title: Acoustic analysis of the voice in pediatric cochlear implant recipients: a longitudinal study.
abstract: OBJECTIVE
  To characterize inherent acoustic abnormalities of the deaf pediatric voice and the effect of artificially restoring auditory feedback with cochlear implantation.
  
  
  METHODS
  Inception cohort.
  
  
  METHODS
  Academic referral center.
  
  
  METHODS
  Twenty-one children with severe to profound hearing loss (15 prelingually deaf, 6 postlingually deaf) accepted into the cochlear implant program were followed for up to 6 months. Patients unable to perform the vocal exercises were excluded.
  
  
  METHODS
  Objective voice analysis was performed using the Computerized Speech Laboratory (Kay Elemetrics) prior to cochlear implantation, at the time of implant activation and at 2 and 6 months postactivation. Assessments were based on sustained phonations and dynamic ranges.
  
  
  METHODS
  Fundamental frequency, long-term control of fundamental frequency (vF0) and long-term control of amplitude (vAM) were derived from sustained phonations. The dynamic frequency range was derived from scale exercises. Formant frequencies (F1, F2, F3) were determined using linear predictive coding.
  
  
  RESULTS
  Fundamental frequency was not altered by implant activation or experience (P = 0.342). With profoundly deaf subject, the most prevalent acoustic abnormality was a poor long-term control of frequency (vF0, 2.81%) and long-term control of amplitude (vAm, 23.58%). Implant activation and experience had no effect on the long-term control of frequency (P = 0.106) but normalized the long-term control of amplitude (P = 0.007). The mean frequency range increased from 311.9 Hz preimplantation to 483.5 Hz postimplantation (P = 0.08). The F1/F2 ratio remained stable (P = 0.476).
  
  
  CONCLUSIONS
  In children, severe to profound deafness results in poor long-term control of frequency and amplitude. Cochlear implantation restores control of amplitude only and implies the need for additional rehabilitative strategies for restoration of control of frequency.
authors.affiliation: Centre for Pediatric Voice and Laryngeal Function, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Campisi
authors.forename: A
authors.initials: A
authors.lastname: Low
authors.forename: B
authors.initials: B
authors.lastname: Papsin
authors.forename: R
authors.initials: R
authors.lastname: Mount
authors.forename: R
authors.initials: R
authors.lastname: Cohen-Kerem
authors.forename: R
authors.initials: R
authors.lastname: Harrison
mesh_terms: D000162:Acoustics; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation; D003638:Deafness / Q000503:physiopathology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D014831:Voice