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Echternach M, Köberlein M, Döllinger M, Kirsch J, Pilsl T. Does forced whisper have an impact on voice parameters? Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08698-7. [PMID: 38709324 DOI: 10.1007/s00405-024-08698-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES There has been the assumption that whispering may impact vocal function, leading to the widespread recommendation against its practice after phonosurgery. However, the extent to which whispering affects vocal function and vocal fold oscillation patterns remains unclear. METHODS 10 vocally healthy subjects (5 male, 5 female) were instructed to forcefully whisper a standardized text for 10 min at a sound level of 70 dB(A), measured at a microphone distance of 30 cm to the mouth. Prior to and following the whisper loading, the dysphonia severity index was assessed. Simultaneously, recordings of high speed videolaryngoscopy (HSV), electroglottography, and audio signals during sustained phonation on the vowel /i/ (250 Hz for females and 125 Hz for males) were analyzed after segmentation of the HSV material. RESULTS The pre-post analysis revealed only minor changes after the intervention. These changes included a rise in minimum intensity, an increase in the glottal area waveform-derived open quotient, and the glottal gap index. However, no statistically significant changes were observed in the harmonic-to-noise-ratio, the glottal- to-noise-excitation-ratio, and the electroglottographic open quotient. CONCLUSION Overall, the study suggests that there are only small effects on vocal function in consequence of a forced whisper loading.
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Affiliation(s)
- Matthias Echternach
- Division Phoniatrics and Pediatric Audiology, Department of Otolaryngology, Munich University Hospital and Faculty of Medicine, Munich University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany.
| | - Marie Köberlein
- Division Phoniatrics and Pediatric Audiology, Department of Otolaryngology, Munich University Hospital and Faculty of Medicine, Munich University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Michael Döllinger
- Division of Phoniatrics and Pediatric Audiology, Department of Otolaryngology Head & Neck Surgery, University Hospital Erlangen, FAU Erlangen-Nuremberg, Erlangen, Germany
| | - Jonas Kirsch
- Division Phoniatrics and Pediatric Audiology, Department of Otolaryngology, Munich University Hospital and Faculty of Medicine, Munich University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Theresa Pilsl
- Division Phoniatrics and Pediatric Audiology, Department of Otolaryngology, Munich University Hospital and Faculty of Medicine, Munich University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
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Ribeiro VV, Casmerides MCB, da Silva Reis ZMC, de Santana ÍV, do Carmo RD, Behlau M. Efficacy of Speech-language Pathology Therapy in Chronic Cough: Systematic Review With Meta-analysis. J Voice 2024; 38:674-682. [PMID: 34969556 DOI: 10.1016/j.jvoice.2021.11.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To analyze the efficacy of speech-language pathology therapy in the self-assessment, in the cough frequency, and the vocal quality of adults with chronic cough. METHODS This is a systematic review with meta-analysis that answered the clinical question: "In adults with chronic cough, what is the effect of the speech-language pathology therapy in the self-assessment, in the cough frequency, and the vocal quality, compared to another intervention?" (PROSPERO 2021/CRD42021226729). An electronic search (MEDLINE, Web of Science, EMBASE, SCOPUS, Cochrane Library, and Lilacs), and a manual search (Journal of Voice, Brazilian Library of Theses and Dissertations, Open Grey and Clinical Trials) with specific search strategies was performed. The risk of bias was assessed using the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials. Meta-analysis (standardized difference of means, Inverse Variance, and random effects model) and heterogeneity analysis (Chi², Tau², and I²) were performed. RESULTS We found 610 studies and selected three. There was an uncertain risk of detection bias. The data were heterogeneous, and there was no difference between interventions in self-perception of cough severity (z = 0.09, P = 0.930; tau² = 0.65, I² = 90%) and in the self-perception of the effects of chronic cough on health status (z = 0.30, P = 0.77; tau² = 0.99, I² = 97%). The estimated mean difference was 0.97 to cough frequency, and it was differ significantly from zero (z = 4.47, P < 0.001) but the results are heterogeneous (Chi² (1) = 22.22, P < 0.001, I² = 95%). CONCLUSION The speech-language pathology therapy had a greater effect size than the control interventions on cough frequency. However, in the subjects' perception, there were no differences between the interventions.
