Differences in Daily Voice Use Measures Between Female Patients With Nonphonotraumatic Vocal Hyperfunction and...

Area of Science:

• Laryngology
• Speech-Language Pathology
• Acoustic Analysis

Background:

• Nonphonotraumatic vocal hyperfunction (NPVH) describes voice use patterns that may lead to vocal dysfunction without obvious vocal fold injury.
• Understanding the acoustic and physiological characteristics of daily voice use in NPVH is crucial for effective diagnosis and treatment.
• Previous research has not fully elucidated the specific voice use patterns associated with NPVH during everyday activities.

Purpose of the Study:

• To comprehensively understand the pathophysiology and daily voice use impact of nonphonotraumatic vocal hyperfunction (NPVH).
• To identify acoustic measures that can differentiate NPVH from healthy voice users and phonotraumatic vocal hyperfunction (PVH).
• To evaluate the effectiveness of voice therapy in altering voice use patterns in NPVH.

Main Methods:

• Ambulatory voice monitoring collected 1 week of data from 36 NPVH patients and 36 matched controls.
• Voice use measures included fundamental frequency (f₀), cepstral peak prominence (CPP), and harmonic difference (H1-H2).
• A classification model was developed using CPP and H1-H2 to differentiate NPVH from controls and PVH.

Main Results:

• NPVH patients exhibited higher fundamental frequency (f₀), reduced cepstral peak prominence (CPP), and less positive H1-H2 skewness compared to controls.
• The classification model using CPP mean and H1-H2 mode achieved an area under the curve of 0.78 for differentiating NPVH from controls.
• The classification model showed efficacy on unseen data, with improvements noted post-therapy and high accuracy in identifying control and PVH groups.

Conclusions:

• Daily voice use in NPVH is characterized by higher pitch, reduced periodicity, and less abrupt vocal fold closure.
• The combination of CPP and H1-H2 measures reflects a continuum of inefficient phonation in NPVH, with low phonotrauma potential.
• The developed classification model shows promise for clinical application in identifying and monitoring NPVH, though further validation is required.