Correlation of Iranian Voice Quality of Life Profile (IVQLP) to VHI-30 and VRQOL: Construct Validity Evidence

Outcomes of Cricothyroid Visor Maneuver (CVM) for Treatment of Vocal Polyp: A Case Report

OBJECTIVE

The aim of the study is the clinical investigation of a patient with a vocal fold polyp, and the visual, acoustical, perceptual, and self-report changes before and after using the cricothyroid visor manoeuvre (CVM).

DESIGN

A 48-year-old female university professor, gynecologist, and obstetrician with a history of laryngopharyngeal reflux and a left vocal polyp participated. Treatment was provided in 10 sessions. Pre- and post-treatment audio recordings of sustained vowels, selected sentences, and connected speech samples were submitted to auditory-perceptual and acoustical analysis to assess the effects of the two-treatment program. Also, laryngoscopic images, perceptions by the patient about her voice quality and quality of life before and after therapy were assessed.

RESULTS

Improvements in acoustic parameters were obtained especially in perturbation and CCPS parameters. The overall voice quality scores on the CAPE-V were moderate before therapy and became mild after therapy. Laryngoscopy images demonstrated improvement in the glottis closure configuration in two phases (open and close) in pre- and post- CVM therapy and a decrease in polyp size. The patient had improvement in VAS, IVQLP, and VRQOL scores.

CONCLUSION

The CVM therapy used in the study resulted in positive changes in acoustic and perceptual-auditory aspects of voice production, self-report, and QOL for the patient. The CVM approach appears to have been effective for this case in decreasing the polyp size or its regression or for vocal adaptation.

Correlations among the Mandarin Voice Handicap Index, its shortened version, and the Voice-Related Quality of Life Measure for laryngectomees

BACKGROUND

The Voice Handicap Index (VHI) and the Voice-Related Quality of Life Measure (V-RQOL) are seldom administered to alaryngeal patients who use pneumatic artificial larynx (PAL) and esophageal speech (ES). As such, the specificity of VHI and 10-item VHI (VHI-10) for assessing voice-related changes in such patients is unclear. Accordingly, this study investigated the correlation between scores on the VHI, its shortened version (VHI-10), and the V-RQOL for Mandarin-speaking laryngectomees using PAL and ES, with the aim of establishing which of these instruments is suited to such patients.

METHODS

The participants comprised 126 PAL and 26 ES patients from Taiwan who completed the Mandarin VHI and V-RQOL. Fifty-two of these alaryngeal participants then completed both those instruments a second time, between 8 and 64 days later.

RESULTS

One item appearing in both the Mandarin long-form VHI and the VHI-10 was excluded because more than half the participants left it unanswered. The correlation of scores on the remaining 29 items on the former with the nine on the latter was high ( r = 0.968), while that between the former and V-RQOL scores was moderate ( r = -0.569), as was the correlation between short-form VHI and Mandarin V-RQOL scores ( r = -0.582). Structural equation modeling was then used as the basis for simplifying the Mandarin long-form VHI into a new 10-item VHI specifically for alaryngeal Mandarin speakers (MA-VHI-10), to eliminate the scoring effect of the original VHI's and VHI-10's work-related item. MA-VHI-10 scores were highly correlated with those on the Mandarin long-form VHI ( r = 0.983).

CONCLUSION

The Mandarin versions of long-form VHI, short-form VHI, and MA-VHI-10 are interchangeable for a Mandarin-speaking alaryngeal population. However, neither of the former two instruments should be substituted for the V-RQOL.