Presence Of Dysphonia Research Articles

Cepstral Acoustic Measurements: Influence of Speech Task and Degree of Vocal Deviation

ObjectiveTo analyze whether there are differences in the cepstral measures obtained in different speech tasks, depending on the presence and degree of vocal deviation, and to analyze if there is a correlation between the cepstral measures obtained from different speech tasks and the general degree of vocal deviation. MethodAnalysis of 258 vocal samples of the sustained vowel [a] and connected speech (counting numbers) from a database, including 160 dysphonic and 98 non-dysphonic voices. The counting number sample were edited in three different durations: counting from 1 to 10, from 1 to 11, and from 1 to 20. Five SLP, voice specialists, carried out the perceptual-auditory judgment (PAJ) of the overall degree of vocal deviation (ODD) using the G from the GRBAS scale. We extracted the cepstral peak prominence (CPP) and smoothed cepstral peak prominence (CPPS) measurements from all the vocal samples using an extraction script in the free software Praat. ResultsCPP and CPPS were different between dysphonic and non-dysphonic individuals, regardless of the speech task, with lower values for dysphonic. Also, CPP values between the vowel and the connected speech tasks were different between both groups. Only the CPPS showed differences between all the speech tasks depending on the degree of vocal deviation. There was a strong negative correlation between the CPPSVowel, CPPS10, CPPS11, CPPS20, and the ODD, and a moderate negative correlation between CPPVowel, CPP10, CPP11, CPP20, and ODD. ConclusionThere are differences in the cepstral measures obtained in different speech tasks, depending on the presence of dysphonia and ODD. CPP and CPPS values are different between dysphonic and non-dysphonic individuals in all speech tasks. There is a moderate negative correlation between CCP in the different speech tasks and ODD while there is a strong negative correlation between CPPS in the different speech tasks and ODD.

Prevalence and recovery of dysphonia in COVID-19 patients requiring intensive care treatment

BackgroundDysphonia and laryngeal pathology are considerable issues in patients hospitalised with COVID-19 with prevalence rates cited between 29% and 79%. Most studies currently are limited to reporting single-institution data with many retrospective. ObjectivesThe aims of this study were to prospectively explore the following: (i) prevalence; (ii) treatment; and (iii) recovery pattern and outcomes for dysphonia, in patients with COVID-19 requiring intensive care unit (ICU) treatment. MethodsPatients admitted to 26 ICUs over 12 months, diagnosed with COVID-19, treated for survival, and seen by speech–language pathology for clinical voice assessment were considered. Demographic, medical, speech–language pathology treatment, and voice outcome data (grade, roughness, breathiness, asthenia, strain [GRBAS]) were collected on initial consultation and continuously monitored throughout the hospital admission. FindingsTwo-hundred and thirty five participants (63% male, median age = 58 yrs) were recruited. Median mechanical ventilation duration and ICU and hospital lengths of stay (LOSs) were 16, 20, and 42 days, respectively. Dysphonia prevalence was 72% (170/235), with 22% (38/170) exhibiting profound impairment (GRBAS score = 3). Of those with dysphonia, rehabilitation was provided in 32% (54/170) cases, with dysphonia recovery by hospital discharge observed in 66% (112/170, median duration = 35 days [interquartile range = 21–61 days]). Twenty-five percent (n = 42) of patients underwent nasendoscopy: oedema (40%, 17/42), granuloma (31%, 13/42), and vocal fold palsy/paresis (26%, 11/42). Presence of dysphonia was inversely associated with the number of intubations (p = 0.002), intubation duration (p = 0.037), ICU LOS (p = 0.003), and hospital LOS (p = 0.009). Conversely, duration of dysphonia was positively associated with the number of intubations (p = 0.012), durations of intubation (p = 0.000), tracheostomy (p = 0.004), mechanical ventilation (p = 0.000), ICU LOS (p = 0.000), and hospital LOS (p = 0.000). More severe dysphonia was associated with younger age (p = 0.045). Proning was not associated with presence (p = 0.075), severity (p = 0.164), or duration (p = 0.738) of dysphonia. ConclusionsDysphonia and laryngeal pathology are common in critically ill patients with COVID-19 and are associated with younger age and protracted recovery in those with longer critical care interventions.

