CoQ10 and vitamin A supplementation support voice rehabilitation. A double-blind, randomized, controlled, three-period cross-over pilot study

Objectives: To evaluate the effectiveness of an adjuvant therapy (CoQ10 in its watersoluble form and vitamin A) in supporting voice rehabilitation in a large group of patients with muscle tension dysphonia (MTD). Study Design: Twelve-week, double-blind, randomized, controlled, three-period crossover pilot study. The primary endpoint was the change in the Dysphonia Severity Index (DSI) over the 12-week study period. Secondary endpoints were the changes in the subcomponents of DSI, including MPT, F0-high, I-low, and jitter. Exploratory endpoints were the changes in the Shimmer and in Voice Handicap Index (VHI). Methods: Patients were randomly assigned in a 1:1 ratio to two counter-balanced arms. Group A (ADJ-PLA) patients were administered QTer 300 mg and Vit A acetate 500.000 Ul/g 1 mg twice daily for a 4-week intervention period, followed by a 4-week period of wash-out, and then were submitted to a last 4-week period of placebo. Patients in Group B (PLB-ADJ) were given the treatment period in reverse order. Both groups received a 45-min voice therapy in a group format once a day for 4 weeks during the first and the second active periods. The therapy was held during the wash-out period. Results: The analysis of main time effect indicated a trend toward recovery of vocal function regardless of group assignment. A significant time by group effect was found on DSI [F = 3.4 (2.5, 80.5), p = 0.03], F0-high [F = 4.5 (2.6, 82.9), p = 0.008] and Shimmer [F = 3.6 (1.5, 46.9), p = 0.048], under CoQ10 and Vit A treatment, with a small effect size. There was no significant time by group effect on the other study measures, namely MPT, I-low, VHI. Conclusions: A trend toward recovery of vocal function was observed in all the patients, likely due to voice rehabilitation. The improvement of DSI was greater under CoQ10 and Vitamin treatment, indicating a more pronounced improvement of vocal quality under adjuvant therapy. The study protocol was reviewed and approved by the Ethics Committee of Policlinico Umberto I Hospital, Rome, Italy Rif. 3069/13.02.2014

It Sounds like It Feels: Preliminary Exploration of an Aeroacoustic Diagnostic Protocol for Singers

To date, no established protocol exists for measuring functional voice changes in singers with subclinical singing-voice complaints. Hence, these may go undiagnosed until they progress into greater severity. This exploratory study sought to (1) determine which scale items in the self-perceptual Evaluation of Ability to Sing Easily (EASE) are associated with instrumental voice measures, and (2) construct as proof-of-concept an instrumental index related to singers’ perceptions of their vocal function and health status. Eighteen classical singers were acoustically recorded in a controlled environment singing an /a/ vowel using soft phonation. Aerodynamic data were collected during a softly sung /papapapapapapa/ task with the KayPENTAX Phonatory Aerodynamic System. Using multi and univariate linear regression techniques, CPPS, vibrato jitter, vibrato shimmer, and an efficiency ratio (SPL/PSub) were included in a significant model (p < 0.001) explaining 62.4% of variance in participants’ composite scores of three scale items related to vocal fatigue. The instrumental index showed a significant association (p = 0.001) with the EASE vocal fatigue subscale overall. Findings illustrate that an aeroacoustic instrumental index may be useful for monitoring functional changes in the singing voice as part of a multidimensional diagnostic approach to preventative and rehabilitative voice healthcare for professional singing-voice users

