Journal of Voice RSS feed: Current Issue. The Journal of Voice is widely regarded as the world's premiere journal for voice medicine and research. This peer-reviewed publication is listed in Index Medicus and is indexed by the Institute for Scientific Information. The journal contains articles written by experts throughout the world on all topics in voice sciences, voice medicine and surgery, and speech-language pathologists' management of voice-related problems. The journal includes clinical articles, clinical research, and laboratory research. Members of the Foundation receive the journal as a benefit of membership.http://www.jvoice.org/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Journal of Voice0892-1997241January 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.jvoice.org/article/PIIS0892199709000885/abstract?rss=yes On December 24, 1922, Christmas Eve (“Aatto” in Finnish), Aatto Albanus Sonninen was born in Kuopio. After studies at the University of Helsinki, Medical School, 1945–1950, he specialized at first in phoniatrics in 1956 and then in otorhinolaryngology in 1957. One may wonder about this sequence, but, in fact, phoniatrics in Finland has been an independent specialty of its own standing since 1948. In spite of being a fully trained otolaryngologist, Aatto decided to “put his knife into the wall forever” (his own words) and to devote himself exclusively to phoniatrics, as senior physician and chief physician (phoniatrics) during 1957–1964 at Helsinki University Hospital and as head of the phoniatric department at Central Hospital of Central Finland in Jyväskylä during 1964–1985. Furthermore, he worked as a senior lecturer in logopedics, in clinical speech research and phoniatrics at University of Jyväskylä during 1968–1985, and in voice research at Sibelius Academy, Helsinki during 1990–95. All his professional life has been shared and supported by his wife Eeva (marriage in 1946), a highly competent special teacher and speech therapist. Prof. Dr. Sonninen retired in 1986, and he died on March 31, 2009.In Memoriam: Aatto SonninenJuergen Wendler10.1016/j.jvoice.2009.06.006Journal of Voice 24, 1 (2010)2009-11-30Journal of Voice2009-11-30241S0892-1997(09)X0007-X11http://www.jvoice.org/article/PIIS0892199708000404/abstract?rss=yesSummary: An experimental study of the pressure distributions in an asymmetric larynx, hereafter referred to as a hemilarynx, was carried out at a glottal diameter of 0.04cm and transglottal pressures of 3, 5, 10, 20, and 40cm H2O. In each case, the glottal wall “on the left” was chosen to have an angle of 0° with the midline, and the angle of the glottal wall “on the right” was varied through converging angles of 5°, 10°, and 20° and diverging angles of 5°, 10°, and 20°. The case of two parallel glottal walls, or the uniform glottis, was also examined. With the exception of the 20° convergent case, the pressure distributions for most angles and pressures were bistable; that is, a stable flow situation persisted when the glottal exit flow jet was directed downstream either to the right or to the left in the rectangular “pharynx” tunnel. Bistability also occurred for the uniform glottis. Pressure differences arising from the different directions of the flow jet were often found to be small; however, differences for the diverging 10° case were as large as 7% or 8%, and for the 20° divergent case, 12%. Calculations with FLUENT, a computational package, gave excellent agreement with observed pressures. Implications of the pressure distribution data for the functional similarity of normal and hemilaryngeal phonation, hypothesized by Jiang and Titze, are discussed. In particular, the intraglottal pressures for converging and diverging angles for the hemilarynx were found to be quite similar to those of the full larynx with the same diameter and included angle or twice the diameter and twice the included angle, suggesting that the same mechanism of energy transfer operates in the two cases. Nondimensionalizing the pressure distributions with the transglottal pressures suggests that the shapes of the distributions at P=3, 5, 10, 20, and 40cm H2O for a given geometry are similar. The pressure average of these dimensionless distributions may be interpreted as a template at that geometry, a description referred to as successful pressure scaling. When the entire data set is considered, variations from consistent pressure scaling averaged 1.4%, although these variations tend to be somewhat larger near the glottal entrance and for diverging angles of 10° and 20°. Some possible implications of the observed pressures for