Parâmetros acústicos e perceptivoauditivos da voz de usuários de dispositivos auditivos

Original Article ISSN 2317-6431 https://doi.org/10.1590/2317-6431-2020-2345 Acoustic and auditory-perceptual parameters of the voice of hearing device users Parâmetros acústicos e perceptivoauditivos da voz de usuários de dispositivos auditivos Jaqueline Cardoso Estácio1 , Maria Madalena Canina Pinheiro2 , Ana Carolina de Assis Moura Ghirardi2  ABSTRACT RESUMO Purpose: To analyze and compare the voice parameters of users of two types of hearing devices (CI and HA) with prelingual and postlingual hearing loss, and verify the influence these hearing devices have on the auditory feedback and voice quality. Methods: The sample comprised 10 CI-using adults and eight HA-using adults – nine with prelingual and nine with postlingual hearing loss. The auditory-perceptual assessment was conducted with the Consensus Auditory-Perceptual Evaluation of Voice protocol, as well as acoustic analysis of the voice, with the PRAAT software. The statistical analysis used nonparametric tests, such as the Mann-Whitney U and the Spearman correlation, with a p ≤ 0.05 significance level. Results: A difference was observed in the sociodemographic characteristics between the groups. Despite the similar results in the voice findings, a significance was observed when comparing the CI and HA groups, regarding the frequencies of the first three formants of some vowels and voice strain. The subjects with prelingual hearing loss had a higher general degree of deviation in the voice and hypernasality. Conclusion: There was a similarity in the voice parameters of both groups. Hence, it was not possible to infer the impact of the different types of hearing devices analyzed in the acoustic parameters of the voice. Objetivo: Analisar e comparar os parâmetros vocais de usuários de dois tipos de dispositivos auditivos, IC e AASI, com perda auditiva pré e pós-lingual, a fim de verificar a influência desses dispositivos auditivos no feedback auditivo e na qualidade vocal. Métodos: participaram dez adultos usuários de IC e oito adultos usuários de AASI, sendo nove com perda auditiva prélingual e nove com pós-lingual. Realizou-se avaliação perceptivoauditiva por meio do protocolo Consenso da Avaliação Perceptivoauditiva da Voz e análise acústica da voz pelo software PRAAT. A análise estatística utilizou testes não paramétricos, como Mann Whitney U e correlação de Spearman, com nível de significância de p<0,05. Resultados: Observouse diferença nas características sociodemográficas entre os grupos. Apesar de resultados semelhantes nos achados vocais, observou-se significância ao comparar os grupos de IC e AASI, em relação às frequências dos três primeiros formantes de algumas vogais e tensão vocal. Os sujeitos com perda auditiva pré-lingual apresentaram maior grau geral de desvio vocal e hipernasalidade. Conclusão: Houve semelhança nos parâmetros vocais de ambos os grupos, não sendo possível inferir o impacto dos diferentes tipos de dispositivos auditivos analisados nos parâmetros acústicos da voz. Keywords: Hearing loss; Voice quality; Cochlear implant; Hearing aids; Speech acoustics Palavras-chave: Perda auditiva; Qualidade da voz; Implante coclear; Auxiliares de audição; Acústica da fala Study carried out at Departamento de Fonoaudiologia, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina – UFSC – Florianópolis (SC), Brasil. 1 Curso de Graduação em Fonoaudiologia, Universidade Federal de Santa Catarina – UFSC – Florianópolis (SC), Brasil. 2 Departamento de Fonoaudiologia, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina – UFSC – Florianópolis (SC), Brasil. Conflict of interests: No. Authors’ contribution: JCE and ACAMG conceptualization, design, data collection and interpretation, and writing; MMCP data interpretation, writing, and critical revision of the article. All the authors approved the final version of the article. Funding: None. Corresponding author: Jaqueline Cardoso Estácio. E-mail: Received: May 22, 2020; Accepted: August 13, 2020 Audiol Commun Res. 2020;25:e2345 This is an open-access article distributed under the terms of the Creative Commons Attribution License. 1|8 Estácio JC, Pinheiro MMC, Ghirardi ACAM INTRODUCTION A person’s speech and voice depend on individual factors, many of which are derived from or related to physical and/or health characteristics. Hearing loss (HL), for instance, is identified as one of the factors responsible for a series of adaptations that define some vocal markers, considered typical of the voice of a person with such a loss. Some examples of these markers are the reduced maximum phonation time, voice breaks due to pneumophonic incoordination or vocal strain, high and/or widely variable fundamental frequency, increased pitch and loudness, and imprecise articulation. Thus, these markers immediately identify the person as such, through their speech, resulting in social and psychological impacts in their lives(1,2). Therefore, aiming to rehabilitate people with HL, improve their acquisition of oral language and inclusion in the verbal community, various hearing devices have been developed, such as the hearing aid (HA) and the cochlear implant (CI). The HA is an external amplification device that habilitates or rehabilitates the person with mild to severe HL. As for people with bilateral severe to profound sensorineural HL, the acoustic gain provided by the HA may be limited, restricted to detecting only high-intensity sounds. As an alternative, the CI is an implantable electronic device that sends electric stimuli to the auditory nerve, enabling the person to receive sound stimuli and comprehend speech(3). The person with HL has impaired auditory feedback – i.e., a lessened or absent auditory perception of the sound stimuli produced by their own voice when speaking, due to HL. Since the absence of auditory feedback has an impact on vocal control, a person lacking it creates inadequate voice production patterns and has difficulties in the reestablishment or improvement of their voice quality, and even in the voice rehabilitation process(4). Studies have described that auditory feedback deprivation influences the control of fundamental frequency and precision of speech articulation, in addition to acoustic parameters – such as shimmer (sound wave amplitude variation), jitter (wave frequency variation), harmonics-to-noise ratio, and formants – when compared with the standards established for normal hearing people(4-6). Some studies conducted with this specific population, in addition to the abovementioned findings, also inferred that there is a correlation between the auditory detection data and the capacity to maintain speech frequency, demonstrating that the hearing device, responsible for promoting the rehabilitation of the auditory threshold, has a strong relationship with voice quality(4-6). There are scarce reports of research analyzing the voice of people with HL and their auditory rehabilitation devices and i (...truncated)