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Electroglottogram approximate entropy: a novel single parameter for objective voice assessment

Published online by Cambridge University Press:  04 February 2010

C M Douglas ,
C Moore ,
K Manickam ,
L Lee ,
A Sykes ,
A Carr ,
S Jones ,
J Jones ,
R Swindell  and
J J Homer
...Show all authors
C M Douglas*
Affiliation:
Department of Head and Neck Surgery, Christie Hospital NHS Trust, Manchester, UK
C Moore
Affiliation:
Department of Medical Physics, Christie Hospital NHS Trust, Manchester, UK
K Manickam
Affiliation:
Department of Medical Physics, Christie Hospital NHS Trust, Manchester, UK
L Lee
Affiliation:
Department of Clinical Oncology, Christie Hospital NHS Trust, Manchester, UK
A Sykes
Affiliation:
Department of Clinical Oncology, Christie Hospital NHS Trust, Manchester, UK
A Carr
Affiliation:
Department of Speech and Language Therapy, Christie Hospital NHS Trust, Manchester, UK
S Jones
Affiliation:
Department of Speech and Language therapy, Wythenshawe Hospital, South Manchester University NHS trust, Manchester, UK
J Jones
Affiliation:
Department of Speech and Language Therapy, Christie Hospital NHS Trust, Manchester, UK
R Swindell
Affiliation:
Department of Medical Statistics, Christie Hospital NHS Trust, Manchester, UK
J J Homer
Affiliation:
Department of Head and Neck Surgery, Christie Hospital NHS Trust, Manchester, UK
N Slevin
Affiliation:
Department of Clinical Oncology, Christie Hospital NHS Trust, Manchester, UK
*
Address for correspondence: Dr C Douglas, Department of Head and Neck Surgery, Christie Hospital NHS Trust, Manchester M20 4BX, UK. Fax: 01614468593 E-mail: [email protected]
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Abstract

Background:

The electroglottogram approximate entropy value is a numerical variable which gives an overall measure of voice quality. It is derived by analysing the complexity of the electroglottogram waveform using regulatory statistics.

Aims:

(1) To use electroglottogram approximate entropy to measure voice quality in patients with glottic pathology and in normal subjects, to ascertain whether this parameter can distinguish between pathological and normal voices. (2) To ascertain whether electroglottogram approximate entropy can measure voice change over time within individual subjects. (3) To determine any correlation between electroglottogram approximate entropy and the grade–roughness–breathiness–asthenia–strain scale.

Methods:

One hundred and forty-one normal volunteers were recruited to characterise electroglottogram approximate entropy in the normal voice. One hundred and eighty-six patients with glottic squamous cell carcinoma underwent electroglottogram approximate entropy measurement prior to radiotherapy and then three to six months and one year after treatment. Subjects’ voices were categorised by a speech therapist using the grade–roughness–breathiness–asthenia–strain scale.

Results:

The mean electroglottogram approximate entropy of the normal volunteers was 0.302 (range 0.05–0.42). The mean electroglottogram approximate entropy of the glottic squamous cell carcinoma patients was significantly lower prior to treatment, at 0.227 (range 0.001–0.397; p < 0.0005), but improved after radiotherapy to 0.277 at three to six months and 0.282 at one year. Electroglottogram approximate entropy results correlated significantly with grade–roughness–breathiness–asthenia–strain scale results.

Conclusion:

Electroglottogram approximate entropy can be used to assess change in voice quality resulting from glottic morphological abnormality. Electroglottogram approximate entropy values improve as voice quality improves after treatment. Electroglottogram approximate entropy values correlate significantly with grade–roughness–breathiness–asthenia–strain scale results.

Keywords

VoiceLaryngeal NeoplasmAssessmentOutcomesRadiotherapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 5 , May 2010 , pp. 520 - 528
Copyright
Copyright © JLO (1984) Limited 2010

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Footnotes

Presented at the British Voice Association Research Study Day, 22nd February 2008, London, UK.

