Acoustic analysis in the diagnosis of voice disorders in children

The main aim of this study was to describe the changes in acoustic analysis in diagnosing voice disorders in children. The secondary goal was the attempt at differentiation of organic and functional disorders by means of acoustic analysis. The study included 112 children in treated due to laryngeal papilloma, gastro-esophageal reflux, atopic disease and noduli vocales. The following values have been determined: basic frequency F(o), jitter, shimmer, F(o) tremor and the harmonics to noise ratio (HNR). The study results confirmed that the HNR value was the most sensitive indicator of changes in the voice organ.     

Acoustic analysis of voice in children with noduli vocales

The acoustic tests of voice were carried out on 46 children with noduli vocales before the treatment and after its completion. Acoustic parameters of voice were compared with the control group of children without voice pathology. The results of the investigation were analysed acoustically. It has been proved that jitter, shimmer, Fo tremor and HNR values significantly differentiate the children with noduli vocales from the children without pathological changes in the larynx. These parameters during treatment tend to approach normal values. Therefore, the acoustic analysis of voice may be used in treatment monitoring.     

Acoustic voice analysis in phonatory fistuloplasty after total laryngectomy

A comparative study was made of the voices of three groups of male patients by acoustic analysis of sustained phonation of the vowel /a/: 1) 20 patients who had undergone total laryngectomy and phonatory fistuloplasty, fitted with a Herrmann voice prosthesis, who had achieved successful prosthetic speech; 2) 20 laryngectomized patients with good quality esophageal speech, and 3) 20 subjects with normal voices. Statistical analysis of fundamental frequency disclosed significant differences between groups, the group with phonatory prostheses having the closest to normal voice of the fistuloplastic groups. There were no statistically significant differences in jitter, shimmer, and the harmonic-to-noise ratio between the esophageal and prosthetic voice groups, which suggests that the disturbances in the vibratory esophageal ring were similar.     

Acoustic voice analysis by means of the hoarseness diagram.

The hoarseness diagram (Michaelis, Fr?hlich, & Strube, 1998a) has been proposed as a new approach to describe different acoustic properties of voices. To test its performance in the analysis of pathologically disturbed and normal voices five requirements are suggested that should be met by any acoustic voice-analysis protocol to be used in voice research and clinical practice. The hoarseness diagram is then tested with regard to these requirements. Individual voices are found to show a satisfactory localization in the diagram. Aspects of stationarity are discussed in the context of four case studies. The different cases illustrate that changes in the acoustic analysis results are observed if the voice-generation conditions change, whereas results are stationary if phonation conditions do not change. Different pathological voice groups defined on grounds of the specific phonation mechanism are found to map to specific regions of the hoarseness diagram, with differences between group locations being significant. All results can be interpreted without exceptions if the two hoarseness diagram coordinates are taken to reflect the vibrational irregularity of the voice-generation mechanisms on the one side and the degree of closure of the vibrating structures on the other side. The hoarseness diagram and its underlying algorithms are thus shown to constitute a useful approach to acoustic voice analysis in research and clinical practice. The tests themselves demonstrate several application possibilities, including the quantitative monitoring of individual voices.     

Acoustic and airflow spectral analysis of voice tremor.

Acoustic spectral analysis has been used to describe voice tremor with some success, but no feature distinguishing pathological from normal tremor has been clearly identified. To assist in monitoring voice tremor associated with neurological diseases, objective and quantifiable measures that can distinguish between normal and pathological tremor are desired. This study explored the plausibility of using airflow and acoustic signals to quantify the frequency and amplitude of voice tremor and potentially to distinguish pathological from normal tremor. Subjects were 10 individuals with pathological tremor, most of them individuals with Parkinson's disease, and 10 gender and age-matched individuals with no voice disorder. Simultaneous acoustic and airflow signals were recorded during sustained vowel phonation. The acoustic intensity contours and the airflow signals were submitted to spectral analysis. A peak prominence ratio, defined as the ratio of the spectral peak energy to the overall signal energy, was calculated for each spectral peak below 30 Hz. For each subject, the 6 spectral peaks with the highest peak prominence ratios were selected. Frequency values of the 6 selected acoustic or airflow spectral peaks failed to distinguish tremor group from control group. Peak prominence ratios of the 6 selected acoustic spectral peaks were significantly higher for tremor group than for control group. Although spectral analysis of airflow signals was not useful in differentiating tremor group from control group, acoustic intensity contours and airflow time waveforms were highly and positively correlated in more tremor subjects (90%) than control subjects (40%). This finding suggests that the relationship between acoustic intensity contours and airflow time waveforms may reflect the presence and the source of voice tremor.     

