L'évaluation objective des dysfonctionnements de la voix et de la parole; 2e partie: les dysphonies
Résumé
The objective assessment of voice and speech disorders - 2) Dysphoniaia
The evaluation of voice quality and the perception of the causes of its impairment through various acoustic cues has always been the main clinical concern of speech therapists. As in other medical disciplines, they have been particularly heedful of all techniques which might be capable of supplying more information as a diagnostic aid and to evaluate the effect of surgical or chemical treatment or the progress of re-education. Since the very purpose of the human voice is to be heard, subjective evaluation by listening tests remain the standard reference compared to a number of objective evaluation methods which have been proposed and which have often little justification and are of doubtful efficiency. In this study we present different acoustic and aerodynamic methods which have all been applied and tested with the EVA1 and 2 systems. Despite some weaknesses, the objective evaluation of dysphonia is making both qualitative and quantitative progress, driven by the need for objective appraisals in response to expert evaluations and to the expectations of patients which tend to impose such techniques more and more in association with more traditional methods.
The evaluation of voice quality and the perception of the causes of its impairment through various acoustic cues has always been the main clinical concern of speech therapists. As in other medical disciplines, they have been particularly heedful of all techniques which might be capable of supplying more information as a diagnostic aid and to evaluate the effect of surgical or chemical treatment or the progress of re-education. Since the very purpose of the human voice is to be heard, subjective evaluation by listening tests remain the standard reference compared to a number of objective evaluation methods which have been proposed and which have often little justification and are of doubtful efficiency. In this study we present different acoustic and aerodynamic methods which have all been applied and tested with the EVA1 and 2 systems. Despite some weaknesses, the objective evaluation of dysphonia is making both qualitative and quantitative progress, driven by the need for objective appraisals in response to expert evaluations and to the expectations of patients which tend to impose such techniques more and more in association with more traditional methods.
L'évaluation de la qualité de la voix et la perception des causes de sa dégradation à travers différents indices acoustiques a toujours été la préoccupation clinique principale des phoniatres. Comme dans les autres disciplines médicales, ils ont été attentifs à toutes les techniques qui seraient susceptibles de leur donner des informations complémentaires, pour aider au diagnostic et évaluer les effets des traitements chirurgicaux ou médicamenteux ou les progrès d'une rééducation. Cependant, la voix étant par essence émise pour être entendue, l'évaluation subjective " à l'écoute" reste la référence face à des méthodes d'évaluation objective très variées, souvent mal fondées et à l'efficacité parfois contestée. Nous présentons dans cette étude différentes méthodes acoustiques et aérodynamiques que nous avons toutes appliquées et testées avec les systèmes EVA 1 et 2. Malgré quelques faiblesses, les évaluations objectives des dysphonies progressent en qualité et pertinence, poussées par la nécessité de disposer de bilans objectifs dans le but de répondre à des expertises, autant qu'aux attentes des patients qui imposent peu à peu l'utilisation de telles méthodes en association avec celles plus traditionnelles.
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