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Öğe Auditory-Perceptual Voice Quality, Self-Perceived Voice Handicap, and Vocal Fatigue in Street Vendors(İstanbul University Press, 2025) Birol, Namık Yücel; Alkan, Ferhat; Tutuş, ZübeyirObjective: In rural labour sectors, individuals who rely heavily on their voices—such as street vendors— are at increased risk of developing voice disorders due to prolonged voice use in noisy environments. Understanding their vocal health needs is essential for developing targeted voice therapy interventions within rural rehabilitation frameworks. This study investigates the auditory-perceptual voice quality, self perceived voice handicap, and vocal fatigue among street vendors in the Cappadocia region, Türkiye. Material and Methods: A descriptive, cross-sectional study was conducted with 30 street vendors. Data collection involved the GRBAS scale for perceptual voice evaluation, the Turkish versions of the Voice Handicap Index-10 (VHI-10-TR), and the Vocal Fatigue Index (VFI-TR). Non-parametric tests were used for the statistical analysis. Results: Voice problems were reported by 40% of the participants. Significant differences were observed in the GRBAS scores, with higher impairments in grade, breathiness, asthenia, and strain among those with voice problems. Participants with voice issues also scored significantly higher on the VHI-10-TR and VFI-TR, indicating a greater voice-related handicap and vocal fatigue. A moderate positive correlation was found between the VHI-10-TR and VFI-TR scores. Conclusion: Street vendors in Cappadocia face significant vocal challenges due to occupational voice use, with notable impacts on perceptual voice quality, vocal fatigue, and quality of life. Preventive measures, including vocal health education and workplace interventions, are essential for reducing these risks.Öğe Dizartride Alternatif ve Destekleyici İletişim Sistemleri(Ankara Nobel Tıp Kitapevleri, 2025) Birol, Namık Yücel; Alkan, Ferhatİletişim, bireyler arasındaki sosyal etkileşimlerin temel yapı taşıdır. Bireylerin duygularını, düşüncelerini ve bilgilerini paylaşmalarına olanak tanır ve insan yaşamının merkezinde yer almaktadır. Ancak, gelişimsel veya edinilmiş bazı nörolojik bozukluklar nedeniyle bu süreçte aksaklıklar yaşanabilmektedir. Özellikle dizartri, konuşmanın motor kontrolünü etkileyerek iletişim becerilerini kısıtlayan bir bozukluktur. Serebral palsi, amyotrofik lateral skleroz (ALS) veya travmatik beyin hasarı gibi rahatsızlıklar, bireylerin anlaşılır bir konuşma üretme yetisini sınırlayabilmektedir. Bu durumda, geleneksel terapi yöntemleri genellikle yetersiz kalırken alternatif ve destekleyici iletişim sistemleri (ADİS) etkili bir çözüm sunar.Öğe Erkeklerin Ses Kalınlaştırma Ameliyatı Öncesi ve Sonrası Ses Özelliklerinin Akustik Analiz ve Kadınlar Üzerindeki Güven Algısı Açısından Değerlendirilmesi(Kapadokya Üniversitesi, Lisansüstü Eğitim, Öğretim ve Araştırma Enstitüsü, 2023) Alkan, FerhatBu çalışma, ses kalınlaştırma ameliyatı olmuş erkek katılımcıların ameliyat öncesi ve sonrası seslerinin akustik analiz yöntemiyle değerlendirilmesi ve bu seslerin kadın katılımcılar üzerindeki güven algısına etkisinin incelenmesi amacıyla gerçekleştirilmiştir.Öğe Multidimensional Voice Profiles of Children With and Without Vitamin D Deficiency: A Pilot Cross-Sectional Comparative Study(Elsevier, 2026) Kılıçaslan Hersekli, Buket; Birol, Namık Yücel; Alkan, Ferhat; Karaman Özcan, Müzeyyen; Akın Şenkal, Özgül; Çiyiltepe, Müge MüzeyyenObjectives: This study aims to compare multidimensional voice profiles of children aged 3-12 years with and without vitamin D deficiency in a pilot pediatric sample and to examine whether low vitamin D status is associated with measurable differences in perceptual, parent-reported, acoustic, and aerodynamic voice characteristics. Methods: This cross-sectional comparative study included 47 children who presented for routine pediatric evaluations at a private pediatric clinic in Adana, Türkiye. Participants were classified