Dysphonia Outperforms Voice Change as a Clinical Predictor of Dysphagia.

Changes in voice quality after consuming food or drink have been used as a clinical indicator of dysphagia during the clinical swallowing evaluation (CSE); however, there is conflicting evidence of its efficacy. This study investigated if dysphonia and/or voice change after swallowing are valid predictors of penetration, aspiration, or pharyngeal residue. Our approach aimed to improve current methodologies by collecting voice samples in the fluoroscopy suite, implementing rater training to improve interrater reliability and utilizing continuous measurement scales, allowing for regression analyses. In this prospective study, 30 adults (aged 49-97 years) referred for a videofluoroscopic swallowing study (VFSS) were audio-recorded completing a sustained /i/ prior to VFSS and again after swallowing each bolus during the VFSS. Swallowing function was measured using the reorganized Penetration-Aspiration Scale and the Normalized Residue Ratio Scale. Following listener training, 84 voice samples were perceptually rated using the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). Ordinal and logistic regression were used to determine whether voice quality and voice quality change after swallowing were predictors of airway invasion and pharyngeal clearance. Results indicated that the presence of dysphonia at baseline during a sustained /i/ task as measured by the CAPE-V predicted airway invasion but not pharyngeal residue. Voice change after swallowing associated with vowel /i/ production as measured by the CAPE-V did not predict either dysphagia measure. These results indicate that voice change during a sustained /i/ after swallowing appears unrelated to airway invasion or pharyngeal residue; however, in the absence of known laryngeal pathology, dysphonia prior to a CSE should alert speech-language pathologists of a possible comorbid dysphagia.

Trajet aberrant d'une artère carotide interne anévrismale révélé par une dysphonie et une toux chronique : à propos d'un cas

Aberrant internal carotid artery is a rare birth defect. It occurs when the artery takes an abnormal course, the discovery of which is fortuitous but in the presence of dysphonia or chronic cough; this anomaly remains a diagnosis of exclusion. Cervicothoracic CT scan with injection of contrast product confirms the diagnosis. We report the case of a 64-year-old patient who presented with an aberrant course of an aneurysmal internal carotid artery revealed by dysphonia and chronic cough.

Screening for oropharyngeal dysphagia in hospitalized COVID-19 patients: a prospective study

PurposeTo screen for oropharyngeal dysphagia (OD) in hospitalized COVID-19 patients.MethodsA descriptive longitudinal study was conducted on 500 adult patients with confirmed COVID-19 in the age range of 19–65 years who were admitted to the main university isolation hospital (whether admitted in the ward or the intensive care unit). Screening for OD was done using the Arabic version of the Eating Assessment Tool (EAT-10) and the Yale swallow protocol.Results45.4% of the admitted and 40.97% of the discharged COVID-19 patients had a positive screen for OD. Several risk factors for OD could be detected. These include older age, longer duration of presenting symptoms of COVID-19, presence of ageusia and anosmia, presence of dysphonia, ICU admission, lower oxygen saturation, higher respiratory rate, presence of OD at admission, longer duration of hospital stay, and use of noninvasive ventilation (NIV) and/or invasive mechanical ventilation (IMV).ConclusionsScreening for OD in hospitalized COVID-19 patients is a mandatory procedure, whether for admitted or discharged patients.

Impacto de la disfonía en la calidad de vida en la edad infantil

IntroductionVoice disorders can negatively affect the child's self-esteem and pose a problem for their socialization. The P-VHI (Pediatric Voice Handicap Index) is a quality of life questionnaire adapted for use in children that studies the impact of dysphonia on the functional, physical and emotional levels. MethodsRetrospective, observational and analytical study of a group of 87 patients aged between 5 and 14 years old with a diagnosis of dysphonia. The control group consisted of 31 patients same age range in whom was discarded the presence of otorhinolaryngological disease. We collected the data referred to age, sex, family environment and sport practice of both groups and analyzed their relationship with the presence of dysphonia. The impact of dysphonia on children's quality of life was studied using the Pediatric Voice Handicap Index (P-VHI) questionnaire. ResultsWe found a statistically significant relationship between the dysphonia and the male sex (65.5% in the group with dysphonia vs. 29% in the control group), having siblings (89.7% vs. 71%) and having a family history of voice disorders (33.3% vs. 3.2%). In the P-VHI questionnaire for all categories a significantly higher score was obtained in the group with dysphonia compared to the control group. ConclusiónDysphonia negatively affects children in the physical, emotional and social spheres. It is convenient an early detection, diagnosis and treatment, proportional to the impact generated.

