Division of Otolaryngology, Department of Surgery, GW Medical Faculty Associates Voice Treatment Center, Washington, DC.
ENT Department, GZA Sint-Augustinus, European Institute for ORL-HNS, Antwerp, Belgium.
J Speech Lang Hear Res. 2024 Jun 6;67(6):1643-1659. doi: 10.1044/2024_JSLHR-23-00576. Epub 2024 Apr 29.
The aim of this study was to determine (a) diagnostic accuracy of acoustic measures of glottal stop production (GSP; intensity differences, slopes, complete voicing cessation) to distinguish between unilateral vocal fold paresis/paralysis (UVFP) patients and controls; (b) if acoustic measures of GSP significantly correlated with an acoustic measure of voice disorder severity, acoustic voice quality index (AVQI); and (c) if acoustic measures from another type of voicing cessation, voiceless consonant production, also significantly differed between groups.
Ninety-seven patients with unilateral paresis/paralysis and 35 controls with normal laryngostroboscopic signs produced two sets of five repeated [i] and four repeated [isi]. Tokens were randomized by type between groups and analyzed blinded using a customized Praat program that computed intensity differences and slopes between vowel maxima and glottal stop minima for inter-[i] tokens and vowel maxima and voiceless consonant minima for intra-[isi] tokens. The number of voicing cessations for inter-[i] tokens was obtained.
Onset and offset intensity differences and number of voicing cessations from inter-[i] tokens had the greatest areas under the curve (.854, .856, and .835, respectively). Correlation coefficients were significant ( < .01) between AVQI and all GSP acoustic measures with weak/medium effect sizes. No significant differences were found between controls and participants with UVFP for acoustic measures from intra-[isi].
Acoustic GSP measures demonstrated good diagnostic accuracy and some relationship to severity of voice disorder. No significant differences in acoustic measures for medial voiceless fricative consonants between controls and participants with UVFP suggested that voicing cessation for voiceless fricatives differs from voicing cessation for GSP.
本研究旨在:(a) 确定声学检测声带完全停止(GSP;声强差、斜率、完全发声停止)区分单侧声带麻痹/瘫痪(UVFP)患者和对照组的诊断准确性;(b) GSP 的声学测量值是否与声扰严重程度的声学测量值(AVQI)显著相关;以及 (c) 来自另一种发声停止(无声摩擦音)的声学测量值是否在组间也有显著差异。
97 例单侧麻痹/瘫痪患者和 35 例声带无异常声门镜征象的正常对照者分别发 2 组 5 次重复[i]和 4 次重复[isi]。根据类型将音素随机分配给组间,并用定制的 Praat 程序进行盲法分析,该程序计算元音最大值和 GSP 最小值之间的声强差和斜率,用于 inter-[i]音素,以及元音最大值和无声辅音最小值之间的声强差和斜率,用于 intra-[isi]音素。获得 inter-[i]音素的发声停止次数。
起始和终止声强差以及 inter-[i]音素的发声停止次数的曲线下面积最大(分别为.854、.856 和.835)。AVQI 与所有 GSP 声学测量值之间的相关系数均显著(<0.01),具有弱/中效应量。在 intra-[isi]的声学测量值方面,对照组和 UVFP 患者之间无显著差异。
GSP 声学测量值具有良好的诊断准确性,并与嗓音障碍严重程度有一定的相关性。对照组和 UVFP 患者的无声摩擦音的声学测量值无显著差异,提示无声摩擦音的发声停止与 GSP 的发声停止不同。