Effect of the Finnish Tube on the Voice of a Deaf Musician: A Case Report

doi:10.1016/j.jvoice.2019.09.019

Journal of Voice

Volume 35, Issue 3, May 2021, Pages 498.e23-498.e29

https://doi.org/10.1016/j.jvoice.2019.09.019 Get rights and content

Summary

Purpose

To verify the auditory-perceptual and acoustic effects of the semioccluded vocal tract exercise with Finnish tube on the vocal quality of a deaf musician.

Methods

A seven-day protocol with Finnish tube was performed with guidance for its home replication twice a day. A 46-years-old man with profound bilateral sensorineural hearing loss, musician and composer participated. Before and after the application of the protocol had undergone tonal audiometry, nasofibrolaryngoscopy, acoustic analysis with Praat and auditory-perceptual evaluation of the voice with Voice Profile Analysis Scheme for Brazilian Portuguese.

Results

The postintervention auditory-perceptual analysis identified reduction of the deviation in lip spreading, extensive labial range, raised tongue body, pharyngeal expansion, nasal resonance, larynx height, larynx and vocal tract tension and irregularity, pitch, speech rate, and a better respiratory support. The maximum phonation time reduced, probably because of elimination of the abrupt vocal attack and tension, articulatory deviations, improvement in voicing and the absence of the use of expiratory reserve air. The fundamental frequency became lower, and the first, second, third, and fourth formants became higher. The jitter increased, and the shimmer reduced.

Conclusion

The use of the Finnish tube might have facilitated the voicing sensations in the deaf musician, by enhancing the tactile-kinesthetic perception of the vocal tract and brought a greater source-filter interaction.

Section snippets

INTRODUCTION

Hearing plays a major role in the development of oral communication and the language and speech abilities of an individual, since speech comprehension is achieved through the detection of certain sounds and sound stimuli by the peripheral organs and their interpretation by the central nervous auditory system.¹

Auditory impairment affects the perception and the comprehension of speech sounds due to sensory deprivation caused by altered audibility thresholds and difficulty in discriminating

Case report

This case report describes the application of a short-term voice-training program in a 46-year-old male with profound sensorineural bilateral hearing loss as a sequela of meningitis at eight months of age. The participant was a user of a behind-the-ear hearing aid since he was seven to nine years old and was accompanied by the speech therapist for the hearing rehabilitation. He suspended wearing the device after less than a year of use due to disadaptation. While using the hearing aid, he

RESULTS

The preintervention APA showed moderate deviation in the “vocal tract features” that included lip spreading (degree 2), extensive labial range (degree 2), advanced lingual tip/blade (degree 1), raised tongue body (degree 2), pharyngeal constriction (degree 1), pharyngeal expansion (degree 2), nasal (degree 2) and denasal (degree 3) resonances, and raised larynx (degree 2). The “overall muscular tension” features were tense vocal tract (degree 3) and tense larynx (degree 3). The “phonation

DISCUSSION

The vocal production in the deaf is usually accompanied by monotony, abrupt vocal attack, laryngeal elevation, pitch and loudness irregularity, vocal register deviations, impaired speech intelligibility, and resonance changes.9, 10, 11, 12, 13

The presence of insufficient glottal closure observed in the nasofibrolaryngoscopy may interfere with the vocal fold vibration pattern and vocal quality, resulting in noise such as hoarseness. The lack of efficiency in the glottic closure, in turn, results

CONCLUSION

The Finnish tube technique facilitated the tactile-kinesthetic perception in the vocal tract and resulted in a better and greater source-filter interaction, which reflected in the APA and in the acoustic and the nasofibrolaryngoscopic examinations. The possibility of its use in therapeutic settings is noteworthy, since it resulted in improvements in voice characteristics of the individuals with impaired hearing, with or without hearing aid. It also resulted in improvements in the auditory

