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Effects on Voice Quality of Thyroidectomy: A Qualitative and Quantitative Study Using Voice Maps
KTH, School of Electrical Engineering and Computer Science (EECS), Intelligent systems, Speech, Music and Hearing, TMH. (Music Acoustics)ORCID iD: 0000-0003-0700-7216
KTH, School of Electrical Engineering and Computer Science (EECS), Intelligent systems, Speech, Music and Hearing, TMH.ORCID iD: 0000-0002-3362-7518
University of Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France; Medical School, Université Grenoble Alpes, Grenoble, France.ORCID iD: 0000-0002-7954-2798
University of Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France.ORCID iD: 0000-0002-3944-611X
2026 (English)In: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, Vol. 40, no 4, p. 1249.e21-1249.e42Article in journal (Refereed) Published
Abstract [en]

Objectives: This study aims to explore the effects of thyroidectomy—a surgical intervention involving the removal of the thyroid gland—on voice quality, as represented by acoustic and electroglottographic measures. Given the thyroid gland's proximity to the inferior and superior laryngeal nerves, thyroidectomy carries a potential risk of affecting vocal function. While earlier studies have documented effects on the voice range, few studies have looked at voice quality after thyroidectomy. Since voice quality effects could manifest in many ways, that a priori are unknown, we wish to apply an exploratory approach that collects many data points from several metrics.

Methods: A voice-mapping analysis paradigm was applied retrospectively on a corpus of spoken and sung sentences produced by patients who had thyroid surgery. Voice quality changes were assessed objectively for 57 patients prior to surgery and 2 months after surgery, by making comparative voice maps, pre- and post-intervention, of six acoustic and electroglottographic (EGG) metrics.

Results: After thyroidectomy, statistically significant changes consistent with a worsening of voice quality were observed in most metrics. For all individual metrics, however, the effect sizes were too small to be clinically relevant. Statistical clustering of the metrics helped to clarify the nature of these changes. While partial thyroidectomy demonstrated greater uniformity than did total thyroidectomy, the type of perioperative damage had no discernible impact on voice quality.ConclusionsChanges in voice quality after thyroidectomy were related mostly to increased phonatory instability in both the acoustic and EGG metrics. Clustered voice metrics exhibited a higher correlation to voice complaints than did individual voice metrics.

Place, publisher, year, edition, pages
Elsevier, 2026. Vol. 40, no 4, p. 1249.e21-1249.e42
Keywords [en]
thyroidectomy, voice quality, electroglottography, voice classification, voice mapping
National Category
Otorhinolaryngology
Research subject
Speech and Music Communication
Identifiers
URN: urn:nbn:se:kth:diva-346224DOI: 10.1016/j.jvoice.2024.03.012PubMedID: 38714436Scopus ID: 2-s2.0-85192255370OAI: oai:DiVA.org:kth-346224DiVA, id: diva2:1856526
Funder
KTH Royal Institute of Technology, 6308
Note

QC 20260710

Available from: 2024-05-07 Created: 2024-05-07 Last updated: 2026-07-10Bibliographically approved
In thesis
1. Mapping voice quality in normal, pathological and synthetic voices
Open this publication in new window or tab >>Mapping voice quality in normal, pathological and synthetic voices
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Voice quality evaluation is an integral aspect of both clinical and technological applications, encompassing areas such as speech therapy, phonation disorder diagnosis, and text-to-speech (TTS) synthesis. Traditional methods of assessing voice quality are often subjective, relying on auditory-perceptual evaluation scales, which introduce variability and bias. This thesis explores several novel applications for objective voice quality assessment, utilizing voice mapping—a visualization technique that integrates voice range and quality metrics. By plotting acoustic and electroglottographic (EGG) metrics across a plane defined by fundamental frequency (fo) and sound pressure level (SPL), voice mapping enables a comprehensive understanding of vocal characteristics.

This thesis is based on a compilation of five studies, three of which have been published in archive journals and two of which are in revision at this writing. Paper I establishes the foundational relationship between voice metrics and the fo and the SPL using data from individuals with vocal disorders. Paper II extends the methodology by employing clustering techniques to classify phonation types based on a diverse dataset of normophonic adults and children. Paper III applies voice mapping to pre- and post-thyroidectomy recordings, revealing surgery-induced changes in voice quality and range. Paper IV develops a deep learning-based model for predicting EGG signals from acoustic recordings. Paper V demonstrates the utility of voice mapping in evaluating the performance of synthetic TTS voices, indicating its potential for objective, metric-based TTS quality assessment.

