Comparison of TEVA vs. PRAAT in the Acoustic Characterization of the Tracheoesophageal Voice in Laryngectomized Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Inclusion and Exclusion Criteria
2.3. Collected Variables
2.4. Recording Environment
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- Type I: The regular harmonic components are mixed with the noise component, chiefly in the formant region of the vowels.
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- Type II: The noise components in the second formants predominate over the harmonic components, and slight additional noise components appear in the high-frequency region above 3000 Hz.
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- Type III: The second formants are totally replaced by noise components, and the additional noise components above 3000 Hz further intensify their energy and expand their range.
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- Type IV: The second formants are replaced by noise components, and even the first formants of all vowels often lose their periodic components, which are supplemented by noise components. In addition, more intensified, high-frequency additional noise components are seen.
2.5. Statistical Analysis
3. Results
3.1. Descriptive Analysis
3.2. Vocal Analysis
3.2.1. Subjective Analysis
3.2.2. Acoustic Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Boersma, P.; Weenink, D. PRAAT: Doing Phonetics by Computer, (Version 5.3.51). 2007.
- Klein-Rodríguez, A.; Cabo-Varela, I.; Vázquez-de la Iglesia, F. Acoustic Characterization of the Voice with a Tracheoesophageal Speech in Laryngectomized Patients. Similarities and Differences with the Laryngeal Voice. J. Voice 2020, 37, 144.e9–144.e14. [Google Scholar] [CrossRef] [PubMed]
- van As-Brooks, C.J.; Koopmans-van Beinum, F.J.; Pols, L.C.; Hilgers, F.J. Acoustic Signal Typing for Evaluation of Voice Quality in Tracheoesophageal Speech. J. Voice 2006, 20, 355–368. [Google Scholar] [CrossRef] [PubMed]
- Clapham, R.P.; van As-Brooks, C.J.; van Son, R.J.; Hilgers, F.J.; Brekel, M.W.v.D. The Relationship between Acoustic Signal Typing and Perceptual Evaluation of Tracheoesophageal Voice Quality for Sustained Vowels. J. Voice 2015, 29, 517.e23–517.e29. [Google Scholar] [CrossRef] [PubMed]
- Cuenca, M.H.; Barrio, M.M. Acoustic Markers of Prosodic Boundaries in Spanish Spontaneous Alaryngeal Speech. Clin. Linguist. Phon. 2010, 24, 859–869. [Google Scholar] [CrossRef] [PubMed]
- NKI TE-VOICE ANALYSIS Tool (EN). Available online: https://www.fon.hum.uva.nl/rob/NKI_TEVA/ (accessed on 26 May 2024).
- van As, C.J. Tracheoesophageal Speech. A Multidimensional Assessment of Voice Quality; Budde-Elinkwijk Grafische Producties: Nieuwegein, The Netherlands, 2001; ISBN 978-90-90-15058-1. [Google Scholar]
- Available online: https://www.atosmedical.es/productos/provox-vega (accessed on 26 May 2024).
- Patel, R.R.; Awan, S.N.; Barkmeier-Kraemer, J.; Courey, M.; Deliyski, D.; Eadie, T.; Paul, D.; Švec, J.G.; Hillman, R. Recommended Protocols for Instrumental Assessment of Voice: American Speech-Language-Hearing Association Expert Panel to Develop a Protocol for Instrumental Assessment of Vocal Function. Am. J. Speech-Lang. Pathol. 2018, 27, 887–905. [Google Scholar] [CrossRef] [PubMed]
- Yanagihara, N. Significance of harmonic changes and noise components in hoarseness. J. Speech Hear. Res. 1967, 10, 531–541. [Google Scholar] [CrossRef] [PubMed]
