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It is well known that non-human animals respond to information encoded in vocal signals, and the same can be said of humans. Specifically, human voice pitch affects how speakers are perceived. As such, does voice pitch affect how we perceive and select our leaders? To answer this question, we recorded men and women saying ‘I urge you to vote for me this November’. Each recording was manipulated digitally to yield a higher- and lower-pitched version of the original. We then asked men and women to vote for either the lower- or higher-pitched version of each voice. Our results show that both men and women select male and female leaders with lower voices. These findings suggest that men and women with lower-pitched voices may be more successful in obtaining positions of leadership. This might also suggest that because women, on average, have higher-pitched voices than men, voice pitch could be a factor that contributes to fewer women holding leadership roles than men. Additionally, while people are free to choose their leaders, these results clearly demonstrate that these choices cannot be understood in isolation from biological influences.

To determine if there is an association between vocal gender presentation and the gender and context of the listener. Quantitative and transversal study. 47 speakers of Brazilian Portuguese of different genders were recorded. Recordings included sustained vowel emission, connected speech, and the expressive recital of a poem. Subsequently, four scripts were used in Praat to extract 16 acoustic measurements related to prosody. Voices underwent Auditory-Perceptual Assessment (APA) of the gender presentation by 236 people [65 speech and language pathologist (SLP) with experience in the area of the voice (SLP), 101 cisgender people (CG), and 70 transgender and non-binary people (TNB)]. Gender presentation was evaluated by visual analogue scale. Agreement analyses were executed among quantitative variables and multiple linear regression models were generated to predict APA, taking the judge context/gender and speaker gender into consideration. Acoustic analysis revealed that cis and transgender women had higher median fundamental frequency (fo) values than other genders. Cisgender women exhibited greater breathiness, while cisgender men showed more vocal quality deviations. In terms of APA, significant differences were observed among judge groups: SLP judged vowel samples differently from other groups, and TNB judged speech samples differently (both p<0.001). The predictive measures for the APA varied based on the sample type, speaker gender, and judge group. For vowel samples, only SLP judges had predictive measures (fo and ABI Jitter) for cisgender speakers. In number counting samples, predictive measures for cisgender speakers included fomed and HNR for CG judges, and fomed for both SLP and TNB judges. For transgender and non-binary speakers, predictive measures were fomed for CG and SLP judges, and fomed, CPPs, and ABI for TNB judges. In the poem recital task, predictive measures for cisgender speakers were fomed and HNR for both SLP and CG judges, with additional measures of cvint and sr for CG judges, and fomed, HNR, cvint, and fopeakwidth for TNB judges. For transgender and non-binary speakers, the predictive measures included a wider range of acoustic features such as fomed, fosd, sr, fomin, emph, HNR, Shimmer, and fo peakwidth for SLP judges, and fomed, fosd, sr, fomax, emph, HNR, and Shimmer for CG judges, while TNB judges considered fomed, sr, emph, fosd, Shimmer, HNR, Jitter, and fomax. There is an association between the perception of gender presentation in the voice and the gender or context of the listener and the speaker. Transgender and non-binary judges diverged to a higher degree from cisgender and SLP judges. Compared to the evaluation of cisgender speakers, all judge groups used a greater number of acoustic measurements when analyzing the speech of transgender and non-binary individuals in the poem recital samples.

Cochlear implant users experience difficulties controlling their vocalizations compared to normal hearing peers. However, less is known about their voice quality. The primary aim of the present study was to determine if cochlear implant users’ voice quality would be categorized as dysphonic by the Acoustic Voice Quality Index (AVQI) and smoothed cepstral peak prominence (CPPS). A secondary aim was to determine if vocal quality is further impacted when using bilateral implants compared to using only one implant. The final aim was to determine how residual hearing impacts voice quality. Twenty-seven cochlear implant users participated in the present study and were recorded while sustaining a vowel and while reading a standardized passage. These recordings were analyzed to calculate the AVQI and CPPS. The results indicate that CI users’ voice quality was detrimentally affected by using their CI, raising to the level of a dysphonic voice. Specifically, when using their CI, mean AVQI scores were 4.0 and mean CPPS values were 11.4 dB, which indicates dysphonia. There were no significant differences in voice quality when comparing participants with bilateral implants to those with one implant. Finally, for participants with residual hearing, as hearing thresholds worsened, the likelihood of a dysphonic voice decreased.