Acoustic measurements are useful therapeutic indicators of patients with dysphonia-related to reflux.

The objective is to study the usefulness of acoustic measurements as therapeutic outcomes for patients with dysphonia related to laryngopharyngeal reflux (LPR). From September 2019 to April 2021, 120 patients with LPR at the hypopharyngeal-esophageal multichannel intraluminal impedance pH-monitoring (HEMII-pH) were prospectively recruited from three University Hospitals. They were divided in two groups regarding the presence of dysphonia. The treatment consisted of a combination of diet, proton-pump inhibitors, magaldrate and alginate for 3-6months. The following clinical and acoustic evaluations were studied regarding groups at baseline, 3- and 6-month posttreatment: reflux symptom score (RSS), reflux sign assessment (RSA), percent jitter, percent shimmer and noise-to-harmonic ratio (NHR). A total of 109 patients completed the evaluations, accounting for 49 dysphonic and 60 non-dysphonic individuals. HEMII-pH, gastrointestinal endoscopy, baseline clinical and acoustic features were comparable between groups. RSS and RSA significantly improved from pre- to 3-month posttreatment in both groups. Jitter, Shimmer and NHR significantly improved from pre- to 3-month posttreatment in dysphonic patients, without additional 3- to 6-month posttreatment changes. Acoustic parameters did not change throughout treatment in patients without dysphonia. Acoustic measurements may be an interesting indicator of treatment in LPR patients who reported dysphonia. In this group of individuals, the evolution of acoustic parameters was consistent with the evolution of symptoms and findings.

Zenker Diverticulum: Does Size Correlate with Preoperative Symptoms?

Introduction Zenker diverticulum (ZD) usually affects adults after the 7 th decade of life. Treatment for ZD is indicated for all symptomatic patients, but some patients prefer to defer surgical treatment until symptoms get worse and decrease their quality of life. Objective To evaluate the association of the preoperative symptoms in ZD patients with the size of the ZD. Methods A retrospective study design. Electronic medical records were used to identify patients diagnosed with ZD and treated over 11 years. Data collection included the chief complaints and symptoms, medical history, and findings on radiologic swallow evaluations of the patients. The diverticulum size was stratified into 3 groups: small (< 1 cm), moderate (1–3 cm), and large (> 3 cm). Results A total of 165 patients were enrolled and stratified by diverticulum size (48 small, 67 medium, and 50 large). Dysphagia, cough, and regurgitation were the most prevalent symptoms. Dysphonia was more frequent among patients with a small pouch. Logistic regression analysis showed that dysphagia and choking were associated with large and medium diverticulum size ( p < 0.05 ) . Additionally, dysphonia was significantly associated with the presence of a small-sized ZD ( p < 0.04). Conclusion Upper gastrointestinal symptoms such as dysphagia and choking may be associated with a ZD > 1 cm and should always be evaluated. Additionally, the presence of dysphonia was found to be correlated with a ZD < 1 cm, suggesting that a prompt and appropriate fluoroscopic evaluation must be considered in those patients in whom no other clear cause of dysphonia is evident.

Predisposing factors of childhood dysphonia in primary school children

BackgroundAlthough dysphonia is a common symptom in children, there is lack of mass screening studies to cover its prevalence rate in the Egyptian Alexandrian schools. The aim of the work was to screen Alexandrian school-age children for dysphonia in order to determine the prevalence and to detect its possible predisposing factors. The study was carried out on 1913 school children (4th-6th grade), age range of 9-13 years and presenting the seven Alexandrian Educational districts. All patients were screened for the presence of dysphonia. The grade of dysphonia was assessed by a phoniatrician using perceptual auditory evaluation. Determination of possible predisposing factors was done through the application of a questionnaire. Only 317 students responded to the questionnaire.ResultsThere was a significant difference between dysphonic and non-dysphonic as regards gender, and school grade. Having a smoking family member and conducting activities requiring high vocal demands were recorded with the highest percentage among dysphonic children.ConclusionThe Study revealed a prevalence rate of childhood Dysphonia of 12.4%. The presence of chest problems, prolonged loud cry, temperament personality and passive smoking predisposed to dysphonia in primary school students.

