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Polo N, Lã FMB. Self-Perceived Voice Handicap During COVID19 Compulsory Facemask Use: A Comparative Study Between Portuguese and Spanish Speakers. J Voice 2024; 38:105-111. [PMID: 34465480 PMCID: PMC8403057 DOI: 10.1016/j.jvoice.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022]
Abstract
This study investigates self-perceptions of voice-related handicap as a function of facemask use in the general working population during the COVID19 outbreak, using the Voice Handicap Index (VHI). Each VHI item was answered twice in a row; the first answer referred to the condition of not wearing a facemask (henceforth, the Without condition) and the second to the condition of using a facemask (henceforth, the With condition). VHI scores were collected via Google Forms (Google, Mountain View, California), targeting 2 groups of speakers of different nationalities, Portuguese (n = 261) and Spanish (n = 297). A Wilcoxon test was carried out to compare VHI scores between With and Without conditions for each group of speakers; a Mann-Whitney U test was used to compare groups within each condition. Results suggested that VHI overall scores and scores for all dimensions were higher for the With condition, for both Portuguese and Spanish speakers. When comparing groups of speakers, Spanish speakers presented higher scores for functional and emotional dimensions, for both With and Without conditions. In addition, the overall score for the Without condition was higher for Spanish speakers. No differences between groups were found for the total VHI score for the With condition. When comparing overall VHIdiff between speakers, that is, the difference in the VHI total score between With and Without conditions, no significant differences could be found. Thus, a multiple regression analysis was carried out between the VHIdiff and the independent variables of interest: age, sex, smoking habits, professional occupation, nationality, facemask type and its hours of use. The resulting model providing the highest association suggested that 2.5% of the variation in overall VHIdiff total score could be associated with sex, smoking habits, and professional level. Female smokers who use their voices during prolonged hours at work (e.g., teachers, lawyers, sales people) presented a higher VHI total score when wearing a mask. Future voice-related health interventions should address preventive strategies towards speaking behaviors leading to vocal fatigue and vocal effort as a consequence of compulsory facemask use, especially with respect to female professional voice users who smoke.
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Affiliation(s)
- Nuria Polo
- Department of Spanish Language and General Linguistics, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain.
| | - Filipa M B Lã
- Department of Didactics, School Organization and Special Didactics, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
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Qayyum U, Mumtaz N, Saqulain G. Vocal health of parents of children with hearing assistive devices. Pak J Med Sci 2023; 39:1434-1439. [PMID: 37680838 PMCID: PMC10480716 DOI: 10.12669/pjms.39.5.7570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/30/2023] [Accepted: 06/16/2023] [Indexed: 09/09/2023] Open
Abstract
Background & Objectives VH (Vocal health) is the need of the hour. VH of parents of children with hearing assistive devices (HAD) reveals a literature gap, during the habilitation process of their children. To explore the vocal health of parents of children with hearing assistive devices. Methods This cross-sectional study was conducted at Riphah International University from September to December 2021. Study recruited N=384 parents of Hearing Impaired children (HIC) using HAD for at least two years, of both genders and aged 2-9 years using convenience sampling. Voice-related quality of life (V-RQOL), and vocal health Index (VHI) -10 were used for data collection. Data was analyzed on SPSS Version 25. Descriptive statistics, Anova and t-test were utilized to see difference between means of groups. P<0.05 shows significant-results. Results Parents of children using hearing assistive devices had excellent V-RQOL score in 350(91.14%) parents. There was no significant difference in V=RQOL as regards type of hearing assistive device use (p=0.102), laterality of device use (p=0.918) and degree of hearing loss (p=0.143). However, type of hearing loss revealed significant difference (p=0.021). Also VHI score revealed significantly (p=0.008) lower means in parents of children with cochlear implants. Conclusion Current study concludes that the parents raising hearing impaired children with hearing assistive devices, possess good vocal health as determined by VHI and V-RQOL scores with only a very small number of parents reporting vocal symptoms.
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Affiliation(s)
- Uzma Qayyum
- Uzma Qayyum, MS (SLP) Speech Language Pathologist, Department of Speech Language Pathology, Riphah International University, Lahore, Pakistan
| | - Nazia Mumtaz
- Nazia Mumtaz, FCPS (Rehab Sciences) Head of Department, Department of Speech Language Pathology, Faculty of Rehab and Allied Health Sciences, Riphah International University, Lahore, Pakistan
| | - Ghulam Saqulain
- Ghulam Saqulain, FCPS (Otorhinolaryngology) Head of Department & Professor, Department of Otorhinolaryngology, Capital Hospital PGMI, Islamabad, Pakistan
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Krtickova J, Svec JG, Haviger J, Phadke KV, Drsata J, Skoloudik L, Homolac M, Svejdova A, Mejzlik J, Hodacova L, Chrobok V. Validation of the Czech Version of the Voice Handicap Index. J Voice 2023:S0892-1997(23)00145-5. [PMID: 37344245 DOI: 10.1016/j.jvoice.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE(S) The present study aims to evaluate the reliability and construct validity of the Czech version of the Voice Handicap Index (VHI-CZ) and determine the cut-off value to distinguish dysphonic patients from nondysphonic individuals. STUDY DESIGN Prospective study, Parallel group design. METHODS The study investigated 100 adult patients with dysphonia, divided into three groups based on the etiology of the voice problem (neurogenic, functional, and structural). Out of these, 25 patients were used for test-retest analysis, and 45 patients to determine the responsiveness to change. The control group consisted of 51 healthy subjects. All 151 individuals completed the VHI-CZ and were examined with the videolaryngostroboscopy. The internal consistency (Cronbach's alpha), the test-retest reliability (Intra-class Correlation Coefficient, ICC), and the construct validity were analyzed and the normative cut-off value was determined. RESULTS The internal consistency of the VHI-CZ was excellent (Cronbach α = 0.984), and test-retest reliability was also excellent (ICC = 0.95, P < 0.001). The correlation between the self-assessed severity of the voice disorder and the VHI-CZ score was strong (Spearman's ρ = 0.877, P < 0.001). The VHI scores differences between dysphonic and nondysphonic patients were statistically significant (Mann-Whitney U test, P < 0.001). The differences among the three etiological subgroups (neurogenic, functional, and structural) were also statistically significant (Kruskal-Wallis test, P < 0.001). Moreover, the differences in the VHI-CZ total scores between pretreatment and posttreatment were statistically significant (Wilcoxon test, P < 0.001). The cut-off score of 13 points was found, by the analysis of the Receiver Operating Characteristic (ROC, Youden Index), to be most suitable for preselecting dysphonic individuals. CONCLUSION The existing VHI-CZ showed excellent reliability and construct validity. The Czech VHI is a useful and valid monitoring tool for clinicians.
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Affiliation(s)
- Jana Krtickova
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
| | - Jan G Svec
- Voice Research Laboratory, Department of Experimental Physics, Faculty of Science, Palacky University, Olomouc, Czech Republic
| | - Jiri Haviger
- Department of Informatics and Quantitative Methods, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Ketaki Vasant Phadke
- Voice Research Laboratory, Department of Experimental Physics, Faculty of Science, Palacky University, Olomouc, Czech Republic
| | - Jakub Drsata
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Lukas Skoloudik
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Michal Homolac
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Anna Svejdova
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Jan Mejzlik
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Lenka Hodacova
- Department of Preventive Medicine, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Viktor Chrobok
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
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Miaśkiewicz B, Gos E, Dębińska M, Panasiewicz-Wosik A, Kapustka D, Szkiełkowska A, Skarżynski H. Validation of the Polish Version of Voice Handicap Index-10. J Voice 2023:S0892-1997(23)00089-9. [PMID: 37173195 DOI: 10.1016/j.jvoice.2023.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 05/15/2023]
Abstract
PURPOSE The aim of this study was to adapt and evaluate the psychometric properties of the Polish version of the VHI-10. METHODS We enrolled 183 subjects-118 patients with voice disorders and 65 without voice disorders. RESULTS All items were correlated with each other and were strongly correlated with the total score (rho ≥ 0.70), the only exception being item five (rho = 0.56). Internal consistency was very high, with Cronbach's alpha = 0.92. There was a statistically significant difference between patients with voice disorders and healthy controls in terms of VHI-10 global score (U = 251.0; P < 0.001). There was a statistically significant negative correlation between mean phonation time (MPT) and VHI-10 (rho = -0.30; P < 0.01). Only the amplitude perturbation quotient (APQ) was correlated positively with the global score (rho = 0.22; P = 0.020). There were statistically significant and positive correlations between VHI-10 scores and GRBAS evaluation. Correlations between global scores of VHI-30 and VHI-10, and between VHI-30 subscales and the corresponding items from VHI-10, were very strong (respectively 0.97 and 0.89-0.94). In the patient group, there was high test-retest reproducibility (intraclass correlation = 0.91). A cut-off value of 8.5 points was estimated. CONCLUSION The Polish version of VHI-10 showed excellent internal consistency, good test-retest reproducibility, and had clinical validity. It is a useful brief tool for self-reported evaluation and reliable assessment of patients with voice disorders.
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Affiliation(s)
- Beata Miaśkiewicz
- Audiology and Phoniatric Clinic, World Hearing Centre of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland.
| | - Elżbieta Gos
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Małgorzata Dębińska
- Audiology and Phoniatric Clinic, World Hearing Centre of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Aleksandra Panasiewicz-Wosik
- Audiology and Phoniatric Clinic, World Hearing Centre of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Dorota Kapustka
- Audiology and Phoniatric Clinic, World Hearing Centre of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Agata Szkiełkowska
- Audiology and Phoniatric Clinic, World Hearing Centre of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Henryk Skarżynski
- Oto-rhino-laryngosurgery Clinic, World Hearing Centre of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland
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Farag HM, Taha AG, Elgohary MAS, Hady AFA. Self-perception of Voice Handicap in COVID 19 Patients. Indian J Otolaryngol Head Neck Surg 2023:1-6. [PMID: 37362127 PMCID: PMC10148616 DOI: 10.1007/s12070-023-03656-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 02/28/2023] [Indexed: 06/28/2023] Open
Abstract
Voice abnormalities were reported in patients during the course of COVID-19 infection. This study aims to evaluate the effect of COVID 19 infection on the self-perception of voice handicap in positive COVID 19 patients in addition to investigating the factors that might correlate with voice handicap if present. Voice handicap index-10 was filled in by 200 patients that were confirmed to be COVID 19 positive based on the RT-qPCR and symptomatology of the disease. The result showed that about 65.5% had mild degree of COVID 19 and 27.5% had moderate degree. Dysphonia was reported by 19% of the patients when questioned about voice symptoms. Dysphonia was detected in 35% of them by auditory perceptual assessment. Symptoms of Dyspnea, dysphonia, headache were significantly correlated with total and subtotal scores of Voice handicap index. COVID 19 infection has a negative impact on some of the patients? self- perception of voice handicap on the functional, physical and emotional domains. Age and degree of COVID 19 severity were correlating with the patients? self -perception of voice handicap.
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Affiliation(s)
- Heba Mahmoud Farag
- Phoniatric Unit, Otorhinolaryngology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | | | | | - Aisha Fawzy Abdel Hady
- Phoniatric Unit, Otorhinolaryngology Department, Faculty of Medicine, Cairo University, Giza, Egypt
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Liu AQ, Ji Y, Hu A. Do patients regret having in-office vocal fold injections for glottic insufficiency? J Otolaryngol Head Neck Surg 2023; 52:33. [PMID: 37098608 PMCID: PMC10129306 DOI: 10.1186/s40463-023-00643-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 04/15/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND In-office vocal fold injections (VFI) are an effective treatment for glottic insufficiency. The primary objective of this study was to assess if patients reported decisional regret after VFI. Secondary objectives included determining if variables were associated with lower decisional regret. METHODS Case-control study of patients who underwent in-office VFIs for glottic insufficiency from August 2017 to December 2019 at a tertiary laryngology clinic. Participants completed the validated Decision Regret Scale (DRS). Demographic data, clinician's perceptual analysis with GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain), and patient's self-reported Voice Handicap Index-10 (VHI-10) were analyzed. Nonparametric tests as well as univariate and multiple logistics regression were performed. RESULTS Of patients eligible, 75% (136/182) completed the DRS (mean age 65.4 years (SD 13.9), 58.1% male). Eighty-three (61.0%) reported no decisional regret, thirty-three (24.3%) reported mild decisional regret, and twenty (14.7%) reported moderate to strong decisional regret. Improvement in most recent VHI-10 (Kendall correlation coefficient tau = 0.156, p = 0.029), Grade of voice (tau = 0.236, p value = 0.002) and Breathiness of voice (tau = 0.150, p = 0.044) were associated with lower DRS. Multivariate logistics regression results showed that the change in Grade of voice (OR 9.9, p < 0.01), Roughness (OR 0.2, p < 0.01) and Breathiness (OR 0.2, p < 0.03) were significantly associated with DRS. CONCLUSION The majority of patients had no or mild decisional regret after in-office VFI for glottic insufficiency. Both patients who reported less vocal handicap after VFI and clinician-noted improvements in perceptual evaluation of voice after VFI were associated with significantly lower decisional regret.
