11/64. Use of speech recognition software: a vocal endurance test for the new millennium?speech recognition software for the personal or office computer is a relatively new area of technology. As the number of these products has increased so has use of this software. Some individuals will employ speech recognition systems due to difficulty with the conventional keyboard and mouse interface: others will use it for perceived efficiency or simply novelty. Regardless of the reason for use of this technology, the voice demands associated with extended or frequent use can be high, placing the user at risk for vocal difficulties. This paper reviews the case of an individual referred to our multidisciplinary voice care program for evaluation and treatment of vocal difficulties that began secondary to utilization of speech recognition software. We discuss medical and vocal histories, examination findings, treatment, and treatment outcomes.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
12/64. Deviant vocal fold vibration as observed during videokymography: the effect on voice quality.Videokymographic images of deviant or irregular vocal fold vibration, including diplophonia, the transition from falsetto to modal voice, irregular vibration onset and offset, and phonation following partial laryngectomy were compared with the synchronously recorded acoustic speech signals. A clear relation was shown between videokymographic image sequences and acoustic speech signals, and the effect of irregular or incomplete vocal fold vibration patterns was recognized in the amount of perceived breathiness and roughness and by the harmonics-to-noise ratio in the speech signal. Mechanisms causing roughness are the presence of mucus, phase differences between the left and right vocal fold, and short-term frequency and amplitude modulation. It can be concluded that the use of simultaneously recorded videokymographic image sequences and speech signals contributes to the understanding of the effect of irregular vocal fold vibration on voice quality.- - - - - - - - - - ranking = 0.66666666666667keywords = speech (Clic here for more details about this article) |
13/64. Response of asthma-related voice dysfunction to allergen immunotherapy: a case report of confirmation by methacholine challenge.Professional singers and other serious voice users are particularly susceptible to alterations in their vocal apparatus. As the support for vocalization, lung function is an essential element of the production of speech and song. patients have been described who presented with voice complaints along with minimal or no abnormalities on spirometry, but responded to conventional bronchodilator and other asthma therapy. It was proposed that this represented an exercise-induced asthmalike condition, brought on by the hyperventilation associated with performing. The objective of this study was to establish whether improvement in vocalization while performing correlated with a decrease in non-specific bronchial reactivity. We concluded that resolution of vocal complaints in conjunction with a decrease in methacholine reactivity supports the hypothesis that these patients do have an exercise-induced asthmalike condition brought on by airway drying. As with other patients with asthma, it appears to respond to allergy-directed therapy.- - - - - - - - - - ranking = 0.16666666666667keywords = speech (Clic here for more details about this article) |
14/64. Gross unilateral abnormalities of the velum and pharynx.OBJECTIVE: Velopharyngeal incompetence because of gross unilateral velopharyngeal hypoplasia is rare, particularly in patients with no significant hemifacial microsomia or facial asymmetry. We describe the abnormal anatomy and treatment of three patients with gross congenital velopharyngeal asymmetry. RESULTS AND CONCLUSIONS: Following surgery, all three patients showed a good improvement in velopharyngeal function and speech. Nasendoscopy and lateral videofluoroscopy were important in confirming the abnormal anatomy and pathology and in evaluating the degree of movement of the affected side of the velum and pharyngeal walls as well as the size and location of the defect. muscles from the normal side were radically dissected and mobilized across the midline to reconstruct the hypoplastic hemivelum. Mucosal lengthening was achieved by suturing the normal mucosa to the mucosa of the hypoplastic hemivelum and the lateral pharyngeal wall or by insetting a posterolateral pharyngeal flap (modified Moore pharyngoplasty) into the nasal surface of the hypoplastic side.- - - - - - - - - - ranking = 0.16666666666667keywords = speech (Clic here for more details about this article) |