Voice problem in a patient with chronic renal failure

BackgroundChronic kidney failure is an irreversible medical condition that impairs the kidney’s ability to function. When CRF reaches a sophisticated stage, dangerous levels of fluid, electrolytes, and wastes can accumulate within the body. Dysphonia detected within the CRF patients was due to affection of the chronic kidney failure on the system and phonatory system. Patients with CRF treated by hemodialysis are exposed to continuous pulmonary insults of multifactorial origin: Fluid retention predisposes them to pulmonary edema which occurs more frequently within the presence of concomitant cardiovascular disease. Also, the spirit of the kidney failure patients can induce psychogenic dysphonia. The aim of this work is to see and analyzed voice problems in patients with chronic kidney failure to ascertain baseline data about the scale and distribution of the probable voice disorder in these patients for early detection and proper management.ResultsThe results obtained from this study showed that there have been statistically significant differences between chronic kidney failure patients G1 and control G2 regarding first harmonic, jitter %, shimmer dB and noise harmonic ratio dB, presence of dysphonia, and also the total score of VHI. The results of the study revealed statistical correlation between the quantity of years of hemodialysis and total acoustic measures.ConclusionThe results of our study revealed that subjects with chronic failure exhibit a clinical evidence of voice disorders and proving that there is interplay of different body systems and the larynx. The voice problems can vary between CRF patients depending on duration of hemodialysis and leading causes of chronic kidney failure.

Perceptual and Acoustic Assessment of Strain Using Synthetically Modified Voice Samples.

Purpose Assessment of strained voice quality is difficult due to the weak reliability of auditory-perceptual evaluation and lack of strong acoustic correlates. This study evaluated the contributions of relative fundamental frequency (RFF) and mid-to-high frequency noise to the perception of strain. Method Stimuli were created using recordings of speakers producing /ifi/ with a comfortable voice and with maximum vocal effort. RFF values of the comfortable voice samples were synthetically lowered, and RFF values of the maximum vocal effort samples were synthetically raised. Mid-to-high frequency noise was added to the samples. Twenty listeners rated strain in a visual sort-and-rate task. The effects of RFF modification and added noise on strain were assessed using an analysis of variance; intra- and interrater reliability were compared with and without noise. Results Lowering RFF in the comfortable voice samples increased their perceived strain, whereas raising RFF in the maximum vocal effort samples decreased their strain. Adding noise increased strain and decreased intra- and interrater reliability relative to samples without added noise. Conclusions Both RFF and mid-to-high frequency noise contribute to the perception of strain. The presence of dysphonia may decrease the reliability of auditory-perceptual evaluation of strain, which supports the need for complementary objective assessments. Supplemental Material https://doi.org/10.23641/asha.13172252.

Analysis of possible factors of vocal interference during the teaching activity.

ABSTRACTOBJECTIVETo measure the risk of dysphonia in teachers, as well as investigate whether the perceptual-auditory and acoustic aspects of the voice of teachers in situations of silence and noise, the signal-to-noise ratio, and the noise levels in the classroom are associated with the presence of dysphonia.METHODSThis is an observational cross-sectional research with 23 primary and secondary school teachers from a private school in the municipality of São Paulo, Brazil, divided into the groups without dysphonia and with dysphonia. We performed the following procedures: general Dysphonia Risk Screening Protocol (General-DRSP) and complementary to speaking voice - teacher (Specific-DRSP), voice recording during class and in an individual situation in a silent room, and measurement of the signal-to-noise ratio and noise levels of classrooms.RESULTSWe have found differences between groups regarding physical activity (General-DRSP) and particularities of the profession (Specific-DRSP), as well as in all aspects of the perceptual-auditory vocal analysis. We have found signs of voice wear in the group without dysphonia. Regarding the vocal resources in the situations of noise and silence, we have identified a difference for the production of abrupt vocal attack and the tendency of a more precise speech in the situation of noise. Both the signal-to-noise ratio and the room noise levels during class were high in both groups.CONCLUSIONSTeachers in both groups are at high risk for developing dysphonia and have negative vocal signals to a greater or lesser extent. Signal-to-noise ratio was inadequate in most classrooms, considering the standards for both children with normal hearing and with hearing loss, as well as equivalent noise levels.

