Acoustic estimation of voice when incorrect resonance function of the nose takes place

doi:10.1016/j.ijporl.2005.02.017

International Journal of Pediatric Otorhinolaryngology

Volume 69, Issue 8, August 2005, Pages 1065-1069

https://doi.org/10.1016/j.ijporl.2005.02.017 Get rights and content

Summary

Phonation is a sensitive indicator of palatopharyngeal obstruction and its physiological force.

The aim of the study was to evaluate the influence of nasality on the voice quality. The study was carried out on 125 patients divided into three subgroups. The first was created of the patients treated due to allergic rhinitis, the second was composed of patients with adenoids, the third one consisted of patients with cleft palate.

The following acoustic parameters were assessed: Fo, Jitter, Shimmer, Fo-tremor, NNE, HNR, SNR.

The results of the experimental and control groups were analysed statistically with Student's t-test.

The performed acoustic tests of voice confirmed statistically significant elevation of Fo, HNR and SNR frequency in the studied group as compared with the control group.

Section snippets

Aim

The aim of the study was to evaluate the influence of nasality on the voice quality.

Materials and methods

The study was carried out on 125 patients from the Department of Paediatric Otolaryngology, Phoniatry and Audiology of Medical University in Lublin.

Due to the kind of abnormality (pathological changes) the group was divided into three subgroups:

1.
the first was formed of the patients treated due to allergic rhinitis, 46 patients—36.8% (aged 5–15, averaged 9.96);
2.
the second was composed of patients with adenoids, 52 patients—41.6% (aged 6–12, averaged 9.23); and
3.
the third one consisted of patients

Results

The performed acoustic tests of voice confirmed statistically significant elevation of Fo, HNR and SNR frequency in the studied group as compared with the control group. As follows from the studies, the higher the nasality index and the ratio of nasal cavity pressure and oral cavity pressure (P) are, the greater value of fundamental frequency (Fo) is observed.

The perceptual voice scale is confirmed by the acoustic analysis of voice. As the group was not uniform, individual subgroups were

Discussion

The measurement of nasal airflow in healthy children and in the children with cleft palate is important and differentiating for speech evaluation. The advantages of acoustic “pharyngometry” are emphasized by Wahlamann [12] as a non-invasive and objective method that monitors the treatment effects. Dalston et al. [3] dealt with aerodynamic characteristics in speech production.

Maureen et al. point out to the necessity of compensating cleft palate by the increase of pressure in the oral cavity [9]

Conclusions

The acoustic analysis of voice indicated pathological values of voice in nasality in children.

Basic frequency and its derivatives are characterized by incorrect values. They indicate glottis hyperfunction.

The acoustic analysis may be an useful method in monitoring treatment and rehabilitation of palatopharyngeal failure.

References (13)

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Tonsillectomy in children with or at risk for velopharyngeal insufficiency: effect speech
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Velopharyngeal insufficiency
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The aerodynamic characteristics of speech produced by normal speakers and cleft palate speakers with adequate velopharyngeal function
Am. Cleft Palate Assoc. Am. Cleft Palate Craniofac. Assoc.
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P.H. Dejonckere
Voice problems in children: pathogenesis and diagnosis
Int. J. Pediatr. Otorhinolaryngol.
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Perceptual evaluation of speech and velopharyngeal function in children with and without cleft palate and the relationship to nasal airflow patterns
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Voice disorders in children
Int. J. Pediatr. Otorhinolaryngol.
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There are more references available in the full text version of this article.