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Affiliation(s)
- Alice Q Liu
- Division of Otolaryngology-Head and Neck Surgery, University of British Columbia, Vancouver, BC, Canada.
| | - Yunqi Ji
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Amanda Hu
- Division of Otolaryngology-Head and Neck Surgery, University of British Columbia, Vancouver, BC, Canada
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Smeltzer JC, Chiou SH, Shembel AC. Interoception, Voice Symptom Reporting, and Voice Disorders. J Voice 2023:S0892-1997(23)00094-2. [PMID: 37012093 PMCID: PMC10544601 DOI: 10.1016/j.jvoice.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVES Interoception may play a role in how individuals perceive their voice disorder. The first objective of this study was to investigate relationships between interoception and voice disorder class (functional, structural, neurological). The second objective was to determine relationships between interoception and voice-related outcome measures between patients with functional voice and upper airway disorders and typical voice users. The third objective was to determine whether patients with primary muscle tension dysphonia (a type of functional voice disorder) had different levels of interoceptive awareness than typical voice users. STUDY DESIGN Prospective cohort study. METHODS One hundred subjects with voice disorders completed the multidimensional assessment of interoceptive awareness-2 (MAIA-2). Voice diagnosis and singing experience were also acquired from each patient's medical chart. Voice handicap (VHI-10) and Part 1 of the vocal fatigue index (VFI-Part1) scores were obtained from patients diagnosed with functional voice and upper airway disorders. MAIA-2, VHI-10, VFI-Part1, and singing experience were also obtained from 25 typical voice users. Multivariable linear regression models were used to assess the association between response variables and voice disorder class, adjusting for singing experience, gender, and age. RESULTS There were no significant group differences between voice disorder class (functional, structural, neurological) after adjusting for multiple comparisons. Participants with functional voice and upper airway disorders who scored significantly higher on the VHI-10 and VFI-Part1 had lower Attention Regulation sub-scores on the MAIA-2 (P's<0.05). Patients with primary muscle tension dysphonia scored significantly lower on the Emotional Awareness MAIA-2 subscale than typical voice users (P=0.005). CONCLUSION Patients with functional voice disorders with lower capabilities to attend to body sensations may score higher on voice-related patient-reported outcome measures, like the VHI-10 and VFI-Part1. Patients with primary muscle tension dysphonia may also have lower capabilities in processing their body sensations than typical voice users.
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Affiliation(s)
- Julianna Comstock Smeltzer
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, Texas
| | - Sy Han Chiou
- Department of Mathematical Sciences, University of Texas at Dallas, Richardson, Texas
| | - Adrianna C Shembel
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, Texas; Department of Otolaryngology-Head and Neck, Voice Center, University of Texas Southwestern Medical Center, Dallas, Texas.
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Santos M, Sousa F, Azevedo S, Casanova M, Freitas SV, E Sousa CA, da Silva ÁM. Presbylarynx: Is it Possible to Predict Glottal Gap by Cut-Off Points in Auto-Assessment Questionnaires? J Voice 2023; 37:268-274. [PMID: 33384247 DOI: 10.1016/j.jvoice.2020.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine cut-off points in auto-assessment questionnaires to predict the presence and extent of presbylarynx signs. METHOD This case control, prospective, observational, and cross-sectional study was carried out on consecutive subjects observed by Otorhinolaryngology, in a tertiary center, in 2020. Each subject underwent fiberoptic videolaryngoscopy with stroboscopy, and presbylarynx was considered when it was identified two or more of the following endoscopic findings: vocal fold bowing, prominence of vocal processes in abduction, and a spindle-shaped glottal gap. Each subject completed three questionnaires: the Voice Handicap Index (VHI), with 30 and 10 questions, and the "Screening for voice disorders in older adults questionnaire" (RAVI). RESULTS The studied population included 174 Caucasian subjects (60 males; 114 females), with a mean age of 73.99 years (standard deviation = 6.37; range 65-95 years). Presbylarynx was identified in 71 patients (41%). Among patients with presbylarynx, a glottal gap was identified in 22 patients (31%). The mean score of VHI-30 between "no presbylarynx" and "presbylarynx" groups was statistically different (P < 0.001), with a higher score for subjects with signs of presbylarynx. The presence of glottal gap was associated to a higher mean score of VHI-30 (41.64 ± 11.87) (P < 0.001). The mean score of VHI-10 between "no presbylarynx" and "presbylarynx" groups was statistically different (P < 0.001), with a higher score for subjects with signs of presbylarynx. Among patients with presbylarynx, the presence of glottal gap was associated to higher mean score of VHI-10 (14.04 ± 3.91) (P < 0.001). There was a strong positive correlation between VHI-30 and VHI-10 (rs = 0.969; P < 0.001). The mean score of RAVI between "no presbylarynx" and "presbylarynx" groups was statistically different (P < 0.001), with a higher score for subjects with signs of presbylarynx. Among patients with presbylarynx, the presence of glottal gap was associated to a higher mean score of RAVI (11.68 ± 1.61) (P < 0.001). There was a strong positive correlation not only between RAVI and VHI-30 (rs = 0.922; P < 0.001), but also between RAVI and VHI-10 (rs = 0.906; P < 0.001). The optimal cut-off points to discriminate "no presbylarynx" from "presbylarynx", obtained by the Youden' index, were 3.5 for RAVI, 4.5 for VHI-30 and 1.5 for VHI-10. RAVI had the highest sensitivity and specificity. The optimal cut-off points to predict glottal gap, obtained by the Youden' index, were 9.5 for RAVI, 21 for VHI-30 and 7.5 for VHI-10. CONCLUSION The optimal cut-off points do discriminate "no presbylarynx" from "presbylarynx" were 3.5 for RAVI, 4.5 for VHI-30 and 1.5 for VHI-10. RAVI had the highest sensitivity and specificity, probably because it was designed specifically for vocal complaints of the elderly. Among patients with presbylarynx, cut-off points of 9.5 for RAVI, 21 for VHI-30 and 7.5 for VHI-10 were determined to predict patients with and without glottal gap. It was found a strong positive correlation between RAVI, VHI-30 and VHI-10. Thus, VHI-10 can be preferred to VHI-30 to assess voice impairment in clinical practice, because for elderly patients it is easier to answer. However, to predict endoscopic signs of presbylarynx, RAVI should be preferred.
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Affiliation(s)
- Mariline Santos
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal.
| | - Francisco Sousa
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal
| | - Sara Azevedo
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal
| | - Maria Casanova
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal
| | - Susana Vaz Freitas
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal; Faculdade de Ciências da Saúde - Universidade Fernando Pessoa, Porto, Portugal; LIAAD - Laboratório de Inteligência Artificial e Apoio à Decisão - INESCTEC, Porto, Portugal
| | - Cecília Almeida E Sousa
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal
| | - Álvaro Moreira da Silva
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal
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Onen C, Golac H, Tunc Songur E, Kemaloglu YK. Acoustic and Auditory-Perceptual Analysis of Voice in the Female Smokers Who Do Not Have Self-Reported Voice Complaint. J Voice 2023; 37:297.e1-297.e6. [PMID: 33451894 DOI: 10.1016/j.jvoice.2020.12.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Smoking affects the voice quality and the previous studies presented higher Voice Handicap Index (VHI) scores, and abnormal acoustic data in smokers. However, there is no study revealing any voice parameter indicating incipient damage in voice functionality. The studies documented that the adverse effects of smoking on phonatory function were higher in females than males and further the prevalence of smoking among females tends to increase. The purpose of this study was to investigate the effect of smoking on the acoustic and auditory-perceptual analysis of the speaking voice in female smokers who scored the VHI-10 scale as grade 0 (absent), and thus to look for a criterion for incipient vocal damage of smoking. METHODS The study group composed of 22 female smokers and 22 female nonsmokers between the ages of 18 and 55 years. The acoustic parameters (mean F0, jitter local [%], jitter local abs, jitter rap, jitter ppq, shimmer local [%], shimmer local [dB], shimmer apq3, shimmer apq5, shimmer apq11, and mean HNR) and the GRBAS scale were analyzed in all subjects. RESULTS No significant difference observed between the smoker and nonsmokers groups in acoustic voice analysis. It was seen that the smokers presented a small but significant increase in the Strain parameter of the GRBAS scale while there was no significant difference in the Grade, Roughness, Breathiness, and Asthenia parameters between the study groups. CONCLUSION The results of this study indicate that increase in Strain could be considered as an early data in the smokers without voice complaints. However, our data declared that conventional acoustic perturbation analysis did not reveal incipient Strain in voice.
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Affiliation(s)
- Cigdem Onen
- Department of Speech and Language Therapy, Ankara Yildirim Beyazit University, Ankara, Turkey.
| | - Hakan Golac
- Department of Speech and Language Therapy, Gazi University, Ankara, Turkey
| | - Elif Tunc Songur
- Department of Speech and Language Therapy, Selcuk University, Konya, Turkey
| | - Yusuf Kemal Kemaloglu
- Department of Otorhinolaryngology and Head-Neck Surgery, Gazi University, Ankara, Turkey.
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Boutsen FR, Park E, Dvorak JD. An Efficacy Study of Voice Quality Using Cepstral Analyses of Phonation in Parkinson's Disease before and after SPEAK-OUT!®. Folia Phoniatr Logop 2023; 75:35-42. [PMID: 35817007 DOI: 10.1159/000525884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/16/2022] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION SPEAK-OUT!® is a behavioral treatment for hypokinetic dysarthria in persons with Parkinson's disease (PD) that has become an alternative to the gold-standard Lee Silverman Voice Treatment (LSVT) in recent years. Acoustic evaluation of the efficacy of SPEAK-OUT!® therapy has focused on prosody. The purpose of this study was to investigate SPEAK-OUT!® efficacy in terms of vocal quality and its impact on quality of life. Vocal quality was measured acoustically using cepstral peak prominence (CPP) analysis and the Acoustic Voice Quality Index (AVQI) and perceptually using clinical ratings of speech performance. Impact on quality of life was measured with the Voice Handicap Index (VHI) and Voice-Related Quality of Life (V-RQOL). An additional goal of this study was to investigate whether dysarthria severity and disease duration were predictive of changes in voice quality due to SPEAK-OUT!®. METHODS Pre- and post-therapy data included PD participants' acoustic and perceptual ratings of audio recordings. Demographic data included age, sex, diagnosis, duration of PD, and severity of dysarthria. RESULTS Participants achieved significant improvement in the vowel and sentence CPP smoothed (CPPS) mean score as well as in their AVQI score post SPEAK-OUT!® treatment. Improvements in AVQI correlated negatively with disease duration and positively with dysarthria severity. DISCUSSION/CONCLUSION SPEAK-OUT!® is effective in improving voice quality in patients with hypokinetic dysarthria due to idiopathic PD. Patients with more severe dysarthria and with a shorter disease duration may benefit the most, supporting earlier intervention. As for the type of measurement, AVQI combines acoustics from both vowel and sentence contexts and may therefore be the measure of choice over CPPS (vowel) or CPPS (sentence).
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Affiliation(s)
- Frank R Boutsen
- Department of Communication Disorders, New Mexico State University, Las Cruces, New Mexico, USA
| | - Eunsun Park
- Department of Communication Disorders and Sciences, William Patterson University, Wayne, New Jersey, USA
| | - Justin D Dvorak
- Department of Biostatistics & Epidemiology, University of Oklahoma Health Sciences, Oklahoma City, Oklahoma, USA
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Kim S, Kim KW, Hong YT. Phonetic features of patients with transoral endoscopic thyroidectomy. Auris Nasus Larynx 2023:S0385-8146(22)00237-1. [PMID: 36621450 DOI: 10.1016/j.anl.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 12/07/2022] [Accepted: 12/16/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The objective of this study was to compare phonetic outcomes of TOETVA with those of conventional transcervical thyroidectomy(OPEN). METHODS Retrospective chart review of total 61 patients who received thyroidectomy through OPEN (n = 34) or TOETVA (n = 27) approach in single tertiary center were enrolled. RESULTS There were significant differences in F0 between the two groups and there were significant changes from different time points within each group in jitter for vowel /i/. Aerodynamically, there were significant differences in mean sound pressure level for vowel /a/ and mean sound pressure level, mean air pressure, and aerodynamic resistance for syllable /pa/ between the two groups. In subjective VHI evaluations, there were no significant differences between the two groups. CONCLUSION This study is significant in that it has investigated voices of patients with TOETVA. Results of this study are expected to be useful for voice evaluation, treatment, and prevention in the future. LEVEL OF EVIDENCE: 3
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Affiliation(s)
- Sol Kim
- Department of Otolaryngology-HNS, Jeonbuk National University Medical School, Jeonju, Korea; Department of Research Institute for Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk, 560-182, Korea
| | - Ki Wook Kim
- Department of Rehabilitation, Jeonbuk National University Medical School, Jeonju, Korea; Department of Research Institute for Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk, 560-182, Korea
| | - Yong Tae Hong
- Department of Otolaryngology-HNS, Jeonbuk National University Medical School, Jeonju, Korea; Department of Research Institute for Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk, 560-182, Korea.
