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Voice Quality in Laryngeal Cancer Patients: A Randomized Controlled Study of the Effect of Voice Rehabilitation
Institution:2. Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden;1. Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan;2. Department of Sport Education, Hokusho University, Ebetsu, Japan;2. Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran;3. Otolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran;2. Speech and Voice Research Laboratory, Faculty of Education, University of Tampere, Tampere, Finland;3. Ear and Oral Diseases, Department of Phoniatrics, Tampere University Hospital, Tampere, Finland;4. Department of Otorhinolaryngology and Phoniatrics—Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;2. Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; and the Federal University of Health Sciences of Porto Alegre;3. Rehabilitation Sciences Program and Speech-Language Pathology Department, Porto Alegre, Rio Grande do Sul, Brazil
Abstract:ObjectivesThe 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.MethodsIn 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.ResultsCPPS 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.ConclusionVoice 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.
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