Correlation between the Perceptual Rating of Speech in Dutch Patients with Velopharyngeal Insufficiency and Composite Measures Derived from Mean Nasalance Scores

Abstract

Objective: To evaluate the potential clinical use of composite measures derived from mean nasalance scores. Procedure: Speech samples with a normal distribution of phonemes (normal text, NT) and speech samples free of nasal consonants (denasal text, DT) of 43 patients with perceived hypernasality were used. The overall grade of severity, hyperrhinophonia, audible nasal emission, misarticulations associated with velopharyngeal insufficiency and intelligibility were perceptually rated on separate visual analog scales. Mean nasalance scores were computed by the Nasometer for the same speech samples on which the perceptual ratings were performed. From the mean nasalance scores computed for the NT and DT passages the difference and the quotient were calculated. The advantage could be that the derived measures provide some normalization with regard to the performance of the individual speaker. Spearman correlation coefficients were computed between these composite measures and the perceptually rated parameters. The results were compared with the correlation coefficients between the mean nasalance scores and the ratings. Setting: The Institute of Phoniatrics, Utrecht University Hospital, The Netherlands. Results: The correlations between the composite measures and the perceptual ratings were generally lower than the correlations between mean nasalance scores and the ratings. Conclusion: Normalization of the nasalance scores did not enhance the correlation with the perceptual ratings in this study.

Normative Nasalance Scores for Brazilian Portuguese Using New Speech Stimuli

“…The Nasometer (Kay Elemetrics Corporation, Lincoln Park, N.J., USA) quantifies nasalance as the ratio of nasal acoustic energy to the sum of nasal plus oral acoustic energy, expressed as a percentage. Measures of nasalance have been used to document oral-nasal balance in numerous clinical populations, including cleft palate, neurogenic dysarthrias and hearing impairment [7,8,9,10,11,12,13]. …”

Hypernasal Speech Is Perceived as More Monotonous than Typical Speech

“…Auditory-perceptual ratings of hypernasality can show variable agreement and be quite unreliable [39, 40]. The variability has been attributed to the types of rating scales used [41] or to listeners’ experience [42, 43].…”

Revisional surgery following the superiorly based posterior pharyngeal wall flap. Historical perspectives and current considerations

“…Many authors argue that these examinations are mandatory because they provide objective and reliable information on which operative choices can be based. Others state that the correlation between these objective measures and the subjective perceptual rating of nasal resonance is only moderate 17,18 .…”

“…For diagnosing VPI and evaluating therapy, instruments that measure nasal resonance, such as the Nasometer1 (Kay Elemetrics Corp, New Jersey, USA) and the Nasalview1 (Tiger Electronics, Seattle, USA), are gaining in popularity, but the correlation between these objective measures and the subjective perceptual rating of nasal resonance is moderate 17,18 . Most authors agree that perceptual evaluation serves as the gold standard against which instrumental measurements must be validated.…”