Voice Handicap Index Scores Research Articles

Long-Term Outcomes and Revision Rates in Laryngeal Reinnervation.

Nonselective laryngeal reinnervation is an effective procedure to improve voice quality after unilateral vocal fold paralysis. Few studies have captured long-term outcome data, and the revision rate for this operation is currently unknown. The objective of this study is to describe the long-term outcomes and revision rates of unilateral, nonselective reinnervation in pediatric and adult patients. Patients who underwent laryngeal reinnervation from 2000 to 2022 with a single surgeon were identified for inclusion. Patients who underwent bilateral, super selective, deinnervation and reinnervation, and/or concurrent arytenoid adduction procedures were excluded. Outcome measures included maximum phonation time [MPT], voice handicap index score [VHI], patient-reported percent normal voice, revision procedures, and complications. Data were compiled and analyzed using paired t-tests, repeated measures analysis of covariance, and binary logistic regression analysis. One hundred thirty-two patients underwent unilateral, nonselective ansa-recurrent laryngeal nerve [RLN] laryngeal reinnervation. Reinnervation significantly improved MPT and patient-reported percentage of normal voice and significantly decreased VHI. Eleven patients underwent revision procedures, corresponding to a revision rate of 8.3%. Additional procedures included medialization laryngoplasty [n = 3], medialization laryngoplastywith arytenoid adduction [n = 3] and injection augmentation greater than 1 year after reinnervation [n = 5]. The only factor associated with the need for additional surgery was time lapse from nerve injury to reinnervation. The overall complication rate was 6.8%; no patient required reintubation or tracheostomy. Unilateral, nonselective laryngeal reinnervation can provide reliable improvement in vocal symptoms after recurrent laryngeal nerve injury. The revision rate after laryngeal reinnervation is favorable and comparable to framework surgery. 4 Laryngoscope, 134:3187-3192, 2024.

Assessment of quality of voice after 3D conformal hypofractionated radical radiotherapy in early-stage glottic cancer: A prospective study

ABSTRACT Purpose: The purpose of this study was to evaluate the short-term outcomes in terms of oncological outcomes, toxicities, and impact of quality of voice on livability of early glottic cancer (EGC) (T1) patients after hypofractionated radiotherapy. Material and Methods: 30 patients of early glottic carcinoma, staged cT1a-T1bN0M0 with Eastern Cooperative Oncology Performance Status (ECOG PS ≤ 2). Exclusion criteria included ECOG PS > 2, T2–T4 disease, and any other head and neck malignancy. Voice Handicap Index-10 (VHI-10) was used to score voice outcomes of patient’s pre- and post-radiation. Results: All the subjects were predominantly smokers (80%) having hoarseness of voice as the most common presenting complaint (76.7%) followed by dry cough (13.3%) and foreign body sensation (10%). On posttreatment response assessment, there has been a significant reduction in VHI-10 scores from pre-radiotherapy (RT) to 6, 12, and 24 weeks post-radiation completion in all three domains (functional, emotional, and physical), as well as total scores, with a significant P value (<0.05) being observed. Conclusion: The use of modest hypofractionated regimen (63 Gy in 28 fractions) in patients of early glottic disease (T1a and T1b) posttreatment completion provides good oncological outcomes with better quality of voice being observed.

Clinical Voice Outcomes for Two Voice Rest Protocols after Phonomicrosurgery.

