Functional evaluation of laryngoscopic examination and its relation to voice quality and voice range profile parameters
Authors:
M. Frič
; B. Mlynářová; M. Kučera
Authors‘ workplace:
Výzkumné centrum hudební akustiky (MARC), Hudební a taneční fakulta AMU v Praze
Published in:
Otorinolaryngol Foniatr, 72, 2023, No. 1, pp. 23-32.
Category:
Original Article
doi:
https://doi.org/10.48095/ccorl202323
Overview
Introduction: Previous laryngoscopy evaluation protocols have mostly focused on assessment of glottal status and morphological description of vocal folds’ shape and oscillations. The basic functional manifestations of laryngeal use, according to new protocols, include a description of supraglottic laryngeal activity. Methods: Laryngoscopic evaluation was performed as a perceptual test, performed online, using a web-based application. The degree and type of glottal insufficiency and the degree of anterior, posterior compression and lateral-medial (L-M) compression separately for each side were evaluated by a total of 15 respondents in a total of 26 video recordings of laryngoscopic examinations. In addition, the correlations between listening evaluations of the voice using modified GRBAS scales and voice range profile parameters were investigated. Results: The ratings of the laryngoscopic scales had well to excellent agreement. Agreement for type of insufficiency was just moderate. The associated ratings of L-M compression on the right and left sides showed correlations. For listening evaluation, medial compression was found to be related to the perception of habitual voice strain, and to strain and instability in the pitch range of the change of registers of the singing voice. Degree of insufficiency predicted less fullness of habitual voice in general but was also related to vocal dyspnea and weakness when calling. At the same time, it was largely responsible for the deterioration of the quality of the singing voice. Medial compression systematically reduced pitch range and the area of the voice range profile. Conclusion: The results of the perceptual evaluation can be used in further education. On their basis, didactic material for training the assessment of supraglottic laryngeal activity was prepared and published in the form of an online tutorial. The degree of insufficiency generally affects various characteristics of the speaking and singing voice. Medial compression systematically affects only the strain of the speaking voice, while in the singing voice it accentuates the strain and instability of the transitional region between registers and impairs the production of high pitches.
Keywords:
laryngoscopy – visual evaluation – voice range profile – GRBAS
Sources
1. Patel RR, Awan SN, Barkmeier-Kraemer J et al. Recommended protocols for instrumental assessment of voice: American speech-language-hearing association expert panel to develop a protocol for instrumental assessment of vocal function. Am J Speech-Language Pathol 2018; 27 (3): 887–905. Doi: 10.1044/2018_AJSLP-17-0009.
2. Kučera M a kol. Vokologie I. Funkční diagnostika a léčba hlasových poruch. Praha: Akademie múzických umění v Praze 2019.
3. Stager S. The Role of the Supraglottic Area in Voice Production. Otolaryngology 2011; S1 (001): 1–7. Doi: 10.4172/2161-119X.S1-001.
4. Sama A, Carding PN, Price S et al. The Clinical Features of Functional Dysphonia. Laryngoscope 2001; 111 (March): 458–463. Doi: 10.1097/ 00005537-200103000-000155.
5. Stager SV, Bielamowicz SA, Regnell JR et al. Supraglottic Activity: Evidence of Vocal Hyperfunction or Laryngeal Articzlation? J Speech Lang Hear Res 2000; 43 (1): 229–238. Doi: 10.1044/ jslhr.4301.229.
6. Yanagisawa E, Estill J, Kmucha ST et al. The Contribution of Aryepiglottic Constriction to “Ringing” Voice Quality A Videolaryngoscopic Study with Acoustic Analysis. J Voice 1989; 3 (4): 342–350. Doi: 10.1016/S0892-1997 (89) 80057-8.
7. Mayerhoff RM, Guzman M, Jackson-Menaldi C et al. Analysis of supraglottic activity during vocalization in healthy singers. Laryngoscope 2014; 124 (2): 504–509. Doi: 10.1002/lary.24310.
8. Ziade G, Haddad G, Assaad S et al. Changes in abnormal muscle tension pattern after fiberoptic injection laryngoplasty. Ear Nose Throat J 2017; 96 (12): 472–476. Doi: 10.1177/01455 6131709601209.
