Comparison of laryngoscopic, glottal and vibratory parameters among Estill qualities – Case study

Estill Voice Training (EVT) is an effective educational system for developing and controlling distinct voice qualities used in contemporary commercial singing. EVT teaches six vocal qualities that differ at 13 levels. This study aims to investigate whether the distinct vocal qualities taught by EVT can be systematically differentiated based on laryngoscopic observations and vocal fold oscillation parameters. To investigate the differences in six EVT qualities, laryngeal dimensions and glottal area waveform parameters were measured in a single female subject who performed it in one-octave scale. Glottis Analysis Tools (GAT) were used to measure these parameters and phonovibrograms were obtained from the analysis. The resulting data were subjected to factor analysis to identify the systematic differences between EVT qualities. High-speed videolaryngoscopy analysis revealed a significant influence of vocal qualities on vocal fold oscillations. The factor analysis of the data identified three factors based on laryngeal dimension and four factors derived from GAT parameters. The first GAT factor was influenced by posterior adduction and distinguished belt quality from other qualities, suggesting a significant influence of the aryepiglottic sphincter. The second GAT factor contained parameters derived from glottal length and amplitude, suggesting a relationship not only with vocal registers but also with laryngeal height. The third GAT factor was best related to body-cover figure and phonation type (membranous medialization), while the fourth GAT factor was related to the amplitude-length-ratio. These findings suggest that vocal fold oscillations can be used to distinguish between Estill voice qualities

A Pilot Study Assessing the Therapeutic Potential of a Vibratory Positive Expiratory Pressure Device (Acapella Choice) in the Treatment of Voice Disorders

Introduction Semioccluded vocal tract exercises (SOVTEs) can involve a single source of vibration (eg, vocal folds in the straw exercise) or a dual source of vibration (eg, vocal folds and water bubbling in tube phonation) in the vocal tract. Oftentimes, this secondary source of vibration causes large oscillations in intraoral pressure and has been likened to a "massage effect." This study assesses the implementation of a positive expiratory pressure device (Acapella Choice) as a possible alternative SOVTE, which presents a secondary source of vibration without the need of a water container. Methods Twenty-two normophonic participants underwent acoustic, electroglottographic, and aerodynamic assessment before, during, and after phonation with two different established SOTVEs (silicone tube in water and straw in air) in addition to Acapella Choice. Results Acapella Choice produced the largest peak-to-peak amplitudes of intraoral pressure oscillation. Straw in air produced the largest static intraoral pressure. Straw in air and Acapella Choice presented significantly larger ranges of static pressures than tube in water phonation. Post-exercise condition showed a statistically larger sound pressure level for Acapella Choice. Conclusions Positive expiratory pressure devices, such as Acapella Choice, may be a promising alternative to established SOVTEs as it promotes large oscillatory pressures in the vocal tract without the need for a water container. This exercise also produces larger sound pressure level with no significant changes in glottic contact quotient, indicating improved vocal economy

Seeing Voices: A Dynamic, Interprofessional Approach to Teaching Performing Arts and Speech-Language Pathology Students About Vocal Anatomy and Physiology

Objectives: Seeing Voices was an interprofessional, technology-enabled, large-scale, teaching and learning event developed to address the need to improve voice students’ knowledge of laryngeal anatomy and physiology toward understanding and maintaining vocal health. Seeing Voices trialed a novel interprofessional educational approach, collected both quantitative and qualitative data about student experiences of laryngostroboscopic examination, and built a databank of laryngeal recordings for future student learning. Methods: Seeing Voices involved two 3-hour seminars in a large, university lecture space, run by an interprofessional team (speech-language pathologists, vocal coach, Ear Nose and Throat consultant) with quality equipment projecting laryngeal images to large screens with expert commentary in real time. Participants were 18 students who volunteered for laryngeal examination (9 per seminar) and student attendees (n = 175) from performing arts courses (classical singing, contemporary, jazz, musical theater, acting) and a speech-language pathology course. A quantitative evaluation of knowledge gained was undertaken using a Qualtrics survey. Results from pre (n = 175; performing arts = 120; speech-language pathology (SLP) = 55) and postevent (n = 99; performing arts = 56; SLP = 43) questionnaires were received from the students who attended. Interviews were collected from 15 of the 18 student volunteers about their experiences of nasendoscopic evaluation and data were analyzed using qualitative description and qualitative content analysis. Results: Quantitative results demonstrated a strong trend toward increased knowledge following attendance at the event across year cohorts for both student groups. Qualitative interviews highlighted the value in seeing multiple examples of normal laryngeal functioning across different vocal techniques in real time. For those undertaking nasendoscopic examination, simultaneously seeing and feeling laryngeal maneuvers used in training appeared to promote understanding of their own vocal mechanism and the purpose of different vocal techniques. Conclusions: Seeing Voices offers a novel way to improve interprofessional collaboration, and engagement with, and understanding of, laryngeal anatomy and vocal health by students in performing arts and speech-language pathology courses

The Flow and Pressure Relationships in Different Tubes Commonly Used for Semi-occluded Vocal Tract Exercises

This experimental study investigated the back pressure (pback) versus flow (U) relationship for 10 different tubes commonly used for semi-occluded vocal tract exercises (SOVTE), i.e., 8 straws of different lengths and diameters, a resonance tube and a silicone tube similar to a Lax Vox tube. All tubes were assessed with the free end in air. The resonance tube and silicone tube were further assessed with the free end under water at the depths from 1 to 7 cm in steps of 1 cm. The results showed that relative changes in the diameter of straws affect pback considerably more compared to the same amount of relative change in length. Additionally, once tubes are submerged into water, pback needs to overcome the pressure generated by the water depth before flow can start. Under this condition, only a small increase in pback was observed as the flow was increased. Therefore, the wider tubes submerged into water produced an almost constant pback determined by the water depth, while the thinner straws in air produced relatively large changes to pback as flow was changed. These differences may be taken advantage of when customizing exercises for different users and diagnoses and optimizing the therapy outcome

