phenylephrine-hydrochloride and Voice-Disorders

The present study proposes a direct surface hydration system based on nasal breathing through a damp gauze. The goal is to observe whether such direct hydration procedure positively modifies vocal fold functionality by improving voice quality and enhancing the mobility and pliability of the vocal fold mucosa.. Sixty-one young adults without voice problems were enrolled and were randomly divided into three double-blinded treatment groups. In the first group (the gauze group), participants breathed through the nose wrapped in a damp gauze for 10 minutes while doing vocal warm-up exercises to facilitate water penetration into the mucosal layers of the vocal folds. The second group (the exercise group) performed the same warm-up exercises as the gauze group for 10 minutes without hydration procedures. The third group (the control group) talked using their normal speaking voice for 10 minutes. The participants were evaluated before and after the treatment tasks with three tests: a laryngostroboscopic examination (ie, the glottic closure, the amplitude of the mucosal wave, and the maximum opening of the glottic space); voice acoustic analysis (multidimensional voice program); and a perceptual voice evaluation (GRBAS scale).. Results showed that after the use of a damp gauze, glottic closure, the amplitude of the mucosal wave, the maximum opening of the glottic space, the shimmer, and the B of GRBAS all improved.. Findings showed significantly better vocal results for the participants of the gauze group, suggesting the damp gauze procedure to be an effective, fast, and economical procedure to improve and optimize vocal fold functionality. It can be hypothesized that the obtained results are related to an improvement in vocal folds surface hydration and viscoelasticity.

Topics: Acoustics; Glottis; Humans; Nose; Randomized Controlled Trials as Topic; Vocal Cords; Voice Disorders; Young Adult

The aim of this study was to adapt the Simplified Nasometric Assessment Procedures-Revised (SNAP-R) [1] to Turkish, gather norms from Turkish speakers, and test the sensitivity and specificity of the adapted test. Finally, this study was designed to determine if there are any differences in average nasalance scores due to age, gender, and vowel content of the passage.. 240 children without any known speech, language or hearing disorders and 40 children with cleft palate participated in the study. Participants were divided into three groups according to their age (ages 4-7; 8-12; and 13-18). Data for this descriptive study was collected in the school settings and in a center of speech and language therapy.. This study showed a slight increase in nasalance with age, but no difference in nasalance based on gender. Furthermore, the nasalance score is determined by vowel content of the passage and that high vowels have higher nasalance than the low vowels.. This paper offers a new test for nasometric evaluation in the Turkish language, which has relatively high specificity and sensitivity in the evaluation of hypernasality.

Topics: Adolescent; Child; Child, Preschool; Cleft Palate; Female; Humans; Language; Male; Nose; Sensitivity and Specificity; Speech; Speech Production Measurement; Turkey; Voice Disorders; Voice Quality

Topics: Adult; Humans; Male; Mediastinal Emphysema; Nose; Voice Disorders

Due to the multidimensional nature of resonance disorders, multivariate diagnostic assessment is advisable. The nasality severity index (NSI) is based on this point of view. Because of the influence of personal and environmental variables on the current NSI, this study aims to refine this index.. Prospective case-control study.. Tertiary university hospital.. Forty-two patients with cleft lip and palate and 50 children without resonance disorders were tested.. Resonance was investigated by perceptual as well as objective measurements. A Nasometer was used to score nasalance, and spectral speech characteristics of a sustained sound /i:/ were determined, among which the voice low tone to high tone ratio (VLHR). Binary logistic regression analysis was performed to calculate the optimal index to discriminate patients from control children. Additionally, the validity of the index was determined based on data from an independent patient and control group.. The NSI 2.0, a weighted linear combination of three variables, can be obtained using the equation NSI 2.0 = 13.20 - (.0824 × nasalance /u:/ [%]) - (.260 × nasalance oral text [%]) - (.242 × VLHR 4.47*F0 [dB]). The NSI has a sensitivity of 92% and a specificity of 100%. Moreover, it has excellent validity (sensitivity 88%, specificity 89%).. The NSI 2.0 discriminates patients from control children with high sensitivity, specificity, and validity. This multiparametric method can offer a more powerful approach in the assessment and treatment planning of individuals with hypernasality.

