Detecting Mild Phonotrauma in Daily Life

Area of Science:

• Otolaryngology
• Speech Science
• Biomedical Engineering

Background:

• Phonotraumatic vocal hyperfunction (PVH) affects vocal fold health.
• Quantifying daily voice use and its impact on vocal folds is crucial for early detection.
• The Daily Phonotrauma Index (DPI) measures voice use via neck-surface acceleration magnitude (NSAM) and harmonic differences (H1-H2).

Purpose of the Study:

• To develop and validate a modified Daily Phonotrauma Index (DPI) for detecting mild phonotrauma.
• To quantitatively assess the role of daily voice use in mild phonotrauma.
• To evaluate the individual contributions of NSAM and H1-H2 to phonotrauma detection.

Main Methods:

• Weeklong voice data collected using ambulatory monitors from 151 female patients with PVH and 181 controls.
• Phonotrauma severity rated by three laryngologists via laryngoscopy.
• Mixed generalized linear models used to compare original DPI and mild DPI performance.

Main Results:

• The mild DPI demonstrated improved classification of mild phonotrauma and reduced misclassification of controls compared to the original DPI.
• Overall classification accuracy remained consistent between the mild and original DPI versions.
• Neck-surface acceleration magnitude (NSAM) showed a greater contribution to mild phonotrauma classification than harmonic difference (H1-H2).

Conclusions:

• The mild DPI is a promising tool for detecting early-stage phonotrauma.
• Neck-surface acceleration magnitude (NSAM) may serve as a key indicator for early phonotrauma.
• Harmonic difference (H1-H2) might act as a biomarker for vocal fold vibration in the presence of lesions.