Jiang Jing-Yi, Hsu Pei-Min, Pan Yi-An, Yu Yi-Hsuan, Chen Chin-Kuo, Hsieh Li-Chun
Department of Otolaryngology Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
Department of Special Education (Master's Program of Speech and Language Pathology), University of Taipei, Taipei, Taiwan.
J Voice. 2025 Jan 4. doi: 10.1016/j.jvoice.2024.11.031.
This study investigated the relationship between the position of the paralyzed vocal fold and voice quality in patients with unilateral vocal fold paralysis (UVFP) and identified a reliable acoustic analysis tool to enhance the accuracy of voice quality assessments in this population.
A retrospective case-control study was conducted with 70 patients with UVFP diagnosed at Mackay Memorial Hospital. Acoustic features-jitter, shimmer, the harmonic-to-noise ratio (HNR), and the cepstral peak prominence smoothed (CPPs)-were analyzed using the Praat software. A speech-language pathologist performed an auditory-perceptual assessment by using a perceptual voice evaluation scale, and a senior laryngologist reviewed the paralyzed fold's position endoscopically. Spearman's linear regression analysis was used to examine correlations between perceptual and acoustic parameters and the position of the paralyzed vocal fold.
The position of the paralyzed vocal fold exhibited weak correlations with acoustic and auditory-perceptual variables (r = 0.205-0.39). By contrast, moderate-to-strong correlations were discovered between auditory-perceptual variables and acoustic parameters (r = 0.378-0.803). Notably, the CPPs was more strongly associated with overall grade (severity: r = 0.673) and breathiness (r = -0.803) than with jitter, shimmer, and the HNR (r = 0.378-0.614).
The position of the paralyzed vocal fold alone is insufficient for predicting voice outcomes in patients with UVFP. The CPPs is a more valuable indicator of perceived dysphonia severity, particularly in cases with audible breathiness, making it superior to jitter, shimmer, and the HNR for perceptual voice assessments in patients with UVFP.
本研究调查了单侧声带麻痹（UVFP）患者中麻痹声带位置与嗓音质量之间的关系，并确定一种可靠的声学分析工具，以提高该人群嗓音质量评估的准确性。
对在马偕纪念医院确诊的70例UVFP患者进行了一项回顾性病例对照研究。使用Praat软件分析声学特征——抖动、闪烁、谐波噪声比（HNR）和平滑后的谐波峰值突出度（CPPs）。一名言语病理学家使用感知嗓音评估量表进行听觉感知评估，一名资深喉科医生通过内镜检查评估麻痹声带的位置。采用Spearman线性回归分析来检验感知参数、声学参数与麻痹声带位置之间的相关性。
麻痹声带的位置与声学和听觉感知变量之间呈现弱相关性（r = 0.205 - 0.39）。相比之下，听觉感知变量与声学参数之间发现了中度至强相关性（r = 0.378 - 0.803）。值得注意的是，与抖动、闪烁和HNR（r = 0.378 - 0.614）相比，CPPs与总体等级（严重程度：r = 0.673）和呼吸声（r = -0.803）的相关性更强。
仅麻痹声带的位置不足以预测UVFP患者的嗓音结果。CPPs是感知到的发声困难严重程度的更有价值指标，特别是在有明显呼吸声的情况下，使其在UVFP患者的感知嗓音评估中优于抖动、闪烁和HNR。
