The present study aimed at measuring the smoothed and non-smoothed cepstral peak prominence (CPPS and CPP) in teachers who considered themselves to have normal voice but some of them had laryngeal pathology. The changes of CPP, CPPS, sound pressure level (SPL) and perceptual ratings with different voice tasks were investigated and the influence of vocal pathology on these measures was studied. Method: Eighty four Finnish female primary school teachers volunteered as participants. Laryngoscopically, 52.4 % of these had laryngeal changes (39.3 % mild, 13.1 % disordered). Sound recordings were made for phonations of comfortable sustained vowel, comfortable speech and speech produced at increased loudness levels as used during teaching. CPP, CPPS and SPL values were extracted using Praat software for all three voice samples. Sound samples were also perceptually evaluated by five voice experts for overall voice quality (10 point scale from poor to excellent) and vocal firmness (10 point scale from breathy to pressed, with normal in the middle). Results: The CPP, CPPS and SPL values were significantly higher for vowels than for comfortable speech and for loud speech compared to comfortable speech (p<0.001). The loud speech was perceived to be firmer and have a better voice quality than comfortable speech. No significant relationships of the laryngeal status with cepstral values, perceptual ratings or voice SPLs were found (p>0.05).
Conclusion:Neither cepstral measures nor perceptual evaluations could clearly distinguish teachers with laryngeal changes from laryngeally healthy teachers. Considering no vocal complaints of the subjects, the data could be considered representative of teachers with functionally healthy voice.
This study aimed at determining the clinical value of videokymography (VKG) as an additional tool for the assessment of voice disorders. 105 subjects with voice disorders were examined by an experienced laryngologist. A questionnaire was used to specify diagnosis, diagnostic confidence, and treatment recommendations before and after VKG. The first part of questionnaire was filled by the laryngologist for each patient after routine ear-nose-throat evaluation, including stroboscopy, the second part after the subsequent VKG examination. In 31% of subjects VKG confirmed the stroboscopic diagnosis, in 44% it made the diagnosis more accurate, in 20% there was adjustment of the treatment, and in 5% it was not found diagnostically useful. After VKG the diagnostic confidence increased in 68% of the subjects. VKG may help clinicians to take some important treatment decisions and may be recommended to be performed in patients, where clinicians are uncertain about diagnosis and treatment.
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