phonosurgery are discussed.Pressure Distributions in a Static Physical Model of the Hemilarynx: Measurements and ComputationsLewis P. Fulcher, Ronald C. Scherer, Kenneth J. De Witt, Pushkal Thapa, Yang Bo, Bogdan R. Kucinschi10.1016/j.jvoice.2008.02.005Journal of Voice 24, 1 (2010)2008-06-09Journal of Voice2008-06-09241S0892-1997(09)X0007-X220http://www.jvoice.org/article/PIIS089219970800043X/abstract?rss=yesSummary: High-speed digital imaging can provide valuable information on disordered voice production in voice science. However, the large amounts of high-speed image data with limited image resolutions produce significant challenges for computer analysis, and thus effective and efficient image edge extraction methods allowing for the batch analysis of high-speed images of vocal folds is clinically important. In this paper, a novel algorithm for automatic image edge detection is proposed to effectively and efficiently process high-speed images of the vocal folds. The method integrates Lagrange interpolation, differentiation, and Canny edge detection, which allow objective extraction of aperiodic vocal fold vibratory patterns from large numbers of high-speed digital images. This method and two other popular algorithms, histogram and active contour, are performed on 10 sets of high-speed video data from excised larynx experiments to compare their performances in analyzing high-speed images. The accuracy in computing glottal area and the computation time of these methods are investigated. The results show that our proposed method provides the most accurate and efficient detection, and is applicable when processing low-resolution images. In this study, we focus on developing a method to effectively and efficiently process high-speed image data from excised larynges. However, in addition we show the clinical potential of this method by use of example high-speed image data obtained from a patient with vocal nodules.The proposed automatic image-processing algorithm may provide a valuable biomedical application for the clinical assessment of vocal disorders by use of high-speed digital imaging.Efficient and Effective Extraction of Vocal Fold Vibratory Patterns from High-Speed Digital ImagingYu Zhang, Erik Bieging, Henry Tsui, Jack J. Jiang10.1016/j.jvoice.2008.03.003Journal of Voice 24, 1 (2010)2008-05-27Journal of Voice2008-05-27241S0892-1997(09)X0007-X2129http://www.jvoice.org/article/PIIS0892199708000635/abstract?rss=yesSummary: This study aimed to investigate the role of voice source and formant frequencies in the perception of emotional valence and psychophysiological activity level from short vowel samples (∼150 milliseconds). Nine professional actors (five males and four females) read a prose passage simulating joy, tenderness, sadness, anger, and a neutral emotional state. The stress carrying vowel [a:] was extracted from continuous speech during the Finnish word [ta:k:ahan] and analyzed for duration, fundamental frequency (F0), equivalent sound level (Leq), alpha ratio, and formant frequencies F1–F4. Alpha ratio was calculated by subtracting the Leq (dB) in the range 50Hz–1kHz from the Leq in the range 1–5kHz. The samples were inverse filtered by Iterative Adaptive Inverse Filtering and the estimates of the glottal flow obtained were parameterized with the normalized amplitude quotient (NAQ = fAC/(dpeakT)). Fifty listeners (mean age 28.5 years) identified the emotional valences from the randomized samples. Multinomial Logistic Regression Analysis was used to study the interrelations of the parameters for perception. It appeared to be possible to identify valences from vowel samples of short duration (∼150 milliseconds). NAQ tended to differentiate between the valences and activity levels perceived in both genders. Voice source may not only reflect variations of F0 and Leq, but may also have an independent role in expression, reflecting phonation types. To some extent, formant frequencies appeared to be related to valence perception but no clear patterns could be identified. Coding of valence tends to be a complicated multiparameter phenomenon with wide individual variation.Perception of Emotional Valences and Activity Levels from Vowel Segments of Continuous SpeechTeija Waaramaa, Anne-Maria Laukkanen, Matti Airas, Paavo Alku10.1016/j.jvoice.2008.04.004Journal of Voice 24, 1 (2010)2008-12-29Journal of Voice2008-12-29241S0892-1997(09)X0007-X3038http://www.jvoice.org/article/PIIS0892199708000726/abstract?rss=yesSummary: The male classical singing voice is a musical instrument that is very important in western culture. It has many acoustic features which should