Measurement of Phonation Threshold Power in Normal and Disordered Voice Production

Zhuang, Pinghui; Swinarska, Joanna T.; Robieux, Camille; Hoffman, Matthew R.; Lin, Sheng-zhi; Jiang, Jack J.

doi:10.1177/000348941312200904

Cited by 23 publications

(12 citation statements)

References 24 publications

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“…Alternative aerodynamic parameters more suited for atrophy patients could be the phonation threshold pressure (PTP) and phonation threshold flow (PTF) reflecting the minimum pressure and flow required to sustain phonation. These parameters may better mirror the ease of phonation [ 28 ] [personal communication S. Thibeault and D. Phyland]. Frame-by-frame analysis (FBFA) of laryngovideostroboscopy in which subject’s average percentage of closed frames per glottic cycle is recorded may be another option [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral trial vocal fold injection with hyaluronic acid in patients with vocal fold atrophy with or without sulcus

Broek

Heijnen

Hendriksma

et al. 2019

Eur Arch Otorhinolaryngol

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Purpose To evaluate the outcome of bilateral trial vocal fold injection (VFI) with hyaluronic acid in patients with vocal fold atrophy ± sulcus and to assess the predictive value of trial VFI on the outcome of durable medialization procedure. Methods Voice data collected according to a standardized protocol before and one month after trial VFI of 68 patients with vocal fold atrophy (30) and atrophy with sulcus (38) were analyzed. Voice Handicap Index (VHI)-30 was compared to the outcome of a durable medialization at 3 and 12 months. Results The overall VHI-30 improvement was 16.8 points (from 49.9 to 33.1), which was statistically significant and clinically relevant. 57.8% of the patients experienced enough subjective benefit after trial VFI to undergo durable medialization. Of the patients that experienced subjective benefit 62% had a clinically relevant improvement in VHI-30. There was no relevant change in other parameters and no difference between ± sulcus. After durable medialization 90–94% of the patients had VHI-30 scores similar to or better than post-trial VFI. Conclusion The majority of patients experience subjective improvement after bilateral trial VFI indicating that medialization is a valid treatment option for patients with vocal fold atrophy ± sulcus. The VHI-30 only partially overlaps with patients’ subjective evaluation and does not predict which patients will experience subjective improvement. It is, however, predictive for VHI-30 outcome after durable medialization. The aerodynamic and acoustic parameters showed no relevant change. Further identification of voice assessment parameters accurately reflecting the subjective experience of these patients is warranted.

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Section: Discussionmentioning

confidence: 99%

Bilateral trial vocal fold injection with hyaluronic acid in patients with vocal fold atrophy with or without sulcus

Broek

Heijnen

Hendriksma

et al. 2019

Eur Arch Otorhinolaryngol

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“…Jiang and Tao then proposed another aerodynamic parameter, PTF, which is defined as the minimum airflow necessary to initiate vocal fold vibration [22]. PTP is a better descriptor of vocal fold viscoelasticity, whereas PTF is a better descriptor of vocal fold width [23]. Thus, PTP and PTF are irreplaceable landmarks in the aerodynamic assessment of laryngeal function [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Effects of a simulated system of straw phonation on the complete phonatory range of excised canine larynges

Kang

Scholp

Tangney

et al. 2019

Eur Arch Otorhinolaryngol

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Purpose-This study investigated the effects of straw phonation therapy on the aerodynamic and acoustic parameters of the vocal folds at different levels of elongation and subglottal pressure. Methods-20 excised canine larynges were used in both experimental (straw phonation therapy simulation) and control conditions. Aerodynamic parameters, including phonation threshold pressure (PTP), phonation instability pressure (PIP), phonation pressure range (PPR), phonation threshold flow (PTF), phonation instability flow (PIF), phonation flow range (PFR), were obtained at different level of vocal fold elongation (0%, 10%, 20%). Acoustic parameters, including fundamental frequency (F0), jitter, shimmer, signal noise ratio (SNR) were detected at different levels of vocal fold elongation (0%, 10%, 20%) and subglottal pressure (15 cmH 2 O, 20 cmH 2 O, 25 cmH 2 O). Results-Significant decreases in PTP and PTF and significant increases in PIP, PIF, PPR, PFR were occurred in experimental condition at all levels of elongation when compared with control condition. However, no significant changes of acoustic parameters were obtained between conditions at all levels. Conclusion-At different levels of vocal fold elongation, straw phonation not only lowered the onset of normal voice, but also elevated the onset of chaotic voice, indicating a better voice economy and voice control. Moreover, the improved phonatory range demonstrated straw phonation had the potential to prevent voice users who have high voice demand from voice fatigue and vocal damage.

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“…Because of the changes in vocal fold stiffness and mass, it can be speculated that oscillation patterns would change, not only with regard to the ƒ o range, but also under different loudness conditions. In this context, it has been shown that the phonation threshold pressure increased in patients with vocal fold mass lesions and decreased after phonomicrosurgery [ 19 , 20 ]. However, greater loudness could itself have an effect on vocal fold oscillation patterns.…”

Section: Introductionmentioning

confidence: 99%

Vocal fold oscillation pattern changes related to loudness in patients with vocal fold mass lesions

Echternach¹,

Döllinger

Köberlein

et al. 2020

Journal of Otolaryngology - Head & Neck Surgery

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Introduction Vocal fold mass lesions can affect vocal fold oscillation patterns and therefore voice production. It has been previously observed that perturbation values from audio signals were lower with increased loudness. However, how much the oscillation patterns change with gradual alteration of loudness is not yet fully understood. Material and methods Eight patients with vocal fold mass lesions were asked to perform a glide from minimum to maximum loudness on the vowel /i/, ƒo of 125 Hz for male or 250 Hz for female voices. During phonation the subjects were simultaneously recorded with transnasal high speed videoendoscopy (HSV, 20,000 fps), electroglottography (EGG), and an audio recording. Based on the HSV material the Glottal Area Waveform (GAW) was segmented and GAW parameters were computed. Results The greatest vocal fold irregularities were observed at different values between minimum and maximum sound pressure level. There was a relevant discrepancy between the HSV and EGG derived open quotients. Furthermore, the EGG derived sample entropy and GAW values also evidenced different behavior. Conclusions The amount of vocal fold irregularity changes with varying loudness. Therefore, any evaluation of the voice should be performed under different loudness conditions. The discrepancy between EGG and GAW values appears to be much stronger in patients with vocal fold mass lesions than those with normal physiological conditions. Level of evidence 4.

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Measurement of Phonation Threshold Power in Normal and Disordered Voice Production

Cited by 23 publications

References 24 publications

Bilateral trial vocal fold injection with hyaluronic acid in patients with vocal fold atrophy with or without sulcus

Bilateral trial vocal fold injection with hyaluronic acid in patients with vocal fold atrophy with or without sulcus

Effects of a simulated system of straw phonation on the complete phonatory range of excised canine larynges

Vocal fold oscillation pattern changes related to loudness in patients with vocal fold mass lesions

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