After undergoingtotal laryngectomy, patients could speakby various methods: electric voice, tracheoesophageal voice or esophageal voice. The use of electric voice has shown high success rate,butpatients still experience difficulties in expressing the tones in the Vietnamese.
JOURNAL OF MEDICAL RESEARCH ASSESSMENT OF VIETNAMESE TONE USING ELECTRIC VOICE BEFORE AND AFTER TRAINING Pham Thi Bich Dao; Pham Tran Anh Department of Otorhinolaryngology - Hanoi Medical University After undergoingtotal laryngectomy, patients could speakby various methods: electric voice, tracheoesophageal voice or esophageal voice The use of electric voice has shown high success rate,butpatients still experience difficulties in expressing the tones in the Vietnamese Thus, they usually requireadditional practice to express the accent Thisstudy was conducted with 30 patients using electric voice method for 12 monthsto practice Vietnamese tonal language The results indicated thatgiven a regular conversation communicate by a particular patient using electric voice, a regular person cancatch 57.2% of the conversation content, 56.2% of the words and 27.2% of the words' tone An analysis of the components of the 27.2 % audible tones yields the following statistics: “Ngang” tone and “Huyền” tone account for 89.1%, “Sắc” tone 34.5%, 18.9% “Hỏi” tone, “Nặng” tone 56.4%, “Ngã” tone 21.7% On graph tones have similar structures in normal tones with legendary “Ngang”, “Huyền”.After electronic voice training: vocal placement in the hollow electric bass blockers combined with the pronunciation accent tone when used electric voice 72.1% understand conversation, each sound 69.2%, 58.9% out of each tone, “ngang- level” tone, “Huyền- hanging” tone 90.6%, 67.5% “Sắc - sharp” tone, 65.6 % “Hỏi - asking” tone, 74.4% “Nặng - heavy” tone, “Ngã- tumbling” tone 57.9% On graph tones have similar structures in normal tones with “Ngang” and “Huyền”, “Nặng” tone and “Ngã” tone Keywords: Electric voice, whiff, tone, electronic voice training I BACKGROUND mechanical emitted Placement of electric Electric voice is one of the methods used larynx into the throat or mouth area is to make for the total laryngectomy patients to speak the vibration of these parts helps create post-surgery [1] However, the monotonicity of sound Electric larynx is two types: i) type in electric cannot the neck vibration (vibration Patients first set pronounce the more nuanced tones of the of electric larynx in the neck to the sound) and Vietnamese to ii) type in your mouth (sucking mouth larynx pronounce the tones correctly, the patients generated electricity into sound) [4] Many need deliberate practice [2] Accents mainly practitioners use cases electric larynx as show the “Ngang” tone, and the suspension motivation for the collective voice of the should hear monotonously as machine [3] esophagus - after [5] Electric vibrating vocal Patients use electric machine as new larynx muscles in the neck, which creates airflow so they need to practice the accent tone from moving in the resonance of the throat electric voice Electric larynx vibrating parts, dropping about, bumping into the anatomy voice means language patients To be able create the sound to say [6] Electric voice can Corresponding author: Pham Thi Bich Dao, Department of Otorhinolaryngology - Hanoi Medical University E-mail: daoent@yahoo.com Received: 20 October 2016 Accepted: 10 December 2016 JMR 105 E1 (7) - 2016 use to communicate immediately after surgery [7] Using electric voice is relatively easy However, the sound emitted from electric voice often monotonous, is not clear, just 75 JOURNAL OF MEDICAL RESEARCH communicate in small groups, not the sentiments expressed when communicating [8] When using electric larynx, total Methods Cross - horizontal representation, intervention, following, before and after compares laryngectomy patients can not change the basic sound frequency (F0) and change the type of sound to create the pronunciation Use computer programs to analyze sound PRAAT Ngã Perform analysis sets the tone before and Vietnamese tone [9] To overcome this after being set according to the instructions weakness, we recommended users to find the Analyze advantages of each placement ma- optimal placement makes in order to have the chine on the neck in order to find the best lo- best sound guidance and training to create a cation tones Ngang, Huyền, Sắc, Hỏi, Vietnamese tone when using electric voice and subsequently how to Recording of the test to analyze the tone of