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Yildiz MG, Bilal N, Kara I, Sagiroglu S, Orhan I, Doganer A. Voice Disorders in Lower Primary School Teachers: An Observational Study. J Voice 2023; 37:141.e1-8. [PMID: 33349479 DOI: 10.1016/j.jvoice.2020.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Voice problems are very common among teachers, and etiology-based methods are used in the diagnosis and treatment process. Our study aims to reveal the changes in subjective voice analysis during the diagnosis and treatment process of dysphonia in lower primary school teachers. METHODS The nature of the study is a prospective observational one designed for lower primary school teachers in Kahramanmaraş conducted between the year 2015 and 2019 and evaluations for parameters including sociodemographic characteristics, laryngeal lesions and pre- and post-treatment scales such as Voice Handicap Index-10 (VHI-10), Reflux Symptom Index (RSI) and Hospital-Anxiety Depression Scale (HADS) for treatment subgroups were made. Statistical analysis was analyzed using SPSS. RESULTS Three hundred and fifty-one lower primary school teachers were included in the study. A statistically significant difference was found for the development of dysphonia in terms of sociodemographic features such as smoking, professional experience and crowdedness of classroom. Changes in RSI, VHI-10 and HADS values after treatment were clinically significant in all treatment groups. While there was a significant post-treatment improvement in terms of RSI in patients with granuloma and laryngopharyngeal reflux disorders, the VHI-10, and HADS assessments revealed a significant difference in clinical recovery compared to laryngeal lesions. CONCLUSION The RSI, VHI-10 and HADS values for various laryngeal pathologies were found to be high in dysphonic teachers. An improvement was observed in the scale scores upon the application of treatment modalities. This situation emphasizes the importance of questionnaire survey in the diagnosis, treatment, and follow-up process of dysphonia.
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Itigi S, Sikdar A, Phatak S, Nivsarkar S. Comparative Study of Videolaryngostroboscopic Findings and Voice Handicap Index Before and After Treatment in Patients Presenting with Hoarseness Due to Non Malignant Lesions. Indian J Otolaryngol Head Neck Surg 2022; 74:5160-5168. [PMID: 36742882 PMCID: PMC9895267 DOI: 10.1007/s12070-021-03047-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/26/2021] [Indexed: 02/07/2023] Open
Abstract
Voice personifies an individual. Change in voice can be the only presentation for a benign malady like vocal nodule or acute laryngitis but can also indicate life threatening malignancy. Hence every voice change must be evaluated. The aim of this pioneering study was to assess patients with voice change due to non-malignant conditions, using Videolaryngostroboscopy (VLS) and Voice Handicap Index (VHI) pre and post1 month therapy. Diagnosis determined conservative therapy or Co2 laser phonosurgery according to accepted medical protocol. On VLS, glottic closure pattern and wave form was noted both before and after treatment. Patient completed VHI form before and after treatment. There is no previous study comparing pre and post treatment VHI and VLS in a extensive etiology of conservatively managed patients. In our study, 100 patients were enrolled in the age group between 10 years to the eighties, with majority in their thirties. The male to female ratio was 1.9:1. The majority of patients belonged to level IV occupation. A wide gamut of diagnosis was noted, majority being vocal nodules, followed by polyps, cysts, vocal cord palsy etc. A statistically significant improvement was seen pre and post treatment VLS in glottic closure pattern, waves presence along with improvement in VHI. Thus, Voice Handicap Index and Videostroboscopy can be used to prognosticate the vocal cord lesions and measure the effectiveness of treatment in both surgically and conservatively managed patients.
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Affiliation(s)
- Sphoorthy Itigi
- Department of ENT, Choithram Hospital and Research Centre, Flat 902, Block A3 Avasa, Indore, Madhya Pradesh 452012 India
- Present Address: Department of ENT, Sri Lalithambigai Medical College, Chennai, Tamil Nadu India
| | - Abhik Sikdar
- Department of ENT, Choithram Hospital and Research Centre, Flat 902, Block A3 Avasa, Indore, Madhya Pradesh 452012 India
| | - Shrikant Phatak
- Department of ENT, Choithram Hospital and Research Centre, Flat 902, Block A3 Avasa, Indore, Madhya Pradesh 452012 India
| | - Sameer Nivsarkar
- Department of ENT, Choithram Hospital and Research Centre, Flat 902, Block A3 Avasa, Indore, Madhya Pradesh 452012 India
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Pomal P, Bhalodiya N, Mishra S. Effects of Voice Therapy in Early Onset Unilateral Vocal Fold Paralysis in Our Tertiaty Care Centre. Indian J Otolaryngol Head Neck Surg 2022; 74:5075-5081. [PMID: 36742849 PMCID: PMC9895689 DOI: 10.1007/s12070-021-02740-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/27/2021] [Indexed: 02/07/2023] Open
Abstract
Unilateral vocal cord paralysis presents with dysphonia, shortness of breath and swallowing difficulty and occurs secondary to damage to the recurrent laryngeal nerve by causes such as viral infection, iatrogenic, trauma and idiopathic. The objective of this study was to study the efficacy of early voice therapy in the management of patients with unilateral vocal fold paralysis. Total 116 patients in previous two years were included in this retrospective study suffering from unilateral vocal fold paralysis. They were subjected to a protocol of voice evaluation including Voice handicap index, Maximum phonation time and S/Z ratio. Patients were also examined using Hopkins Examination. All patients included received voice therapy for 6-month duration in 24 sessions. Patients who had started voice therapy early during their symptoms within few days or 1 to 2 weeks had better outcomes regarding Voice handicap index, Maximum phonation time and S/Z ratio than patients who had started voice therapy at 1 to 1.5 month after symptom onset. Early onset voice therapy may enhance the reduction in glottal gap and improvement of voice quality by hindering the development of faulty hyper functional compensatory behaviors; early voice therapy may therefore enhance the patient's quality of life.
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Affiliation(s)
- Parth Pomal
- Department of Otorhinolaryngology, Sola Civil Hospital, Room No.102, PG Hostel, Near Gujarat High Court, S.G. Highway, Sola, Ahmedabad, 380060 India
| | - Neena Bhalodiya
- Department of Otorhinolaryngology, Sola Civil Hospital, 201, Block-A, Near Gujarat High Court, S. G. Highway, Sola, Ahmedabad, 380060 India
| | - Swati Mishra
- Department of Otorhinolaryngology, Sola Civil Hospital, 201, Block-A, Near Gujarat High Court, S. G. Highway, Sola, Ahmedabad, 380060 India
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Kaliavaradan S, Bhat PS, Rajagopal M, Venugopal V, Surendran P, Muruganidhi N, Srinivasane KR. Translation and validation of the Voice Handicap Index in Tamil language. Indian J Otolaryngol Head Neck Surg 2022; 74:4965-4972. [PMID: 36742755 PMCID: PMC9895191 DOI: 10.1007/s12070-021-02469-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/16/2021] [Indexed: 02/07/2023] Open
Abstract
Voice Handicap Index (VHI) is the most commonly used tool to assess the quality of life in voice disordered patients. A validated Tamil language version of VHI is not developed yet. Hence, this study was undertaken to translate and validate the Voice Handicap Index in Tamil language, which can potentially benefit Tamil speaking patients with voice disorders. This was a translation and tool validation study done at a tertiary care teaching hospital using an analytical, follow up design according to WHO guidelines. Dysphonic (Group A) and Normal (Group B) respondents were purposively invited to fill a self administered VHI-Tamil questionnaire. The content validity, response process validity, internal consistency and clinical validity of the questionnaire was calculated using appropriate statistical analysis methods using SPSS version 24.0 software. Out of 117 respondents, 61 respondents were dysphonic (Group A) and 56 respondents were normal (Group B). Overall index for content validation was over 0.84, and response process validation was 1.00 in all domains. Overall internal consistency was excellent, with Cronbach's alpha of 0.993. Excellent test-retest reliability was identified using the Spearman rank correlation coefficient (r = 0.96; p-value < 0.001). For clinical validity, a statistically significant difference between the dysphonic and the normal groups, for the overall VHI-Tamil scores and each of the three domain scores was noted. VHI-Tamil was found to be reliable and valid for assessing the quality of life in patients with voice disorders. It can be recommended for future use among Tamil speaking population.
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Affiliation(s)
- Santhanakrishnan Kaliavaradan
- Department of Otorhinolaryngology, Sri Manakula Vinayagar Medical College and Hospital, Kalitheerthalkuppam, Madagadipet, Puducherry, 605107 India
| | - Poornima Shankar Bhat
- Department of Otorhinolaryngology, Sri Manakula Vinayagar Medical College and Hospital, Kalitheerthalkuppam, Madagadipet, Puducherry, 605107 India
| | - Mariappan Rajagopal
- Department of Otorhinolaryngology, Sri Manakula Vinayagar Medical College and Hospital, Kalitheerthalkuppam, Madagadipet, Puducherry, 605107 India
| | - Vinayagamoorthy Venugopal
- Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Kalitheerthalkuppam, Madagadipet, Puducherry, 605107 India
| | - Pravin Surendran
- Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Kalitheerthalkuppam, Madagadipet, Puducherry, 605107 India
| | - Nisha Muruganidhi
- Department of Otorhinolaryngology, Sri Manakula Vinayagar Medical College and Hospital, Kalitheerthalkuppam, Madagadipet, Puducherry, 605107 India
| | - K. R. Srinivasane
- Department of Otorhinolaryngology, Sri Manakula Vinayagar Medical College and Hospital, Kalitheerthalkuppam, Madagadipet, Puducherry, 605107 India
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Sneha V, Malhotra M, Priya M, Bhardwaj A, Potluri P, Varshney S, Tyagi AK, Arya V, Kumar N, Moideen A. Subjective and Objective Assessment of Effect of Allergic Rhinitis on Voice in Indian Patients. Indian J Otolaryngol Head Neck Surg 2022; 74:949-955. [PMID: 36452795 PMCID: PMC9702152 DOI: 10.1007/s12070-020-02008-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022] Open
Abstract
To perform a subjective and objective assessment of vocal complaints in patients of allergic rhinitis (AR) using voice handicap index and video-stroboscopy respectively and find the association of their parameters with severity of the disease. Cross-sectional-observational study design. Outpatient department of Otorhinolaryngology of a tertiary centre. Seventy-five adult patients diagnosed with AR and classified according to 'Allergic Rhinitis and its Impact on Asthma' guidelines were compared with same number of normal subjects as controls, with the same age and sex, to ensure uniformity. Both the groups were asked to fill a self-answered questionnaire called Voice Handicap Index (VHI) and underwent laryngeal examination with Video-Stroboscopy (VS). The mean VHI score of the AR group (29.45 ± 32.11) was significantly higher (p < 0.05) than that of controls (12.07 ± 16.62). VS parameters including amplitude, supraglottic activity, vocal edge and phase closure also showed significant difference between cases and controls (p < 0.05). VHI scores increased, but the VS findings did not change significantly with the severity of the disease. AR patients show subjective and objective derangements of voice quality. VHI scores show increase, while VS parameters do not change with the severity of AR.
