Effect of the Finnish Tube on the Voice of a Deaf Musician: A Case Report.

PURPOSE: To verify the auditory-perceptual and acoustic effects of the semioccluded vocal tract exercise with Finnish tube on the vocal quality of a deaf musician. METHODS: A seven-day protocol with Finnish tube was performed with guidance for its home replication twice a day. A 46-years-old man with profound bilateral sensorineural hearing loss, musician and composer participated. Before and after the application of the protocol had undergone tonal audiometry, nasofibrolaryngoscopy, acoustic analysis with Praat and auditory-perceptual evaluation of the voice with Voice Profile Analysis Scheme for Brazilian Portuguese. RESULTS: The postintervention auditory-perceptual analysis identified reduction of the deviation in lip spreading, extensive labial range, raised tongue body, pharyngeal expansion, nasal resonance, larynx height, larynx and vocal tract tension and irregularity, pitch, speech rate, and a better respiratory support. The maximum phonation time reduced, probably because of elimination of the abrupt vocal attack and tension, articulatory deviations, improvement in voicing and the absence of the use of expiratory reserve air. The fundamental frequency became lower, and the first, second, third, and fourth formants became higher. The jitter increased, and the shimmer reduced. CONCLUSION: The use of the Finnish tube might have facilitated the voicing sensations in the deaf musician, by enhancing the tactile-kinesthetic perception of the vocal tract and brought a greater source-filter interaction.

Systematic Review of Auditory Perceptual and Acoustic Characteristics of the Voice of Cochlear Implant Adult Users.

STATEMENT OF PROBLEM: What are the normative data available on the perceptual and acoustic characteristics of the voice of adults of both sexes who have hearing-impairment and who use cochlear implants? PURPOSE: To identify in the literature, normative data about the perceptual auditory and acoustic characteristics of the voice of hearing-impaired cochlear implant adult users. SEARCH STRATEGY: A systematic search was carried out in the Virtual Health Library, Web of Science, Science Direct, SciELO, and SCOPUS databases with no temporal restriction. SELECTION CRITERIA: The articles were selected if they led with citation to normative data of the acoustic analysis of the voice of deaf cochlear implant users. And duplicate articles, case studies, letters to the editor, reviews, and studies that were not directly related to the topic were excluded. DATA EXTRACTION: The data from each article were extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist: title, abstract, year of publication, journal, authors and country of origin, identification of background, purpose, study design, participants, variables, and data measurement. DATA SYNTHESIS: There were 1,052 publications that met the search criteria. After applying the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist, excluding duplicates, and reading of the full text, 10 papers were selected for further analysis. Although several voice parameters have been studied, there is a great variation in study designs, sample sizes, age of participants, voice samples analyzed, and cochlear implant specifications. CONCLUSION: The normative data available in the literature concerning the voice of cochlear implant users are consistent only in terms of fundamental frequency.

Voice symptoms and handicap in adults with cochlear implants / Sintomas vocais e desvantagem vocal em adultos usuários de implante coclear

ABSTRACT Purpose: to investigate the presence of vocal symptoms and handicap in adults with cochlear implants, and verify the correlation with their self-perception of the voice quality. Methods: twenty-seven adults of both genders, with cochlear implants, in the age range of 19 to 57 years participated. The participants answered the self-assessment protocols Voice Handicap Index and Voice Symptom Scale. Furthermore, the participants answered an additional question about how they rated their voices. Results: for the Voice Handicap Index, the average score was 28.74, in total, and the average score for the Voice Symptom Scale was 29.22, in total. The correlation between the scores of the Voice Handicap Index and the self-perception of the voice showed that the worse the perception, the more handicap in every domain of the protocol. For the Voice Symptoms Scale, the results showed that there is a positive and moderate correlation between the self-perception of the voice and the total scores as well as for the impairment and emotional subscales. Conclusion: this study verified the presence of handicap and symptoms related to voice, mainly, regarding physical, functional and limitation aspects for the adults with cochlear implants. There is a positive and moderate correlation between the score of the protocols applied and self-evaluation of the vocal quality of the participants.

RESUMO Objetivo: investigar a presença de desvantagem vocal e sintomas vocais em usuários adultos de implante coclear e verificar sua correlação com a autoavaliação da qualidade vocal. Métodos: participaram 27 adultos com implante coclear de ambos os sexos com idade entre 19 e 57 anos. Foram aplicados os questionários de autoavaliação Índice de Desvantagem Vocal e Escala de Sintomas Vocais. Além disso, os participantes responderam uma questão sobre autopercepção vocal. Resultados: a pontuação média para o Índice de Desvantagem Vocal foi de 28,74 no total, e a pontuação média da Escala de Sintomas Vocais foi de 29,22. A correlação entre o Índice de Desvantagem Vocal e a questão de autopercepção vocal indicaram que ao passo que a percepção da voz piora, há maior desvantagem vocal em todos os domínios do questionário. Para a Escala de Sintomas Vocais houve correlação positiva e moderada entre a autopercepção vocal e a pontuação dos domínios limitação, emocional e a pontuação total. Conclusão: foi possível verificar presença de desvantagem e sintomas relacionados à voz, no que se refere a questões funcionais, orgânicas e de limitação na população estudada. Existe correlação positiva e moderada entre a pontuação dos questionários e a autoavaliação da qualidade vocal dos participantes.

