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May 02, 2012

Dr. Robert E. HillmanMGH Institute of Health Professions Associate Provost for Research Robert E. Hillman, PhD, CCC-SLP, has been awarded a new $2.4 million grant from the National Institute on Deafness and Other Communication Disorders (NIDCD), part of the National Institutes of Health, that will use smart phone technology to improve the diagnosis and treatment of patients with laryngeal voice disorders.

The device he is working on will monitor voice use as people go about their normal day-to-day activities, and provide quantitative measures that can be used to more accurately determine the role that vocal habits play in causing many of the most common voice disorders that plague approximately 6.6% of the working-age population in the United States.

“We ask people how they use their voices, but the problem is, people are really bad historians when it comes to voice use,” said Dr. Hillman in a story on the NIDCD Web site. “We have data that shows people tend to be off on average 150 to 200 percent when simply trying to estimate how much they use their voices during a typical day.”

The project, called "Ambulatory monitoring of vocal function to improve voice disorder assessment," has total funding of $2,415,383 for a four-year period that began in April 2012. It includes subcontracts to the MGH Institute and Massachusetts Institute of Technology.

Dr. Hillman is also an Associate Professor of Surgery and Health Sciences and Technology at Harvard Medical School and co-directs the Center for Laryngeal Surgery and Voice Rehabilitation at Massachusetts General Hospital with his colleague Steven Zeitel, M.D., surgeon to singers such as Adele, Steven Tyler, and Julie Andrews.

The device that Dr. Hillman and his team have developed uses a small receiver the size of a dime, called an accelerometer, attached with double-sided sticky tape to the base of the throat which captures the vibrations that are transmitted from the larynx through the skin.

“The goal is to make it as unobtrusive as possible,” Dr. Hillman said, “because you want people to be doing things the way they normally do them. The impact has to be minimal.” An earlier version of the device was so unobtrusive that Tyler wore it during an Aerosmith concert to document the vocal extremes of rock-and-roll singing.

One of the goals of the monitoring device is to be able to use the data to begin to make some correlations between patterns of voice use and the risk for a vocal disorder. A future feature, when the device goes into clinical testing, will be the addition of a feedback method, such as a buzzer or vibration, to tell the wearer when he is using his voice incorrectly.

“Voice therapy is like any kind of behavior change therapy,” said Dr. Hillman. “People will do what we tell them to do when they’re in front of us, but maybe not when they’re not being watched. Highly habituated vocal habits are hard to break.”

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