Phonetics and Speech Sciences (말소리와 음성과학)

Korean Society of Speech Sciences (한국음성학회)
권호 표지
DOI QR코드

DOI QR Code

Clinical utility of auditory perceptual assessments in the discrimination of a diplophonic voice

이중음성 판별에 있어 청지각적 평가의 임상적 유용성

  • Received : 2018.02.13
  • Accepted : 2018.03.07
  • Published : 2018.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Diplophonia is generally defined as the perception of more than one fundamental frequency component in a voice. Its perceptual aspect has traditionally been used to evaluate diplophonia because the perceptions can be easily evaluated, but there are limitations in the validity of the reliability of the intra- and inter-raters, examination situation, and variation of voice sample. Therefore, the purpose of this study is to confirm the reliability and accuracy of auditory perceptual evaluation by comparing non-invasive indirect assessment methods (sound waveform and EGG analysis), and to identify their usefulness with diplophonia. A total of 28 diplophonic voices and 39 non-periodic voices were assessed. Three raters assessed the diplophonia by performing an auditory perception evaluation and identifying the quasi-periodic perturbations of the acoustic waveform and EGG. Among the three discrimination methods, intra- and inter-rater reliability, sensitivity, specificity, accuracy, positive likelihood ratio, and negative likelihood ratio were examined, and the McNemar test was performed to compare the discriminant agreement. The accuracy of the auditory perceptual evaluation (86.57%) was not significantly different from that of sound waveform acoustic (88.06%), but it was significantly different from that of EGG (83.33%). The reading time (6.02 s) for the auditory perceptual evaluation was significantly different from that for sound waveform analysis (30.15 s) and EGG analysis (16.41 s). In the discrimination of diplophonia, auditory perceptual evaluation has sufficient reliability and accuracy as compared to sound waveform and EGG. Since immediate feedback is possible, auditory perceptual evaluation is more convenient. Therefore, it can continue to be used as a tool to discriminate diplophonia in clinical practice.

