Journal of Voice最新文献

{"title":"Wendler's Glottoplasty in Italian Transgender Women: A Retrospective Cohort Study on Efficacy and Safety.","authors":"Alfonso Scarpa, Pietro De Luca, Pasquale Viola, Giovanni Salzano, Giuseppe Chiarella, Claudia Cassandro, Filippo Ricciardiello, Emilio Avallone, Francesco Antonio Salzano","doi":"10.1016/j.jvoice.2025.02.022","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.02.022","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the outcomes of Wendler's glottoplasty in an all-Italian cohort of transgender women, focusing on its efficacy, safety, and impact on patient satisfaction.</p><p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>The study was conducted on 10 Italian transgender women aged 25-40 years who underwent Wendler's glottoplasty at the University of Salerno from January 2020 to December 2022. Comprehensive preoperative and postoperative assessments included acoustic analysis, laryngostroboscopy, and validated questionnaires such as the Italian versions of the Transsexual Voice Questionnaire for Male-to-Female Transsexuals (I-TVQMtF) and the Voice Handicap Index (I-VHI). Statistical analysis used paired t-tests and effect size calculations to measure changes across key parameters.</p><p><strong>Results: </strong>The mean fundamental frequency (F0) increased significantly from 151.4 Hz (±10.8 Hz) preoperatively to 231.6 Hz (±13.5 Hz) postoperatively (P < 0.001), achieving a range typical of cisgender women. I-TVQMtF scores improved markedly from 71.6 (±9.2) to 24.9 (±5.1), while I-VHI scores decreased significantly from 59.2 (±8.9) to 19.8 (±5.4) (P < 0.001). Perceptual femininity ratings (PA-VAS) also improved, with scores decreasing from 4.4 (±0.3) to 1.9 (±0.4) (P < 0.001). Laryngostroboscopy confirmed 90% glottic closure and 80% symmetrical vocal fold vibration. Minor complications, such as transient dysphonia (10%), resolved with conservative management.</p><p><strong>Conclusions: </strong>Wendler's glottoplasty is a safe and effective procedure for vocal feminization in Italian transgender women, demonstrating substantial improvements in acoustic, perceptual, and self-reported outcomes. These findings highlight the value of integrating surgical and multidisciplinary care to enhance patient satisfaction and quality of life.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conceptual Metaphors About Voice in the Teacher-Student Interaction System During Western Classical Singing Lessons.","authors":"Jaime Crisosto-Alarcón, Paulina Maldonado-Delgado, Maximiliano Rivas-Campos","doi":"10.1016/j.jvoice.2025.02.021","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.02.021","url":null,"abstract":"<p><strong>Objectives: </strong>This study explores the use of conceptual metaphors (CM) by teachers during Western classical singing lessons to facilitate communication and improve students' understanding of vocal technique. It examines the role of metaphors in enhancing the interaction between teachers and students within a cognitive linguistics framework.</p><p><strong>Study design: </strong>Cross-sectional, interpretative study. 10 individual Western Classical singing lessons conducted by five different teachers were recorded, transcribed, and analyzed to identify metaphorical expressions related to vocal instruction. The analysis followed a four-level model to classify and interpret these expressions based on source and target domains, applying metaphor validation through teacher review groups.</p><p><strong>Results: </strong>Four primary CMs emerged: SINGING IS WALKING, THE VOICE IS LIGHT, THE VOICE IS A FLUID, and THE VOICE IS A MOVING THING. These metaphors reveal how teachers convey complex vocal concepts through relatable imagery, aiding students' proprioceptive and emotional connection to vocal production.</p><p><strong>Conclusions: </strong>CMs serve as an essential pedagogical tool in Western classical singing education, bridging the abstract aspects of vocal technique and practical performance. The findings underscore the importance of metaphorical language in facilitating an embodied understanding of singing, suggesting the need for adaptive metaphor use tailored to students' sensory experiences. Further research should investigate the universality of these metaphors across diverse teaching settings and vocal styles.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vocal Fatigue and Recovery Patterns Among Call Center Operators: A Workday Progression Study.","authors":"Aishwarya Nallamuthu, Sahana Rajaram, Prakash Boominathan","doi":"10.1016/j.jvoice.2025.02.023","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.02.023","url":null,"abstract":"<p><strong>Objective: </strong>Call centers in India, rely heavily on call center operators' (CCO) vocal abilities, putting them on a high vocal demand and the related risk of voice-related problems. This study investigated vocal changes among CCOs during a workday.