Abstract
Objectives
The study aimed to investigate the short-term and long-term effects of voice rehabilitation
in patients treated with radiotherapy for laryngeal cancer as measured by both the
acoustic measure smoothed cepstral peak prominence (CPPS) and perceptual measures.
A secondary aim was to investigate the relationship between acoustic and perceptual
measures.
Methods
In total, 37 patients received voice rehabilitation post-radiotherapy and 37 patients
constituted the irradiated control group. Outcome measures were mean CPPS for connected
speech and ratings with the auditory-perceptual Grade, Roughness, Breathiness, Asthenia
and Strain (GRBAS) scale. Outcome measures were analyzed 1 (baseline), 6, 12, and
24 months post-radiotherapy, where voice rehabilitation was conducted between the
first two time-points. Additional recordings were acquired from vocally healthy participants
for comparison.
Results
CPPS values of the voice rehabilitation group and vocally healthy group were not significantly
different at 24 months post-radiotherapy. Ten out of 19 patients who received voice
rehabilitation yielded a CPPS value above the threshold for normal voice 24 months
post-radiotherapy, compared to 11 out of 26 in the irradiated control group. No statistically
significant correlations were found between CPPS and perceptual parameters of GRBAS.
Conclusion
Voice rehabilitation for irradiated laryngeal cancer patients may have positive effects
on voice quality up to 24 months post-radiotherapy. The relationship between CPPS
and GRBAS as well as the applicability of CPPS for evaluation over several points
of measurement needs to be studied further.
Key Words
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References
- Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012.Int J Cancer. 2015; 136: E359-E386
- Voice outcomes after radiotherapy treatment for early glottic cancer: assessment using multidimensional tools.Head Neck. 2008; 30: 600-610
- Vocal quality 10 years after radiotherapy for early glottic cancer.Clin Radiol. 1988; 39: 295-296
- The efficacy of voice therapy in patients after treatment for early glottic carcinoma.Cancer. 2006; 106: 95-105
- Consequences of voice impairment in daily life for patients following radiotherapy for early glottic cancer: voice quality, vocal function, and vocal performance.Int J Radiat Oncol Biol Phys. 1999; 44: 1071-1078
- Long-term efficacy of voice therapy in patients with voice problems after treatment of early glottic cancer.J Voice. 2012; 26: 398-401
- Effects of voice rehabilitation after radiation therapy for laryngeal cancer: a randomized controlled study.Int J Radiat Oncol Biol Phys. 2014; 89: 964-972
- Voice rehabilitation for laryngeal cancer patients: Functional outcomes and patient perceptions.Laryngoscope. 2016; 126: 2029-2035
- Effects of voice rehabilitation after radiotherapy for laryngeal cancer: a longitudinal study.Logoped Phoniatr Vocol. 2017; 42: 167-177
- Voice range profile and health-related quality of life measurements following voice rehabilitation after radiotherapy; a randomized controlled study.J Voice. 2017; 31 (115.e119–115.e116)
- A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques.Eur Arch Otorhinolaryngol. 2001; 258: 77-82
- Cepstral peak prominence: a more reliable measure of dysphonia.Ann Otol Rhinol Laryngol. 2003; 112: 324-333
- Voice outcomes after transoral laser microsurgery for early glottic cancer—considering signal type and smoothed cepstral peak prominence.J Voice. 2015; 29: 370-381
- Acoustic correlates of breathy vocal quality: dysphonic voices and continuous speech.J Speech Lang Hear Res. 1996; 39: 311-321
- Acoustic measurement of overall voice quality: a meta-analysis a.J Acoust Soc Am. 2009; 126: 2619-2634
- A meta-analysis: acoustic measurement of roughness and breathiness.J Speech Lang Hear Res. 2018; 61: 298-323
- Quantifying the cepstral peak prominence, a measure of dysphonia.J Voice. 2014; 28: 783-788
- A randomized controlled trial of stretch‐and‐flow voice therapy for muscle tension dysphonia.Laryngoscope. 2015; 125: 1420-1425
- Perceptual structure of adductor spasmodic dysphonia and its acoustic correlates.J Voice. 2012; 26 (818 e815–813)
- A multidimensional study of vocal function following radiation therapy for laryngeal cancers.Ann Otol Rhinol Laryngol. 2017; 126: 483-492
- Long-term voice outcome following radiation versus laser microsurgery in early glottic cancer.J Voice. 2017; (Advance online publication)https://doi.org/10.1016/j.jvoice.2017.10.018
- Prognostic importance of comorbidity in a hospital-based cancer registry.JAMA. 2004; 291: 2441-2447
- Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial.Biometrics. 1975; 31: 103
- A cross-sectional validation study of self-evaluation of communication experiences after laryngeal cancer: a questionnaire for use in the voice rehabilitation of laryngeal cancer patients.Acta Oncol. 1999; 38: 573-580
- Psycho-acoustic evaluation of voice: GRBAS scale.Clinical Examination of Voice. Springer Verlag, Wien1981
- A prospective longitudinal study of voice characteristics and health-related quality of life outcomes following laryngeal cancer treatment with radiotherapy.Acta Oncol. 2016; 55: 693-699
- The measurement of observer agreement for categorical data.Biometrics. 1977; 33: 159-174
- Predictive value and discriminant capacity of cepstral- and spectral-based measures during continuous speech.J Voice. 2013; 27: 393-400
- Voice outcomes after radiotherapy treatment for early glottic cancer: long-term follow-up.J Voice. 2017; (Advance online publication)https://doi.org/10.1016/j.jvoice.2017.08.025
- Vocal aging and the impact on daily life: a longitudinal study.J Voice. 2004; 18: 193-202
- Perceptual and acoustic correlates of abnormal voice qualities.Acta Otolaryngol. 1980; 90: 441-451
- Efficacy of a behaviorally based voice therapy protocol for vocal nodules.J Voice. 2001; 15: 395-412
- Interventions for treating functional dysphonia in adults.Cochrane Database Syst Rev. 2007; (CD006373)
- Risk factors for voice quality after radiotherapy for early glottic cancer.Radiother Oncol. 2009; 93: 524-529
- Functional outcomes following nonsurgical treatment for advanced‐stage laryngeal carcinoma.Laryngoscope. 2003; 113: 720-728
- Xerostomia following radiotherapy of the head and neck affects vocal function.J Clin Oncol. 2005; 23: 3016-3023
- A physiological and acoustic study on voiced bilabial fricative /β:/ as a vocal exercise.J Voice. 1996; 10: 67-77
- Resonance tube phonation in water: high-speed imaging, electroglottographic and oral pressure observations of vocal fold vibrations—a pilot study.Logoped Phoniatr Vocol. 2015; 40: 113-121
- Vocal tract adjustments of dysphonic and non-dysphonic women pre- and post-flexible resonance tube in water exercise: a quantitative MRI study.J Voice. 2017; 31: 442-454
- Nebulized isotonic saline improves voice production in Sjogren's syndrome.Laryngoscope. 2015; 125: 2333-2340
Article info
Publication history
Published online: October 26, 2018
Accepted:
September 13,
2018
Identification
Copyright
© 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
