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Fifteen patients, 13 women and 2 men, with a mean age of 72.7 years (56 to 86 years) and a clinical diagnosis of essential voice tremor, were treated with botulinum injections to the thyroarytenoid muscles, and in some cases, to the cricothyroid or thyrohyoid muscles. Evaluations were based on subjective judgments by the patients, and on perceptual and acoustic analysis of voice recordings. Subjective evaluations indicated that the treatment had a beneficial effect in 67% of the patients. Perceptual evaluations showed a significant decrease in voice tremor during connected speech (p < .05). Acoustic analysis showed a nearly significant decrease in the fundamental frequency variations (p = .06) and a significant decrease in fundamental frequency during sustained vowel phonation (p < .01 ). The results of perceptual evaluation coincided most closely with the subjective judgments. It was concluded that the treatment was successful in 50% to 65% of the patients, depending on the method of evaluation.

SummaryThe purpose of this investigation was to study children's exposure to background noise at the ears during a normal day at the day care center and also to relate this to a perceptual evaluation of voice quality. Ten children, from three day care centers, with no history of hearing and speech problems or frequent infections were selected as subjects. A binaural recording technique was used with two microphones placed on both sides of the subject's head, at equal distance from the mouth. A portable digital audio tape (DAT) recorder (Sony TCD-D 100, Stockholm, Sweden) was attached to the subject's waist. Three recordings were made for each child during the day. Each recording was calibrated and started with three repetitions of three sentences containing only sonorants. The recording technique allowed separate analyses of the background noise level and of the sound pressure level (SPL) of each subjects' own voice. Results showed a mean background noise level for the three day care centers at 82.6 dBA Leq, ranging from 81.5 to 83.6 dBA Leq. Day care center no. 2 had the highest mean value and also the highest value at any separate recording session with a mean background noise level of 85.4 dBA Leq during the noontime recordings. Perceptual evaluation showed that the children attending this day care center also received higher values on the following voice characteristics: hoarseness, breathiness, and hyperfunction. Girls increased their loudness level during the day, whereas for boys no such change could be observed.

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SPL of voice and speech should be reported together with the mouth-to-microphone distance so that the levels can be related to vocal power. Sound level measurement settings (i.e., frequency weighting and time weighting/averaging) should always be specified. Classified sound level meters should be used to assure measurement accuracy. Head-mounted microphones placed at the proximity of the mouth improve signal-to-noise ratio and can be taken advantage of for voice SPL measurements when calibrated. Background noise levels should be reported besides the sound levels of voice and speech.

Abstract

The recommendations, while preliminary and in need of further numerical justification, should provide the basis for better accuracy and repeatability of studies on voice and speech production in the future.