Version Of Voice Handicap Index Research Articles

(I)INFVo scale for perceptive evaluation of substitutional voices - validation of the Polish version.

<br><b<Aim:</b> The aim of this study was to evaluate the relevance and reliability of the (I)INFVo scale - a clinical tool for the perceptual assessment of substitutional voice in patients after total laryngectomy. The process involved translating the scale into Polish and verifying the relevance and reliability of the tool in 33 native Polish-speaking patients using tracheo-esophageal or esophageal substitutional voice.</br> <br><b>Methods:</b> Voice recordings were rated using the perceptual-auditory (I)INFVo scale by two experts with 10 years of experience in phoniatrics and speech therapy and a clinical speech therapy graduate. One of the specialists listened to and assessed the voice recordings twice at a one-week interval. Objective measures - speech rate, diadochokinesis (DDK), and maximum phonation time (MPT) were calculated from the aforementioned recordings. The results of the Polish version of Voice Handicap Index (VHI-POL) self-assessment questionnaire including three subscales (functional, physical, and emotional) as obtained from the medical records of the study subjects were also used in the analysis. All values obtained in the study were submitted to correlation analysis.</br> <br><b>Results:</b> Very strong statistical relationships were obtained for inter- and intra-rater reliability. A statistically significant correlation was found between the parameters of the (I)INFVo scale and the objective measures (speech rate, DDK, MPT), the total VHI-POL scores, and the scores within the physical and functional subscales of the VHI-POL questionnaire, confirming the reliability of ratings provided by the experts using the validated scale.</br> <br><b<Conclusion:</b> The perceptual (I)INFVo scale appears to be a reliable and adequate tool for the diagnostics of patients using tracheo-esophageal and esophageal substitutional voice after total laryngectomy.</br&gt.

Determining Cutoff Point in Bahasa Malaysia Version of Voice Handicap Index-10 (mVHI-10)

Determining the cutoff point on Bahasa Malaysia version of Voice Handicap Index (mVHI-10) questionnaire scores for distinguishing between dysphonic and normal voice samples. A cross-sectional study was conducted in the tertiary hospital, Otorhinolaryngology-Head and Neck clinic. The study involved 205 subjects (105 in the dysphonia group; 100 in the normal group) with a complete database of flexible laryngoscopy/stroboscopy, voice recording, acoustic analysis, and mVHI-10 score. A sample with a discrepancy between subjective evaluation and acoustic analysis results was excluded from the study. Each classified dataset matched with the respective mVHI-10 questionnaire score. Finally, all the collected data were subjected to data analysis. The best cutoff point for mVHI-10 was 7.5 by the receiver operating characteristiccurve, with an area under the curve value of 0.997. Its sensitivity, specificity, positive predictive value, and negative predictive value were 92.4%, 100.0%, 100.0%, and 93.0%, respectively. The best cutoff point for mVHI-10 is 7.5, as determined by stringent data evaluation and rigorous statistical analysis. With excellent diagnostic accuracy properties, it enhances the usage of the mVHI-10 questionnaire as an excellent screening tool. Nevertheless, we advocate multidimensional voice assessment for diagnostic purposes.

One Year Outcomes and Longitudinal Changes in Voice Improvement With Single High Dose Intracordal Trafermin Injections for Age-Related Vocal Fold Atrophy

Although intracordal trafermin injection has been performed in the treatment of age-related vocal fold atrophy, the effects of single high dose trafermin injections are unknown. In this study, we examined the 1 year outcomes and longitudinal changes in voice improvement with single high dose intracordal trafermin injections. Retrospective study with approval by our Ethics Committee. The medical records of 34 patients who underwent single high dose (50ug per side) intracordal trafermin injections under local anesthesia for vocal fold atrophy were retrospectively reviewed at 1 month pre-injection and 1 month, 6 months and 1 year post injection. Maximum phonation time (MPT), pitch range (PR), Japanese version of voice handicap index (VHI), grade of GRBAS evaluation, and jitter% improved significantly at 1-year post-injection compared to 1-month pre-injection. MPT and PR improved as early as 1-month post-injection and continued to improve most at 1-year post-injection. VHI showed negative progression from 6-months to 1-year post-injection, during which time the speaking fundamental frequency (SFF) changed to the high pitch in men. Single high dose intracordal trafermin injections can be expected to improve voice in the early post-injection period and to maintain its effect for 1 year. SFF may play a role in worsening VHI in men. level 4.

