Vocal quality characteristics in children with cleft palate: a multiparameter approach.
ABSTRACT The main purpose of the present study was to examine the vocal quality and to investigate the effects of gender on vocal quality in 28 children with a unilateral or bilateral cleft palate. In this study, the vocal quality was determined using videolaryngostroboscopic and perceptual evaluations, aerodynamic, voice range, acoustic, and dysphonia severity index (DSI) measurements. The DSI is based on the weighted combination of four voice measurements and ranges from +5 to -5 for, respectively, normal and severely dysphonic voices. Additional objectives were to compare the vocal quality characteristics of children with cleft palate with the available normative data and to investigate the impact of the cleft type on vocal quality. Gender-related vocal quality differences were found. The male cleft palate children showed an overall vocal quality of +0.62 with the presence of a perceptual slight grade of hoarseness and roughness. The female vocal quality had a DSI value of +2.4 reflecting a perceptually normal voice. Irrespective of the type of cleft, all subjects demonstrated a significantly lower DSI-value in comparison with the available normative data. The results of the present study have provided valuable insights into the vocal quality characteristics of cleft palate children.
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ABSTRACT: The voice is arguable still the most important tool of communication despite the growing importance of e-mails and text messaging (SMS) in daily contact. Indeed in modern society people are probably even more dependent on their voice than in the rural societies of old. Approximately one third of the working population nowadays need their voice to earn money1. And it goes without saying that most people need their voice for daily social activities. Any impairment of the voice therefore will have large impact both on daily work and social activities for many people. Diagnosis and treatment of voice disorders is by that of great importance. The voice has a variety of characteristics and so have any of its disorders. The complaints of the patient are the starting point in any diagnosis. These complaints usually consist of ‘my voice is hoarse’. They may also concern the consequences of professional activities, like a teacher whose voice does not reach the back of the classroom, especially in a noisy one. The sound of the voice may have changed and, finally, we have to pay attention to the cause of the problems, the aetiology of the voice disorder. All these aspects need to be assessed in a description of any voice disorder. The complaints of the patient may be collected with a self-evaluation form by the patient him/herself. The character of the sound of the voice (voice quality) can be assessed subjectively with the listening ear of the diagnostician and objectively by instruments. The aetiology is determined by the thorough history taking and physical examination. The form and function of the larynx is examined with, for example, (video)laryngostroboscopy. The outcome of these examinations together leads to a diagnosis, which is the basis for decisions about any modality of treatment including intervention like surgical procedures, voice therapy, medication or any combination of these. The results of these interventions need to be evaluated.
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ABSTRACT: Objectives. To clarify the difference between Lyapunov exponents (LEs) for cleft palate (CP) patients with hypernasality versus without hypernasality and to investigate the relationship between their LEs and nasalance scores (NSs). Material and Methods. Six CP patients with severe hypernasality (mean age 9.2 years) and six CP patients without hypernasality (mean age 8.0 years) were enrolled. Five Japanese vowels were recorded at 44.1 KHz, and the NSs were measured simultaneously. The mean first LE (mLE(1)) from all one-second intervals was computed. Results. The mLE(1) for /o/ in patients with hypernasality was significantly higher than that in patients without hypernasality. The correlation coefficients between the mLE(1) and NS for all vowels were not statistically different. Conclusion. The voice signal of /o/ for the patients with hypernasality was more instable than in those without hypernasality. The chaotic phenomenon was independent of nasal resonance in CP voice.International Journal of Otolaryngology 01/2012; 2012:739523. DOI:10.1155/2012/739523