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Affiliation(s)
- Vanessa Veis Ribeiro
- Speech-Language Pathology Department, Universidade Federal da Paraíba - UFPB, João Pessoa, PB, Brazil.
| | | | | | - Ícaro Vinícius de Santana
- Student Speech-Language Pathology Department, Universidade Federal de Sergipe - UFS, Lagarto, Sergipe, Brazil
| | - Rodrigo Dornelas do Carmo
- Speech-Language Pathology Department, Universidade Federal do Rio de Janeiro - UFRJ, Cidade Universitária, Rio de Janeiro, RJ, Brazil
| | - Mara Behlau
- Speech-Language Pathology Department, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
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Dornelas R, Casmerides MCB, da Silva RC, Victória Dos Anjos Souza M, Pereira LT, Ribeiro VV, Behlau M. Clinical Parameters of the Speech-Language Pathology Assessment of the Chronic Cough: A Scoping Review. J Voice 2024; 38:703-710. [PMID: 35012819 DOI: 10.1016/j.jvoice.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE to map the clinical parameters used in the speech-language pathology assessment of the chronic cough. METHODS a scoping review was performed to answer the clinical question: "What are the clinical parameters included in the speech-language pathology assessment of patients with chronic cough?" Evidence was searched by electronic and manual search. The electronic search included: MEDLINE, Cochrane Library, EMBASE, Web of Science, SCOPUS, and LILACS. Each database had a specific search strategy. The manual search included Journal of Voice, Chest, and Thorax, Brazilian Library of Theses and Dissertations, Open Grey, and Clinical Trials, in addition to scanning the references of the included studies. The extracted data considered information regarding the publication, sample, assessment, and measures used when assessing chronic cough. RESULTS the electronic search found 289 studies; the manual search found 1036 studies; 12 were selected for the present study. The most used assessments were: self-assessment (75%), aerodynamic analysis (66.67%), the perceptual auditory judgment of the voice quality (58.33%), acoustic analysis of the voice (41.67%), cough frequency, and cough threshold (41.67%) and electroglottography (25%). CONCLUSIONS the subjective instruments were used more frequently, while specific objective instruments, which are recent, were used less frequently. Complementary assessments such as vocal assessment, have been frequently used, also, with no other parameter. A lack of homogeneity was identified in the speech-language pathology assessment and measures of patients with chronic cough, thus, the comparison among studies and clinical analysis is difficult.
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Affiliation(s)
- Rodrigo Dornelas
- Speech-Language Pathology Department, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Centro de Estudos da Voz - CEV, São Paulo, Brazil
| | - Maria Christina Bussamara Casmerides
- Postgraduate Program in Medicine (Otorhinolaryngology), Universidade Federal de São Paulo, São Paulo, Brazil; Centro de Estudos da Voz - CEV, São Paulo, Brazil
| | - Rebeca Cardoso da Silva
- Speech-Language Pathology Department, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil; Centro de Estudos da Voz - CEV, São Paulo, Brazil
| | - Maria Victória Dos Anjos Souza
- Speech-Language Pathology Department, Universidade Federal de Sergipe - UFS. Lagarto, Sergipe, Brazil; Speech-Language Pathology Department, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil; Centro de Estudos da Voz - CEV, São Paulo, Brazil
| | - Lucas Tito Pereira
- Speech-Language Pathology Department, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Centro de Estudos da Voz - CEV, São Paulo, Brazil; Speech-Language Pathology Department, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vanessa Veis Ribeiro
- Speech-Language Pathology Department, Universidade Federal da Paraíba, João Pessoa, Paraiba, Brazil; Centro de Estudos da Voz - CEV, São Paulo, Brazil.