Topics: Adolescent; Case-Control Studies; Child; Child, Preschool; Cleft Lip; Cleft Palate; Female; Humans; Male; Nose; Prospective Studies; Speech Acoustics; Speech Production Measurement; Voice Disorders; Voice Quality

Emerging literature has documented the effectiveness of intralesional steroid injection as an alternative treatment for benign vocal fold disorders. However, clinical application is frequently limited by the associated technical demands for adequate anesthesia and precise needle placement. This study investigated the applicability and effectiveness of the more practical and less technically demanding method of transnasal endoscopic steroid injection (TESI).. Prospective case series.. This study recruited 30 patients with vocal nodules and polyps. Dexamethasone was injected into the Reinke's space under local anesthesia via the operating channel of a transnasal flexible laryngoscope in an office setting. Treatment outcome were measured before, 1 month after, and 3 months after the injection, using videolaryngostroboscopy (VLS), maximal phonation time (MPT), 10-item voice handicap index (VHI-10), acoustic analysis, and perceptual evaluation.. VLS examinations at 3 months post-treatment demonstrated that vocal lesions of 10 and 19 patients were resolved or reduced, respectively. Objective measurements showed increased MPT and decreased VHI-10 (P < .05 and P < .01, respectively). Acoustic analysis revealed significant decrease in jitter and shimmer (P < .05). Perceptual evaluation using the GRB (grade, roughness, breathiness) scale also showed improved voice quality (P < .01). Treatment outcomes were similar between vocal nodules and polyps (P > .05). Mild vocal hematoma occurred in three patients following TESI, but resolved spontaneously within 1 month.. TESI is a simple and practical office-based treatment modality for benign vocal fold lesions, suitable for most otolaryngologists. Treatment outcomes showed significant subjective and objective improvements that were comparable to the results of other injection procedures reported in the literature.. 4.

Topics: Adult; Aged; Dexamethasone; Endoscopy; Female; Follow-Up Studies; Glucocorticoids; Humans; Injections, Intralesional; Male; Middle Aged; Nose; Phonation; Prospective Studies; Stroboscopy; Treatment Outcome; Vocal Cords; Voice Disorders; Young Adult

Upper aerodigestive tract may harbour foreign bodies such as sponges, grains, toy parts, stones, paper, insects, cotton, etc. These objects may go undetected for days or even weeks. A metallic foreign body after being inhaled and ultimately being lodged in the nasopharynx is a rare entity. We report a case of an unusual nasopharyngeal foreign body (metallic bolt) presenting with symptoms of nasal regurgitation and change in voice in a 2-year boy. The foreign body was diagnosed by X-ray skull lateral view including nasopharynx and was removed under general anaesthesia.

Topics: Child, Preschool; Foreign Bodies; Humans; Male; Nasopharynx; Nose; Voice Disorders

The purpose of this controlled study is to determine satisfaction with speech and facial appearance in Flemish pre-pubescent children with unilateral cleft lip and palate. Forty-three subjects with unilateral cleft lip and palate and 43 age and gender matched controls participated in this study. The Cleft Evaluation Profile was used to assess the perceived satisfaction for individual features related to cleft care. Both the cleft palate subjects and their parents were satisfied with the speech and facial appearance. The Pearson χ(2) test revealed significant difference between the cleft palate and the control group regarding hearing, nasal aesthetics and function, and the appearance of the lip. An in depth analysis of well specified speech characteristics revealed that children with clefts and their parents significantly more often reported the presence of an articulation, voice and resonance disorder and experienced /s/ /r/ /t/ and /d/ as the most difficult consonants. To what extent the incorporation of specific motor oriented oral speech techniques regarding the realisation of specific consonants, attention to vocal and ear care, and the recommendation of secondary velopharyngeal surgery, with the incorporation of primary correction of the cleft nose deformity simultaneously with primary lip closure, will aid these patients are future research subjects.

