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Tanvi Shrivastava
Nalanda Medical College, India

Dr. Tanvi Shrivastava has completed her ‘Masters in Otorhinolaryngology and Head and Neck Surgery’ at the age of 28, and has worked as a resident at Netaji Subhash Chandra Bose Medical College, India. She has also attained special training as a fellow in Endoscopic ear and nose surgeries. Her papers have been published in prestigious and reputed national and International journals, and have been presented at various otolaryngology conferences.


Abstract Aim: To evaluate the laryngeal causes of dysphonia, correla­tion of acoustic voice analysis with Indirect laryngoscopic/ endoscopic findings in various voice disorders. Study design: Hospital based prospective observational study. Materials and methods: Forty patients attending the ear nose throat (ENT) outpatient department (OPD) at a Tertiary Care Government Hospital in one year, with dysphonia for more than 15 days were selected. History, examination, endoscopy, voice analysis was done. For consensus auditory-perceptual evaluation of voice (CAPE-V), the voice was analyzed under the following parameters: roughness, breathiness, strain, pitch, loudness, overall severity. Scores were given out of 100. For acoustic analysis, a computer-based software. Praat was used based on jitter, shimmer, noise-harmonic ratio and mean pitch. Result: Benign lesions were most common in adults of age group 21 to 40 years, and malignancy in 41 to 50 years and 61 to 70 years; with male preponderance (4.7:1). Isolated vocal cord palsy (32.5%) was the most common lesion presenting with dysphonia, followed by malignancy (25%). Out of benign lesions, vocal polyp (10%) and nodule (10%) were the commonest, with equal incidence. On analyzing the voice, jitter and shimmer were found to be important parameters depicting the perturbation in frequency and amplitude, respectively. These parameters, indi­rectly, gave an idea about the vibratory motion of the vocal cords. On statistical analysis, jitter and shimmer showed significant direct correlation with the severity of dysphonia (jitter>shimmer). Noise to harmonic ratio (NHR) was raised in a significant number of dysphonic patients, with direct correlation with an increase in jitter. Although a significant relationship between the variation in mean pitch and CAPE V could not be established in this study; instrumental analysis was still useful in documen­tation and quantification of mean pitch in various dysphonic samples. Conclusion: Acoustic measurement of voice is a simple yet powerful tool to analyze the patients with dysphonic voice.

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