Estimating phonation threshold pressure

Phonation threshold pressure (PTP) is the minimum subglottal pressure required to initiate vocal fold oscillation. Although potentially useful clinically, PTP is difficult to estimate noninvasively because of limitations to vocal motor control near the threshold of soft phonation. Previous investigators observed, for example, that trained subjects were unable to produce flat, consistent oral pressure peaks during/pae/syllable strings when they attempted to phonate as softly as possible (Verdolini-Marston, Titze, & Druker, 1990). The present study aimed to determine if nasal airflow or vowel context affected phonation threshold pressure as estimated from oral pressure (Smitheran & Hixon, 1981) in 5 untrained female speakers with normal velopharyngeal and voice function. Nasal airflow during /p/occlusion was observed for 3 of 5 participants when they attempted to phonate near threshold pressure. When the nose was occluded, nasal airflow was reduced or eliminated during /p/;however, individuals then evidenced compensatory changes in glottal adduction and/or respiratory effort that may be expected to alter PTP estimates. Results demonstrate the importance of monitoring nasal flow (or the flow zero point in undivided masks) when obtaining PTP measurements noninvasively. Results also highlight the need to pursue improved methods for noninvasive estimation of PTP.     

Excess mortality and its relation to hypertension and proteinuria in diabetic patients. The world health organization multinational study of vascular disease in diabetes

The speech problem in patients born with cleft lip and palate is mainly due to the insufficiency of the velopharyngeal (VP) valving mechanism, manifested as in visually seen nasal emission, and auditorily perceived hypernasality and articulation disorders. Evaluations of resonance and VP function can be conducted by: (1) perceptual rating scale based on speech pathologist's subjective judgement and (2) objective instrumental assessment, by the use of specific instrument. Nasopharyngoscopy has been commonly used clinically to diagnose VP function. The purpose of this study is: using nasopharyngoscopy to investigate the differences in VP mechanism between those with VP competence and VP incompetence in the dimension of velar displacement, lateral pharyngeal wall (LPW) displacement, degree of VP closure and pattern of VP closure. Ninty-eight subjects were studied from June 1990 to August 1991. They were divided into 4 groups: (1) group 1: normals with normal speech; (2) group 2: cleft of lip only, with normal speech; (3) group 3: cleft palate without nasal emission, but normal articulation; (4) group 4: cleft palate with nasal emission, with or without articulation error. Age range was from 6-47 years old with equal sex distribution. Ten Chinese sentences were used for standard test sentences, and were grouped according to Mandarin phonological distinctive features into 5 categories: (1) nasals; (2) vowels; (3) plosives; (4) fricatives/affricates; (5) connected number counting. The result indicates that the insufficient velar displacement to contact posterior pharyngeal wall is a determining factor causing velopharyngeal insufficiency in group 4; however, the lateral pharyngeal wall movement is not significantly different among 4 groups. Coronal pattern of velopharyngeal closure is the most common pattern among 4 groups of speakers.     

Lip and jaw kinematics in bilabial stop consonant production

This paper reports two experiments, each designed to clarify different aspects of bilabial stop consonant production. The first one examined events during the labial closure using kinematic recordings in combination with records of oral air pressure and force of labial contact. The results of this experiment suggested that the lips were moving at a high velocity when the oral closure occurred. They also indicated mechanical interactions between the lips during the closure, including tissue compression and the lower lip moving the upper lip upward. The second experiment studied patterns of upper and lower lip interactions, movement variability within and across speakers, and the effects on lip and jaw kinematics of stop consonant voicing and vowel context. Again, the results showed that the lips were moving at a high velocity at the onset of the oral closure. No consistent influences of stop consonant voicing were observed on lip and jaw kinematics in five subjects, nor on a derived measure of lip aperture. The overall results are compatible with the hypothesis that one target for the lips in bilabial stop production is a region of negative lip aperture. A negative lip aperture implies that to reach their virtual target, the lips would have to move beyond each other. Such a control strategy would ensure that the lips will form an air light seal irrespective of any contextual variability in the onset positions of their closing movements.     