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Affiliation(s)
- V Sneha
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249201 India
| | - Manu Malhotra
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249201 India
| | - Madhu Priya
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249201 India
| | - Abhishek Bhardwaj
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249201 India
| | - Praneeth Potluri
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249201 India
| | - Saurabh Varshney
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249201 India
| | - Amit Kumar Tyagi
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249201 India
| | - V Arya
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249201 India
| | - Narendra Kumar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249201 India
| | - Areej Moideen
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249201 India
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Lukaschyk J, Illg A. Subjective Voice Handicap and Vocal Tract Discomfort in Patients With Cochlear Implant. J Voice 2022:S0892-1997(22)00208-9. [PMID: 35945098 DOI: 10.1016/j.jvoice.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVES Changes in the auditory system, for example due to hearing impairment, can cause changes in breathing, phonation, and articulation. Aim of this study was to provide first data on subjective Voice Handicap and Vocal Tract Discomfort in subjects with hearing impairment and cochlear implant (CI) after initial fitting. STUDY DESIGN Prospective cross-sectional study METHODS: A total of 111 participants (57 female and 54 male) between 20 and 85 years of age (mean = 58.21, SD = 14.96) were recruited between October 2019 and March 2020 from the Clinic of Otorhinolaryngology at Medical University of Hannover. Participants were tested after initial CI fitting, six weeks after implantation, using the German version of the VTD (Vocal Tract Discomfort) Scale and VHI (9i) (Voice Handicap Index) as well as speech comprehension tests and a specifically developed questionnaire evaluating data concerning voice usage and other influential factors. Statistics included descriptive analysis, group comparisons (t-Test), Pearson correlation coefficient between VTD Scale and VHI, and hearing status. RESULTS Patients with CI did show low scores in VTD Scale and VHI-9i (VTD mean = 7.85 [SD = 10.4]; VHI-9i mean = 4.04 [SD = 5.77]). We found neither a correlation between any of the speech comprehension tests and the VTD Scale nor the VHI-9i. Further, we could show no correlation between subjective Voice Handicap and/or Vocal Tract Discomfort and age or the kind of treatment. CONCLUSION Patients included in this study did not show more subjective Voice Handicap or Vocal Tract Discomfort than normal hearing peers. Scores of VTD Scale and VHI-9i did not depend on the duration of hearing loss, speech comprehension, kind of treatment or age.
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Affiliation(s)
- Julia Lukaschyk
- ENT, Phoniatrics and Pedaudiology - Klosterstern, Eppendorfer Baum 3, Hamburg 20249, Germany.
| | - Angelika Illg
- Department of Otolaryngology, Hannover Medical University, Hannover, Germany
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Tans L, Al-Mamgani A, Kwa SLS, Elbers JBW, Keskin-Cambay F, Sewnaik A, Dorr M, Nout R, Heemsbergen W. Single vocal cord irradiation for early-stage glottic cancer: Excellent local control and favorable toxicity profile. Oral Oncol 2022; 127:105782. [PMID: 35276637 DOI: 10.1016/j.oraloncology.2022.105782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/27/2022] [Accepted: 02/14/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To validate the earlier reported promising oncologic outcomes and favorable toxicity profile following single vocal cord irradiation (SVCI) in an expanded cohort of patients with early-stage glottic cancer treated at our institute with longer follow-up time. MATERIALS AND METHODS Between February 2011 and January 2020, 111 consecutive patients with early-stage glottic cancer were treated with SVCI to the whole involved vocal cord (58.08 Gy, given in 16 fractions of 3.63 Gy). Setup verification was done using cone-beam CT, prior to each fraction. The endpoints were local control (LC), overall survival (OS), grade ≥ 3 toxicity and voice quality assessment using voice-handicap index (VHI) questionnaires. RESULTS Median follow-up was 41 months (range; 8-84). Two patients developed in-field local failure (LF). The 3- and 5-year LC rates were 99.1% and 97.1%, respectively. As both patients with LF were successfully salvaged with total laryngectomy, the 5-year ultimate LC-rates was 99%. The 5-years OS was 80.6%. All patients finished treatment without any interruption. No patients developed acute grade ≥ 3 toxicity. Late grade 3 toxicity was reported in 7 patients (6.5%) out of 108 patients evaluable for late toxicity; 2 because of severe hoarseness and 5 because of laryngeal radionecrosis (4.5%). The 5-years laryngectomy-free survival was 98.1%. The VHI-scores improved over time, only 22% of patients had VHI > 30 at 3-years post-radiotherapy, compared to 38% at baseline. CONCLUSIONS Local control rate and laryngectomy-free survival of SVCI are excellent with favorable toxicity profile and good VHI-score. These results validate our early results.
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Affiliation(s)
- Lisa Tans
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands.
| | - Abrahim Al-Mamgani
- Department of Radiation Oncology, Netherlands Cancer Institute/Antoni van Leeuwenhoek, Amsterdam, the Netherlands.
| | - Stefan L S Kwa
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands.
| | - Jos B W Elbers
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands.
| | - Fatma Keskin-Cambay
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands.
| | - Aniel Sewnaik
- Department of Otolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
| | - Maarten Dorr
- Department of Otolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
| | - Remi Nout
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands.
| | - Wilma Heemsbergen
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands.
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Koyuncu H, Fidan V, Toktas H, Binay O, Celik H. Effect of ketogenic diet versus regular diet on voice quality of patients with Parkinson's disease. Acta Neurol Belg 2021; 121:1729-1732. [PMID: 32892250 DOI: 10.1007/s13760-020-01486-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/26/2020] [Indexed: 11/24/2022]
Abstract
Diets that have effects on health problems can vary in their composition. Whilst following a regular diet (RD) a person typically consumes about 30% of calories from fat. Ketogenic diet (KD) is a form of diet whereby a person consumes as much as 90% of calories from fat. KD has been trialed as a treatment for neurological diseases and obesity. Parkinson's disease (PD) is a neurologic disease that impacts the quality of voice. Voice Handicap Index (VHI) is a test that gives information to clinical and physiological assessment about voice. We assessed the impact of KD and RD on voice quality (VQ). Seventy-four patients with PD who reported a voice disorder related to their disease were randomly assigned to the KD or RD groups. We investigated the VHI change of subjects before and 3 months after diet. Sixty-eight PD patients completed the study. Baseline VHI values did not differ significantly between groups. All mean VHI parameters improved in KD group (p˂ 0.001). Currently there are different therapies that address speech and voice disorders in patients with PD. As such KD may be an alternative therapy to improve VQ of patients with PD. A larger sample size is necessary to determine the role and pathophysiology of KD on VQ of PD patients.
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Affiliation(s)
- Handan Koyuncu
- Department of Otorhinolaryngology, Eskisehir Gov Hosp, Cavdarlar Street, Eskisehir, 26080, Turkey
| | - Vural Fidan
- Department of Otorhinolaryngology, Eskisehir Gov Hosp, Cavdarlar Street, Eskisehir, 26080, Turkey.
| | - Hayal Toktas
- Department of Neurology, Atasehir Memorial Hospital, Istanbul, Turkey
| | - Omer Binay
- Department of Otorhinolaryngology, Corlu State Hospital, Tekirdag, Turkey
| | - Hamit Celik
- Department of Neurology, Buhara Hospital, Erzurum, Turkey
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Valsamidis K, Printza A, Constantinidis J, Okalidou A, Triaridis S. Nasalance and perceived voice changes in patients undergoing septoplasty and turbinate hypertrophy reduction. Eur Arch Otorhinolaryngol 2021; 279:1899-1910. [PMID: 34125283 DOI: 10.1007/s00405-021-06937-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/09/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this study was to investigate the changes in voice nasality after septoplasty and turbinate hypertrophy reduction and to evaluate the effect of these changes on patients' voice-related quality of life. METHODS Sixty patients with nasal obstruction symptoms caused by septal deviation and inferior turbinate hypertrophy who underwent septoplasty and inferior turbinate hypertrophy reduction and 25 healthy controls were included. Active anterior rhinomanometry and acoustic rhinometry were utilized for the evaluation of nasal patency and nasometry was used for quantitative assessment of nasalance. All participants completed validated questionnaires for assessing nasal obstruction symptom severity, psychological status and the impact of voice performance on their quality of life preoperatively and 6 months after septoplasty. RESULTS Patients presented preoperatively statistically significantly lower nasalance scores and higher VHI scores than controls (p < 0.05). Septoplasty and inferior turbinate hypertrophy reduction led to improvement of nasalance for the nasal text and the physical subscale of the VHI scores. Postoperatively, there were no statistically significant differences in nasalance and VHI scores between patients and controls. Significant correlations were found only for the baseline and the postoperative nasalance scores for the nasal text and the total nasal cavity volume (p < 0.05). Postoperatively, patients who presented significant improvement of nasal obstruction symptoms and resolution of stress levels were more likely to positively evaluate the impact of their voice quality on their daily life (OR: 2.32, 95% CI 1.08-5.15, p = 0.041 and OR: 3.06, 95% CI 1.15-7.04, p = 0.038, respectively). CONCLUSION Septoplasty and inferior turbinate hypertrophy reduction may increase the nasal resonance, but in the long term, this change appears not to be significant enough. The severity of nasal obstruction symptoms and psychological status mainly affect the patients' perceptual assessment regarding the effect of voice performance on their quality of life.
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Affiliation(s)
- Konstantinos Valsamidis
- 1st Otolaryngology Department, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
| | - Athanasia Printza
- 1st Otolaryngology Department, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
| | - Jannis Constantinidis
- 1st Otolaryngology Department, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece
| | - Areti Okalidou
- Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece
| | - Stefanos Triaridis
- 1st Otolaryngology Department, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54124, Thessaloniki, Greece.
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Zeleník K, Formánek M, Walderová R, Formánková D, Komínek P. Five-year results of vocal fold augmentation using autologous fat or calcium hydroxylapatite. Eur Arch Otorhinolaryngol 2021; 278:1139-44. [PMID: 33226462 DOI: 10.1007/s00405-020-06479-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/05/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate 5-year voice outcomes of vocal fold augmentation (VFA) using autologous fat (AF) injection via direct microlaryngoscopy versus office-based calcium hydroxylapatite (CaHA) injection. METHODS Retrospective study of patients who underwent VFA between 2012 and 2015, with a 5-year follow-up. Patients with a glottic gap of ≤ 3 mm caused by unilateral vocal fold paralysis or vocal fold atrophy were included in the study. VFA was performed using AF injection via direct microlaryngoscopy in 17 patients, and using office-based CaHA injection in 19 patients. Subjective satisfaction with voice, voice handicap index (VHI), and maximal phonation time (MPT) were analyzed pre-injection, and at 12 and 60 months post-VFA. RESULTS Altogether 36 patients underwent VFA between 2012 and 2015, of whom 5 were excluded within 1 year post-VFA, and 2 were excluded between 1 and 5 years post-VFA. Of the remaining 29 patients, 3 (10.3%) underwent re-intervention at between 1 and 3 years post-VFA. Thus, the 5-year follow-up included 26 patients (72.2%; 11 males and 15 females). At 5 years after surgery, 73.1% of the patients were satisfied with their voice, with no significant between-group difference (P = 0.307). The mean improvement of VHI was 28.8 ± 17.82 in the autologous fat group versus 33 ± 26.24 in the CaHA group (P = 0.458). MPT improvement was also similar between the two groups: 6.2 ± 4.26 for the autologous fat group versus 6.3 ± 4.34 for the CaHA group (P = 0.667). CONCLUSIONS Both AF injection via direct microlaryngoscopy and office-based CaHA injection yielded good and comparable 5-year results.
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Alarouj H, Althekerallah JM, AlAli H, Ebrahim MA, Ebrahim MAK. A Comparative Study Utilizing the Voice Handicap Index-10 (VHI-10) in Teachers and the General Population of Kuwait. J Voice 2020; 36:289.e1-289.e10. [PMID: 32576523 DOI: 10.1016/j.jvoice.2020.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/10/2020] [Accepted: 05/18/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The objective of this study was to determine the prevalence of voice handicap perception of teachers in Kuwait and compare them within the general population by using the validated Arabic version of the voice handicap index-10 (VHI-10). Moreover, we explored variations within the teaching profession itself with regards to specific characteristics. METHODS The study was a cross-sectional survey design, in which participants from all governates of Kuwait (1820 teachers and 755 controls) completed the validated Arabic VHI-10, health-related, and demographic questions. The questionnaires were distributed among a random sample of elementary, middle, and high school teachers of both genders, and a random sample of the control population. RESULTS The mean VHI-10 of teachers was significantly higher than nonteachers (mean VHI-10 of teachers = 5.7, mean VHI-10 of nonteachers = 3.7, P < 0.001). Furthermore, there was a significant difference between teachers and controls in those who scored >11 in the VHI-10 (>11 = 17.6%, 10.2% respectively, P = <0.001). Female teachers scored a higher mean VHI-10 than male teachers (B = 0.66, P < 0.001). There was no difference in the mean VHI-10 among the different teaching class levels. However, elementary school teachers were the most group to exceed the cut-off point (VHI-10 >11) (Odds Ratio = 1.38, P = 0.04). With regards to smoking, we found no difference in the mean VHI-10 and scoring >11 in the questionnaire. Art and science teachers had the highest mean VHI-10 (P = 0.005 and 0.03, respectively). CONCLUSION The results of the study revealed a higher perception of voice handicap in teachers than nonteachers. Therefore, emphasis should be on teachers in order to prevent voice damage.
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Affiliation(s)
- Hamoud Alarouj
- ENT department, Farwaniya Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Jasem M Althekerallah
- Internal Medicine Department, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Hussain AlAli
- General Surgery Department, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Mohammad A Ebrahim
- General Surgery Department, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Mahmoud A K Ebrahim
- ENT department, Farwaniya Hospital, Ministry of Health, Kuwait City, Kuwait.