Efficiency and Cutoff Values of Self-Assessment Instruments on the Impact of a Voice Problem

To evaluate the efficiency of four self-assessment questionnaires that rate the impact of a voice problem on the individual's life: Voice-Related Quality of Life (V-RQOL), the original and reduced versions of the Voice Handicap Index (VHI) and VHI-10, Vocal Performance Questionnaire (VPQ), and Voice Symptom Scale (VoiSS). Data from 975 subjects, 486 with a diagnosis of dysphonia and 489 vocally healthy individuals, were submitted to the receiver operating characteristic (ROC) curve analysis to obtain the cutoff values that determine the discriminating power of these instruments (presence of dysphonia vs healthy voice). The ROC curve analysis showed that the most efficient questionnaires were the VoiSS and the VHI. Results showed that they presented as a perfect classification based on their efficiency, specificity, and sensitivity values (all three of them=1). The VHI-10 and the V-RQOL showed excellent classification (VHI-10: efficiency=0.991; specificity=1; sensitivity=0.981; V-RQOL: efficiency=0.914; specificity=0.860; sensitivity=0.967). Finally, the VPQ showed a good level of classification (efficiency=0.828; specificity=0.824; sensitivity=0.831). The cutoff values for the instruments are as follows: VoiSS=16 points, VHI=19 points, VHI-10=7.5 points, V-RQOL=91.25, and VPQ=20.5 points. These values are important for screening large populations as well as for helping in the decision-making process of clinical management. The cutoff values for maximum sensitivity and specificity of the instruments that did not produce perfect classification are as follows: VHI-10: sensitivity=5; specificity=7.5, V-RQOL: sensitivity=86.25; specificity=98.75, and VPQ: sensitivity=15.5; specificity=31.5. Both the VoiSS and the VHI are perfect classifiers. The VHI-10 and the V-RQOL are excellent classifiers, and the VPQ is good at discriminating individuals with dysphonia from the ones without dysphonia.

Depression and voice handicap in Parkinson disease

BackgroundDysphonia is common in Parkinson's disease (PD), but the mechanism underlying the development remains unclear. This study investigated possible clinical factors related to PD dysphonia. MethodsDysphonia severity was assessed in 147 non-demented patients with PD and 30 non-PD controls using the Voice Handicap Index (VHI)-10. A threshold of 12 VHI-10 score was used to define the presence of dysphonia. The severity of PD and depression was measured using the Unified Parkinson's Disease Rating Scale (UPDRS)-motor and the Geriatric Depression Scale (GDS). ResultsDysphonia was observed in 52 patients (35.4%). Patients with dysphonia scored higher on the UPDRS and GDS scores compared with patients without dysphonia. Multivariate logistic regression analysis revealed that GDS was the only factor significantly associated with the presence of dysphonia. Non-PD controls did not show this association. ConclusionsThe results support a high prevalence of dysphonia in patients with PD, and suggest that the presence of dysphonia is more closely related to depression than to the severity of PD.