Voice rest is commonly recommended for patients with benign vocal fold lesions (BVFLs) after phonomicrosurgery. The study compares the clinical voice outcomes of two protocols, 7-day complete voice rest (CVR) and 3-day CVR followed by 4-day relative voice rest (CVR + RVR), for patients with BVFLs after phonomicrosurgery. Prospective, randomized controlled trial. Patients with BVFLs undergoing phonomicrosurgery were recruited prospectively and randomly assigned to either protocol. Outcomes were assessed on objective measures of acoustics (fundamental frequency, frequency range, mean intensity, cepstral peak analysis) and aerodynamics (vital capacity, airflow rate, subglottal pressure, phonation threshold pressure), as well as subjective measures, both provider-reported through the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), and patient-reported through the Voice Handicap Index (VHI). Clinical measures were collected at three-time points: preoperatively, 1-week postoperatively (on voice rest), and 1-month postoperatively. In addition, adherence was estimated using a vocal dosimeter. Twenty-five patients were recruited and randomized to 7-day CVR (n = 13) and CVR + RVR regimen (n = 12). Statistically significant changes were found within both groups for subglottal pressure (p = 0.03) and VHI score (p < 0.001) comparing pre-operative baseline to 1-month postoperative follow-up. There were no statistically significant differences between the groups. Regardless of group assignment, a significant decrease in overall severity ratings for the CAPE-V was found by comparing the preoperative scores to postoperative scores at 1-week (p < 0.001) and 1-month (p < 0.001). Both groups improved their overall voice quality comparably 1 month after undergoing phonomicrosurgery as measured by objective and subjective parameters. 2. Laryngoscope, 134:2812-2818, 2024.

Analysis of swallowing and voice-related quality of life in patients after supracricoid partial laryngectomy

ObjectiveThis study evaluated the swallowing and voice function of laryngeal cancer patients after Supracricoid Partial Laryngectomy(SCPL), and its influence on quality of life to provide a reference for the selection of surgical methods for laryngeal cancer patients.MethodsTwenty-one patients who received SCPL between April 2015 and November 2021 were included. Each patient’s swallowing function and quality of life were assessed through fiberoptic endoscopic examination of swallowing (FEES) and the M.D. Anderson Dysphagia Inventory (MDADI). Fundamental, jitter, shimmer, maximum phonation time (MPT), and voice handicap index-10 (VHI-10) were performed to assess voice function and voice-related quality of life.ResultsThe results of the FEES of the 21 patients were as follows: the rates of pharyngeal residue after swallowing solid, semiliquid, and liquid food were 0%, 28.57%, and 38.09%, respectively; the rates of laryngeal infiltration after swallowing solid, semiliquid, and liquid food were 0%, 28.57%, and 4.76%, respectively; and aspiration did not occur in any of the patients. In the evaluation of swallowing quality of life, the mean total MDADI score was 92.6 ± 6.32. The voice function evaluation showed that the mean F0, jitter, shimmer, and MPT values were 156.01 ± 120.87 (HZ), 11.57 ± 6.21 (%), 35.37 ± 14.16 (%) and 7.85 ± 6.08 (s), respectively. The mean total VHI-10 score was 7.14 ± 4.84.ConclusionSCPL provides patients with satisfactory swallowing and voice function. The patients in this study were satisfied with their quality of life in terms of swallowing and voice. SCPL can be used as a surgical method to preserve laryngeal function in patients with laryngeal cancer.

Evaluation of Voice in Inflammatory Bowel Diseases

Introduction: Inflammatory bowel diseases, which are among the most common chronic gastrointestinal diseases, can also affect the voice for different reasons. The aim of this study was to investigate acoustic, perceptual, and subjective voice evaluation parameters in inflammatory bowel diseases (IBD). Methods: This prospective case-control study included a total of 80 participants: 28 patients with ulcerative colitis (UC), 22 patients with Crohn’s disease (CD), and 30 healthy controls. Following the endoscopic examination, the fundamental frequency (F0), shimmer (dB), jitter (%), and harmonic/noise ratio (HNR) were measured. GRBAS (grade, roughness, breathiness, asthenia, strain) scale was used for perceptual evaluation, and Voice Handicap Index-10 (VHI-10) Turkish version was used for subjective assessment. Results: The F0 value was within normal limits in both disease groups in male and female participants and in the control group. Jitter and shimmer values were statistically higher in the UC and CD groups than in the control group. HNR did not differ between CD and control; however, it was statistically lower in the UC group when compared to both the control and CD groups. The total GRBAS score did not differ between the UC and CD groups; however, it was greater in IBD patients compared to the control group. However, these differences were within normative parameters. Although total VHI-10 score did not differ between UC and CD groups, both had a higher voice handicap than the control group. Conclusion: IBD might have an effect on the voice and voice quality. This disease group was discovered to have perceptual and subjective voice problems additionally.

