Characterization and Improvement of the Clinical Assessment of Vocal Hyperfunction

Vocal hyperfunction refers to "conditions of abuse and/or misuse of the vocal mechanism due to excessive and/or 'imbalanced' muscular forces" (Hillman, Holmberg, Perkell, Walsh, & Vaughan, 1989), characterized by excessive laryngeal and paralaryngeal tension (Aronson, 1980; M. D. Morrison, Rammage, Belisle, Pullan, & Nichol, 1983; N. Roy, Ford, & Bless, 1996). There is no widely accepted diagnostic measure of the presence and degree of vocal hyperfunction, and currently, assessment during diagnosis is often primarily based on subjective impressions given the patient's history and presentation of symptoms such as auditory-perceptual and visual or tactile discrimination of muscle tension (e.g., laryngeal palpation). Clinical care is hindered by the lack of a "gold standard" objective measure for the assessment of vocal hyperfunction. The first study in this thesis evaluated a novel experimental design for the study of vocal hyperfunction, making use of the established clinical procedure of injection laryngoplasty. This work found that the use of injection laryngoplasty as a platform for the study of some types of vocal hyperfunction is limited, but may offer a convenient opportunity to study selected associated parameters. Particular promising objective measures were investigated in the remaining four studies: kinematics of the vocal folds, root-mean-squared (RMS) measures of surface electromyography (sEMG), and spectral characteristics of sEMG. Kinematic features of vocal fold abduction and adduction were shown to discriminate between individuals with muscle tension dysphonia and controls.

Department dc:contributor.department

Harvard University--MIT Division of Health Sciences and Technology.

Grantor dc:publisher

Massachusetts Institute of Technology

Year dc:date.issued

2009

Author dc:creator

• Stepp, Cara Elizabeth

Advisor dc:contributor.advisor

• James T. Heaton.

• Harvard University--MIT Division of Health Sciences and Technology.

Statement dc:rights

• M.I.T. theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission. See provided URL for inquiries about permission.

Licence dc:rights.uri

• http://dspace.mit.edu/handle/1721.1/7582

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/1721.1/54668

OAI identifier oai:identifier

oai:dspace.mit.edu:1721.1/54668