</p><p><strong>Method: </strong>Fifty CCOs from various sectors participated undergoing evaluation, including acoustical, perceptual, aerodynamic, and self-perceptual measures. Measurements were taken at three points during a workday and the following day pre shift.</p><p><strong>Results: </strong>Common symptoms included throat dryness and voice breaks. Both male and female CCOs exhibited increased F₀ and reduced maximum phonation duration over the day. Perceptually, most voices deteriorated from normal to hoarse/strained, indicating the effects of vocal loading. Vocal fatigue was evident, with recovery observed after rest.</p><p><strong>Conclusion: </strong>This study documented subtle vocal changes due to vocal loading in CCOs in a naturalistic working environment, emphasizing the risks involved, need for early identification of voice problems, and facilitating healthy voice practices in CCOs.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resonance Strategies in the Upper Range of Western Operatic Tenors.","authors":"Gustavo do Amaral Ambros, Marta Assumpção de Andrada E Silva","doi":"10.1016/j.jvoice.2025.02.025","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.02.025","url":null,"abstract":"<p><strong>Background: </strong>High notes pose a challenge for classical tenors due to physiological and acoustic aspects. According to nonlinear source-filter interactions, it is beneficial in these notes to position the resonances just above the frequency of their closest harmonics, amplifying them while avoiding phonatory discontinuities. Intentional tuning of resonances to harmonics in the high tenor tessitura has been described in the literature.</p><p><strong>Objectives: </strong>Identify the resonance strategies employed by operatic tenors in high notes.</p><p><strong>Method: </strong>Five professional tenors were recorded emitting the vowels /a, e, i, o, u/, sung in ascending scales between the notes C3 (131 Hz) and C5 (523 Hz) and spoken in carrier sentences. The frequencies of the first two resonances were extracted through inverse filtering, as well as the amplitudes of the first four harmonics and the peak in the singer's formant region in the radiated spectrum.</p><p><strong>Results: </strong>From low to high notes, the frequencies of the first two resonances of all vowels tended to converge. Resonance tuning was most employed in the passaggio (first resonance tuned to the second harmonic, second resonance to the fourth harmonic) and at its upper limit (second resonance tuned to the third harmonic). In the highest notes, the balanced distribution of energy among the lower harmonics was more frequent, with the more dramatic voices exhibiting an equally strong singer's formant. Only in the vowel /i/ did first resonance tunings to the first harmonic occur.</p><p><strong>Conclusions: </strong>The vowels became progressively less distinguishable towards the high notes. Systematic resonance tuning was not observed in the high notes, with a greater occurrence of similarly strong lower harmonics, without strong distinct spectrum envelope peaks. Where resonance tuning was identified, there was no apparent preference for positioning the resonances above or below the frequency of their closest harmonics.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open-Source Manually Annotated Vocal Tract Database for Automatic Segmentation from 3D MRI Using Deep Learning: Benchmarking 2D and 3D Convolutional and Transformer Networks.","authors":"Subin Erattakulangara, Karthika Kelat, Katie Burnham, Rachel Balbi, Sarah E Gerard, David Meyer, Sajan Goud Lingala","doi":"10.1016/j.jvoice.2025.02.026","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.02.026","url":null,"abstract":"<p><strong>Objectives: </strong>Accurate segmentation of the vocal tract from MRI data is essential for various voice, speech, and singing applications. Manual segmentation is time-intensive and susceptible to errors. This study aimed to evaluate the efficacy of deep learning algorithms for automatic vocal tract segmentation from 3D MRI.</p><p><strong>Study design: </strong>This study employed a comparative design, evaluating four deep learning architectures for vocal tract segmentation using an open-source dataset of 3D-MRI scans of French speakers.