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Effects of maxillary expansion on hearing and voice function in non-cleft lip palate and cleft lip palate patients with transverse maxillary deficiency: a multicentric randomized controlled trial
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Jitter percentage (pitch perturbation): representing short-term (cycle-to-cycle) deviation in the fundamental frequency of a signal/deviation from true periodicity of a presumably periodic signal25; Shimmer percentage (amplitude perturbation): representing the variability of the peak-to-peak amplitude between adjacent cycles of vocal fold vibrations26; Harmonic-to-noise ratio (HNR; dB): quantifying the amount of additive noise in the voice signal.
The association between the treatment of transverse maxillary deﬁciency and the recovery of hearing and voice functions has gained attention in recent years.
This prospective controlled trial aimed to evaluate the effects of rapid maxillary expansion on hearing and voice function in children with non-cleft lip palate and bilateral cleft lip palate with transverse maxillary deficiency
53 patients (26 non-cleft and 27 bilateral cleft lip palate; mean age, 11.1 ± 1.8 years) requiring rapid maxillary expansion for correction of narrow maxillary arches were recruited for this trial. Eight sub-groups were established based on the degree of hearing loss. Pure-tone audiometric and tympanometric records were taken for each subject at four different time periods. The first records were taken before rapid maxillary expansion (T0), the second after expansion (T1) (mean, 0.8 months), the third after three months (T2) (mean, 3 months) and the fourth at the end of retention period (T3) (mean, 6 months). ANOVA and Tukey HSD post-hoc tests were used for data analysis. Additionally, voice analysis was done using an updated PRAAT software program in a computerized speech lab at T0 and T2. A paired-samplet-test was used for comparisons of mean values of T0 and T2 voice parameters within both groups.
Rapid maxillary expansion treatment produced a significant increase in the hearing levels and middle ear volumes of all non-cleft and bilateral cleft lip palate patients with normal hearing levels and with mild conductive hearing loss, during the T0–T1, T1–T2, T0–T2, and T0–T3 observation periods (p < 0.05). The significant increase was observed in right middle ear volumes during the T0–T1, T0–T2 and T0–T3 periods in non-cleft patients with moderate hearing loss. For voice analysis, significant differences were observed only between the T0 and T2 mean fundamental frequency (F0) and jitter percentage (p < 0.05) in the non-cleft group. In the cleft group, no significant differences were observed for any voice parameter between the T0 and T2 periods.
Correction of the palatal anatomy by rapid maxillary expansion therapy has a beneficial effect on both improvements in hearing and normal function of the middle ear in both non-cleft and bilateral cleft lip palate patients. Similarly, rapid maxillary expansion significantly influences voice quality in non-cleft patients, with no significant effect in BCLP patients.
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Computer-assisted acoustic analysis can be used to objectively distinguish the pathologic voice abnormalities from a healthy voice.10,11,20 It was reported that the increased F0, jitter, shimmer, and NHR values were associated with pathological sounds.11 Because we observed significantly decreased voice parameters after surgeries, it could be argued that orthognathic surgery could also reduce the pathologic sounds of the patients in addition to the correction of dentofacial deformity.
Orthognathic surgery not only corrects dentofacial deformities but also affects some vital structures involving voice production. The primary aim of this study was to analyze the effects of bimaxillary orthognathic surgery on voice characteristics of patients with class II and III skeletal deformities; the second aim was to evaluate possible associations among acoustic parameters, pharyngeal airway, and skeletal changes after surgery.
Using a prospective cohort study design, we enrolled a sample of patients who underwent bimaxillary orthognathic surgery in the university hospital between January 2018 and January 2019. Voice records and cone-beam computed tomography (CBCT) scans of the patients were acquired before surgery and 6 months after surgery. Pharyngeal airway volume, minimum cross-sectional area, hyoid bone position, and skeletal movements of the maxilla and mandible were assessed with Dolphin Imaging software using CBCT data as predictor variables. Acoustic analysis of voice samples (vowel/a/) were performed with Praat software as outcome variables. The within-group and between-group differences in data were analyzed using paired-sample and independent-sample t tests. The degree of relationship between voice and CBCT parameters was assessed using Pearson correlation and multiple regression analysis.
The study sample comprised 33 patients; 14 patients had class II skeletal deformity and 19 patients had class III skeletal deformity. Orthognathic surgery in both patients with class II and III skeletal deformities resulted in significant changes in all the voice parameters (All P < .05). Only patients with class II skeletal deformity showed significant changes in airway parameters (increase; all P < .001) and hyoid bone positions (anterosuperior movement; P = .001 and P = .008, respectively). Multiple regression analysis showed that some specific structural changes significantly affected some specific acoustic parameters.
Bimaxillary orthognathic surgery significantly changed the acoustic parameters of voice in patients with class II and III skeletal deformities. Some of the structural changes were significantly associated with some of the acoustic parameters.
Voice characteristics before versus after mandibular setback surgery in patients with mandibular prognathism using nonlinear dynamics and conventional acoustic analyses
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The reasons for these discrepancies may be the small sample size and inconsistent subjects, problems with the occlusal and skeletal patterns, and improper analyses in many studies. Acoustic analyses such as the F0, jitter, shimmer and SNR are classified by conventional acoustic analysis (D’Antonio et al., 1988; Niedzielska, 2005). Zajac and Linville (1989) and Lewis et al. (1993) reported that cleft palate speakers have larger frequency perturbations (jitter) than their normal counterparts.
The purpose of this study was to explore the voice characteristics of patients with mandibular prognathism, and to investigate the effects of mandibular setback surgery on these characteristics using nonlinear dynamics and conventional acoustic analyses.
Sixteen patients (8 males and 8 females) who had skeletal 3, class III malocclusion without cleft palate, and who underwent a bilateral sagittal split ramus osteotomy (BSSRO), were enrolled. As controls, 50 healthy adults (25 males and 25 females) were enrolled. The mean first LEs (mLE1) computed for each one-second interval, and the fundamental frequency (F0) and frequencies of the first and second formant (F1, F2) were calculated for each Japanese vowel.
The mLE1s for /u/ in males, and /o/ in females and the F2s for /i/ and /u/ in males, changed significantly after BSSRO. Class III voice characteristics were observed in the mLE1s for /i/ in both males and females, in the F0 for /a/, /i/, /u/ and /o/ in females, and in the F1 and F2 for /a/ in males, and the F1 for /u/ and the F2 for /i/ in females. Most of these characteristics were preserved after BSSRO.
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This letter describes a novel algorithm that is based on autoregressive decomposition and pole tracking used to recognize two patterns of speech data: normal voice and disphonic voice caused by nodules. The presented method relates the poles and the peaks of the signal spectrum which represent the periodic components of the voice. The results show that the perturbation contained in the signal is clearly depicted by pole’s positions. Their variability is related to jitter and shimmer. The pole dispersion for pathological voices is about 20% higher than for normal voices, therefore, the proposed approach is a more trustworthy measure than the classical ones.
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View full text

Acoustic estimation of voice when incorrect resonance function of the nose takes place

Summary

Section snippets

Aim

Materials and methods

Results

Discussion

Conclusions

Tonsillectomy in children with or at risk for velopharyngeal insufficiency: effect speech

Otolaryngol. Head Neck Surg.

Velopharyngeal insufficiency

Bluestone, Stool, Paediatric Otolaryngology

The aerodynamic characteristics of speech produced by normal speakers and cleft palate speakers with adequate velopharyngeal function

Am. Cleft Palate Assoc. Am. Cleft Palate Craniofac. Assoc.

Voice problems in children: pathogenesis and diagnosis

Int. J. Pediatr. Otorhinolaryngol.

Perceptual evaluation of speech and velopharyngeal function in children with and without cleft palate and the relationship to nasal airflow patterns

Cleft Palate Craniofac. J.

Voice disorders in children

Int. J. Pediatr. Otorhinolaryngol.