Which is a better management for vocal fold cyst: cold knife or laser resection?

BackgroundThe objective of the study is to compare the conventional microlaryngeal surgery and the CO2 laser in the treatment of cysts of vocal folds, regarding the postoperative quality of voice.This study was conducted on 53 cases with vocal fold cysts. The cases were randomly allocated into two groups: group 1 (27 cases) was operated by the conventional technique, and group 2 (26 cases) was operated with CO2 laser microlaryngeal operation. At 3-month postoperative, evaluation was done by stroboscopic evaluation of vocal folds, grade of hoarseness, roughness, breathiness, asthenia, and strain (GRBAS) scale and Arabic version of Voice Handicap Index (VHI).ResultsThe stroboscope assessment revealed that glottic closure was complete, symmetrical motion, the reappearance of the mucosal wave, normal amplitude, and periodicity in all patients. There is insignificantly different between either group as regards the postoperative scores on VHI and GRBAS scale.ConclusionThere is insignificantly different when comparing laser to conventional microlaryngeal surgery for excision of vocal fold cysts regarding the quality of voice.

Polish version of the pediatric Voice Handicap Index (pVHI)

IntroductionThe modern standard of voice diagnostics in both the adult and pediatric populations is based on perceptual, acoustic and videolaryngoscopic assessment, as well as self-assessment of voice quality. Currently, only two tools for assessing the voice in the pediatric population were translated into Polish: pVHI and its abbreviated version - cVHI (Children Voice Handicap Index). Thanks to the use of pVHI, the therapist and the patient, as well as his family and relatives, become aware of what functional zones are disturbed as a result of voice problems. AimThe aim of the study was to analyze various methods of assessing children's voice, including the pVHI voice disability questionnaire in children with various voice disorders. In addition, the authors wanted to develop a classification of the degree of disability of children's voice expressed by the sum of points obtained in pVHI. Material and methodThe study included a group of 89 children aged 5-12. Each child underwent a standard otolaryngological and phoniatric examination procedure with hearing assessment and fiberoscopic laryngeal evaluation. The voice of the dysphonic children was assessed with a spectrogram and the GRBAS scale. The children's guardians completed the Pediatric Voice Handicap Index (pVHI). ResultsPolish children without voice disorders obtained an average of 1.9 points as a total result of the pVHI questionnaire. The results of the questionnaire obtained from children with voice disorders were on average 24.7 (SD 13.9). Total and individual domain scores were significantly higher in children with dysphonia than in asymptomatic children. Children with voice disorders were rated an average of 1.95 (SD 0.6) degree of hoarseness in Yanagihara's scale, and obtained an average overall score of 4.8 on the GRBAS scale (SD 2). A common upward trend in all types of evaluation is evident, along with an increase in the handicap expressed in pVHI score. Statistical analysis showed significant dependence between the overall pVHI score and other voice rating indicators. The result correlated to a moderate degree with the sum of points obtained from GRBAS and the severity of hoarseness assessed subjectively (G) and objectively according to Yanagihara's scale. In addition, weak correlations of the functional part of the questionnaire with the presence of learning problems, and the emotional part with the presence of problems with socialization were noticed. Analyzing the results of the questionnaire depending on the GRBAS results and the Yanagihara scale, a better fit of the exponential trend line than the linear one was observed. The point of inflection of the exponential curve, and thus a significant deterioration in voice assessment indicators, was observed in children who obtained over 32 points, which is 33% of the maximum value that can be obtained from the questionnaire. ConclusionsA new voice assessment tool for the pediatric population has been developed that complements the diagnostic facilities of the otolaryngologist, phoniatrician and speech therapist. Adaptation of the Polish version of the Voice Handicap Index (pVHI) allows the introduction of a new diagnostic indicator into medical and speech therapy practice. The pVHI questionnaire result differentiates children with voice and speech disorders from healthy children. The analysis of children's voice using various methods allows the clinician to further characterize the disturbance of voice quality. It is possible to assess the scale of the severity and type of problem, as well as the spheres of life it concerns most. There is a correlation between the severity of voice disorders and the severity of voice disability expressed in the pVHI question.

