Phonation threshold flow measurements in normal and pathological phonation

Zhuang, Pinghui; Sprecher, Alicia J.; Hoffman, Matthew R.; Zhang, Yi; Fourakis, Marios; Jiang, Jack J.; Wei, Chun

doi:10.1002/lary.20165

Cited by 33 publications

(26 citation statements)

References 19 publications

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“…These results support previous findings that PTF is more sensitive to changes in the prephonatory glottal area 12 and suggest that PTP may be more sensitive to the presence of mass lesions.…”

Section: Discussionsupporting

confidence: 91%

“…We measured PTP and PTF with the KayPENTAX phonatory aerodynamic system (KayPENTAX, Montvale, New Jersey). PTF was measured according to the method described by Zhuang et al 12 The subjects produced a sustained /α/ into a cardboard tube. The subject's lips were wrapped tightly around the tube to prevent air leakage, and the tube rested above the tongue, approximately 1 inch into the mouth.…”

Section: Methodsmentioning

confidence: 99%

“…When a polyp or nodule is present, the glottal closure is limited, thus increasing air leakage during phonation and resulting in higher-than-normal airflow measurements. 12 Previous experiments using excised canine larynges have shown PTF to increase with the size of a posterior glottal gap, 13 vocal fold elongation, 14 and surface dehydration. 15 Hottinger et al 13 determined that PTF is more sensitive than PTP to changes in posterior glottal width, demonstrating the potential value of the flow parameter in evaluating disorders that are characterized by glottal insufficiency.…”

Section: Introductionmentioning

confidence: 98%

“…11 Thus, it is possible to estimate glottal airflow by using a device external to the vocal tract. Zhuang et al 12 measured PTF in 41 normal subjects, 21 subjects with vocal fold nodules, and 23 subjects with a vocal fold polyp. The PTF values were significantly different between controls and subjects with a vocal fold polyp.…”

Section: Introductionmentioning

confidence: 99%

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Measurement of Phonation Threshold Power in Normal and Disordered Voice Production

Zhuang

Swinarska²,

Robieux

et al. 2013

Ann Otol Rhinol Laryngol

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Objectives Phonation threshold pressure (PTP) and phonation threshold flow (PTF) are useful aerodynamic parameters, but each is sensitive to different disorders. A single comprehensive aerodynamic parameter sensitive to a variety of disorders might be beneficial in quantitative voice assessment. We performed the first study of phonation threshold power (PTW) in human subjects. Methods PTP and PTF were measured in 100 normal subjects, 19 subjects with vocal fold immobility, and 94 subjects with a benign mass lesion. PTW was calculated from these two parameters. In 41 subjects with a polyp, measurements were obtained before and after excision. Receiver operating characteristic (ROC) analysis was used to determine the ability of the three parameters to distinguish between controls and disordered groups. Results The PTW (p < 0.001), PTP (p < 0.001), and PTF (p < 0.001) were different among the three groups. All parameters decreased after polyp excision. PTW had the highest area under the ROC curve for all analyses. Conclusions PTW is sensitive to the presence of mass lesions and vocal fold mobility disorders. Additionally, changes in PTW can be observed after excision of mass lesions. PTW could be a useful parameter to describe the aerodynamic inputs to voice production.

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Measurement of Phonation Threshold Power in Normal and Disordered Voice Production

Zhuang

Swinarska²,

Robieux

et al. 2013

Ann Otol Rhinol Laryngol

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“…Measurement of phonation threshold pressure (PTP) and phonation threshold flow (PTF) can provide valuable insights into the effort required to initiate vocal fold oscillation 7,8 ; however, they do not provide information on the aerodynamic characteristics of chaotic voice production.…”

Section: Introductionmentioning

confidence: 99%

Phonation Instability Flow in Excised Canine Larynges

et al. 2012

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Objective Disordered voices are often associated with abnormal changes in aerodynamic parameters of subglottal pressure and airflow. Phonation instability pressure (PIP) has been previously proposed to evaluate subglottal pressure at the onset of chaotic phonation. We propose the concept of and measure phonation instability flow (PIF), the airflow at which phonation becomes chaotic. Phonation flow range (PFR), PIF minus phonation threshold flow (PTF), is proposed to assess the range over which normal vocal fold vibration occurs. Study Design Repeated measures with each ex vivo larynx serving as its own control. Methods Pressure and airflow were measured at phonation onset and chaos onset in seven excised canine larynges under three experimental conditions: 0% elongation with no glottal gap; 20% elongation with no glottal gap; 20% elongation with a 3 mm posterior glottal gap. Paired t-tests were performed to determine if experimental measurements differed between elongations (0% and 20%) or degrees of abduction (20% elongation with and without a 3 mm glottal gap). Results Both PIF and PFR were dependent on abduction but not elongation. PIP was not significantly dependent on either condition. PIF and PFR showed greater differences for abduction than either phonation threshold pressure (PTP) or PTF. Conclusions PIF and PFR may be useful parameters in the experimental or clinical settings, particularly when evaluating disorders characterized by a glottal gap such as vocal fold paralysis and presbylaryngis.

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Phonation threshold pressure and flow in excised human larynges

et al. 2011

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Objectives/Hypothesis 1. To determine the phonation threshold pressure (PTP) and phonation threshold flow (PTF) in excised human larynges. 2. To determine the effects of posterior glottal width, glottal area, and gender on PTP and PTF. 3. To test the hypothesis that hysteresis is present in excised human laryngeal phonation. 4. To compare these results to those from canine experiments and human subject measurements. Study Design Induced phonation of excised human larynges in the laboratory. Methods Nine human larynges were harvested within 24 hours post-mortem. PTP and PTF at phonation onset and offset were measured on a bench apparatus. The effects of posterior glottal width, glottal area, and gender were examined. Results Large inter-subject variability was observed in PTP and PTF. PTP was comparable to those measured in vivo, whereas PTF was substantially higher. One-way ANOVA showed no significant dependence of PTP and PTF on posterior glottal width. Hysteresis was observed, with offset PTP and PTF lower than onset values. Offset measurements had significantly less variability than onset measurements (P = 0.012 for PTP, P = 0.0001 for PTF). Conclusions This study is one of the first to report onset and offset PTP and PTF in fresh excised human larynges. The high PTF observed likely reflects a large DC flow component due to vocal fold bowing. Offset PTP and PTF values may be intrinsically more reliably measured than onset values. The large inter-subject variability in PTP and PTF may have implication for the clinical application of these aerodynamic parameters of phonation. Level of Evidence N/A (Laboratory study).

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Phonation threshold flow measurements in normal and pathological phonation

Cited by 33 publications

References 19 publications

Measurement of Phonation Threshold Power in Normal and Disordered Voice Production

Measurement of Phonation Threshold Power in Normal and Disordered Voice Production

Phonation Instability Flow in Excised Canine Larynges

Phonation threshold pressure and flow in excised human larynges

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