pronunce the object of study mentioned above (with Vietnamese tone [10] The target of this study dedicated microphone, Sony VAIO laptop) was to assess pronunciation of voice tone Audience subjects tried to low pronounce: U, electric larynx after practice Ù, Ú, Ụ, Ủ, Ũ II SUBJECTS AND METHODS Research ethic: Research subjects were informed goals and voluntarily agree to partici- Subjects pate in research All personal information were 30 people spoke with electric voice kept confidential III RESULTS The ability to pronounce the tone of the electro larynx before training electric larynx position Chart The level of language used in different electric larynx position 76 JMR 105 E1 (7) - 2016 JOURNAL OF MEDICAL RESEARCH The results indicated that there were significant differences of under chin, maddent neck and jugular notch in conversation and sound understanding of the patients While no difference has been shown between under chin and maddent neck in tone understanding, there was big gap of jugular notch between tone and conversation as well as sound understanding The ability to understand communication by electric voice Chart The ability to understand when communicating at a normal distance Understanding the entire content when the patients communicated at a normal distance was 57.2% The rates of understanding each sound and tone were 56.2 %, 27.2 %, respectively The ability to pronounce the accent tone when using electric voice Chart The ability to pronounce the tone of the Electro larynx before and after training The results indicates that: “Ngang” tone, “Huyền” tone showed no difference after and before training The “Sắc” tone, “Hỏi” tone, and “Ngã” tone showed significantly differences between after and before training JMR 105 E1 (7) - 2016 77 JOURNAL OF MEDICAL RESEARCH The ability to pronounce tone of voice before and after training electric larynx Chart F0 Chart Electro larynx before and after training If no training, electric larynx of the patients could not be changed the basic sound frequency (F0) and change the type of sound to create the pronunciation Vietnamese tones The pitch contour of each tone between lowest (28.6 St.) and the highest (29.4 St.) in just 0.8 st not enough for the audience to recognize the distinction of tone In addition, the type of electronic voice to create vocal sound was not reflected in the “Hỏi”, “Ngã” tone After using U vowel for training tone: Huyền, Ngang tone chartsimilar larynx pronounced “Ngã” tone completely different pitch, different from but not far from the starting point and the line shape similar expressions IV DISCUSSION to produce the sound Therefore, we found the that if the vibrations coming from the throat speaker's electric voice is usually the same tube structure, the sound of creation will be However, hard power laryngeal voice tone same mechanism of esophageal voice and represents Vietnamese, mostly succeed in can perform pronounced tone Thereby, we horizontal bar and suspension Therefore, the make bookings electric larynx in different posi- identification language tions: under chin, middle of the neck, Jugular difficulties, mainly to guess in context, does notch find the best electric larynx in hollow not express emotions discourse Vietnamese depression language when communicating [8] Thus, 57.2%, syllables: 56.2%, 27.2% tone If self-assembled, of the the quality listener of with: understanding content when using fluently electric voice, people often Stems from the fact, we trained electric pronounce using esophagus voice because voice pronunciation by natural bass tones, this is the most natural method of training [2] sounds best matches of the larynx vibrating From practical principles of electric voice, vibration impact on the resonant cavity 78 electric power, to be able to control steam flow [2] Thus, the real oral mucosa is able to man- JMR 105 E1 (7) - 2016 JOURNAL OF MEDICAL RESEARCH age vibration frequencies and different amplitudes to generate tones in Vietnamese [9] In - “Sắc” tone: pronounced with lines going up; normal voice Vietnamese, the tone is the change in eleva- - “Ngã” tone: pronounced with bending tion and radio while generating pronounce lines, starting slightly higher, going down, syllables, bring distinctive value means [2] going on cultural phenomena larynx, and then In height, together with distinguished bars and vocal lines, lines - also known as rhythm change the upward, ending at the highest elevations [12] or melody line, which were determined by the - “Nặng” tone: pronounced and slightly oscillation frequency changes of the vocal downward; ending phenomenon glottis rules cords pronounce syllables [11] Contours can [13] be represented as curved lines, or graphs of frequency function, change as a function of time About contours distinction of tone: equal linetone (Ngang tone) other lines tone down (Huyền tone) lines up different tones (Sac tone) other tone-bending lines (down to - up) (Hỏi, Ngã tone) Extreme vocal range is either low or high, in which the tone is shown On the negative distinction of high-pitched The pronunciation tones: sounds emanating from the larynx of vocal power looms, so the best sound for electric voice pronounced negative "U" [14] Way flow control stick slightly to create the following: - “Nặng” tone This is a very short bar, just tone a short blast, should be set first The bar is (Ngang, Huyền, Ngã tone) Other low vocal formed when the blast went through the pro- tones (Huyền, Nặng, Hỏi tone) In terms of nunciation abrupt stop, causing sticky mucus creating a distinction audio tone create audio layer is vibrating rod stop creating negative with the normal mode (Ngang, Huyền, Sắc - “Ngang” tone: the pronounced vibration tone) other than the tone has turned generat- from start to finish with a regular frequency, so ing larynx bar (Hỏi, Ngã tone) and tone with we have to object to pronounce prolonged audio switches generating bar subjects (Nặng vowel "u" with frequencies unchanged until the tone) end of the moisture reserves Described the change as pronounced tone set by former patient’s bass: U, Ù, Ú, Ủ, Ụ, Ũ - “Ngang” tone: yes contours flat, slightly downward; usually vocals - “Huyền” tone: pronounced with lines going down; usually vocals - “Hỏi” tone: pronounced with bending lines, the average comes, then comes down to - “Huyền” tone: when the vibration frequency pronounced decrease towards the end, this time the apprentice audio pronunciation "magical" time release slightly stronger and slightly decreasing the pressure flow - “Sắc” tone: pronounce the vibration with increasing frequency of late, forming negative "identity" lower altitudes, occur chemical larynx, then - “Hỏi” tone: pronounced decrease in the changed upward, the lower end of the starting middle region then increased at the end, the point student pushed a bit slowly and cumulative JMR 105 E1 (7) - 2016 79 JOURNAL OF MEDICAL RESEARCH force of the diaphragm to push air out negative 11 115 San Antonio TX 78230-3609 Whisper at the end of " ask " Hollow - “Ngã” tone: The instructions on how to set Geraldo Pereira Jotz (2002) Harmon- controls so that the jet blast going through the ics Ratio -to- Noise as an Acoustic Measure of throat cavity, then stop, then push the jet Voice Disorders in Boys Journal of Voice, 16 gradually go out with increasing frequency of (1), 28 - 31 Daniel E M (1994) Pre-and Postopera- late [15] tive anatomical and physiological observations V CONCLUSION in laryngectomy.Laryngectomee rehabilitation, In summary, our results indicated that- placement of electric larynx was Jugular notch and set the tone with deep vowel U was necessary for electric voice training 77 - 89 Pham Thi Bich Dao, Nguyen Van Loi, Nguyen Tan Phong (2006).The acoustic properties of human esophageal Vietnam accent.Journal of Medical Research, 46(6), 114 - 118 Acknowledgement André States, Pham (2003) VietnamWe are grateful to all patients who volun- ese Tone: A new analysis.London/ New York / teered to joint this study The authors would Osho / Singapore, Routledge Taylor and Fran- like to thank members of Editorial board for cis, 87 - 90 editing manuscript and critical comments We declare no conflicts of interest Instructors.Current Otolaryngology & Head REFRENCES Nguyen Van Loi, James C Shanks (2001) A history of teaching speech after laryngectomy, by lay and opinion in Neck Surgery, 9, 129 - 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The ability to pronounce tone of voice before and after training electric larynx Chart F0 Chart Electro larynx before and after training If no training, electric larynx of the patients could not... difference after and before training The “Sắc” tone, “Hỏi” tone, and “Ngã” tone showed significantly differences between after and before training JMR 105 E1 (7) - 2016 77 JOURNAL OF MEDICAL... sound guidance and training to create a cation tones Ngang, Huyền, Sắc, Hỏi, Vietnamese tone when using electric voice and subsequently how to Recording of the test to analyze the tone of pronunce