Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The development of children s vocal apparatus reflects in their voice characteristics. Objectives: To review the characteristics of the child s voice; to assess and correlate the results of the acoustic analysis of the glottal source, maximum phonation times (MPT), body height and body mass index (BMI) of children aged 4-8 years. Methods: A sample of 484 eutrophic children without a speech-language pathology diagnosis of dysphonia; mailing of questionnaires to parents; auditory screening; BMI determination, and auditory-perceptual analysis of voice (CAPE-V scale); acoustic assessment of /a:/ using the Multi Dimensional Voice Program Advanced; /a,i,u/ MPT measurements; descriptive statistics analysis, t-test and multiple regression (SPSS, significance at 5%). Results: hoarseness and/or breathiness is expected, as well as voice instability; increased loudness, and hard glottal attack; lowered fundamental frequency (f0) as the child grows; measures of jitter, shimmer, noise-to-harmonics ratio (NHR), and voice turbulence index (VTI) tend to be higher in younger children and decrease with body growth and increasing age; due to the maturation of the structures, increased soft phonation index (SPI) is also expected; MPT in seconds parallels the child s age in years, with slightly more sustained phonation than the respective chronological age. In childhood, voice disorders are frequent and more prevalent in boys, with characteristics such as hoarseness and breathiness; lowered f0 and increased jitter and shimmer in dysphonic voices. Original papers: lower f0 as age increases; lower f0 values in girls; greater jitter, shimmer, and VTI measures in girls at six years; higher SPI in boys at seven years; negative correlations between f0, height, and BMI at four years; positive correlations between height and BMI and measures of jitter, shimmer, and VTI, as well as between height and NHR in girls at five years; variability in amplitude and height at seven years in girls; SPI and height in boys at five and seven years. Mean /a/ MPTs for boys at four, five, six and seven years, respectively: 3.77s, 5s, 5.85s, and 7.5s. Mean /a/ MPTs for girls at the same ages: 3.89s, 4.89s, 5.61s, and 6.61s, respectively. Mean /i/ MPTs for boys: 3.49s, 4.96s, 5.72s, and 6.88s. Mean /i/ MPTs for girls: 3.49s, 4.73s, 5.41s, and 6.63s. Mean /u/ MPTs for boys: 3.64s, 4.85s, 5.76s, and 7.08s. Mean /u/ MPTs for girls: 3.54s, 4.73s, 5.64s, and 6.47s. Longer /a/ MPT in boys at seven years, which correlated positively with height. Conclusion: Body height seemed to be the anthropometric measure with the greatest correlation to the acoustic measures, predominantly in girls. The age ranges showing acoustic abnormalities coincided with those rated as having mild deviance in auditory-perceptual analysis. Children s MPT increases with age; /a,i,u/ MPTs in seconds follow the age in years; at seven years, /a/ MPT was longer for boys and influenced by body height, while BMI had no influence on MPT. / O aparato vocal da criança se desenvolve com reflexos nas características acústicas da voz. Objetivo: realizar revisão sobre características da voz de crianças, verificar e correlacionar os resultados da análise acústica de fonte glótica, tempos máximos de fonação (TMF), estatura e índice de massa corporal (IMC) de crianças com voz considerada normal. Método: Amostra de 484 crianças de quatro a oito anos, eutróficas com voz considerada normal; envio de questionário aos pais, triagem auditiva, avaliação do IMC e análise vocal perceptivo-auditiva (Escala CAPE-V); análise acústica de /a:/ pelo Multi Dimensional Voice Program Advanced; obtenção dos TMF/a,i,u/; análise estatística descritiva, Teste t e regressão múltipla (SPSS, significância de 5%). Resultados: discreto grau de rouquidão e/ou soprosidade, instabilidade, loudness aumentada e ataque vocal brusco; diminuição da frequência fundamental (f0) conforme a criança cresce; medidas de Jitter, Shimmer, proporção ruído-harmônico (NHR) e índice de turbulência da voz (VTI) tendem a ser maiores em crianças jovens, diminuindo com o crescimento e aumento da idade; pela maturação das estruturas, espera-se, igualmente, aumento dos valores de índice de fonação suave (SPI); TMF em segundos gira em torno número de anos de idade da criança, podendo observar-se sustentações discretamente maiores do que as idades cronológicas. Na infância os distúrbios vocais comportamentais são frequentes e prevalentes nos meninos, com características como rouquidão e soprosidade; f0 mais grave e aumento das medidas de Jitter e Shimmer nas vozes disfônicas. Observou-se: Diminuição de f0 com o aumento da idade; medidas de f0 mais graves nas meninas, Jitter, Shimmer e VTI maiores nas meninas aos seis anos; SPI maior nos meninos aos sete anos; correlação negativa: entre medidas de f0, estatura e IMC aos quatro anos; correlação positiva entre: estatura e IMC e medidas de Jitter, Shimmer e VTI, bem como entre estatura e NHR nas meninas aos cinco anos; variação da amplitude e estatura aos sete anos nas meninas; SPI e estatura nos meninos, aos cinco e sete anos. Média TMF/a/ de 3,77s aos quatro anos, 5s aos cinco, 5,85s aos seis e 7,5s aos sete nos meninos, nas meninas respectivamente de 3,89s, 4,89s, 5,61s, e 6,61s; TMF/i/ 3,49s aos quatro, 4,96s aos cinco, 5,72s aos seis e 6,88s aos sete nos meninos, nas meninas respectivamente de 3,49s, 4,73s, 5,41s, e 6,63s; TMF/u/ 3,64s aos quatro, 4,85s aos cinco, 5,76s aos seis e 7,08s aos sete nos meninos, nas meninas respectivamente de 3,54s, 4,73s, 5,64s, e 6,47s. TMF/a/ maior nos meninos aos sete anos com correlação positiva com a estatura. Conclusão: estatura pareceu ser a medida antropométrica de maior correlação com as medidas acústicas, relação observada predominantemente nas meninas. As faixas etárias que apresentaram alterações acústicas coincidiram com aquelas classificadas com alteração discreta na avaliação perceptivo-auditiva. Os TMF de crianças aumentam com a idade; TMF/a,i,u/ em segundos ficaram em torno do número de anos de idade; aos sete anos, TMF/a/ foi maior nos meninos, sendo afetado pela estatura; o IMC não mostrou influência sobre os TMF.