| | - Mara Behlau
- Speech-Language Pathology Department, Universidade Federal de São Paulo, São Paulo, Brazil; Centro de Estudos da Voz - CEV, São Paulo, Brazil
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Ribeiro VV, Lopes LW, da Silva ACF, Neto AHDM, Gartner-Schmidt J, Behlau M. Cough Severity Index: Validation in Brazilian Portuguese. J Voice 2023; 37:967.e15-967.e20. [PMID: 34266734 DOI: 10.1016/j.jvoice.2021.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/29/2021] [Accepted: 06/02/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To develop a validity profile for the cough severity index in the Brazilian Portuguese language (CSI-Br). METHODS The study sample consisted of 100 participants divided into Chronic Cough Group (CG; 50 individuals with a mean age of 46.4; standard deviation [SD]: 11.7) and Healthy Control Group (HCG; 50 individuals with a mean age of 33.0 [SD: 12.3]). The data collection procedures were as follows: (a) application of CSI-Br for all participants; (b) application of the Voice Handicap Index (VHI)-10 and the Newcastle Laryngeal Hypersensitivity Questionnaire (LHQ-Br) in the CG; (c) application of CSI-Br for test-retest reliability with an interim of between 2-14 days. The CSI-Br validation was composed of five stages: construct validity, reliability, reproducibility, convergent validity, and discriminant validity. RESULTS In construct validity, the instrument identified two factors and explained 67.6% of the total variance. The reliability had a value of a=0.914. Reproducibility showed an ICC value of 0.909. CSI-Br showed a negative correlation with VHI-10 and a positive correlation with LHQ-Br in convergent validity. In discriminant validity, all items and factors differentiated participants in the CG from those in the HCG. CONCLUSION The ten-item CSI-Br with two factors is reliable and valid for analyzing the severity of chronic cough symptoms in Brazilian individuals.
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Affiliation(s)
- Vanessa Veis Ribeiro
- Speech-Language Pathology Department, Universidade Federal de São Paulo - UNIFESP. São Paulo, Brazil; Speech-Language Pathology Department, Universidade Federal de Sergipe - UFS. Lagarto, Sergipe, Brazil.
| | - Leonardo Wanderley Lopes
- Speech-Language Pathology Department, Universidade Federal da Paraíba - UFPB. Cidade Universitária, João Pessoa, Paraíba, Brazil
| | - Allan Carlos França da Silva
- Speech-Language Pathology Department, Universidade Federal da Paraíba - UFPB. Cidade Universitária, João Pessoa, Paraíba, Brazil
| | | | - Jackie Gartner-Schmidt
- University of Pittsburgh School of Medicine, Department of Otolaryngology, UPMC Voice Center, Pennsylvania
| | - Mara Behlau
- Speech-Language Pathology Department, Universidade Federal de São Paulo - UNIFESP. São Paulo, Brazil
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Abstract
PURPOSE OF REVIEW Chronic cough is common in severe diseases, such as COPD, interstitial lung disease, lung cancer and heart failure, and has a negative effect on quality of life. In spite of this, patients with cough sometimes feel their cough is neglected by healthcare workers. This review aims to briefly describe cough mechanisms, highlight the burden chronic cough can be for the individual, and the clinical impact of chronic cough. RECENT FINDINGS Chronic cough is likely caused by different mechanisms in different diseases, which may have therapeutic implications. Chronic cough, in general, has a significant negative effect on quality of life, both with and without a severe comorbid disease. It can lead to social isolation, recurrent depressive episodes, lower work ability, and even conditions such as urinary incontinence. Cough may also be predictive of more frequent exacerbations among patients with COPD, and more rapid lung function decline in idiopathic pulmonary fibrosis. Cough is sometimes reported by patients to be underappreciated by healthcare. SUMMARY Chronic cough has a significant negative impact on quality of life, irrespective of diagnosis. Some differences are seen between patients with and without severe disease. Healthcare workers need to pay specific attention to cough, especially patients with severe disease.
