Computer-assisted voice analysis - Establishing a pediatric database

Objectives: To establish and characterize the first pediatric normative database for the Multi-Dimensional Voice Program, a computerized voice analysis system, and to compare the normative data with the vocal profiles of patients with vocal fold nodules. Design: A cross-sectional, observational design was used to establish the normative database. The comparative study was completed using a case-control design. Setting: University-based outpatient pediatric otolaryngology clinic. Participants: One hundred control subjects (50 boys and 50 girls) aged 4 to 18 years contributed to the normative database. The voices of 26 patients (19 boys and 7 girls) with bilateral vocal fold nodules were also analyzed. Main Outcome Measures: Demographic data, including sex, age, height, weight, body mass index, and cigarette smoke exposure, were obtained. The Multi-Dimensional Voice Program extracted up to 33 acoustic variables from each voice analysis. Results: The mean (SEM) values of each of the acoustic variables are presented. At age 12 years, boys experience a dramatic decrease in fundamental frequency measurements. The voices of patients with vocal fold nodules had significantly elevated frequency perturbation measurements compared with control subjects (P<.001). Conclusions: The vocal profile of children is uniform across all girls and prepubescent boys. Patients with vocal fold nodules demonstrated a consistent acoustic profile characterized by an elevation in frequency perturbation measurements. Normal acoustic reference ranges may be used to detect various vocal fold pathologic abnormalities and to monitor the effects of voice therapy.