Vocal Tract Discomfort Symptoms Research Articles

Vocal Tract Discomfort Scale-Brazil (VTDS-BR): Validation Based on Internal Consistency, Reliability, and Accuracy

ObjectiveTo validate the Vocal Tract Discomfort Scale for the Brazilian Portuguese (VTDS-BR), based on internal consistency, reliability and accuracy. MethodsThe participants were 431 adults of both sexes, divided in two groups: dysphonia (DG) and vocally healthy (VHG). We built a digital database with personal, professional information and the item-by-item VTDS-BR responses of the participants. We applied Cronbach's alpha, exploratory factor analysis (EFA); confirmatory factor analysis (CFA); Item Response Theory (IRT) using the Samejima model; and ROC curve analysis to obtain the VTDS-BR cut-off point. ResultsThe VTDS-BR has an eight-item structure and two factors: vocal hyperfunction without phonotraumatic injury and with phonotraumatic injury. Each item is evaluated based on two facets related to frequency and intensity, with a Likert scale response key. There are four possible answers: never, sometimes, often, and always for frequency and none, mild, moderate, and intense for intensity. We applied an IRT model, which allowed the identification of which items are more related to dysphonia, based on higher values in the parameters discrimination (a) and difficulty (b), which contributed to the calculation of each participant's aptitude for the development of voice problems, by means of a score. The cut-off value was determined using the ROC curve, in which values greater than -1.432 indicate a higher probability of voice alterations. ConclusionVTDS-BR went through the stages of validation of internal consistency, reliability and accuracy. It presents an 8-item, two-factor, and two-facet structure to assess frequency and intensity of vocal tract discomfort symptoms. VTDS-BR is suitable for clinical use or in screening activities, as it is quick to apply and its interpretation is indicative of people with and without phonotraumatic injury.

Vocal Tract Discomforts among Smokers

Smoking is a dangerous behavior for the human body and the vocal tract. Smoking can cause several laryngeal and vocal tract symptoms in smokers. One of these symptoms can be physical discomfort experienced by this population. Therefore, the aim of the present study was to investigate vocal tract discomfort (VTD) in smokers compared to healthy non-smoker participants. The smokers group was forty-eight men with a mean age of 47.54±9.21 years, and the matched non-smokers group was 48 men with a mean age of 44.88±10.81 years. The participants underwent vocal tract discomfort assessment using the Persian version of the VTD scale. Statistical Package for the Social Science (SPSS) was used for statistical analysis and the Mann-Whitney U test was used to compare variables between groups. The smokers more frequently had VTD symptoms (P<0.05) than non-smokers for all items of the VTD scale with the exception of aches. Also, smokers had more significant VTD severity in all items than non-smokers (P<0.05). Moreover, there were significant statistical differences between the total score of both frequency and severity of VTD between smokers and non-smokers. The most to the least VTD symptoms in smokers were irritation, sore, tickling, burning, tightness, lump in the throat, dry, and aching symptoms, respectively. The present study suggests that smoking can cause more physical vocal tract discomfort in smokers compared to non-smokers. These results can inform future research and interventions in the smoker population.

Wind instrumentalists' work-related vocal tract discomfort.

Wind instrumentalist use the vocal tract intensively in their professional activities, which can lead to the development work-related voice disorders. To analyze the perception of vocal tract discomfort (VTD) by wind instrumentalists from Natal, Brazil. Cross-sectional study with 117 professional musicians and music students from six official bands/orchestras in the city of Natal. Both the Vocal Tract Discomfort Scale and a sample characterization questionnaire were applied. The Chi-square test, Fisher's exact test, and Mann-Whitney U test were applied in the statistical analysis of the variables. The most frequent and intense symptoms of VTD were sensitive throat and sore throat. There was a significant difference between the values of frequency and intensity of all symptoms both before and after playing the instrument. Dryness was the most intense symptom felt after playing the instrument. Musicians who report muscle pain and gastroesophageal reflux showed more VTD symptoms. Symptoms of VTD are experienced by wind instrumentalists and can be work-related since there was a difference in their perception after playing their instruments. There was also a relationship with gastroesophageal reflux and muscle pain, indicating that, in addition to collective issues, the individual musicians' health should be taken into account.