- Núñez-Batalla, F.; Corte-Santos, P.; Señaris-González, B.; Llorente-Pendás, J.L.; Górriz-Gil, C.; Suárez-Nieto, C. Adaptation and validation to the Spanish of the Voice Handicap Index (VHI-30) and its shortened version (VHI-10). Acta Otorrinolaringol. Esp. 2007, 58, 386–392. [Google Scholar] [CrossRef] [PubMed]
- Titze, I.R. Workshop on Acoustic Voice Analysis: Summary Statement; National Center for Voice and Speech: Iowa City, IA, USA, 1995. [Google Scholar]
- Lechien, J.R.; Geneid, A. Consensus for Voice Quality Assessment in Clinical Practice: Guidelines of the European Laryngological Society and Union of the European Phoniatricians. Eur. Arch. Otorhinolaryngol. 2023, 280, 5459–5473. [Google Scholar] [CrossRef] [PubMed]
- Moerman, M.; Martens, J.-P.; Dejonckere, P. Multidimensional Assessment of Strongly Irregular Voices Such as in Substitution Voicing and Spasmodic Dysphonia: A Compilation of Own Research. Logop. Phoniatr. Vocol. 2015, 40, 24–29. [Google Scholar] [CrossRef] [PubMed]
- van Sluis, K.E.; van der Molen, L.; van Son, R.J.J.H.; Hilgers, F.J.M.; Bhairosing, P.A.; van den Brekel, M.W.M. Objective and Subjective Voice Outcomes after Total Laryngectomy: A Systematic Review. Eur. Arch Otorhinolaryngol. 2018, 275, 11–26. [Google Scholar] [CrossRef]
- Hurren, A.; Miller, N. Voice Outcomes Post Total Laryngectomy. Curr. Opin. Otolaryngol. Head Neck Surg. 2017, 25, 205–210. [Google Scholar] [CrossRef] [PubMed]
- Sirić, L.; Sos, D.; Rosso, M.; Stevanović, S. Objective Assessment of Tracheoesophageal and Esophageal Speech Using Acoustic Analysis of Voice. Coll. Antropol. 2012, 36 (Suppl. S2), 111–114. [Google Scholar] [PubMed]
- Maniaci, A.; Lechien, J.R.; Caruso, S.; Nocera, F.; Ferlito, S.; Iannella, G.; Grillo, C.M.; Magliulo, G.; Pace, A.; Vicini, C.; et al. Voice-Related Quality of Life After Total Laryngectomy: Systematic Review and Meta-Analysis. J. Voice 2021, 38, 539.e11–539.e19. [Google Scholar] [CrossRef]
- Cobeta, I. Evaluación Clínica de la Fonación. Laboratorio de Voz. Suárez C, Gil-Carcedo LM. In Tratado de Otorrinolaringología y Cirugía de Cabeza y Cuello; Proyectos Médicos: Madrid, Spain, 2000. [Google Scholar]
Variables | Subgroups | N (%) |
---|---|---|
Surgery Type | TL 1 + BFND 2 | 21 (63.6) |
TL + FLND 3 + RRND 4 | 1 (3) | |
TL + BFND + RFFF 5 | 2 (6.1) | |
TL + BFND | 3 (9.1) | |
TL + RLND 6 + FRND 7 | 2 (6.1) | |
TL + FLND | 3 (9.1) | |
TL + RRND | 1 (3) | |
Tumor location | Transglottic | 8 (24.2) |
Supraglottic | 10 (30.3) | |
Glottic | 10 (30.3) | |
Hypopharynx | 5 (15.2) | |
pTNM | T4N1 | 2 (7.1) |
T3N1 | 2 (7.1) | |
T4N0 | 3 (10.7) | |
T2N0 | 4 (14.3) | |
T3N2 | 10 (35.7) | |
T3N0 | 6 (21.4) | |
T4N2 | 1 (3.6) | |
TEP 8 | Primary | 20 (58.8) |
Secondary | 14 (41.2) | |
N. of voice prosthesis | 8 | 17 (50) |
6 | 11 (32.4) | |
4 | 5 (14.7) | |
10 | 1 (2.9) | |
Radiotherapy treatment | Yes | 20 (58.8) |
No | 14 (41.2) | |
Pulmonary pathology | Yes | 11 (32.4) |
No | 23 (67.6) | |
Dysphagia | No | 34 (100) |
Pharyngeal closure | T + Tapia corset | 12 (35.3) |
Hormaeche | 12 (35.3) | |
Others | 10 (29.4) |
Mean | Median | Standard Deviation | Min | Max | |
---|---|---|---|---|---|
Age (years) | 63.41 | 62.50 | 9.55 | 48.00 | 89.0 |
Number of VP 1 replacements | 4.12 | 3.00 | 3.68 | 1.00 | 17.0 |
Gy 2 of RT 3 received | 54.62 | 54.00 | 4.43 | 46.00 | 64.0 |
GRBAS 4 | 7.35 | 7.50 | 3.36 | 1.00 | 14.0 |
VHI 5 | 11.29 | 6.50 | 11.16 | 0.00 | 34.0 |
[a] Phonation time (s) | 13.16 | 13.13 | 5.89 | 3.20 | 24.3 |