Topics: Adolescent; Articulation Disorders; Attitude to Health; Case-Control Studies; Child; Cleft Lip; Cleft Palate; Esthetics; Esthetics, Dental; Face; Female; Finland; Hearing; Humans; Interpersonal Relations; Lip; Male; Nose; Parents; Patient Satisfaction; Personal Satisfaction; Phonetics; Respiration; Self Concept; Speech; Speech Intelligibility; Speech Therapy; Voice Disorders

A 3-year, single-center, prospective study was undertaken to measure the effect and long-term results of using the Monarch Nasal Implant to surgically correct nasal valve dysfunction. Thirty-nine patients were implanted, with follow-up lasting 36 months for 9 of the patients. Implant effectiveness and maintenance of effectiveness were determined through acoustic rhinomanometry and a subjective patient questionnaire. Rhinomanometry studies and patient questionnaires revealed a significant initial improvement in internal nasal valve areas and patient symptoms; the improvements were maintained or had even increased at 36 months. The cosmetic changes were acceptable to the patients. The Monarch Nasal Implant provides a consistent and lasting correction of nasal valve dysfunction with minimal drawbacks when properly used.

Topics: Adult; Aged; Aged, 80 and over; Fluorocarbon Polymers; Follow-Up Studies; Humans; Middle Aged; Nasal Surgical Procedures; Nose; Prospective Studies; Prostheses and Implants; Prosthesis Design; Prosthesis Implantation; Rhinomanometry; Titanium; Voice Disorders

To assess the nasalance/nasality relationship and Nasometer test sensitivity and specificity when nasality ratings are obtained with both equal appearing interval (EAI) and direct magnitude estimation (DME) scaling procedures. To test the linearity of the relationship between nasality ratings obtained from different perceptual scales. STIMULI: Audio recordings of the Turtle Passage.. Participants' nasalance scores and audio recordings were obtained simultaneously. A single judge rated the samples for nasality using both EAI and DME scaling procedures.. Thirty-nine participants 3 to 17 years of age. Across participants, resonance ranged from normal to severely hypernasal.. Nasalance scores and two nasality ratings.. The magnitude of the correlation between nasalance scores and EAI ratings of nasality (r  =  .63) and between nasalance and DME ratings of nasality (r  =  .59) was not significantly different. Nasometer test sensitivity and specificity for EAI-rated nasality were .71 and .73, respectively. For DME-rated nasality, sensitivity and specificity were .62 and .70, respectively. Regression of EAI nasality ratings on DME nasality ratings did not depart significantly from linearity.. No difference was found in the relationship between nasalance and nasality when nasality was rated using EAI as opposed to DME procedures. Nasometer test sensitivity and specificity were similar for EAI- and DME-rated nasality. A linear model accounted for the greatest proportion of explained variance in EAI and DME ratings. Consequently, clinicians should be able to obtain valid and reliable estimates of nasality using EAI or DME.

Topics: Adolescent; Child; Child, Preschool; Humans; Linear Models; Nose; Observer Variation; Psychophysics; Regression Analysis; Sensitivity and Specificity; Speech Production Measurement; Voice Disorders; Voice Quality

Hypernasality in velocardiofacial syndrome (VCFS) is more severe, persistent, and difficult to manage compared to other populations with cleft palate or velopharyngeal (VP) dysfunction. This pilot study investigated why children with VCFS have more severe hypernasality.. Pressure-flow methodology indirectly measured VP orifice size and VP closure timing during speech in a group of 5 children with VCFS, 5 children with cleft palate, and 6 normal children.. Children with VCFS demonstrated significant differences in VP closure timing and hypernasality. There were no significant group differences in VP orifice size. Duration of nasal airflow was the strongest predictor of judgments of hypernasality.. This study provides preliminary evidence that VP closure timing may account for the more severe hypernasality in children with VCFS, compared to structural factors alone.

