Journal of voice : official journal of the Voice Foundation
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One of the critical requirements for high-speed videoendoscopy (HSV) to become a clinically useful tool is to pair it with a technique, which provides a quick overview of the vast amount of HSV data and rapidly identifies the best video segments for subjective and objective analyses. This article proposes intensity-based representations that are easily computed from the HSV data and can be used to identify the HSV features quickly. The first representation-termed the Quick Vibratory Profile (QVP)-is an HSV-based one-dimensional waveform that captures the vocal fold vibration as well as nonglottic activities. ⋯ Moreover, this article proposes a pair of spatial profiles to locate the vibrating vocal folds within the HSV frames. These profiles are useful in automation of objective assessments as their use together with the QVP are demonstrated in a proposed cyclewise three-dimensional glottal area segmentation. The article illustrates the usefulness of these proposed representations with examples.
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Changes in vocal function that can occur after thyroidectomy were tracked with acoustic analyses of sustained vowel productions. The purpose was to determine which time-based or spectral/cepstral-based measures of two vowels were able to detect voice changes over time in patients undergoing thyroidectomy. ⋯ This study indicated that shimmer, HNR, and CPP determined from vowel productions can be used to track changes in voice over time as patients undergo and subsequently recover from thyroid surgery, with CPP being the strongest variable for this purpose. Evidence did not clearly reveal whether acoustic voice evaluations should include both /ɑ/ and /i/ vowels, but they should specify which vowel is used to allow for comparisons across studies and multiple clinical assessments.
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Comparative Study
Readability of patient-reported outcome questionnaires for use with persons with dysphonia.
The purpose of this study was to examine the readability of several published patient-reported outcome (PRO) questionnaires for persons with dysphonia, and to compare the readability results with existing data about average reading levels for English-speaking adults living in the United States. ⋯ In the demand for standardization of voice-related quality of life assessment tools, developers should consider readability as another testable construct because poor readability may affect validity, reliability and sensitivity. The voice clinician should consider the average reading level needed to understand a particular PRO questionnaire when administering it to a patient or their proxy. Developers of PRO questionnaires should consider reading level of respondents and include information about this when reporting psychometric data.
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To discuss four techniques used to overcome the problem of difficult exposure during operative microlaryngoscopy (microdirect laryngoscopy [MDL]). The protocol uses four techniques in escalating fashion. These techniques are: high-frequency jet ventilation (high-frequency positive pressure ventilation [HFPPV]), using a narrow-bore diagnostic laryngoscope (Holinger) with suspension, using the 30° and 70° telescopes with angled instruments, and using a flexible laryngoscope through a laryngeal mask anesthesia (LMA) device. ⋯ Difficult exposure during MDL is unusual but not rare. It is often unanticipated. A proposal for graded use of the four techniques preserves some advantages of MDL. With each escalation, there is a degradation of the advantages afforded by traditional MDL. These include minor increase in movement with HFPPV, loss of binocular visualization with diagnostic laryngoscopes, loss of bimanual instrument manipulation with the telescopes, and loss of stability with flexible laryngoscopy. Having an understanding of each technique and the need for escalation will allow the surgeon to perform rescue laryngoscopy and complete the surgery.
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Comparative Study Clinical Trial
Differences between flexible and rigid endoscopy in assessing the posterior glottic chink.
To determine whether different modalities of laryngeal examination produce differences in the assessment of the posterior glottic chink (PGC), and whether the prevalence of PGC differs by gender. ⋯ From this pilot study, we determined that there is a difference in male and female PGC prevalence and size. PGC is more common in females than males. Prevalence (or the detection rate) is about the same with RL and FL in females, but higher with RL than FL in males. The average score of the glottic opening, when present, was statistically significantly different between RL and FL in females but not in males. Furthermore, females had a larger PGCS on both modalities when compared with males, although this difference was only found to be statistically significant on RL; and complete glottic closure was more common in older than in younger subjects.