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Volitional and Non-volitional Devices Used in Voice Therapy and Training: A Scoping Review—Part A
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To map the volitional and non-volitional devices used by speech and language pathologists (SLPs) in voice training and therapy and characterize their use in research on voice interventions.
This scoping review is the first part of a larger study. The electronic search was carried out by mapping the references in PubMed/Medline, LILACS/BVS, Scopus, Web of Science, EMBASE, and the Cochrane Library, and the manual search was carried out in the grey literature. Two blind independent reviewers selected and extracted data; divergences were solved by consensus. The data extracted in this part of the study were the authorship and year of publication, country, study design, sample characteristics, intervention modality, ingredient, target, mechanism of action, dosage, and outcome measures. They were addressed with descriptive analysis.
Publications that use devices as ingredients are mostly from the last two decades, mainly carried out in the United States of America and Brazil, in adults of both sexes with behavioral dysphonia. Forty-two types of devices were used, many of them with similar approaches but different nomenclatures. Most devices were used voluntarily, focusing on vocal function, and aiming to increase source and filter interaction. Most studies used silicone tubes. The most reported technical specification to apply the ingredient was surface electrodes on the neck. Device dosage was time-controlled, and the most used outcomes were self-assessment and acoustic analysis.
Devices are currently used as ingredients in vocal interventions, with a greater focus on increasing the source and filter interaction, associated with silicone tubes (the most used devices in these studies), which have been dosed with performance time. Outcomes were measured with self-assessment instruments.
Respiratory and Sound Pressures, Maximum Phonation Time, Cervical Disability and Voice-Related Quality of Life of Teachers
2022, Journal of Voice
Citation Excerpt :
The teachers in our study had significantly lower MPT/a/ with an average of 12.8s (Table 1). Several authors state that MPT is higher in the vocal hyperfunction.25,57-61 However, we found the opposite, in agreement with part of the literature that states that vocal hyperfunction reduces MPT,62-65 possibly due to vocal fatigue.
Many teachers report discomfort and a decrease in the quality of aerodynamic, respiratory, and cervical vocal aspects as well as of vocal self-assessment.
Characterize and correlate measurements of Sound Pressure Levels, Maximum Phonation Time of /a/, Maximum Respiratory Pressures, Voice-Related Quality of Life and cervical pain in teachers with vocal and musculoskeletal complaints and no organic vocal fold lesions, and compare with normative values.
Retrospective study with 56 teachers. Anamnesis, video laryngoscopy, hearing screening, measurements of sound pressure and maximum phonation time, and manovacuometry were performed. Self-assessment protocols for Voice-Related Quality of Life and Neck Disability Index were completed.
there was significant higher Sound Pressure Levels; significant lower Maximum Phonation Time of /a/, Maximum Expiratory Pressure, and total and physical scores of Voice-Related Quality of Life; most participants had mild cervical disability; there was a negative correlation between Maximum Expiratory Pressure and Neck Disability Index, between Maximum Inspiratory Pressure and Maximum Sound Pressure Level, and between Neck Disability Index and Voice-Related Quality of Life.
The results showed that there are damages and inadequacies in teachers’ vocal production which affect their quality of life. Therefore, it is necessary to pay attention to the conditions of use of the voice by professionals, and to their health education.
MUSIC IN ACCESSIBLE EXPERIENTIAL EVENTS FOR THE DEAF EVIDENCE FROM THE YOUNG MUSIC FEST 2019 CASE
2022, Prisma Social

: Authors’ Contribution: JMBB participated in data collection and interpretation and preparation of the manuscript; LNB participated in data collection and interpretation; LSA participated in data collection and interpretation; RSO participated in data collection and interpretation; YFG participated in the design of the study, the data collection and interpretation; DMSM participated in data collection and interpretation; ACNF participated as the advisor of the study, in the design of the study, data collection and interpretation, critical review and interpretation of the data and preparation of the manuscript; EMS participated as the advisor of the study, elaboration and critical review of the manuscript.

: Conflicts of Interest: The authors declare no conflicts of interest.

View full text

Effect of the Finnish Tube on the Voice of a Deaf Musician: A Case Report

Summary

Purpose

Methods

Results

Conclusion

Section snippets

INTRODUCTION

Case report

RESULTS

DISCUSSION

CONCLUSION

J Voice

J Voice

J Voice

Clin Exp Otorhinolaryngol

J Voice

J Voice

J Voice

J Voice

Braz J Otorhinolaryngol

J Voice

J Voice

J Voice

J Voice

J Voice

J Voice

J Voice

J Commun Disord

J Voice

Braz J Otorhinolaryngol

Predicting behavior problems in deaf and hearing children: the influences of language, attention, and parent–child communication

Dev Psychopathol

Deficiência de audição e contraste de vozeamento em oclusivas do português brasileiro: análise acústica e perceptiva

Distúrbios da Comun

Systematic analysis of the benefits of cochlear implants on voice production

J Soc Bras Fonoaudiol

Auditory-motor mapping for pitch control in singers and nonsingers

Exp Brain Res