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23
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Wertz A, Carroll LM, Zur KB. Pediatric laryngopharyngeal reflux: Perceptual, acoustic, and laryngeal findings. Int J Pediatr Otorhinolaryngol 2020; 133:109974. [PMID: 32197186 DOI: 10.1016/j.ijporl.2020.109974] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/04/2020] [Accepted: 02/27/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Describe acoustic and laryngeal findings in pediatric patients with subjective dysphonia attributed to laryngopharyngeal reflux (LPR). Determine the impact of LPR on perceived voice quality using the pediatric Voice Handicap Index (pVHI). Compare these findings with age-matched normative values as well as data on pediatric patients with dysphonia due to other etiologies. METHODS Retrospective case series of pediatric patients (age 2-17 years) evaluated at a specialty pediatric voice clinic at a tertiary care children's hospital from January 1 2007 to December 31 2017 in whom LPR in whom LPR was deemed to be the most significant contributing factor for dysphonia based on physical examination and history. Patients with structural laryngeal abnormalities unrelated to LPR, such as raised lesions, stenosis, papillomatosis, or vocal fold immobility were excluded. RESULTS 163 out of 1195 evaluable patients met inclusion criteria. Of these, 87% had pVHI and 83% had acoustic data available from their first appointment for analysis. Mean total pVHI score was 24 (range: 0-81). Perturbation measures were elevated in both females (jitter 1.38%, shimmer 4.16%) and males (jitter 2.01%, shimmer 5.62%). Laryngologic assessment revealed: vocal fold changes including erythema and/or pre-nodules in 72% of patients. Cobblestoning of any portion of the pharynx was present in 67% with hypopharyngeal cobblestoning the most common, present in 64% of patients. CONCLUSION Pediatric patients with clinically diagnosed LPR have pVHI, jitter, and shimmer scores that are comparable to previously reported patients with raised lesions, scar and immobility, and values that are significantly higher than published normative data. Dysphonic children should be assessed for LPR and treated when indicated. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Aileen Wertz
- Department of Otolaryngology, Geisinger Medical Center, USA
| | - Linda M Carroll
- Division of Otolaryngology, Children's Hospital of Philadelphia, USA
| | - Karen B Zur
- Division of Otolaryngology, Children's Hospital of Philadelphia, USA; Department of Otolaryngology: Head & Neck Surgery, Perelman School of Medicine, University of Pennsylvania, USA.
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Frajkova Z, Krizekova A, Missikova V, Tedla M. Translation, Cross-Cultural Validation of the Voice Handicap Index (VHI-30) in Slovak Language. J Voice 2020; 36:145.e1-145.e6. [PMID: 32402663 DOI: 10.1016/j.jvoice.2020.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/26/2020] [Accepted: 04/01/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The objective of the study is to verify the psychometric properties of Voice Handicap Index (VHI-30) in Slovak language. METHODS Original VHI-30 has been translated into the Slovak language. Fifty-two dysphonic individuals and 104 individuals of the control group without voice disorders were included in the study. Item to total correlation, internal consistency (Cronbach's alpha coefficient α and split-half coefficient), test-retest reliability (correlation coefficient), and validity of VHI 30 (Kruskal-Wallis test) were analyzed. RESULTS Item analysis proved that questionnaire items have a good to excellent correlation to the total score (0.42-0.87, P < 0.05). Good internal consistency was proved by calculating Cronbach's alpha coefficient (0.88, P < 0.05) and split-half correlation for the Total score in VHI (0.997, P < 0.05). Test-retest reliability was found to be strong (0.86, P < 0.05). Validity results of Slovak VHI suggests that total mean scores of control group were significantly lower than total mean scores of dysphonic groups (structural, neurogenic, inflammatory, functional, and nonspecified). Total mean scores indicated no statistically significant difference between dysphonic groups (P < 0.05). The cut-off value of 21 points was determined by Receiver Operating Characteristics (ROC) analysis. CONCLUSION The results of the study proved that the Slovak VHI-30 is a reliable and valid tool. It is useful for assessing disadvantage related to voice disorders from the patient's perspective.
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Affiliation(s)
- Zofia Frajkova
- Department of ENT and HNS, Medical Faculty of Comenius University, Bratislava, Slovakia; Department of Communication Disorders, Faculty of Education, Comenius University, Bratislava, Slovakia
| | - Alzbeta Krizekova
- Department of Communication Disorders, Faculty of Education, Comenius University, Bratislava, Slovakia
| | - Viera Missikova
- Department of Communication Disorders, Faculty of Education, Comenius University, Bratislava, Slovakia
| | - Miroslav Tedla
- Department of ENT and HNS, Medical Faculty of Comenius University, Bratislava, Slovakia.
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Maksimovic JM, Vukasinovic MM, Vlajinac HD, Jotic AD, Milovanovic MS, Ivanov SY, Maksimovic MZ, Milovanovic JP. Anxiety and depression in patients with vocal fold nodules, edema and polyps. Eur Arch Otorhinolaryngol 2020; 277:2493-500. [PMID: 32355993 DOI: 10.1007/s00405-020-06001-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 04/20/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare the prevalence and severity of depression and anxiety among patients with vocal fold (VF) nodules, polyps and edema. At the same time the aim was to analyse association between severity of distress and the level of vocal handicap as well as to identify other factors related to severity of depression and anxiety in these patients. METHODS To all participants were given five questionnaires: (1) questionnaire on socio-demographic and some other characteristics of patient; (2) Beck's Depression Inventory (BDI); (3) State-Trait Anxiety Inventory (STAI) 1 (State Anxiety); (4) STAI 2 (Trait Anxiety); and (5) Voice Handicap Index (VHI)-10. RESULTS A total of 205 patients were included in this study. Mild-to-severe depression, according to BDI was present in 79 (38.6%) patients. Mild-to-severe state anxiety and trait anxiety were present in 199 (97.1%) and 200 (97.6%) patients, respectively. Only 10 patients had VHI-10 score ≤ 11. Multivariate analyses showed that there were no significant differences in the level of depression and anxiety between patients with VF nodules, polyps and edema. The VHI-10 score was significantly higher in patients with VF edema in comparison with VF nodule patients (p = 0.001), as well as in comparison with VF polyp patients (p = 0.001). CONCLUSION The present study identified a high prevalence of psychological and vocal distress among patients with vocal disorders. Severity of depression and anxiety did not differ between patients with VF nodules, polyps and edema, and it was not related to the level of vocal handicap.
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Wolters TLC, Roerink SHPP, Drenthen LCA, Wagenmakers MAEM, van den Broek GB, Rutten KIM, Herruer JM, Hermus ARMM, Netea-Maier RT. Voice Characteristics in Patients with Acromegaly during Treatment. J Voice 2020; 35:932.e13-932.e27. [PMID: 32005626 DOI: 10.1016/j.jvoice.2020.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Active acromegaly is characterized by Growth Hormone and Insulin-like Growth Factor (IGF)-1 excess. Voice complaints are common in active acromegaly and are suggested to be caused by effects of Growth Hormone or IGF-1 on vocal cords and the surrounding soft tissues. Prospective studies on the course of voice characteristics in acromegaly patients are scarce and results are conflicting. This study investigates objective changes in voice parameters, self-reported perception of voice and laryngostroboscopic features during the first 2.5 years of acromegaly treatment. MATERIAL AND METHOD In this prospective study, acoustic voice analysis (and videolaryngostroboscopic examination were performed in 27 consecutive treatment-naive acromegaly patients at diagnosis (T0), after 1 year (T1) and after 2.5 years (T2) of treatment. The voice handicap index (VHI-30) questionnaire was taken. RESULTS During acromegaly treatment, VHI scores decreased, and mucosal edema & hypertrophy diminished. No significant changes in objective voice parameters were detected. The within-subject change in serum IGF-1 levels (97.3 (40.6-208) to 22.4 (10.2-34.1) nmol/L (P < 0.001)) during follow-up correlated positively with the changes in VHI questionnaire scores (R 0.32-0.45; P = 0.002-0.03). CONCLUSIONS At diagnosis and during acromegaly treatment, mean VHI scores were in the normal range, although they decreased during follow-up. Mucosal edema and hypertrophy largely resolved during treatment. No significant changes in objective voice parameters were observed. Voice characteristics are in the normal range in patients with acromegaly, but may change during treatment. However, voice complaints are important to discuss, since they may influence quality of life.
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Affiliation(s)
- Thalijn L C Wolters
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Sean H P P Roerink
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands
| | - Linda C A Drenthen
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Margaretha A E M Wagenmakers
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Internal Medicine, Center for Lysosomal and Metabolic Diseases, Erasmus MC Medical University Center Rotterdam, Rotterdam, The Netherlands
| | - Guido B van den Broek
- Department of Otolaryngology/Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kim I M Rutten
- Department of Rehabilitation, Section of Speech and Language Therapy, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jasmijn M Herruer
- Department of Otolaryngology/Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Adrianus R M M Hermus
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Romana T Netea-Maier
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands
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Carrera Fernández SM, Massé PG, Wilder F, Preciado D, Rodriguez HA. Index of pediatric voice handicap: Translation, transculturalization and validation to Argentinian Spanish. Int J Pediatr Otorhinolaryngol 2019; 127:109663. [PMID: 31526934 DOI: 10.1016/j.ijporl.2019.109663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/26/2019] [Accepted: 08/28/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Voice disorders are very common in the pediatric population, with 6% and 23% of all children presenting with some form of dysphonia [1,2]. For many years, these patients have been underdiagnosed. There has been increasing awareness and interest in the study of voice alterations in children, and, most importantly, their impact in their quality of life. To do this, an instrument capable of measuring the quality of life in pediatric patients with vocal pathology is required, which can be used extensively in the scientific community. The objective of our study is to carry out the translation, transculturalization and validation of pVHI (Pediatric Voice Handicap Index) to Argentinian Spanish-speakers. MATERIAL AND METHODS A study was carried out in the Hospital de Pediatria Dr. JP Garrahan in the city of Buenos Aires, Argentina. It included patients between 3 and 18 years old. The pVHI was translated and transculturalized for said population and for its validation, a survey was carried out in two groups of patients: one group being children with a background of both reconstructive larynx surgery, and dysphonia (n = 35) and the other group being control patients, without any voice pathology (n = 35). The survey was conducted among either parents or caregivers of the children in question. RESULTS A significant difference was found between both groups, for both overall pVHI score and survey subgroups score (p < 0.001) with an optimal internal confidence and a good Alpha Cronbach for each of the subgroups (functional 0,92; organic 0,87 and emotional 0,88). Test-retest for reliability revealed "p-values" without any significant difference (p > 0.05) for each of all subgroups (functional 0,68; organic 0,32 and emotional 0,72). CONCLUSION The validation and transculturalization of the rate of pediatric vocal impairment to Argentinian Spanish population presented an adequate validity and reliability. The rate of pediatric vocal impairment was identified through this simple and practical survey, offering additional information on the child's own vocal perception by part of the caregiver. We recommend this survey being included as a valuable tool in the evaluation of pediatric dysphonia in Spanish-speaking families.
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Affiliation(s)
| | | | - Fabiana Wilder
- Hospital de Clinicas José de San Martín, Buenos Aires, Argentina
| | - Diego Preciado
- Department of Otolaryngology, Children's National Medical Center, Washington, D.C, USA
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Munjal S, Alam MN, Panda NK. Subjective Evaluation of Voice Characteristics of School Aged Children in a Basket Ball Team. Indian J Otolaryngol Head Neck Surg 2019; 71:465-468. [PMID: 31742004 DOI: 10.1007/s12070-018-1354-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/06/2018] [Indexed: 11/28/2022] Open
Abstract
Voice disorders have been estimated to be present in between 3 and 9% of general population. Sports children have vocal abusive behavior i.e. the extra effort which they put on their voice while playing, leading to voice disorders. It is imperative to find out the voice characteristics of children involved in sports activity. To assess voice characteristics of school aged children, who are active participants in a basket ball team. A group of twenty children (13 males and 7 females) were included in the study. He or she was member of school basket ball team and had participated in many events. The perceptual voice assessment was conducted using GRBAS scale, Buffalo III Voice Profile and Voice Handicap Index (VHI). Findings on GRBAS voice rating scale-In the first parameter i.e. grade 46.7% of the subjects reported slight hoarse component. In the second parameter i.e. Roughness 46.7% of the subjects showed slight roughness component. In another parameter i.e. the asthenia 20% % of the subjects reported slight asthenia component in their voice. In the next parameter i.e. strain in the voice, 26.7% of the subjects showed slight strain component in their voice. Finding on BUFFALO III voice screening profile-In the laryngeal tone, 46.7% of the subjects showed mild hoarse component. Findings on voice handicap index (VHI)-28% of the subjects had functional symptoms of voice problems. 43% of the subjects had some physical symptoms while 28% had affected emotional component. Present study is first of its kind to focus on voice disorders among school going children who are members of a basket ball team. During sport events players tend to scream in order to communicate among their team mates, to show their aggressiveness to their opponents and to show excitement of win or frustration of the lost match leading to various voice problems. There is a high probability of occurrence of voice disorders among children who are active participants of basket ball. Proper counselling of these children is required for preventive measures and to seek voice therapy when required.