change and improve over the period in which the singer trains. In this study we compare nine singers in different stages of training, from university level students through to international soloists. Typically, Energy Ratio (ER; a measure of mean spectral slope) and mean sound pressure level (SPL) may be calculated to summarize an entire singing sample. We investigate an alternative approach, by calculating the time-varying ER and SPL. The inspection of the distribution of these descriptors over an aria's time period yields a more detailed picture of the strategies for high-frequency energy production used by singers with different levels of training.Effects of Training on Time-Varying Spectral Energy and Sound Pressure Level in Nine Male Classical SingersSam Ferguson, Dianna T. Kenny, Densil Cabrera10.1016/j.jvoice.2008.05.002Journal of Voice 24, 1 (2010)2009-01-30Journal of Voice2009-01-30241S0892-1997(09)X0007-X3946http://www.jvoice.org/article/PIIS0892199708000684/abstract?rss=yesSummary: This paper evaluates the capabilities of the Glottal to Noise Excitation Ratio for the screening of voice disorders. A lot of effort has been made using this parameter to evaluate voice quality, but there do not exist any studies that evaluate the discrimination capabilities of this acoustic parameter to classify between normal and pathological voices, and neither are there any previous studies that reflect the normative values that could be used for screening purposes. A set of 226 speakers (53 normal and 173 pathological) taken from a voice disorders database were used to evaluate the usefulness of this parameter for discriminating normal and pathological voices. To evaluate this parameter, the effect of the bandwidth of the Hilbert envelopes and the frequency shift have been analyzed, concluding that a good discrimination is obtained with a bandwidth of 1000 Hz and a frequency shift of 300 Hz. The results confirm that the Glottal to Noise Excitation Ratio provides reliable measurements in terms of discrimination among normal and pathological voices, comparable to other classical long-term noise measurements found in the literature, such as Normalized Noise Energy or Harmonics to Noise Ratio, so this parameter can be considered a good choice for screening purposes.The Effectiveness of the Glottal to Noise Excitation Ratio for the Screening of Voice DisordersJuan Ignacio Godino-Llorente, Víctor Osma-Ruiz, Nicolás Sáenz-Lechón, Pedro Gómez-Vilda, Manuel Blanco-Velasco, Fernando Cruz-Roldán10.1016/j.jvoice.2008.04.006Journal of Voice 24, 1 (2010)2009-01-12Journal of Voice2009-01-12241S0892-1997(09)X0007-X4756http://www.jvoice.org/article/PIIS089219970800074X/abstract?rss=yesSummary: The use of hard-walled narrow tubes, often called resonance tubes, for the purpose of voice therapy and voice training has a historical precedent and some theoretical support, but the mechanism of any potential benefit from the application of this technique is not well understood. Fifteen vocally untrained male participants produced a series of spoken /ɑ/ vowels at a modal pitch and constant loudness, before and after a minute of repeated phonation into a 50-cm hard-walled glass tube at the same pitch and loudness targets. Electroglottography was used to measure the glottal contact quotient (CQ) during each phase of the experiment. Single-subject analysis revealed statistically significant changes in CQ during tube phonation, but with no discernable pattern across the 15 participants. These results indicate that the use of resonance tubes can have a distinct effect on glottal closure, but the mechanism behind this change remains unclear. The implication is that vocal loading techniques such as this need to be studied further with specific attention paid to the underlying mechanism of any measured changes in glottal behavior, and especially to the role of instruction and feedback in the therapeutic and pedagogical application of these techniques.The Effect of an Artificially Lengthened Vocal Tract on Estimated Glottal Contact Quotient in Untrained Male VoicesChristopher S. Gaskill, Molly L. Erickson10.1016/j.jvoice.2008.05.004Journal of Voice 24, 1 (2010)2009-01-12Journal of Voice2009-01-12241S0892-1997(09)X0007-X5771http://www.jvoice.org/article/PIIS0892199708000891/abstract?rss=yesSummary: The goal of this pilot study was to determine whether the ability to change the degree of posterior glottal adduction (PGA) during phonation can be acquired more easily with the aid of electroglottographic (EGG) real-time feedback. The subject was a 37-year-old untrained female with habitually breathy voice. Before