Effect of Smoking on Cepstral Parameters.

Smoking exerts certain damage to the voice, which affects sound characteristics. This study explored the effects of smoking, smoking time, and smoking amount on cepstral parameters. We collected the acoustic signals of sustained vowels in 301 participants (135 smokers and 166 nonsmokers). The cepstral parameters, including cepstral peak prominence (CPP), CPP standard deviation (CPP SD), low to high-frequency spectral ratio (L/H), low to high-frequency spectral ratio standard deviation (L/H SD), and voice disorder cepstral/spectral index of dysphonia (CSID), of the sustained vowels were investigated through the analysis of dysphonia in speech and voice (ADSV) application. The effects of smoking on these parameters were explored. The influences of smoking time and smoking amount on cepstral parameters were also analyzed by multiple linear regression. The CPP and L/H values in the smoking group were lower than those in the nonsmoking group (CPP: P < 0.001, L/H: P = 0.033) and negatively correlated with smoking time (CPP: R2 = 0.3828, P < 0.0001; L/H: R2 = 0.02996, P = 0.0447) and smoking amount (CPP: R2 < 0.4526, P < 0.0001; L/H: R2 = 0.08823, P = 0.00005). The CPP SD, L/H SD, and CSID values in the smoking group were higher than those in the nonsmoking group (CPP SD: P = 0.006, L/H SD: P = 0.034, CSID: P < 0.001) and positively correlated with smoking time (CPP SD: R2 = 0.03648, P = 0.0265, L/H SD: R2 = 0.09121, P = 0.0004, CSID: R2 = 0.01247, P = 0.1972) and smoking amount (CPP SD: R2 = 0.05495, P = 0.0062, L/H SD: R2 = 0.1316, P < 0.0001, CSID: R2 = 0.03851, P = 0.0225). Compared with other cepstral parameters, smoking time and smoking volume had the greatest impact on CPP (smoking time: R2 = 0.385, smoking amount: R2 = 0.443). This study confirmed that smoking has a significant effect on cepstral parameters. Compared with the cepstral parameters of nonsmokers, an increase in smoking time and smoking volume increases the abnormality of the cepstral parameters of smokers.

[Detection of speech pathology based on parameters of analysis of dysphonia in speech and voice].

Objective:To analysis speech pathology based on dysphonia in speech and voice（ADSV）. Methods:The acoustic signals of continuous vowels and continuous speech of one-hundred and thirteen individuals were collected, including 93 vocal cord polyps cases, 20 glottis laryngeal carcinoma cases and 47 volunteers without speech sound disorders. Cepstral peak prominence（CPP）, CPP standard deviation（CPP SD）, L/H spectral ratio（L/H ratio）, L/H ratio standard deviation（L/H ratio SD） and cepstral/spectral index of dysphonia（CSID） were analyzed by ADSV to explore the role of these parameters in the recognition of speech pathology. Results:In the acoustic signal of continuous vowels, CPP and L/H ratio in normal group were higher than those in pathological voice group（P<0.001）, while CPP SD and CSID were lower than those in pathological voice group（P<0.001）, CPP and CSID areas under ROC curve were 0.95 and 0.99, respectively, which were important acoustic parameters for diagnosing pathological voice. In continuous speech acoustic signals, CPP, CPP SD and L/H ratio in the normal group were all higher than those in the speech disorders group（P<0.001）, and the area under the curve of CPP SD was 0.90, which showed high accuracy in diagnosing pathological voice. The ADSV voice analysis parameters CPP, CPP SD, CSID, and L/H ratio also showed significant differences between the vocal cord polyp group and the glottic laryngeal cancer group. The results of the discriminant analysis model show that the use of ADSV voice parameters can distinguish vocal cord polyps and laryngeal cancers. Conclusion:The ADSV voice analysis parameters can not only distinguish the voice signals of the normal group and the pathological group, but also distinguish different types of pathological voices. It has high sensitivity and specificity in diagnosing pathological voices.

Voice disorders in severe obstructive sleep apnea patients and comparison of two acoustic analysis software programs: MDVP and Praat.