Posterior Pharyngeal Candidiasis in the Absence of Clinically Overt Oral Involvement: A Cross-Sectional Study

Although oropharyngeal candidiasis is associated with inhaled corticosteroid (ICS) usage, there is sparse data on the prevalence of posterior pharyngeal candidiasis in those without any detectable oral candidiasis on clinical examination. We systematically investigated the relationship between oral candidiasis on clinical examination and the presence of posterior pharyngeal candidiasis at bronchoscopy. We conducted a cross-sectional study on a convenience sample of 100 patients undergoing bronchoscopy at our institution. Patients were assessed for symptoms of and risk factors for candida infection and had an examination of their oropharynx for evidence of candidiasis before bronchoscopy. They subsequently had a detailed assessment for posterior candidiasis at bronchoscopy. We performed a posteriori subgroup analysis, which focused solely on those patients on ICS maintenance therapy. Median age was 54.7 (27-84) years, and 55 patients were male; 47% of patients were on ICS, and 20% of this cohort received recent oral corticosteroids. Twenty-eight percent of this convenience sample had posterior pharyngeal candidiasis; however, only 10.7% (3/28) of these patients had clinically detectable oral candidiasis on clinical examination before bronchoscopy. Factors that were independently associated with the presence of pharyngeal candidiasis at bronchoscopy were OR (95% CI) ICS usage 6.9 (2.5-19.2), particularly fluticasone usage 6.8 (2.62-17.9) and the presence of dysphonia 3.2 (1.3-8.0). In the subgroup analysis of ICS usage, posterior pharyngeal candidiasis was correlated with the presence of dysphonia but was not independently associated with fluticasone or budesonide dosage. This study demonstrates that posterior pharyngeal candidiasis in the absence of clinically overt oral candidiasis is frequent amongst ICS users. A history of ICS use, particularly fluticasone usage, as well as the presence of dysphonia are associated with posterior pharyngeal candidiasis at bronchoscopy, even in the absence of clinically overt oral involvement.

Comparison of Postoperative Throat and Neck Complaints after the Use of the i-Gel versus the Traditional Laryngeal Mask

Introduction: One of the most important jobs of an anesthesiology is to preserve an adequate gaseous exchange. With the coming in the 80’s of the laryngeal mask airway, a less invasive technique was introduced for this end. There are a lot of variants of these supraglotic issues, being the i-gel a no inflate mask; witch principle is to provide a perilaryngel stamp that reduced the incidence of sore throat, cervical pain compared with the traditional laryngeal mask. Method: A group of 121 ASA I-II patients with general anesthesia administration, where divided in two groups, one of 60 patients where a traditional laryngeal mask airway was used, and a second group of 61 patients where an i-gel mask was used. In both groups the presence of postoperative sore throat, cervical pain and dysphonia; number of attempts and pressure in the airway tract was measured. Results: The group of patients where the i-gel was used present lower incidence of sore throat (11% vs 27%) and cervical pain (3% vs 9%) and lower values of pressure on the airway tract compared with the group in which the conventional laryngeal mask was used. On the other hand there was no difference in the presence of dysphonia, trauma or number of attempts used to insert the mask. Conclusions: The i-gel larygeal mask demonstrated to be a safe issue, with low incidence of morbidity to administrated general anesthesia.

Regressão logística como modelo de decisão para a disfonia em professores e não professores

Distúrbios da voz; Sinais e sintomas; Docentes; Modeloslogísticos

Equivalência cultural da versão Brasileira da Voice Symptom Scale: VoiSS

To present the cultural equivalence of the Brazilian version of the Voice Symptom Scale - VoiSS. The questionnaire was translated into Portuguese by two Brazilian bilingual speech-language pathologists, who were informed about the purpose of this research. The back translation was performed by a third bilingual Brazilian speech-language pathologist, who was also an English teacher, and had not participated in the previous stage. After the comparison of translations, a final version of the questionnaire was produced and called Escala de Sintomas Vocais--ESV, which was administered to 15 individuals with vocal complaint. The inclusion criterion was the presence of dysphonia, regardless of type or degree. The option "not applicable" was added to each item of the protocol. During the process of translation and cultural adaptation, no item was changed and/or eliminated from the questions. The ESV kept the same structure as the original British version with 30 questions, 15 regarding the impairment domain (functionality), eight the emotional domain (psychological effect), and seven the physical domain (organic symptoms). The cultural equivalence of the Brazilian version of the VoiSS, entitled ESV, was demonstrated. The ESV validation is currently being concluded.