the experiment, she participated in one voice coaching session where exercises for increasing PGA were explained and executed. During the experiment, phonation has been monitored simultaneously with videostroboscopy, electroglottography, and audio recording. While phonating, the subject saw amplitude and period normalized EGG waveform representing one glottal cycle consecutively changing over time. The assignment was to increase the width of the EGG waveform during phonation. Laryngeal imaging revealed a posterior glottal chink during habitual phonation. The subject could only introduce intentional changes into the EGG waveform after its relevance had been explained, and after recapitulation of the exercises of the voice coaching session: An increase of the EGG waveform width coincided with the increase of high-frequency partials and an increase of PGA. For pitches B3 and B4, full glottal closure could be achieved. At G5, a reduction of the posterior glottal chink occurred. The findings of this study suggest that the skill to control the degree of PGA can be acquired, and that EGG real-time feedback can be a crucial element in optimizing the process of skill acquisition, but only if (1) the context and nature of the feedback is explained and (2) proper instructions are provided. The EGG contact quotient might not be sensitive to changes of PGA in falsetto phonation.Using Electroglottographic Real-Time Feedback to Control Posterior Glottal Adduction during PhonationChristian T. Herbst, David Howard, Josef Schlömicher-Thier10.1016/j.jvoice.2008.06.003Journal of Voice 24, 1 (2010)2009-01-30Journal of Voice2009-01-30241S0892-1997(09)X0007-X7285http://www.jvoice.org/article/PIIS0892199708000878/abstract?rss=yesSummary: Some vocal disorders in teachers are associated with occupational factors, but there are few studies that analyze the influence of vocal habits, fluid intake, mastication, and sleep on these disorders. The objective was to analyze the occurrence of vocal fatigue, hoarseness, and dry throat in elementary and high school teachers and their association with vocal habits, fluid intake, mastication, and sleep. A sample of 422 elementary and secondary school teachers was studied using a specific questionnaire. The multiple regression analysis showed that hoarseness was associated with absence of water intake (odds ratio (OR)=1.7; P=0.047), yelling/speaking loudly (OR=1.6; P=0.058), jaw-opening limitations (OR=3.8; P=0.003), average of 6 hours of sleep/night (OR=1.7; P=0.039), and waking-up feeling replenished (OR=2.0; P=0.020). The presence of vocal fatigue was significantly associated with yelling/speaking loudly (OR=2.2; P=0.013), speaking excessively (OR=2.4; P=0.023), difficulty to open the mouth to masticate (OR=6.6; P=0.003), less than 6 hours of sleep (OR=4.0; P=0.008), and waking-up feeling replenished (sometimes OR=2.8; P=0.003; or never OR=3.3; P=0.002). The presence of dry throat was associated with being a former smoker (OR=3.3; P=0.011) and having jaw-opening limitations (OR=3.9; P=0.021). In recent years, speech and hearing interventions with teachers have focused on health-care promotion actions and prevention of vocal disorders, prioritizing issues related with hydration and healthy vocal use habits. However, the findings in the present study show the need to further focus on lifestyle habits related to sleep and eating habits.Influence of Abusive Vocal Habits, Hydration, Mastication, and Sleep in the Occurrence of Vocal Symptoms in TeachersLeslie Piccolotto Ferreira, Maria do Rosario Dias de Oliveira Latorre, Susana Pimentel Pinto Giannini, Ana Carolina de Assis Moura Ghirardi, Delmira de Fraga e Karmann, Eliana Egerland Silva, Silmara Figueira10.1016/j.jvoice.2008.06.001Journal of Voice 24, 1 (2010)2009-01-12Journal of Voice2009-01-12241S0892-1997(09)X0007-X8692http://www.jvoice.org/article/PIIS0892199708000702/abstract?rss=yesSummary: The objectives of this study were to determine the effect of musical background on both pitch discrimination abilities and the reliability of judging voice quality in dysphonic speakers, and to determine the relationship between pitch discrimination abilities and the reliability of voice quality judgments. Twenty musicians and 20 nonmusicians performed pitch discrimination tests. They also made judgments of dysphonic vowels and speech samples for breathiness and roughness using 100-mm visual analog scales. Musicians demonstrated significantly smaller pitch discrimination thresholds than nonmusicians. For measures of intrarater agreement, musicians were significantly more consistent than nonmusicians