Effects of Virtual Teaching on Swedish Teachers’ Voices During the COVID-19 Pandemic

Since the beginning of 2020, teachers all over the world have had to switch over to virtual teaching because of the COVID-19 pandemic. This change of teaching mode has unknown consequences on the vocal health of teachers who already experience voice disorders at a rate nearly double that of the general population. Therefore, the purpose of this study is to investigate teachers' self-reported voice problems during virtual teaching compared to face-to-face teaching and how they are associated to perceived risk factors in the work environment. Participants included 141 teachers (49 males, 92 females) in high schools and higher education in Sweden who responded to an internet-based survey. Information was collected about participants' self-reported voice handicap using a translated version of the Voice Handicap Index-10 (VHI-10). Information about self-reported VTD (Vocal Tract Discomfort) symptoms and dysphonia was collected in regard to both modes of teaching (virtual vs face-to- face). The survey also included questions on risk factors related to vocal health. Self-reported voice handicap and VTD symptoms were slightly lower during periods of virtual teaching compared to periods of face-to-face teaching. There was a lower frequency of dysphonia symptoms during virtual teaching compared to face-to- face teaching, however the difference was not statistically significant. In addition, 34% of teachers reported experiencing more voice problems when teaching face-to-face while 15% reported more voice problems when teaching virtually. The most reported VTD symptoms during both virtual and face-to-face teaching were having a dry and a tight throat. The dysphonia symptoms with the highest reported frequency were a tense voice and hoarseness in both modes of teaching. Risk factors associated with higher prevalence of voice symptoms and/or higher levels of voice handicap during virtual teaching were air quality and straining the voice while teaching face-to-face. In addition, those teachers who reported more voice problems while teaching virtually also reported feeling more stressed. The results showed a slight decrease in voice symptoms and voice handicap during virtual teaching compared to face-to-face teaching. Although multifactorial, results suggest that a potential positive effect may be attributed to better air quality in the work environment and more favorable acoustic conditions preventing teachers from straining their voice.

Effects of Virtual Instruction on Educators’ Voices During the COVID-19 Pandemic

Introduction: Resulting from the COVID-19 pandemic, professionals in the United States were mandated to work virtually from home to protect the health needs of the population. The shift in setting and ergonomic factors posed a threat to the vocal health of workers, and more specifically, to those whose professions inflict significant vocal load, such as educators. This study compared the symptoms of vocal tract discomfort and self-perceived voice handicap in full-time educators between face-to-face and virtual settings. Additionally, this study sought to identify relationships between specific environmental factors and levels of discomfort.Methods. A cross-sectional research study was conducted by distributing an online survey to 223 individuals who identified as full-time educators. This survey collected data on vocal tract symptoms during both face-to-face and virtual instruction, environmental factors of virtual work setting, personal vocal health habits, and self-perceived voice handicap in each setting.Results. In this sample population, the shift to a virtual work setting did not result in a significant increase in the number of vocal discomfort symptoms or an increase in vocal handicap. However, environmental factors such as air quality and water intake had the strongest correlation with levels of vocal tract discomfort.Conclusion. It is beneficial to provide resources to full-time educators regarding the risk of voice disorders and the impact of environmental factors on vocal health.

Prevalence of vocal tract discomfort in patients with voice disorders.

To analyse the prevalence of vocal tract discomfort in patients with voice disorders. The analytical cross-sectional study was conducted at Riphah International University, Lahore, Pakistan, from September 2020 to January 2021, and comprised voice disorder patients of either gender aged 18-65 years enrolled from Mayo Hospital, Sheikh Zayed Hospital and Jinnah Hospital, Lahore. The Vocal Tract Discomfort Scale was used for data-collection. Data was analysed using SPSS 21. Of the 137 patients, 68(49.6%) were males and 69(50.4%) were females. The overall mean age was 36.36±12.47 years. The most affected age group was 18-33 years 70(51.1%) while those aged 50-65 years were the least affected 28(20.4%). The most common VTD symptom was dryness with mean frequency 3.48±1.97 and mean severity 3.36±1.99, followed by irritation 2.88±2.08 and 2.88±2.12, and lump in the throat 2.42±2.27 and 2.31±2.23, respectively. Dryness, irritation and a lump in the throat were the most common symptoms of vocal tract discomfort.