Self‐reported impact of dysphonia in a primary care population: An epidemiological study

This study's objectives are to 1) to assess the prevalence of dysphonia in the primary care community, 2) evaluate the severity of dysphonia, 3) explore potential risk factors for dysphonia, 4) examine the treatment of dysphonic patients, and 5) assess treatment-related barriers. The hypotheses are that 1) dysphonia is common in the primary care community, 2) it adversely impacts patients' quality of life (QOL), and 3) patients are underevaluated and experience obstacles with respect to seeking treatment. Cross-sectional, practice-based study in the primary care population. English-speaking patients 18 years of age and older were recruited from a primary care research network. Patients presenting to their primary care practices were given a packet of questionnaires to complete that documented demographic information, risk factors, presence of dysphonia, prior treatment, and reasons for not seeking treatment. The Voice-Related Quality of Life (VRQOL) and Center for Epidemiological Studies-Depression Scale (CES-D) served as quality-of-life outcome measures. A priori sample size calculations were performed indicating a sample size of 780. Univariate analyses, descriptive statistics, odds ratios and 95% confidence intervals, and multivariate analyses were performed. A total of 789 patients with a mean age of 49.9 years and range of 18 to 94 years participated. Lifetime prevalence of dysphonia was 29.1%, point prevalence of dysphonia 7.5%, and 4.3% had had dysphonia for >4 weeks. Of those with current dysphonia, only 46% had not missed work. Of those with current dysphonia, 73.3% had had dysphonia more than once. Patients with dysphonia had lower VRQOL scores and higher CES-D scores (t test, P ≤.001). Risk factors for dysphonia and impaired VRQOL on multivariate analysis included neurologic disease, dry mouth, family history of dysphonia, college or postgraduate level education, allergies or sinus problems, neck pain, medication for depression/anxiety, more than three upper respiratory infections per year, gastroesophageal reflux at least monthly, and asthma or lung disease. Of the patients who had ever had dysphonia, 22.1% received treatment. Common treatment modalities included antireflux treatment, antiallergy treatment, and antibiotics. Speech-language pathology evaluation was rare. Compared to those not interested in treatment, patients wanting treatment were more likely to have chronic dysphonia >4 weeks (30.6% vs. 8.1%; χ(2), P ≤.001), more likely to have dysphonia more than once (85.1% vs. 58.0%; χ(2), P ≤.001), and lower VRQOL scores (median 67.5 vs. 97.5; rank sum test, P <.001). Reasons for not seeking treatment included thinking the dysphonia would go away, physicians did not ask about voice problems, and being unaware of treatment options. At the time one in 13 primary care patients had dysphonia resulting in significant functional impairment with reduced voice-specific QOL and greater depression scores. Risk factors for dysphonia and voice-specific QOL impairment were identified and might be useful for identifying patients at risk for dysphonia. Barriers exist that prevent dysphonic patients from receiving evaluation and treatment. Whether improved methods of dysphonia screening leads to better outcomes and reduced societal impact needs investigation. Laryngoscope, 2010.

Correlação entre dados perceptivo-auditivos e qualidade de vida em voz de idosas

vocal quality and voice-related quality of life in elderly women to assess the vocal quality and voice-related quality of life in elderly women, as well as verify if the presence of dysphonia has an influence on the life quality of these women. one hundred and three elderly women, with ages ranging from 60 to 103 years, were recruited. The V-RQOL was answered by the participants and their voices were registered and analyzed perceptually by five experienced speech pathologists, using the GRBASI scale. After the intra-rater reliability analysis, three speech pathologists were selected with whom a single GRBASI scale was built for each of the participant's voice. Later, this single assessment was compared to the physical, socio-emotional and total V-RQOL scores. most of the elderly women presented V-RQOL total scores between 70 and 100. They also presented a mild to moderate vocal disorder in the overall scores related to dysphonia, roughness, breathiness and instability in the GRBASI scale and did not present scores related to asthenia or strain. The G, R, B and I parameters of the GRBASI scale were statistically correlated to the physical and total V-RQOL scores. although most of the elderly women presented some level of dysphonia, the vocal disorders did not have an influence on their life quality. However, the physical and total V-RQOL scores were correlated to dysphonia severity, indicating that the more sever the dysphonia, the lower the voice-related quality of life.