for judgments of breathiness in both vowels and speech produced by dysphonic speakers. Musicians also showed significantly better interrater agreement for judgments of breathiness in vowels. Weak to moderate relationships were found between pitch discrimination abilities and agreement values for voice quality judgments. Results suggest that musical background may affect a listener's reliability in making judgments of dysphonia, particularly for judgments of breathiness. However, simple pitch discrimination skills of pure tones do not explain these differences. More complex stimuli should be used in future investigations to help determine the nature of underlying differences.The Effect of Musical Background on Judgments of DysphoniaTanya L. Eadie, Lana Van Boven, Kelli Stubbs, Eboli Giannini10.1016/j.jvoice.2008.04.008Journal of Voice 24, 1 (2010)2008-11-27Journal of Voice2008-11-27241S0892-1997(09)X0007-X93101http://www.jvoice.org/article/PIIS0892199708001458/abstract?rss=yesSummary: Lasers are a relatively recent addition to laryngeal surgery. Since their invention, laser use and applications have expanded rapidly. In this article, we discuss the benefits and disadvantages of lasers for different procedures, as well as ways to overcome commonly faced clinical problems. The use of lasers in surgery has offered a time- and cost-efficient alternative to cold surgical techniques, and has been used in the treatment of numerous laryngeal pathologies, including stenoses, recurrent respiratory papillomatosis, leukoplakia, nodules, malignant laryngeal disease, and polypoid degeneration (Reinke's edema). However, lasers can incur adjacent tissue damage and vocal fold scarring. These problems can be minimized through understanding the mechanisms by which lasers function and correctly manipulating the parameters under a surgeon's control. By varying fluence, power density, and pulsation, tissue damage can be decreased and lasers can be used with greater confidence. The various types of lasers and their applications to the treatment of specific pathologies are reviewed with the intention of helping surgeons select the best tool for a given procedure. Recent applications of lasers to treat benign laryngeal lesions and severe laryngomalacia demonstrate that additional research must be conducted to realize the full potential of this surgical tool.Use of Lasers in Laryngeal SurgeryYan Yan, Aleksandra E. Olszewski, Matthew R. Hoffman, Peiyun Zhuang, Charles N. Ford, Seth H. Dailey, Jack J. Jiang10.1016/j.jvoice.2008.09.006Journal of Voice 24, 1 (2010)2009-06-01Journal of Voice2009-06-01241S0892-1997(09)X0007-X102109http://www.jvoice.org/article/PIIS0892199708000714/abstract?rss=yesSummary: This study was performed retrospectively to evaluate the incidence of documented vocal fold injury as a result of elective endotracheal intubation during general surgical procedures. Medical record review was performed at a single institution and all surgical cases reviewed which required endotracheal intubation in the nonemergent setting between April 1, 2003 and August, 31, 2007. Cases with unexpected and documented vocal fold immobility postoperatively formed the study cohort, and data were gathered regarding diagnosis and procedures performed. Of 23 010 general surgery cases performed during the study period, only seven documented cases of vocal fold paralysis were discovered (0.03%). There were five women and two men in the group; all were adults. Only one patient had a primary diagnosis related to the head and neck. Comorbidities were recorded as well, but there were no statistically significant patterns discerned. Furthermore, during the study period, a total of 31 patients overall (both surgical and nonsurgical) were admitted who carried a primary diagnosis of vocal fold paralysis. Therefore, the study cohort therefore constituted 22.6% of this total. Finally, cohort patients spent a total of 150 days in hospital during the study period; this length of stay (an average of 16.7 hospital days per patient) was significantly longer than the average of 5.1 days, presumably at least in part related to the vocal paralysis.Vocal Fold Hypomobility Secondary to Elective Endotracheal Intubation: A General Surgeon's PerspectiveJack Sariego10.1016/j.jvoice.2008.05.001Journal of Voice 24, 1 (2010)2009-01-30Journal of Voice2009-01-30241S0892-1997(09)X0007-X110112http://www.jvoice.org/article/PIIS0892199708000775/abstract?rss=yesSummary: The objective was to determine if particle size affects durability of medialization in patients undergoing injection laryngoplasty (IL) with hyaluronic acid (HA) for