Voice Disorders - Science topic

Would this help at least a little bit? http://www.fon.hum.uva.nl/praat/manual/PowerCepstrum__Get_peak_prominence___.html

I take care of many patients with dysphonia of a wide variety of etiologies, paralysis would be one. Electrical stimulation is good for strengthening weak muscles particularly in the sphere of dysphagia where, perhaps post cerebrovascular accident, the swallowing system is deranged and not capable of productive peristalsis and safe swallowing. Unfortunately this technology keeps "morphing" into cures/treatment for an ever growing sphere of disease. I am unfamiliar with the literature on treating muscular tension dysphonia with E-Stim. I would imagine you could fatigue already overused muscles to work properly but its a reach for me since the majority of Speech Pathology colleagues I work with, endeavor to get patients to RELAX the inappropriately contracted muscle groups. Pain is the sine qua non of MTD. Ergo, it is a manifestation of over contracted, inappropriately contracted muscles. The primary cause for this problem such as paralysis or presbylaryngis need treatment to effectively keep the MTD from recurring, as well.

This is not to assume Prof. Koch is advocating this kind of "treatment creep" since he specifically is describing E-Stim for PARESIS, not paralysis. Paresis is a diagnosis that is hard to make to any firm degree. Even electromyography or EMG can be very hard to use to lock this diagnosis in. I have been practicing Laryngology for many years and have only seen a handful of paresis patients whose "weakness" could be attributed to a weak RLN rather than some structural asymmetry or joint pathology.

Paralysis can be helped by nonsurgical means particularly in two veins. One involves the  prevention of developing maladaptive practices that can harm the production of voice. The second is in the use of other tissues to recover some voicing mechanism. In Germany, and perhaps in other parts of the EU, so called dysphonia plica ventricularis or DPV is actually taught as a means of recovering from radical cordectomy post cancer resection to generate, at times, an excellent alternative voice. This is uncommon in the USA.

For the Voice Related Quality of Life (VRQOL) you should read article  by Hogikyan et al in Journal of Voice (2009) which describes the validation of the VRQOL and information is given on scoring. The raw scores are converted to standard scores using an alogorithm (in the article).

I do not have experience with the VOS.

Hope this helps

Patricia

Yes. You can measure nasality and there are signal proxessing techniques. In particular Nasality is an aspect of voice “quality” traditionally assessed by the perceptions of professionals involved in the evaluation and treatment of resonance disorders.  However, despite the importance of an expert’s perception of the absence, or presence and degree, of nasality to the evaluation process, there is also a need for objective measurement.

For this purpose clinical instruments like the Nasometer has provided an easy method for assessing nasality objectively.The nasality measure is derived from the ratio of acoustic energy output from the nasal and oral cavities of the speaker.  Using an innovative input device consisting of a directional microphone mounted on either side of an efficient sound separator plate (with 25 dB separation between channels), the Nasometer headset facilitates accurate signal analysis, which ultimately yields a “nasalance” score.  As the speech signal enters the system, the ratio of the nasal acoustic energy to the oral plus nasal acoustic energy is calculated in terms of percentage (i.e., (N/(N + O)) x 100 = Nasalance) and is displayed graphically on the host computer screen in real time.

You can find more details in the following link. Do not hesitate to contact me for any more details.

I hope this is useful.

Best Eugenia

Hi, a few years ago I'v seen and heard presentation of prof Kukwa Andrzej - ENT from Poland, Warsaw - about cranial nervs action during sleep. it was a symposium for snorring and OSAS. He reported and showed in his study - electrical potentials of several cranial nervs including vagus - X nerv - you can proove electr. potentials of muscles nerved by cranial nervs. There is phisiological vocal fold activity during a sleep - abduction during brath take, and adduction during exhaust. As well as phisiological activity of the nervs V,VII, IX, XII that helps us breath well during sleep.

Patophysiology of this activity can provide to snoring and sleep apneas, besides hole others typical causes. It is very important and amazing to discover and know physiology when you deal with OSAS patients.