The perception of speech gestures

Two experiments examined the effects of temporal overlap of speech gestures on the perception of stop consonant clusters. Sequences of stop consonant gestures that exhibit temporal overlap extreme enough to potentially eliminate the acoustic evidence of (at least) one of the consonants were obtained from x-ray microbeam data. Subjects were given a consonant monitoring task using stimuli containing stop sequences as well as those containing single stops. Results showed that (1) the initial consonant in the stop sequences was detected significantly less often than in the single stops; (2) bilabial gestures were considerably more effective at obscuring a preceding alveolar than the reverse; and (3) the detection rate correlated with an index of overlap between lip and tongue tip gestures. Experiment 2 employed stimuli that were truncated during the closure for the critical stop or stop sequence, so as to eliminate any information occurring in the acoustic signal at the stop release. This experiment showed that removing release information decreased detectability of the consonants generally. However, consistent with the observed gestural patterns, removing the release did not decrease detection of the alveolar stop when it was the first consonant of a sequence, indicating that there was no information about the alveolar stop present in acoustic realization of the second stop release. These experiments show that certain gestural patterns actually produced by English speakers may not be completely recoverable by listeners, and further, that it is possible to relate recoverability to particular metric properties of the gestural pattern.     

Production constraints on utterance-final consonant characteristics in babbling

In order to evaluate hypotheses regarding production constraints on final consonants in babbling, 721 utterance-final consonants produced by 6 infants in consonant-vowel-consonant (CVC) syllables were examined and compared with the preceding consonant in the CVC. Consistent with earlier studies, major patterns were observed for each of the three main consonantal properties--place and manner of articulation and voicing. These patterns included a strong tendency for final consonants to repeat the place of articulation of nonfinal consonants and a tendency for relatively more fricative, nasal and voiceless consonants to occur in final position than in nonfinal position. The high frequency with which final consonants shared place of articulation with the preceding consonant was considered to reflect 'frame dominance' or the tendency of a relatively constant mandibular cycle (the frame) to determine the structure of utterances with very little contribution from other active articulators. The manner and voicing effects were attributed to an overall terminal energy decrease in the vocal production system.     

An electromyographic study of velopharyngeal function in speech

Electromyographic (EMG) recordings were obtained from the levator palatini, superior pharyngeal constrictor, middle pharyngeal constrictor, palatoglossus, and palatopharyngeus muscles of three talkers of American English. Bipolar hooked-wire electrodes were used. Each subject read nonsense words composed of three vowels (/i, a, u/), six stop consonants (/p, b, t, d, k, g/), and two nasal consonants (/m, n/) to form various stop-nasal and nasal-stop contrasts. Multiple repetitions of each utterance type were recorded and subsequently processed by computer. The levator palatini was found to be the primary muscle of velopharyngeal closure for each of the subjects. The palatopharyngeus also showed consistent oralization activity for each of the subjects, although the activity of this muscle was strongly affected by vowel environment. Two subjects showed pharyngeal constrictor muscle activity related to oral articulation, but pharyngeal constrictor activity for the third subject was related to vowel quality. Nasal articulation was accomplished by suppression of oral articulation for each subject. Vowel quality affected the strength of EMG signals for lateral and posterior pharyngeal wall muscles. In those cases where activity was different for the three vowels, activity was greatest for /a/.     

The double-reversing Z-plasty in primary palatoplasty: operative experience and early results

The double-reversing Z-plasty of Furlow for closure of the soft palate was used in 34 children with various types of cleft palate. Mean age at repair was 12.8 months. Intraoperative experience was favorable, with acceptable operating time and blood loss. Length of hospitalization averaged 1.9 days. Postoperatively, two children experienced temporary stridor, which resolved within 24 to 48 hours. One child had dehiscence of the hard palate (Von Lagenbeck repair) 4 weeks postoperatively, and three children developed small oronasal fistulae. Early speech evaluation demonstrated adequate soft palate mobility in 33 of 34 patients, with observable velopharyngeal function. Twelve children had mild velar compromise, with eight exhibiting slight nasal air escape.     

