Division of Phoniatrics-Logopedics, Department of Otorhinolaryngology, Medical University Hospital Vienna, Vienna, Austria,
Division of Phoniatrics-Logopedics, Department of Otorhinolaryngology, Medical University Hospital Vienna, Vienna, Austria.
Folia Phoniatr Logop. 2022;74(5):335-344. doi: 10.1159/000524299. Epub 2022 Mar 28.
Voice diagnostics including voice range profile (VRP) measurement and acoustic voice analysis is essential in laryngology and phoniatrics. Due to COVID-19 pandemic, wearing of 2 or 3 filtering face piece (FFP2/3) masks is recommended when high-risk aerosol-generating procedures like singing and speaking are being performed. Goal of this study was to compare VRP parameters when performed without and with FFP2/3 masks. Further, formant analysis for sustained vowels, singer's formant, and analysis of reading standard text samples were performed without/with FFP2/3 masks.
Twenty subjects (6 males and 14 females) were enrolled in this study with an average age of 36 ± 16 years (mean ± SD). Fourteen patients were rated as euphonic/not hoarse and 6 patients as mildly hoarse. All subjects underwent the VRP measurements, vowel, and text recordings without/with FFP2/3 mask using the software DiVAS by XION medical (Berlin, Germany). Voice range of singing voice, equivalent of voice extension measure (eVEM), fundamental frequency (F0), sound pressure level (SPL) of soft speaking and shouting were calculated and analyzed. Maximum phonation time (MPT) and jitter-% were included for Dysphonia Severity Index (DSI) measurement. Analyses of singer's formant were performed. Spectral analyses of sustained vowels /a:/, /i:/, and /u:/ (first = F1 and second = F2 formants), intensity of long-term average spectrum, and alpha-ratio were calculated using the freeware praat.
For all subjects, the mean values of routine voice parameters without/with mask were analyzed: no significant differences were found in results of singing voice range, eVEM, SPL, and frequency of soft speaking/shouting, except significantly lower mean SPL of shouting with FFP2/3 mask, in particular that of the female subjects (p = 0.002). Results of MPT, jitter, and DSI without/with FFP2/3 mask showed no significant differences. Further mean values analyzed without/with mask were ratio singer's formant/loud singing, with lower ratio with FFP2/3 mask (p = 0.001), and F1 and F2 of /a:/, /i:/, /u:/, with no significant differences of the results, with the exception of F2 of /i:/ with lower value with FFP2/3 mask (p = 0.005). With the exceptions mentioned, the t test revealed no significant differences for each of the routine parameters tested in the recordings without and with wearing a FFP2/3 mask.
It can be concluded that VRP measurements including DSI performed with FFP2/3 masks provide reliable data in clinical routine with respect to voice condition/constitution. Spectral analyses of sustained vowel, text, and singer's formant will be affected by wearing FFP2/3 masks.
包括嗓音范围图(VRP)测量和声学语音分析在内的嗓音诊断在喉科学和语音学中至关重要。由于 COVID-19 大流行,当进行高风险气溶胶产生程序(如唱歌和说话)时,建议佩戴 2 或 3 层过滤式面罩(FFP2/3)。本研究的目的是比较不戴和戴 FFP2/3 口罩时的 VRP 参数。此外,还对面罩不戴/戴 FFP2/3 时的元音共振峰分析、歌唱家共振峰和标准朗读文本样本分析进行了研究。
本研究纳入了 20 名受试者(6 名男性和 14 名女性),平均年龄为 36±16 岁(均值±标准差)。14 名患者被评为声音悦耳/不嘶哑,6 名患者轻度嘶哑。所有受试者均使用 XION medical(柏林,德国)的 DiVAS 软件进行 VRP 测量、元音和文本录音,不戴/戴 FFP2/3 口罩。计算并分析了歌唱嗓音范围、等效嗓音扩展测量(eVEM)、基频(F0)、软发声和呼喊时的声压级(SPL)。最大发音时间(MPT)和抖动-%纳入用于测量嗓音障碍严重指数(DSI)。进行了歌唱家共振峰分析。使用免费软件 praat 计算了/a:/、/i:/和/u:/元音的第一共振峰(F1)和第二共振峰(F2)、长期平均谱强度和α-比的频谱分析。
对所有受试者的无/戴口罩常规嗓音参数的平均值进行了分析:除了大声呼喊时的平均 SPL 明显较低(女性受试者 p = 0.002)外,歌唱嗓音范围、eVEM、SPL 和软发声/呼喊频率的结果均无显著差异。无/戴 FFP2/3 口罩时 MPT、抖动和 DSI 的结果无显著差异。进一步分析无/戴口罩时的平均值,歌唱家共振峰/大声歌唱的比值较低(p = 0.001),/a:/、/i:/、/u:/元音的 F1 和 F2 无显著差异,除了/i:/的 F2 值较低(p = 0.005)。除了上述情况外,t 检验显示在无和戴 FFP2/3 口罩的记录中,测试的每个常规参数均无显著差异。
可以得出结论,在临床常规中,使用 FFP2/3 口罩进行 VRP 测量,包括 DSI,可提供可靠的数据,说明嗓音状况/构成。佩戴 FFP2/3 口罩会影响元音、文本和歌唱家共振峰的频谱分析。