title: Nasalance distance and ratio: two new measures.
abstract: OBJECTIVE
  Mean nasalance in speakers with perceptually normal nasal resonance can differ in magnitude considerably. In addition, categorizations of speech based on nasalance scores may not agree with perceptual judgments. To overcome this limitation, we evaluated two new simple measures derived from mean nasalance data: the nasalance distance (range between maximum and minimum nasalance) and the nasalance ratio (minimum nasalance divided by maximum nasalance).
  
  
  METHODS
  Department of Oral and Maxillofacial Surgery, University of Technology, Munich, Germany.
  
  
  METHODS
  The sample consisted of 133 cleft lip and palate patients with normal nasal resonance or varying degrees of hypernasality.
  
  
  METHODS
  Oral and nasal acoustic measurements were made using the NasalView system. Nasalance distance and nasalance ratio were calculated for five non-nasal and three nasal sentences from the modified Heidelberg Rhinophonia Assessment Form.
  
  
  RESULTS
  Optimum cutoffs were derived from receiver-operating characteristics. Results for the sentence stimuli ranged from 64.4% to 89.6% sensitivity and from 91.2% to 94.1% specificity. When the analysis was limited to only one nonnasal and one nasal sentence, results ranged from 79.7% to 87.5% sensitivity and from 88.2% to 97.1% specificity.
  
  
  CONCLUSIONS
  We conclude that the two new measurements are valuable in routine clinical examinations. Nasalance distance and ratio derived from sentence stimuli are two useful and easily applicable measures that can be used to supplement the nasalance mean value.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Technology, Klinikum rechts der Isar, Munich, Germany. tbressma@mkg.med.tu-muenchen.de
authors.forename: T
authors.initials: T
authors.lastname: Bressmann
authors.forename: R
authors.initials: R
authors.lastname: Sader
authors.forename: T L
authors.initials: TL
authors.lastname: Whitehill
authors.forename: S N
authors.initials: SN
authors.lastname: Awan
authors.forename: H F
authors.initials: HF
authors.lastname: Zeilhofer
authors.forename: H H
authors.initials: HH
authors.lastname: Horch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002971:Cleft Lip / Q000150:complications / Q000175:diagnosis; D002972:Cleft Palate / Q000150:complications / Q000175:diagnosis; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010699:Phonation; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013064:Speech Disorders / Q000175:diagnosis / Q000209:etiology; D013068:Speech Production Measurement / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D014833:Voice Quality