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Doctoral Thesis Doctoral Thesis Selected topics in laryngeal, perceptual and acoustic assessments of human voice: Videokymographic evaluations of vocal folds and investigations of teachers’ voices Ketaki Vasant Phadke, M.Sc. Department of Biophysics Faculty of Science Palacký University Olomouc, Czech Republic Supervisor: RNDr. Jan G. Švec, Ph.D. et Ph.D. 2018 Ketaki Vasant Phadke Selected topics in laryngeal, perceptual and acoustic assessments of human voice: Videokymographic evaluations of vocal folds and investigations of teachers’ voices Vybraná témata k hodnocení lidského hlasu pomocí vyšetření hrtanu, percepčních a akustických metod: Videokymografické hodnocení hlasivek a výzkum hlasu učitelů Doctoral Thesis, Palacký University Olomouc, Czech Republic – With an abstract in Czech. Copyright © 2018: Ketaki Vasant Phadke, Olomouc, Czech Republic All rights reserved. No part of this publication may be reprinted or utilized in any form by any electronic, mechanical or other means, now known or hereafter invented, including (but not limited to) photocopying and recording, or in any information storage or retrieval system without permission of the author. Inspired by ‘The Law of Attraction’ “Faith is taking the first step even when you can’t see the whole staircase” -Dr. Martin Luther King, Jr. What We Think, We Create What We Feel, We Attract What We Imagine, We Become -Buddha? Table of Contents ACKNOWLEDGEMENT ............................................................................................................................. i LIST OF PUBLICATIONS IN THIS THESIS ............................................................................................. ii ABSTRACT ................................................................................................................................................. iii ABSTRAKT ................................................................................................................................................. v 1 MOTIVATION FOR THE WORK OF THE AUTHOR ...................................................................... 1 2 INTRODUCTION ................................................................................................................................ 2 2.1 Voice Production Mechanism ....................................................................................................... 2 2.2 Voice disorders and their classification ........................................................................................ 4 2.3 Professional voice users: Teachers’ voice..................................................................................... 7 2.3.1 Factors affecting teachers’ voice ........................................................................................... 7 2.3.2 Voice symptoms in teachers ................................................................................................. 8 2.4 Recommended protocols for assessment of voice disorders ......................................................... 9 2.5 Auditory-perceptual evaluation of voice ..................................................................................... 10 2.6 Self-evaluation of voice by patient ............................................................................................. 11 2.7 Laryngeal examination (direct visualization of the larynx or vocal folds) ................................. 11 2.7.1 Indirect laryngoscopy .......................................................................................................... 12 2.7.1.1 Mirror laryngoscopy ....................................................................................................... 12 2.7.1.2 Flexible and rigid laryngoscopy ...................................................................................... 13 2.7.2 Laryngeal imaging techniques for observing vocal fold vibrations .................................... 15 2.7.2.1 Videostroboscopy............................................................................................................ 15 2.7.2.2 High-speed videoendoscopy (HSV) ................................................................................ 16 2.7.2.3 Videokymography (VKG) .............................................................................................. 18 2.7.2.3.1 Working principle of VKG and components of VKG system .................................. 18 2.7.2.3.2 VKG vibration features and evaluation procedure .................................................... 20 2.7.2.3.3 Mucosal waves and lateral peak shape in VKG images ............................................ 25 2.7.2.3.4 VKG analyzer software ............................................................................................. 27 2.7.2.4 Clinical value of stroboscopy, HSV and VKG ............................................................... 28 2.8 Acoustic evaluation of voice ....................................................................................................... 31 2.8.1 Cepstral analysis of voice ................................................................................................... 32 2.8.1.1 The cepstrum concept ..................................................................................................... 32 2.8.1.2 The cepstral peak prominence (CPP) .............................................................................. 34 2.8.1.3 Smoothed cepstral peak prominence (CPPS) .................................................................. 35 2.8.1.4 Extraction of CPP and CPPS using different software packages .................................... 37 2.8.1.5 Applications of CPP and CPPS for assessing voice ........................................................ 40 2.8.2 Voice sound pressure level ................................................................................................. 42 2.8.2.1 Measurement of voice SPL ............................................................................................. 42 2.8.2.2 SPL Calibration ............................................................................................................... 43 3 ORIGINAL WORK OF AUTHOR .................................................................................................... 46 3.1 Aims of the thesis ........................................................................................................................ 46 3.1.1 Manuscript I: Clinical Value of Videokymography (VKG) ............................................... 46 3.1.1.1 Introduction ..................................................................................................................... 46 3.1.1.2 Questions addressed ........................................................................................................ 47 3.1.1.3 Materials and Methods .................................................................................................... 47 3.1.1.4 Results ............................................................................................................................. 48 3.1.1.5 Discussion ....................................................................................................................... 50 3.1.1.6 Conclusion ...................................................................................................................... 51 3.1.2 Manuscript II: Quantifying ‘lateral peak sharpness’ from VKG images ............................ 51 3.1.2.1 Introduction ..................................................................................................................... 51 3.1.2.2 Objectives ....................................................................................................................... 51 3.1.2.3 Materials and methods .................................................................................................... 51 3.1.2.4 Results ............................................................................................................................. 53 3.1.2.5 Discussion ....................................................................................................................... 54 3.1.2.6 Conclusion ...................................................................................................................... 55 3.1.3 Manuscript III: Cepstral and perceptual analysis of teachers’ voice................................... 56 3.1.3.1 Introduction ..................................................................................................................... 56 3.1.3.2 Materials and Methods .................................................................................................... 56 3.1.3.3 Results ............................................................................................................................. 57 3.1.3.4 Discussion ....................................................................................................................... 59 3.1.3.5 Conclusion ...................................................................................................................... 61 3.1.4 Manuscript IV: Influence of noise on teachers’ voice ........................................................ 61 3.1.4.1 Introduction ..................................................................................................................... 61 3.1.4.2 Materials and methods .................................................................................................... 61 3.1.4.3 Results ............................................................................................................................
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