Self-assessment characteristics of voice handicap index for voice disorders and its influencing factors

Abstract

To investigate the self-assessment characteristics of Voice Handicap Index (VHI) for voice disorders and its influencing factors. One thousand seven hundred and sixty six dysphonic patients and 120 control subjects were included in this study. Two hundred twenty seven patients were treated with phonosurgery or Botulinumtoxin injection. VHI was used for self-assessment. Dysphonic patients had worse VHI scores than control (z from 8.039 to 17.043, P = 0.000). There was a significant difference among the VHI scores of different diseases. VHI scores were descending in order among spasmodic dysphonia, vocal fold paralysis, functional dysphonia, sulcus vocalis, benign and malignant tumor of vocal fold, vocal fold cyst, Reinke's edema, vocal fold polyp, vocal fold keratosis and chronic laryngitis, vocal nodule. The emotional scores were the highest in spasmodic dysphonia, and followed by functional dysphonia. In another group, the physical scores were higher than functional scores and emotional scores. Treatment resulted in statistical improvement in VHI scores (P < 0.05). The total scores were different significantly between different educational background and age groups (F from 8.701 to 27.371, P = 0.000). The higher the educational degree, the higher the VHI scores. As to age groups, the juvenile group's scores were the lowest, while the youth's group the highest, then the scores declined when ages increased. As a useful supplementary instrument to measure the voice disorder severity and the treatment's effect, VHI can comprehensively assess the voice handicap's affect to the life quality and the difference after the treatment, especially in physical, functional and emotional aspects, but it is somehow subject to the educational degree and age.