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Multidimensional evaluation of vocal quality in children with cochlear implants: a cross‐sectional, case‐controlled study
Author(s) -
Hsu H.W.,
Fang T.J.,
Lee L.A.,
Tsou Y.T.,
Chen S.H.,
Wu C.M.
Publication year - 2014
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.12213
Subject(s) - medicine , audiology , phonation , cross sectional study , loudness , cochlear implant , quality of life (healthcare) , mandarin chinese , speech perception , rehabilitation , perception , physical therapy , psychology , linguistics , philosophy , nursing , pathology , neuroscience
Objectives This study aimed to compare the differences in vocal quality between Mandarin‐speaking children with cochlear implants and normal‐hearing peers and to understand which cochlear implant usage parameters may predict unfavourable voice outcomes. Design A cross‐sectional, case‐controlled study. Setting A tertiary medical centre. Participants Thirty‐five pre‐lingually deaf children (age = 10.3 ± 1.6 years; 17 boys and 18 girls) who had used cochlear implants for >2 years and 35 age‐ and gender‐matched controls with normal hearing. Main outcome measures Through sustained phonation of /a/ and reading of the Hare and Tortoise passage, the subjects' voice quality was analysed with aerodynamics and acoustics. A six‐point scale was used for auditory‐perceptual evaluation. A Pediatric Voice‐Related Quality of Life Survey was filled out by the caregivers. Results The implanted subjects had significantly lower mean airflow rate ( P = 0.006), higher phonation threshold pressure ( P < 0.001), higher fundamental frequency variations ( P < 0.001) and peak‐amplitude variations ( P < 0.001), wider fundamental frequency range ( P = 0.043), wider speaking intensity range ( P = 0.015) and greater perceptual severity level of monotone ( P < 0.001), resonance ( P < 0.001), loudness ( P < 0.001) and strain ( P = 0.006) than their normal‐hearing peers. Duration of postoperative rehabilitation was an independent predictor of unfavourable mean speaking fundamental frequency (odds ratio = 8.56, P = 0.008). Conclusion Inadequate postoperative rehabilitation may hinder the normalisation of Mandarin‐speaking implantees' voice quality. A multidimensional analysis may precisely evaluate the voice of paediatric implantees; however, the generalisability of these findings requires different forms of validation, including data from other languages and other institutions.