Comparative Study Between Conventional Microlaryngeal Surgery and Carbon Dioxide Laser in Management of Minimal Associated Pathological Lesions of Vocal Folds

The aim of this study is to compare the relatively new CO2 laser microlaryngeal surgery and conventional cold dissection method in treatment of minimal associated pathological lesions of vocal folds. Eighty patients aged 20-70 years old were randomly divided into two groups, group A (40 patients) was treated by the conventional method and group B (40 patients) was treated with CO2 laser microlaryngeal surgery. Assessment procedures included GRBAS scale, stroboscopic examination, and Arabic version of voice handicap index. Results stated that improvement of quality of voice after surgery in both techniques had no significant difference. The significant difference was in operative time and bleeding because laser had less time and bleeding. Both techniques had no recurrence within 3-months follow-up.

Impact of Uncomplicated Total Thyroidectomy on Voice and Swallowing Symptoms: a Prospective Clinical Trial

Voice and swallowing alterations are frequently reported after thyroidectomy, even in absence of nerve injury. The symptoms impair the quality of life. Aim of the study was to evaluate prospectively vocal function and swallowing symptom changes after total thyroidectomy in the early and late postoperative period. Prospective observational study. All consecutive patients scheduled for total thyroidectomy were included. Subjective voice evaluation using the Greek version of Voice Handicap Index (VHI) was performed preoperatively and at 2nd postoperative day, 1 month, 12 months postoperatively to assess the functional outcome. Laryngoscopy was performed at the same timing. Subjective swallowing evaluation using the Swallowing Impairment score (SIS) evaluated the swallowing symptoms. The study population included 125 patients. Total VHI score differed significantly between preoperative values and at 48 h and 1 year postoperatively (p = 0.000). Significant changes were observed for the functional and emotional domain of VHI between preoperative and 48 h postoperatively (p = 0.001, 0.003, respectively). There were statistically significant changes for physical domain of VHI between preoperative values and values at 48 h and 1 year (p = 0.000, 0.001, respectively). Regarding the swallowing symptoms, the mean postoperative score at 1 month did not differ significantly from the mean preoperative score (p = 0.103). Swallowing alterations showed a tendency to increase 48 h postoperatively and decreased thereafter. Swallowing score at 1 year postoperatively was statistical significant lower compared to preoperative values. Even with intact laryngeal nerves, transient voice and swallowing alterations may occur after total thyroidectomy. Patients should be informed about these mild changes to lower anxiety following the operation.

Responsiveness of Persian Version of Consensus Auditory Perceptual Evaluation of Voice (CAPE-V), Persian Version of Voice Handicap Index (VHI), and Praat in Vocal Mass Lesions with Muscle Tension Dysphonia