Purpose To use objective and subjective voice function analysis to compare outcomes in patients who had undergone conventional open thyroidectomy or robotic thyroidectomy. Methods The study involved 88 consecutive patients who underwent thyroid surgery between May 2009 and December 2009; 46 patients underwent a conventional open thyroidectomy, and 42 underwent a robotic thyroidectomy. Auditory perceptual evaluation was used to make subjective assessments of voice function, and videolaryngostroboscopy, acoustic voice analysis with aerodynamic study, electroglottography, and voice range profile were used to make objective assessments. Each assessment was made before surgery, and at 1 week and 3 months after surgery. Results The conventional open and robotic thyroidectomy groups were similar in terms of age, gender ratio, and disease profile. We found that 18 (20.5%) of the 88 patients showed some level of voice dysfunction at 1 week after surgery; that the dysfunction resolved by 3 months after surgery in all cases; and that it was not permanent according to postoperative videolaryngostroboscopy. The conventional open and robotic thyroidectomy groups were found to have similar levels of dysfunction at 1 week after surgery, except for jitter, which was greater in the robotic group. For both groups, any such dysfunction spontaneously resolved by 3 months after surgery, and there were no significant differences between the groups in terms of any voice function parameter. Conclusions Voice dysfunction was present after both open and robotic thyroidectomy (without any evident laryngeal nerve injury). However, function subsequently normalized to preoperative levels at 3 months after surgery in both groups. Voice function outcomes after robotic thyroidectomy are similar to those after conventional open thyroidectomy.

Dysphonia, characterized by disturbances in voice quality and modulation, has been sporadically observed in individuals with Anorexia Nervosa (AN), potentially stemming from both organic and psychopathological factors. This study seeks to employ software-based voice analysis to compare the voices of girls with AN to those of female healthy controls (HC). Case-control study adopting “Praat” software to assess voices. Various parameters, including Acoustic Voice Quality Index (AVQI), Fundamental Frequency (F0), Yanagihara’s Spectrographic Dysphonia Classifications, and “GIRBAS” perceptual qualitative voice rating, were investigated. Participants completed questionnaires for Vocal Fatigue Index (VFI) and the Reflux Symptoms Index (RSI). Puberty-related voice spectrum changes were considered, and Bonferroni-corrected BMI-adjusted Analyses of Covariance (ANCOVAs) were conducted. The study enrolled 15 girls with AN and 23 girls with HC. AN patients demonstrated greater impairment in voice tiredness/voice avoidance (VFI-1, p  < 0.001), vocal physical discomfort (VIF-2, p  = 0.002), and rest as alleviation (VFI-3, p  = 0.012). Reflux-related scores were higher in AN ( p  < 0.001). Differences were observed in voice quality (AVQI) ( p  = 0.001), and GIRBAS scales showed alterations in multiple parameters. Spectrograms documented more frequent pathological findings in AN patients ( p  = 0.021). No difference was observed in Fundamental Frequency. These group (AN/HC) differences were independent of weight measures. This study is the first to connect voice irregularities in AN by employing standardized, non-invasive tools and accounting for weight-related factors. Young AN patients demonstrated substantial voice quality changes and heightened self-reported symptoms. Future research should expand on these findings with prospective designs and invasive investigations.

Purpose: Resonance tube phonation in water (RTPW) or in air is a voice therapy method successfully used for treatment of several voice pathologies. Its effect on the voice has not been thoroughly studied. This investigation analyzes the effects of RTPW on collision and phonation threshold pressures (CTP and PTP), the lowest subglottal pressure needed for vocal fold collision and phonation, respectively. Method: Twelve mezzo-sopranos phonated into a glass tube, the end of which was placed under the water surface in a jar. Subglottal pressure, electroglottography, and audio signals were recorded before and after exercise. Also, the perceptual effects were assessed in a listening test with an expert panel, who also rated the subjects' singing experience. Results: Resonance tube phonation significantly increased CTP and also tended to improve perceived voice quality. The latter effect was mostly greater in singers who did not practice singing daily. In addition, a more pronounced perceptual effect was found in singers rated as being less experienced. Conclusion: Resonance tube phonation significantly raised CTP and tended to improve perceptual ratings of voice quality. The effect on PTP did not reach significance.

Purpose: The aim of this study was to investigate secondary voice outcomes and detraining effects of 2 head and neck strengthening exercises, which have been used in swallowing rehabilitation, that is, the head-lift exercise (HLE) and the recline exercise (RE), in healthy older adults. Method: Twenty-seven healthy older adults (between 60 and 85 years of age) were randomized to perform either the RE or the HLE for a 6-week period. Isometric and isokinetic portions of the exercise were performed 3 times daily. Patients were evaluated at baseline, postexercise, and following a 6-week detraining period. Acoustic outcome measures included the highest and lowest frequencies of vocal range on pitch glides (measured in hertz) and cepstral peak prominence on sustained vowels and connected speech. Self-perceptual measures included perceived phonatory effort. Results: Twenty-two individuals completed their assigned exercise regimen. No significant differences between exercise groups were observed at baseline for age, body mass index, or body fat percentage. A significant postexercise increase was seen in the highest frequency of vocal range on pitch glide, t(2, 56.79) = -10.28, p = .0001, for both groups. This increase was not fully maintained following the 6-week detraining period; however, data remained significantly above baseline at this time point, t(2, 57.01) = -4.70, p = .0001. Seventeen of the individuals who made postexercise gains were followed postdetraining. On average, these 17 individuals maintained 51% of their postexercise gains in the highest frequency of vocal range. No differences were observed between exercise groups. In addition, no significant changes in the lowest frequency of vocal range, cepstral peak prominence on sustained vowels or connected speech, or perceived phonatory effort were observed following the exercise regimens. Conclusions: Both the HLE and the RE produced gains in the highest frequency of vocal range in healthy older adults. This finding is promising; however, further research is required to understand how suprahyoid muscle strengthening influences upper pitch range and whether this relationship has potential clinical implications for patients with dysphonia.

