The Correlation Of Voice Objective Parameters Analysis And Subjective Assessment In Evaluation Of Vocal Cords Benign Diseases

Objective:1.Try to establish the database of the normal adult, bycomparing the differences of the voice between the people with vocal cordsbenign diseases and the normal adualt,to explore the acoustic characterize ofthe vocal benign diseases.2.Explor acoustic measure and theelectroglottograph(EGG)in evaluation of the people with voice dysphonia ofthe vocal cords benign diseases.3.To investigate the correlation between thesubjective assessment and objective parameters analysis.4.To analysis therelationship between patient-base outcome measures and voice acousticanalysis,and to investigate the characteristic of the VHI. Methods Voiceacoustic parameters of452normal people and174patients with vocal cordsbenign diseases were measured by Kay Science for Windows,then comparedthe objective parameters between two groups.The objectiveparameters,including fundamental frequency (F0),jitter,shimmer,Noise toHarmonic Ratio(NHR)and Contact Quotient(EGG-CQ),which weremeasured mainly on a sustained vowel/a:/, were recorded on a softwarenamed Kay. According to the G component of the GRBAS, the voice of50healthy adult randomly chosen from the all healthy adults and all patients wasgraded from0for normal to3for severe dysphonia.35subjects with normalvoice and all patients with vocal cords benign diseases underwent VHI.Methods:174patients with vocal cords benign diseases and452subjectswith normal voice were tested by Multi Dimensional Voice Program(MDVP).After that, all the patients and35healthy adult randomly chosenfrom the all healthy adults underwent VHI.Fundamental frequency(Fo),pitchperturbation(jitter),amplitude perturbation(shimmer) and noise to harmonicratio(NHR)as objective items of the voice acoustic analysis to evaluate.Voice handicap index(VHI) concluded function(F), physiology(P) andemotion(E),recording the scores of the three items respectively and the thetotal scores of the VHI.Result: Table1showed a mult-parametric objective evaluation protocal ofthe normal adults.Table2showed that Fo, Jitter and NHR were significantlydifferent between the men and the women(P＜0.05),but the differences ofShimmer and EEG-CQ were no significant；Table3showed all the values ofthe objectieve acoustic parameters had significant differences between thepatients with benign vocal cord diseases and people with normal voice(P＜0.05), Fo were significantly different between the Reike's Edema and othergroups of benign vocal cord diseases,but the other parameters had no obviousdifferences between all the groups of benign vocal cord diseases.Table4showed G grade have significant differences between the normal group andpatient group and also within each patient group.Table5showed that the values of Fo, Jitter, Shimmer and NHR incresed with the severity of thehorness.Table6showed the scores of the F,E,P and TVH had significantdifferences between the normal group and the group with vocal cord benigndiseases.Table7showed the differences of G and VHI between the two groupswere significant except when VHI was used for chronic laryngitis/vocalnodules and vocal polyps/chorditis. VHI had significant differences betweenG grades.Table8showed the correlation between P,E and F,F had nocorrelation with E, and P,F,E had well corellation with TVH.Table9showedP,E,F and TVH had no correlation with the acoustic parameters. Table10showed except the F,P,E and TVH had well correlation.The G and EGG-CQalso had well correlation with TVH. Jitter,shimmer and NHR had wellcorrelation with each other.Conclusion:1. Establish a mult-parametric objective evaluation protocal ofthe normal adults.Analysis of the voice should accord to the gender and theacoustic parameters.2. The objective acoustic parameters can used to evaluatethe quality of the voice.The acoustic parameters have well value to diagnosethe vocal cord benign diseases,but have certain difficulty to distinguish the specific kind of the disease.3. The self-assessment of the patients with vocalcord benign diseases is an important way to acquire the comprehensiveinformation,the objective testing can not predict the subjective assessment.4.The subjective perceptual appraisal consist with the self-assessment of thepatients,the acoustic parameters analysis have well consistence with subjectiveperceptual appraisal.5. About the self-assessment of the patients,the acousticparameters analysis can not used to suppose or judge the severity of the vocaldisorders.