This study was aimed at determining the internal and external responsiveness of the Persian version of the Consensus Auditory-Perceptual Evaluation of Voice (called ATSHA), Persian version of the Voice Handicap Index (VHI), and Praat scales among patients with vocal mass lesions and secondary muscle tension dysphonia. Prospective, within-participant repeated measures. Thirty patients with vocal fold nodules, polyps, and cysts related to secondary muscle tension dysphonia participated in the study. The measures of interest and videostroboscopy examination were used before and after treatment. The Global Perceived Effect questionnaire was used to separate those improved (moderately or greatly improved) and stable (slightly improved) patients. The mean standardized response, standardized effect size, and Guyatt analyses indicated high internal responsiveness for the all target parameters of the ATSHA, total score of the VHI, and two parameters of the Praat (0.8<). There was poor correlation between the videostroboscopy and the other target scales (r Pearson = -0.1-0.1). The receiver operating characteristic analysis indicated that all the target scales did not significantly separate those improved and stable subjects (area under the curve = 0), except for the overall severity and roughness parameters of the ATSHA scale (area under the curve = 1). This study recommends both the Consensus Auditory-Perceptual Evaluation of Voice and the VHI scales to show voice therapy changes. The target voice scale changes were not able to predict the videostroboscopy changes as external standard. Furthermore, we recommend that the overall severity and roughness may properly classify those improved and stable patients.

VOICE QUALITY BEFORE AND AFTER THYROIDECTOMY

Introduction: Voice disorders are a well-known complication which is often associated with thyroid gland diseases and because voice is still the basic mean of communication it is very important to maintain its quality healthy. Objectives : The aim of this study referred to questions whether there is a statistically significant difference between results of voice self-assessment, perceptual voice assessment and acoustic voice analysis before and after thyroidectomy and whether there are statistically significant correlations between variables of voice self-assessment, perceptual assessment and acoustic analysis before and after thyroidectomy. Methods : This scientific research included 12 participants aged between 41 and 76. Voice self-assessment was conducted with the help of Croatian version of Voice Handicap Index (VHI). Recorded reading samples were used for perceptual assessment and later evaluated by two clinical speech and language therapists. Recorded samples of phonation were used for acoustic analysis which was conducted with the help of acoustic program Praat. All of the data was processed through descriptive statistics and nonparametric statistical methods. Results : Results showed that there are statistically significant differences between results of voice self-assessments and results of acoustic analysis before and after thyroidectomy. Statistically significant correlations were found between variables of perceptual assessment and acoustic analysis. Conclusion : Obtained results indicate the importance of multidimensional, preoperative and postoperative assessment. This kind of assessment allows the clinician to describe all of the voice features and provides appropriate recommendation for further rehabilitation to the patient in order to optimize voice outcomes.

Multiparameter Voice Assessment for Voice Disorder Patients: A Correlation Analysis Between Objective and Subjective Parameters

The aim of this study was to establish a multiparameter voice assessment profile using objective multiparameter test and subjective voice quality assessment. We assessed 50 patients with voice disorders before and after operation. The assessment incorporates (1) subjective voice quality assessment, (2) patients' self-assessment, and (3) objective acoustic analysis. The subjective voice quality assessment uses GRABS system to evaluates the grade of hoarseness (G), proposed by the Japanese Society for Logopedics and Phoniatrics. Patients' self-assessment is modified based on the Chinese version of voice handicap index (VHI) scale, composed of functional (F), physiological (P), emotional (E) part, and a total score (T). The acoustical analysis evaluate the patients' voice sample by voice analysis software "Dr. Speech". Three parameters, jitter (J), shimmer(S), and normalized noise energy (NNE), were taken in analysis. We observed high correlations among subentries F, P, and the total score TvH of the VHI scale in patients' subjective assessment. Parameter E does not correlate well with other assessed parameters. The Chinese version ofVHI, which incorporate multifactors including age, education, and especially the cultural difference may account for the inconsistent correction in parameter E. In the objective acoustic analysis, high correlation among the three parameters J, S, and NNE is observed. Systemic assessment combining a subjective voice quality assessment, an objective acoustic analysis, and a self-assessment is helpful in clinical practice in the diagnosis and treatment for voice disorders. The E component in VHI scale assessment may not be a reliable parameter to evaluate treatment outcome.