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Wamkpah NS, Peterson AM, Lee JJ, Jia L, Hardi A, Stoll C, Huston M. Curbing the Cough: Multimodal Treatments for Neurogenic Cough: A Systematic Review and Meta-Analysis. Laryngoscope 2022; 132:107-123. [PMID: 33085095 PMCID: PMC8058694 DOI: 10.1002/lary.29146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVES/HYPOTHESIS Neurogenic cough affects 11% of Americans and causes significant detriment to quality of life. With the advent of novel therapies, the objective of this review is to determine how procedural therapies (e.g., superior laryngeal nerve block) compare to other established pharmacologic and non-pharmacologic treatments for neurogenic cough. METHODS With the assistance of a medical librarian, a systematic review was performed using PICOS (patients, interventions, comparator, outcome, study design) format: adults with neurogenic cough receiving any pharmacologic or non-pharmacologic treatment for neurogenic cough compared to adults with neurogenic cough receiving any other relevant interventions, or treated as single cohorts, assessed with cough-specific quality of life outcomes, in all study designs and case series with ≥ 10 cases. Case reports, review articles, non-human studies, non-English language articles, and unavailable full-text articles were excluded. RESULTS There were 2408 patients with neurogenic cough in this review, treated with medical therapy (77%), speech therapy (19%), both medical and speech therapy (1%), and procedural therapy (3%). The included studies ranged from low to intermediate quality. Overall, most interventions demonstrated successful improvement in cough. However, the heterogeneity of included study designs precluded direct comparisons between intervention types. CONCLUSION This meta-analysis compared various treatments for neurogenic cough. Procedural therapy should be considered in the armamentarium of neurogenic cough treatments, particularly in patients refractory to, or intolerant of, the side effects of medical therapy. Lastly, this review illuminates key areas for improving neurogenic cough diagnosis, such as strict adherence to diagnostic and treatment guidelines, sophisticated reflux testing, and standardized, consistent outcome reporting. Laryngoscope, 132:107-123, 2022.
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Affiliation(s)
- Nneoma S Wamkpah
- Department of Otolaryngology-Head and Neck Surgery, Washington University in St. Louis, St. Louis, Missouri, U.S.A
| | - Andrew M Peterson
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, U.S.A
| | - Jake J Lee
- Department of Otolaryngology-Head and Neck Surgery, Washington University in St. Louis, St. Louis, Missouri, U.S.A
| | - Lena Jia
- Washington University School of Medicine, St. Louis, Missouri, U.S.A
| | - Angela Hardi
- Bernard Becker Medical Library, Washington University in St. Louis, St. Louis, Missouri, U.S.A
| | - Carolyn Stoll
- Washington University Division of Public Health Sciences, St. Louis, Missouri, U.S.A
| | - Molly Huston
- Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, Washington University in St Louis, St. Louis, Missouri, U.S.A
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Ribeiro VV, Lopes LW, Behlau M. Presentation of the Therapy Program for Management of Chronic Cough. Codas 2021; 33:e20200057. [PMID: 34076101 DOI: 10.1590/2317-1782/20202020057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/22/2020] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To present a proposal for speech-language pathology rehabilitation called the Therapy Program for Management of Chronic Cough (TMCC) for the treatment of refractory chronic cough. METHODS TMCC was developed based on two stages: literature and clinical analysis. The literature analysis stage was carried out through the following procedures: electronic and manual search for articles and books published until June 2019 that included adult participants with chronic cough and intervention with speech-language pathology therapy; selection of sources; analysis of articles and books included; and, preparation of the initial version of the therapy program. The initial version of the therapy program resulting from literature analysis stage was submitted to clinical analysis stage through the following procedures: analysis by three judges; revision of the proposal by the authors; judges' re-analysis; elaboration of the final version called the Therapy Program for Management of Chronic Cough (TMCC). RESULTS TMCC synthesizes scientific knowledge and current clinical experience on the behavioral management of refractory chronic cough into a program with three main components, each one with specific objectives and strategies. TMCC consists of four sessions, with weekly frequency and duration between 30-45 minutes per session, executed in hierarchical phases, with specific objectives and strategies per session. CONCLUSION TMCC is a program structured to offer global cough rehabilitation. To obtain scientific evidence about its effectiveness is necessary, so that it can be used in clinical practice.
