Patients without voice complaints can have VF motion impairment. Patients can also have VF motion impairment contralateral to the thyroid lesion. Preoperative VF examination helps counsel patients appropriately about the risks of surgery and helps outline a plan for the extent of surgery while minimizing the medicolegal ramifications of iatrogenic RLN injury.

Purpose To determine 1) how specific vocal fold structural and vibratory features relate to breathy voice quality and 2) the relation of perceived breathiness to four acoustic correlates of breathiness. Method A computational, kinematic model of the vocal fold medial surfaces was used to specify features of vocal fold structure and vibration in a manner consistent with breathy voice. Four model parameters were altered: vocal process separation, surface bulging, vibratory nodal point, and epilaryngeal constriction. Twelve naïve listeners rated breathiness of 364 samples relative to a reference. The degree of breathiness was then compared to 1) the underlying kinematic profile and 2) four acoustic measures: cepstral peak prominence (CPP), harmonics-to-noise ratio, and two measures of spectral slope. Results Vocal process separation alone accounted for 61.4% of the variance in perceptual rating. Adding nodal point ratio and bulging to the equation increased the explained variance to 88.7%. The acoustic measure CPP accounted for 86.7% of the variance in perceived breathiness, and explained variance increased to 92.6% with the addition of one spectral slope measure. Conclusions Breathiness ratings were best explained kinematically by the degree of vocal process separation and acoustically by CPP.

At present, two important questions about voice remain unanswered: When voice quality changes, what physiological alteration caused this change, and if a change to the voice production system occurs, what change in perceived quality can be expected? We argue that these questions can only be answered by an integrated model of voice linking production and perception, and we describe steps towards the development of such a model. Preliminary evidence in support of this approach is also presented. We conclude that development of such a model should be a priority for scientists interested in voice, to explain what physical condition(s) might underlie a given voice quality, or what voice quality might result from a specific physical configuration.

The patients tolerated regular diets, yet continued to exhibit silent aspiration and a variety of decompensations. Their voices were breathy, rough, and strained. Their voice quality ratings improved over the year. Group changes were not captured, and it appears that the changes in speech and voice 2 months after surgery were subtle.