Cross-Cultural Adaptation and Validation of the Voice Handicap Index Into Croatian

This article presents preliminary results of cultural adaptation and validation of the Croatian version of Voice Handicap Index (VHI). The translated version was completed by 38 subjects with voice disorders and 30 subjects without voice complaints. Compared with the subjects in the control group, subjects with voice disorders had significantly higher average total VHI score and scores in each of the three VHI domains (functional, physical, and emotional). Cronbach alpha for total VHI was .94, and coefficients obtained for the three VHI subscales were as follows: α=.87 for functional, α = .88 for physical, and α = .85 for emotional subscales. Intraclass correlation coefficient estimation was also high, for both total VHI (0.92) and subscales (0.85 for functional subscale, 0.87 for physical subscale, and 0.81 for emotional subscale). The overall VHI score positively correlated with auditory perceived grade of dysphonia. In the group with voice disorders, age was not correlated to the total VHI or the subscales. Also, there was no significant difference between male and female voice subjects in total VHI or the subscales. Preliminary findings of this research indicate that the Croatian VHI could provide a reliable and clinically valid measure of patient's current perception of voice problem and its reflection on the quality of life.

Japanese Version of Voice Handicap Index for Subjective Evaluation of Voice Disorder

Recently, the Voice Handicap Index (VHI), developed in the United States, has been highlighted as a means to assess a patient's perceptions of the severity of his or her voice disorder. The VHI is based on a self-administered questionnaire that quantifies the degree of a patient's disability related to his/her voice disorder. The questionnaire was translated into Japanese and applied to Japanese patients with various kinds of disordered voice or dysphonia. The results were analyzed and the usefulness discussed. In this study, 546 patients (281 males and 265 females) were included. Mean VHI scores were 36.2/120 in males and 44.1/120 in females. In the male patients, VHI scores were the highest among teens. However, VHI scores did not vary with age in the female patients. Patients with vocal fold paralysis, functional dysphonia, psychological dysphonia, and spasmodic dysphonia showed relatively high VHI scores, whereas those with laryngeal granuloma and laryngopharyngeal reflux disease showed low scores. In most diseases, functional and physiological scores were higher than emotional scores. In any treated patients, those with vocal nodule, vocal polyp, polypoid vocal fold, and recurrent laryngeal nerve paralysis, VHI scores decreased after therapeutic intervention. These findings suggest that the Japanese VHI is a useful tool for monitoring a patient's psychological status, choosing appropriate treatment, and assessing the therapeutic outcome.

Evaluating the Outcome of Phonosurgery: Comparing the Role of VHI and VoiSS Questionnaires in the Greek Language

The objective was to study the role of the Greek version of Voice Handicap Index (VHI) in comparison with Voice Symptom Scale (VoiSS) in terms of measuring voice surgery outcome in patients with benign laryngeal lesions. Nonrandomized prospective. Forty-six patients operated for benign laryngeal lesions were enrolled in the present study. All patients were assessed according to the European Laryngological Society guidelines. In terms of self-evaluation, patients answered the Greek versions of both VHI and VoiSS, preoperatively and 6 weeks postoperatively, and the results were statistically analyzed. The strongest correlation was observed between the functional subscale of VHI and the impairment subscale of VoiSS, as well as, between the emotional subscales of both VHI and VoiSS, pre- and postoperatively. A statistically significant change in subscale and total scores was found. VHI and VoiSS subscales and total scores correlated with the stroboscopic and aerodynamic measurements in a variable manner. Perceptual measurements, as well as shimmer and harmonic-to-noise ratio showed significant correlation with both VHI and VoiSS subscale and total scores postoperatively. VHI and VoiSS are considered useful tools in evaluating voice surgery outcome, in the Greek language.

Ｖｏｉｃｅ Ｈａｎｄｉｃａｐ Ｉｎｄｅｘ日本語版による音声障害の自覚度評価

Ｖｏｉｃｅ Ｈａｎｄｉｃａｐ Ｉｎｄｅｘ日本語版による音声障害の自覚度評価