"Functionally specific articulatory cooperation following jaw perturbations during speech: Evidence for coordinative structure": Correction to Kelso et al.

Reports an error in "Functionally specific articulatory cooperation following jaw perturbations during speech: Evidence for coordinative structures" by J. Scott Kelso, Betty Tuller, E. Vatikiotis-Bateson and Carol A. Fowler (Journal of Experimental Psychology: Human Perception and Performance, 1984[Dec], Vol 10[6], 812-832). There is a typographical error on page 818 (line 3, right-hand column): '(SD = 18 ms)" should read '(SD = 7 ms)". (The following abstract of the original article appeared in record 1985-27687-001.) Three experiments revealed that articulatory patterns in response to jaw perturbations are specific to the utterance produced. In Exps I and II (using one of the authors as an S), an unexpected constant force load (5.88 Newton) applied during upward jaw motion for final /b/ closure in the utterance /b?b/ revealed nearly immediate compensation in upper and lower lips, but not the tongue, on the 1st perturbation trial. In Exp III (with 1 adult male S), the phase of the jaw perturbation was varied during the production of bilabial consonants. Remote reactions in the upper lip were observed only when the jaw was perturbed during the closing phase of motion. Findings provide evidence for flexibly assembled coordinative structures in speech production. (51 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autonomic regulation of nasal vessels during changes in body position

The effects of postural changes on nasal airflow and nasal capillary blood flow were investigated in 15 healthy volunteers. Measurements were performed following nasal application of saline solution (control), the alpha-1 receptor antagonist prazosin, the alpha-2 receptor antagonist yohimbine, and after application of both prazosin and yohimbine. Nasal airflow in the control experiments did not significantly differ in the upright (362 +/- 166 ml/s), dorsally recumbent (350 +/- 167 ml/s) and 70 degrees head down position (311 +/- 167 ml/s). Following application of prazosin, nasal airflow was reduced to 223 +/- 121 ml/s in the upright position. Prazosin treatment significantly reduced nasal airflow to 177 +/- 111 ml/s when subjects were placed in dorsally recumbent positions and to 117 +/- 104 ml/s in 70 degrees head down positions (P < 0.001). Following application of yohimbine, nasal airflow remained stable when subjects were turned from upright (348 +/- 165 ml/s) to supine position (352 +/- 186 ml/s), whereas it was reduced to 199 +/- 137 ml/s in the head-down position. Application of both prazosin and yohimbine significantly increased nasal capillary blood flow in laser Doppler flowmetry measurements (P < 0.05). Changes in body position with or without application of the active drugs did not alter nasal capillary blood flow. These findings suggest that nasal congestion due to increased filling pressure in nasal capacitance vessels following postural changes is mainly prevented by alpha-1 adrenergic mechanisms.     

A cineradiographic study of articulation in two talkers with temporarily induced oral sensory deprivation

Cineradiography was used to study the behavior of the lips, tongue, and mandible in two subjects talking normally and under the influence of trigeminal nerve-block anesthesia. The speech sample consisted of isolated words and sentences. The nerve block was administered to eliminate somesthetic sensation in all of the oral articulators except the jaw. Frame-by-frame measurements of lip protrusion, tongue position, and jaw placement were taken from the film data for selected stops, glides, fricatives, and vowels in the speech sample. Comparison of these measurements from the normal and nerve-block condition revealed the following changes in the nerve-block data: (1) reduction in context-appropriate lip protrusion and loss of precision in lip closure activity, which was more noticeable for the upper than the lower lip; (2) a reduction in the precision of tongue articulations particularly on contacts for lingua-alveolar and lingua-velar consonants, apical retroflexion on glides, and steady state postures for lingua-palatal fricatives and vowels; and (3) noticeable alterations in inferior/superior jaw position which was systematically closer to the maxilla for bilabial consonant closures and often reduced or extended in excursion for vowels and other consonants. The data are discussed in terms of the relative effects of an oral somesthetic feedback deficit on speech production, and also with respect to compensation within the articulatory system under conditions of sensory deprivation.     