Effect of Akson Therapy on Acoustic Parameters in Patients with Functional Dysphonia.

Functional dysphonia can impair the language expression ability and adversely affect the career development of some patients. Therefore, an active exploration of effective treatment options is imperative. This study investigated the effect of Akson therapy on acoustic parameters in patients with functional dysphonia. In this retrospective analysis, 79 patients with functional dysphonia who received conventional voice correction training from June 2020 to June 2021 were included in the reference group (RG). Our hospital has implemented Akson therapy since July 2021. Correspondingly, 72 patients with functional dysphonia who underwent Akson therapy from July 2021 to July 2022 were enrolled in the observation group (OG). The acoustic parameters such as fundamental frequency (F0), jitter, shimmer, and normalized noise energy (NNE); the aerodynamic parameters including maximum phonation time (MPT), mean airflow rate (MFR), and Voice Handicap Index-10 (VHI-10) score; and the Grade, Roughness, Breathiness, Asthenia, and Strain scale (GRBAS) score were measured before and after treatment and compared between the two groups. The F0, jitter, shimmer, NNE, MPT, and MFR values as well as the VHI-10 score and the grade (G), roughness (R), and breathiness (B) scores on the GRBAS did not significantly differ between the two groups before treatment (P > 0.05). However, significantly lower F0, jitter, shimmer, NNE, and MFR values and higher MPT levels were found in the OG compared to the RG after treatment (P < 0.001). Furthermore, the VHI-10 score and the G, R, and B scores were significantly lower in the OG than in the RG after treatment (P < 0.001), whereas the asthenia (A) and strain (S) scores remained at 0 before and after treatment. Akson therapy can improve the acoustic parameters of patients with functional dysphonia to a certain extent, indicating its potential application value.

Vocal risk mapping in classical singers: an analysis of the self-perception of voice quality, vocal fatigue, and singing voice handicap.

To map the vocal risk in professional classical singers, analyzing their self-assessment of voice and self-perception of singing voice handicap and vocal fatigue. The study sample comprised of 52 professional classical choir singers, aged 31 to 72 years. They answered an online questionnaire in Google Forms, addressing their characterization, self-assessment of voice, the Voice Handicap Index-10 (VHI-10), Classical Singing Handicap Index (CSHI), and Vocal Fatigue Index (VFI). The mean self-assessment of voice was between "Good" and "Very good" (1.2). The mean total VHI-10 score was 1.35, which is below the cutoff. The mean total CSHI score was 10.04. The mean total VFI score was 10.83, near the cutoff value. Classical singers who use their voice to give examples to students in their classes had higher scores in VHI-10 (p = 0.013), VFI voice restriction (p = 0.011), and VFI total score (p = 0.015). Besides, classical singers who already visited a Speech-Language Pathologist for voice problems had higher scores in VFI voice restriction (p = 0.040) and VFI recovery with voice rest (p = 0.019), in addition to correlations between instrument scores. Professional classical singers did not have voice handicaps. However, their self-perception of vocal fatigue was more present when the singing voice was used, such as giving examples with their own voice in class. Having had voice problems and visited a Speech-Language Pathologist in the past led to a greater perception of vocal recovery with rest.

