Cortés Ponce José Rosmal, Garza Montelongo Luis Ángel, Juárez Silva Jorge Eduardo, Trevino González José Luis
Otolaryngology-Head and Neck Surgery Universitary Center, Hospital Universitario "Dr. José Eleuterio González", Monterrey, MEX.
Cureus. 2024 Oct 24;16(10):e72292. doi: 10.7759/cureus.72292. eCollection 2024 Oct.
Background Acoustic vocal analysis provides objective and measurable values for various voice parameters, such as fundamental frequency (F0), shimmer, jitter, and the noise-to-harmony ratio (NHR). In severely dysphonic patients, who present increased variability in glottic cycles and abnormalities in vocal intensity, conventional acoustic analysis is an unreliable predictor of dysphonia. The logarithmic transformation of the vocal spectrum (cepstrum) allows capturing the signal without relying on recording technique, frequency, or vocal intensity. Smoothed cepstral peak prominence (CPPS) is a variable in cepstral analysis that serves as a reliable predictor of dysphonia, being directly proportional to its severity. Objective To determine the mean value of CPPS in continuous speech and sustained vowels in dysphonic and non-dysphonic Mexican adults, with or without laryngeal pathology. Materials and methods Sustained vowel and continuous speech analysis was performed using the Praat software (Version 6.1.15, developed by Paul Boersma and David Weenink, Phonetic Sciences, University of Ámsterdam, https://www.praat.org/) to obtain the smoothed cepstral peak prominence (CPPS) in 51 dysphonic patients with laryngeal pathology and 24 non-dysphonic patients without underlying laryngeal pathology. Frequency perturbation variables such as shimmer, jitter, and NHR were collected. Quality of life was assessed using the 30-item Voice Handicap Index (VHI-30). Results We found significantly lower median CPPS values in patients with laryngeal pathology, both in sustained vowel (6.59, IQR 4.09-9.38, p < 0.001) and in connected speech (4.82, IQR 3.57-6.03, p < 0.001), compared with the non-dysphonic population (sustained phonation: 11.69, IQR 9.26-12.81, p < 0.001; connected speech: 6.38, IQR 0.90-7.09, p < 0.001). Conclusions A low CPPS value is a reliable predictor of underlying laryngeal pathology in dysphonic voices and could be considered for routine screening and diagnosis in patients with vocal pathology.
背景 声学嗓音分析可为各种嗓音参数提供客观且可测量的值，如基频（F0）、微扰、抖动以及噪声谐波比（NHR）。在重度发声困难患者中，其声门周期变异性增加且发声强度异常，传统声学分析对于发声困难而言是不可靠的预测指标。嗓音频谱（cepstrum）的对数变换能够在不依赖录音技术、频率或发声强度的情况下捕捉信号。平滑的谐波峰值突出度（CPPS）是谐波分析中的一个变量，可作为发声困难的可靠预测指标，且与发声困难的严重程度成正比。目的 确定患有或未患有喉部病变的墨西哥成年发声困难和非发声困难者在连续语音和持续元音中CPPS的平均值。材料与方法 使用Praat软件（版本6.1.15，由保罗·博尔斯马和大卫·韦宁克开发，阿姆斯特丹大学语音科学系，https://www.praat.org/）对持续元音和连续语音进行分析，以获取51例患有喉部病变的发声困难患者和24例无潜在喉部病变的非发声困难患者的平滑谐波峰值突出度（CPPS）。收集诸如微扰、抖动和NHR等频率扰动变量。使用30项嗓音障碍指数（VHI - 30）评估生活质量。结果 我们发现，与非发声困难人群相比，患有喉部病变的患者在持续元音（中位数为6.59，四分位距为4.09 - 9.38，p < 0.001）和连贯语音（中位数为4.82，四分位距为3.57 - 6.03，p < 0.001）中的CPPS中位数显著更低（持续发声：11.69，四分位距为9.26 - 12.81，p < 0.001；连贯语音：6.38，四分位距为0.90 - 7.09，p < 0.001）。结论 低CPPS值是发声困难嗓音中潜在喉部病变的可靠预测指标，可考虑用于嗓音病变患者的常规筛查和诊断。