Aerodynamic and acoustic characteristics of a speaker with turbulent nasal emission: a case report

Aerodynamic and acoustic characteristics were determined from the speech of an adult female with mild mental retardation and severe velopharyngeal inadequacy. The speaker's productions of /s/ were characterized by consistent nasal grimacing and turbulent air emission. Aerodynamic assessment estimated the size of the velopharyngeal orifice to exceed 200 mm2 during plosive production. Nasal cross-sectional area was estimated to be 35 mm2 during quiet breathing. Nasometric evaluation indicated nasalance of 63% associated with the "Zoo" passage. Acoustic analysis of the separately recorded oral and nasal speech signals indicated spectral energies in the region of approximately 2.5 to 7.0 kHz associated with nasal emission during /s/ production. The occurrence of these frequencies suggested an acoustic/perceptual function of the nasal grimace. Pressure-flow evidence also suggested that the nasal grimace, perhaps with lingual assistance, functioned to enhance speech aerodynamics.     

Magnetic resonance imaging of muscle in amyotrophic lateral sclerosis

In the present study we were interested to determine whether the maximum unilateral nasal airflow associated with the nasal cycle (Fmax physiol) was equivalent to the maximum unilateral nasal airflow that could be achieved by the application of a topical nasal decongestant (Fmax pharmacol). Eight healthy subjects (three male and five female, aged between 19-28 years) were recruited for this study. Unilateral nasal airflow was measured using posterior rhinomanometry at the inspiratory reference pressure of 75 Pa by alternately occluding each nostril with surgical tape. The study was run over 2 consecutive days. On day one, measurements of unilateral nasal airflow were performed every hour for 8 h in each subject and Fmax physiol was found to be 265 cm3/sec (147) (median and interquartile range). On day 2 the median unilateral nasal airflow before application of the nasal decongestant was 171 cm3/sec (140) and this increased to 251 cm3/sec (127) (p = 0.046) at 15 min and to 278 cm3/sec (134) (p = 0.005) at 45 min after application of the decongestant (Fmax pharmacol). A paired comparison of Fmax physiol and Fmax pharmacol showed that these nasal airflow measurements were not significantly different (p > 0.999). The results show that there was no difference between the maximum physiological decongestion produced during the course of the nasal cycle and that produced pharmacologically by a topical nasal decongestant. This indicates that the point of maximal sympathetic vasoconstrictor tone occurring during the nasal cycle causes a constriction of the nasal venous sinuses that is equal to the constrictor response that can be achieved by applying a topical sympathomimetic medication.     

Occurrence and trends in ski injuries in Norway

OBJECTIVE: The objective of this study was to determine the influence of velopharyngeal (VP) inadequacy on respiratory speech compensations. DESIGN: The pressure-flow technique was used to measure pressure, airflow, and timing variables associated with VP closure during the production of the initial plosive consonant /p/ in a series of the utterance "papa." SETTING: The study was conducted in the speech and breathing laboratory of the UNC Craniofacial Center. PARTICIPANTS: Eighty-two subjects with cleft lip and/or palate were assessed. The subjects were divided into two groups, those with adequate VP closure (VP size <.010 cm2) and those with inadequate VP closure (VP size >0.10 cm2). The adequate group was comprised of 62 subjects, and 20 subjects were categorized as inadequate. RESULTS: Peak intraoral pressure decreased in the inadequate group, but the difference was not significant. Nasal airflow increased (p < .01), but duration of the pressure pulse was the same for both groups. The area under the pressure curve decreased for the inadequate group (p = .04). CONCLUSION: These data contrast with previously reported published data using /p/ in the utterance "hamper." This suggests that phonetic context influences the compensatory response to velopharyngeal inadequacy. Additionally, while the findings are somewhat similar to studies that involved noncleft subjects whose oral airway was suddenly vented during the production of /p/, there is enough difference to suggest that learning also affects the compensatory outcome.     

