Personalized beta band HD-tACS over the left SMA improves speech and limb movement by modulating prefrontal delta oscillations in neurotypical young adults.

Objective: The supplementary motor area (SMA) demonstrates abnormal beta activity (13-30 Hz) during speech and limb movement tasks in neurological conditions such as Parkinson's disease (PD). Transcranial Alternating Current Stimulation (tACS) has demonstrated promising improvements in motor and non-motor functions by entraining endogenous neural oscillations. We conducted an exploratory study on the modulatory effects of personalized beta high-definition (HD)-tACS over the left SMA on speech production and limb movement.

Unstructured Electronic Health Records of Dysphagic Patients Analyzed by Large Language Models.

Objective: Dysphagia is a common and complex disorder that complicates both diagnoses and treatment. Consequently, the associated electronic health records (EHR) are often unstructured and complex, posing challenges for systematic data analysis.

Methods And Procedures: In this study, we employ natural language processing (NLP) techniques and large language models (LLMs) to automatically analyze clinical narratives and extract diagnostic information from a diverse set of EHRs.

Machine learning based assessment of hoarseness severity: a multi-sensor approach centered on high-speed videoendoscopy.

Introduction: Functional voice disorders are characterized by impaired voice production without primary organic changes, posing challenges for standardized assessment. Current diagnostic methods rely heavily on subjective evaluation, suffering from inter-rater variability. High-speed videoendoscopy (HSV) offers an objective alternative by capturing true intra-cycle vocal fold behavior.

Machine Learning-Based Estimation of Hoarseness Severity Using Acoustic Signals Recorded During High-Speed Videoendoscopy.

Objectives: This study investigates the use of sustained phonations recorded during high-speed videoendoscopy (HSV) for machine learning-based assessment of hoarseness severity (H). The performance of this approach is compared with conventional recordings obtained during voice therapy to evaluate key differences and limitations of HSV-derived acoustic recordings.

Methods: A database of 617 voice recordings with a duration of 250 ms was gathered during HSV examination (HS).

Patient-Reported Outcomes after False Vocal Folds Injections for Adductor Spasmodic Dysphonia.

Objectives: The primary objective of this study is to investigate if false vocal folds (FVF) or simultaneous FVF with thyroarytenoid (FVF+TA) Botox® injections achieve comparable treatment effects to standard TA injections. This study also aims to determine how patient-reported outcomes contribute to the transition to, and continuation of, FVF or FVF+TA injections.

Methods: Retrospective chart review was performed for all patients receiving Botox® for adductor spasmodic dysphonia at a laryngology practice between 2005 and 2018.

Machine learning based estimation of hoarseness severity using sustained vowelsa).

Auditory perceptual evaluation is considered the gold standard for assessing voice quality, but its reliability is limited due to inter-rater variability and coarse rating scales. This study investigates a continuous, objective approach to evaluate hoarseness severity combining machine learning (ML) and sustained phonation. For this purpose, 635 acoustic recordings of the sustained vowel /a/ and subjective ratings based on the roughness, breathiness, and hoarseness scale were collected from 595 subjects.

Re-Training of Convolutional Neural Networks for Glottis Segmentation in Endoscopic High-Speed Videos.

Endoscopic high-speed video (HSV) systems for visualization and assessment of vocal fold dynamics in the larynx are diverse and technically advancing. To consider resulting "concepts shifts" for neural network (NN)-based image processing, re-training of already trained and used NNs is necessary to allow for sufficiently accurate image processing for new recording modalities. We propose and discuss several re-training approaches for convolutional neural networks (CNN) being used for HSV image segmentation.

Formant-Aware Spectral Analysis of Sustained Vowels of Pathological Breathy Voice.

Objectives: This paper reports the effectiveness of formant-aware spectral parameters to predict the perceptual breathiness rating. A breathy voice has a steeper spectral slope and higher turbulent noise than a normal voice. Measuring spectral parameters of acoustic signals over lower formant regions is a known approach to capture the properties related to breathiness.

Computational fluid dynamics model of laryngotracheal stenosis and correlation to pulmonary function measures.

