Center of Hearing and Speech, Kajetany, Poland.
Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.
J Voice. 2024 Nov;38(6):1531.e5-1531.e11. doi: 10.1016/j.jvoice.2022.05.005. Epub 2022 Jun 3.
Partial deafness is a condition characterised by normal hearing thresholds in low frequencies and increased hearing thresholds (nearly deafness) for high frequencies. Typical hearing aids are rather of a very limited use in this condition as they do not improve understanding of speech. Patients with partial deafness can be presently treated with cochlear implants, which had not been used before due to the risk of damage of hearing remains by electrode introduced into cochlea. The purpose of our study was an objective and subjective assessment of voice quality in partial deafness patients before and after cochlear implantation. The subjects in this study were 25 post-lingual, bilaterally partially deaf patients, 13 females and 12 males. The reference group composed of 55 normal hearing individuals (28 females and 27 males). The acoustic analysis was performed with a multidimensional voice analysis MDVP (Multi Dimension Voice Program), and the subjective assessment was done with GRBAS scale. Initial analysis of voice changes in partial deafness patients was performed versus normal hearing individuals, then voice parameters were measured and perceptual voice assessment was done before and 9 months after cochlear implantation. Measurements of acoustic voice parameters in partially deaf patients showed changes in most of frequency, amplitude, noise and subharmonic components versus normal hearing control group. The most significant, statistically important changes were observed in fundamental frequency variation (vF0), absolute jitter (Jita), jitter percent (Jitt), amplitude perturbation quotient (APQ), smoothed amplitude perturbation quotient (sAPQ), relative average perturbation (RAP), peak amplitude variation (vAm), relative amplitude modulation (Shim), percent shimmer (%Shim), pitch perturbation quotient (PPQ), smoothed pitched perturbation quotient (sPPQ), degree of subharmonics (DSH), degree of voiceless (DUV), number of subharmonic segments (NSH), noise-to-harmonic ratio (NHR), voice turbulence index (VTI). All patients in the study group were subjects to cochlear implantation. After 9 months objective and subjective assessment of patients voices were performed again. Statistically important changes were identified in average fundamental frequency variability (vF0), relative amplitude modulation index (ShdB), noise-to-harmonic ratio (NHR), number of subharmonics NSH, degree of subharmonics (DSH) and the degree of voiceless (DUV). Comparison of the objective voice parameters changes after cochlear implantation with subjective, perceptual voice quality assessments leads to observation, that improvement of subjective voice quality after cochlear implantation takes place parallelly with improvement of certain objective acoustic voice parameters and some correlations exist. We found, that G correlates with vF0 and Shim, R correlates with DSH and NSH, B correlates with NSH and NHR, A correlates with DUV. We did not prove correlation of S with any of the objective parameters in our research group. Our study proved, that acoustic and perceptual features of voice in partially deaf adults are different than in normally hearing people and cochlear implantation in partial deafness patients is an effective tool to improve hearing and leads to improvement of the acoustic structure of the voice.Partial deafness is a condition characterised by normal hearing thresholds in low frequencies and increased hearing thresholds (nearly deafness) for high frequencies. Typical hearing aids are rather of a very limited use in this condition as they do not improve understanding of speech. Patients with partial deafness can be presently treated with cochlear implants, which had not been used before