Measures of Voice

Question 1

High Speed Laryngeal Imaging

Answer 1

Direct measure of vocal function

Question 2

Indirect measures of vocal function

Answer 2

aerodynamic, spectrographic, glottographic, acoustic AND manual-assessment AND auditory-perceptual measures

Question 3

Factors that Affect Reliability of Perceptual Ratings

Answer 3

instrumentation
severity of stimulus
scale used/dimension rated
rater experience
interactions between rater and other factors

Question 4

Likelihood of Use

Answer 4

voice quality ratings
observation of body posture
patient perception scale (psychosocial)/stroboscopy
acoustic
aerodynamic
EGG

Question 5

Instrumental Factors that Affect Reliability of Visual Assessment

Answer 5

Periodicity of signal
Object-lens distance
Angle of endoscope
Brightness of monitor
# views of exam
Image focus
Endoscope type
Color vs. black/white

Question 6

Auditory-Perceptual Measures

Answer 6

presence of lesion correlates with physiology

reliability varies according to dimensions, experience; must consider sources of bias

Question 7

Instrumental Approach

Answer 7

obtain measures related to certain physiological or acoustic characteristic of voice produciton
assumption: changes in the physiologic or acoustic waveforms reflect changes in voice quality

Question 8

Common Acoustic Measures

Answer 8

f0
Intensity
Perturbation measures
Ratio of signal-to-noise
Spectral features

Question 9

f0

Answer 9

acoustic measure of the perceptual judgment of pitch

Question 10

Intensity

Answer 10

acoustic measure of the perceptual judgment of loudness

Question 11

Perturbation measures

Answer 11

assess the cycle-to-cycle variation in the acoustic signal (either frequency or amplitude)

Question 12

Ratio of signal-to-noise

Answer 12

reflects the relative contribution of periodic and aperiodic components of the signal

Question 13

Spectral features

Answer 13

indications of the contribution of the supraglottic vocal tract to the voice signal

Question 14

Cepstral Analysis

Answer 14

Analysis of Dysphonia in Speech and Voice
A cepstrum is a fourier transform of the logarithmic power spectrum of an acoustic signal
Graphically displays the extent to which spectral harmonics are individualized and emerge out of background noise
Measures: cepstral peak prominence; Low to high spectral ratio; cepstral spectral index of dysphonia

Question 15

Acoustics

Answer 15

discrimination best with spectral measures
listeners only sensitive to harmonic noise ratios
objective only moderately correlate with perceptual dimensions

Question 16

Other instrumental measures

Answer 16

EGG
Aerodynamic: airflow, air pressure, S/Z ratio, MPT
Subglottic pressure relates to perceived effort

Question 17

Aerodynamics

Answer 17

the potential to provide information about a pt’s laryngeal/respiratory function

Question 18

Airflow

Answer 18

aerodynamic measure
measured by a pneumotach (detects differential pressure across a known resistance)
avg airflow rate is most often assessed during sustained phonation

Question 19

Subglottal pressure

Answer 19

aerodynamic measure

indirectly measured using /p/ + vowel; with lips sealed for /p/, there is continuous column of air from lungs to lips

Question 20

Laryngeal airway resistance

Answer 20

aerodynamic measure

the ratio of air pressure over air flow

Question 21

Treatment of UVFP (laryngeal framework surgery)

Answer 21

Small implant of some material is implanted inside the larynx to move the immobile VF towards midline
can use custom carved silastic; goretex; bone-like “hydroxyapatite”