according to serum 25-hydroxyvitamin D [25(OH)D] levels as having vitamin D deficiency (< 20 ng/mL; n = 23) or normal vitamin D levels (≥ 20 ng/mL; n = 24). Voice assessment included the Turkish Pediatric Voice Handicap Index (pVHI), GRBAS scale, acoustic analysis of sustained /a/ including fundamental frequency, jitter, shimmer, harmonics-to-noise ratio (HNR), and cepstral peak prominence smoothed (CPPS), as well as maximum phonation time (MPT) and s/z ratio. Between-group comparisons were performed using independent-samples t tests or Mann-Whitney U tests, as appropriate. Age- and sex-adjusted sensitivity analyses were also conducted for parent-reported, acoustic, and aerodynamic outcomes. Results: In the primary unadjusted analyses, no statistically significant differences were found between children with vitamin D deficiency and those with normal vitamin D levels for any GRBAS parameter, including Grade, Roughness, Breathiness, Asthenia, and Strain (all P > 0.05). Similarly, pVHI functional, physical, emotional, and total scores did not differ significantly between groups (all P > 0.05). No significant between-group differences were observed for any acoustic or aerodynamic measure, including fundamental frequency, jitter, shimmer, HNR, CPPS /a/, connected speech CPPS, MPT, or s/z ratio (all P > 0.05). In age- and sex-adjusted sensitivity analyses, acoustic and aerodynamic outcomes remained nonsignificant, although an isolated adjusted difference was observed for the pVHI Emotional subscale. Conclusion: In this pediatric pilot sample, vitamin D deficiency was not associated with significant differences in primary multidimensional voice measures. These findings suggest that low vitamin D status may not produce overt voice impairment detectable by conventional perceptual, parent-reported, acoustic, and aerodynamic assessment in children, although subtle or domain-specific effects cannot be excluded. Larger age-stratified studies using more sensitive voice measures are needed.Öğe Prevalence and risk factors of voice disorders among tour guides in Cappadocia(May, 2026) Birol, Namık Yücel; Yaşar Gündüz, Esra; Alkan, Ferhat; Tutuş, ZübeyirPurpose This study aimed to determine the prevalence and risk factors of voice disorders among professional tour guides working in the Cappadocia region of Türkiye, a globally renowned tourism destination with high tourist density. Methods A cross-sectional quantitative design was employed. Eighty-five licensed tour guides (41 females, 44 males; mean age = 42.9 ± 12.2 years) participated by completing an online self-report questionnaire developed for the Cappadocia context. The 61-item survey assessed demographics, vocal symptoms, phonotraumatic behaviors, occupational, lifestyle, and health-related risk factors. Descriptive statistics, chi-square tests, and logistic regression analyses were conducted using SPSS 27. Results Voice problems were reported by 42.4% of guides during their careers (95% CI: 32.4–53.0) and 16.5% currently (95% CI: 10.1–25.8), while 23.5% experienced aphonia at least once annually (95% CI: 15.8–33.6). The most prevalent symptoms were throat dryness (77.6%), vocal fatigue (65.9%), and hoarseness (56.5%). Speaking loudly and continuing to talk despite voice problems were significantly associated with vocal complaints (p = .039 and p < .001, respectively). Environmental and health factors, including guiding noisy groups, long tour durations, and ear–nose–throat (ENT)-related conditions (sinus and other ENT disorders), increased the likelihood of voice problems. Logistic regression identified ENT disorders as an independent predictor (adjusted odds ratio [aOR] = 6.12, 95% CI: 1.33–28.17, p = .020). Conclusion Voice disorders are common among Cappadocia tour guides and are associated with both occupational and health-related factors. These findings suggest that implementing voice hygiene education, ergonomic adaptations, and occupational health monitoring may help reduce risk and support vocal sustainability in this professional group.