Topics: Air Pressure; Child; Cleft Palate; DiGeorge Syndrome; Female; Humans; Linear Models; Male; Nose; Pilot Projects; Sound Spectrography; Speech; Speech Production Measurement; Transducers, Pressure; Velopharyngeal Sphincter; Voice Disorders; Voice Quality

The primary objective of this descriptive and correlational study was to determine the level of pain and discomfort perceived by children undergoing nasendoscopy for investigation of voice and resonance disorders. The secondary objective was to explore whether gender, age, previous experience of painful or distressing medical procedures, and previous experience of nasendoscopy influenced the perception of pain during nasendoscopy. Twenty-three children self-reported the degree of pain perceived during nasendoscopy using the Wong-Baker Faces Pain Rating Scale. Parents also used this scale to rate their child's perceived pain. Otolaryngologists and speech pathologists rated the intensity and frequency of observed pain-related behaviors using the Child-Adult Medical Procedure Interaction Scale-Revised and the Procedure Behavior Checklist. Children perceived the procedure, on average, to be moderately painful, as did their parents. Only two children reported perceiving no pain during the procedure. The most frequently observed pain-related behaviors were muscle tension (86.96%), physical resistance (69.57%), requiring physical restraint (60.87%), crying (43.48%), and expressions of verbal pain (39.13%). No significant correlations were found between self-reported pain or observed pain and the variables of age, gender, previous experience of nasendoscopy, and previous experience of painful or distressing medical procedures, although children aged 4-7 years reported significantly more pain than children aged 8-18 years. Most children perceive nasendoscopy to be painful to some degree. This perceived pain occurred in conjunction with several observable pain-related behaviors that have the potential to interfere with the success of the procedure.

Topics: Adolescent; Age Factors; Child; Child, Preschool; Crying; Endoscopy; Female; Humans; Male; Muscle Tonus; Nose; Pain; Pain Measurement; Perception; Restraint, Physical; Sex Factors; Voice Disorders

Hypernasality is associated with various diseases and interferes with speech intelligibility. A recently developed quantitative index called voice low tone to high tone ratio (VLHR) was used to estimate nasalization. The voice spectrum is divided into low-frequency power (LFP) and high-frequency power (HFP) by a specific cutoff frequency (600 Hz). VLHR is defined as the division of LFP into HFP and is expressed in decibels. Voice signals of the sustained vowel [a :] and its nasalization in eight subjects with hypernasality were collected for analysis of nasalance and VLHR. The correlation of VLHR with nasalance scores was significant (r = 0.76, p < 0.01), and so was the correlation between VLHR and perceptual hypernasality scores (r = 0.80, p < 0.01). Simultaneous recordings of nasal airflow temperature with a thermistor and voice signals in another 8 healthy subjects showed a significant correlation between temperature rate of nasal airflow and VLHR (r = 0.76, p < 0.01), as well. We conclude that VLHR may become a potential quantitative index of hypernasal speech and can be applied in either basic or clinical studies.

Topics: Adult; Auscultation; Cleft Palate; Diagnosis, Computer-Assisted; Female; Humans; Male; Middle Aged; Nose; Phonation; Phonetics; Respiratory Sounds; Severity of Illness Index; Sound Spectrography; Speech Acoustics; Speech Production Measurement; Voice Disorders

This paper presents an assessment protocol for the evaluation and description of speech, resonance and myofunctional characteristics commonly associated with cleft palate and/or velopharyngeal dysfunction. The protocol is partly based on the GOS.SP.ASS'98 and adapted to Flemish. It focuses on the relevant aspects of cleft type speech necessary to facilitate assessment, adequate diagnosis and management planning in a multi-disciplinary setting of cleft team care.

