Perceptual and acoustic assessment of a child’s speech before and after laryngeal web surgery

The aim of this paper was to point to the importance of early diagnostics and surgery in patients with laryngeal web in order to achieve normal breathing, as well as to stress the need for an interdisciplinary approach to observing the quality of voice and prosodic features at an early age. The subject under consideration was a 6.5-year-old girl who had previously been diagnosed with irregular breathing (R06). An endoscopic exam revealed a laryngeal web between the vocal folds and the fact that the posterior intercartilaginous section of the glottis of the child’s larynx was in order (normal). The child’s speech had been recorded in the acoustic studio, both before and after the vocal-fold surgery (six and twelve months later). Due to severe dysphonia, difficulties with breathing, and frequent noisy breathing (stridor), we recorded only the phonation of the vowel [a], as well as spontaneous speech before the surgery. In addition, there was intense glottic and supraglottic strain before the surgery, which in phonetics corresponds to the term laryngeal and supralaryngeal strain and pathologically creaky whispery phonation (according to VPA protocol). This strain was visible in the area of the chest, neck, and head, as well as audible in the voice quality. Acoustic analysis showed that the average F0 for the vowel [a] was remarkably high (442 Hz), and the pathological values were established using the following measures: local jitter (1.68%), local shimmer (0.7 dB), and the harmonic to noise ratio (17.6 dB). In contrast, six months after the surgery, the pitch for [a] was half the value of the preoperative one (220.5 Hz, p < 0.001), and the local jitter for all vowels (0.30-0.47%) and the harmonic to noise ratio (22.46 dB, p = 0.05) was within the normal range. There was also significant improvement in the F0 values, standard deviation of F0, and minimum and maximum F0 values. The average and median F0 values in spontaneous speech were also lower postoperatively. The voice quality showed a more balanced timbre (LTASS), particularly after one year. Some other prosodic features also showed improvement.