unilateral vocal cord paralysis (UVCP). We hypothesized that large particle-size HA (LPHA) persists longer after injection to produce a more durable vocal result. The study design used was a prospective randomized controlled single-blind trial. Patients underwent IL with Restylane (small particle-size HA, SPHA) or Perlane (LPHA) (Q-Med AB, Uppsala, Sweden). Injections were performed transcutaneously in the outpatient clinic. The Voice Handicap Index (VHI) at 6 months postinjection was the primary outcome measure. Secondary outcomes included videostroboscopic findings, and objective acoustic and aerodynamic measures. Seventeen patients (eight SPHA, nine LPHA) were available for follow-up at 6 months. Normalized VHI scores at 6 months after IL were significantly lower in the LPHA group compared to the SPHA group when not adjusted for age and sex (P=0.027). After adjustment, the difference was not significant (P=0.053) but the LPHA group trended toward lower normalized VHI scores. The findings support the hypothesis that the larger particle-size of LPHA makes this material more durable than SPHA for IL. This material may be considered for temporary medialization in patients with UVCP in whom medium-term improvement of at least 6 months is desirable. The transcutaneous route can be used safely in the office setting in non-anticoagulated patients.Injection Laryngoplasty With Hyaluronic Acid for Unilateral Vocal Cord Paralysis. Randomized Controlled Trial Comparing Two Different Particle SizesDavid P. Lau, Gwyneth A. Lee, Seng Mun Wong, Valerie P. Lim, Yiong Huak Chan, Nam Guan Tan, Linda A. Rammage, Murray D. Morrison10.1016/j.jvoice.2008.05.007Journal of Voice 24, 1 (2010)2009-06-17Journal of Voice2009-06-17241S0892-1997(09)X0007-X113118http://www.jvoice.org/article/PIIS0892199708000738/abstract?rss=yesSummary: The objective of this study was to document functional results and to compare objective and subjective voice measures after endoscopic laryngoplasty with injection of polydimethylsiloxane (PDMS) for the treatment of unilateral vocal fold paralysis, and to verify PDMS biocompatibility in vocal fold. The design used was a longitudinal prospective study. Fifteen patients with unilateral vocal fold paralysis underwent endoscopic injection of PDMS in general anesthesia. Accurate voice evaluation protocol (acoustic and aerodynamics analyses, GIRBAS [Grade, Instability, Roughness, Breathiness, Asthenia, and Strain] scale, videostrobolaryngoscopy, and Voice Handicap Index test) before, after surgery, and at follow-up time was performed. The median follow-up was 21.7 months (range, 6–35). Data obtained were statistically significant. All acoustic, aerodynamics, perceptive, and subjective evaluations showed a significant improvement. No complications due to PDMS were reported. Functional results were found comparable to framework surgery. Endoscopic injection laryngoplasty with PDMS is a safe and long-term option for treatment of unilateral vocal fold paralysis.Therapy of Unilateral Vocal Fold Paralysis With Polydimethylsiloxane Injection Laryngoplasty: Our ExperienceG. Bergamini, M. Alicandri-Ciufelli, G. Molteni, D. Villari, M.P. Luppi, E. Genovese, L. Presutti10.1016/j.jvoice.2008.05.003Journal of Voice 24, 1 (2010)2009-01-30Journal of Voice2009-01-30241S0892-1997(09)X0007-X119125http://www.jvoice.org/article/PIIS0892199709002446/abstract?rss=yesInstructions for Contributors10.1016/S0892-1997(09)00244-6Journal of Voice 24, 1 (2010)2010-01-01Journal of Voice2010-01-01241S0892-1997(09)X0007-X126126http://www.jvoice.org/article/PIIS0892199709002306/abstract?rss=yesTable of Contents10.1016/S0892-1997(09)00230-6Journal of Voice 24, 1 (2010)2010-01-01Journal of Voice2010-01-01241S0892-1997(09)X0007-XFrontmatterA1A2http://www.jvoice.org/article/PIIS0892199709002318/abstract?rss=yesEditorial Board10.1016/S0892-1997(09)00231-8Journal of Voice 24, 1 (2010)2010-01-01Journal of Voice2010-01-01241S0892-1997(09)X0007-XFrontmatterA3A3http://www.jvoice.org/article/PIIS0892199709002574/abstract?rss=yesCalendar10.1016/S0892-1997(09)00257-4Journal of Voice 24, 1 (2010)2010-01-01Journal of Voice2010-01-01241S0892-1997(09)X0007-XFrontmatterA4A4http://www.jvoice.org/article/PIIS0892199709002379/abstract?rss=yesCalendar Listings10.1016/S0892-1997(09)00237-9Journal of Voice 24, 1 (2010)2010-01-01Journal of Voice2010-01-01241S0892-1997(09)X0007-XFrontmatterA5A5http://www.jvoice.org/article/PIIS0892199709002458/abstract?rss=yesInstructions for Contributors10.1016/S0892-1997(09)00245-8Journal of Voice 24, 1 (2010)2010-01-01Journal of Voice2010-01-01241S0892-1997(09)X0007-XFrontmatterA7A8