ABSTRACT
Obesity may be associated with increased tissue bulk in the laryngeal airway, neck, and chest wall, and as such may affect vocal function. Eight obese and eight nonobese adults participated in this study; the obese participants underwent bariatric surgical procedures. This mixed-design study included cross-sectional analysis for group differences and longitudinal analysis for multidimensional changes in vocal function from four assessments collected over 6 months. No significant differences were detected between groups from the preoperative assessment. Further, no changes were detected over time for acoustic parameters, maximum phonation time, laryngeal airway resistance, and airflow during a sustained vowel for either group. Only minor differences were detected for strain, pitch, and loudness perceptions of voice over time, but not between groups. Phonation threshold pressure (PTP), at comfortable and high pitches (30% and 80% of the F0 range) changed significantly over time, but not between groups. Examination of individual data revealed a trend for PTP at 30% F0 to decrease as body mass index decreased. PTP may be informative for assessing vocal function in clients who present with obesity and voice symptoms.
KEYWORDS
Obesity - voice - perceptual - acoustic - aerodynamic
REFERENCES
-
1
Nguyen D M, El-Serag H B.
The epidemiology of obesity.
Gastroenterol Clin North Am.
2010;
39
(1)
1-7
-
2
Hora F, Nápolis L M, Daltro C et al.
Clinical, anthropometric and upper airway anatomic characteristics of obese patients with obstructive sleep apnea syndrome.
Respiration.
2007;
74
(5)
517-524
-
3
Tagaya M, Nakata S, Yasuma F et al.
Pathogenetic role of increased nasal resistance in obese patients with obstructive sleep apnea syndrome.
Am J Rhinol Allergy.
2010;
24
(1)
51-54
-
4
Martinho F L, Tangerina R P, Moura S MGT, Gregório L C, Tufik S, Bittencourt L R.
Systematic head and neck physical examination as a predictor of obstructive sleep apnea in class III obese patients.
Braz J Med Biol Res.
2008;
41
(12)
1093-1097
-
5
Shelton K E, Woodson H, Gay S, Suratt P M.
Pharyngeal fat in obstructive sleep apnea.
Am Rev Respir Dis.
1993;
148
(2)
462-466
-
6
Horner R L, Mohiaddin R H, Lowell D G et al.
Sites and sizes of fat deposits around the pharynx in obese patients with obstructive sleep apnoea and weight matched controls.
Eur Respir J.
1989;
2
(7)
613-622
-
7
Busetto L, Calo' E, Mazza M et al.
Upper airway size is related to obesity and body fat distribution in women.
Eur Arch Otorhinolaryngol.
2009;
266
(4)
559-563
-
8
Salome C M, King G G, Berend N.
Physiology of obesity and effects on lung function.
J Appl Physiol.
2010;
108
(1)
206-211
-
9 Rubin J S, Sataloff R TT, Korovin G S, eds. Diagnosis and Treatment of Voice Disorders. San Diego, CA: Plural Publishing; 2006
-
10
da Cunha M B, Passerotti G H, Weber R, Zilberstein B, Cecconello I.
Voice feature characteristic in morbid obese population.
Obes Surg.
2009;
September 18 [Epub ahead of print]
-
11 Physical status: the use and interpretation of anthropometry. Geneva, Switzerland: Report of a WHO Expert Committee; 1995
-
12
Wuyts F L, De Bodt M S, Molenberghs G et al.
The dysphonia severity index: an objective measure of vocal quality based on a multiparameter approach.
J Speech Lang Hear Res.
2000;
43
(3)
796-809
-
13
Hakkesteegt M M, Wieringa M H, Brocaar M P, Mulder P GH, Feenstra L.
The interobserver and test-retest variability of the dysphonia severity index.
Folia Phoniatr Logop.
2008;
60
(2)
86-90
-
14
Kempster G B, Gerratt B R, Verdolini Abbott K, Barkmeier-Kraemer J, Hillman R E.
Consensus auditory-perceptual evaluation of voice: development of a standardized clinical protocol.
Am J Speech Lang Pathol.
2009;
18
(2)
124-132
-
15
Solomon N P, Helou L B, Stojadinovic A.
Clinical versus laboratory ratings of voice using the CAPE-V.
J Voice.
2011;
25
(1)
e7-e14
-
16
Smitheran J R, Hixon T J.
A clinical method for estimating laryngeal airway resistance during vowel production.
J Speech Hear Disord.
1981;
46
(2)
138-146
-
17
Titze I R.
The physics of small-amplitude oscillation of the vocal folds.
J Acoust Soc Am.
1988;
83
(4)
1536-1552
-
18
Titze I R.
Phonation threshold pressure: a missing link in glottal aerodynamics.
J Acoust Soc Am.
1992;
91
(5)
2926-2935
-
19
Solomon N P, Ramanathan P, Makashay M J.
Phonation threshold pressure across the pitch range: preliminary test of a model.
J Voice.
2007;
21
(5)
541-550
-
20
Eadie T L, Kapsner M, Rosenzweig J, Waugh P, Hillel A, Merati A.
The role of experience on judgments of dysphonia.
J Voice.
2010;
24
(5)
564-573
-
21 Solomon N P. Aerodynamics: glottal enterprises. In:, Ma E, Yiu E, eds. Handbook of Voice Assessments. San Diego, CA: Plural Publishing; 2011
-
22 Baken R J, Orlikoff R F. Clinical Measurement of Speech and Voice. 2nd ed. San Diego, CA: Singular Publishing Group; 2000
-
23
Dogan M, Eryuksel E, Kocak I, Celikel T, Sehitoglu M A.
Subjective and objective evaluation of voice quality in patients with asthma.
J Voice.
2007;
21
(2)
224-230
-
24
Solomon N P, Garlitz S J, Milbrath R L.
Respiratory and laryngeal contributions to maximum phonation duration.
J Voice.
2000;
14
(3)
331-340
-
25
Roy N.
Assessment and treatment of musculoskeletal tension in hyperfunctional voice disorders.
Int J Speech-Language Pathol.
2008;
10
(4)
195-209
Nancy Pearl SolomonPh.D.
Army Audiology & Speech Center, Walter Reed Army Medical Center
Building 2, Room 6a53D, Washington, DC 20307
Email: Nancy.P.Solomon@us.army.mil
