Department of Otorhinolaryngology-Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Department of Speech and Language, Statped Vest, Bergen, Norway.
Department of Otorhinolaryngology-Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.
J Voice. 2020 Jan;34(1):161.e27-161.e35. doi: 10.1016/j.jvoice.2018.07.002. Epub 2018 Aug 6.
Patients with voice-related disorders are ideally treated by a multidisciplinary team. Acoustic voice analysis and patient-reported outcome measures are recommended parts of the clinical assessment. The present paper aims at further documenting the importance of acoustic voice analyses, maximum phonation time (MPT) and Voice Handicap Index (VHI) into clinical investigations.
The participants (N = 80 larynx cancer, N = 32 recurrent palsy, N = 23 dysfunctional, N = 75 degenerative/inflammation (N = 19 various excluded)) were included consecutively at the outpatient laryngology clinic at Haukeland University Hospital. In addition, a control group of 98 healthy subjects were included.
Voice samples, MPT, and the VHI scores in addition to standard clinical information were obtained. Acoustic analyses were performed from these samples determining level of jitter, shimmer and Noise-to-Harmonic ratio (NHR) as well as analyzing frequency of a prolonged vowel.
Jitter, shimmer, and NHR scores correlated strongly (r ≈ 0.8; P < 0.001) to each other. By Analysis of Variance analyses, we have determined significant dependence on diagnostic group analyzing all the obtained acoustic scores (all P < 0.001). All patient groups but the dysfunctional group scored to some extent worse than the control group (mostly at P < 0.001). In addition, jitter scores from dysfunction group were lower than recurrent palsy group (P < 0.05) and shimmer scores were lower among dysfunctional than the cancer group (P < 0.05). Regarding NHR the cancer patients scored higher than the degenerative/inflammatory group (P < 0.05). The cancer group scored with longer MPT than the degenerative/inflammatory (P < 0.001) and recurrent palsy groups (P < 0.05).
Among larynx disease patients acoustic and MPT analyses segregated with all determined analyses between patients and control conditions except the dysfunctional group, but also to some extent between various patient groups. VHI scores correlated to jitter, shimmer and NHR scores among cancer and degenerative/inflammatory disease patients. Acoustic analyses potentially add information useful to laryngological patient studies.
患有嗓音障碍的患者最好由多学科团队进行治疗。声学嗓音分析和患者报告的结果测量被推荐为临床评估的一部分。本文旨在进一步记录声学嗓音分析、最长发音时间（MPT）和嗓音障碍指数（VHI）在临床研究中的重要性。
参与者（80 例喉癌患者、32 例复发性麻痹患者、23 例功能障碍患者、75 例退行性/炎症性疾病患者（19 例各种原因排除））连续在豪克兰德大学医院的门诊喉科诊所就诊。此外，还纳入了 98 名健康对照组。
获取嗓音样本、MPT 和 VHI 评分以及标准临床信息。从这些样本中进行声学分析，确定振铃、颤音和噪声与谐波比（NHR）的水平，并分析延长元音的频率。
振铃、颤音和 NHR 评分之间高度相关（r≈0.8；P<0.001）。通过方差分析，我们确定了诊断组之间的显著依赖性，分析了所有获得的声学评分（均 P<0.001）。除功能障碍组外，所有患者组的评分均在某种程度上比对照组差（大多数 P<0.001）。此外，功能障碍组的振铃评分低于复发性麻痹组（P<0.05），颤音评分低于癌症组（P<0.05）。至于 NHR，癌症患者的评分高于退行性/炎症性组（P<0.05）。癌症组的 MPT 比退行性/炎症性组（P<0.001）和复发性麻痹组（P<0.05）长。
在喉病患者中，声学和 MPT 分析在患者与对照条件之间的所有确定分析中与功能障碍组分离，但在各种患者组之间也有一定程度的分离。癌症和退行性/炎症性疾病患者的 VHI 评分与振铃、颤音和 NHR 评分相关。声学分析可能提供对喉科患者研究有用的信息。