Topics: Articulation Disorders; Cleft Palate; Facial Expression; Humans; Language Development; Nose; Palatal Muscles; Palate, Soft; Patient Care Planning; Phonetics; Speech; Speech Disorders; Velopharyngeal Insufficiency; Voice; Voice Disorders; Voice Quality

The practice of injection laryngoplasty under local anesthesia has become more common as both the indications for the procedure and the number of injectable substances increased. Modifications to the injection techniques used for vocal fold augmentation have been described over the last decade that reflect changes in the established percutaneous and transoral approaches. These percutaneous and transoral injection techniques for the treatment of dysphonia secondary to glottic incompetence are well described and provide an adequate approach for most cases. However, these traditional methods may be difficult to master, require great patient tolerance, and may be impossible to perform when anatomic or physiologic barriers exist. We describe a new application of the fiberoptic transnasal endoscope to perform laryngeal injection using a flexible needle through a port in the endoscope. This technique is easily mastered and readily tolerated by patients who would not be candidates for the other injection techniques under local anesthesia. We present our favorable experience with this technique and identify its shortcomings coupled with recommendations to address future technical modifications.

Topics: Collagen; Humans; Injections; Laryngoscopy; Nose; Prosthesis Implantation; Treatment Outcome; Vocal Cords; Voice Disorders

The aim was to study the relationship between perceptual evaluation of speech variables related to velopharyngeal function and the pattern of nasal airflow during the velopharyngeal closing phase in speech in children with and without cleft palate.. Fourteen children with cleft lip and palate or cleft palate only and 15 controls aged 7 and 10 years. All were native Swedish speakers.. Three experienced listeners performed a blinded perceptual speech evaluation. Nasal airflow was transduced with a pneumotachograph attached to a nasal mask. The duration from peak to 5% nasal airflow, maximum flow declination rate, and nasal airflow at selected points in time during the transition from nasal to stop consonants in bilabial and velar articulatory positions in sentences were estimated. The analysis was focused on the perceptual ratings of "velopharyngeal function" and "hypernasality.". A strong association was found between ratings of "velopharyngeal function" and "hypernasality" and the pattern of nasal airflow during the bilabial nasal-to-stop combination /mp/. Both the sensitivity and specificity were 1.00 for the bilabial temporal airflow measure in relation to ratings of "velopharyngeal function." The nasal airflow rate during /p/ in /mp/ had a sensitivity of 1.00 and specificity of 0.92 to 0.96 in relation to ratings of "hypernasality.". Assessment of the nasal airflow dynamics during the velopharyngeal closing phase in speech presents quantitative, objective data that appear to distinguish between perceptually normal and deviant velopharyngeal function with high sensitivity and specificity.

Topics: Articulation Disorders; Case-Control Studies; Child; Cleft Lip; Cleft Palate; Female; Humans; Male; Nose; Observer Variation; Pulmonary Ventilation; Sensitivity and Specificity; Speech Disorders; Speech Production Measurement; Velopharyngeal Insufficiency; Voice Disorders

To evaluate 27 congenital veloparyngeal insufficiency(CVPI) subjects and 6 normal articulation subjects with airflow pressure techniques.. A compare analysis was performed in two groups (CVPI subjects and normal articulation subjects) during speech production of /hemper/ and /papa/.. There wasn't statistical significance between two groups in oral air pressure and velopharyngeal orifice areas, however, CVPI group differed significant in nasal airflow on the articulation of /hemper/ and /papa/.. When the degree of CVPI subject's VP opening was small, hypernasality appeared to be related to duration of the opening-closing movements.

Topics: Adolescent; Adult; Airway Resistance; Child; Child, Preschool; Female; Humans; Male; Mouth; Nose; Pharynx; Phonetics; Speech Production Measurement; Velopharyngeal Insufficiency; Voice Disorders

Although the primary cause of hypernasality is impaired velopharyngeal (VP) function, a variety of other factors influence the outcome perceived by the listener. The purpose of the current study was to assess the relationship between oral-nasal resonance balance and (1) velopharyngeal orifice area; (2) nasal airflow rate; and (3) duration of nasal airflow. The pressure-flow technique was used to estimate VP area and measure nasal airflow rate and duration. Ratings of oral-nasal balance were made on a 6-point equal-appearing interval scale. Results indicated a moderate correlation between hypernasality rating and VP area (0.66), nasal airflow (0.61), and nasal airflow duration (0.53). Adults tended to be perceived as more hypernasal than children for a given degree of VP impairment. Finally, when the degree of VP opening was small, perceived oral-nasal resonance balance appeared to be related to duration of the opening-closing movements.