This thesis further speaks for the importance of integrating acoustic and EGG metrics to achieve an objective assessment of voice quality. The metrics used in this approach, including acoustic and EGG-based measures, capture aspects of phonation in both the time and frequency domains, enabling detailed characterization of vocal dynamics. The findings demonstrate that voice mapping is effective not only in clinical settings for understanding voicedisorders but also offers a robust framework for evaluating synthetic voices, helping to bridge the gap between perceptual evaluation and quantitative analysis. Future directions include refining clustering methodologies, enhancing EGG prediction accuracy, and expanding the application of voice mapping to broader clinical and technological applications.

Abstract [sv]

Utvärdering av röstkvalitet är en viktig aspekt inom både kliniska och teknologiska tillämpningar och omfattar områden som talterapi, diagnos av fonationsstörningar och text-till-tal (TTS) syntes. Traditionella metoder för att bedöma röstkvalitet är ofta subjektiva och bygger på auditiv-perceptuella utvärderingsskalor, vilket kan leda till variation och partiskhet. Denna avhandling utforskar flera nya tillämpningar för objektiv röstkvalitetsbedömning med hjälp av röstkartläggning – en visualiseringsteknik som integrerar röstomfång och kvalitetsmått. Genom att plotta akustiska och elektroglottografiska (EGG) mått på ett plan definierat av grundtonsfrekvens (fo) och ljudtrycksnivå (SPL), möjliggör röstkartläggning en omfattande förståelse av röstegenskaper.

Denna avhandling bygger på en sammanställning av fem studier, varav tre har publicerats i arkivtidskrifter, och två i skrivande stund är under granskning. Artikel I påvisar det grundläggande beroendet hos röstmått av grundtonsfrekvens och ljudtrycksnivå, genom analys av data från individer med röststörningar. Artikel II utökar metodiken genom att använda klustringstekniker för att klassificera fonationstyper baserat på ett inspelnings-korpus av normofoniska vuxna och barn. Artikel III tillämpar röstkartläggning på inspelningar före och efter tyroidektomi och påvisar kirurgiska förändringar i röstkvalitet och omfång. Artikel IV redogör för en djupinlärningsbaserad modell för att förutspå EGG-signaler från akustiska inspelningar. Artikel V visar nyttan av röstkartläggning vid utvärdering av syntetiska TTS-röster och lyfter fram dess potential för objektiv, måttbaserad bedömning av TTS-kvalitet.

Denna avhandling belyser vikten av att integrera akustiska och EGG-mått för att uppnå en objektiv bedömning av röstkvalitet. De mått som används i denna metodik, inklusive akustiska och EGG-baserade mått, fångar aspekter av fonation i såväl tids- som frekvensdomänen, vilket möjliggör en detaljerad karakterisering av röstens dynamik. Resultaten visar att röstkartläggning är effektiv inte bara i kliniska miljöer för att förstå röststörningar utan också erbjuder en robust ram för utvärdering av syntetiska röster. Röstkartor bidrar till synergin mellan perceptuell och kvantitativ röstanalys. Framtida forskningsinriktningar inkluderar förbättring av klustringsmetoder, ökad noggrannhet i EGG-prediktion och utvidgning av röstkartläggning till bredare kliniska och teknologiska tillämpningar.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2025. p. 72
Series
TRITA-EECS-AVL ; 2025:25
Keywords
Voice quality, voice mapping, text-to-speech (TTS), electroglottography (EGG), acoustic metrics, Röstkvalitet, röstkartläggning, text-till-tal (TTS), elektroglottografi (EGG), akustiska mått
National Category
Signal Processing
Research subject
Computer Science
Identifiers
urn:nbn:se:kth:diva-360211 (URN)978-91-8106-206-9 (ISBN)
Public defence
2025-03-14, https://kth-se.zoom.us/j/61856204062?pwd=0aLP1ptM9OMUaaXUFuSBxV6bbu74iO.1, Rum B:218, Q2, Malvinas Väg 10, KTH Campus, Stockholm, 14:00 (English)
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Note

QC 20250224

Available from: 2025-02-24 Created: 2025-02-21 Last updated: 2025-03-05Bibliographically approved

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Cai, HuanchenTernström, Sten

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