocal symptoms in women undergoing in vitro fertilization.

OBJECTIVE: The aim of this study was to investigate changes in vocal symptoms in relation to estrogen level in women undergoing in vitro fertilization. MATERIALS AND METHODS: A total of 31 women were enrolled in this study. The following vocal symptoms were investigated: vocal tiring or fatigue, vocal straining, throat clearing, lump sensation, hoarseness, and aphonia (or loss of voice). The severity of these symptoms was graded from 0 to 4, where 0 means absence of the symptom and 3 means severe symptom presence. The frequency of these symptoms was evaluated in the first visit at presentation; second visit, 4 to 5 days after ovarian stimulation; and third visit, 8 to 10 days after stimulation. In the second and third visits, the estradiol levels were measured. RESULTS: The mean age was 32.33 ± 4.80 years. Ten of the 31 patients had at least 1 vocal symptom. The most common vocal symptom in all 3 visits was throat clearing, with an incidence of 22.6% in the first and second visits and 19.4% in the third visit. This was followed by vocal fatigue or tiring and lump sensation, with an incidence of 9.68% for both. The incidence of all the vocal symptoms as well as their severity did not change throughout the visits, except for throat clearing, which has decreased in the third visit but not significantly (22.6% vs 19.4%, P = 1). Subjects with vocal symptoms had lower estradiol level compared with those with no vocal symptoms; however, the difference was not statistically significant (P = .108 and .267, respectively). CONCLUSION: Subjects undergoing in vitro fertilization do not experience changes in their vocal symptoms when present, except for throat clearing. However, those with vocal symptoms have lower levels of estradiol compared with those with no vocal symptoms.

Correlation of SVINT and Sensory Organization Test in Children with Hearing Loss.

Objective: The skull vibration-induced-nystagmus test (SVINT) is a noninvasive and effective screening tool for the function of the otolith and canal structures in children. It can instantaneously assess vestibular asymmetry. This study aimed to analyze the SVINT results of healthy children vs. children with hearing loss (HL) and to correlate it with sensory organization test (SOT) results as a functional balance evaluation tool. Design: This case-controlled study compared the results of SVINT to the results of the SOT of the computerized dynamic posturography (CDP) in a control group of 120 healthy normal-hearing children (i.e., NH group) vs. hearing loss (HL) group of 60 children, including 30 children with hearing aids (HAs) and 30 children with a unilateral cochlear implant (CI). The SVINT results were compared to the caloric test (CaT) and video head impulse test (vHIT) and associated with SOT scores. Results: Thirty-one children in the HL group had normal SVINT and normal SOT results. A total of 21 children in the HL group had SVINT-negative and abnormal results in the SOT (possibly due to bilateral vestibular loss (BVL)). Eight children in the HL group had positive SVINT and abnormal SOT results. However, none of the children had only positive SVINT with normal SOT findings. Moreover, 52% of children had a normal result on both the SOT and CaT, whereas 27% had abnormal results on both tests (17% bilateral weakness and 10% unilateral), and 22% had the only result of the SOT suggesting a functional abnormality. Similarly, when associating the result to vHIT, 51% had normal results on both tests, and 25% had abnormal results (13% bilateral and 12% unilateral weakness). Conclusions: SVINT findings can be correlated with SOT findings in the case of the unilateral vestibular lesion (UVL), which adds a diagnostic value in these pediatric cases but may differ in the case of the bilateral vestibular lesion (BVL). However, SVINT findings need to be cautiously interpreted in light of other test findings such as the SOT, CaT, and vHIT.

Evolution of postural control assessment: From dynamic posturography to virtual reality.

During the early years of spaceflight it was documented that astronauts were impaired and incapacitated upon return to earth. Computerized Dynamic Posturography (CDP) was devised to investigate and quantify this deficit, and eventually progressed into a clinical assessment tool. The current sprouting of virtual reality (VR) technologies has allowed for the development of an alternative approach that could be more informative. Many low-cost VR systems (including desktop gaming programs designed for rehabilitation) are now available. Continued improvements in this technology indicate a high probability that VR will become an integral component of posturography by replacing present mechanical CDP techniques. We researched the relevant literature to evaluate the strengths and weaknesses of CDP using the Equitest (Neurocom International; Clackamas USA), and the added benefits of incorporating VR to help clinicians assess the complex task of balance maintenance. VR is capable of manipulating task and environmental demands in order to assess functional postural behavior. VR is also a useful tool for clinical testing of postural disorders resulting from sensory mismatch. Although posturography is still a useful clinical tool, VR provides an inherent conflict between the visual and vestibular senses and can elevate the effectiveness of CDP for both assessment and intervention. We conclude that, when initially developed, CDP was innovative and ahead of its time. However, with the advent of VR, we have a chance to modernize CDP and enhance its value as a clinical instrument.