Voice Quality and Vocal Tract Discomfort Symptoms in Patients With COVID-19

IntroductionDysphonia and laryngeal problems are some of the manifestations of the COVID-19 pandemic due to respiratory disease as a primary effect of COVID-19. The aim of the present study was to investigate voice quality and vocal tract discomfort symptoms in patients with COVID-19.Materials and methodsForty-four COVID-19 patients with a mean age of 49.61 ± 16.48 years and 44 healthy subjects with a mean age of 48.52 ± 13.8 years participated in the study. The voice quality of the participants was evaluated using auditory-perceptual evaluation with the Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale. The vocal tract discomfort symptoms of the participants were assessed using the Persian version of the VTD scale.ResultsPatients with COVID-19 had higher scores in all items of the GRBAS, including grade, roughness, breathiness, asthenia, and strain, than healthy subjects, and these differences were statistically significant (P < 0.05). Among the GRBAS parameters, grade had the highest effect size and asthenia had the lowest effect size in both speech tasks. The COVID-19 patients had a greater frequency of vocal tract discomfort symptoms than healthy subjects in all items of the VTDp scale and these differences were statistically significant (P < 0.05) in the following items: burning, tight, dry, pain, sore, irritable, and lump in the throat. The most and the least effect size in frequency of the vocal tract discomfort symptoms were related to dry (d = 1.502) and tickling (d = 0.157), respectively. Also, COVID-19 patients had more significant severity in all items of the VTDp scale except tight and tickling. The most and the least effect size in severity of the vocal tract discomfort symptoms was related to dry (d = 1.416) and tickling (d = 0.152), respectively.ConclusionThe present study suggests that COVID-19 patients have more deviations in voice quality than healthy subjects. Moreover, mild vocal tract discomfort is prevalent in patients with COVID-19, and patients have more frequent and severe physical discomforts of the vocal tract than healthy subjects.

Self-rated vocal complaints relationship to Vocal Tract Discomfort and Singers Voice Handicap Index in Iranian religious singers.

The religious singing is a popular group of professional voice users in Iran which is performed in a sadness form to persuade the audiences to cry and think to holy persons. This style has its own unique vocal demands and abuses. Therefore, the present study, for the first time, aimed to investigate the prevalence of self-reported vocal complaints, vocal discomfort symptoms, and its effects on the vocal-related life of the Iranian religious singers. In a cross-sectional study, 62 religious singers (28 women, 34 men) completed Singers Voice Handicap Index (SVHI), Vocal Tract Discomfort (VTD), and also a non-standard self-rated vocal complaint question. Spearman correlation test was applied to analyze correlations. Furthermore, 39 non-singers (18 women, 21 men) as a control group participated in this study. The religious singer's mean score of the SVHI test was 34.84 (SD = 24.89). According to the self-rated vocal complaint question, almost 80% of the participants reported mild to the severe vocal complaints that was significantly higher than control group which was about 10%. The self-rated complaints indicated a significant positive correlation with the SVHI and the VTD reported by singers (p ≤ 0.001). The mean scores of the VTD symptoms in singers were significantly greater than control group. There was also a significant positive correlation between the two VTD and SVHI tests (p ≤ 0.001). Religious singers are at a great risk of developing voice problems. Therefore, their vocal demands and requirements need to be followed precisely. The SVHI and VTD tests should also be considered as two efficient tools for religious singers.