9. Morrison MD, Rammage LA. Muscle Misuse Voice Disorders: Description and Classification. Acta Otolaryngol 1993; 113 (3): 428–434. Doi: 10.3109/00016489309135839.
10. Stager SV, Bielamowicz S, Gupta A et al. Quantification of Static and Dynamic Supraglottic Activity. J Speech, Lang Hear Res 2001; 44 (6): 1245–1256. Doi: 10.1044/1092-4388 (2001/097).
11. Novakovic D, Nguyen DD, Chacon A et al. Injection laryngoplasty as adjunct treatment method for muscle tension dysphonia: Preliminary findings. Laryngoscope 2020; 130 (4): 980–985. Doi: 10.1002/lary.28205.
12. Fernández S, Garaycochea O, Martinez-Arellano A et al. Does More Compression Mean More Pressure? A New Classification for Muscle Tension Dysphonia. J Speech Lang Hear Res 2020; 63 (7): 2177–2184. Doi: 10.1044/2020_jslhr-20-00 042.
13. Kulhánek T, Frič M. Psychoakustické a psychofyzikální testy pro hodnocení hlasu. In: MEDSOFT 2021. 2021; 33 (1): 53–56. Doi: 10.35 191/medsoft_2021_1_33_53 _56.
14. Machalová N. Vlastnosti hlasu při gradaci volání. Univerzita Palackého v Olomouci; Diplomová práce 2018.
15. Šimonová J. Projevy funkčních poruch hlasu při zpěvu stupnic v rámci vyšetření hlasového pole. Univerzita Palackého v Olomouci; Diplomová práce 2018.
16. Frič M, Kučera M, Šimonová J, Machalová N. Porovnání hlasových polí zdravé a patologické skupiny žen a základy funkčního vyšetření vlastností hlasu – předběžná studie. In: Vitásková K. Výzkum poruch a odchylek komunikační schopnosti a orofaciálního systému z logopedického hlediska. Olomouc: Univerzita Palackého v Olomouci 2017: 63–85.
17. Alipour F, Karnell M. Aerodynamic and acoustic effects of ventricular gap. J Voice 2014; 28 (2): 154–160. Doi: 10.1016/j.jvoice.2013.10.005.
18. Frič M, Krasňanová V. Vztah mezi parametry hlasového pole a percepčním hodnocením poruchy hlasu u mužů. Otorinolaryngol Foniatr 2014; 63 (1): 16–28.
19. D‘Haeseleer E, Claeys S, Meerschman I et al. Vocal Characteristics and Laryngoscopic Findings in Future Musical Theater Performers. J Voice 2017; 31 (4): 462–469. Doi: 10.1016/j.jvoice.2016. 11.018.
20. Behrman A, Dahl LD, Abramson AL et al. Anterior-posterior and medial compression of the supraglottis: signs of nonorganic dysphonia or normal postures? J Voice 2003; 17 (3): 403–410. Doi: 10.1067/s0892-1997 (03) 00018-3.
21. Bielamowicz S, Kapoor R, Schwartz J et al. Relationship among glottal area, static supraglottic compression, and laryngeal function studies in unilateral vocal fold paresis and paralysis. J Voice 2004; 18 (1): 138–145. Doi: 10.1016/ j.jvoice.2003.11.005.
22. Inwald EC, Döllinger M, Schuster M et al. Multiparametric analysis of vocal fold vibrations in healthy and disordered voices in high--speed imaging. J Voice 2011; 25 (5): 576–590. Doi: 10.1016/j.jvoice.2010.04.004.
23. Madill CJ, Sheard C, Heard R. Are Instructions to Manipulate Specific Parameters of Laryngeal Function Associated with Auditory-Perceptual Ratings of Voice Quality in Nondisordered Speakers? J Voice 2017; 31 (4): 504.e521–504.e533. Doi: 10.1016/j.jvoice.2016.10.008.
24. Online nácvikové hodnotící testy. 2022 [online]. Dostupné z: https: //www.hamu.cz/cs/ veda-a-vyzkum/vedecka-pracoviste/marc/hlas-vokologie/vzdelavaci-akce/#nacvikove_testy
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Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
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