Fifty Years of Development of the Skull Vibration-Induced Nystagmus Test.

This review enumerates most of the studies on the Skull Vibration-Induced Nystagmus Test (SVINT) in the past 50 years from different research groups around the world. It is an attempt to demonstrate the evolution of this test and its increased interest around the globe. It explores clinical studies and animal studies, both permitting a better understanding of the importance of SVINT and its pathophysiology.

Changes in the Sensory Weighting Strategies in Balance Control Throughout Maturation in Children.

BACKGROUND: The central nervous system integrates information from different sensory inputs (vestibular, visual, and somatosensory) to maintain balance. However, strategies for weighing sensory information change as maturation occurs. PURPOSE: The purpose of this study was to: (1) evaluate postural control development in a large sample of healthy children aged 5 to 17 years old, (2) analyze changes in sensory weighting strategies as maturation occurs, and (3) determine the extent to which anthropometric characteristics (height, weight, body mass index [BMI]) influence postural control. SAMPLE SIZE: This study recruited 120 healthy children, equally distributed in gender and number, into four age groups (5-8 years, 9-11 years, 12-14 years, and 15-17 years) and compared them to a control group of 20 healthy adults (aged 20-25 years). RESEARCH DESIGN: The sensory organization test (SOT) was used to assess overall balance and the use of specific sensory inputs to maintain postural control. All children underwent the six SOT conditions: (1) eyes open, surround and platform stable, (2) eyes closed, surround and platform stable, (3) eyes open, sway-referenced surround, platform stable, (4) eyes open, sway-referenced platform, (5) eyes closed, sway-referenced platform, and (6) eyes open, sway-referenced surround and platform. DATA ANALYSIS: Condition-specific equilibrium scores (ES), composite equilibrium scores (CES), and sensory analysis ratios were analyzed to determine whether the performance was related to age, gender, or specific anthropometric characteristics (height, weight, and BMI). RESULTS: Data showed a significant age-associated improvement in ES for all 6 conditions (p < 0.05) and in CES (p = 0.001). For both genders, (1) somatosensory function was adult-like by age 5 to 8 years, (2) visual function peaked around age 12 years, and (3) vestibular function reached maturity by age 15 to 17 years (p < 0.05). A moderate positive correlation (r(140) = 0.684, p = 0.01; two-tailed) between height and CES was found and a weak positive correlation (r(140) = 0.198, p = 0.01) between height and somatosensory ratio was noted. Lower vestibular ratio scores were observed in children who had a higher BMI (p = 0.001). CONCLUSION: The efficient use of individual sensory system input to maintain balance does not occur at the same age. Age and gender affect the changes in sensory weighting strategies, while height and BMI influence postural control in children. These factors need to be accounted for in child assessment.

Normative Values of Saccades and Smooth Pursuit in Children Aged 5 to 17 Years.

BACKGROUND: Pediatric oculomotor function can be evaluated via videonystagmography. Adult normative data for saccades and smooth pursuit tests cannot be used as a benchmark for pediatric patients because children's peripheral and central systems continue to mature throughout adolescence. PURPOSE: The purpose of this study was to establish normative data for saccade and smooth pursuit tests that can be used clinically in the assessment of vestibular and neurological disorders in children, and to investigate the effect of age and eye movement direction (left/right) on tests parameters. RESEARCH DESIGN: The present study is prospective cross-sectional study. STUDY SAMPLE: A total of 120 healthy children were recruited and equally distributed according to age and gender to each of the following groups: 5-8, 9-11, 12-14, and 15-17 years old. Participants had to pass a comprehensive otological and neurological assessment prior to inclusion in the study. Each subject underwent saccade and smooth pursuit testing. DATA COLLECTION AND ANALYSIS: Saccade latency, velocity and accuracy/precision, and smooth pursuit gain were analyzed across groups using a two-way repeated measure multivariate analysis of variance (MANOVA). RESULTS: Saccadic latency was longer in the youngest group aged 5-8 years old (305 ± 48 msec) in comparison to children aged 9-11 years old (276 ± 22 msec) (P = 0.017), 12-14 years old (252 ± 34 msec) (P = 0.001) adolescents 15-17 years (256 ± 33 msec) (P = 0.001). Age did not affect the results of saccadic velocity and accuracy/precision. Saccade parameters (latency, velocity, accuracy/ precision) were not affected by oculomotor direction (left vs. right). Smooth pursuit gain increased from 0.63 in children aged 5-8 years old to 0.85 in children aged 15-17 years (P = 0.0001). The percentage of gain asymmetry was significantly different in the youngest two groups. CONCLUSION: Saccade latency decreased as age increased. Smooth pursuit gains increased with increased age. Saccade velocity and accuracy/precision did not change significantly from ages 5-8 to 15-17 years of age. These data provide normative values for pediatric oculomotor evaluation and suggest that saccade and pursuit pathways may mature at different rates.