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Affiliation(s)
- Vanessa Veis Ribeiro
- Programa de Pós-graduação em Distúrbios da Comunicação Humana, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brasil
| | - Leonardo Wanderley Lopes
- Departamento de Fonoaudiologia, Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil
| | - Mara Behlau
- Programa de Pós-graduação em Distúrbios da Comunicação Humana, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brasil
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Sandage MJ, Ostwalt ES, Allison LH, Cutchin GM, Morton ME, Odom SC. Irritant-Induced Chronic Cough Triggers: A Scoping Review and Clinical Checklist. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1261-1291. [PMID: 33989029 DOI: 10.1044/2021_ajslp-20-00362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The primary aim of this review was to identify environmental irritants known to trigger chronic cough through the life span and develop a comprehensive clinically useful irritant checklist. Method A scoping review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews, checklist, and explanation. English-language, full-text resources were identified through Medline, PsycINFO, SPORTDiscus, Web of Science, and ProQuest Dissertations and Theses Global. Results A total of 1,072 sources were retrieved; of these, 109 were duplicates. Titles of abstracts of 963 articles were screened, with 295 selected for full-text review. Using the exclusion and inclusion criteria listed, 236 articles were considered eligible and 214 different triggers were identified. Triggers were identified from North America, Europe, Africa, Asia, and Australia. Occupational exposures were also delineated. Conclusions A clinically useful checklist of both frequently encountered triggers and idiosyncratic or rare triggers was developed. The clinical checklist provides a unique contribution to streamline and standardize clinical assessment of irritant-induced chronic cough. The international scope of this review extends the usefulness of the clinical checklist to clinicians on most continents.
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Affiliation(s)
- Mary J Sandage
- Department of Speech, Language, and Hearing Sciences, Auburn University, AL
| | | | - Lauren H Allison
- Department of Speech, Language, and Hearing Sciences, Auburn University, AL
| | - Grace M Cutchin
- Department of Speech, Language, and Hearing Sciences, Auburn University, AL
| | | | - Shelby C Odom
- Department of Speech, Language, and Hearing Sciences, Auburn University, AL
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Yang J, Crawley B, Dehom S, Krishna P, Murry T. Chronic Refractory Cough: Objective Improvement With Aerodynamic-Focused. J Voice 2021; 35:324.e9-324.e13. [DOI: 10.1016/j.jvoice.2019.08.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/15/2019] [Accepted: 08/26/2019] [Indexed: 12/12/2022]
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Ribeiro VV, Lopes LW, da Silva ACF, de Medeiros Neto AH, Gartner-Schmidt J, Behlau M. Cough Severity Index in Brazilian Portuguese: Translation and Cross-Cultural Adaptation. J Voice 2020; 36:289.e11-289.e16. [PMID: 32576524 DOI: 10.1016/j.jvoice.2020.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/12/2020] [Accepted: 05/18/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To translate and cross-culturally adapt the Cough Severity Index to Brazilian Portuguese. MATERIAL AND METHODS This is a study with observational, cross-sectional, and analytical design. The procedure for translation and cross-cultural adaptation followed the recommendations of the Scientific Advisory Committee of the Medical Outcomes Trust and was performed in five stages: translation, synthesis, back translation, committee review, and pretesting. The sample for the pretest consisted of 34 participants with refractory chronic cough, 11 males and 23 females, with an average age of 48 years and 1 month. RESULTS The title of the questionnaire, the answer options, and seven of the ten questions were agreed upon by three judges, the remaining three questions were retranslated by a fourth judge. After back-translation and committee review, editing of question five was necessary. The option "never" was more frequently selected for four questions and the option "always" for six questions. There was a significantly higher proportion of other response categories of the instrument compared to the response category "not applicable." CONCLUSION This study resulted in the elaboration of a translated and cross-culturally adapted version of the Cough Severity Index in Brazilian Portuguese.