Keywords

References

  1. Behrnman, A., Agresti, C., Blumstein, E., & Lee, N. (1998). Microphone and electroglottographic data from dysphonic patients: Type 1, 2 and 3 signals. Journal of Voice, 12(2), 249-260. https://doi.org/10.1016/S0892-1997(98)80045-3
  2. Titze, I. (1995). Workshop on acoustic voice analysis: Summary statement. Denver, CO: National Center for Voice and Speech.
  3. Dejonckere, P., & Lebacq, J. (1983). An analysis of the diplophonia phenomenon. Speech Communication, 2(1), 47-56. https://doi.org/10.1016/0167-6393(83)90063-8
  4. Moore, B. (2008). Basic auditory processes involved in the analysis of speech sounds. Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences, 363 (1493), 947-963.
  5. Cavalli, L., & Hirson, A. (1999). Diplophonia reappraised. Journal of Voice, 13(4), 542-556. https://doi.org/10.1016/S0892-1997(99)80009-5
  6. Kiritani, S., Imagawa, H., Miyaji, M., Kumada, M., & Niimi, S. (1995). Quasi-periodic pertubations pathological vocal fold vibration. Ann Bull RILP, 29, 27-33.
  7. Aichinger, P. (2015). Diplophonic voice-definitions, models, and detection. Ph.D. Dissertation, Graz University of Technology, Austria.
  8. Larsson, H., Hertegard, S., Lindestad, P., & Hammarberg, B. (2000). Vocal fold vibrations: High-speed imaging, kymography, and acoustic analysis: A preliminary report. The Laryngoscope, 110(12), 2117-2122. https://doi.org/10.1097/00005537-200012000-00028
  9. Yan, Y., Damrose, E., & Bless, D. (2007). Functional analysis of voice using simultaneous high-speed imaging and acoustic recordings. Journal of Voice, 21(5), 604-616. https://doi.org/10.1016/j.jvoice.2006.05.011
  10. Hirose, H., Kiritani, S., & Imagawa, H. (2002). Neurogenic diplophonia: A high-speed digital image analysis. Asia Pacific Journal of Speech, Language, and Hearing, 7(2), 71-78. https://doi.org/10.1179/136132802805576472
  11. Kang, D., Wang, S., Park, H., Lee, J., Jeon, G., Choi, I., Kim, S., & Shin, B. (2017). Real-time simultaneous DKG and 2D DKG using high-speed digital camera. Journal of Voice, 31(2), 247.e1-247.e7. https://doi.org/10.1016/j.jvoice.2016.08.005
  12. Carding, P., Steen, I., Webb, A., Mackenzie, K., Deary, I., & Wilson, J. (2004). The reliability and sensitivity to change of acoustic measures of voice quality. Clinical Otolaryngology & Allied Sciences, 29(5), 538-544.
  13. Kent, R. (1996). Hearing and believing: Some limits to the auditory-perceptual assessment of speech and voice disorders. American Journal of Speech-Language Pathology, 5(3), 7-23. https://doi.org/10.1044/1058-0360.0503.07
  14. Bae, I., Kim, G., Lee, Y., Park, H., Kim, J., Lee, I., & Kwon, S. (2015). The effect on intervention program and auditory-perceptual discrimination feature of postlingual cochlear implant adults about pathological voice. Phonetics and Speech Science, 7(2), 9-17. (배인호.김근효.이연우.박희준.김진동.이일우.권순복 (2015). 병리적 음성에 대한 언어습득 이후 인공와우이식 성인의 청지각적 변별특성과 중재 프로그램의 효과. 말소리와 음성과학, 7(2), 9-17.) https://doi.org/10.13064/KSSS.2015.7.2.009
  15. Hillenbrand, J., & Gayvert, R. (2005). Open source software for experiment design and control. Journal of Speech, Language, and Hearing Research, 48(1), 45-60. https://doi.org/10.1044/1092-4388(2005/005)
  16. Hong, K., & Kim, H. (1999). Diplophonia in unilateral vocal fold paralysis and intracordal cyst. Otolaryngology - Head and Neck Surgery, 121(6), 815-819. https://doi.org/10.1053/hn.1999.v121.a94214
  17. Lee, O., & Kim, S. (2009). A comparison of three equally-appearing interval scales for auditory-perceptual evaluation: preliminary study. Journal of Speech-Language & Hearing Disorder, 18(2), 1-15. (이옥분.김소연 (2009). 음성장애 청지각적 평가를 위한 등간척도법 비교. 언어치료연구, 18(2), 1-15.)
  18. Keating, P., Garellek, M., & Kreiman, J. (2015). Acoustic properties of different kinds of creaky voice. Proceedings of the 18th International Congress of Phonetic Sciences, Glasgow, UK. 10-14 August, 2015.
  19. Kim, G., Lee, Y., Bae, I., Park, H., Lee, J., Wang, S., & Kwon, S. (2016). A cepstral analysis of voices with glottic cancer and laryngeal leukoplakia: Sustained vowels and continuous speech. Journal of Speech-Language & Hearing Disorder, 25(3), 135-145. (김근효.이연우.배인호.박희준.이재석.왕수건.권순복 (2016). 성문암과 후두백반증 음성의 켑스트럼 분석 및 청지각적 평가: 연장모음과 연속발화. 언어치료연구, 25(3), 135-145.)
  20. Deliyski, D., Petrushev, P., Bonilha, H., Gerlach, T., Martin-Harris, B., & Hillman, R. (2008). Clinical implementation of laryngeal high-speed videoendoscopy: Challenges and evolution. Folia Phoniatrica et Logopaedica, 60(1), 33-44. https://doi.org/10.1159/000111802
  21. Lee, J., Wang, S., Sung, E., Bae, I., Kim, T., & Lee, W. (2017). (in press). Clinical practicability of a newly developed real-time digital kymographic system. Journal of Voice.
  22. Bae, I., Wang, S., Lee, J., Sung, E., Kim, S., Lee, Y., Kang, D., & Wang, Y. (2018). (in press) Efficacy of two-dimensional scanning digital kymography in evaluation of atrophic vocal folds. Journal of Voice.