[a] 1° formant Frequency (F1)(Hz) | 835.42 | 826.84 | 118.08 | 627.49 | 1059.1 |
[a] 2° formant Frequency (F2)(Hz) | 1560.44 | 1553.92 | 209.94 | 1205.41 | 2272.2 |
[a] 3° formant Frequency (F3)(Hz) | 2955.33 | 2948.03 | 242.54 | 2429.03 | 3477.7 |
[i] Phonation time (s) | 12.11 | 11.15 | 5.84 | 2.89 | 25.6 |
[i] 1° formant Frequency (F1)(Hz) | 472.86 | 388.39 | 210.93 | 283.26 | 1074.5 |
[i] 2° formant Frequency (F2)(Hz) | 2450.03 | 2454.26 | 211.79 | 1838.55 | 2826.2 |
[i] 3° formant Frequency (F3)(Hz) | 3112.98 | 3102.33 | 180.60 | 2865.25 | 3711.3 |
TEVA 1 | PRAAT | p-Value | |||||
---|---|---|---|---|---|---|---|
Mean ± SD | Median | Range | Mean ± SD | Median | Range | ||
[a] Jitter (%) | 2.09 ± 3.34 | 1.5 | 0.3–20 | 2.86 ± 2.61 | 1.75 | 0.34–9.19 | <0.001 |
[a] Shimmer (%) | 25.6 ± 12.8 | 21.3 | 8.70–57.3 | 15 ± 5.86 | 15.8 | 0.5–26.3 | 0.213 |
[a] Mean SPL (dB) | 64.1 ± 6.22 | 64 | 50.6–78.5 | 63.9 ± 7.08 | 63.9 | 51–81 | <0.001 |
[a] Maximum SPL (dB) | 74.8 ± 10.1 | 73.1 | 54.8–91.4 | 66.9 ± 6.95 | 66.7 | 54.9–83.1 | <0.001 |
[a] Fundamental frequency (F0) (Hz) | 105 ± 41.7 | 96 | 49–215 | 275 ± 83 | 115 | 58.4–264 | <0.001 |
[a] HNR 2 (dB) | 3.36 ± 2.12 | 2.75 | 0.5–8 | 3.49 ± 2.36 | 3.13 | 0.07–7.99 | <0.001 |
[i] Jitter (%) | 1.57 ± 1.66 | 0.85 | 0.2–6.5 | 2.8 ± 2.54 | 1.82 | 0.29–11.1 | <0.001 |
[i] Shimmer (%) | 22.4 ± 12.4 | 17.9 | 4.1–52.2 | 14.9 ± 4.27 | 16 | 4.83–21.9 | <0.001 |
[i] Mean intensity (dB) | 63.3 ± 5.75 | 62.5 | 49.3–76.1 | 62 ± 6.24 | 61.7 | 48.4–74.8 | <0.001 |
[i] Maximum intensity (dB) | 66.9 ± 6.52 | 66.8 | 49.9–80.8 | 64.8 ± 5.9 | 64.5 | 51.1–76.4 | <0.001 |
[i] Fundamental frequency (F0) (Hz) | 109 ± 47.5 | 93 | 59–240 | 142 ± 117 | 90.3 | 54.8–635 | <0.001 |
[i] HNR (dB) | 5.46 ± 2.67 | 5.05 | 0.9–11.1 | 4.56 ± 2.47 | 4.2 | 1.39–10.9 | <0.001 |
Grade I | Grade II | Grade III | Grade IV | p-Value | ||
---|---|---|---|---|---|---|
N (%) | N (%) | N (%) | N (%) | |||
[a] | TEVA | 14 (41.2) | 10 (29.4) | 4 (11.8) | 6 (17.6) | 0.201 |
PRAAT | 15 (44.1) | 15 (44.1) | 3 (8.8) | 1 (2.9) | ||
[i] | TEVA | 8 (23.5) | 15 (44.1) | 8 (23.5) | 3 (8.8) | 0.414 |
PRAAT | 13 (38.2) | 15 (44.1) | 5 (14.7) | 1 (2.9) |
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Klein-Rodríguez, A.; Cabo-Varela, I.; Vázquez-de la Iglesia, F.; Chiesa-Estomba, C.M.; Mayo-Yáñez, M. Comparison of TEVA vs. PRAAT in the Acoustic Characterization of the Tracheoesophageal Voice in Laryngectomized Patients. J. Clin. Med. 2024, 13, 3748. https://doi.org/10.3390/jcm13133748
Klein-Rodríguez A, Cabo-Varela I, Vázquez-de la Iglesia F, Chiesa-Estomba CM, Mayo-Yáñez M. Comparison of TEVA vs. PRAAT in the Acoustic Characterization of the Tracheoesophageal Voice in Laryngectomized Patients. Journal of Clinical Medicine. 2024; 13(13):3748. https://doi.org/10.3390/jcm13133748
Chicago/Turabian StyleKlein-Rodríguez, Alejandro, Irma Cabo-Varela, Francisco Vázquez-de la Iglesia, Carlos M. Chiesa-Estomba, and Miguel Mayo-Yáñez. 2024. "Comparison of TEVA vs. PRAAT in the Acoustic Characterization of the Tracheoesophageal Voice in Laryngectomized Patients" Journal of Clinical Medicine 13, no. 13: 3748. https://doi.org/10.3390/jcm13133748
APA StyleKlein-Rodríguez, A., Cabo-Varela, I., Vázquez-de la Iglesia, F., Chiesa-Estomba, C. M., & Mayo-Yáñez, M. (2024). Comparison of TEVA vs. PRAAT in the Acoustic Characterization of the Tracheoesophageal Voice in Laryngectomized Patients. Journal of Clinical Medicine, 13(13), 3748. https://doi.org/10.3390/jcm13133748