The vocal behavior of telemarketing operators before and after a working day

PURPOSE: To evaluate the vocal behavior of receptive telemarketing operators in pre- and post-work shift moments, and to relate the results to the variable gender. METHODS: Participants were 55 telemarketing operators (11 men and 44 women) working in a receptive mode in the city of Maceió (Alagoas, Brazil). A questionnaire was applied before the work shift to initially identify the vocal complaints. After that, vocal samples were recorded, comprising sustained emissions and connected speech produced 10 minutes before and 10 minutes after the workday to be later evaluated. Auditory-perceptual and acoustic analyses of voice were conducted. RESULTS: Vocal complaints and symptoms reported by the operators after the work shift were: dry throat (64%); neck and cervix pain (33%); hoarseness (31%); voice failure (26%); and vocal fatigue (22%).Telemarketing operators presented reduced maximum phonation time before and after the day of work (p=0.645). Data from the auditory-perceptual assessment of voice were similar in pre- and post-shift moments (p=0.645). No difference was found between moments also on acoustic analysis data (p=0.738). CONCLUSION: Telemarketing operators have high indexes of vocal symptoms after the work shift, and there are no differences between pre- and post-work shift in auditory-perceptual and acoustic assessments of voice.OBJETIVO: Avaliar o comportamento vocal de teleoperadores receptivos em momento pré e pós-jornada de trabalho e relacionar os resultados à variável gênero. MÉTODOS: Participaram 55 teleoperadores de uma empresa de teleatendimento na cidade de Maceió (AL), sendo 11 homens e 44 mulheres, com atuação no modo receptivo. Inicialmente, foi aplicado um questionário antes da jornada de trabalho para identificação das queixas vocais. Em seguida foi feita gravação de amostras vocais compostas por emissões sustentadas e fala encadeada 10 minutos antes e 10 minutos após a jornada de trabalho para serem posteriormente avaliadas. Foram realizadas avaliações perceptivo-auditiva e acústica da voz. RESULTADOS: Os sintomas e queixas vocais referidos pelos teleoperadores após a jornada de trabalho foram: garganta seca (64%); dores na região de nuca e pescoço (33%); rouquidão (31%); falhas na voz (26%) e cansaço vocal (22%). Os teleoperadores apresentaram tempos máximos fonatórios reduzidos antes e após a jornada de trabalho (p=0,645). Os dados da avaliação perceptivo-auditiva da voz foram semelhantes nos momentos pré e pós-jornada (p=0,645). Também não houve diferença nos dados de análise acústica no início e ao final da jornada de trabalho (p=0,738). CONCLUSÃO: Os teleoperadores apresentam elevado índice de sintomas vocais após a jornada de trabalho, e não há diferenças entre a pré e pós-jornada de trabalho nas avaliações perceptivo-auditiva e acústica da voz.Universidade Estadual de Ciências da Saúde de AlagoasUniversidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo, EPM, São Paulo, BrazilSciEL

Perception of voice use and problems in female singers and broadcasters an impairment, activity limitation and participation restriction perspective

Also available in print."A dissertation submitted in partial fulfilment of the requirements for the Bachelor of Science (Speech and Hearing Sciences), The University of Hong Kong, May 4, 2001."Thesis (B.Sc)--University of Hong Kong, 2001published_or_final_versionSpeech and Hearing SciencesBachelorBachelor of Science in Speech and Hearing Science

Risk Factors for Hyperfunctional Voice Disorders Among Teachers

The aim of the study was to assess the prevalence of voice problems among teachers, and identify risk factors for developing voice pathology. In this study we evaluated 448 teachers (400 females and 48 males) between the age range of 25 to 55 years, from primary school as well as secondary school which were selected randomly. A questionnaire was given to them to find out how many of them had a voice problem. All the positive cases were further evaluated by an Otorhinolaryngologist, an Audiologist and a Speech Language Pathologist. Out of the 448 teachers, 39 of them(9%) had an indication of voice disorder based on the positive respose got from the questionnaire. Among the 39 cases identified 11 were males (28%) and 28 were females (71%). We tried to investigate on the factors that would have contributed to voice problem in the identified 9% of cases .Detailed history was taken and was examined by an otorhinolaryngologist, an audiologist and a Speech Language Pathologist.Out of the 39 cases identified 26% had history of recurrent allergic rhinitis and laryngitis, 18% had sinusitis and post nasal drip, 18% had asthma, 26% had gastoesophageal reflux disorder, (8%) had minimal sensori neural hearing loss and hypothyroidism was found in 8%. Interaction of multiple factors like hereditory, behavioral, lifestyle, medical and environmental can contribute to voice disorders in occupational voice users. Teachers need to be educated regarding vocal mechanism, vocal hygiene and effective voice use , dust free and noise free work environment, diet modification like drinking adequate water, avoiding spicy and deep fried food, regularizing meals and avoiding sleeping immediately after food. The underlying medical issues like allergy, sinusitis, laryngitis, hypothyroidism, gastroesophageal reflux, hearing loss etc also need to be addressed , since vocal hygiene alone will not help until and unless the underlying cause is taken care of

"Prologues To A Bad Voice": Effect Of Vocal Hygiene Knowledge And Training On Voice Quality Following Stage Performance

The purpose of this investigation was to determine the effects of intensive stage rehearsal and performance on perceptual, acoustic, and aerodynamic measures of voice, and to determine the impact of knowledge and practice of vocal hygiene on measures of voice during intensive vocal performance. Nineteen stage actors who were participating in the Arkansas Shakespeare Theatre festival took part in the study. Each participant completed auditory-perceptual, acoustic, aerodynamic, and quality of life measures before and after 1 month of intensive rehearsals and stage performances. They also completed a questionnaire documenting their vocal use, vocal hygiene, and previous vocal training, if any. Subjects demonstrated statistically significant deterioration in auditory-perceptual measures and mean expiratory airflow. Other acoustic measures trended toward poorer outcomes after the performances; however, these were not statistically significant. Knowledge of vocal hygiene and vocal training did not have an impact on the change in vocal measures. Conclusions: Stage performances do impact vocal outcomes with reduction in quality and efficient use of airflow for voice production. Knowledge and practice of vocal hygiene have some impact on these changes; however, vocal hygiene may not be the best preventive strategy of potential phonotrauma in this subject population