due to the risk of damage of hearing remains by electrode introduced into cochlea. The purpose of our study was an objective and subjective assessment of voice quality in partial deafness patients before and after cochlear implantation. The subjects in this study were 25 post-lingual, bilaterally partially deaf patients, 13 females and 12 males. The reference group composed of 55 normal hearing individuals (28 females and 27 males). The acoustic analysis was performed with a multidimensional voice analysis MDVP (Multi Dimension Voice Program), and the subjective assessment was done with GRBAS scale. Initial analysis of voice changes in partial deafness patients was performed versus normal hearing individuals, then voice parameters were measured and perceptual voice assessment was done before and 9 months after cochlear implantation. Measurements of acoustic voice parameters in partially deaf patients showed changes in most of frequency, amplitude, noise and subharmonic components versus normal hearing control group. The most significant, statistically important changes were observed in fundamental frequency variation (vF0), absolute jitter (Jita), jitter percent (Jitt), amplitude perturbation quotient (APQ), smoothed amplitude perturbation quotient (sAPQ), relative average perturbation (RAP), peak amplitude variation (vAm), relative amplitude modulation (Shim), percent shimmer (%Shim), pitch perturbation quotient (PPQ), smoothed pitched perturbation quotient (sPPQ), degree of subharmonics (DSH), degree of voiceless (DUV), number of subharmonic segments (NSH), noise-to-harmonic ratio (NHR), voice turbulence index (VTI). All patients in the study group were subjects to cochlear implantation. After 9 months objective and subjective assessment of patients voices were performed again. Statistically important changes were identified in average fundamental frequency variability (vF0), relative amplitude modulation index (ShdB), noise-to-harmonic ratio (NHR), number of subharmonics NSH, degree of subharmonics (DSH) and the degree of voiceless (DUV). Comparison of the objective voice parameters changes after cochlear implantation with subjective, perceptual voice quality assessments leads to observation, that improvement of subjective voice quality after cochlear implantation takes place parallelly with improvement of certain objective acoustic voice parameters and some correlations exist. We found, that G correlates with vF0 and Shim, R correlates with DSH and NSH, B correlates with NSH and NHR, A correlates with DUV. We did not prove correlation of S with any of the objective parameters in our research group. Our study proved, that acoustic and perceptual features of voice in partially deaf adults are different than in normally hearing people and cochlear implantation in partial deafness patients is an effective tool to improve hearing and leads to improvement of the acoustic structure of the voice.
部分性聋是一种以低频听力正常、高频听力（近乎耳聋）阈值升高为特征的病症。典型的助听器在这种情况下的使用效果非常有限，因为它们并不能提高对言语的理解。目前，部分性聋患者可以使用人工耳蜗植入物进行治疗，以前由于电极引入耳蜗会造成听力残留损伤的风险，因此未使用该方法。本研究的目的是对人工耳蜗植入前后部分性聋患者的嗓音质量进行客观和主观评估。本研究的受试者为 25 名后天性双侧部分性聋患者，其中 13 名女性，12 名男性。对照组由 55 名听力正常的个体（28 名女性和 27 名男性）组成。通过多维嗓音分析 MDVP（多维嗓音程序）进行声学分析，并通过 GRBAS 量表进行主观评估。首先与听力正常的个体进行部分性聋患者嗓音变化的初始分析，然后测量嗓音参数，并在人工耳蜗植入前和植入后 9 个月进行感知嗓音评估。部分性聋患者的声学嗓音参数测量显示，与听力正常对照组相比，大多数频率、幅度、噪声和次谐波成分都发生了变化。观察到最显著的、具有统计学意义的变化是基频变化（vF0）、绝对抖动（Jita）、抖动百分比（Jitt）、幅度微扰商（APQ）、平滑幅度微扰商（sAPQ）、相对平均微扰（RAP）、峰值幅度变化（vAm）、相对幅度调制（Shim）、闪烁百分比（%Shim）、音高微扰商（PPQ）、平滑音高微扰商（sPPQ）、次谐波程度（DSH）、无声程度（DUV）、次谐波段数（NSH）、噪声与谐波比（NHR）、嗓音湍流指数（VTI）。研究组所有患者均接受了人工耳蜗植入。9 个月后，再次对患者的嗓音进行客观和主观评估。观察到平均基频变异性（vF0）、相对幅度调制指数（ShdB）、噪声与谐波比（NHR）、次谐波数 NSH、次谐波程度（DSH）和无声程度（DUV）等客观嗓音参数发生了统计学意义上的显著变化。与主观、感知嗓音质量评估相比，人工耳蜗植入后客观嗓音参数的变化表明，在某些客观声学嗓音参数得到改善的同时，主观嗓音质量也得到了改善，并且存在一些相关性。我们发现，G 与 vF0 和 Shim 相关，R 与 DSH 和 NSH 相关，B 与 NSH 和 NHR 相关，A 与 DUV 相关。我们在研究组中没有证明 S 与任何客观参数之间存在相关性。我们的研究证明，成年部分性聋患者的嗓音声学和感知特征与听力正常的人不同，人工耳蜗植入是改善听力并改善嗓音声学结构的有效工具。