15/64. Multidimensional voice program analysis (MDVP) and the diagnosis of pediatric vocal cord dysfunction.BACKGROUND: vocal cord dysfunction (VCD) can present with signs and symptoms that mimic asthma. This may lead to unnecessary pharmacologic treatment or more invasive measures including intubation. Presently, the diagnosis of VCD can only be confirmed when a patient is symptomatic, via pulmonary function testing (PFT) or visualization of adduction of the vocal cords during inspiration by direct laryngoscopy. OBJECTIVE: Multidimensional Voice Program (MDVP) analysis. a computer program which analyzes various aspects of voice, can detect abnormal voice patterns of patients with upper airway pathology. We determined whether MDVP analysis was useful in the diagnosis of VCD. methods: We conducted chart reviews of patients referred to our department from 1995 to 1998 with the presumed diagnosis of VCD who had undergone MDVP analysis. The diagnosis of VCD was based on the presenting history, PFT results, laryngoscopy results, as well as voice evaluation conducted by a speech-language pathologist. We analyzed six consecutive patients referred for this investigation. We delineated common trends in the variables measured on MDVP analysis in VCD patients. and compared these with controls and other vocal cord pathology. RESULTS: Five cases of possible VCD had abnormalities in the MDVP variable of soft phonation index (SPI). All five also had abnormalities in the variation in fundamental frequency (vFo). In one case, MDVP analysis was conducted pre- and posttreatment for VCD, and SPI and vFo both normalized. In a sixth case of possible VCD. the diagnosis was not confirmed as the patient had normal PFTs and laryngoscopy. MDVP analysis was normal in this individual. The pattern of abnormal SPI and vFo was not seen in a group of normal controls or in patients with vocal cord nodules. CONCLUSIONS: MDVP analysis may be a useful tool when diagnosingVCD, as well as in evaluating response to treatment.- - - - - - - - - - ranking = 0.16666666666667keywords = speech (Clic here for more details about this article) |
16/64. Phonological agraphia after superior temporal gyrus infarction.BACKGROUND: Phonological agraphia refers to a condition in which the ability to write nonwords to dictation is impaired, while writing words to dictation is preserved, as is oral repetition of the words and nonwords. This condition has been regarded as reflecting a disconnection within the phonological writing system, and previous neurolinguistic correlations suggested that the anterior-inferior supramarginal gyrus was a crucial link within the system. SETTING: A neurology department of a university hospital. PATIENT: A 51-year-old right-handed man presented with speech disturbances. On initial evaluation of his language, his deficit was consistent with that of conduction aphasia, which improved rapidly to an apparently normal level. A subsequent detailed examination of oral and written repetition of words and nonwords revealed a rather selective form of phonological agraphia. A magnetic resonance imaging scan of his brain showed a focal ischemic lesion at the left posterior superior temporal gyrus and at the underlying white matter. CONCLUSIONS: In contrast to most previously described patients, this patient showed a selective impairment of phonological agraphia in association with a focal infarction restricted to the left posterior superior temporal gyrus, suggesting that this region of the brain is an important node within a wider network of areas that subserve the phonological route for writing.- - - - - - - - - - ranking = 0.16666666666667keywords = speech (Clic here for more details about this article) |
17/64. Inspiratory pressure threshold training in a case of congenital bilateral abductor vocal fold paralysis.We present a non-surgical treatment option to decrease symptoms of dyspnea in a 6 year-old child with congenital bilateral abductor vocal fold paralysis. A respiratory muscle strength-training program was used to strengthen her inspiratory muscles for 8 months, 3 to 5 days per week. Inspiratory muscle strength increased over the course of training, resulting in reported decreases in dyspnea by both the child and parents during speech and exercise.- - - - - - - - - - ranking = 0.16666666666667keywords = speech (Clic here for more details about this article) |