Effect of a Chinese herbal tonic, 'watermelon frost', in preventing vocal fatigue

Also available in print."A dissertation submitted in partial fulfilment of the requirements for the Bachelor of Science (Speech and Hearing Sciences), The University of Hong Kong, June 30, 2006."Thesis (B.Sc)--University of Hong Kong, 2006.published_or_final_versionSpeech and Hearing SciencesBachelorBachelor of Science in Speech and Hearing Science

Relationship Between Laryngeal Signs and Symptoms, Acoustic Measures, and Quality of Life in Finnish Primary and Kindergarten School Teachers

Objective This study investigated the relationship between the acoustic measure smoothed cepstral peak prominence (CPPS), teacher's quality of life as measured by the voice activity and participation profile (VAPP), laryngeal signs and symptoms, voice related health problems and laryngoscopic findings in Finnish teachers. The relationship between CPPS and sound pressure level (SPL) was also assessed. Methods Vowel and text samples from 183 healthy Finnish teachers (99 kindergarten teachers [KT] and 84 primary school teachers [PST]) were analyzed for CPPS. Text reading was recorded in conversational loudness by PST, and KT were recorded wearing headphones, while listening to a masking noise of children talking to simulate their classroom voice and environment. CPPS values were correlated with the VAPP, self-reported laryngeal signs and symptoms, voice related health variables, and laryngoscopic findings. Results There was a significant difference between the two groups for CPPS text, PST showed significantly lower CPPS values (10.44) than KT (11.52). There was no difference between the two groups for CPPS vowel phonation. There was a significant correlation between SPL text and CPPS text for KT (P < 0.001, r = 0.43) but not for PST (P < 0.10, r = 0.16). There was a significant correlation between SPL vowel and CPPS vowel for both PST (P < 0.001, r = 0.47) and KT (P < 0.001, r = 0.45). CPPS did not correlate with the VAPP, laryngeal signs and symptoms, health variables or laryngeal findings. Factorial analysis of variance resulted in a significant relationship between the VAPP, laryngeal signs and symptoms, and teacher type. Teacher type and symptoms had a significant effect on VAPP scores. Conclusions In the present work CPPS does not correlate with vocal health indicators of functionally healthy teachers. CPPS was significantly influenced by differences in speaking voice SPL, emphasizing the impact of recording conditions and technique. There was a significant relationship between laryngeal signs and symptoms, teacher type and the VAPP. Laryngeal signs and symptoms and teacher type are important variables and should be included in the clinical evaluation of occupational voice users, and voice problems

Respiratory And Laryngeal Function In Teachers Pre- And Posta 1-Hour Vocal Loading Challenge

Teachers use their voice as a key part of their profession, often speaking at an increased loudness for multiple hours a day. This places teachers at a high risk for voice disorders, which costs the United States billions of dollars annually. Vocal fatigue, or worsening of the voice as the day progresses, is a common complaint from teachers. The present study investigated respiratory and laryngeal function in teachers pre and post a 1-hour vocal loading challenge. Six teachers and three student teachers (total of 9 subjects) produced four speech tasks and completed two perceptual ratings pre and post a 1-hour reading aloud vocal loading challenge in 70 dB multi-talker babble. Dependent variables included vocal tiredness and vocal effort ratings, cepstral peak prominence (CPP), low/high spectral ratio (L/H ratio), sound pressure level (SPL), utterance length (# of syllables), percent vital capacity expended per syllable (%VC/syllable), and lung volume initiation (%LVI-EEL), termination (%LVT-EEL), and excursion (%LVE). Following the vocal loading challenge, utterance length and SPL significantly increased, and %VC/syllable significantly decreased. %LVI-EEL increased post-vocal loading challenge, but it did not reach statistical significance. No laryngeal differences were found. These results suggest that subjects altered the respiratory system for three possible scenarios: to overcome perceived increase in difficulties for speech, to plan for longer utterances, or to overcome hyperventilation caused by the 1-hour vocal loading challenge

Effect of Flow Phonation Voice Exercises on Vocal and Aerodynamic Measures in Undergraduate Student Singers

This study examined the effects of Flow Phonation Voice Exercises on vocal measures in undergraduate student singers. Whereas these exercises have provided positive outcomes in individuals with vocal hyperfunction, the use of these exercises in potentially enhancing the singing voice has not been explored. A total of 10 participants were randomly assigned into an experimental group (n = 6), that received 5 sessions of the Flow Phonation Voice Exercises across 5 weeks, and a control group (n = 4) which did not receive the treatment. Changes in auditory-perceptual, acoustic, subjective respiratory, quality-of-life and fatigue related measures compared across two groups. Results indicate statistically significant differences in Singing Voice Handicap Index and perceptual singing voice quality and a positive trend toward improvement in Vocal Fatigue Index in the experimental group alone. The results suggest positive outcomes of the use of these exercises. Small sample size and COVID-19 related methodological constraints should be considered while interpreting these results