Vocal Tract Discomfort Symptoms in Elementary and High School Teachers

The vocal tract discomfort scale is a self-rating seven-point Likert scale that quantifies frequency and severity of eight qualitative descriptors including burning, tight, dry, aching, tickling, sore, irritable, and lump in the throat, and ranges from 0 (never/none) to 6 (always/extreme; Mathieson et al. 2009). The objectives of the current study were to compare the vocal tract discomfort scale results between elementary school teachers and high school teachers and between male and female teachers using the Persian vocal tract discomfort scale. Also, teachers in different age ranges and with different experiences were compared regarding vocal tract discomfort symptoms. The researchers chose 20 elementary and high schools by simple random sampling in Khorramabad, Iran. The survey was given to available teachers of the selected schools. Considering the inclusion criteria, required sample size, and after excluding questionnaires that were not correctly answered, 120 were selected such that 30 were chosen for each subgroup. Subjects consisted of 60 elementary school teachers (30 females and 30 males) with the mean age of 40.92 years (standard deviation=6.07) and 60 high school teachers (30 females and 30 males) with the mean age of 40.67 years (standard deviation=6.00). SPSS 25 was used for analyzing the data. Results indicated that the frequency and severity of the vocal tract discomfort in elementary school teachers were significantly higher than for the high school teachers with a medium to large effect size. Although the frequency and severity of the symptoms were higher in female compared with male teachers, those differences were not significantly different. Younger teachers had lower frequency and severity ratings of vocal tract discomfort symptoms than older teachers. Teaching experience was not an important factor in predicting vocal tract discomfort symptoms in teachers. The results of this study suggest that there is higher frequency, greater severity, and higher percentages of vocal tract discomfort symptoms in elementary compared with high school teachers. In addition, although the mean frequency and severity of vocal tract discomfort symptoms were not significantly different between females and males, females reported higher percentages of the symptoms. Because each of the eight vocal tract symptoms was experienced at the time of testing by between 42% (tightness) and 68% (dryness) of the participants, it is suggested that an educational program regarding vocal tract discomfort may be helpful for this profession.

Vocal tract discomfort and voice handicap index in patients undergoing thyroidectomy

Purpose This study aims to investigate the frequency and severity of vocal tract discomfort (VTD) symptoms and to determine the relationship between VTD and type of thyroidectomy, voice problem history, vocal abuse, and misuse behaviors, and the voice handicap index (VHI) in the thyroidectomy patients undergoing thyroidectomy, pre- and post-operatively pre- and post-thyroidectomy. Materials The sample comprised 21 thyroidectomy patients undergoing thyroidectomy, including 10 patients with total thyroidectomy and 11 patients with partial thyroidectomy. The participants underwent videolaryngoscopy examination and completed the voice history questionnaire, the VTD scale, and the VHI, before and after the surgery. Results Dryness was the most frequently occurring symptom, pre- and post-thyroidectomy. Participants with total thyroidectomy reported significantly higher frequency and severity of tickling than those in the preoperative status (p<.05). The frequency and severity of many VTD symptoms in the participants with voice problems and a vocal abuse and misuse history were higher than those without such a history at both assessment times (p<.05). There was significant correlation between the frequency and severity of VTD and VHI scores, pre-thyroidectomy pre-operatively (r = 0.488–0.575, p<.05). Conclusions An increment in the frequency and severity of tickling was reported by total thyroidectomy patients, post-thyroidectomy post-operatively. The type of thyroidectomy, voice problem history, and vocal abuse and misuse behaviors seem to influence the frequency and severity of VTD. Considering the correlation between VTD and VHI, the VTD scale provides important clinical information and can be used for evaluation and consultation purposes.

Vocal Quality, Symptoms, and Habits in Musical Theater Actors

The purpose of this study was to measure and compare the voice characteristics and vocal complaints and habits of musical theater actors and musical theater students. Thirty participants were included in the study, 18 musical theater students and 12 professional musical theater actors. Vocal quality was measured by the multiparameter indices Dysphonia Severity Index (DSI) and Acoustic Voice Quality Index (AVQI). A perceptual evaluation of the speaking voice was performed using the GRBASI scale. All participants completed the Voice Handicap Index (VHI), the VHI adapted to the singing voice, the Vocal Tract Discomfort (VTD) Scale and the Corporal Pain Scale. Excellent scores for DSI (resp. 7.3, 7.1) and AVQI (resp. 2.6, 2.5) were found in the musical theater actors and students. All participants reported at least two symptoms of VTD and the mean scores for the VHI adapted to the singing voice were located in the clinical zone. Musical theater students reported significantly more VTD and pain symptoms compared to the professionals. No significant differences in perceptual and objective voice characteristics were found between musical theater actors and students. A higher presence of vocal misuse and stress in the students was observed. Musical theater students and actors are elite vocal performers with comparable excellent objective vocal measures (DSI, AVQI). In both groups, an increased number of VTD and complaints of the singing voice were reported. Especially students were vulnerable for stress, vocal misuse, VTD, and pain symptoms. The findings suggest that musical theater actors are a risk group for developing voice disorders requiring multidimensional voice assessment and voice care.