3D models of airway lumens were created from CT scans of 19 patients with laryngotracheal stenosis. Computational fluid dynamics (CFD) simulations were completed for each, and results were compared to measured peak inspiratory flow rate, grade of lumen constriction, and measures of airway geometry. Results demonstrate flow resistance and shear stress correlate with degree of lumen constriction and absolute cross-sectional area as well as flow rate.

Pixel-Based Swallow Measurements: Correcting Nonsquare Pixels.

Purpose: This research note illustrates the effects of video data with nonsquare pixels on the pixel-based measures obtained from videofluoroscopic swallow studies (VFSS).

Method: Six pixel-based distance and area measures were obtained from two different videoflouroscopic study units; both yielding videos with nonsquare pixels with different pixel aspect ratios (PARs). The swallowing measures were obtained from the original VFSS videos and from the videos after their pixels were squared.

Investigation of Vocal Bifurcations and Voice Patterns Induced by Asymmetry of Pathological Vocal Folds.

Purpose: Vocal fold asymmetry creates irregular entrainments and modulations in voice, which may lead to rough perceptual quality. The presence of asymmetry can also cause mid-phonation bifurcations where a small change in the phonatory system causes a drastic change in vibration pattern, resulting in transitions in and out of rough voice. This study surveys sustained phonation recordings of speakers with the diagnoses of vocal fold polyp or unilateral vocal fold paralysis to investigate the resulting voice patterns.

Harmonics-to-noise ratio estimation with deterministically time-varying harmonic model for pathological voice signals.

The harmonics-to-noise ratio (HNR) and other spectral noise parameters are important in clinical objective voice assessment as they could indicate the presence of nonharmonic phenomena, which are tied to the perception of hoarseness or breathiness. Existing HNR estimators are built on the voice signals to be nearly periodic (fixed over a short period), although voice pathology could induce involuntary slow modulation to void this assumption. This paper proposes the use of a deterministically time-varying harmonic model to improve the HNR measurements.

A Deep Learning Enhanced Novel Software Tool for Laryngeal Dynamics Analysis.

Purpose High-speed videoendoscopy (HSV) is an emerging, but barely used, endoscopy technique in the clinic to assess and diagnose voice disorders because of the lack of dedicated software to analyze the data. HSV allows to quantify the vocal fold oscillations by segmenting the glottal area. This challenging task has been tackled by various studies; however, the proposed approaches are mostly limited and not suitable for daily clinical routine.

Interdependencies between acoustic and high-speed videoendoscopy parameters.

In voice research, uncovering relations between the oscillating vocal folds, being the sound source of phonation, and the resulting perceived acoustic signal are of great interest. This is especially the case in the context of voice disorders, such as functional dysphonia (FD). We investigated 250 high-speed videoendoscopy (HSV) recordings with simultaneously recorded acoustic signals (124 healthy females, 60 FD females, 44 healthy males, 22 FD males).

Predicting Need for Surgery in Recurrent Laryngotracheal Stenosis Using Changes in Spirometry.

Objectives/hypothesis: We sought to identify changes that occur in spirometric values between surgical interventions in patients with recurrent laryngotracheal stenosis and assess the utility of tracking those changes in predicting the need to return to surgery.

Methods: This is a retrospective, case-control study of laryngotracheal stenosis. Charts from a 10 year period were reviewed, and 80 patients were identified with recurrent laryngotracheal stenosis and serial spirometry.

BAGLS, a multihospital Benchmark for Automatic Glottis Segmentation.

Laryngeal videoendoscopy is one of the main tools in clinical examinations for voice disorders and voice research. Using high-speed videoendoscopy, it is possible to fully capture the vocal fold oscillations, however, processing the recordings typically involves a time-consuming segmentation of the glottal area by trained experts. Even though automatic methods have been proposed and the task is particularly suited for deep learning methods, there are no public datasets and benchmarks available to compare methods and to allow training of generalizing deep learning models.

Determination of Clinical Parameters Sensitive to Functional Voice Disorders Applying Boosted Decision Stumps.

Background: Various voice assessment tools, such as questionnaires and aerodynamic voice characteristics, can be used to assess vocal function of individuals. However, not much is known about the best combinations of these parameters in identification of functional dysphonia in clinical settings.

Methods: This study investigated six scores from clinically commonly used questionnaires and seven acoustic parameters.