Topics: Adolescent; Adult; Air Pressure; Airway Resistance; Analysis of Variance; Chi-Square Distribution; Child; Child, Preschool; Humans; Middle Aged; Nasal Obstruction; Nose; Observer Variation; Palate, Soft; Pharynx; Pulmonary Ventilation; Reproducibility of Results; Respiratory Function Tests; Statistics, Nonparametric; Time Factors; Transducers, Pressure; Velopharyngeal Insufficiency; Voice Disorders; Voice Quality

Fourteen children were seen prior to adenoidectomy and at 1 month, 3 months, and 6 months following surgery. On each visit, nasal airway resistance values, nasal cross-sectional area estimates, nasalance scores, and perceptual ratings of nasality were collected. These data were analyzed to identify changes that were related to the time of the test, and to the primary indication for surgery (nasal airway obstruction or recurrent infection). Results revealed significant reduction in nasal airway resistance and significant changes in nasalance following surgery. Perceptual changes were not significant. Clinical implications of these findings are discussed.

Topics: Adenoidectomy; Air Pressure; Airway Resistance; Analysis of Variance; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Male; Nasal Obstruction; Nose; Pulmonary Ventilation; Reproducibility of Results; Respiratory Function Tests; Rhinitis; Sex Factors; Sinusitis; Speech Acoustics; Time Factors; Transducers, Pressure; Voice Disorders; Voice Quality

Intralaryngeal injections of botulinum toxin (Botox), under electromyographic guidance, have emerged as an effective treatment for adductor spasmodic dysphonia. To remain effective, these injections must be repeated every 3 to 9 months as the symptoms recur. One drawback to the current method is the need for electromyographic confirmation of needle placement into the thyroarytenoid muscle. This report describes an anatomic approach to Botox injection that requires only flexible nasopharyngeal endoscopy and careful evaluation of the anatomic landmarks. This technique has been used successfully on 13 patients, and objective pretreatment and posttreatment measures are reported.

Topics: Adult; Aged; Botulinum Toxins; Electromyography; Endoscopy; Female; Humans; Injections, Intramuscular; Laryngeal Muscles; Laryngismus; Male; Middle Aged; Nose; Pharynx; Speech; Voice Disorders

A series of 155 patients referred for evaluation at the UNC Craniofacial Center was studied to compare nasometric performance data obtained from the Rainbow Passage to information provided when subjects read two other standardized passages (Zoo Passage and Nasal Sentences). Nasometric findings obtained using the three reading passages were compared to aerodynamic estimates of velopharyngeal area and nasal cross-sectional area as well as clinical judgments of hypernasality and hyponasality. The results suggest that the Rainbow Passage does not provide clinically relevant information that cannot be obtained using the other speech samples studied.

Topics: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Male; Middle Aged; Nose; Palate, Soft; Peak Expiratory Flow Rate; Pharynx; Pressure; Pulmonary Ventilation; Reference Values; Regression Analysis; Speech Acoustics; Speech Articulation Tests; Velopharyngeal Insufficiency; Voice Disorders

Topics: Child; Endoscopy; Humans; Laryngoscopy; Nose; Palate, Soft; Pediatrics; Pharynx; Speech Disorders; Voice Disorders

The elderly patient may infrequently present with symptoms or signs of disorders of the upper airway. Once a malignancy or other life-threatening illness has been excluded by a thorough history and physical examination, the physician should then consider one of the common upper airway disorders associated with aging.