Vocal Tract Discomfort Scale (VTDS) and Voice Symptom Scale (VoiSS) in the Early Identification of Italian Teachers with Voice Disorders.

Introduction The current Italian law does not include any guidance regarding voice education, prevention of voice disorders and screening in subjects with high vocal loading such as teachers. Objectives We aimed to check the correlation between the Vocal Tract Discomfort Scale (VTDS) with the Voice Symptom Scale (VoiSS) for the evaluation of Italian teachers. In addition, we aimed to investigate whether there are differences in the frequency and intensity of discomfort symptoms in teachers with disabilities comparing vocal tract discomfort symptoms in teachers with high risk (HRVD) and low risk (LRVD) of vocal disorders according to the VoiSS cutoff (> 15.5). Methods We analyzed 160 Italian teachers (111 women and 49 men) that completed the VTDS and VoiSS at vocal evaluation. The Spearman correlation test was applied to all variables. The Mann-Whitney U test was used to compare the average number of discomfort symptoms among HRVD and LRVD teachers. Results A moderate positive correlation was observed between the average number, frequency, and intensity of discomfort symptom and the total score, physical domain score, and limitation domain score of the VoiSS. Only the emotional domain score of the VoiSS showed a weak positive correlation ( p < 0.001). Teachers considered in the HRVD group according to the VoiSS score had a higher number, frequency, and intensity of vocal tract discomfort symptoms. Conclusion There is correlation between the VTDS and VoiSS scales. Like the VoiSS, the VTDS is a questionnaire that detects HRVD teachers. Therefore, the results suggest that both questionnaires could be useful for a preventive voice program for Italian teachers

Long-Term Effects of a Voice Training Program to Prevent Voice Disorders in Teachers

Research findings about long-term effectiveness of voice training programs for teachers are limited. This study shows long-term evaluation results of a statewide voice training program for teachers in Lower Saxony/Germany. Twenty-seven voice training sessions with 286 participating teachers were evaluated with different questionnaire surveys on three different occasions (prior and after seminar, follow-up 3 months later). Prior the training and 3 months after completion of the training the validated self-assessment tool Voice Profile for Professional Voice users (VPPV) was used to measure subjective impact of voice problems on the participating teachers. In addition, questionnaires to evaluate benefits of the seminars for everyday working life, possible voice changes and satisfaction with the program were used. Prior the training 64.9% of the participating teachers were above the cut-off point of the VPPV that indicates a high subjective impact of voice problems. Three month after the training this number decreased by -14.9% down to 50% (P= 0.001, T = 3.437, df = 314). Ninety-three percent of the respondents implemented aspects of the voice training seminar in their occupational everyday life. Furthermore, teachers showed a slight or considerable improvement of their vocal resilience (72.2%) 3 months after the training. This included rarer clearing of the throat (80.6%) and/or a reduction of vocal tract discomfort symptoms (66%). The results indicate that a vast majority of teachers implement contents of the voice training program in their occupational everyday life and that these changes in behavior lead to a better vocal capacity and vocal performance. Nevertheless, the number of teachers that have a mean value in the VPPV that can be regarded as very high self-perceived voice impact which indicates a risk for a voice disorder is still high after the voice training. Voice training sessions held so far proofed to be an important aspect to reduce self-perceived voice impact in teachers in Lower Saxony/Germany.

Vocal Tract Discomfort and Dysphonia in Patients Undergoing Empiric Therapeutic Trial with Proton Pump Inhibitor for Suspected Laryngopharyngeal Reflux

Introductionthe aim of this study was to evaluate the correlation among dysphonic and vocal tract discomfort symptoms in patients who underwent empiric therapeutic trial with proton pump inhibitor (PPI) for a suspected laryngopharyngeal reflux (LPR). Materials and methodsA total of 34 patients with suspected LPR were enrolled in this study. All of them were evaluated using the reflux finding score, the reflux symptom Index (RSI), the vocal tract discomfort scale (VTDS), and the voice symptom scale (VoiSS) before and after the PPI treatment. ResultsA significant difference was found between pretreatment and posttreatment reflux finding score, RSI, VTDS, and VoiSS scores. Significant correlations among RSI, VTDS, and VoiSS before the PPI treatment were found. ConclusionPPI treatment determined a significant improvement of symptoms related to dysphonia and vocal tract discomfort in patients with suspected LPR, in addition, significant correlations among the RSI, VTDS, and VoiSS scores were demonstrated thus suggesting that LPR might influence the response of questionnaires not specifically developed in order to assess the complains in LPR patient.