References

1Hirano, M. Clinical examination of voice. Wien, New York: Springer-Verlag, 1981Google Scholar
2Carding, P. BMJ 2001;323:645–6CrossRefGoogle Scholar
3Dejonckere, PH, Remacle, M, Fresnel-Elbaz, E, Woisard, V, Crevier-Buchman, L, Millet, B. Differentiated perceptual evaluation of pathological voice quality: reliability and correlations with acoustic measurements. Rev Laryngol Otol Rhinol (Bord) 1996;117:219–24Google ScholarPubMed
4Dejonckere, PH, Obbens, C, de Moor, GM, Wieneke, GH. Folia Phoniatr (Basel). Perceptual evaluation of dysphonia: reliability and relevance. 1993;45:76–83Google Scholar
5Laver, J. The phonetic description of voice quality. Cambridge: Cambridge University Press, 1980Google Scholar
6Wilson, DK. Voice problems of children, 3rd ed. Baltimore: Williams and Wilkins, 1987Google Scholar
7Carding, P, Carlson, E, Epstein, R, Mathieson, L, Shewell, C. Formal perceptual evaluation of voice quality in the United Kingdom. Logoped Phoniatr Vocol 2000;25:133–8CrossRefGoogle ScholarPubMed
8Fourcin, AJ, Abberton, E. First application of a new laryngograph. Medical and biological Illustration. 1971;21:172–82Google ScholarPubMed
9Mathieson, L. The voice and Its Disorders, 6th edn. London: Whurr, 2001Google Scholar
10Kazi, R, Venkitaraman, R, Johnson, C, Prasad, V, Clarke, P, Rhys-Evans, P et al. Prospective, longitudinal electroglottographic study of voice recovery following accelerated hypofractionated radiotherapy for T1/T2 larynx cancer. Int J Radiat Oncol Biol Phys 2008;87:230–6Google ScholarPubMed
11Manickam, K, Moore, C, Willard, T, Slevin, N. Quantifying aberrant phonation using approximate entropy in electrolaryngography. Speech Commun 2005;47:312–21CrossRefGoogle Scholar
12Moore, C, Manickam, K, Willard, T, Jones, S, Slevin, N, Shalet, S. Spectral pattern complexity analysis and the quantification of voice normality in healthy and radiotherapy patient groups. Med Eng Phys 2004;26:291–301CrossRefGoogle ScholarPubMed
13Pincus, SM. Approximate entropy (ApEn) as a complexity measure. Journal of Chaos 1988;5:110–17CrossRefGoogle Scholar
14 In: http://info.cancerresearchuk.org/cancerstats/types/larynx/index.htm [27 September 2008]Google Scholar
15Spector, JG, Sessions, DG, Chao, KS, Haughey, BH, Hanson, JM, Simpson, JR et al. Stage I (T1 N0 M0) squamous cell carcinoma of the laryngeal glottis: therapeutic results and voice preservation. Head Neck 1999;21:707–173.0.CO;2-2>CrossRefGoogle Scholar
16Steiner, W. Results of curative laser microsurgery of laryngeal carcinomas. Am J Otolaryngol 1993;14:116–21CrossRefGoogle ScholarPubMed
17Barthel, SW, Esclamado, RM. Primary radiation therapy for early glottic cancer. Otolaryngol Head Neck Surg 2001;124:35–9CrossRefGoogle ScholarPubMed
18Gallo, A, de Vincentiis, M, Manciocco, V, Simonelli, M, Fiorella, ML, Shah, JP. CO2 laser cordectomy for early-stage glottic carcinoma: a long-term follow-up of 156 cases. Laryngoscope 2002;112:370–4CrossRefGoogle ScholarPubMed
19Epstein, BE, Lee, DJ, Kashima, H, Johns, ME. Stage T1 glottic carcinoma: results of radiation therapy or laser excision. Radiology 1990;175:567–70CrossRefGoogle ScholarPubMed
20Rydell, R, Schalen, L, Fex, S, Elner, A. Voice evaluation before and after laser excision vs. radiotherapy of T1A glottic carcinoma. Acta Otolaryngol 1995;115:560–5CrossRefGoogle ScholarPubMed
21McGuirt, WF, Blalock, D, Koufman, JA, Feehs, RS, Hilliard, AJ, Greven, K et al. Comparative voice results after laser resection or irradiation of T1 vocal cord carcinoma. Arch Otolaryngol Head Neck Surg 1994;120:951–5CrossRefGoogle ScholarPubMed
22Tamura, E, Kitahara, S, Ogura, M, Kohno, N. Voice quality after laser surgery or radiotherapy for T1a glottic carcinoma. Laryngoscope 2003;113:910–14CrossRefGoogle ScholarPubMed
23Wedman, J, Heimdal, JH, Elstad, I, Olofsson, J. Voice results in patients with T1a glottic cancer treated by radiotherapy or endoscopic measures. Eur Arch Otorhinolaryngol 2002;259:547–50CrossRefGoogle ScholarPubMed
24Benninger, MS, Gillen, J, Thieme, P, Jacobson, B, Dragovich, J. Factors associated with recurrence and voice quality following radiation therapy for T1 and T2 glottic carcinomas. Laryngoscope 1994;104:294–8CrossRefGoogle ScholarPubMed
25Hoyt, DJ, Lettinga, JW, Leopold, KA, Fisher, SR. The effect of head and neck radiation therapy on voice quality. Laryngoscope 1992;102:477–80CrossRefGoogle ScholarPubMed
26Stewart, MG, Chen, AY, Stach, CB. Outcomes analysis of voice and quality of life in patients with laryngeal cancer. Arch Otolaryngol Head Neck Surg 1998;124:143–8CrossRefGoogle ScholarPubMed
27Krengli, M, Policarpo, M, Manfredda, I, Aluffi, P, Gambaro, G, Panella, M et al. Voice quality after treatment for T1a glottic carcinoma – radiotherapy versus laser cordectomy. Acta Oncol 2004;43:284–9CrossRefGoogle ScholarPubMed
28Goor, KM, Peeters, AJ, Mahieu, HF, Langendijk, JA, Leemans, CR, Verdonck-de Leeuw, IM et al. Cordectomy by CO2 laser or radiotherapy for small T1a glottic carcinomas: costs, local control, survival, quality of life, and voice quality. Head Neck 2007;29:128–36CrossRefGoogle ScholarPubMed