Acoustic analysis of voice for computerized laryngeal pathology assessment

The purpose of this paper is to review the techniques of computerized acoustic analysis of voice signals used for laryngeal pathology assessment. Results of using a methodology described by Davis for distinguishing between T1 glottic cancer, noncancerous pathology, and normal speakers are presented. These results indicate that this technique is not sufficiently sensitive for general clinical usefulness. There is an intentional lack of mathematical detail in this paper, as its prime intent is to conceptually outline issues and approaches.     

Acoustic analysis of snoring sounds by a multidimensional voice program

OBJECTIVES: This prospective study aimed to determine whether the acoustic characteristics of snoring sounds differed between simple snorers and patients with obstructive sleep apnea syndrome (OSAS) by using a multidimensional voice program (MDVP) that analyzes various aspects of voice. METHODS: Fifty-eight patients (48 men, 10 women) with a history of snoring were included in the study. All patients underwent conventional polysomnography (PSG). Twelve subjects were diagnosed as simple snorers and 46 subjects were diagnosed with OSAS. The mean body mass index (BMI) of simple snorers was 24.7 kg/m and that of patients with OSAS was 25.8 kg/m. Natural overnight snoring was recorded from each subject while they slept during PSG. Using the multiple token protocols of MDVP, 30 snores from each subject were analyzed automatically. For data analysis, four markers were used: peak frequency, soft phonation index (SPI), noise to harmonics ratio (NHR), and power ratio. RESULTS: The Mann-Whitney U test revealed significant differences between the SPI, NHR, and power ratio of simple snorers and patients with OSAS. Simple snorers had a high SPI value. OSAS-related snorers demonstrated a high NHR and low power ratio. CONCLUSIONS: MDVP can be used for snoring sound analysis as a noninvasive examination of sleep-related breathing disorders for differential diagnosis. However, a suitable option that is rapid and has an easy-to-use interface would be more advantageous for analyzing snoring sounds.     

气管食管裂隙状瘘发音重建术的声学分析

目的　客观评价气管食管裂隙状瘘发音重建术后的发音效果 ,并以此指导临床工作。方法　对喉全切除术后Ⅰ期与Ⅱ期气管食管裂隙状瘘发音患者、食管发音患者、安装Blom Singer发音钮患者以及健康人分别进行语音测试 ,分析 7项客观声学参数 ,比较发音效果。结果　经统计学t检验 ,气管食管裂隙状瘘语音最长发音时间短于健康人 ,明显长于食管音 ,但和Blom Singer发音钮语音差异无显著性 ;其声音的强度和健康人及Blom Singer发音钮差异无显著性 ,明显高于食管音 ;其基频明显低于健康人 ;其频率微扰和振幅微扰明显高于健康人 ,而明显低于食管发音 ,与Blom Singer发音钮语音差异无显著性 ;其共振峰频率和能量仅在F1共振峰能量上明显高于食管音 ,其余各频率上差异均无显著性。虽然喉全切除Ⅰ期气管食管裂隙状瘘发音重建术中制作帽状气室 ,而Ⅱ期发音重建术中不制作帽状气室 ,但两者语音声学分析各参数间差异均无显著性。结论　气管食管瘘语音比食管音接近健康人语音 ,能满足日常生活需要。气管食管裂隙状瘘发音重建术中不制作帽状气室不影响术后的发音。     

频域相对信噪比对正常、病态嗓音声学的分析

通过对36例正常人和30例病态嗓音者的频域相对信噪比进行分析，结果表明：正常女性嗓音的频域相对信噪比呈稳定分布，而病态嗓音的相对信噪比＞1700Hz频段，与正常人比较，有显著差异（P＜0．01）。可以认为频域相对信噪比是区分病态嗓音和正常嗓音的有效参数。     

Acoustic analysis of the voice in pediatric cochlear implant recipients: a longitudinal study

OBJECTIVE: To characterize inherent acoustic abnormalities of the deaf pediatric voice and the effect of artificially restoring auditory feedback with cochlear implantation. DESIGN: Inception cohort. SETTING: Academic referral center. PATIENTS: Twenty-one children with severe to profound hearing loss (15 prelingually deaf, 6 postlingually deaf) accepted into the cochlear implant program were followed for up to 6 months. Patients unable to perform the vocal exercises were excluded. INTERVENTIONS: Objective voice analysis was performed using the Computerized Speech Laboratory (Kay Elemetrics) prior to cochlear implantation, at the time of implant activation and at 2 and 6 months postactivation. Assessments were based on sustained phonations and dynamic ranges. MAIN OUTCOME MEASURE: Fundamental frequency, long-term control of fundamental frequency (vF0) and long-term control of amplitude (vAM) were derived from sustained phonations. The dynamic frequency range was derived from scale exercises. Formant frequencies (F1, F2, F3) were determined using linear predictive coding. RESULTS: Fundamental frequency was not altered by implant activation or experience (P = 0.342). With profoundly deaf subject, the most prevalent acoustic abnormality was a poor long-term control of frequency (vF0, 2.81%) and long-term control of amplitude (vAm, 23.58%). Implant activation and experience had no effect on the long-term control of frequency (P = 0.106) but normalized the long-term control of amplitude (P = 0.007). The mean frequency range increased from 311.9 Hz preimplantation to 483.5 Hz postimplantation (P = 0.08). The F1/F2 ratio remained stable (P = 0.476). CONCLUSION: In children, severe to profound deafness results in poor long-term control of frequency and amplitude. Cochlear implantation restores control of amplitude only and implies the need for additional rehabilitative strategies for restoration of control of frequency.     