Adiamento da gravidez: relação com fatores socioeconômicos e culturais / Postponing pregnancy: relationship with Socioeconomic and cultural factores

Introdução: A maternidade tardia é quando a concepção ocorre após os 35 anos de idade, sendo uma gestação de alto risco. As tecnologias artificiais estão cada vez mais presentes, o que permite gestações em mulheres fora da idade reprodutiva biológica usual. É necessário que haja uma conscientização das mulheres a respeito das complicações da gravidez tardia e que sejam acompanhadas e orientadas sobre os cuidados para que os índices de morbimortalidade materna possam diminuir. Objetivo: Verificar como os fatores socioeconômicos e culturais interferem na vida reprodutiva das mulheres. Métodos: Estudo observacional tipo transversal, na clínica Climar e no Departamento de Saúde da Mulher, da Gestante, da Criança e do Adolescente em Juiz de Fora - MG. Foram entrevistadas 195 pacientes ginecológicas. Foi aplicado um questionário contendo questões referentes a dados socioeconômicos, culturais e idade na primeira gestação.  Resultados: Das entrevistadas 56,9% eram da rede privada e 43,1% da pública. Na renda salarial foi observado que, 46,7% das mulheres da rede privada recebiam de 5-20 salários mínimos enquanto nenhuma das usuárias da rede pública recebiam esse valor. Já sobre os motivos que levaram ao adiamento da gravidez, 72,6% queriam uma carreira acadêmica e/ou conquistar o sucesso profissional antes da maternidade, sendo dessas 55% tinham idade maior ou igual a 35 anos. Conclusão: Há expressiva relação dos fatores socioeconômicos, culturais e educacionais com o adiamento da maternidade. Quanto maior o nível de escolaridade e renda salarial, maior a chance de ocorrer o adiamento da gestação, sendo necessário, a conscientização dos riscos dessa escolha e a importância de um pré-natal orientado e de cuidados contínuos

Traumatismo orofacial e a qualidade de vida relacionada à saúde bucal: uma revisão sistemática

A região orofacial é uma das regiões corporais que mais são acometidas com danos traumáticos, em especial na dentição e nos tecidos moles adjacentes. A análise dos diferentes aspectos da saúde bucal relatadas pelo paciente faz parte da pesquisa sobre qualidade de vida relacionada à saúde bucal (QVRSB), que ajuda a melhorar a prestação de tratamento odontológico. Esta revisão sistemática objetiva analisar os impactos do trauma orofacial sobre a qualidade de vida relacionada à saúde bucal (QVRSB). Foi realizada busca nos bancos de dados PubMed, ScienceDirect, Scopus, Google Scholar e Scielo e com base na ferramenta PRISMA e na aplicação dos critérios de inclusão e exclusão foram selecionados 5 artigos para análise e discussão. Infere-se que a QVRSB dos pacientes é impactada pelas lesões traumáticas orofaciais, tendo relação diretamente proporcional, maior impacto imediatamente após o diagnóstico e de acordo com a gravidade do trauma. A maioria dos estudos limita-se a crianças e adolescentes, contudo, o traumatismo orofacial ocorre em qualquer idade. O questionário “condensed oral health impact profile – 14 (OHIP-14)” e suas adaptações são ferramentas importantes para os estudos sobre a QVRSB. Por fim, os estudos que relacionam a QVRSB e o trauma orofacial são importantes para retirar ensinamentos para a prática clínica dos atendimentos odontológicos

The application of kinesiology tape as a tactile feedback for management of lower larynx position: a pilot study

Kinesiology tape (KT) therapy has successfully been incorporated into speech pathology clinical practice for treatment of myofunctional orofacial disorders. The elastic property of the tape allowed for support without hindering movement range. Subjects with hyperfunctional voice disorders often present with a high held larynx position. Therefore, the aim of this study is to assess the possibility of using an adapted application of KT as a tool for the management of the vertical larynx position (VLP)

Building Design and Classroom Acoustics

Teachers and students suffer from the impact of noisy classrooms. This is due to poor sound isolation, traffic and noise generated by electronic data processors, HVAC (Heating, Ventilation and Air Conditioning) interference and reverberation levels. For teachers, this resulted in increased vocal loading and fatigue, frequently leading to vocal issues. Furthermore, poor acoustic conditions influence children language acquisition process, sometimes leading to impaired concentration, behavioural disorders, and attention deficit. The problem is more enhanced in children with hearing impairment (temporary or permanent) or with other disabilities. Lack of information and normative data on the aspects of building design and classroom acoustics have prompted this review, which comprises of sources originated from Canada, France and Belgium

Observational study of differences in head position for high notes in famous classical and non-classical male singers

<p><i>Introduction.</i> Differences in classical and non-classical singing are due primarily to aesthetic style requirements. The head position can affect the sound quality. This study aimed at comparing the head position for famous classical and non-classical male singers performing high notes.</p> <p><i>Method.</i> Images of 39 Western classical and 34 non-classical male singers during live performances were obtained from YouTube. Ten raters evaluated the frontal rotational head position (depression versus elevation) and transverse head position (retraction versus protraction) visually using a visual analogue scale.</p> <p><i>Results.</i> The results showed a significant difference for frontal rotational head position.</p> <p><i>Discussion and conclusion.</i> Most non-classical singers in the sample elevated their heads for high notes while the classical singers were observed to keep it around the neutral position. This difference may be attributed to different singing techniques and phonatory system adjustments utilized by each group.</p