Auditory-Perceptual Evaluation of Voice Quality of Cochlear-implanted and Normal-hearing Individuals: A Reliability Study.

OBJECTIVE: This study aimed to present an experience in rating voices of adults with normal hearing and adults with cochlear implants and critically examine the outcomes, discussing pros and cons of the methodology used. STUDY DESIGN: This is a cross-sectional, prospective study. METHODS: One hundred and fifty voice samples, consisting of 50 sustained vowels, 50 samples of connected speech, and 50 samples of conversational speech, belonging to 25 adults with hearing impairment with cochlear implants and 25 adults with normal hearing, were perceptually analyzed for inter-rater agreement and intra-rater reliability. Three experienced judges rated the voice samples using visual analog scales of parameters considered relevant for cochlear-implanted population such as articulation, intonation, and resonance. The raters participated in three training sessions for calibration and had 1 month to complete the ratings individually. Twenty percent of the samples were repeated randomly to verify intra-rater reliability. The levels of agreement and reliability were verified using the interclass correlation coefficient. RESULTS: The inter-rater agreement varied widely across the parameters and speech tasks, from poor to excellent agreement. The only parameter for which the raters maintained consistently good or excellent agreement for all groups and emissions was the pitch. For intra-rater reliability, two of the raters presented excellent reliability for most parameters across all of the speech tasks, whereas one rater presented more inconsistencies. CONCLUSIONS: In this reliability study, factors such as extensive deadline for the auditory perceptual evaluation, lack of periodic recalibration, speech tasks, and familiarity with the population studied were identified as factors that contributed to inconsistent reliability results.

Hábitos vocais em dois grupos de idosos / Vocal habits in two groups of aged

OBJETIVO: comparar as diferenças quanto à presença dos hábitos inadequados, as formas de prevenção e os sintomas vocais, mais freqüentes, em dois grupos da terceira idade. MÉTODOS: foi aplicado um questionário com questões do tipo fechada, previamente elaboradas em 45 idosos de ambos os sexos, sendo que apenas um grupo recebeu orientações vocais durante o ano anterior à pesquisa por um profissional fonoaudiólogo. É um estudo descritivo, observacional, transversal. RESULTADOS: de acordo com os resultados, o grupo 2 que recebeu orientação vocal, possui menor freqüência de hábitos inadequados quando comparado ao grupo 1. Quanto às formas de prevenção de distúrbios da voz, a maioria do grupo 1, não possui nenhum cuidado. No grupo 2, já se constata, entre outras formas de prevenção, a referência de realização de treinamento vocal. Com relação à presença de sintomas, o grupo 1 apresentou maior freqüência quanto a cansaço ao falar (50 por cento), dor na garganta (50 por cento), sensação de corpo estranho (67 por cento), do que o grupo 2. CONCLUSÃO: observa-se que houve diferenças quanto hábitos inadequados, formas de prevenção e sintomas nos dois grupos, sendo que o grupo 2 (que recebeu orientação quanto aos cuidados com a voz) possui índices menores quanto aos hábitos inadequados e sintomas vocais, ou seja, de acordo com os resultados, orientações sobre saúde vocal em grupos de terceira idade é eficaz.

PURPOSE: to compare the differences as for the presence of inadequate habits, forms of prevention and vocal symptoms, more frequent, in two groups of the third age. METHODS: a questionnaire was applied with questions of the closed type, previously elaborated in the 45 aged of both genders, being that only one group received vocal orientation during the previous year the research by a speech therapist professional. It is a study of the descriptive, observational, transversal. RESULTS: of accordance with the results, group 2 that received orientation vocal, has minor frequency of inadequate habits when compared with group 1. As for the forms of prevention of riots in the voice, the majority of group 1, does not take any care. In group 2, it is already evidenced, among others prevention forms, the reference regarding accomplishment of vocal training. With regard to the presence of symptoms, group 1 showed greater frequency as for the fatigue when speaking (50 percent), pain in throat (50 percent), sensation of strange body (67 percent), than group 2. CONCLUSION: we note that thee has been differences as for inadequate habits, forms of prevention and symptoms in the two groups, being that group 2 (that received orientation as for to the cares related to voice) has minor indices as for to the inadequate habits and vocal symptoms, that is, in accordance with the results, orientation on vocal health in groups of third age is efficient.