Voice Changes in Laryngeal Intraepithelial Neoplasia and Nonneoplastic Lesions

OBJECTIVES: The objectives were to (1) compare the voices of patients with laryngeal intraepithelial neoplasia (LIN) or nonneoplastic lesions (NNL) to a control group matched in gender, age, and smoking habits, and (2) investigate if voice characteristics can be used as a supplementary diagnostic tool to distinguish NNL and LIN.

STUDY DESIGN: Between-subject case-control study.

METHODS: Comparison of patients with LIN (n = 126), patients with NNL (n = 110), and a control group (n = 100) matched in age, gender, and smoking habits. A multidimensional voice assessment protocol was applied: (1) voice and speech range profiles (SRP); (2) aerodynamics; (3) cepstral analysis; (4) patient-evaluated voice handicap; and (5) auditory perceptual assessment.

RESULTS: The voices in both patient groups differed significantly (P < 0.05) from the control group in all parameters of voice and SRP, aerodynamics, cepstral analysis, and patient-evaluated voice handicap, except for the females' mean speaking fundamental frequency. The overall grade of dysphonia and breathiness in the auditory perceptual assessment was significantly higher in both patient groups as were aphonia (NNL) and hyperfunctionality (LIN). The remaining parameters were not significantly different. Patients with LIN were rated as having significantly more hyperfunctional voices than patients with NNL.

CONCLUSION: LIN and NNL affect the voice extensively. Assessment of voice intensity, maximum phonation time, cepstral peak prominence, self-assessed voice handicap, and overall grade of dysphonia and breathiness rated by auditory perceptual assessment, are recommended, in order to provide a standard of reference after treatment. Although patients with LIN had more hyperfunctional voices than patients with NNL, voice parameters cannot separate NNL from LIN.