Desconforto do trato vocal e qualidade de vida em deglutição em idosos

Introdução: O processo do envelhecimento no ser humano se dá por alterações funcionais de forma progressiva e degenerativa, pelo enfraquecimento dos mecanismos de defesa e perda das reservas funcionais que atingem todo o organismo. Objetivo: Caracterizar o desconforto do trato vocal e a qualidade de vida relacionada à deglutição em indivíduos idosos. Métodos: Estudo transversal, realizado no setor de clínica médica e nos arredores do hospital Universitário. Aprovado pelo Comitê de Ética em Pesquisa sob o nº 1.943.445. Foram aplicados os questionários Escala de Desconforto do Trato Vocal e Qualidade de Vida relacionada à deglutição em dois grupos: idosos internados (n=200), acima de 60 anos, e idosos considerados saudáveis (n=200), acima de 60 anos, de ambos os sexos. Resultados: Nos idosos saudáveis houve prevalência do sexo feminino (50,50% n=101) e nos internados houve prevalência do sexo masculino (61,50% n=123). Os idosos internados apresentaram maior frequência e intensidade de sintomas sensoriais de desconforto do trato vocal. Em relação à qualidade de vida em deglutição, os menores escores foram para os domínios sono e fadiga. Houve correlação negativa e fraca entre os sintomas sensoriais de desconforto do trato vocal e qualidade de vida relacionada à deglutição. Conclusão: Os idosos internados apresentaram mais sintomas/sensações de desconforto do trato vocal com pior impacto na qualidade de vida em deglutição, quando comparados a idosos saudáveis.

Vocal Tract Discomfort Scale (VTDS) and Voice Symptom Scale (VoiSS) in the Evaluation of Patients With Voice Disorders

We aimed to correlate the Vocal Tract Discomfort Scale (VTDS) with the Voice Symptom Scale (VoiSS) for evaluation of patients with dysphonia. In addition, we aimed to compare vocal tract discomfort symptoms in patients with and without self-reported voice problem. This is a descriptive, cross-sectional, and retrospective study. We analyzed 143 women and 62 men with voice disorders, as confirmed by endoscopic larynx examination. All patients completed the VTDS and VoiSS at vocal evaluation. Descriptive statistics and the Spearman correlation test were applied to all variables. The degree of covariance of variables was noted. The Mann-Whitney U test was used to compare the average number of discomfort symptoms among patients with and without self-reported voice problems. A weak to moderate positive correlation was observed between the average number, frequency, and intensity of comfort symptom and the total score, physical domain score, and limitation domain score of the VoiSS. The vocal tract discomfort symptoms and the emotional domain score of the VoiSS were weakly correlated. Patients with self-reported voice problems had a higher number, frequency, and intensity of vocal tract discomfort symptoms. There is correlation between the VTDS and VoiSS scales, with greater references to vocal tract discomfort symptom in patients with self-reported voice problems. Therefore, the discomfort symptoms seem to influence the perception of the impact of a voice problem.

Comparison of Vocal Tract Discomfort Symptoms and Acoustic Features in Patients with Gastro Esophageal Reflux (GER) and Laryngo Pharyngeal Reflux (LPR)