Acoustic voice analysis: reliability of a set of multi-dimensional parameters

A correlational study of the reliability of acoustic voice parameters was made of 148 healthy adults. Acoustic analysis was performed with MDVP-Multi-Dimensional Voice Program implemented in a CSL-Computerized Speech Lab of Kay Elemetrics. A set of 29 voice parameters were obtained from two samples of sustained vowel /a/ recorded from each subject. General results separated by sex are showed and the test-retest reliability in each pair of measures was calculated. Data show a high intra-subject stability of Frequency Fundamental parameters; acceptable stability in parameters of Frequency and Amplitude Perturbation, Noise, Subharmonics and Voice irregularities; and a very low consistency in Tremor parameters. Parameters related with shimmer were more reliable than parameters related with jitter. According to results several conclusions are reported.     

Acoustic analysis of pathological voice. Some results of clinical application

Tape-recorded voices of 30 patients were acoustically analysed: 10 had glottic Tla carcinoma, 10 unilateral vocal fold polyp and 10 unilateral recurrent laryngeal nerve paralysis. The carcinoma cases were treated with laser surgery with/without radiotherapy, the polyp cases with endolaryngeal microsurgery and the paralysis cases with intrafold silicone injection. The acoustic analysis was conducted before and after the treatment for each patient. Three acoustic parameters, viz. pitch perturbation quotient (PPQ), amplitude perturbation quotient (APQ) and normalized noise energy (NNE), were employed. The results were as follows: (1) PPQ and APQ were greater in paralysis cases than in carcinoma and polyp cases; (2) none of the parameters was useful in differentiating the three disease groups investigated; (3) all three parameters proved to be useful in monitoring the effects of treatments; (4) all three parameters were positively correlated to the grade of hoarseness, rough and breathy quality of hoarseness, mean airflow rate and regularity of vocal fold vibration viewed under stroboscopy; (5) PPQ, APQ and NNE were positively related to each other.     

频域相对信噪比正常,病态嗓音声学的分析

通过对３６例正常人和３０例病态嗓音者的频域相对信噪比进行分析，结果表明，正常女性嗓音的频域相对信噪比呈稳定分布，而病态嗓音的相对信噪比，１７００Ｈｚ频段，与正常人比较，有显著差异，可以认为频域相对信噪比及区分病态嗓音和正常嗓音的有效参数。     

气管食管裂隙状瘘发音重建术的声学分析

目的 客观评价气管食管裂隙状瘘发音重建术后的发音效果，并以此指导临床工作。方法 对喉全切除术后I期与Ⅱ期气管食管裂隙状瘘发音患者、食管发音患者、安装Blom—Singer发音钮患者以及健康人分别进行语音测试，分析7项客观声学参数，比较发音效果。结果 经统计学t检验，气管食管裂隙状瘘语音最长发音时间短于健康人，明显长于食管音，但和Blom—Singer发音钮语音差异无显著性；其声音的强度和健康人及Blom—Singer发音钮差异无显著性，明显高于食管音；其基频明显低于健康人；其频率微扰和振幅微扰明显高于健康人，而明显低于食管发音，与Blom—Singer发音钮语音差异无显著性；其共振峰频率和能量仅在F1共振峰能量上明显高于食管音，其余各频率上差异均无显著性。虽然喉全切除I期气管食管裂隙状瘘发音重建术中制作帽状气室，而Ⅱ期发音重建术中不制作帽状气室，但两者语音声学分析各参数间差异均无显著性。结论气管食管瘘语音比食管音接近健康人语音，能满足日常生活需要。气管食管裂隙状瘘发音重建术中不制作帽状气室不影响术后的发音。     

Acoustic correlates of pathologic voice types

Listeners classified 49 samples of vowels /a/ and /i/ on the basis of four voice types: hoarse, breathy, strained, and normal. The vowels were analyzed acoustically for mean harmonic/noise differences in four spectral regions, average fundamental frequency, natural logarithm of fundamental frequency, and jitter. Discriminant analysis showed that classifications of voice type were made with 80% accuracy using three acoustic parameters: (a) mean harmonic/noise difference factor (1-3.5 kHz), (b) natural log of fundamental frequency, and (c) vowel type. The significance of these particular acoustic parameters for the perception and classification of voice types is discussed.