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Sasindran V, Moosankutty S, Mathew N, George NS. Study of Pre and Post Operative Videostroboscopic Evaluation of Benign Vocal Cord Lesions. Indian J Otolaryngol Head Neck Surg 2019; 71:333-340. [PMID: 31741982 DOI: 10.1007/s12070-018-1303-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 03/13/2018] [Indexed: 11/27/2022] Open
Abstract
To determine pre and postoperative vocal fold vibratory changes using videostroboscopy (VS) and effect of surgery on functional, physical and emotional levels of voice using voice handicap index (VHI). To determine correlation between VHI and VS in patients with benign vocal fold pathology. This is a prospective study done at Pushpagiri Medical College. 40 patients in the age group of 14-75 years who presented with complaints of voice change were included. VS and VHI of patients done preoperatively in 40 patients. Patients were re-evaluated postoperatively at 1 month by VHI and VS. All patients underwent microlaryngoscopic excision of the benign vocal cord lesion with biopsy under GA in the conventional manner. One month postoperatively, these patients were evaluated by VS and VHI and the findings noted. There was statistically significant improvement in the stroboscopy ratings and VHI scores post operatively (p < 0.0001). The mucosal wave was diminished or absent in 100% of the studied TVC cysts and present in approximately 60% of vocal polyps. There was no significant correlation found between preoperative VHI scores and stroboscopy ratings except for mucosal waves. Whereas there was significant correlation noted between the VHI subscales and total scores with stroboscopic scores postoperatively except for symmetry. All but 6 patients in this study benefitted from surgery and 85% had a normal voice post-operatively. Pre and post operative assessment of patients with benign vocal fold lesions by stroboscopy and VHI is a useful way to determine the degree of improvement following surgery.
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Affiliation(s)
- Vivek Sasindran
- Department of ENT, Pushpagiri Institute of Medical Science and Research Centre, Thiruvalla, Pathanamthitta, Kerala India
| | - Sabah Moosankutty
- Department of ENT, Pushpagiri Institute of Medical Science and Research Centre, Thiruvalla, Pathanamthitta, Kerala India
| | - Nidhi Mathew
- Department of ENT, Pushpagiri Institute of Medical Science and Research Centre, Thiruvalla, Pathanamthitta, Kerala India
| | - Neethu Sara George
- Department of ENT, Pushpagiri Institute of Medical Science and Research Centre, Thiruvalla, Pathanamthitta, Kerala India
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Mobarsa V, Samdani SK, Gurjar VS. Outcome Analysis of Microlaryngeal Surgery for Benign Lesions of Vocal Cord Using Videostroboscopy and Voice Handicap Index. Indian J Otolaryngol Head Neck Surg 2019; 71:327-332. [PMID: 31741981 DOI: 10.1007/s12070-018-1300-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 03/12/2018] [Indexed: 10/17/2022] Open
Abstract
Benign vocal cord mass lesions are common causes of dysphonia which are often surgically correctable. They include lesions like vocal polyps, vocal cysts, vocal nodules and Reinke's edema. A prospective study of 30 patients was carried out at SMS medical college and hospital between April 2014 to November 2015 after institutional ethical committee clearance. The purpose of our study was to evaluate outcome of microlaryngeal surgery for benign lesions of vocal cord using videostroboscopy and voice handicap index. All cases between the age group 15-60 years with clinical evidence of benign lesions of vocal cord were included in study. Preoperative amplitude, mucosal wave, glottic closure was seen by videostroboscopy and subjective assessment of severity of handicap in voice was assessed by set of questionnaire using voice handicap index (Jacobson et al. in Am J Speech Lang Pathol 6: 66-70, 1997). Postoperative follow up was done at 3rd week and 10th week, and outcome of microlaryngeal surgery was assessed using videostroboscope and voice handicap index. At the end of study data was compiled systemically and analysed using paired 't' test and Chi square test. Our study observed statistically significant improvement in amplitude and mucosal wave and glottic closure. Subjective improvement in perception of severity of handicap in voice was analysed by voice handicap index which shows statistically significant data. Overall our study conclude microlaryngeal surgery as an effective way for improvement in speech parameters, that can be assessed by use of videostroboscopy and voice handicap index.
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Affiliation(s)
- Veena Mobarsa
- Department of ENT, SMS Medical College, Jaipur, Rajasthan 302004 India
| | - Sunil K Samdani
- Department of ENT, SMS Medical College, Jaipur, Rajasthan 302004 India
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Aghadoost S, Jalaie S, Khatoonabadi AR, Dabirmoghaddam P, Khoddami SM. A Study of Vocal Facilitating Techniques Compared to Manual Circumlaryngeal Therapy in Teachers With Muscle Tension Dysphonia. J Voice 2019; 34:963.e11-963.e21. [PMID: 31353126 DOI: 10.1016/j.jvoice.2019.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 06/01/2019] [Accepted: 06/05/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE There are several voice therapy techniques been suggested in patients with muscle tension dysphonia (MTD), however a few studies are compared between them. The purpose of present study was to compare the effect of vocal facilitating techniques (VFTs) and manual circumlaryngeal therapy (MCT) in teachers with MTD. STUDY DESIGN This is a randomized clinical trial study. METHODS Sixteen teachers with MTD (female; mean age: 38.6 ± 4.6 years) participated in this study. The participants allocated to two treatment groups: the first group received VFTs (n: 8) and MCT was presented to the second one (n: 8). In each group, the voice therapy techniques were given for 10 individual sessions twice a week. The effect of both techniques was assessed using voice handicap index (VHI) and dysphonia severity index (DSI). RESULTS Within group comparison, the VHI, DSI, and theirs components showed significantly better results after both treatment groups (P ≤ 0.05). Although, effect size was strong for all target features (η2 > 0.36); the greatest magnitude was obtained on the physical subscale of VHI following MCT and for the DSI after VFTs (η2 = 0.92 and 0.90, respectively). Moreover, the interactive effect of time and treatment groups indicated that there was significant main effect on the physical and functional subscales of VHI (P = 0.00 and 0.02, respectively) as well as I-low and DSI (P = 0.01 and 0.02, respectively). CONCLUSION VFTs and MCT are two effective techniques in voice therapy of teachers with MTD. However, the greatest improvement obtained on the DSI following VFTs and for the physical aspect of VHI after MCT demonstrated voice therapist can use appropriate technique based on the voice complaints and results of voice assessments in MTD.
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Affiliation(s)
- Samira Aghadoost
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Jalaie
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Khatoonabadi
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Seyyedeh Maryam Khoddami
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
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Lyu D, Huang MJ, Chen Y, Ren J, Zheng YT, Hu JJ, Yang H. [The application of pediatric voice handicap index in children with voice disorders]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 54:121-125. [PMID: 30776864 DOI: 10.3760/cma.j.issn.1673-0860.2019.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: To access the influence of voice disorders on children's voice-related quality of life through the parental version of pediatric voice handicap index (pVHI). Methods: From April 2017 to March 2018, a total of 192 children with voice disorders (dysphonic group) and 111 children without voice disorders (control group) were enrolled in this work. Parents of children in both groups were asked for fill out the questionnaire containing the parental version of pVHI and the data of non-normal distribution were analyzed by Mann-Whitney U test. Spearman test was used for correlation analysis. Results: (1)Vocal cord nodule was the most common voice disorder in children, and boys were more susceptible to voice disorder than girls in this study (70.3%(135/192) vs 29.7%(57/192)). (2)The most common voice abuse or misuse habit was "Shouting loudly". (3)In dysphonic group, the scores of function, physiology, emotion and total were higher than those in control group (all P<0.05). (4)In dysphonic group, there was a weak correlation between the parents' overall evaluation of the children's voice status and the three dimensions of the parental version of pVHI (function: r=0.339, physiology: r=0.334, emotion: r=0.208, all P<0.001). Conclusions: Voice disorders can cause a negative impact on children's quality of life. Parental version of pVHI can be used to assess the voice-related quality of life in children with voice disorders.
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Affiliation(s)
- D Lyu
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - M J Huang
- Department of Otorhinolaryngology, Women's & Children's Central Hospital, Chengdu 610031, China
| | - Y Chen
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - J Ren
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Y T Zheng
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - J J Hu
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - H Yang
- Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
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Pommée T, Maryn Y, Finck C, Morsomme D. The Acoustic Voice Quality Index, Version 03.01, in French and the Voice Handicap Index. J Voice 2018; 34:646.e1-646.e10. [PMID: 30583889 DOI: 10.1016/j.jvoice.2018.11.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The Acoustic Voice Quality Index (AVQI), version 03.01, is a tool for quantitative assessment of the overall severity of dysphonia. Its computation includes six acoustic parameters, which are all analyzed with Praat freeware. It is based on recordings of a sustained vowel and part of a text read aloud. The psychometric qualities of this tool in various languages, including French, have been confirmed by numerous publications. However, studies investigating the correlation between tools for objective vocal assessment and voice-related quality of life show inconsistent results. Hence, the aim of this study was to contribute to the debate on measuring the correlations between the AVQI 03.01 score computed on French samples and the Voice Handicap Index (VHI). METHODS Data from 78 patients were used; they were collected during initial vocal assessment and stored in the ear, nose, and throat caseload database of the University Hospital of Liège. The Spearman rank-order correlations (rs) between the VHI total score and subscores and the AVQI 03.01 scores for French samples were measured. The correlation between the diagnostic decisions ("normophonia" versus "dysphonia") of both tools was assessed using Cramer's phi. RESULTS The Spearman correlation between AVQI 03.01 score and total VHI score, controlling for age, was moderate (rs = 0.62, P < 0.0001). The correlations between the AVQI 03.01 score and the functional, emotional, and physical subscores of the VHI were also moderate (rs = 0.643, 0.543, and 0.514, respectively, P < 0.0001). The correlation between the two instruments' diagnostic decisions ("normophonia" versus "dysphonia") was also moderate (φ = 0.52, P = 0.000). CONCLUSIONS Although AVQI 03.01 scores were moderately correlated with the VHI total score and subscores, they measure two different things. The AVQI 03.01 assesses overall voice quality in terms of acoustic parameters, whereas the VHI assesses the multidetermined impact on the patient's everyday life. Both results should thus be taken into account, as part of a comprehensive vocal assessment.
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Affiliation(s)
- Timothy Pommée
- University of Liège, Faculté de Psychologie, Logopédie et Sciences de l'Education, Unité de Logopédie des Troubles de la Voix, Liège, Belgium.
| | - Youri Maryn
- Faculty of Medicine and Health Sciences, University of Antwerp; Antwerp, Belgium; European Institute for ORL, Sint-Augustinus Hospital, Antwerp, Belgium; Department of Speech, Language and Hearing Sciences, Ghent University; Ghent, Belgium; Faculty of Education, Health and Social Work, University College Ghent, Liège, Belgium
| | - Camille Finck
- Centre Hospitalier Universitaire de Liège, Service ORL, Liège, Belgium
| | - Dominique Morsomme
- University of Liège, Faculté de Psychologie, Logopédie et Sciences de l'Education, Unité de Logopédie des Troubles de la Voix, Liège, Belgium
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Karlsen T, Sandvik L, Heimdal JH, Aarstad HJ. Acoustic Voice Analysis and Maximum Phonation Time in Relation to Voice Handicap Index Score and Larynx Disease. J Voice 2018; 34:161.e27-161.e35. [PMID: 30093166 DOI: 10.1016/j.jvoice.2018.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/29/2018] [Accepted: 07/02/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Patients with voice-related disorders are ideally treated by a multidisciplinary team. Acoustic voice analysis and patient-reported outcome measures are recommended parts of the clinical assessment. The present paper aims at further documenting the importance of acoustic voice analyses, maximum phonation time (MPT) and Voice Handicap Index (VHI) into clinical investigations. STUDY DESIGN The participants (N = 80 larynx cancer, N = 32 recurrent palsy, N = 23 dysfunctional, N = 75 degenerative/inflammation (N = 19 various excluded)) were included consecutively at the outpatient laryngology clinic at Haukeland University Hospital. In addition, a control group of 98 healthy subjects were included. METHOD Voice samples, MPT, and the VHI scores in addition to standard clinical information were obtained. Acoustic analyses were performed from these samples determining level of jitter, shimmer and Noise-to-Harmonic ratio (NHR) as well as analyzing frequency of a prolonged vowel. RESULTS Jitter, shimmer, and NHR scores correlated strongly (r ≈ 0.8; P < 0.001) to each other. By Analysis of Variance analyses, we have determined significant dependence on diagnostic group analyzing all the obtained acoustic scores (all P < 0.001). All patient groups but the dysfunctional group scored to some extent worse than the control group (mostly at P < 0.001). In addition, jitter scores from dysfunction group were lower than recurrent palsy group (P < 0.05) and shimmer scores were lower among dysfunctional than the cancer group (P < 0.05). Regarding NHR the cancer patients scored higher than the degenerative/inflammatory group (P < 0.05). The cancer group scored with longer MPT than the degenerative/inflammatory (P < 0.001) and recurrent palsy groups (P < 0.05). CONCLUSION Among larynx disease patients acoustic and MPT analyses segregated with all determined analyses between patients and control conditions except the dysfunctional group, but also to some extent between various patient groups. VHI scores correlated to jitter, shimmer and NHR scores among cancer and degenerative/inflammatory disease patients. Acoustic analyses potentially add information useful to laryngological patient studies.
