Correlation Among the Dysphonia Severity Index (DSI), the RBH Voice Perceptual Evaluation, and Minimum Glottal Area in Female Patients With Vocal Fold Nodules

Abstract

To investigate the clinical significance and correlation of the dysphonia severity index (DSI), the RBH (roughness [R]; breathiness [B]; hoarseness [H]) perceptual voice quality evaluation, and minimum glottal area (MGA) in patients with vocal fold nodules and validate the practicality of the DSI further. The DSI evaluation, the voice RBH perceptual evaluation, and the MGA were performed on 30 female patients with vocal fold nodules (the patient group) and 30 female volunteers with normal voices (the control group). The DSI determination was calculated using the following formula: DSI=0.13×MPT+0.0053×F(0)-High - 0.26×I-Low - 1.18×Jitter(%)+12.4. The RBH evaluation was graded according to four scales. The MGA was measured by KayPENTAX Kips (7105) software. The differences among the DSI, the RBH grade, and MGA of the patients were compared. The median DSI values of the patient group and the control group were -0.81 and 3.79, respectively, and the difference was statistically significant (P<0.01). The median MGA of the patient group and the control group were 355.5 and 121, respectively, and the difference was statistically significant (P<0.01). DSI exhibited moderate negative correlation with R (rP=-0.686, P<0.01), B (rP=-0.609, P<0.01), and H (rP=-0.487, P<0.01). MGA demonstrated moderate positive correlation with R (rP=0.667, P<0.01), B (rP=0.545, P<0.01), and H (rP=0.449, P<0.01), whereas MGA showed strong negative correlation with DSI (rP=-0.888, P<0.01). The application of the DSI as an objective parameter to evaluate dysphonia in female patients with vocal nodules has significant clinical application and good correlation with MGA measurement.