Quantification of perceptual voice characteristics allows the assessment of voice changes. Acoustic measures of jitter, shimmer, and noise-to-harmonic ratio (NHR) are often unreliable. Measures of cepstral peak prominence (CPP) may be more reliable predictors of dysphonia. Trained listeners analyzed voice samples from 281 patients. The NHR, amplitude perturbation quotient, smoothed pitch perturbation quotient, percent jitter, and CPP were obtained from sustained vowel phonation, and the CPP was obtained from running speech. For the first time, normal and abnormal values of CPP were defined, and they were compared with other acoustic measures used to predict dysphonia. The CPP for running speech is a good predictor and a more reliable measure of dysphonia than are acoustic measures of jitter, shimmer, and NHR.

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These data suggest that laryngeal reinnervation has the potential to bring about a return to normal or near-normal voice in patients with isolated unilateral vocal fold paralysis.