Multidimensional evaluation of vocal quality in children with cochlear implants: a cross-sectional, case-controlled study
Article first published online: 27 FEB 2014
© 2013 John Wiley & Sons Ltd
Volume 39, Issue 1, pages 32–38, February 2014
How to Cite
Clin. Otolaryngol. 2014, 39, 32–38
- Issue published online: 27 FEB 2014
- Article first published online: 27 FEB 2014
- Accepted manuscript online: 26 DEC 2013 07:41AM EST
- Manuscript Accepted: 12 DEC 2013
This study aimed to compare the differences in vocal quality between Mandarin-speaking children with cochlear implants and normal-hearing peers and to understand which cochlear implant usage parameters may predict unfavourable voice outcomes.
A cross-sectional, case-controlled study.
A tertiary medical centre.
Thirty-five pre-lingually deaf children (age = 10.3 ± 1.6 years; 17 boys and 18 girls) who had used cochlear implants for >2 years and 35 age- and gender-matched controls with normal hearing.
Main outcome measures
Through sustained phonation of /a/ and reading of the Hare and Tortoise passage, the subjects' voice quality was analysed with aerodynamics and acoustics. A six-point scale was used for auditory-perceptual evaluation. A Pediatric Voice-Related Quality of Life Survey was filled out by the caregivers.
The implanted subjects had significantly lower mean airflow rate (P = 0.006), higher phonation threshold pressure (P < 0.001), higher fundamental frequency variations (P < 0.001) and peak-amplitude variations (P < 0.001), wider fundamental frequency range (P = 0.043), wider speaking intensity range (P = 0.015) and greater perceptual severity level of monotone (P < 0.001), resonance (P < 0.001), loudness (P < 0.001) and strain (P = 0.006) than their normal-hearing peers. Duration of postoperative rehabilitation was an independent predictor of unfavourable mean speaking fundamental frequency (odds ratio = 8.56, P = 0.008).
Inadequate postoperative rehabilitation may hinder the normalisation of Mandarin-speaking implantees' voice quality. A multidimensional analysis may precisely evaluate the voice of paediatric implantees; however, the generalisability of these findings requires different forms of validation, including data from other languages and other institutions.