Locus of selective adaptation in speech perception.

Used the interaural transfer technique in 2 experiments with 19 Ss (aged 18–45 yrs) and 9 Ss (aged 19–34 yrs), respectively, to determine the relative locus of selective adaptation in speech perception. Findings show that voiced (/ba/ or /da/) and voiceless (/pa/ or /ta/) consonants seemed to affect different auditory system loci. On a voice-onset-time continuum (/ba/ to /pa/ or /da/ to /ta/) the selective adaptation effects produced by voiceless consonants were largely ear independent and endured over delays of at least 1 min. However, voiced adapters produced selective adaptation effects that were highly ear specific and relatively short lived (     

Physiological and perceptual features of dysarthria in Moebius syndrome: directions for treatment

The functioning of the major subsystems of the speech production apparatus of a 12 year old female with Moebius syndrome was investigated using a battery of perceptual and physiological instrumental measures. Perceptual tests administered included: The Assessment of Intelligibility of Dysarthric Speech; the Frenchay Dysarthria Assessment; and a perceptual analysis of a speech sample based on a reading of the Grandfather Passage. Instrumental procedures included: spirometric and kinematic analysis of speech breathing; electroglottographic and aerodynamic evaluation of laryngeal function; nasometric assessment of velopharyngeal function; and evaluation of lip and tongue function using a variety of strain-gauge and pressure transducers. Consistent with the pathophysiological basis of Moebius syndrome, the major dysfunctions of the speech production mechanism were found at the level of the articulatory valve. Somewhat unexpectedly, however, impaired function was also identified at the level of the velopharyngeal and laryngeal valves by both the perceptual and instrumental assessments and at the level of the respiratory system by the physiological analysis alone. The results are discussed with reference to the neurological basis and clinical features of Moebius syndrome. The implications of the findings for the treatment of congenital dysarthria associated with Moebius syndrome are also discussed. The advantage of instrumental analysis over perceptual assessments in defining treatment goals for children with congenital dysarthria is highlighted.     

Effects of word linguistic properties on phonological awareness in Spanish children.

We investigated whether some word linguistic properties studied by R. Treiman and S. Weatherston (see record 1992-37025-001) in the English language have the same influence on phonological awareness of preschoolers and kindergartners in the Spanish language. We examined the effects of these word linguistic properties on children's ability to isolate the initial consonant: phoneme articulatory properties, the position of stressed syllables in the words, the presence of initial consonant clusters, and the word length. We found that effects due to word length and the syllable-initial consonant cluster were similar in English and Spanish. In contrast to English-speaking children, the Spanish-speaking children could pronounce the first consonant regardless of the position of the stressed syllable, and continuant consonants were easier to isolate than stop consonants. Implications for the training of phonological awareness in the Spanish language are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Complete eradication of Aspergillus fumigatus from the lung in an immunocompromised patient by oral itraconazole

Fifty-three deaf subjects with a history of prelingual profound bilateral sensorineural hearing loss, similar language habilitation with hearing aids, and normal velopharyngeal structures underwent a study protocol including speech evaluation, behavioral pure-tone audiometry, videonasopharyngoscopy, multiview videofluoroscopy, and electromyography of the velopharyngeal muscles. Subjects were divided into two groups: the first group included 13 subjects with normal nasal resonance or mild hypernasality (four normals and nine with mild hypernasality); the second group had subjects with severe hypernasality and severe articulation deficits. Pure-tone thresholds, velopharyngeal closure patterns, and electromyographic activity of velopharyngeal muscles were similar for both groups of subjects. However, in subjects with severe hypernasality, despite normal muscle activity as observed by electromyography, velopharyngeal valving activity lacked rhythm and strength during speech. It is concluded that deaf subjects may present a functional disorder of the velopharyngeal sphincter related to absence of auditory regulation during phonation. Visual biofeedback using videonasopharyngoscopy may be useful for treating this disorder.     

