Biomedical subjects

J Barkmeier

Publications and source records attributed to J Barkmeier.

6 recordsLinked to original sources

PubMed2001

Quantification of static and dynamic supraglottic activity.

For estimating supraglottic compression in disordered voice production, categorical rating scales of true vocal fold coverage by supraglottic structures are the current standard. Quantification of change in the position of supraglottic structures compared to no supraglottic activity would be a better method for distinguishing between and within voice-disordered groups. This study developed a method for quantifying static supraglottic activity and extent of false vocal fold (FVF) motion during dynamic supraglottic activity. Twelve control participants and 12 individuals with voice disorders (6 with complaints of vocal fatigue and 6 with vocal fold nodules) were enrolled in the study. These individuals participated in a transnasal fiberoptic laryngeal examination in which various speech tasks were recorded. Single-frame images were selected to represent the positions of minimum and maximum supraglottic compression for each speech task. Two individuals rated these single-frame images using a categorical rating scale. Two other individuals measured the anterior-to-posterior (A-P) distance, vocal fold length, and vocal fold area. A-P and FVF compression were derived from these three measures. Reliability was demonstrated between judges for the ratings and between and within judges for the measures. Significant differences in normalized static supraglottic compression measures corresponded to the rating scale categories. Significant differences in normalized dynamic supraglottic compression measures corresponded to the differences in category ratings between minimum and maximum compression. Using the normalized measures, the voice-disordered groups demonstrated significantly greater static A-P compression (t test, p < .03) than did the control participants. These results suggest that static supraglottic activity may be diagnostic of voice disorder. Normalized dynamic FVF compression ratios were not significantly different between groups. This supports a previous hypothesis that dynamic supraglottic activity serves as an articulatory function at the level of the larynx and is part of the linguistic/phonemic system, rather than evidence of disordered laryngeal function.

Adult↗

PubMed2000

Respiratory and acoustic signals associated with bolus passage during swallowing.

In order to advance our understanding of the relation between respiration and deglutition, simultaneous videofluoroscopy and respirodeglutometry was performed. Fifteen normal, healthy, young adults (20-29 years of age) were connected to a respirodeglutometer and positioned for simultaneous videofluoroscopic assessment in the lateral plane. Subjects performed three swallows each of a 5-ml and a 10-ml bolus of liquid barium and a 5-ml bolus of paste barium, for a total of nine swallows per subject. Location of the bolus head as identified with videofluoroscopy was associated with eight respirodeglutometric variables. In addition, temporal relations for seven respirodeglutometric variables were calculated as a function of bolus volume and viscosity. Significant temporal differences were found for five of the variables by volume. No significant temporal differences were noted by viscosity. Expiration occurred before 79% and after 96% of the swallows. The number of inspirations preceding a swallow suggested a possible effect resulting from the need to hold a bolus in the mouth before receiving instructions to swallow during videofluoroscopic assessment. This effect may be important during patient evaluation. For a significant number of swallows, respiratory flow ceased before the velum was fully elevated.

Acoustics↗

PubMed1999

The effects of excessive vocalization on acoustic and videostroboscopic measures of vocal fold condition.

Although dysphonia is a recognized consequence of acute vocal abuse, associated changes in vocal fold appearance and function are not well understood. To document these presumed effects of vocal abuse, audio recordings of sustained vowel production were obtained from 42 drill sergeants daily during the first 6 days of a vocally demanding training exercise. Acoustic analysis showed abnormal levels of jitter and shimmer on Day 1 in 16 of the 42 subjects. Considering only the 26 subjects who showed normal voice acoustics on Day 1, the median levels of jitter and shimmer varied little over the course of training, and significant increases in jitter and shimmer were not seen during the study period. However, the distributions for both jitter and shimmer became more positively skewed and showed a greater number of positive outliers over the course of training. This trend was attributed to 11 subjects who showed two or more instances of abnormal voice acoustics over Days 2 through 6. Laryngeal videostroboscopic recordings of sustained vowel production also were obtained prior to and following training. Perceptual ratings of these recordings by 2 observers revealed significant increases in vocal fold edema, erythema, and edge irregularity, and decreases in vocal fold mucosal wave and amplitude of excursion following the 5-day training period. In general, there was considerable intersubject variability in the extent of acoustic and videostroboscopic effects over the course of training. Of the two types of data, videostroboscopy appears to provide a more sensitive indication of the effects of excessive vocalization.

Adult↗

PubMed1998

Spasmodic dysphonia and vocal fold paralysis: outcomes of voice problems on work-related functioning.

Patients at a university voice disorder clinic diagnosed with spasmodic dysphonia (SD, n = 68) or vocal fold paralysis (VFP, n = 57) reported vocal symptoms and adverse work outcomes in contrast to a nondisordered group (ND, n = 68). Patients with SD most frequently cited symptoms of effortfulness (57%) and weakness (54%), VFP cited hoarseness (70%) and weakness (60%), while the nondisordered reported hoarseness (28%). SD and VFP produced greater (p< .05) adverse work outcomes than the nondisordered in the past (SD: 65%, VFP: 41%, ND: 3%), potential future (SD: 78%, VFP: 65%, ND: 19%), and current job performance (SD: 64%, VFP: 46%, ND: 2%). These disorders significantly disrupt socioeconomic outcomes and research is needed to improve functional ability and quality of life.

Adult↗

PubMed1992

Vocal evaluation of thyroplastic surgery in the treatment of unilateral vocal fold paralysis.

Vocal function was assessed in 15 patients who received thyroplasty type I for the rehabilitation of unilateral vocal fold paralysis. The function was assessed by perceptual evaluation, voice intensity and frequency range profiles, and questionnaire. Goals of the study were to evaluate the efficacy of thyroplasty in improving the voice, to compare postoperative thyroplasty voices to normal voices, and to correlate objective measurements to the results of the questionnaire regarding satisfaction with the voice. Perceptual evaluations were performed by randomizing normal and thyroplasty voices on a recording tape. The voices on the tape were then rated by independent, blinded, trained listeners. The perceptual qualities of pitch, intonation, and loudness were not statistically different than normals; however, voice qualities of strain, breathiness, hoarseness, harshness, and unsteadiness were different than normals. Mean frequency range and mean intensity range were moderately to severely reduced from normals with a wide variation being present in the results. The correlation between the higher threshold phonation pressures and decreased intensity ranges found in some patients is discussed. Questionnaire results indicated that a high degree of satisfaction with the surgery was present (92%). Extreme or general satisfaction with voice was present in 73%. The most difficult voicing was experienced at work, with 25% needing to adjust their employment to accommodate their voice abilities. These results indicate that thyroplasty type I is effective in partially rehabilitating unilateral voice fold paralysis. Voice function is still not normal, probably in part due to the underlying disease.

Adolescent↗

PubMed1991

Scaling and transcription measures of intelligibility for populations with disordered speech.

Although Samar and Metz (1988) have addressed significant issues regarding the assessment of the intelligibility of hearing-impaired talkers, we cannot agree with their interpretation of their findings. Because the transcription and rating-scale measures were performed on different types of speech samples, the two sets of scores cannot be compared. Moreover, transcription and scaling measures may provide fundamentally different estimates of speech performance. Investigators should select which measure to use after considering the appropriate construct validity and the purpose of the measurement.

Hearing Disorders↗