Gillespie Amanda I, Gartner-Schmidt Jackie, Lewandowski Ali, Awan Shaheen N
University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
J Voice. 2018 Mar;32(2):169-176. doi: 10.1016/j.jvoice.2017.04.018. Epub 2017 Jul 5.
The objective, instrumental acoustic measure of Cepstral Spectral Index of Dysphonia (CSID) correlates with audio-perceptual measures, is sensitive in detecting voice abnormalities, and tracks change following treatment. The goals of the current study were to (1) test the agreement between CSID versus auditory perceptual measures of pre- versus posttreatment voice change, and (2) investigate whether change in scores is based on voice disorder or phonemic structure of sentence stimuli.
Forty patients with benign voice disorders produced sentences and a sustained /a/ vowel from the Consensus Auditory Perceptual Evaluation of Voice protocol before and after treatment. CSID was calculated, and overall audio-perceptual voice severity was judged by 7 blinded, trained raters using a 100-mm visual analog scale. Differences between CSID and audio-perceptual measures of voice change across voice disorder and stimuli, and correlation between change in CSID and perceptual rating scores were assessed pre- and postintervention.
Across all subjects, there were significant correlations between CSID and perceptual ratings change scores (P < 0.001), and no significant differences in pre- and posttreatment change. Disorder-specific analyses indicated that all tested sentence/vowel contexts are effective measures for pre- versus posttreatment change in atrophy and paralysis cases. Acoustic versus perceptual measures of voice change were significantly correlated in lesion cases for the sentence "How hard did he hit him" and with all sentences combined. There were no significant findings observed for muscle tension dysphonia.
CSID provides an accurate objective correlate to auditory-perceptual posttreatment change in overall voice severity ratings. Implications for outcomes testing and disorder-specific findings are discussed.
嗓音障碍的谐波倒谱谱指数（CSID）这一客观的仪器声学测量指标与听觉感知测量指标相关，在检测嗓音异常方面很敏感，并且能追踪治疗后的变化。本研究的目的是：（1）测试CSID与治疗前后嗓音变化的听觉感知测量指标之间的一致性，以及（2）调查分数变化是基于嗓音障碍还是句子刺激的音素结构。
40例良性嗓音障碍患者在治疗前后按照嗓音共识听觉感知评估方案说出句子和持续发/a/元音。计算CSID，并由7名不知情的经过培训的评分者使用100毫米视觉模拟量表判断总体听觉感知嗓音严重程度。在干预前后评估了CSID与跨嗓音障碍和刺激的嗓音变化听觉感知测量指标之间的差异，以及CSID变化与感知评分分数之间的相关性。
在所有受试者中，CSID与感知评分变化分数之间存在显著相关性（P < 0.001），治疗前后的变化无显著差异。特定障碍分析表明，所有测试的句子/元音语境都是萎缩和麻痹病例治疗前后变化的有效测量指标。对于句子“他打他有多用力”以及所有句子综合起来，病变病例中嗓音变化的声学测量指标与感知测量指标显著相关。肌肉紧张性发声障碍未观察到显著结果。
CSID为总体嗓音严重程度评分中治疗后的听觉感知变化提供了准确的客观关联。讨论了对结果测试和特定障碍发现的影响。
