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Quality of Life, Survivorship, and Outcomes in Head and Neck Cancer
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Voice and speech represent different ends of the same spectrum. The larynx serves as the source of phonation, thereby producing voice, while the vocal tract (oral cavity, oropharynx, nasopharynx, nasal cavity, and paranasal sinuses) act as a filter, altering the voice and shaping speech. Speech is the final outcome of voiced sound. Cancers or treatments involving the vocal tract sites will affect speech and not the voice. Voice is predominantly affected by laryngeal cancers or treatments affecting the larynx, directly or indirectly. Numerous tools are used for the evaluation of voice and speech (Box 74.1), but there is no widely accepted outcome measure.
Anatomy overview
Published in Stephanie Martin, Working with Voice Disorders, 2020
The muscles of the larynx may be divided into extrinsic and intrinsic muscle groups. The extrinsic muscles have one point of attachment to a structure within the larynx and one point of attachment to a structure outside the larynx. Their function is to position the larynx within the vocal tract, either fixing, raising or lowering it. The intrinsic muscles have both points of attachment to structures within the larynx. They are concerned with fine movement of the vocal folds for phonation, for respiration, for containing air below the glottis and for assisting in the protective mechanism of preventing food or liquid being ingested during swallowing.
Stammering and voice
Published in Trudy Stewart, Stammering Resources for Adults and Teenagers, 2020
The structures of the vocal tract include: PharynxOropharynxNasopharynx. Vibratory sound waves that are created by vocal cord vibration move within these structures, and this is known as resonance.
Acoustic parameter changes after bariatric surgery
Published in Logopedics Phoniatrics Vocology, 2022
Fakih Cihat Eravci, Barış Doğu Yildiz, Kürşat Murat Özcan, Münevver Moran, Mustafa Çolak, Süleyman Emre Karakurt, Mehmet Fatih Karakuş, Aykut Ikinciogullari
Although the voice emerges from the voice box (i.e. larynx), it is not the only anatomic level that gives these characteristics. The lower respiratory tract and upper respiratory tract contribute to the form of the voice. The supralaryngeal vocal tract plays a resonator role for the voice, which is produced in the larynx with the force of the airflow obtained from the lungs [13]. This contribution determines the acoustic features and in addition to the conventional acoustic parameters (e.g. F0, jitter, shimmer, noise-to-harmonic ratio), the resonance peaks in the vocal tract are called formants which are labeled with numbers (F1, F2, F3, and F4). F1 and F2 frequencies are essential for phonemic recognition and mainly reflect the tongue position and lip roundness. F3 and F4 are more related to lip spreading and protrusion and are therefore related more to emotional expressions [14,15]. Obstruction, the narrowness of any level or change in the anatomic length and shape of each level has an impact on voice analysis as it affects articulation and resonance [13]. Previous studies have investigated the effect of some otolaryngological surgical procedures (adenotonsillectomy, septoplasty, palatoplasty, pharyngoplasty, etc.) on the voice [16,17]. However, the relationship between obesity and the voice has been a relatively untouched issue.
Vocal tract discomfort in caregivers for the elderly during an interval of the COVID-19 pandemic
Published in Logopedics Phoniatrics Vocology, 2022
Sophia Gantner, Ursula Deitmerg, Maria Schuster
Vocal tract discomfort frequently occurs in patients with voice disorders. This is in accordance with a study by Mathieson [18], who identified VTD as a symptom of voice disorder. Aside from the primary symptom of hoarseness, vocal tract symptoms include sensations such as sore throat, lump in the throat, dryness, and others [24,25]. Depending on the origin of the voice disorder, these sensations may have different prevalences, as reported by Lopes et al. [25]. For example, patients with a neurological etiology of hoarseness report less lump in the throat than those with inflammatory changes in the larynx due to gastrolaryngeal reflux. In our study group, the most reported sensations were dryness, irritability, and tightness. In particular, dryness is a sensation that is often reported in patients experiencing voice disorders [20,24]. The German evaluation of the VTD questionnaire by Lukaschyk et al. [17] reported a similar distribution of sensations in patients with dysphonia. In the study by Luyten et al. [23], dryness, tightness, and lump in the throat were mostly reported in the Flemish population without known dysphonia, whereas Niebudek-Bogusz et al. [24] reported mostly tickling, dryness, and lump in the throat in 218 patients with occupational dysphonia.
Listener impressions of alaryngeal communication modalities
Published in International Journal of Speech-Language Pathology, 2021
Stephanie M. Knollhoff, Stephanie A. Borrie, Tyson S. Barrett, Jeff P. Searl
Oesophageal speech is an alaryngeal communication mode that does not rely on anything other than the person’s body to produce (i.e. no manufactured devices required). The primary components of this method involve the movement of air from the upper vocal tract into the oesophagus, and then the return of that air through the pharyngoesophageal segment which is set into vibration to create the new voice. The sound created by the pharyngoesophageal segment can then be shaped via the lips, teeth and tongue for speech production (Boone, McFarlane, Von Berg, & Zraick, 2014; Şahin et al., 2016). With appropriate professional intervention and practice, individuals may become proficient with ES and produce verbal communication that allows for variation in pitch, rate and volume. A primary limitation of ES is that timeframe for attaining proficiency can be long. As the pharyngoesophageal segment is the vibratory mechanism, some people are unable to utilise this type of communication as medical treatment such as surgery and radiation resulted in the pharyngoesophageal segment not being optimal or viable for ES.