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Affiliation(s)
- Tom Karlsen
- Department of Otorhinolaryngology-Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Department of Speech and Language, Statped Vest, Bergen, Norway.
| | - Lorentz Sandvik
- Department of Otorhinolaryngology-Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
| | - John-Helge Heimdal
- Department of Otorhinolaryngology-Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Hans Jørgen Aarstad
- Department of Otorhinolaryngology-Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Wang H, Zhuge P, You H, Zhang Y, Zhang Z. Comparison of the efficacy of vocal training and vocal microsurgery in patients with early vocal fold polyp. Braz J Otorhinolaryngol 2018; 85:678-684. [PMID: 29784620 PMCID: PMC9443021 DOI: 10.1016/j.bjorl.2018.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 03/13/2018] [Accepted: 03/29/2018] [Indexed: 02/03/2023] Open
Abstract
Introduction Vocal fold polyp is a benign proliferative disease in the superficial lamina propria of the vocal fold, and vocal microsurgery can improve the voice quality of patients with vocal fold polyp. In preliminary studies, we found that vocal training could improve the vocal quality of patients with early vocal fold polyp. Objective This study aimed to compare the efficacies of vocal training and vocal microsurgery in patients with early vocal fold polyp. Methods A total of 38 patients with early vocal fold polyp underwent 3 months of vocal training (VT group); another 31 patients with early vocal fold polyp underwent vocal microsurgery (VM group). All subjects were assessed using laryngostroboscopy, voice handicap index, and dysphonia severity index, and the efficacies of vocal training and vocal microsurgery were compared. Results The cure rates of vocal training and vocal microsurgery were 31.6% (12/38) and 100% (31/31), respectively. The intragroup paired-sample t-test showed that the post treatment vocal handicap index, maximum phonation time, highest frequency (F0-high), lowest intensity (I-low), and dysphonia severity index in both the VT and VM groups were better than those before treatment, except for the jitter value. The intergroup independent-sample t-test revealed that the emotional values of vocal handicap index (t = − 2.22, p = 0.03), maximum phonation time (t = 2.54, p = 0.013), jitter (t = − 2.11, p = 0.03), and dysphonia severity index (t = 3.24, p = 0.002) in the VT group were better than those in the VM group. Conclusions Both, vocal training and vocal microsurgery could improve the voice quality of patients with early vocal fold polyp, and these methods present different advantages.
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Affiliation(s)
- Hanqing Wang
- Jinhua Central Hospital, Department of Otolaryngology, Jinhua, China
| | - Pan Zhuge
- Jinhua Central Hospital, Department of Otolaryngology, Jinhua, China.
| | - Huihua You
- Jinhua Central Hospital, Department of Otolaryngology, Jinhua, China
| | - Yulan Zhang
- Jinhua Central Hospital, Department of Otolaryngology, Jinhua, China
| | - Zhifeng Zhang
- Jinhua Central Hospital, Department of Otolaryngology, Jinhua, China
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Khatoonabadi AR, Khoramshahi H, Khoddami SM, Dabirmoghaddam P, Nakhostin Ansari N. Patient-Based Assessment of Effectiveness of Voice Therapy in Vocal Mass Lesions with Secondary Muscle Tension Dysphonia. Iran J Otorhinolaryngol 2018; 30:131-137. [PMID: 29876327 PMCID: PMC5985614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 01/31/2018] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Use of patient-based voice assessment scales is an appropriate method that is frequently used to demonstrate effectiveness of voice therapy. This study was aimed at determining the effectiveness of voice therapy among patients with secondary muscle tension dysphonia (MTD) and vocal mass lesions. MATERIALS AND METHODS The study design was prospective, with within-participant repeated measures. Thirty-three patients with secondary MTD and vocal mass lesions participated in the study, selected on the basis of voice history, laryngeal palpation, and videostroboscopy examination. An experienced otolaryngologist and one experienced speech language pathologist undertook the diagnostic process. Voice therapy included both direct and indirect techniques and lasted approximately 2 months for all included patients. The voice handicap index (VHI) was used to evaluate the effectiveness of voice therapy among included patients. Paired t-test, size of the standardized effect (ESI), and mean standardized response (ESII) were used to analyze effectiveness of the target voice therapy. RESULTS The findings of this study indicate a statistically significant improvement after the voice therapy protocol (P<0.05; t>1.96). Results of ESI and ESII demonstrate that the VHI scale is sufficiently responsive to detect voice therapy change (ES>0.8). CONCLUSION This study recommends a combination of direct and indirect voice therapy in the vocal rehabilitation of patients with secondary MTD and vocal mass lesions. Furthormore, we recommend use of the VHI scale to show voice therapy changes for both clinical and research purposes.
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Affiliation(s)
- Ahmad Reza Khatoonabadi
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hassan Khoramshahi
- Musculoskeletal RehabilitationResearch Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz,Iran; Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Seyyedeh Maryam Khoddami
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Payman Dabirmoghaddam
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Liu K, Liu S, Zhou Z, Ren Q, Zhong J, Luo R, Qin H, Zhang S, Ge P. Reliability and validity of the Chinese pediatric voice handicap index. Int J Pediatr Otorhinolaryngol 2018; 105:127-131. [PMID: 29447800 DOI: 10.1016/j.ijporl.2017.12.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To evaluate the reliability and validity of the Chinese version of pediatric voice handicap index (pVHI). MATERIAL AND METHODS The original English version-pVHI was translated into Chinese. Parents of 52 children with voice dysphonia and 43 children with no history or symptoms of voice problems were asked to fill the Chinese pVHI questionnaires twice with an interval of 2 weeks. GRB (Grade, Roughness, Breathiness) scale was used for perceptual assessment by two otolaryngologists and one speech pathologist for each child's voice. The internal consistency was assessed using Cronbach's alpha coefficient. Pearson's correlation coefficient was used to evaluate the test-retest reliability. The Kendall's coefficient of concordance W was used to assess the consistency of GRB scores of 3 voice specialists. The nonparametric Mann-Whitney test was used to assess the differences between the dysphonia group and controls. The correlation between pVHI and GRB scores were assessed using Pearson's correlation coefficient. RESULTS The internal consistency of total score and three subscales scores of Chinese pVHI were 0.788-0.944. The test-retest reliability was 0.631-0.887(P < .001). The pVHI scores of control group significantly were lower than the pathological group (P = .000). The GRB scores of 3 voice specialists have an excellent consistency (W = 0.694-0.807, P = .000). The pVHI scores positively correlated with GRB assessment (P < .01). CONCLUSIONS The Chinese version of pVHI had a good reliability and validity. It can be applicable and useful supplementary tool for evaluating parents' perception of their children's dysphonia.
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Affiliation(s)
- Kena Liu
- School of Medicine, South China University of Technology, China
| | - Shaofeng Liu
- Department of Otolaryngology, Guangzhou Women and Children's Medical Center, China
| | - Zhou Zhou
- Department of Otolaryngology, Shenzhen People's Hospital, China
| | - Qinyi Ren
- Department of Otolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Southern Medical University, China
| | - Jie Zhong
- Department of Otolaryngology, Guangzhou Women and Children's Medical Center, China
| | - Renzhong Luo
- Department of Otolaryngology, Guangzhou Women and Children's Medical Center, China
| | - Huabiao Qin
- School of Electronic and Information Engineering, South China University of Technology, China
| | - Siyi Zhang
- School of Medicine, South China University of Technology, China; Department of Otolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Southern Medical University, China
| | - Pingjiang Ge
- School of Medicine, South China University of Technology, China; Department of Otolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Southern Medical University, China.
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Malmström E, Hertegård S. Background Factors and Subjective Voice Symptoms in Patients with Acquired Vocal Fold Scarring and Sulcus Vocalis. Folia Phoniatr Logop 2018; 69:125-130. [PMID: 29346796 DOI: 10.1159/000484169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 10/11/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Vocal fold scarring (VFS) and sulcus vocalis (SV) often result in severe and chronic voice disorders. This study compares subjective voice complaints as rated with the Voice Handicap Index and etiological factors for patients with VFS and SV. PATIENTS AND METHODS Data were collected from the medical records at the Department of Otorhinolaryngology, Karolinska University Hospital, for 27 VFS patients and 27 SV patients. Descriptive background factors were compared between the groups and data were compared from the Swedish Voice Handicap Index (Sw-VHI) questionnaires. RESULTS Previous laryngeal surgery/trauma was significantly more common for the patients with VFS. The SV group had significantly more persistent dysphonia since childhood. It was significantly more common to have a non-Germanic language origin among the SV patients. VFS and SV rated high for the total median Sw-VHI scores. The VFS group's total Sw-VHI and the three domain scores were significantly higher compared to the SV group. The physical domain showed a significantly higher score when compared to the functional and emotional domains in the SV cohort and when compared to the emotional domain in the VFS cohort. CONCLUSION There are significant differences between the VFS group and SV group regarding etiological factors as well as the Sw-VHI. The degree and profile of VHI should be considered when selecting patients and evaluating the result of new treatments for this group of patients.
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Devadas U, Dhanya M, Gunjawate D. Adaptation and validation of the Malayalam pediatric voice handicap index. Int J Pediatr Otorhinolaryngol 2015; 79:1425-8. [PMID: 26143127 DOI: 10.1016/j.ijporl.2015.06.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 06/13/2015] [Accepted: 06/16/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The aim of the present study was to adapt and validate the English version of pediatric voice handicap index (pVHI) into Malayalam language. METHODS The English version of pediatric voice handicap index was translated into Malayalam language using parallel back translation. The translated version was content validated by three qualified speech language pathologists. The content familiarity was carried out by 10 parents of children with voice problems. This was distributed to 136 parents (57 parents of children with dysphonia, 79 parents of children with no voice problems). The internal consistency and test--retest reliability was determined using Cronbach's alpha and intraclass correlation coefficient. Independent sample t-test was used to assess the difference in means. Kappa coefficient was used to determine the correlation between overall severity of the problem and total pVHI. Discriminant analysis was used to identify thresholds for differentiating between normal and dysphonic participants. RESULTS The results obtained revealed that the Malayalam version of pVHI has an excellent internal consistency; total (α=0.974), functional (α=0.922), physical (α=0.953), and emotional (α=0.923). There was an excellent test-retest reliability; total (r=0.937), functional (r=0.954), physical (r=0.95), and emotional (r=0.929). The prediction probability of the dysphonics is 98.2% using the discriminant score function. CONCLUSIONS The translated and validated pVHI tool can be effectively used in the assessment of children with voice problems. It can provide a better insight into the parents' perception of their child's voice problems.
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Pinar D, Cincik H, Erkul E, Gungor A. Investigating the Effects of Smoking on Young Adult Male Voice by Using Multidimensional Methods. J Voice 2015; 30:721-725. [PMID: 26277074 DOI: 10.1016/j.jvoice.2015.07.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 07/13/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Smoking is one of the most common harmful habits in the world, especially common among young adult male population in Turkey. The purpose of this study was to evaluate the effect of smoking on the young adults' male voice using multidimensional voice assessment methods. STUDY DESIGN This is a case-control study. METHODS The study included 109 young adult men, 51 nonsmokers and 58 smokers between the ages of 20 and 34 years. The voice evaluation protocol consisted of voice handicap index (VHI), maximum phonation time (MPT), and perceptual, acoustic, and videostroboscopic analyses. RESULTS A statistically significant increase for physical, physiological, and total scores of VHI was found in smokers group (P < 0.05). MPT showed significantly lower values among smokers (P < 0.05). There were no significant changes in perceptual analysis of voice samples between smoker and nonsmoker groups. There were no significant changes in any of the acoustic parameters between smoker and nonsmoker groups. Results of videostroboscopic analysis showed significant relationships between smoking and increased vocal fold erythema (P < 0.05). In addition, significantly asymmetry, amplitude, and periodicity abnormality of vocal fold movements were observed in smoker group during phonation (P < 0.05). CONCLUSIONS The results of this study indicate that observable signs of laryngeal irritation and disturbed phonatory physiology occur even in young adults with relatively brief smoking habits. Subjective symptoms of smoking on voice appear to occur earlier than objective findings.