</p><p><strong>Methods: </strong>Fifty-three vocal tract volumes from 10 French speakers were manually annotated by an expert vocologist, assisted by two graduate students in voice science. These included 21 unique French phonemes and three unique voiceless tasks. Four state-of-the-art deep learning segmentation algorithms were evaluated: 2D slice-by-slice U-Net, 3D U-Net, 3D U-Net with transfer learning (pre-trained on lung CT), and 3D transformer U-Net (3D U-NetR). The STAPLE algorithm, which combines segmentations from multiple annotators to generate a probabilistic estimate of the true segmentation, was used to create reference segmentations for evaluation. Model performance was assessed using the Dice coefficient, Hausdorff distance, and structural similarity index measure.</p><p><strong>Results: </strong>The 3D U-Net and 3D U-Net with transfer learning models achieved the highest Dice coefficients (0.896±0.05 and 0.896±0.04, respectively). The 3D U-Net with transfer learning performed comparably to the 3D U-Net while using less than half the training data. It, along with the 2D slice-by-slice U-Net models, demonstrated lower variability in HD distance compared to the 3D U-Net and 3D U-NetR models. All models exhibited challenges in segmenting certain sounds, particularly /kõn/. Qualitative assessment by a voice expert revealed anatomically correct segmentations in the oropharyngeal and laryngopharyngeal spaces for all models, except the 2D slice-by-slice U-NET, and frequent errors with all models near bony regions (eg, teeth).</p><p><strong>Conclusions: </strong>This study emphasizes the effectiveness of 3D convolutional networks, especially with transfer learning, for automatic vocal tract segmentation from 3D MRI. Future research should focus on improving the segmentation of challenging vocal tract configurations and refining boundary delineations.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance for Proposing a Treatment for Laryngopharyngeal Reflux Disease Considering the Weakly Acid Pattern.","authors":"Theodora Merenda, Antonino Maniaci, Matteo Lazzeroni, Manon Louvrier, Jerome R Lechien","doi":"10.1016/j.jvoice.2025.02.029","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.02.029","url":null,"abstract":"","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and Task Effects in CAPE-V Auditory-Perceptual Voice Assessments: Insights From the PVQD₃₀ Subset.","authors":"Timothy Pommée, Sara-Eve Renaud, Ingrid Verduyckt","doi":"10.1016/j.jvoice.2025.02.020","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.02.020","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the inter- and intra-rater reliability of consensus auditory-perceptual evaluation of voice (CAPE-V) auditory-perceptual ratings and explore task-specific differences (sustained vowels versus sentences) in ratings and reliability.</p><p><strong>Study design: </strong>Cross-sectional reliability study using a curated subset of dysphonic voice samples (PVQD₃₀).</p><p><strong>Methods: </strong>Thirty voice samples representing varying dysphonia severities were selected from the Perceptual Voice Qualities Database. Eight Quebecois speech-language pathologists (SLPs) rated the samples using the CAPE-V protocol on the Bridge2Practice platform. Ratings included six vocal features on a visual analog scale (VAS) and binary consistency (C/I) judgments. Reliability was assessed using intra-class correlation coefficients (ICCs) for VAS ratings and Gwet's AC1 for C/I ratings. Task effects were analyzed using Wilcoxon signed-rank tests and Spearman correlations.</p><p><strong>Results: </strong>Overall severity ratings demonstrated good inter-rater reliability for both vowels (ICC = 0.79) and sentences (ICC = 0.87). Pitch and loudness ratings showed low inter-rater reliability (ICCs < 0.5) across tasks. Vowels were rated as more impaired for most features, except strain, which showed higher impairment on sentences. Inter-rater reliability was higher for roughness and breathiness on vowels, whereas strain showed better reliability on sentences. Intra-rater reliability was consistently higher on sentences for all features (ICCs > 0.75 for most). Consistency ratings were more reliable on vowels than sentences for most features, except loudness.</p><p><strong>Conclusions: </strong>Task type significantly impacts CAPE-V ratings and their reliability. Vowels provided higher inter-rater reliability for roughness and breathiness, while sentences yielded better intra-rater consistency and strain reliability. These findings highlight the need for ongoing refinement of assessment tools and training protocols to ensure accurate and reliable voice evaluations.