Predicting Swallowing Outcomes from Objective Videofluoroscopic Timing and Displacement Measures in Head and Neck Cancer Patients.

Radiation therapy with or without chemotherapy compromises swallowing efficiency and safety in patients with head and neck cancer (HNC). The resulting dysphagia leads to overall morbidity, with altered diets, reduced nutritional intake, reduced quality of life, and potential interruption of curative cancer treatment. Despite well-documented radiation-related changes in swallowing physiology, scarce research exists on the potential clinical value for measurements of swallowing timing and displacement in this population.

Influence of spatial camera resolution in high-speed videoendoscopy on laryngeal parameters.

In laryngeal high-speed videoendoscopy (HSV) the area between the vibrating vocal folds during phonation is of interest, being referred to as glottal area waveform (GAW). Varying camera resolution may influence parameters computed on the GAW and hence hinder the comparability between examinations. This study investigates the influence of spatial camera resolution on quantitative vocal fold vibratory function parameters obtained from the GAW.

Voice Outcomes Following Multiple Surgeries for Recurrent Respiratory Papillomatosis.

Objectives: Recurrent Respiratory Papillomatosis (RRP) is a rare disease caused by the human papilloma virus that presents as warty, exophytic growths in the upper airway. RRP in the larynx can lead to severe airway obstruction and voice changes. It is clinically known that patients with RRP frequently experience dysphonia.

Vocal Fold Vibration in Older Adults With and Without Age-Related Dysphonia.

Purpose: The purpose of this study was to identify the extent to which 7 measures of glottal area timing and regularity differ between older adults with and without age-related dysphonia (ARD).

Method: Laryngeal high-speed videoendoscopy was completed at 4,000 frames per second for 42 adults aged 70 years and older (ARD: 9 female, 5 male; control group: 15 female, 13 male). Relative glottal gap, open quotient, speed index, maximum area declination rate, harmonics-to-noise ratio, harmonic richness factor, and standard deviation of fundamental frequency were measured from a 0.

Dependencies and Ill-designed Parameters Within High-speed Videoendoscopy and Acoustic Signal Analysis.

Objective: The phonatory process is often judged during sustained phonation by analyzing the acoustic voice signal and the vocal fold vibrations. Many formulas and parameters have been suggested for qualifying the characteristics of the acoustic signal and the vocal fold vibrations during sustained phonation. These parameters are directly computed from the acoustic signal and the endoscopic glottal area waveform (GAW).

Reliability of High-speed Videoendoscopic Ratings of Essential Voice Tremor and Adductor Spasmodic Dysphonia.

Objectives: The main objectives of this study were to (1) examine intrarater and inter-rater reliabilities in perceptual ratings of vocal fold vibratory patterns and supraglottic characteristics for essential vocal tremor and adductor spasmodic dysphonia (AdSD) using high-speed videoendoscopy (HSV), and (2) to investigate the specificity of the parameters in differentiating these two voice disorders.

Methods: HSV recordings of 34 cases diagnosed with essential vocal tremor, AdSD, or AdSD with vocal tremor were evaluated blindly by two voice speech pathologists. The two raters examined all HSV video segments twice across nine supraglottic and vocal fold vibratory characteristics for inter-rater and intrarater reliabilities.

Laryngeal High-Speed Videoendoscopy: Sensitivity of Objective Parameters towards Recording Frame Rate.

The current use of laryngeal high-speed videoendoscopy in clinic settings involves subjective visual assessment of vocal fold vibratory characteristics. However, objective quantification of vocal fold vibrations for evidence-based diagnosis and therapy is desired, and objective parameters assessing laryngeal dynamics have therefore been suggested. This study investigated the sensitivity of the objective parameters and their dependence on recording frame rate.

A review of postsurgical dysphagia in nonmalignant disease.

Purpose Of Review: This article reviews current literature regarding postsurgical dysphagia in nonmalignant disease examining the current recommendations, risk factors, and potential implications.

Recent Findings: Surgical interventions including anterior cervical spine surgery, thyroidectomy, laryngeal and pulmonary, cardiac, esophageal and fundoplication, gastric and bariatric, and posterior fossa surgeries are known to result in swallowing dysfunction. Postsurgical dysphagia may increase the length of hospitalization, overall cost, risk of pneumonia, and time to oral intake.