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Characterizing Vocal Hyperfunction Using Ecological Momentary Assessment of Relative Fundamental Frequency

Journal of Voice 2024年

作者： Cheema, Ahsan J. Marks, Katherine L. Ghasemzadeh, Hamzeh Van Stan, Jarrad H. Hillman, Robert E. Mehta, Daryush D. Speech and Hearing Bioscience and Technology Program Harvard University 25 Shattuck St Boston 02115 Massachusetts United States Harvard Medical School 25 Shattuck St Boston 02115 Massachusetts United States Mass General Hospital (MGH) Voice Center 1 Bowdoin Sq Boston 02114 Massachusetts United States Eaton-Peabody Laboratories Massachusetts Eye and Ear 243 Charles St Boston 02114 Massachusetts United States Sargent College of Health and Rehabilitation Sciences Boston University 677 Beacon St Boston 02215 Massachusetts United States MGH Institute of Health Professions 36 1st Ave Boston 02129 Massachusetts United States

Many common voice disorders are associated with vocal hyperfunction (VH), with subtypes including phonotraumatic VH (leading to organic vocal fold lesions such as nodules and/or polyps) and nonphonotraumatic VH (often diagnosed as primary muscle tension dysphonia). VH has been hypothesized to influence baseline vocal fold tension during phonation, and the relative fundamental frequency (RFF) during onset and offset cycles of phonation has been related to vocal fold tension and has been shown to differentiate typical voices from patients with VH in laboratory settings. In this study, we investigated whether the laboratory sensitivity of RFF to the presence of VH found in the laboratory is preserved in naturalistic, in-field settings and whether ecological momentary assessment of RFF during daily life could be a correlate of self-reported vocal effort. RFF analysis was carried out after performing smartphone-based monitoring of anterior neck-surface vibration with accelerometer sensors in both laboratory and in-field settings. Supervised machine learning was applied to combine multiple RFF values to discriminate and classify patients with VH from vocally typical speakers. Results showed that RFF-based classification of VH can be preserved in the naturalistic environments for patients with phonotraumatic (81.3% accuracy) and nonphonotraumatic (62.5% accuracy) VH. Additionally, we used explainability techniques to understand which RFF features were clinically relevant in the classification tasks. No direct relationship was observed between RFF and self-reported vocal effort. Overall, this study advances our understanding about RFF as a potential biomarker of VH as individuals go about their daily life. Machine learning algorithms can be implemented within a monitoring device for proactive screening or in biofeedback-based voice therapy paradigms. © 2024 The Authors

关键词： Relative fundamental frequency—Vocal hyperfunction—Phonotraumatic vocal hyperfunction—Nonphonotraumatic vocal hyperfunction—Vocal effort—Machine learning—Random forest

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Impedance measurements of the human cochlear partition

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AIP Conference Proceedings 2018年第1期1965卷

作者： Stefan Raufer Hideko H. Nakajima 1Program in Speech and Hearing Bioscience and Technology Harvard University USA 2Dept. of Otolaryngology Harvard Medical School Massachusetts Eye and Ear Boston MA USA

The cochlea is a mechanical frequency analyzer, owing its characteristics to the impedance of the cochlear partition. In humans, the impedance of the partition has not been measured directly, and estimates of the stiffness (a principal component of the impedance) are based on loose assumptions. In this study, we examine not only the stiffness of the basilar membrane (BM), but also the osseous spiral lamina (OSL), which, in human, vibrates substantially. We hypothesize that the OSL contributes significantly to the volume stiffness of the cochlear partition (CP). We measured velocities of the BM and OSL at different radial locations 1 mm from the base of the cochlea in a fresh human cadaveric specimen. Simultaneously, we measured intracochlear pressures on the other side of the partition, in scala vestibuli. With the velocity and pressure measurements we can estimate the specific acoustic impedance of the BM and OSL (Z = p/v). At frequencies well below the resonant frequency, the stiffness of these structures can be extracted by multiplying the impedance by the radian frequency. The specific acoustic stiffness was found to be 1.2 GPa/m on the BM, 6 GPa/m at the juncture where the BM attaches to the OSL, and 10 GPa/m at the midpoint of the OSL. A beam model, appropriate to model the radial motion of the BM in guinea pig or gerbil, cannot describe the displacement of the human CP in the base. Instead, we find that the OSL is hinged near the modiolus and vibrates significantly near the connection to the more compliant BM, contributing greatly the volume compliance of the CP.