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airflow Vibrato Dependence on Pitch, Loudness, Adduction, and Straight Tone: A Single Case Study.","authors":"Brooke Howell, Ronald C Scherer, Katherine Pracht Phares","doi":"10.1016/j.jvoice.2025.01.041","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.01.041","url":null,"abstract":"<p><p>The purpose of this study was to examine the relationship between airflow vibrato (primarily extent) and pitch, loudness, and adduction, as well as the differences between vibrato production and straight tone singing. A single professional mezzo soprano was the participant. A Glottal Enterprises aerodynamic system was used to record wide-band airflow. Results indicated that airflow vibrato extent tended to increase with pitch and loudness and decrease with greater adduction. The standard deviation of the airflow signal (including both the vibrato conditions and straight tone conditions) tended to increase with increase in the standard deviation of the fundamental frequency signal. Straight tone productions have small airflow variations that appear random, but acoustically contain the fundamental frequency and at least 10 additional harmonics of the intended sung pitch. Average airflow was higher for vibrato productions than for straight tones by about 17%.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of the Visual Design of Spaces on Female Speakers' Vocal Effort: An Exploratory Study.","authors":"Tiffany Chang, Timothy Pommée, Annie Ross, Ingrid Verduyckt","doi":"10.1016/j.jvoice.2025.02.018","DOIUrl":"https://doi.org/10.1016/j.jvoice.2025.02.018","url":null,"abstract":"<p><p>Vocal effort, as defined by Hunter et al, is a subjective perceptual phenomenon influenced by individual and environmental factors. This study investigates the impact of visual room design on vocal effort and measurable vocal demand response, which includes acoustic metrics such as sound pressure level, fundamental frequency (f_o), and cepstral peak prominence. Twenty female participants performed speech tasks in two acoustically identical rooms that differed visually: an undecorated room (Room A) and a visually stimulating, classroom-like room (Room B). Participants reported significantly lower vocal effort on a visual analog scale in Room A compared with Room B (P < 0.001), suggesting that visual design can modulate subjective vocal experience. However, acoustic measures of vocal demand response revealed no significant differences between the two environments. These findings reinforce the need to explore multimodal influences on vocal effort, emphasizing the role of visual environments in shaping perceptual experiences of voice use without altering acoustic output. Implications for experimental design and therapeutic interventions are discussed.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid-Structure Interaction Analysis of Aerodynamic and Elasticity Forces During Vocal Fold Vibration","authors":"Elias Sundström ,&nbsp;Liran Oren ,&nbsp;Charles Farbos de Luzan ,&nbsp;Ephraim Gutmark ,&nbsp;Sid Khosla","doi":"10.1016/j.jvoice.2022.08.030","DOIUrl":"10.1016/j.jvoice.2022.08.030","url":null,"abstract":"<div><div>The effect of the intraglottal vortices on the glottal flow waveform was explored using flow-structure-interaction (FSI) modeling. These vortices form near the superior aspect of the vocal folds during the closing phase of the folds’ vibration. The geometry of the vocal fold was based on the well-known M5 model. The model did not include a vocal tract to remove its inertance effect on the glottal flow. Material properties for the cover and body layers of the folds were set using curve fit to experimental data of tissue elasticity. A commercially available FSI solver was used to perform simulations at low and high values of subglottal input pressure. Validation of the FSI results showed a good agreement for the glottal flow and the vocal fold displacement data with measurements taken in the excised canine larynx model. The simulations result further support the hypothesis that intraglottal vortices can affect the glottal flow waveform, specifically its maximum flow declination rate (MFDR). It showed that MFDR occurs at the same phase when the highest intraglottal vortical strength and the negative pressure occur. It also showed that when MFDR occurs, the magnitude of the aerodynamic force<span> acting on the glottal wall is greater than the elastic recoil force predicted in the tissue. These findings are significant because nearly all theoretical and computational models that study the vocal fold vibrations mechanism do not consider the intraglottal negative pressure caused by the vortices as an additional closing force acting on the folds.</span></div></div>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":"39 2","pages":"Pages 293-303"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9188334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}