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ISSN 2007-6037 (Print)
Órgano Oficial de Difusión de la Asociación Mexicana de Comunicación, Audiología, Otoneurología y Foniatría, A.C.,

2014, Number 3

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Rev Mex AMCAOF 2014; 3 (3)

Tomoacustic analysis of voice and cochlear implantation

Berruecos-Villalobos P, Hernández PMP

Language: Spanish
References: 28
Page: 95-104
PDF size: 200.54 Kb.


ABSTRACT

Introduction. The human being is superior because of the capacity to exchange information through the refined system of linguistic communication. Speech sounds are necessarily linked with the sonorous envelope provided by the vocal apparatus. There are not linguistic exchanges if speech has no sounds or when the voice is not linked with articulated phonemes. Speech and language are related with intelligence and thoughts but voice expresses the psychological and emotional context of the speaker. In spite of that, in the CI field it was be privileged the analysis of speech development but very little or no attention has been paid to the voice parameters. In this paper we show the standardization of normal parameters of voice, according to a computerized digital analysis of its characteristics. The normality or deviations are the basis for the comprehensive intervention in all the expressive processes of implanted patients. Objectives. 1) To establish with objective and quantifiable basis the normal ranges of the acoustic parameters of normal voice in the adult Mexican population through the multidimensional digital voice program (MDVP); 2) to apply the obtained norms in the analysis of voice changes in implanted patients in order to establish the necessary association of auditory-verbal with voice therapy programs. Material and methods. 240 normal persons, 120 men and 120 women divided in six groups of 20 persons each one according with their age (20-30, 31-40, 41-50, 51-60, 61-70 and › 70 years) were studied. Each participant registered the vowel /a/ with a microphone Shure sm dynamic 10z, to proceed to the digital analysis in the MDVP 5105 program of the CSL Kay Elemetrix-Pentax Speech Lab 4300B. We studied 13 of the 19 parameters of the program, related with frequency and seven with intensity. All the results were plotted in Excel to have analysis with the SPSS program taking into account the average and the standard deviation. Results. The obtained results show clear differences related with age and sex and some similarities with studies carried out in other countries. Based on that, we are suggesting norms or thresholds to standardize the values of the parameters that must be taking in consideration to estimate the quality of voice in normal or as in this case, in implanted patients. Discussion. The uniformity of the groups and the consistency of the results allow us to their immediate clinical use. An electroacoustic equipment produce sounds without variations and so, in theory, the frequency and intensity changes could be equivalent to 0.000. The vocal system obviously produce variations that can be considered as normal if included within certain limits. We didn’t studied children in this protocol but if we take into account that the main difference with the adult’s voices is only related with the Fo, but no with the other frequency and intensity parameters, the results can be applied also to children. In the final part of this presentation we show some results of voices of implanted persons before the surgery and two years later, in which it is possible to appreciate the changes in most of the parameters studied, as a consequence of the better control of the vocal emissions that follows the new form of auditory input provided by the cochlear implant. Conclusions. The use of a computerized equipment for the digital voice analysis complements the clinical evaluation, make easier the diagnosis confirmation and make possible the comprehensive clinical/subjective and objective/instrumental follow-up of the implanted patients. We consider that the normal digital values of voice parameters obtained in our protocol, must be the basis of its use in a routine way. The assessment of the voice quality in parallel with and speech-language processes must be as comprehensive as possible, because voice is one of the most important features of the human being to achieve the best possible quality of life.


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