Objective evaluation of physiological responses using non-invasive methods has attracted great interest regarding the assessment of vocal performance and disorders. This paper, for the first time, demonstrates that the topographical features of the cervical-cranial intermuscular coherence network generated using surface electromyography (sEMG) have a strong potential for detecting subtle changes in vocal performance. For this purpose, in this paper, 12 sEMG signals were collected from six cervical and cranial muscles bilaterally. Data were collected from four subjects without a history of a voice disorder performing a series of vocal tasks. The vocal tasks were varied phonation (an /a/ sustained for the maximal duration with combinations of two levels of loudness and two levels of pitch), a pitch glide from low to high, singing a familiar song, spontaneous speech, and reading with different loudness levels. The varied phonation tasks showed the median degree, and weighted clustering coefficient of the coherence-based intermuscular network ascends monotonically, with a high effect size (|r rb | = 0.52). The set of tasks, including pitch glide, singing, and speech, was significantly distinguishable using the network features as both degree and weighted clustering coefficient had a very high effect size (|r rb | > 0.83) across these tasks. Also, pitch glide has the highest degree and weighted clustering coefficient among all tasks (degree > 0.6, weighted clustering coefficient > 0.6). Spectrotemporal features performed far less effective than the proposed functional muscle network metrics to differentiate the vocal tasks. The highest effect size for spectrotemporal features was only |r rb | = 0.19. In this paper, for the first time, the power of a cervical-cranial muscle network has been demonstrated as a neurophysiological window to vocal performance. The results also shed light on the tasks with the highest network involvement, which may be potentially used in monitoring vocal disorders and tracking rehabilitation progress.

Objectives/Hypothesis: We sought to identify changes that occur in spirometric values between surgical interventions in patients with recurrent laryngotracheal stenosis and assess the utility of tracking those changes in predicting the need to return to surgery.Methods: This is a retrospective, case-control study of laryngotracheal stenosis. Charts from a 10 year period were reviewed, and 80 patients were identified with recurrent laryngotracheal stenosis and serial spirometry. Recorded forced expiratory volume in 1 second (FEV 1 ), forced inspiratory volume in 1 second (FIV 1 ), peak expiratory flow (PEF), and peak inspiratory flow (PIF), and body mass index (BMI) were tabulated. Calculations were then performed to determine deviations in spirometric measurements from maximums. Comparing the patients who required intervention to those who did not, we used a regression analysis to generate a decision tree based on factors with the strongest predictive power. We then calculated receiver operating characteristic (ROC) curves for all calculated variables.Results: Deviations in PEF, PIF, and FIV 1 from each patient's maximums had strong predictive power in determining return to surgery. PIF was the only fixed measurement found to have a statistically significant role in predicting return to surgery. BMI did not play a role.Conclusion: For each patient, the deviation from their overall spirometric maximums had the statistically strongest predictive power in determining need to return to surgery. This suggests the importance of the trends in spirometric measures for each individual, and implies these trends have greater import than fixed measures alone.

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Patients with both phonotraumatic and non-phonotraumatic dysphonia commonly present with vocal hyperfunction, defined as excessive perilaryngeal muscle activity and characterized by muscular pain and strain in the neck, increased vocal effort, and vocal fatigue. The inability to reliably measure vocal hyperfunction is a barrier to adequate evaluation and treatment of hyperfunctional voice disorders. We have recently demonstrated that the perilaryngeal functional muscle network can be a novel sensitive neurophysiological window to vocal performance in vocally healthy subjects. In this paper, for the first time, we evaluate the performance and symmetry of functional perilaryngeal muscle networks in three patients with voice disorders. Surface electromyography signals were recorded from twelve sensors (six on each side of the neck) using the wireless Trigno sEMG system (Delsys Inc., Natick, MA). Patient 1 was diagnosed with primary muscle tension dysphonia, Patient 2 was diagnosed with unilateral vocal fold paresis, and Patient 3 was diagnosed with age-related glottal insufficiency. This paper reports altered functional connectivity and asymmetric muscle network scan behavior in all three patients when compared with a cohort of eight healthy subjects. Our approach quantifies synergistic network activity to interrogate coordination of perilaryngeal and surrounding muscles during voicing and potential discoordination of the muscle network for dysphonic conditions. Asymmetry in muscle networks is proposed here as a biomarker for monitoring vocal hyperfunction.

Conclusion Measurement of the posterior airway space (PAS) using modified barium swallow (MBS) appears to correlate well with CT imaging. This data suggests MBS may be a low-cost alternative imaging modality to assess obstructive sleep apnea patients. Objectives Obstructive sleep apnea research has focused on imaging modalities that supplement polysomnography in evaluation of potential sites of airway obstruction. While several techniques have been used to assess the PAS, many incur significant costs and risks to the patient. This study proposes use of MBS as a simple modality to measure PAS. Advantages include its simplicity, lower radiation, and dynamic tongue base visualization, which may help predict surgical outcomes. It is hypothesized that cephalometric measurements obtained using MBS will correlate well with CT. Methods Thirty-six adult patients who underwent both CT imaging and MBS for head and neck cancer were included. Cephalometric measurements of the PAS were obtained using each imaging modality. Statistical analysis focused on correlating measurements taken using CT and MBS. Results The average PAS measurements were 12.53 ± 1.81 mm and 12.80 ± 1.75 mm by MBS and CT imaging, respectively. In comparing the two modalities, Pearson correlation between CT and MBS measurements revealed significant positive correlations between r = 0.769 and 0.937.