Auditory-perceptual and acoustic characteristics of the voice of deaf adults using cochlear implants

Abstract

INTRODUCTION: Auditory-perceptual assessment (APA) of the voice is carried out in the clinical and research context and is considered the gold standard in voice assessment, while acoustic analysis extracts measures that quantify short-term disturbance and noise, with a clear determination of the glottic cycles. OBJECTIVE: To explore the auditory-perceptual and acoustic characteristics of the voice of deaf adults using cochlear implants (CI) in three different speech tasks: sustained emission, connected speech and spontaneous conversation. METHOD: A voice bank of deaf adults, which was part of another study in the area, was used. Participants were divided into 2 groups: listeners or control (CG) and CI adult users or experimental (GE), matched in age and sex. The Protocol for the Evaluation of Voice in Subjects with Hearing Impairment (PEV-SHI) was used by three specialist professionals with experience in voice analysis in clinical and research contexts, and the PRAAT, for acoustic analysis and cepstral filtering. The following parameters were determined: fundamental frequency (F0, in Hz), jitter ppq5 (in %), shimmer apq5 (in %), harmonic-noise ratio (PHR, in dB), intensity (in dB), the formants F1, F2, F3 and F4 (in Hz), anti-formants and nasal formants. RESULTS: APA differs depending on the phonatory task analyzed and the gender. There are no differences between the GC and the female GE in the sustained vowel. Men have more tense, hyponasal voices, with higher pitch and loudness. In connected speech, the general degree of vocal alteration is perceived in both genders, with the presence of vocal tension. More characteristics were found with significant differences between women (laryngeal, pharyngeal, hyponasal, hypernasal and anterior resonances; instability) than among men (pharyngeal, hypernasal and posterior resonances). In spontaneous conversation, the general degree of vocal alteration is perceived in both sexes, with the presence of vocal tension and instability. There are different characteristics with significant differences between women (pharyngeal, hypernasal and posterior resonances; roughness and loudness) and among men (pneumophonoarticulatory coordination, laryngeal, hyponasal, hypernasal and posterior resonances and breathiness). The F0 is higher among both groups (127.0Hz, p=0.035 among men / 213.6Hz, p = 0.011 among women), the other parameters evaluated (jitter, shimmer, harmonic-noise ratio, intensity and formants – F1, F2, F3 and F4) showed no differences between GC and GE, regardless of sex. The presence of antiformants and/or increased bandwidth, suggestive of nasality, was not observed in cepstral filtering. CONCLUSION: APA and acoustic analysis have a complementary nature in evaluating the voice of deaf CI adult users, as the joint action of the articulators favors the perceptual identification of nasality perceived in their voices.

Keywords: Voice Quality; Speech Acoustics; Voice; Hearing Loss; Cochlear implant.