Nasalance distance and ratio: Two new measures

Abstract

Objectives: 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). Setting: Department of Oral and Maxillofacial Surgery, University of Technology, Munich, Germany. Subjects: The sample consisted of 133 cleft lip and palate patients with normal nasal resonance or varying degrees of hypernasality. Procedures: Oral and nasal acoustic measurements were made using the NasalView system. Nasalance distance and nasalance ratio were calculated for five nonnasal 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.