Acoustic voice analysis in the COVID-19 era

Abstract

Objective. Among the different procedures used by the ENT, acoustic analysis of voice has become widely used for correct diagnosis of dysphonia. The instrumental measurements of acoustic parameters were limited during the COVID-19 pandemic by the common belief that a face mask affects the results of the analysis. The purpose of our study was to investigate the impact of surgical masks on F0, jitter, shimmer and harmonics-to-noise ratio (HNR) in adults. Methods. The study was carried out on a selected group of 50 healthy subjects. Voice samples were recorded directly in Praat. All subjects were trained to voice a vocal sample of a sustained /a/, at a conversational voice intensity, with no intensity or frequency variation, for the Maximum Phonation Time (MPT), wearing the surgical mask and then without wearing the surgical mask. Results. None of the variations in acoustic voice analysis detected wearing a surgical mask and not wearing a surgical mask were statistically significant. Conclusions. Our study demonstrates that the acoustic voice analysis procedure can continue to be performed with the use of a surgical mask for the patient, even during the COV-ID-19 pandemic.

Effect of Face Mask on Voice Production During COVID-19 Pandemic: A Systematic Review

“…Same two studies [14] , [15] have also used author-developed questionnaires such as self-perception of vocal effort-5 point Likert Scale (0=Never, 5=Always) and an anonymous ‘self-perceived voice symptoms-23 item questionnaire survey’ to identify vocal effort, and perceived voice problems. The remaining eight studies have researched the acoustic measures [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] and one has also investigated an aerodynamic measure along with [29] .…”

“…of participants (%) - 67.43% (147) no voice problem, 21.56% (47) mild and 11.10% (24) severe Low Spanish validated VHI-10 [35] VHI score - 160 had normal score & 58 abnormal scores (>11) [25] n=1 Not stated Not stated Speechreading recorded for 30 s Sound level attenuation (dB) - Transparent – 8; Cloth - 6.36; N95 -5.4; Surgical -2.8; KN95-2.6; Peak attenuation (>1 kHz): N95 -6; Surgical; KN95- 4 Low [26] n=1, male A male speaker with a standard American English dialect. Not stated ‘Consonant-Nucleus-Consonant (CNC)’ word list of monosyllabic words with equal phonemic distribution [36] , [37] recorded using compact disc [38] Sound level attenuation dB - Fabric -4.2; N95-2.9; Surgical -2.3 Low [27] n=50 (20 males, 30 females); 26-69 years Individuals with an ability to sustain vowels for at least 10 s were included. Individuals with a current or history of voice disorder and voice therapy taken, or with a history of respiratory infection in 2 weeks before recording, were excluded.…”

“…Generally, various types of instruments are used to objectively quantify the voice problems in terms of the fundamental frequency, intensity, perturbation, and noise-related measures. Many studies carried out on fundamental frequency related measures (f 0 mean, Hz; f 0 CoV, %), intensity related measures (mean intensity, dB; Intensity prominence dB; p95 Intensity), and perturbation related measures (Jitter, %; Shimmer, %) reported no significant difference between ‘no mask’ and ‘mask’ conditions with surgical, N95/KN95, and cloth masks [27] , [28] , [29] , [30] . In contrary to these findings, a study [32] is in partial agreement with the above findings which has reported no significant difference between ‘no mask’ and ‘surgical mask’ conditions for ‘f 0 ’measure and significant difference between ‘no mask’ and ‘surgical’ mask conditions present for ‘SPL (dB), Jitter (%) and shimmer (%)’.…”

“…Studies carried out on noise-related measures such as CPPS and HNR reported no significant differences between ‘no mask’ and ‘mask’ conditions [ 27 , 28 , 32 ]. On the contrary, another study is in partial agreement with the previous study, reporting no significant difference between ‘no mask’ and mask conditions for CPPS, but reporting a significant increase in HNR while wearing either a surgical mask or KN95 compared to ‘no mask’ [30] .…”

A Longitudinal Normative Dataset and Protocol for Speech and Language Biomarker Research

“…During this task, each participant is asked to say the vowel "/a/" for as long as they could hold their breath, with a maximum duration of 30 seconds (Maslan et al, 2011). This sustained phonation task has been used across a wide range of studies to measure motor symptoms, such as Parkinson's disease (Wroge et al 2018), as well as respiratory symptoms, such as COVID-19 (Cavallaro, Di Nicola, Quaranta, & Fiorella, 2021). The sustained phonation task also generalizes to individuals from various locations, accents, and languages.…”