Validez de las medidas del pico cepstral para la valoración objetiva de la disfonía en sujetos de habla hispana

Introduction and objectivesPerceptual rating of overall voice quality and other more specific perceptual dimensions is difficult, as such judgments depend on the listener's subjectivity. Thus, finding objective, valid, and accessible clinical measures to include in comprehensive voice evaluation protocols is a priority.The purposes of this study were to 1) determine the diagnostic accuracy of a single acoustic measure, smoothed cepstral peak prominence (CPPS), to predict voice disorder status from sustained vowels and connected speech samples using the software Praat; 2) to determine the relationship between measures of CPPS and perceptual ratings of vocal quality; and 3) describe the normative values of CPPS.MethodMeasures of CPPS were obtained from connected speech and sustained vowel recordings of 72 Spanish-speaking subjects with voice disorders and 52 nondysphonic Spanish-speaking subjects with no vocal disorders using freely downloadable Praat software. IBM SPSS Statistics software version 23 was used to complete the statistical analyses.Resultsresults revealed a 70% sensitivity rate, a specificity rate of 85%. Estimated severity for sustained vowels and connected speech were strongly correlated and significantly associated with listener ratings of dysphonia severity.ConclusionsA single acoustic measure of CPPS was highly predictive of voice disorder status using Praat software. Clinicians may consider using CPPS to complement clinical voice evaluation and screening protocols.     

Praat软件及DSI对改良杓状软骨内收术治疗单侧声带麻痹的疗效评估

目的探讨Praat软件及嗓音障碍严重程度指数(dysphonin severity index,DSI)对改良杓状软骨内收术治疗单侧声带麻痹疗效评估的意义。方法 65例单侧声带麻痹患者均于患侧行改良杓状软骨内收术。全部病例于手术前及术后3月、12月分别行DSI分析及以Praat软件分析基频(fundamental frequency,F0)、声音强度(intensity)、噪谐比(NHR)、基频微扰[包括:局部基频微扰(jitter local)、局部绝对基频微扰(jitter local absolute)、基频微扰间期系数5(jitter ppq5)]、振幅微扰[包括:局部振幅微扰(shi mmer local)、局部振幅微扰dB(shi mmer localdB)、振幅微扰间期系数5(shi mmer apq5)]。结果术后3月、12月患者F0、NHR、jitter local、jitter local absolute、jitter ppq5、shi mmer local、shi mmer local dB、shi mmer apq5较术前明显下降,差异均有统计学意义(均为P<0.05)。术后3月、12月声音强度(intensity)分别与术前相比差异均无统计学意义(均为P>0.05)。术后3月、12月DSI值较术前均有显著提高(均为P<0.05)。术后12月上述所有指标与术后3月相比,差异均无统计学意义(均为P>0.05)。结论 Praat软件及DSI可客观、有效地评估改良杓状软骨内收术治疗单侧声带麻痹的疗效,该术式治疗单侧声带麻痹远期效果稳定。     

喉部分切除术患者的发音效果观察

目的观察喉部分切除术患者的发音效果。方法选择行喉部分切除术的患者共118例,评估其发音效果。结果发音效果以喉水平半切除术患者的最好,其后依此为喉裂开术、喉垂直部分切除术、喉3/4切除术患者。不同术式患者的声学参数两两比较,P均〈0.05。结论喉部分切除术患者术后发音效果及嗓音质量以喉水平半切除术者最好。     

Effects of unilateral vocal cord paralysis on objective voice measures obtained by Praat

Unilateral vocal cord paralysis (VCP) affects the objective properties of voice by diminished neurologic control and degenerative changes in laryngeal tissue. The goal of this study was to compare the acoustic parameters of VCP patients with control volunteers using the software Praat. Acoustic analysis results of 18 unilateral VCP patients were compared with age and sex matched 72 normal adult volunteers. Comparison of acoustic analysis results of male and female VCP patients with their age and sex matched control groups revealed statistically significant difference in jitter, shimmer, and noise-to-harmonics ratio values (P < 0.01) in both groups. There were no differences in mean fundamental frequency and intensity values. We conclude that these differences were in accordance with the results obtained by commercially available voice analysis programs. This study reflects the first results obtained with Praat software in VCP patients. Using the software Praat, is free and easy, that supports the clinician to rely on objective scientific data.     

