Purpose: In this study, the authors evaluated the diagnostic value of spectral/cepstral measures to differentiate dysphonic from nondysphonic voices using sustained vowels and continuous speech samples. Methodology: Thirty-two age- and gender-matched individuals (16 participants with dysphonia and 16 controls) were recorded reading a standard passage (The Rainbow Passage; Fairbanks, 1960) and sustaining the vowel /ɑ/. Recorded voices were analyzed with custom software that calculated 4 spectral/cepstral measures. Results: Measures of cepstral peak prominence (CPP) and low–high spectral ratio (L/H ratio) were significantly different between groups in both speaking conditions; the standard deviation of the CPP was significantly different between groups in continuous speech only. In differentiating dysphonic individuals with a hypofunctional etiology from nondysphonic individuals, receiver operating characteristic (ROC) analyses demonstrated (a) high sensitivity and high specificity for the CPP in the sustained vowel condition and (b) high sensitivity and moderate specificity for the CPP in the speech condition. Conclusions: In a sample of dysphonic speakers (hypofunctional etiologies) versus typical speakers, spectral/cepstral measures of CPP and L/H ratio were able to differentiate these groups from one another in both vowel prolongation and continuous speech contexts with high sensitivity and specificity. The results of this study support the growing body of literature documenting the significant value of cepstral and other spectral-based acoustic measures to the clinical evaluation and management processes.

Background: The assessment of voice quality can be evaluated perceptually with standard clinical practice, also including acoustic evaluation of digital voice recordings to validate and further interpret perceptual judgments. The goal of the present study was to determine the strongest acoustic voice quality parameters for perceived hoarseness and breathiness when analyzing the sustained vowel [a:] using a new clinical acoustic tool, the VOXplot software. Methods: A total of 218 voice samples of individuals with and without voice disorders were applied to perceptual and acoustic analyses. Overall, 13 single acoustic parameters were included to determine validity aspects in relation to perceptions of hoarseness and breathiness. Results: Four single acoustic measures could be clearly associated with perceptions of hoarseness or breathiness. For hoarseness, the harmonics-to-noise ratio (HNR) and pitch perturbation quotient with a smoothing factor of five periods (PPQ5), and, for breathiness, the smoothed cepstral peak prominence (CPPS) and the glottal-to-noise excitation ratio (GNE) were shown to be highly valid, with a significant difference being demonstrated for each of the other perceptual voice quality aspects. Conclusions: Two acoustic measures, the HNR and the PPQ5, were both strongly associated with perceptions of hoarseness and were able to discriminate hoarseness from breathiness with good confidence. Two other acoustic measures, the CPPS and the GNE, were both strongly associated with perceptions of breathiness and were able to discriminate breathiness from hoarseness with good confidence.