Introduction: Singers perform elite vocals, represent a professional class with high vocal demand, with different degrees of demands and refinements. In this sense, tube phonation exercises have been widely used in clinical practice to favor speech economy and efficiency, facilitate source-filter interaction, and reduce the risks of work-related voice disorders. Aim: To verify, through a systematic review of the literature, the effects of phonation on tubes on vocal quality, glottal function and/or vocal tract of the singers. Methods: We searched the literature, without restrictions regarding the publication period, in the Portuguese, English and Spanish languages, in the databases Lilacs, Scielo, PubMed and Cochrane. Eligible articles were subjectively assessed for methodological quality based on the checklist proposed by the Joanna Briggs Institute for observational studies. Resuts: The research resulted in a sample of 1,715 papers. The verifications of the records were done by two evaluators, obtaining an excellent level of agreement (Kappa = 0.88). At the end of the process, 05 studies fell within the eligibility criteria. To evaluate the effects of the phonation exercise in tubes, the studies used vocal self-assessment, perceptual-auditory analysis, acoustic analysis, aerodynamic measurements and electroglotography. The tubes used were plastic straws (02), glass tube immersed in water (01), glass tube in the air (01) and LaxVox (01). Conclusion: In general, studies showed that phonation in tubes in singers produced positive effects on vocal quality, with greater vocal comfort and vocal projection, more economic emission, increased collision threshold during phonation in water-immersed tube and intraoral pressures more consistent with phonation in narrow straws, favoring efficient and effective vocal therapy. / Introdução: Os cantores, considerados interpretes vocais de elite, representam uma classe profissional geralmente de alta demanda vocal, com diferentes graus de exigências e requintes. Neste sentido, os exercícios de fonação em tubos têm sido amplamente utilizados na prática clínica para favorecer a economia e eficiência da voz, facilitar a interação fonte-filtro e reduzir os riscos de distúrbios da voz relacionados ao trabalho. Objetivo: Verificar, por meio de uma revisão sistemática da literatura, os efeitos da fonação em tubos sobre a qualidade da voz, função glótica e/ou trato vocal dos cantores. Métodos: Foi realizada uma busca na literatura, sem restrições quanto ao período de publicação, nos idiomas português, inglês e espanhol, nas bases de dados Lilacs, Scielo, PubMed e Cochrane. Os artigos elegíveis foram avaliados subjetivamente quanto à qualidade metodológica com base no checklist proposto pelo Instituto Joanna Briggs para estudos observacionais. Resultados: A pesquisa resultou em uma amostra de 1.715 trabalhos. As verificações dos registros foram feitas por dois avaliadores, sendo obtido um nível de concordância excelente (Kappa = 0,88). Ao final do processo, 05 estudos se enquadraram nos critérios de elegibilidade. Para avaliar os efeitos do exercício de fonação em tubos, os estudos utilizaram autoavaliação vocal, análise perceptivo-auditiva, análise acústica, medidas aerodinâmicas e eletroglotografia. Os tubos utilizados foram canudos plásticos (02), tubo de vidro imerso em recipiente com água (01), tubo de vidro no ar (01) e LaxVox (01). Conclusão: Em geral, os estudos demonstraram que a fonação em tubos em cantores produziu efeitos positivos sobre a qualidade vocal, com maior conforto fonatório e projeção vocal, emissão mais econômica, aumento do limiar de colisão durante a fonação em tubo imerso em água e pressões intraorais mais consistentes após a fonação em canudo estreito, favorecendo à terapia vocal eficiente e efetiva. / Lagarto, SE

