The purpose of our study was to investigate the impact of surgical mask on some vocal parameters such as F0, vocal intensity, jitter, shimmer and harmonics-to-noise ratio in order to understand how surgical mask can affect voice and verbal communication in adults. Methods. The study was carried out on a selected group of 60 healthy subjects. All subjects were trained to voice a vocal sample of a sustained /a/, at a conversational voice intensity for the Maximum Phonation Time (MPT), wearing the surgical mask and then without wearing the surgical mask. Voice samples were recorded directly in Praat. Results. There were no statistically significant differences in any acoustic parameter between the masked and unmasked condition. There was a non-significant decrease in vocal intensity in 65% of the subjects while wearing a surgical mask. Conclusions. The statistical comparison carried out between all the acoustic voice parameters observed, extracted wearing and not wearing a surgical mask did not reveal any significant statistical difference. Most of the subjects, after wearing the surgical mask, presented a decrease in vocal intensity measured. Our conclusion was that wearing a mask is likely to induce the unconscious need to increase the vocal effort, resulting over time in a greater risk of developing functional dysphonia. The reduction of intensity can affect also social interaction and speech audibility, especially for individuals with hearing loss.
Objective. Among the different procedures used by the ENT, acoustic analysis of voice has become widely used for correct diagnosis of dysphonia. The instrumental measurements of acoustic parameters were limited during the COVID-19 pandemic by the common belief that a face mask affects the results of the analysis. The purpose of our study was to investigate the impact of surgical masks on F0, jitter, shimmer and harmonics-to-noise ratio (HNR) in adults. Methods. The study was carried out on a selected group of 50 healthy subjects. Voice samples were recorded directly in Praat. All subjects were trained to voice a vocal sample of a sustained /a/, at a conversational voice intensity, with no intensity or frequency variation, for the Maximum Phonation Time (MPT), wearing the surgical mask and then without wearing the surgical mask. Results. None of the variations in acoustic voice analysis detected wearing a surgical mask and not wearing a surgical mask were statistically significant. Conclusions. Our study demonstrates that the acoustic voice analysis procedure can continue to be performed with the use of a surgical mask for the patient, even during the COV-ID-19 pandemic.
Changes in voice and speech are thought to involve 75-90% of people with PD, but the impact of PD progression on voice/speech parameters is not well defined. In this study, we assessed voice/speech symptoms in 48 parkinsonian patients staging <3 on the modified Hoehn and Yahr scale and 37 healthy subjects using the Robertson dysarthria profile (a clinical-perceptual method exploring all components potentially involved in speech difficulties), the Voice handicap index (a validated measure of the impact of voice symptoms on quality of life) and the speech evaluation parameter contained in the Unified Parkinson's Disease Rating Scale part III (UPDRS-III). Accuracy and metric properties of the Robertson dysarthria profile were also measured. On Robertson dysarthria profile, all parkinsonian patients yielded lower scores than healthy control subjects. Differently, the Voice Handicap Index and the speech evaluation parameter contained in the UPDRS-III could detect speech/voice disturbances in 10 and 75% of PD patients, respectively. Validation procedure in Parkinson's disease patients showed that the Robertson dysarthria profile has acceptable reliability, satisfactory internal consistency and scaling assumptions, lack of floor and ceiling effects, and partial correlations with UPDRS-III and Voice Handicap Index. We concluded that speech/voice disturbances are widely identified by the Robertson dysarthria profile in early parkinsonian patients, even when the disturbances do not carry a significant level of disability. Robertson dysarthria profile may be a valuable tool to detect speech/voice disturbances in Parkinson's disease.
The aim of this study was a retrospective analysis of the oncological results in a group of patients treated by frontolateral laryngectomy using clinical and histopathological correlations in order to review the indications for surgery. In all, 150 patients underwent frontolateral laryngectomy as described by Leroux-Robert. All were staged according to the 1992 UICC TNM classification. Factors examined were clinical T, histopathological T, tumor infiltration of the anterior commissure and the vocal cord muscle, survival without disease and the percentage of local relapses. Twenty-one patients had local relapses (14%), while four patients developed second primary tumors (2.7%). Among the different correlations examined, microscopic infiltration of the anterior commissure was related to a greater number of local relapses (25.5% vs 5%) and a 55% survival with with no evidence of disease (NED). The crude 5-year NED survival was 66% and was influenced by second primary tumors and metastases (7.4%) and non-oncological diseases (14.6%). These data show the need for a re-evaluation of the indications for frontolateral laryngectomy because subtotal reconstructive laryngectomy could be performed more safely in the more advanced cases. In contrast, cases with more limited tumors might be better treated by laser for a more functional and cost-beneficial result.
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