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Complications of Thyroid Surgery
Published in Madan Laxman Kapre, Thyroid Surgery, 2020
Gregory W. Randolph, Dipti Kamani, Cristian Slough, Selen Soylu
Bilateral vocal cord palsy is a life threatening complication associated with thyroidectomy. Previous reports place its incidence at 0.6%, but the advent of IONM and staging procedures have likely decreased this incidence. A recent review by Sarkis et al. of 7,406 patients found the incidence to be much lower at 0.09% [49]. Their work and work by the International Neural Monitoring Study Group corroborate the importance of IONM to avoid this most dreaded complication [44,49]. The typical symptoms include inspiratory stridor, but phonation may be normal due to medial position of the vocal cords. Acutely, the majority of patients will require intubation and subsequent tracheostomy to stabilize the airway prior to definitive treatment [49].
Renal, Cardiovascular, and Pulmonary Functions of Dopamine
Published in Nira Ben-Jonathan, Dopamine, 2020
The larynx houses the vocal folds and manipulates pitch and volume, which is essential for phonation. From the larynx, air moves into the trachea and down to the right and left primary bronchi. Each of these bronchi branch into secondary (lobar) bronchi that branch into tertiary (segmental) bronchi that branch into smaller airways called bronchioles that eventually connect with tiny specialized structures called alveoli that function in gas exchange. More details on structure of the lungs are presented below in Section 7.7.
Control of Respiratory Muscles During Speech and Vocalization
Published in Alan D. Miller, Armand L. Bianchi, Beverly P. Bishop, Neural Control of the Respiratory Muscles, 2019
Takashi Sakamoto, Satoshi Nonaka, Akihiro Katada
Although voluntary sound is produced by most mammals in order to communicate with each other, only humans have the highest advanced tool known as speech. Speech normally occurs during the expiratory phase of respiration and is dependent on expiratory air flow. Thus, for generating speech in humans, characteristic activations of major respiratory, laryngeal, and other upper airway muscles including the pharynx, tongue, and lips are required, which are totally different from those during quiet breathing. Speech involves three mechanical processes: (1) for the power source of the voice signal, expiratory air flow is sent from the alveoli, (2) for the voice source, the larynx modifies the air flow and makes sound, (3) for the final voice signal, upper airway structures complete the voice signal. Among these three processes, (1) and (2) can be categorized as phonation or vocalization that generates the basic sound, and (3) is categorized as articulation in which the basic sounds are changed into the phonemes, syllables, and words of language. The process of articulation, which is accomplished by the speech center in the cerebral cortex, can only be analyzed in human subjects. However, vocalization is an essential process for speech and is common to both humans and animals. Therefore, the process of vocalization can be analyzed in experiments using animal models. In this chapter, we will review the basic functional aspects of the respiratory and upper airway muscles during speech and will mention the brainstem neuronal mechanisms involved in vocalization in animal models.
Early detection of Parkinson disease using stacking ensemble method
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Saroj Kumar Biswas, Arpita Nath Boruah, Rajib Saha, Ravi Shankar Raj, Manomita Chakraborty, Monali Bordoloi
Parkinson's Disease (PD), a degenerative disorder of the central nervous system, is the second most common neurodegenerative disease (De Lau and Breteler 2006). The number of people suffering from PD has increased rapidly worldwide (Van den Eeden et al. 2003), especially in developing countries in Asia (Dorsey et al. 2007). Although its underlying cause is unknown, the symptoms associated with PD can be significantly alleviated if detected in the early stages of illness (Harel et al. 2004; Singh et al. 2007; Rusz et al. 2011). PD is characterized by tremors, rigidity, slowed movement, motor symptom asymmetry, and impaired posture (Jankovic 2008; Massano and Bhatia 2012). Research has shown phonation and speech disorders are also common among PD patients (Ho et al. 1999). In fact, phonation and speech disorders can appear in PD patients as many as five years before being clinically diagnosed with the illness (Harel et al. 2004). The voice disorders associated with PD include dysphonia, impairment in vocal fold vibration, and dysarthria, disability in correctly articulating speech phonemes (Baken and Orlikoff 2000; Brabenec et al. 2017). Little et al. (2009) have first attempted to identify PD patients with dysphonic indicators using a combination of Support Vector Machines (SVM), efficient learning machines, and the feature selection approach. The study results have indicated that the proposed method efficiently identified PD patients with only four dysphonic features. But the drawback of this approach is that use of single classifier, an ensemble technique with feature selection gives better results.
Mean fundamental frequency in connected speech and sustained vowel with and without a sentence-frame
Published in Logopedics Phoniatrics Vocology, 2020
Jenny Iwarsson, Rikke Hollen Nielsen, Josefine Næs
The purpose of this study was to examine mean fo in text reading and to compare it with sustained vowel phonation with and without a sentence-frame. It was hypothesized, that a sentence-frame would affect mean fo of the vowel to be closer to that of text reading, and thus more representative to reflect connected speech. A risk when analyzing a small dataset statistically is the type 2 error, meaning that the analysis fails to report an effect that actually is. In spite of the low number of subjects in this study, the isolated vowel condition showed a significant difference in mean fo from both the sentence-framed vowel condition and from a connected speech in terms of text reading. This indicates quite strongly, a difference in using isolated sustained vowel phonation in voice recordings, as compared to sentence-framed vowel phonation and text reading.
Brain activity during phonation in healthy female singers with supraglottic compression: an fMRI pilot study
Published in Logopedics Phoniatrics Vocology, 2019
Maryna Kryshtopava, Kristiane Van Lierde, Charlotte Defrancq, Michiel De Moor, Zoë Thijs, Evelien D'Haeseleer, Iris Meerschman, Pieter Vandemaele, Guy Vingerhoets, Sofie Claeys
Human phonation is a laryngeal motor behavior that extends from reflexive and unlearned limbic laryngeal actions (1–3) to controlled and coordinated, highly skilled vocal movements to support speech and/or singing (4,5). Phonation requires coordination of the respiratory, laryngeal and articulatory systems. A component of normal phonation is the variation of voice pitch (habitual, high and low), which requires a complex interplay between respiratory (i.e., subglottic pressure) and laryngeal control (6). Pitch variation depends on the interactions between intrinsic and extrinsic laryngeal muscles (7–9) which influence the properties of the vocal folds (i.e., the sound source system) and in this way, control the fundamental frequency (F0), as well as the interplay between F0 and vocal tract resonance frequencies (i.e., F0 adjustment). Activity of the intrinsic cricothyroid and thyroarytenoid muscles (6,10,11) and the extrinsic sternohyoid (12) muscle increases as F0 increases during vocalization. High-pitched phonation is associated with increased tracheal pressure (13) as well as increments of loudness and glottal airflow (14). Sensorimotor integration control plays an important role in the feedback-based adjustments during phonation (15). Moreover, vocal training also may result in changes in laryngeal activity and its control (16).