This thesis presents tools and components necessary to further develop an implementation of a method. The method attempts to use the non invasive electroglottographic signal to locate rapid transitions between voice registers. Implementations for sample entropy and the Discrete Fourier Transform (DFT) implemented for the programming language SuperCollider are presented along with tools necessary to evaluate the method and present the results in real time. Since different algorithms have been used, both for clustering and cycle separation, a comparison between algorithms for both of these steps has also been done. / Denna rapport presenterar verktyg och komponenter som är nödvändiga för att vidareutveckla en implementation av en metod. Metoden försöker att använda en icke invasiv elektroglottografisk signal för att hitta snabba övergångar mellan röstregister. Det presenteras implementationer för sampelentropi och den diskreta fourier transformen för programspråket SuperCollider samt verktyg som behövs för att utvärdera metoden och presentera resultaten i realtid. Då olika algoritmer har använts för både klustring och cykelseparation så har även en jämförelse mellan algoritmer för dessa steg gjorts.

Several studies involving excised animal larynges have been performed to simulate the structural and physiological properties of the human larynx. The most common way to preserve the laryngeal tissue being studied is by immersing it in a 0.9% isotonic saline solution and then flash freezing it. Isotonic saline is used empirically to replenish the potential ion loss that occurs postmortem. Each larynx is flash frozen so it can be used at a more convenient time while still maintaining the integrity of the tissue. However, the preservation methods found in previous studies tend to vary and no consensus had been reached about which method of preservation is ideal. This study sought to investigate the effects of solution and storage on phonation threshold pressure (PTP). Phonation threshold pressure is commonly used to investigate mucosal wave of the vocal folds, prephonatory glottal width, and vocal fold cover. This study involved a prospective, mixed experimental design with three groups, including a control group and two experimental groups. Each group consisted of 10 bench-mounted porcine larynges. The control group was immersed in 0.9% isotonic saline, flash frozen with liquid nitrogen within 24 hours postmortem, and thawed overnight before the experiment. The second group was immersed in 0.9% isotonic saline and the third group was submersed in Ringer's solution. Each of these groups was kept in their solution in a refrigerator for approximately 15 hours and was used for the experiment within 24 hours postmortem. Each larynx was mounted on a bench on a tabletop with three micropositioners to adduct and elongate the vocal folds. A pseudolung connected to the trachea directed humidified air to the vocal folds subglottally until phonation was achieved. The larynges in all three groups underwent these phonatory trials with 5-minute desiccation trials between each until phonation could no longer be achieved. Phonation threshold pressure was then observed and compared within groups and between groups. The signals were obtained using MATLAB. The results indicated that PTP was lowest for the frozen versus fresh groups. PTP values increased slightly for the frozen group, but the frozen group demonstrated less variability across specimens as compared to the fresh groups. Collectively, these results indicate that there are substantial differences between fresh and frozen specimens. These differences should be considered when designing tissue studies for purposes of generalization to human phonation.