OBJECTIVE: The purposes of this study were to explore the effect of obstructive sleep apnea-hypopnea syndrome (OSAHS) on the voice by analyzing the acoustic parameters between patients with OSAHS and those without OSAHS and to compare acoustic analyses performed by two software programs (MDVP and Praat). METHODS: Patients with OSAHS (n = 75) and normal controls (n = 46) were asked to produce a sustained sound of the vowel /i/ and were analyzed with electroglottography (EGG), MDVP, and Praat software. A self-rated scale (Voice Handicap Index, VHI-10) and acoustic parameters were compared. RESULTS: There were no statistically significant differences in the fundamental frequency (F0), jitter, shimmer, noise/harmonic ratio (NHR), contact quotient perturbation (CQP), or contact index perturbation (CIP) between the patient group and the normal group. The VHI-10 values were significantly increased in patients with OSAHS. The receiver operating characteristic (ROC) analysis suggested that the shimmer obtained from MDVP and Praat possessed relatively high accuracy in differentiating patients with OSAHS from healthy individuals. The results for F0, jitter, shimmer, and NHR were significantly different between MDVP and Praat in OSAHS patients. In normal persons, there was a significant difference in NHR; however, no significant differences were found for F0, jitter, or shimmer between the two software programs. The results demonstrated that high correlations were found between values obtained by both software programs. CONCLUSIONS: Patients with OSAHS were prone to vibration irregularity, incomplete glottal closure, hoarseness, and other vocal problems. The two acoustic software programs present different values of acoustic measures. There was a strong correlation and consistency between the parameters calculated by the two software programs.

[Aerodynamic study of the low-resistance Groningen button in voice prosthesis].

OBJECTIVE: To study the aerodynamic characteristics of low-resistance Groningen voice prosthesis for total laryngectomees and the related clinical significance. METHODS: Three aerodynamic parameters were measured in 24 laryngectomees implanted with low-resistance Groningen voice prosthesis: the sound pressure level (SPL), intratracheal pressure (pressure) and airflow rate (flowrate). Among them, 6 cases were initially implanted with other prosthesis which was replaced by the Groningen buttons later. The parameters were measured for both old and new prosthesis. The relationship between the variables were computed with means of Pearson' s product-moment correlations. RESULTS: The parameters were measured repeatedly among all cases, 180 group data were collected. Screening test showed that the median of sound pressure level, intratracheal pressure and airflow rate are respectively 88.0 dB, 73.6 cm H2O (1 cm H2O = 0.098 kPa) and 123.2 ml/s. Thirty times measurement of patients phonation showed that the correlation between SPL and pressure was not significant (r = -0.058, P > 0.05). The relationship between flow rate and SPL was not significant(r = -0.119, P > 0.05). The correlation between pressure and flow rate was significant(r = 0.699, P < 0.05). CONCLUSIONS When pseudoglottis vibration is produced by sub pseudoglottis air flow, pseudoglottis vibration and voice loudness can not be increased by continuous air flow.

[Oncologic outcome of carbon dioxide laser microsurgery for early glottic carcinoma].

OBJECTIVE: To explore the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carcinoma. METHOD: Retrospectively study 91 patients with glottic carcinoma (9 Tis, 45 pT1a, 25 pT1b, 12 pT2) treated in our department from October 1999 to August 2004. Surgical treatment included endoscopic CO2 laser cordectomies according to the classification of the European Laryngological Society in 2000. RESULT: According to the Kaplan-Meier method, the probability of remaining free of local recurrence 5 years after primary surgery alone was 100.00% for the Tis, 93.33% for the T1a, 84.00% for T1b and 75.00% for the T2 respectively, without statistical significance of various groups by the Log-Rank tests (P > 0.05). The probability of remaining free of local recurrence 5 years after primary surgery alone was 78.57% (6/28) of tumors offended the anterior commissure, versus 93.65% (4/63) with no involvement of anterior commissure, have statistical significance (P < 0.01). The 5 year overall survival and the disease free survival were 92.72% and 84.62% respectively. Perceptive evaluation was performed with the "GRBAS" evaluation system 6 month after laser operation. All patients in the group of type I and type II had an normal voice or mild dysphonia. The patients treated with type III, type IV and type V had a mild or moderate vocal disease. CONCLUSION: According to the present series, endoscopic CO2 laser surgery is an effective treatment for early glottic cancer.

[Diagnosis and treatment and prevention of iatrogenic functional aphonia].

OBJECTIVE: To discuss the diagnosis, treatment and prevention of iatrogenic functional aphonia. METHODS: Twenty three patients who either lost their voice or only could whisper after surgery in other hospitals were included in this study as the first group, history was well collected and laryngostroboscopy performed. All cases were confirmed as iatrogenic functional aphonia patients and received phonation therapy. In another group of patients who received vocal cord surgery in our hospital from 2003 to 2005, speaking was restricted while not prohibited after surgery, voice quality was closely observed, and 1028 cases were included. RESULTS: All 23 cases of functional aphonia were cured with phonation therapy. No iatrogenic functional aphonia occurred in the second group of patients. CONCLUSIONS: The iatrogenic functional aphonia can be caused by post operative mistreatment and could be cured with phonation therapy, and it is preventable if speaking is not strictly prohibited after surgery.