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Affiliation(s)
- Dogan Pinar
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
| | - Hakan Cincik
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - Evren Erkul
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - Atila Gungor
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
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SEIFPANAHI S, JALAIE S, NIKOO MR, SOBHANI-RAD D. Translated Versions of Voice Handicap Index (VHI)-30 across Languages: A Systematic Review. Iran J Public Health 2015; 44:458-69. [PMID: 26056664 PMCID: PMC4441958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 02/15/2015] [Indexed: 11/02/2022]
Abstract
BACKGROUND In this systematic review, the aim is to investigate different VHI-30 versions between languages regarding their validity, reliability and their translation process. METHODS Articles were extracted systematically from some of the prime databases including Cochrane, googlescholar, MEDLINE (via PubMed gate), Sciencedirect, Web of science, and their reference lists by Voice Handicap Index keyword with only title limitation and time of publication (from 1997 to 2014). However the other limitations (e.g. excluding non-English, other versions of VHI ones, and so on) applied manually after studying the papers. In order to appraise the methodology of the papers, three authors did it by 12-item diagnostic test checklist in "Critical Appraisal Skills Programme" or (CASP) site. After applying all of the screenings, the papers that had the study eligibility criteria such as; translation, validity, and reliability processes, included in this review. RESULTS The remained non-repeated articles were 12 from different languages. All of them reported validity, reliability and translation method, which presented in details in this review. CONCLUSION Mainly the preferred method for translation in the gathered papers was "Brislin's classic back-translation model (1970), although the procedure was not performed completely but it was more prominent than other translation procedures. High test-retest reliability, internal consistency and moderate construct validity between different languages in regards to all 3 VHI-30 domains confirm the applicability of translated VHI-30 version across languages.
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Affiliation(s)
- Sadegh SEIFPANAHI
- Dept. of Speech & Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shohreh JALAIE
- Biostatistics Division, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza NIKOO
- School of Rehabilitation Sciences, Hamedan University of Medical Sciences, Hamedan, Iran,Corresponding Author:
| | - Davood SOBHANI-RAD
- Dept. of Speech Pathology, Paramedical Science Faculty, Mashhad University of Medical Sciences, Mashhad, Iran
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Van Lierde K, Kryshtopava M, Gadeyne S, Luyten A, D'haeseleer E, Bruneel L, Van Maele G, Boehme B, Piens N, Vonck K. Impact of Vagal Nerve Stimulation on Objective Vocal Quality, a Pilot Study. J Voice 2015; 29:777.e9-15. [PMID: 25795351 DOI: 10.1016/j.jvoice.2015.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 01/30/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the impact of vagal nerve stimulation (VNS) on the vocal quality using the dysphonia severity index (DSI). It was hypothesized that the objective vocal quality and other vocal characteristics are disordered in comparison with an age- and gender-matched control group. In addition, the acoustic vocal parameters were compared during three conditions: at rest, during normal stimulation, and raised stimulation. A significant relation between the amount of stimulation and the presence of disturbed acoustic parameters was hypothesized. METHODS Subjective (auditory-perceptual evaluation and voice handicap index) and objective (aerodynamic, vocal range, acoustic measurements and determination of the DSI) measurements were used to determine the vocal quality in 13 subjects with VNS in three different conditions (at rest and during normal and raised stimulation) and the age- and gender-matched control group. RESULTS The subjects with VNS had a disordered perceptual vocal quality mainly characterized by the presence of a moderate roughness and slight breathiness, and the objective vocal quality by means of the DSI value is -2.4. During stimulation and especially during raised stimulation, the fundamental frequency is significantly increased. However, the subjects experienced no psychosocial handicapping effect of the vocal quality on the quality of life. CONCLUSIONS Subjects with VNS have typical vocal characteristics. Ear, nose, and throat specialists and voice therapist must be aware of the presence of this vocal pattern at rest and during normal and raised stimulation. Especially, professional voice users and elite vocal performers must be informed before implantation.
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Affiliation(s)
- Kristiane Van Lierde
- Department of Speech, Language, and Hearing Sciences, Ghent University, Gent, Belgium.
| | - Marina Kryshtopava
- Department of Ear, Nose, and Throat and Head and Neck Surgery, Ghent University, Gent, Belgium
| | - Stefanie Gadeyne
- Reference Center for Refractory Epilepsy, Department of Neurology, Ghent University, Gent, Belgium
| | - Anke Luyten
- Department of Speech, Language, and Hearing Sciences, Ghent University, Gent, Belgium
| | - Evelien D'haeseleer
- Department of Speech, Language, and Hearing Sciences, Ghent University, Gent, Belgium
| | - Laura Bruneel
- Department of Speech, Language, and Hearing Sciences, Ghent University, Gent, Belgium
| | | | - Beatrijs Boehme
- Department of Speech, Language, and Hearing Sciences, Ghent University, Gent, Belgium
| | - Nina Piens
- Department of Speech, Language, and Hearing Sciences, Ghent University, Gent, Belgium
| | - Kristl Vonck
- Reference Center for Refractory Epilepsy, Department of Neurology, Ghent University, Gent, Belgium
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Salturk Z, Çakır O, Kumral TL, Yıldırım G, Ötünçtemur A, Aydoğdu Ï, Uyar Y. Subjective and Objective Effects of Androgen Ablation Therapy on Voice. J Voice 2015; 29:490-3. [PMID: 25704476 DOI: 10.1016/j.jvoice.2014.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Accepted: 09/08/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of present study was to evaluate possible side effects of androgen deprivation therapy (ADT) on voice quality by means of objective and subjective measures. STUDY DESIGN Cross-sectional. METHODS Thirty-five male patients who had been diagnosed with prostate cancer and who had been using bicalutamide and goserelin acetate combination for at least 12 months were included in the study. Thirty healthy nonsmoker males of similar age and without any laryngeal pathology constituted the control group. Acoustic and aerodynamic voice analyses and voice handicap index-10 were applied to both groups. Maximum phonation time, fundamental frequency, jitter, shimmer, and noise-to-harmonic ratio were determined during acoustic and aerodynamic voice analyses. RESULTS Maximum phonation times were 18.86 ± 5.24 and 24.20 ± 3.59 in ADT and control groups, respectively. It was significantly higher in the control group. Fundamental frequencies were 143.73 ± 18.47 and 135.00 ± 13.18 in ADT and control groups, respectively. Jitter values were 2.72 ± 0.62 and 1.99 ± 0.27 in ADT and control groups, respectively. Shimmer values were 11.50 ± 1.81 and 10.48 ± 1.36 in ADT and control groups, respectively. Fundamental frequency, jitter, and shimmer values were significantly higher in the ADT group. Noise-to-harmonic ratio values did not differ between groups. Voice handicap index-10 result was significantly higher in the ADT group. CONCLUSIONS ADT has adverse effects on the human voice. Prospective studies with long-term follow-up of a larger cohort are required for more detailed analysis.
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Affiliation(s)
- Ziya Salturk
- Okmeydanı Training and Research Hospital ENT Clinic, Istanbul, Turkey.
| | - Ozan Çakır
- Okmeydanı Training and Research Hospital ENT Clinic, Istanbul, Turkey
| | | | - Güven Yıldırım
- Okmeydanı Training and Research Hospital ENT Clinic, Istanbul, Turkey
| | - Alper Ötünçtemur
- Okmeydanı Training and Research Hospital Urology Clinic, Istanbul, Turkey
| | - Ïmran Aydoğdu
- Okmeydanı Training and Research Hospital ENT Clinic, Istanbul, Turkey
| | - Yavuz Uyar
- Okmeydanı Training and Research Hospital ENT Clinic, Istanbul, Turkey
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Develioglu ON, Paltura C, Koleli H, Kulekci M. The effect of medical treatment on voice quality in allergic rhinitis. Indian J Otolaryngol Head Neck Surg 2013; 65:426-30. [PMID: 24427691 DOI: 10.1007/s12070-013-0639-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 03/06/2013] [Indexed: 10/27/2022] Open
Abstract
To evaluate the change in the voice quality of patients with allergic rhinitis (AR) after medical treatment. The study enrolled 69 subjects: 39 with high serum-specific IgE levels to inhalant allergens as the study group and 30 healthy individuals as controls. All patients were evaluated using the total nasal symptom score (TNSS) and voice handicap index-10 (VHI-10) and then underwent an acoustic voice analysis. After 1 month of treatment with mometasone furoate nasal spray (two 50-μg puffs in each nostril once daily) and desloratadine (5-mg tablet once daily), the patients repeated the surveys and acoustic voice analysis. The results before and after treatment were compared. The TNSS and VHI-10 scores decreased significantly after treatment (p < 0.01). After treatment, the acoustic analysis parameters improved significantly and were similar to the control group, and the maximum phonation time increased significantly (p < 0.05). The voice quality of patients with AR is improved with medical treatment.
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NERI G, CASTIELLO F, VITULLO F, DE ROSA M, CIAMMETTI G, CROCE A. Post-thyroidectomy dysphonia in patients with bilateral resection of the superior laryngeal nerve: a comparative spectrographic study. Acta Otorhinolaryngol Ital 2011; 31:228-34. [PMID: 22065652 PMCID: PMC3203714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2010] [Accepted: 04/03/2011] [Indexed: 10/26/2022]
Abstract
The most serious complications of total thyroidectomy, in cases of widespread and invasive diseases, are mainly hypoparathyroidism and laryngeal inferior nerve palsy. Lesions of the external branch of superior laryngeal nerve instead, although less obvious than the those caused by the recurrent laryngeal nerve lesions, have been taken less into consideration. The frequency of this lesion varies from 14% to 20% of cases, although in reality it is underestimated; in fact, on the one hand it is difficult to assess this, and on the other, post-thyroidectomy dysphonia is often considered inevitable. In the present retrospective research, 15 thyroidectomized patients (4 male, 11 female), have been subjected to qualitative and quantitative evaluation of the voice. Of these, 7 had a nerve lesion, while 8 did not. All the patients received a self-evaluation voice questionnaire (VHI). In all cases, a videolaryngostroboscopy has been carried out and the voice acoustic features examined through a spectrographic analysis. The results showed that removal of the thyroid, at the end of a 12-month post-surgery period, still causes an impact on the qualitative and quantitative aspects of the vocal function, whether the superior larynx nerve was injured or not. The majority of the patients, in both groups, reported that their voice had worsened in quality and durability. Hence, we have shown that the patients with upper larynx nerve lesion have an alteration of F0, show a lower energy level and a modified spectrographic quality compared to patients without injury. This low voice is often considered by patients as a normal consequence of thyroid surgery. The present research confirms that the attempt to identify and protect the superior laryngeal nerve is essential to prevent post-thyroidectomy dysphonia, but this is not sufficient to obtain the best results because of the existence of muscular and psychogenic factors that reduce the still voice capacity of the patient.
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Affiliation(s)
- G. NERI
- Address for correspondence: Dr. Giampiero Neri, Strada Collemarino 136, 65125 Pescara, Italy. Fax: +39 0871 358582. E-mail:
| | | | - F. VITULLO
- Surgical and Experimental Sciences Department, "G. d'Annunzio" University Chieti-Pescara, Chieti, Italy
| | - M. DE ROSA
- Surgical and Experimental Sciences Department, "G. d'Annunzio" University Chieti-Pescara, Chieti, Italy
| | | | - A. CROCE
- Surgical and Experimental Sciences Department, "G. d'Annunzio" University Chieti-Pescara, Chieti, Italy
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Thomas G, Mathews SS, Chrysolyte SB, Rupa V. Outcome analysis of benign vocal cord lesions by videostroboscopy, acoustic analysis and voice handicap index. Indian J Otolaryngol Head Neck Surg 2007; 59:336-40. [PMID: 23120468 DOI: 10.1007/s12070-007-0096-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Benign vocal cord lesions affect vibratory vocal fold function resulting in significant dysphonia. A prospective study of 30 patients with benign vocal fold lesions was undertaken at our centre to compare the pre and post operative voice using videostroboscopy, voice analysis and voice handicap index. The vibratory pattern of the cord improved as evidenced by the stroboscopic parameters-symmetry, mucosal wave and glottic closure (p<0.05). Voice analysis showed a trend towards normalcy but the values obtained did not attain statistical significance. Voice handicap index showed a reduction in the total and the subscales scores. Videostroboscopy along with acoustic analysis and voice handicap index are useful tools in the objective and subjective assessment of the effectiveness of treatment in patients with benign vocal cord lesions. Their routine use in a voice clinic is recommended.
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