构音评估与训练系统的声学分析研究

目的 比较智能提取语音参数的构音评估与训练系统和人工提取语音参数的Praat声学软件在重要参数上的差异。 方法 选取32例正常受试者,分别用构音评估与训练系统和传统Praat语音软件进行语音采集,前者可以即时智能分析出持续元音／a／、／i／、／u／的平均基频（mF0）、第一共振峰（F1）、第二共振峰（F2）,传统Praat软件则是通过人工提取采录语音参数并进行数据分析。对上述两种语音分析工具的重要声学参数进行一致性分析。 结果 采用构音评估与训练系统对同一受试者进行第1次评估和第2次评估,除元音／u／的mF0（ICC=0.75）重测信度较好外,元音／a／的mF0（ICC=0.97）、F1(ICC=0.97)和F2(ICC=0.98),元音／i／的mF0(ICC=0.93)、F1(ICC=1.00)和F2(ICC=0.95),元音／u／的F1(ICC=0.98)和F2(ICC=0.94)的ICC值均高于0.90,说明构音评估与训练系统的重测信度极好。两种声学分析软件元音／a／的mF0(ICC=0.99)、F1(ICC=0.96)和F2(ICC=0.90),元音／i／的mF0(ICC=0.98)、F1(ICC=0.94)和F2(ICC=0.94),元音／u／的mF0(ICC=0.95)和F1(ICC=0.94)的ICC值均高于0.90,说明两种声学分析软件在分析元音／a／、／i／的mF0、F1和F2,元音／u／的F1和F2方面的一致性极好。元音／u／的F2 ICC值介于0.75～0.90,说明两种声学分析软件在分析元音／u／的F2方面的一致性较好。两种声学分析软件的元音／a／、／i／、／u／的mF0、F1、F2、共振峰集中率（FCR）、元音清晰度指数（VAI）、舌距、元音空间面积（VSA）、下颌距在Bland-Altman图中数据点多分布在95%可信区间内,说明两种声学分析软件在语音测量中具有较高的准确性。男性长元音／a／的mF0（151.35±30.94）、／i／的mF0（163.84±27.92）、／u／的mF0（170.96±31.99）均低于女性长元音／a／的mF0（277.93±23.48）、／i／的mF0（280.34±27.23）、／u／的mF0（284.97±37.08）,差异均有统计学意义（P＜0.05）。 结论 构音评估与训练系统的重测信度较好,在自然状态下的构音检查结果与Praat检查结果比较的一致性较好,在构音检查上可以相互替代。     

Variación del parámetro acústico harmonic-to-noise ratio en relación con distintos niveles de ruido de fondo

Introduction and objectivesAcoustic analysis is a tool widely used by professionals related to the study of voice that gives us information from a recording. It has been identified that in investigations carried out today that involve acoustic analysis, the recording process takes place in rooms with different levels of background noise. The objective of this study is to establish whether the acoustic parameter harmonic-to-noise ratio (HNR) varies in relation to the different background noise levels of the premises where the recording is made and recommend a maximum level of background noise.MethodsThrough the Praat programme, the average value of the acoustic parameter HNR of 43 subjects was obtained, inside the audiometric booth of the Universidad Autónoma de Chile, whose background noise level is 28.1 dB(A) and it was compared with the HNR average values obtained with higher background noise levels.ResultsThe HNR average values decreased from 19.8 to 14.0 dB(A) as the background noise level of the premises increased from 28.1 to 57.8 dB(A). The t-test for dependent samples was performed, with which the HNR average values obtained were compared with the baseline background noise level (28.1 dB[A]). Significant differences were found with the baseline background noise level when the room noise level was higher than 47.7 dB(A).ConclusionsThe background noise of the premises where the voice recording for the acoustic analysis is performed, influences the value of the acoustic parameter HNR, which decreases as the background noise of the premises increases. It is recommended that the background noise level should not exceed 43.8 dB(A).     

Análisis acústico de la voz mediante el progama Praat: estudio comparativo con el programa Dr. Speech

Introduction and objectivesThe European Laryngological Society (ELS) basic protocol for functional assessment of voice pathology includes 5 different approaches: perception, videostroboscopy, acoustics, aerodynamics and subjective rating by the patient. In this study we focused on acoustic voice analysis.The purpose of the present study was to correlate the results obtained by the commercial software Dr. Speech and the free software Praat in 2 fields:1. Narrow-band spectrogram (the presence of noise according to Yanagihara, and the presence of subharmonics) (semi-quantitative).2. Voice acoustic parameters (jitter, shimmer, harmonics-to-noise ratio, fundamental frequency) (quantitative).Material and methodsWe studied a total of 99 voice samples from individuals with Reinke's oedema diagnosed using videostroboscopy. One independent observer used Dr. Speech 3.0 and a second one used the Praat program (Phonetic Sciences, University of Amsterdam).The spectrographic analysis consisted of obtaining a narrow-band spectrogram from the previous digitalised voice samples by the 2 independent observers. They then determined the presence of noise in the spectrogram, using the Yanagihara grades, as well as the presence of subharmonics. As a final result, the acoustic parameters of jitter, shimmer, harmonics-to-noise ratio and fundamental frequency were obtained from the 2 acoustic analysis programs.ResultsThe results indicated that the sound spectrogram and the numerical values obtained for shimmer and jitter were similar for both computer programs, even though types 1, 2 and 3 voice samples were analysed.ConclusionsThe Praat and Dr. Speech programs provide similar results in the acoustic analysis of pathological voices.     

Análisis cepstral de la voz normal y patológica en adultos españoles. Medida de la prominencia del pico cepstral suavizado en vocales sostenidas versus habla conectada

Introduction and objectives

In recent years, the use of cepstral measures for acoustic evaluation of voice has increased. One of the most investigated parameters is smoothed cepstral peak prominence (CPPs). The objectives of this paper are to establish the usefulness of this acoustic measure in the objective evaluation of alterations of the voice in Spanish and to determine what type of voice sample (sustained vowels or connected speech) is the most sensitive in evaluating the severity of dysphonia.