Background Laryngeal cancer often leads to total laryngectomy (TL), which results in the loss of natural voice, necessitates voice rehabilitation and affects the individuals Quality of Life (QoL). Despite advancements in treatment, Voice-Related QoL (VRQoL) post TL remains a neglected area in the field of rehabilitation. This study seeks to fill this gap by evaluating though a scoping review the impacts of TL on patients’ voice-related QoL. Methods A scoping review was conducted to assess the impact of total laryngectomy (TL) on voice-related quality of life (VRQoL). The search was performed across various electronic databases—PubMed, Scopus, Embase, Cohrane Library, Google scholar and Web of Science— using a broad set of keywords to capture studies addressing total laryngectomy and voice-related quality of life (VRQoL). Articles were screened using predefined inclusion and exclusion criteria, focusing on studies that directly addressed TL and VRQoL outcomes. Results A total of eleven papers were finally selected to respond to the research question. The review indicates that TL significantly impacts VRQoL. Common issues included difficulties with communication in noisy environments, social interactions, anxiety about being understood, and physical challenges related to voice production. These difficulties were reflected in lower scores on various assessment tools. Patients reported declines in socio-emotional functioning and faced challenges in physical activities requiring voice use. Conclusions This scoping review highlights the profound impact of TL on patients’ voice-related QoL. Despite advances in surgical techniques and rehabilitation methods, patients continue to experience significant challenges in communication and social integration, which are crucial components of overall well-being. The persistent lower scores across various QoL assessment tools underscore the necessity for enhanced supportive care and innovative rehabilitation strategies tailored to the specific needs of this population.

Purpose: This study investigated whether perceptual ratings of speech parameters were predictive of transcription intelligibility in quiet and in noise for speakers with Parkinson's disease (PD). Method: Ten speakers with PD and five healthy controls read 56 sentences. One group of 60 listeners orthographically transcribed the sentences in quiet, and another group of 60 listeners transcribed in noise. An additional 23 listeners judged a variety of speech parameters, including articulation, prosody, resonance, voice quality, and ease of understanding on a visual analog scale. Scores of the visual analog scale ratings were regressed against transcription intelligibility in quiet and in noise. Results: Perceptual ratings of all the speech parameters were lower for speakers with PD. Global speech understanding, indexed by ease of understanding ratings, was associated with transcription intelligibility in quiet and in noise with a stronger effect in noise. Among the rated speech parameters, ease of understanding and voice quality ratings were significant predictors of speech intelligibility in noise. Conclusions: Speech in individuals with PD was more difficult for listeners to understand and was characterized by deficits in articulation, prosody, resonance, and voice quality compared to normal speech produced by healthy older adults. Ease of understanding ratings, even when performed in quiet, predicted intelligibility in noise. Poor voice quality ratings in PD, a sign of phonatory deficit, had a negative impact on intelligibility in noise for speakers with PD.

Purpose The aim of this prospective case–control study was to determine the effect on the voice of type 1 diabetes mellitus (T1DM) in paediatric patients. Materials and methods The study included patients aged 6–18 years followed up for at least 1 year because of T1DM, and a control group of age and gender-matched healthy volunteers. Following an Ear, Nose, and Throat (ENT) examination, all subjects underwent flexible endoscopic laryngeal examination. Fasting venous blood samples were taken in the morning for the examination of fasting blood glucose (FBG), HgbA1C, and kidney, liver, and thyroid function tests. Data were recorded from the patient files of age, gender, comorbidities, and the development of diabetes-related complications. Voice recordings were taken and the Voice Handicap Index (VHI)-10 form was completed. The patients and control group were compared in respect of the parameters of fundamental frequency, jitter, shimmer, and acoustic voice quality index (AVQI). Results Evaluation was made of 64 children and adolescents as 32 in the patient group (Group 1) and 32 healthy control subjects (Group 2). Group 1 comprised 17 females and 15 males with a mean age of 12.75 ± 3.23 years. Group 2 comprised 17 females and 15 males with a mean age of 12.75 ± 3.33 years. In Group 1, mean disease duration was 5.21 ± 3.17 years (range, 1–13 years), the FBG value was mean 216.6 ± 122.3 mg/dl, mean HgbA1c was 10.7 ± 2.8, as ≤ 7 in 4 patients, 7–9 in 4, and > 9 in 24. Maximum phonation time (MPT) was determined as 10.66 ± 3.6 secs in Group 1 and 12.11 ± 4.43 in Group 2. VHI was determined as 2.33 ± 3 in Group 1 and 2.31 ± 2.77 in Group 2. No statistically significant difference was determined between the groups was determined in respect of acoustic analysis, perturbation parameters, AVQI and body mass index. Conclusions This study is the first to have investigated the effects of T1DM on the voice in paediatric patients. The study results showed that the AVQI value was higher in the patient group but not to a statistically significant level. Therefore, there is a need for further studies with larger samples. The current study can be of guidance for further studies in this field.