YOLANDA D. HEMAN-ACKAH, MD; REINHARDT J. HEUER, PHD; DEIDRE D. MICHAEL, PHD; MARGARET M. BAROODY, MM; MICHELLE HORMAN, BM, MA; ROSEMARY OSTROWSKI, MM; ROBERT T. SATALOFF, MD, DMA
PHILADELPHIA, PENNSYLVANIA

Quantification of perceptual voice characteristics allows the assessment of voice changes. Acoustic measures of jitter, shimmer, and noise-to-harmonics ratio (NHR) are often unreliable. Measures of cepstral peak prominence (CPP) may be more reliable predictors of dysphonia and breathiness. Voice samples from 281 patients were analyzed by trained listeners. We obtained NHR, amplitude perturbation quotient, smoothed pitch perturbation quotient, percent jitter, and CPP (CPPS-ah) from sustained vowel phonation; and CPP (CPPS-s) was obtained from running speech. For the first time, normal and abnormal values of CPP were defined, and they were compared with other acoustic measures used to predict dysphonia and breathiness. CPPS-s and CPPS-ah correlated with dysphonia (r =-.77 and r =-.70, respectively; p < .001) and CPPS-s with breathiness (r =-.70, p < .001) to a greater degree than did any of the other measures (r = .59 and r = .53, respectively, p < .001). CPPS-s is a good predictor and a more reliable measure of dysphonia and breathiness than acoustic measures of jitter, shimmer, and NHR.