Acoustic and perceptive analysis of esophageal and tracheoesophageal voice

Abstract

Total laryngectomy is a radical surgery where the larynx is completely removed. Each type of surgical treatment has an impact on voice quality and speech intelligibility. However, it is important to know that the methods of speech adoption, esophageal speech and speech with use of tracheoesophageal prosthesis, are available and applicable methods for establishing functional communication between laryngectomy patients. The main objective of this research is to ascertain whether there is a correlation between the acoustic and perceptual characteristics of voice and speech intelligibility observed among persons with use of esophageal speech and persons with tracheoesophageal prosthesis, as well as to examine which of the following characteristics have the greatest impact on speech intelligibility among these two groups of respondents. The research was conducted on a sample of 85 laryngectomy patients, of both genders, 48 to 85 years old. Acoustic vocal characteristics were examined with a computer program for multidimensional analysis of vocals, model 4300 of 'Kay Elemetrics' corporation. Perceptual vocal characteristics were analyzed on GRBAS scale. Phonetically balanced text was used for the subjective assessment of speech intelligibility. For statistical analysis of the obtained data we used: arithmetic mean, standard deviation, frequencies, percentages, ANOVA, Pearson correlation coefficient, linear regression analysis and the multiple correlation coefficient. Study results have shown that the contribution on explaining the assessment of speech intelligibility are provided by parameters of speech perceptual analysis. The highest degree of variance in the speech intelligibility assessment is explained with the model composed of scores on the GRBAS scale, R parameters (F=26.1; p=0.000) (roughness of the voice), A (F=26.1; p=0.001) (asthenia) and S (F=18.33; p=0.000) (strain).

Totalna laringektomija je radikalan operativni zahvat pri kojem se kompletno odstranjuje larinks. Svaka vrsta hirurškog tretmana ima uticaj na kvalitet glasa i razumljivost govora. Međutim, veoma je važno saznanje da su metode usvajanja govora, i ezofagealni i govor pomoću traheoezofagealne vokalne proteze, dostupne i primenjive u cilju uspostavljanja funkcionalne komunikacije među laringektomiranim bolesnicima. Cilj istraživanja je utvrđivanje povezanosti između akustičkih i perceptivnih karakteristika glasa i razumljivosti govora kod osoba koje koriste ezofagealni govor i osoba kojima je ugrađena traheoezofagealna vokalna proteza, kao i koja od navedenih karakteristika ima najveći uticaj na razumljivost govora kod ove dve grupe ispitanika. U istraživanju je učestvovalo 85 laringektomiranih bolesnika, starosti od 48 do 85 godina. Akustičke karakteristike glasa su ispitane kompjuterskim programom za multidimenzionalnu analizu vokala model 4300 korporacije 'Kay Elemetrics'. Perceptivne karakteristike glasa su analizirane GRBAS skalom. Kao instrument za procenu razumljivosti govora korišćen je balansirani tekst. Prilikom obrade podataka korišćene su: aritmetička sredina, standardna devijacija, frekvencije, procenti, jednofaktorska analiza varijanse, Pirsonov koeficijent korelacije, linearna regresiona analiza i koeficijent multiple korelacije. Rezultati istraživanja pokazuju da doprinos objašnjenju ocene o razumljivosti govora daju parametri perceptivne analize govora. Najveći stepen varijanse u oceni razumljivosti govora objašnjava model sastavljen od skorova skale GRBAS, i to parametara R (F=26,1; p=0,000) (hrapavost u glasu), A (F=26,1; p=0,001) (slabost u glasu) i S (F=18,33; p=0,000) (napetost u glasu).