APPLICATION OF THE SPEECHVIEWER-II FOR VO ICE TRAINING IN VOCAL FOLD PARALYSIS

Referring to traditional therapeutical concepts of vocal fold paralysi s a microphone-controlled computer programme was used for voice treatm ent in 13 patients with unilateral vocal fold paralysis. 6 of these pa tients were female, 7 were male. The age ranged from 18 to 72 years (m ean: 50 years). The etiology of the paralysis was distributed as follo ws: post strumectomy (4 cases), post operation of the aortic arch (3 c ases), post mediastinoscopy (I case), post operation of the cervical v ertebrae (I case). 2 cases are not decided yet, 2 are probably idiopat hic. The vocal fold dysfunction lasted between 24 hours and 8 years be fore our first examination, less than 4 weeks in 11 cases. With 1 exce ption (intermediate) the vocal fold position was classified as paramed ian. 8 patients suffered from left, and 5 patients from right vocal fo ld paralysis. The voice treatment took place with a microphone-control led speech viewer including an audio capture and playback adapter. 7 o f the 15 training modules of the computer programme were chosen to be useful for voice training. Those modules can be differentiated in phys ical-technical modules showing voice spectra or pitch scales and in ob ject-related modules showing images such as landscapes, animals and ot hers. These programme-specific modules (monitor exercises) were primar ily built to train the following voice qualities separately: loudness, pitch, voicing, voice onset, fundamental frequency, sustained phonati on etc. Modifying certain therapeutic instructions (see Tables 1 and 2 ) the monitor exercises were used to improve the coordination of diffe rent voice parameters, thus resembling physiological speech. The compu terised voice training had to be supplemented by breathing exercises a nd manual techniques. During the computer-assisted voice training the patients showed first improvements of the above mentioned voice parame ters within a few sessions, since even small training effects could be demonstrated on the monitor. Even patients without own experience in handling a personal computer developed good compliance to the speech v iewer training. Thus the programme seems to be a useful completion of voice training in unilateral vocal fold paralysis.