Elongation and folding of nascent ricin chains as peptidyl-tRNA on ribosomes: the effect of amino acid deletions on these processes

This paper is an investigation of articulatory-acoustic correlations differing in degree of articulatory constraint. Data on F2 and on dorsopalatal contact (electropalatographic, EPG) were collected for the sequences /iCi/ and /aC./ with seven Catalan consonants differing in place and manner of articulation (velarised /l/, /n/, /n/, /s/, /f/, /l/, /p/). These consonants are characterised by different degrees of tongue dorsum constraint depending on their production requirements (dorsals > non-dorsals, fricatives > non-fricatives, etc.). The results showed an inverse relationship between vowel-dependent coarticulation and the degree of consonant-dependent articulatory constraint. F2 and dorsopalatal contact size were found to be positively correlated across consonants and speakers, and across consonants for each individual speaker. Correlation values were much lower for each consonant across speakers. These findings are discussed in the light of the acoustic theory of speech production and possible clinical applications are suggested.     

Nasal airflow after septorhinoplasty

The changes in nasal function which occur after septorhinoplasty for obstruction were investigated by anterior rhinomanometry in 15 subjects. Objective and subjective measures of outcome were compared. Anterior rhinomanometry was performed after nasal decongestion. These data were mathematically transformed to determine the amount of airflow asymmetry through the nostrils and the stiffness of the nasal valve. The results suggested that the presence of gross airflow asymmetry (> +/- 80%) in patients prior to surgery was a bad prognostic indicator for post-operative satisfaction with the airway. Patient satisfaction with function and cosmetic appearance post-operatively was correlated with the presence of symmetrical nasal airflow. Nasal valve stiffness did not seem to be affected by septorhinoplasty.     

Anamnestic and polygraphic parameters in obstructive sleep apnea syndrome patients with reduced nasal respiration during the day in comparison with obstructive sleep apnea patients with normal nasal respiration

Nasal obstruction is a predictive factor for snoring and may contribute to the development of an obstructive sleep apnea syndrome (OSAS). The aim of this study was to further evaluate the impact of nasal obstruction in OSAS. Therefore, we investigated 2 groups of OSAS-patients, matched pairs concerning gender, age, and BMI: OSAS-patients with nasal obstruction (N, n = 28), total nasal airflow < 500 ccm/s (referred to 150 pa pressure of difference or unilateral nasal resistance > 1 pa/ccm/s), and 28 OSAS-patients without nasal obstruction (control-group K, total nasal airflow > 700 ccm/s [referred to 150 pa pressure of difference or unilateral nasal resistance > 1 pa/ccm/s]). We performed anterior rhinomanometry, lung-function testing, cardio-respiratory polygraphy, and patients answered a standardized questionnaire. We found the following significant differences: 1) N complained more often (n = 17) about dyspnea at night than K (n = 7, p < 0.05, Chi2-test). 2) N had a higher apnea index (20.4 +/- 19.0/h) than K (9.6 +/- 10.0/h, p < 0.05, Student's t-test). There were, however, no significant differences concerning lung function, number of nocturnal hypopneas, nocturnal SaO2 and heart rate. Our results underline the importance of nasal ventilation in the pathogenesis of OSAS. At least in moderate cases of OSAS a therapy of nasal obstruction might be of success in order to abolish nCPAP-therapy or might reduce nasal problems during nCPAP-therapy and thus ameliorate patient's therapy compliance.