Formant frequency in relation to body mass composition.

OBJECTIVES: This study examines the relationship between total body mass composition and vowel formant frequency and formant dispersion in men. METHODS: A total of 60 healthy male volunteers were recruited. Formant frequencies and dispersions of F1, F2, F3, and F4 for the vowels /ɑː/ and /iː/ were determined using spectrographic analysis. RESULTS: The mean height and weight were 179.17 cm and 80.53 kg, respectively, with fat-free weight averaging to 67.02 kg (65.5% in the extremities vs 16.7% in the trunk). The body mass index (BMI) was 25.5 ± 3.34 kg/m(2). For the vowel /ɑː/, F1 and F4 correlated poorly with weight and trunk fat-free mass. There was also a poor negative correlation between F4 and muscle mass and body fat-free mass (r < 0.36). For the /iː/ vowel, there was a weak negative correlation between F2, F3, and F4 and height (r = -0.260, -0.299, and -0.320, respectively). Similarly, there was a negative correlation between F2 and muscle mass, trunk fat-free mass, and body fat-free mass (r = -0.291, -0.276, and -0.272, respectively). For the vowel /ɑː/, F1-F2 interspace correlated positively with fat weight, fat mass in the extremities, and trunk (r = 0.313, 0.350, and 0.264, respectively), whereas F2-F3 negatively correlated with weight (r = -0.255). For the /iː/ vowel, only F1-F2 negatively correlated with weight and BMI (r = -0.297 and -0.281). CONCLUSION: There is no significant correlation between body mass composition, formant frequencies, and dispersions. All the correlations were poor with r values less than 0.36.

Relationship between acoustic parameters and body mass analysis in young males.

PURPOSE: To analyze the correlation between acoustic parameters and body height, weight, and mass composition in young males. MATERIAL: A total of 40 male subjects were included in this study. Each subject underwent acoustic analysis using the Kay Elemetric VISI Pitch (Model 3300, KayPentax, Lincoln Park, NJ) and complete body mass analysis. Pearson correlation was calculated to estimate the strength of the relationship between acoustic parameters and each of the weight analysis variables. RESULTS: The mean age of the male subjects was 24 years with a range between 18 and 40 years. The average weight and height were almost 80 and 180cm, with standard deviation (SD) of 7.42 and 10.46, respectively. The fat weight ranged between 3 and 25kg, with the main concentration being in the extremities, 61.84%±17.4 and less concentrated in the trunk, 16.20% ± 7.6. The mean fundamental frequency was 120.13Hz with an SD of 19.16Hz. The mean Habitual Pitch was 114.16Hz with an SD of 16.55Hz. There was no significant correlation between the acoustic parameters and any of the body composition variables, in particular fat weight and distribution. There was a weak correlation between Shimmer, trunk fat (r value=0.328, P=0.039), and muscle mass (r value=0.326, P=0.038). CONCLUSION: The body mass composition and distribution do not correlate significantly with the fundamental frequency and the Habitual pitch.

The effect of snoring on voice: a controlled study of 30 subjects.

We conducted a study to determine the prevalence of vocal symptoms in snorers. A total of 30 patients with a history of snoring were investigated for the presence or absence of three vocal symptoms immediately after they awoke from sleep: hoarseness, voice weakness, and other changes in voice quality. All patients were also asked to complete a voice-related quality-of-life (V-RQOL) questionnaire. Findings were compared with those of an age- and sex-matched control group of 30 nonsnorers. The most common vocal symptom in the snoring group was hoarseness, which occurred in 11 patients (36.7%); voice weakness and other voice quality changes were present in 8 snorers each (26.7%). In the control group, the most common vocal symptom was voice weakness, which was present in 7 subjects (23.3%); 5 controls (16.7%) experienced other changes in voice quality, and 3 controls (10.0%) experienced hoarseness. The difference between the prevalence of hoarseness in the two groups was statistically significant (p = 0.030), and the differences in voice weakness and other voice quality changes were not. The mean V-RQOL score was 87.50 ± 26.89 in the snoring group and 96.00 ± 5.82 in the control group-again, not a statistically significant difference. Finally, we found no association between any of the three vocal symptoms and the prevalence of mouth breathing, the level of snoring loudness, and the mean number of snores per minute. We conclude that snorers are more likely to experience hoarseness than are nonsnorers.