Acoustic and perceptual correlates of pathological videostroboscopic patterns

This study investigates the possible relationship between one the one hand biomechanical aspects of vocal fold vibration, as rated with videostroboscopy, and on the other hand perceptual and acoustic measurements. 62 patients with various kinds of organic benignant voice pathology (vocal fold nodules, polyp, Reinke's oedema, unilateral paralysis, sulcus/scar) and 19 patients with muscle tension dysphonia were evaluated by means of a basic multidimensional protocol including: Perception: Grade, Breathiness, Roughness, Asthenicity and Strain (GRBAS-scale), rated by two experienced judges (visual analog scales), as well as the variability of voice quality over time. Acoustics: The jitter, the shimmer and the normalized noise energy (NNE) of a /a:/ (comfortable pich and loudness) Videostroboscopy: Glottal closure, regularity, symmetry, and mucosal wave were rated separately on visual analog scales of 10 cm by 2 experienced laryngologists (comfortable pitch and loudness) Results: Only quite weak correlations (< 0.53) can be demonstrated between specific videostroboscopic characteristics and acoustic/perceptual features. This seems to provide arguments for the necessity of a multidimensional assessment of voice function. With a multidimensional approach (perception, acoustics, biomechanics) to voice pathology, it is possible to identify, using factor analysis, 3 main clusters: Grade and normalized noise energy Roughness, jitter, stroboscopic irregularity and (a)symmetry Breathiness, shimmer and insufficient glottic closure.