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Bone-conduction circuit model for chinchilla part I: Defining parameters by fitting to air-conduction data

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AIP Conference Proceedings 2018年第1期1965卷

作者： Peter Bowers John J. Rosowski 1Eaton-Peabody Laboratory Mass. Eye & Ear MA USA 3Speech and Hearing Bioscience and Technology program Harvard and M.I.T. MA USA 2Department of Otology and Laryngology Harvard Medical School MA USA

An air-conduction circuit model that will serve as the basis for a model of bone-conduction hearing is developed for chinchilla. The lumped-element model is based on the classic Zwislocki model of the human middle ear. Model parameters are fit to various measurements of chinchilla middle-ear transfer functions and impedances. The model is in agreement with studies of the effects of middle-ear cavity holes in experiments that require access to the middle-ear air space.

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Impedances of the ear estimated with intracochlear pressures in normal human temporal bones

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AIP Conference Proceedings 2018年第1期1965卷

作者： Darcy Frear Xiying Guan Christof Stieger Hideko Heidi Nakajima 1Speech and Hearing Bioscience and Technology Program Harvard Medical School USA 2Dept. Otolaryngology Massachusetts Eye & Ear Harvard Medical School Boston MA USA 3University Hospital Basel Switzerland 4University Bern Switzerland

We have measured intracochlear pressures and velocities of stapes and round window (RW) evoked by air conduction (AC) stimulation in many fresh human cadaveric specimens. Our techniques have improved through the years to ensure reliable pressure sensor measurements in the scala vestibuli and scala tympani. Using these measurements, we have calculated impedances of the middle and inner ear (cochlear partition, RW, and physiological leakage impedance in scala vestibuli) to create a lumped element model. Our model simulates our data and allows us to understand the mechanisms involved in air-conducted sound transmission. In the future this model will be used as a tool to understand transmission mechanisms of various stimuli and to help create more sophisticated models of the ear.

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The effect of middle ear cavity and superior canal dehiscence on wideband acoustic immittance in fresh human cadaveric specimens

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AIP Conference Proceedings 2018年第1期1965卷

作者： Salwa F. Masud Stefan Raufer Stephen T. Neely Hideko H. Nakajima 1Speech and Hearing Bioscience and Technology Program Harvard Medical School Cambridge MA USA 3Boys Town National Research Hospital Omaha NE USA 2Department of Otolaryngology Harvard Medical School Massachusetts Eye & Ear Boston MA USA

Superior canal dehiscence (SCD) is a hole in the bony wall of the superior semicircular canal, which can cause various auditory and/or vestibular symptoms and can result in wrong and/or delayed diagnosis. Wideband acoustic immittance (WAI) can potentially distinguish various mechanical middle-ear pathologies as well as inner-ear pathologies non-invasively. We found that in patients, SCD was commonly associated with a narrow-band decrease in power reflectance (PR, derived from WAI) near 1 kHz. Because clinical data has large variation across individual ears and because we do not know the individual “normal” state prior to SCD, we measured WAI in five fresh temporal bone specimens to determine the effects of SCD with respect to the normal state. In temporal bone, we measured PR to assess mechanical changes before and after SCD, as well as to assess the effect of an open or closed middle-ear cavity. After SCD, PR had a consistent decrease between 0.48 and 0.76 kHz, and a slight increase between 1.04 and 1.4 kHz in the open cavity condition. However, in several experiments, we observed low PR around 1 kHz in the normal state before SCD, likely due to the specimen’s open middle ear cavity (MEC). Because we see effects of both SCD and open MEC around 1 kHz, some of the SCD effect can be masked by the effect of the MEC in the temporal bone specimens. To compensate for this MEC effect, we estimated the effect of SCD in a closed MEC case, but the effect did not differ significantly from the measured open MEC. This study demonstrates the limitation of temporal bone experiments with open MEC when studying inner-ear lesions with WAI.

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Auditory-nerve phenomena relevant to cochlear mechanics

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AIP Conference Proceedings 2018年第1期1965卷

作者： John J. Guinan, Jr. Hui Nam 1Eaton-Peabody Laboratories Mass. Eye and Ear Infirmary 243 Charles St. Boston MA 02114 USA 2Harvard Medical School Dept. of Otolaryngology Boston MA USA 3Harvard-MIT HST Speech and Hearing Bioscience and Technology Program Cambridge MA. USA

We review auditory-nerve response properties that provide insight into cochlear mechanics with special emphasis on properties that are not well explained by the current understanding of cochlear mechanics.

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