발성장애 환자에서 주관적 음성검사와 객관적 음성검사의 연관성 연구
Study for Correlation between Objective and Subjective Voice Parameters in Patients with Dysphonia
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background and Objectives Voice evaluation is classified into subjective tests such as auditory perception and self-measurement, and objective tests such as acoustic and aerodynamic analysis. When evaluating dysphonia, subjective and objective test results do not always match. The purpose of this study was to analyze the relationship between subjective and objective evaluation in patients with dysphonia and to identify meaningful parameters by disease. Materials and Method The total of 322 patients who visited voice clinic from May 2017 to May 2018 were included in this study. Laryngeal lesions were identified using stroboscopy. Pearson correlation test was performed to analyse correlation between subjective tests including GRBAS scale and voice handicap index, and objective tests including jitter, shimmer, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), maximal phonation time (MPT), mean flow rate, and subglottic pressure. Results In vocal nodule and sulcus vocalis, among GRBAS system, grade and breathiness showed good correlation with CPP, and roughness showed good correlation with jitter or shimmer. In unilateral vocal cord paralysis (UVCP), grade and breathiness showed a very good correlation with CPP, and also good correlation with jitter, shimmer, NHR, and MPT. Also asthenia showed good correlation with CPP and MPT. Vocal polyp has a limited association with other diseases. Conclusion In patients with dysphonia, grade and breathiness showed good correlation with CPP, jitter, and shimmer, and reflect the state of voice change well especially in UVCP, CPP, and MPT.
Abstract
Background and Objectives Voice evaluation is classified into subjective tests such as auditory perception and self-measurement, and objective tests such as acoustic and aerodynamic analysis. When evaluating dysphonia, subjective and objective test results do not always match. The purpose of this study was to analyze the relationship between subjective and objective evaluation in patients with dysphonia and to identify meaningful parameters by disease. Materials and Method The total of 322 patients who visited voice clinic from May 2017 to May 2018 were included in this study. Laryngeal lesions were identified using stroboscopy. Pearson correlation test was performed to analyse correlation between subjective tests including GRBAS scale and voice handicap index, and objective tests including jitter, shimmer, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), maximal phonation time (MPT), mean flow rate, and subglottic pressure. Results In vocal nodule and sulcus vocalis, among GRBAS system, grade and breathiness showed good correlation with CPP, and roughness showed good correlation with jitter or shimmer. In unilateral vocal cord paralysis (UVCP), grade and breathiness showed a very good correlation with CPP, and also good correlation with jitter, shimmer, NHR, and MPT. Also asthenia showed good correlation with CPP and MPT. Vocal polyp has a limited association with other diseases. Conclusion In patients with dysphonia, grade and breathiness showed good correlation with CPP, jitter, and shimmer, and reflect the state of voice change well especially in UVCP, CPP, and MPT.
참고문헌 (20)
- Dejonckere PH, "A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical)treatments and evaluating new assessment techniques. Guideline elaborated by the Committee on Phoniatrics of the European Laryngological Society (ELS)", Eur Arch Otorhinolaryngol, 258(2), pp.77~82 (2001)
- Maryn Y, "Acoustic measurement of overall voice quality : a meta-analysis", J Acoust Soc Am, 126(5), pp.2619~2634 (2009)
- V Latoszek BB, "A meta-analysis : acoustic measurement of roughness and breathiness", J Speech Lang Hear Res, 61(2), pp.298~323 (2018)
- Woisard V, "The voice handicap index : correlation between subjective patient response and quantitative assessment of voice", J Voice, 21(5), pp.623~631 (2007)
- Hillenbrand J, "Acoustic correlates of breathy vocal quality", J Speech Hear Res, 37(4), pp.769~778 (1994)
- 김재옥, "한국어판 음성장애지수와 음성관련 삶의 질의 타당도 및 신뢰도 연구", 음성과학, 14(3), pp.111~125 (2007), 한국음성과학회
- Schindler A, "Correlation between the Voice Handicap Index and voice measurements in four groups of patients with dysphonia", Otolaryngol Head Neck Surg, 141(6), pp.762~769 (2009)
- Muñoz J, "Acoustic and perceptual indicators of normal and pathological voice", Folia Phoniatr Logop, 55(2), pp.102~114 (2003)
- Bhuta T, "Perceptual evaluation of voice quality and its correlation with acoustic measurements", J Voice, 18(3), pp.299~304 (2004)
- de Krom G, "Some spectral correlates of pathological breathy and rough voice quality for different types of vowel fragments", J Speech Hear Res, 38(4), pp.794~811 (1995)
- Heman-Ackah YD, "Cepstral peak prominence : a more reliable measure of dysphonia", Ann Otol Rhinol Laryngol, 112(4), pp.324~333 (2003)
- Klatt DH, "Analysis, synthesis, and perception of voice quality variations among female and male talkers", J Acoust Soc Am, 87(2), pp.820~857 (1990)
- Awan SN, "Toward the development of an objective index of dysphonia severity : a four-factor acoustic model", Clin Linguist Phon, 20(1), pp.35~49 (2006)
- Awan SN, "Outcomes measurement in voice disorders : application of an acoustic index of dysphonia severity", J Speech Lang Hear Res, 52(2), pp.482~499 (2009)
- Kim TH, "Comparison of vowel and text-based cepstral analysis in dysphonia evaluation", J Korean Soc Laryngol Phoniatr Logop, 26(2), pp.117~121 (2015)
- 박민철, "음성장애 평가에서 켑스트럼 분석의 임상적 유용성", 대한이비인후-두경부외과학회지, 56(9), pp.574~578 (2013), 대한이비인후과학회[DOI]
- Dejonckere PH, "Acoustic, perceptual, aerodynamic and anatomical correlations in voice pathology", ORL J Otorhinolaryngol Relat Spec, 58(6), pp.326~332 (1996)
- Dejonckere PH, "Differentiated perceptual evaluation of pathological voice quality : reliability and correlations with acoustic measurements", Rev Laryngol Otol Rhinol(Bord), 117(3), pp.219~224 (1996)
- Eadie T, "Does knowledge of medical diagnosis bias auditory-perceptual judgments of dysphonia?", J Voice, 25(4), pp.420~429 (2011)
- Awan SN, "Exploring the relationship between spectral and cepstral measures of voice and the Voice Handicap Index(VHI)", J Voice, 28(4), pp.430~439 (2014)