18/64. Spasmodic dysphonia combined with insufficient glottic closure by phonation.The authors describe the case history of a patient who suffered from symptoms deriving from two different origins. The patient's voice was spasmodic dysphonia-like interrupted and pressed. At the same time, his voice was powerless, too. The reason for this was that besides the spasmodic dysphonia caused by hyperkinesis, an incomplete closure of the vocal cords during phonation in the middle third was present. It was caused by the atrophy of the vocal cords. In order to eliminate the symptoms, initially we injected 25 IU Botox into the left vocal cord transcutaneously under the direction of EMG control. It resulted in a fluent, though breathy voice. In order to manage the closing insufficiency during phonation, we performed lipoaugmentation on the left vocal cord under high-frequency jet anaesthesia. The result of the two-step procedure was a fluent and clear voice. The speech without interruption lasted for 5 months, until the drug was eliminated. Of course, to prolong the result, the Botox injection should be repeated.- - - - - - - - - - ranking = 0.16666666666667keywords = speech (Clic here for more details about this article) |
19/64. Posterior cricoarytenoid myoplasty with medialization thyroplasty in the management of refractory abductor spasmodic dysphonia.Of the approximately 100,000 Americans with primary (idiopathic) laryngeal dystonia, 10% to 15% are thought to havethe abductor form. Botulinum A toxin injected into the posterior cricoarytenoid muscle and/or cricothyroid muscle has been employed as the "gold standard" for therapeutic management; however, successful results are significantly less frequent than with injections for the adductor form. This report describes a new phonosurgical procedure, posterior cricoarytenoid myoplasty with medialization thyroplasty, designed for these refractory patients. Posterior cricoarytenoid myoplasty with medialization thyroplasty has been performed on 3 patients with abductor laryngeal dystonia. All patients had failed at least 5 previous botulinum A injections to the posterior cricoarytenoid and cricothyroid muscles. All patients underwent preoperative and 3 postoperative (2 weeks, 3 months, and 1 year) phonatory analyses. Analysis consisted of recording an aloud reading of a standard passage while a blinded trained speech pathologist counted prolonged voiceless consonants. The patients also completed a satisfaction survey at 1 year. The results demonstrated significant, long-lasting, uniform reduction in breathy breaks in all subjects. The participants all judged their symptoms as greatly improved. Bilateral procedures may be necessary, but should be staged to prevent possible airway compromise. When applied appropriately, posterior cricoarytenoid myoplasty with medialization thyroplasty is a viable tool in the management of refractory abductor laryngeal dystonia.- - - - - - - - - - ranking = 0.16666666666667keywords = speech (Clic here for more details about this article) |
20/64. Autogenous fat injection for vocal fold atrophy.Autogenous fat augmentation for glottic insufficiency has been used previously in patient treatment regimes. However, relatively little information is currently available regarding the effectiveness of fat injection for patients with vocal fold atrophy who have complete glottal closure (VFACGC). This paper compares, in retrospect, the efficiency of fat injection after surgery in patients with VFACGC (n=21). The perceptual acoustic and phonatory functions and videolaryngostroboscopic data were evaluated before and after fat augmentation was performed on 13 patients. Mean follow-up time was 9.5 months. Fifteen patients displayed excellent results, four experienced post-procedure failure, and two were unavailable for follow-up analysis. The majority of VFACGC patients (71%) also suffered from muscular tension dysphonia (MTD) preoperatively. The procedure also resolved the MTD in half (54%) of the patients in this study. Perceptual rating showed significant improvement in grade, roughness and breathiness (P<0.05). The videolaryngostroboscopic rating showed significant improvements in vocal fold edge linearity (P<0.01), vocal fold vibration amplitude and mucosal wave excursion (P<0.05). VFACGC is commonly misdiagnosed as MTD and is, therefore, unresponsive to speech therapy that is targeted to the latter. Fat injection is an effective autogenous implant and should be considered as an option in the treatment of patients with VFACGC. Although fat re-absorption was identified as a problem, repeating the procedure could be considered to minimize the effect of such.- - - - - - - - - - ranking = 0.16666666666667keywords = speech (Clic here for more details about this article) |
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