Introduction: Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) are associated with voice disorders, which cause changes in the structure of the vocal cords and subsequently changes in the voice quality and unpleasant feelings. Since LPR is stronger and has more direct impact on the laryngopharyngeal mucosa and vocal cords than the GERD, it is supposed to create more stable sensory symptoms and acoustic features. Therefore, this study aimed to examine and compare patients with LPR and GERD as well as their acoustic features and vocal tract discomfort (VTD) symptoms. Materials and Methods: This cross-sectional descriptive-analytic study included 17 patients with GERD and 18 patients with LPR. The voices of patients were recorded in an acoustic room (noise 28 dB). Besides, both groups of patients were asked to complete the VTDs. Then, acoustic features were analyzed using praat software. In addition, the frequency and severity scores of the VTDs were analyzed via SPSS software. Results: Baseline frequency, jitter (local), and shimmer (local), and also harmonic-to-noise ratio were not significantly different between the two groups. Meanwhile, the severity of soreness and the frequency and severity of pain were significant between the two groups. Conclusion: The severity and the frequency of pain and the frequency of soreness are more prevalent in patients suffering from LPR than the patients with GERD. LPR has more destructive effects on the acoustic features and the vocal tracts of patients with LPR, due to its stronger involvement with the laryngopharyngeal space. Therefore, patients with voice disorders indicating higher scores than normal in VTD must be examined for LPR, although they do not show symptoms of heartburn or acid reflux.

Correlation between vocal tract symptoms and modern singing handicap index in church gospel singers.

To verify the correlation between vocal tract discomfort symptoms and perceived voice handicaps in gospel singers, analyzing possible differences according to gender. 100 gospel singers volunteered, 50 male and 50 female. All participants answered two questionnaires: Vocal Tract Discomfort (VTD) scale and the Modern Singing Handicap Index (MSHI) that investigates the vocal handicap perceived by singers, linking the results of both instruments (p<0.05). Women presented more perceived handicaps and also more frequent and higher intensity vocal tract discomfort. Furthermore, the more frequent and intense the vocal tract symptoms, the higher the vocal handicap for singing. Female gospel singers present higher frequency and intensity of vocal tract discomfort symptoms, as well as higher voice handicap for singing than male gospel singers. The higher the frequency and intensity of the laryngeal symptoms, the higher the vocal handicap will be.

Vocal Tract Discomfort and Voice-Related Quality of Life in Wind Instrumentalists

This study aimed to investigate vocal tract discomfort and quality of life in the voice of wind instrumentalists. It is a cross-sectional study. The sample was composed of 37 musicians of the orchestra of Caxias do Sul city, RS, Brazil. The participants answered a nonstandard questionnaire about demographic and professional information, the Voice-Related Quality of Life (V-RQOL), the Vocal Tract Discomfort (VTD) scale, and additional items about fatigue after playing the instrument and pain in the cervical muscles. Correlation analyses were performed using Spearman correlation test. The most frequent symptoms mentioned by musicians in the VTD, for both frequency and intensity of occurrence, were dryness, ache, irritability, and cervical muscle pain, in addition to the frequency of occurrence of fatigue after playing. The musicians showed high scores in the V-RQOL survey. Several symptoms evaluated by the VTD had a negative correlation with the musicians' years of orchestra membership and with V-RQOL scores. Symptoms of vocal tract discomfort are present in wind instrumentalists in low frequency and intensity of occurrence. However, these symptoms affect the musicians' voice-related quality of life, and they occur more in musicians with fewer years of orchestra membership.

Effect of vitamin D deficiency on the laryngo-pharyngeal tract

ObjectiveTo investigate the effect of vitamin D deficiency on the laryngopharyngeal tract. Study designProspective cohort study. SettingTertiary care center. Subjects and methodsA total of 38 human subjects were prospectively recruited, equally divided into two groups. The Vitamin D deficiency group defined as 25-OH<25ng/dl and the control subjects with normal vitamin D level defined as 25-OH>25ng/dl. The presence and severity of vocal tract symptoms was assessed using the Vocal Tract Discomfort score. ResultsThere was no significant difference in vocal tract discomfort score for frequency and severity between patients with Vitamin D deficiency and patients with no vitamin D deficiency (p value 0.272). However there was a significant difference in the mean frequency of burning, aching, soreness and lump sensation (p value<0.05) in patients with vitamin D deficiency compared to those with no vitamin D deficiency. There was also a significant difference in the means of vocal tract severity symptoms, namely for burning and aching between patients with vitamin D deficiency compared to patients with no vitamin D deficiency (p value<0.05). ConclusionSubjects with vitamin D deficiency do not have a higher vocal tract discomfort score than subjects with no vitamin D deficiency. However the frequency and severity of certain vocal tract discomfort symptoms was higher and can be based hypothetically on the similarity in structure between the laryngopharyngeal complex and the musculoskeletal system.