The purpose of the present study was to examine the effects of external laryngeal vibration on voice function. The current study was based on a recent pilot study using silicone vocal folds that demonstrated a decrease in phonation threshold pressure (PTP; cmH2O) when an external oscillation was applied to the vocal folds. Using a within-subjects experimental design, a custom external oscillatory device was fitted to the posterior portion of 12 excised pig larynges using a traditional benchtop phonation setup. For each larynx, phonation was elicited during 30 repeated trials, including 15 with and 15 without external oscillation. During the phonation trials, aerodynamic measures were collected. The outcome measure for this study was PTP, which has been established in the literature as being correlated with physiologic and self-perceived vocal effort. Furthermore, PTP is used routinely as an aerodynamic indicator of voice function, vocal efficiency, and the nature and severity of voice disorders. Although the aim was to quantify either positive (i.e., PTP decrease) or negative (i.e., PTP increase) effects of external oscillation on PTP, it was hypothesized that external oscillation would result in a reduction in average PTP values. The results of the study indicate that application of an external oscillatory device results in significantly lower PTP. These findings have important clinical implications for PTP signal acquisition and the potential use of external oscillation as a therapeutic tool to improve voice function.

Hydration of the vocal folds is important for the production of normal voice. Dehydration makes voice production more difficult and increases vocal effort. Laryngeal desiccation has been shown to increase phonation threshold pressure (PTP) and self-perceived phonatory effort (PPE) in females. Nebulized saline may reverse or offset this effect. However, few data exist regarding the effects of laryngeal desiccation and nebulized treatments in males. Further, the dose-response relationship between laryngeal desiccation and nebulized hydration treatments is unknown. This study examined the effects of two doses of nebulized isotonic saline following a laryngeal desiccation challenge in healthy male speakers. In a double-blinded, within-subjects design, 10 male college students (age range 18-26 years) attended two data collection sessions involving a 30-minute desiccation challenge followed by 3 mL or 9 mL of nebulized isotonic saline. PTP for the 10th and 80th fundamental frequency (F0) percentiles and PPE were collected before and after the desiccation challenge and at 5, 35, and 65 minutes after the nebulized treatment. PPE increased significantly following the laryngeal desiccation challenge (p < .01). Following nebulization, PPE decreased toward baseline for both doses of isotonic saline (p < .01), but failed to reverse the desiccation effect completely. No statistically significant changes in PTP occurred following the laryngeal desiccation challenge or subsequent treatments. Compared with previous research involving females, these results suggest males may respond differently to laryngeal desiccation and nebulized hydration treatments.

Vocal fold hydration is important for healthy function of the vocal mechanism. Vocal fold surface fluid protects the mucosa and facilitates efficient vocal fold oscillation. Dry air exposure, mouth breathing, insufficient intake of liquids, and behavioral factors may contribute to laryngeal dehydration. Singers are believed to be particularly at risk for voice problems related to dehydration due to environmental and voice use factors. Laryngeal desiccation and nebulized hydration treatments have been shown to influence phonation threshold pressure (PTP) and self-perceived phonatory effort (PPE) in females. However, little research exists exploring the effects of hydration in males. Additionally, few studies have examined the dose-response relationship of hydration treatments. This investigation examined the effects of a laryngeal desiccation challenge and two different doses of nebulized isotonic saline on voice production in trained male singers. In a double-blind, within-subjects repeated measures crossover investigation, 10 male singers (ages 18 to 24) received a 30 minute laryngeal desiccation challenge followed by either 3 mL or 9 mL of nebulized isotonic saline on two consecutive weeks. PTP, PPE, and self-perceived mouth and throat dryness were sampled during the following observations: predesiccation, post-desiccation, and at 5, 35, and 65 minutes post-nebulization. No differences in PTP were observed after desiccation or nebulized treatment. PPE, however, rose significantly after desiccation and returned near baseline after treatment. No significant differences between dosages were observed.

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