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BMC Ear, Nose and Throat Disorders

, 17:4

First Online: 21 April 2017Received: 03 November 2016Accepted: 05 April 2017DOI: 10.1186-s12901-017-0037-9

Cite this article as: Siau, R.T.K., Goswamy, J., Jones, S. et al. BMC Ear Nose Throat Disord 2017 17: 4. doi:10.1186-s12901-017-0037-9


BackgroundObjective acoustic analysis is a key component of multidimensional voice assessment. OperaVOX is an iOS app which has been shown to be comparable to Multi Dimensional Voice Program for most principal measures of vocal function. As a relatively cheap, portable and easily accessible form of acoustic analysis, OperaVOX may be more clinically useful than laboratory-based software in many situations. This study aims to determine whether correlation exists between acoustic measurements obtained using OperaVOX, and perceptual evaluation of voice.

MethodsForty-four voices from the multidisciplinary voice clinic were examined. Each voice was assessed blindly by a single experienced voice therapist using the GRBAS scale, and analysed using OperaVOX. The Spearman rank correlation co-efficient was calculated between each element of the GRBAS scale and acoustic measurements obtained by OperaVOX.

ResultsSignificant correlations were identified between GRBAS scores and OperaVOX parameters. Grade correlated significantly with jitter ρ = 0.495, p < 0.05, shimmer ρ = 0.385, p < 0.05, noise-to-harmonic ratio NHR; ρ = 0.526, p < 0.05 and maximum phonation time MPT; ρ = −0.415, p < 0.05. Roughness did not correlate with any of the measured variables. Breathiness correlated significantly with jitter ρ = 0.342, p < 0.05, NHR ρ = 0.344, p < 0.05 and MPT ρ = −0.336, p < 0.05. Aesthenia correlated with NHR ρ = 0.413, p < 0.05 and MPT ρ = −0.399, p < 0.05. Strain correlated with Jitter ρ = 0.560, p < 0.05, NHR ρ = 0.600, p < 0.05 and MPT ρ = −0.356, p < 0.05.

ConclusionsOperaVOX provides objective acoustic analysis which has shown statistically significant correlation to perceptual evaluation using the GRBAS scale. The accessibility of the software package makes it possible for a wide range of health practitioners, e.g. general ENT surgeons, vascular surgeons, thyroid surgeons and cardiothoracic surgeons to objectively monitor outcomes and complications of surgical procedures that may affect vocal function. Given the increasing requirement for surgeons to monitor their outcomes as part of the move towards ‘surgeon reported outcomes’ this may become an invaluable tool towards that goal.

KeywordsOperaVOX Dysphonia Voice assessment Portable voice analysis Perceptual voice analysis Acoustic voice analysis GRBAS AbbreviationsMDVPMulti dimensional voice programme

NHRNoise-to-harmonics ratio

MPTMaximum phonation time

DSIDysphonia severity index

Presented as a poster at the 15th British Academic Conference in Otolaryngology, 8-10 July 2015, Liverpool, UK

Autor: Richard Teck Kee Siau - Jay Goswamy - Sue Jones - Sadie Khwaja


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