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Affiliation(s)
- Vanessa Veis Ribeiro
- Speech-Language Pathology Department, Universidade Federal de São Paulo - UNIFESP, São Paulo, São Paulo, Brazil.
| | - Leonardo Wanderley Lopes
- Speech-Language Pathology Department, Universidade Federal da Paraíba - UFPB, Cidade Universitária, João Pessoa, Paraíba, Brazil
| | - Allan Carlos França da Silva
- Speech-Language Pathology Department, Universidade Federal da Paraíba - UFPB, Cidade Universitária, João Pessoa, Paraíba, Brazil
| | | | - Jackie Gartner-Schmidt
- University of Pittsburgh School of Medicine, Department of Otolaryngology, UPMC Voice Center, Pittsburgh, Pennsylvania
| | - Mara Behlau
- Speech-Language Pathology Department, Universidade Federal de São Paulo - UNIFESP, São Paulo, São Paulo, Brazil
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Echternach M, Huseynov J, Döllinger M, Nusseck M, Richter B. The impact of a standardized vocal loading test on vocal fold oscillations. Eur Arch Otorhinolaryngol 2020; 277:1699-1705. [PMID: 32107614 PMCID: PMC7198646 DOI: 10.1007/s00405-020-05791-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/07/2020] [Indexed: 12/04/2022]
Abstract
Introduction Vocal loading capacity is an important aspect of vocal health and is measured using standardized vocal loading tests. However, it remains unclear how vocal fold oscillation patterns are influenced by a standardized vocal loading task. Methods 21 (10 male, 11 female) vocally healthy subjects were analyzed concerning the dysphonia severity index (DSI) and high speed videolaryngoscopy (HSV) on the vowel /i/ at a comfortable pitch and loudness before and after a standardized vocal loading test (10 min standardized text reading, at a level higher than 80 dB (A) measured at 30 cm from the mouth). Results Changes in DSI were statistically significant, diminishing by 1.2 points after the vocal loading test, which was mainly caused by an increase of the minimum intensity. However, the pre-post comparison of HSV derived measures failed to show any statistically significant changes. Conclusion It seems necessary to analyze the effects of a standardized vocal loading test on vocal fold oscillation patterns with respect to softest phonation and phonation threshold pressure rather than comfortable pitch and loudness. Level of evidence 2c
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Affiliation(s)
- Matthias Echternach
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Munich University Hospital (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany.
| | - Jamal Huseynov
- Freiburg Institute of Musicians' Medicine, Freiburg University, Freiburg, Germany
- Department of Otolaryngology/Head and Neck Surgery, Clinics of Villingen-Schwenningen, Villingen Schwenningen, Germany
| | - Michael Döllinger
- Division of Phoniatrics and Pediatric Audiology, Department of Otolaryngology Head and Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Manfred Nusseck
- Freiburg Institute of Musicians' Medicine, Freiburg University, Freiburg, Germany
| | - Bernhard Richter
- Freiburg Institute of Musicians' Medicine, Freiburg University, Freiburg, Germany
- Medical Faculty, Freiburg University, Freiburg, Germany
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CFD Simulation of Airflow Dynamics During Cough Based on CT-Scanned Respiratory Airway Geometries. Symmetry (Basel) 2018. [DOI: 10.3390/sym10110595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The airflow dynamics observed during a cough process in a CT-scanned respiratory airway model were numerically analyzed using the computational fluid dynamics (CFD) method. The model and methodology were validated by a comparison with published experimental results. The influence of the cough peak flow rate on airflow dynamics and flow distribution was studied. The maximum velocity, wall pressure, and wall shear stress increased linearly as the cough peak flow increased. However, the cough peak flow rate had little influence on the flow distribution of the left and right main bronchi during the cough process. This article focuses on the mathematical and numerical modelling for human cough process in bioengineering.
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