Division of Speech Pathology and Audiology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, Republic of Korea.
Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
J Voice. 2024 Nov;38(6):1525.e23-1525.e31. doi: 10.1016/j.jvoice.2022.06.013. Epub 2022 Jul 12.
The COVID-19 pandemic has affected the voice assessment protocols for dysphonic patients. In this study, we compared the changes in acoustic measures of the healthy population as well as dysphonic patients due to glottic insufficiency between the pandemic period requiring face masks and the prepandemic period when the masks were not essential. The clinical reliability of the acoustic measures with and without face masks was explored.
A total of 120 patients (age = 42.3 ± 11.9 yrs) with glottic insufficiencies such as UVFP and sulcus vocalis and 40 healthy population (age = 40.5 ± 11.2 yrs) cohorts were enrolled during the pandemic period. Age- and gender-matched 120 patients and 40 healthy population cohorts who underwent voice assessment without face masks before the pandemic were enrolled as prepandemic controls. Acoustic measures and overall severity estimates of vowel and speech samples were compared, which included cepstral peak prominence (CPP), L/H spectral ratio (SR), their standard deviations, F0, jitter percent (Jitt), shimmer percent (Shim), noise-to-harmonic ratio (NHR), Cepstral Spectral Index of Dysphonia (CSID), and Acoustic Psychometric Severity Index of Dysphonia.
Both patients and healthy cohorts showed higher SRv and SRs but lower CSIDv during the pandemic compared to the prepandemic period. F0 of the healthy male controls during the pandemic was higher than during the prepandemic periods, while the CSIDs was lower for the pandemic period. The pandemic patient cohort showed lower σSRs compared to the prepandemic patient cohort. When the acoustic measures of patients were compared to the healthy population cohort, the patient cohort showed lower CPP and σCPPs, while higher σCPPv, Jitt, Shim, and NHR during both pandemic and prepandemic period. Overall, the area under the curve of the acoustic measures and overall severity estimates was similar between the mask and non-mask groups, although the AUC of the SR measures was poor.
Wearing face masks during the pandemic did not compromise the overall reliability of the acoustic analysis in patients with glottic insufficiency, suggesting the current protocol of acoustic analysis can be carried out reliably while wearing a mask to ensure safety in the pandemic era.
COVID-19 大流行影响了发音障碍患者的语音评估方案。本研究比较了大流行期间需要戴口罩和大流行前不需要戴口罩时，因声门不全导致的健康人群和发音障碍患者的声学测量变化。探讨了戴口罩和不戴口罩时声学测量的临床可靠性。
在大流行期间，共纳入 120 例（年龄=42.3±11.9 岁）声门不全患者（如 UVFP 和声带沟）和 40 例健康人群（年龄=40.5±11.2 岁）。还纳入了年龄和性别匹配的在大流行前不戴口罩接受语音评估的 120 例患者和 40 例健康人群作为大流行前对照组。比较了元音和语音样本的声学测量和整体严重程度估计值，包括倒谱峰值突出度（CPP）、L/H 光谱比（SR）、其标准差、F0、抖动百分比（Jitt）、晃动百分比（Shim）、噪声与谐波比（NHR）、嗓音障碍的倒谱频谱指数（CSID）和声学心理测量严重度指数（Acoustic Psychometric Severity Index of Dysphonia）。
与大流行前相比，大流行期间患者和健康人群的 SRv 和 SRs 均较高，但 CSIDv 较低。大流行期间健康男性对照组的 F0 高于大流行前，而大流行期间的 CSID 较低。大流行患者组的 σSRs 低于大流行前患者组。当将患者的声学测量值与健康人群进行比较时，患者组在大流行和大流行前均表现出较低的 CPP 和 σCPPs，而较高的 σCPPv、Jitt、Shim 和 NHR。总体而言，口罩组和非口罩组的声学测量和整体严重程度估计的曲线下面积相似，尽管 SR 测量的 AUC 较差。
在大流行期间戴口罩并未影响声门不全患者的声学分析的整体可靠性，表明在确保大流行时代安全的情况下，当前的声学分析方案可以可靠地进行，同时戴口罩。