Topics: Aged; Aging; Female; Humans; Male; Middle Aged; Mouth; Nose; Physical Examination; Vocal Cords; Voice; Voice Disorders; Voice Quality

Nasal coarticulation in phonetically controlled nonsense syllables was investigated in four normal adult speakers. Nasalization was determined using the ratio of a nasal accelerometer signal amplitude to airborn microphone signal amplitude. Measurements of nasalization were made at the midpoint of vowels and at a constant time from the nasal consonant. Nasal acoustical coupling was greater for high vowels than for low vowels in all consonant contexts. Nasalization was also greater for vowels between two nasal consonants than for vowels between a nasal consonant and a fricative or stop. Results for progressive versus regressive assimilation depended on the measurement strategy. For within-vowel measurements made a constant time from the nasal consonant, prenasal vowels showed greater nasalization than postnasal vowels. This nasal accelerometric technique shows promise for clinical assessment of articulatory details of velar function.

Topics: Adult; Articulation Disorders; Female; Humans; Nose; Speech Articulation Tests; Speech Production Measurement; Voice; Voice Disorders; Voice Quality

Many otolaryngologists and speech clinicians have found videofiberoptic evaluations to be invaluable for assessment of velopharyngeal and laryngeal function in adults. However, many professionals question the feasibility of routine use of these procedures in the pediatric population. This article describes a method for successful completion of videonasoendoscopic speech and voice evaluations of children as young as 3 years of age. The importance of the ENT/speech team is emphasized in both the collection and interpretation of data. In addition, contributions of videonasoendoscopic observations to diagnosis, medical treatment, and therapy for speech and voice disorders are discussed.

Topics: Child; Child, Preschool; Endoscopy; Humans; Infant; Infant, Newborn; Larynx; Nose; Palate, Soft; Speech Disorders; Video Recording; Voice Disorders

The focus of this article has been on the disorders of the motor aspects of speech and voice production, as contrasted with the symbolic aspects of the communication process (language). Categories of motor speech problems include those in which the articulation of speech sounds is aberrant, phonatory problems related to laryngeal function, those resulting from craniofacial anomalies, and finally those characterized by disruption in the flow or fluency of speech. Guidelines for timing and type of referral have been suggested. In each case, early referral is urged so that diagnosis of the problem based upon complete assessment can serve to guide treatment planning. Parental reports and concerns about a child's speech development (as well as language, cognitive and auditory behavior) should be given credence and attended to rather than ignored or postponed. Speech disorders are often amenable to total resolution and almost always to a significant degree of improvement, especially if diagnosed and treated early.

Topics: Adolescent; Articulation Disorders; Child; Child, Preschool; Humans; Male; Mouth Abnormalities; Nose; Phonation; Puberty; Speech Disorders; Stuttering; Voice Disorders

Topics: Adult; Down Syndrome; Female; Humans; Male; Nose; Velopharyngeal Insufficiency; Voice Disorders

Two groups of subjects, one with normal speech and one with hypernasal speech, spoke while hearing their voices unfiltered, low-pass filtered with cut-off frequencies of 1000, 500, and 300 Hz and high-pass filtered with cut-off frequencies of 500, 1000, and 2000 Hz. Measurements of nasalization were made with a miniature accelerometer attached to the side of the subject's nose. Both groups of subjects decreased nasalization when hearing their voices low-pass filtered with a cut-off frequency of 300 Hz. This decrease was statistically significant. The results were interpreted as supporting the hypothesis that nasalization is under feedback control.

Topics: Auditory Perception; Feedback; Female; Filtration; Humans; Male; Methods; Nose; Speech; Speech Acoustics; Speech Disorders; Voice; Voice Disorders

The purpose of this study was to determine the prevalence of voice quality deviations in a normal adult population. One-hundred twelve subjects, aged 17 to 80, read a short paragraph aloud into a high-fidelity tape recorder and completed a case history questionnaire. A group of 11 pretrained judges rated overall performance of each taped sample on a seven-point equal-appearing intervals scale, then designated those quality components which contributed toward deviant ratings. Eighty-two percent of the group received a mean severity rating lower than 1.99; 16% had a rating between 2.00 and 2.99; and 2% was assigned a mean rating higher than 3.00.

Topics: Adolescent; Adult; Aged; Female; Hoarseness; Humans; Male; Middle Aged; Nose; Pennsylvania; Self-Assessment; Sex Factors; Smoking; Speech Production Measurement; Voice; Voice Disorders; Voice Quality