Evaluation of the neo-glottal closure based on the source description in esophageal voice

The characteristics of esophageal voice render its study by traditional acoustic means to be limited and complicate. These limitations are even stronger when working with patients lacking minimal skills to control the required technique. Nevertheless the speech therapist needs to know the performance and mechanics developed by the patient in producing esophageal voice, as the specific techniques required in this case are not as universal and well-known as the ones for normal voicing. Each patient develops different strategies for producing esophageal voice due to the anatomical changes affecting the crico-pharyngeal sphincter (CPS) and the functional losses resulting from surgery. Therefore it is of fundamental relevance that practitioners could count on new instruments to evaluate esophageal voice quality, which on its turn could help in the enhancement of the CPS dynamics. The present work carries out a description of the voice of four patients after undergoing laryngectomy on data obtained from the study of the neo-glottal wave profile. Results obtained after analyzing the open-close phases and the tension of the muscular body on the CPS are shown

Valoración del cierre neo-glótico en voz esofágica.

Las características de la voz esofágica hacen que su estudio a través de un análisis acústico tradicional sea complicado y limitado. Estas limitaciones son mayores cuando se trabaja con pacientes que no tienen un gran dominio de la técnica. Sin embargo, el rehabilitador necesita obtener información sobre la mecánica desarrollada por el paciente para la producción de la voz esofágica. Ya que el mecanismo de producción en voz esofágica a diferencia de la voz laríngea no es universal ni tan transparente. Cada paciente, debido a los cambios anatómicos que afectan al esfínter cricofaríngeo (ECF) y a las pérdidas funcionales derivadas de la cirugía, desarrolla diferentes estrategias para producir voz. Por todo ello, es fundamental que los clínicos puedan contar con nuevos instrumentos para valorar la calidad de la voz esofágica, que a su vez le aproximen al conocimiento de la dinámica del ECF. El presente trabajo realiza una descripción de la voz de cuatro pacientes laringectomizados basada en el estudio del perfil de la onda neo-glótica. Se muestran los resultados obtenidos tras analizar las fases de abierto-cerrado y la tensión del cuerpo muscular a nivel del ECF

Cambios en la clasificación de la voz femenina después del tratamiento de la patología vocal

En general en los estudios de patología es importante tener en cuenta factores relacionados con el género. En voz esto se hace más decisivo al existir claras diferencias acústicas y biomecánicas que vienen marcadas por el género. Algunas de estas diferencias son observables en el estudio acústico, pero la relación voz -genero se hace más notable al analizar la fuente glótica. La fuente glótica puede ser obtenida mediante métodos de filtrado inverso en los cuales se elimina toda influencia del tracto vocal en la señal de voz resultante. Un posterior análisis del perfil del espectro de densidad de energía y del perfil de la onda glótica nos permite establecer una serie de puntos singulares que son cruciales para la discriminación del género. Igualmente se pueden extraer de la fuente glótica una serie de parámetros acústicos y biomecánicos que permiten clasificar la voz en función del grado patología. Para el siguiente trabajo se muestra los resultados obtenidos en la clasificación de patología para una voz de mujer, en condición pre y post tratamiento, al compararlo con un grupo de voces no-patológicas de su mismo género

Valoración de los cambios en la fuente glótica: estudio de un caso pre / post- tratamiento en pliegues vocales

Actualmente existe un interés creciente por el estudio de la voz. Cada vez son más lo recursos destinados a este campo de investigación en busca nuevos métodos que faciliten su estudio, evaluación y diagnóstico. Es sabido que la onda mucosa es fundamental en el proceso de producción de la voz, determinando la calidad de la misma. De tal forma que cuando existe una patología la cantidad de onda mucosa y el modelo dinámico de los pliegues vocales se ve alterado. El presente trabajo usa un método de filtrado inverso para obtener la fuente glótica, de la cual posteriormente se extraerá el correlato de la onda mucosa. A través del estudio de un caso clínico, correspondiente a un pólipo unilateral, se usa este método para valorar las alteraciones que la patología ha causado en la dinámica de los pliegues vocales y en la onda mucosa

BioMet®Tools: from modeling and simulation to product design and development

BioMet®Tools is a set of software applications developed for the biometrical characterization of voice in different fields as voice quality evaluation in laryngology, speech therapy and rehabilitation, education of the singing voice, forensic voice analysis in court, emotional detection in voice, secure access to facilities and services, etc. Initially it was conceived as plain research code to estimate the glottal source from voice and obtain the biomechanical parameters of the vocal folds from the spectral density of the estimate. This code grew to what is now the Glottex®Engine package (G®E). Further demands from users in medical and forensic fields instantiated the development of different Graphic User Interfaces (GUI’s) to encapsulate user interaction with the G®E. This required the personalized design of different GUI’s handling the same G®E. In this way development costs and time could be saved. The development model is described in detail leading to commercial production and distribution. Study cases from its application to the field of laryngology and speech therapy are given and discussed

BioMet®Phon: A system to monitor phonation quality in the clinics

BioMet®Phon is a software application developed for the characterization of voice in voice quality evaluation. Initially it was conceived as plain research code to estimate the glottal source from voice and obtain the biomechanical parameters of the vocal folds from the spectral density of the estimate. This code grew to what is now the Glottex®Engine package (G®E). Further demands from users in laryngology and speech therapy fields instantiated the development of a specific Graphic User Interface (GUI’s) to encapsulate user interaction with the G®E. This gave place to BioMet®Phon, an application which extracts the glottal source from voice and offers a complete parameterization of this signal, including distortion, cepstral, spectral, biomechanical, time domain, contact and tremor parameters. The semantic capabilities of biomechanical parameters are discussed. Study cases from its application to the field of laryngology and speech therapy are given and discussed. Validation results in voice pathology detection are also presented. Applications to laryngology, speech therapy, and monitoring neurological deterioration in the elder are proposed

Wavelet description of the Glottal Gap

The Glottal Source correlates reconstructed from the phonated parts of voice may render interesting information with applicability in different fields. One of them is defective closure (gap) detection. Through the paper the background to explain the physical foundations of defective gap are reviewed. A possible method to estimate defective gap is also presented based on a Wavelet Description of the Glottal Source. The method is validated using results from the analysis of a gender-balanced speakers database. Normative values for the different parameters estimated are given. A set of study cases with deficient glottal closure is presented and discussed

Multidisciplinary management of head and neck cancer: First expert consensus using Delphi methodology from the Spanish Society for Head and Neck Cancer (part 2)

Head and neck cancer is one of the most frequent malignances worldwide. Despite the site-specific multimodality therapy, up to half of the patients will develop recurrence. Treatment selection based on a multidisciplinary tumor board represents the cornerstone of head and neck cancer, as it is essential for achieving the best results, not only in terms of outcome, but also in terms of organ-function preservation and quality of life. Evidence-based international and national clinical practice guidelines for head and neck cancer not always provide answers in terms of decision-making that specialists have to deal with in their daily practice. This is the first Expert Consensus on the Multidisciplinary Approach for Head and Neck Squamous Cell Carcinoma (HNSCC) elaborated by the Spanish Society for Head and Neck Cancer and based on a Delphi methodology. It offers a number of specific recommendations based on the available evidence and the expertise of our specialists to facilitate decision-making of all health-care specialists involved.Also, special thanks to Ainhoa Torres and the Merck Health Foundation for funding and promoting the project and development of the Article.Peer Reviewe