Comparing dysphonia severity index, objective, subjective, and perceptual analysis of voice in patients with multiple sclerosis and healthy controls

BackgroundImpairments in voice quality in Multiple Sclerosis (MS) have recently been investigated and different results were found. A voice-centered multidimensional assessment protocol with patient-reported outcome measures was conducted to evaluate all the aspects of the voice changes. ObjectivesThe study aimed to compare the objective, subjective, and perceptual measures of voice between the people with MS and the healthy control group. MethodsA total of 128 participants, including 64 people with MS age, and gender-matched healthy controls were enrolled in the study. Subjective, objective, and auditory-perceptual voice assessments of the participants were performed. The auditory-perceptual evaluation was performed with GRBAS. The Dysphonia Severity index was computed for both groups. All the participants completed the Turkish version of The Voice Handicap Index-10 (VHI-10) and the Voice-Related Quality of Life (VRQoL). ResultsAcoustic and aerodynamic parameters of voice were found significantly different for both males and females between the MS and control group. DSI was found significantly different for both males and females in the MS group compared to the control group (p<0.05). All components of the GRBAS scale were significantly higher in the MS group (p<0.001). Using a multivariate regression model, it was determined that age, gender, EDSS score, number of MS attacks, and disease duration did not affect the DSI. The overall VHI-10 score was higher in the MS group (median=1.0 range= 0–28) and lower in the control group (median=0 range= 0–4). The mean VRQoL was lower in the MS group (median=95 range= 62.5–100) than in controls (median=100 range= 85–100) (p<0.001). ConclusionOur results indicated that people with MS have significant differences in acoustic and aerodynamic parameters of voice compared to healthy individuals. A significant number of persons with MS are aware that their voice problem affects their quality of life. People with MS must be monitored for voice changes and a multidimensional voice assessment protocol should be implemented.

Self-Reported Voice-Related Quality of Life in Cochlear Implant Users

Objective. The aim of this study was to identify if cochlear implant (CI) users are perceiving a decrease in life quality due to voice problems. This study evaluated 43 CI user’s perception of their voice and how it affects their quality of life through a survey. Approach. Forty-three CI users responded to a survey regarding their demographics, details about their CI, the Hearing Health Quick Test (HHQT), the Voice Related Quality of Life (V-RQOL), and the Voice Handicap Index-10 (VHI-10). The survey responses were analyzed using univariate linear regression analysis. Results. Few of the CI users scored below the cut off for normal voice related quality of life. CI users averaged 93.4 out of 100 on the V-RQOL and only four scored abnormally for the VHI-10. Lower scores on the V-RQOL were correlated with the participants having an associate degree and with participants visiting friends, family, and neighbors less often due to hearing loss. The VHI-10 scores were correlated with gender, education levels, difficulty in social situations due to hearing loss, noise exposure, and tinnitus. Limitations of the study. The small n was the primary limitation of this study. Originality. This study was one of the first to examine the voice-related quality of life in CI users. Conclusions. Overall, respondents did not perceive much voice-related difficulty. However, they were more likely to perceive voice-related difficulty if they experienced difficulty hearing in noise and avoided social situations due to hearing loss.

Endoscopic assisted microscopic posterior cordotomy for bilateral abductor vocal fold paralysis using radiofrequency versus coblation

PurposeTo assess the outcomes of endoscopic assisted microscopic posterior cordotomy for bilateral abductor vocal fold paralysis (BAVFP) using radiofrequency versus coblation.MethodsThis was a randomized prospective cohort study that carried out on 40 patients with BAVFP who were subjected to endoscopic/assisted microscopic posterior cordotomy. The patients were randomly allocated into two groups: group (A) patients were operated with radiofrequency, and group (B) patients were operated with coblation. Glottic chink, grade of dyspnea, voice handicap index 10 (VHI10), and aspiration were evaluated pre-operatively and 2 weeks and 3 months post-operatively.ResultsThere was a significant improvement in the glottic chink and VHI10 scores postoperatively with a non-significant difference between both groups regarding the degree of improvement. In addition, there was a significant improvement of the grade of dyspnea with a non-significant impact on the degree of aspiration in both groups post operatively. There was a lower incidence of oedema and granulation formation in the coblation group but without a statistical significance.ConclusionBoth techniques are effective alternatives for performing posterior transverse cordotomy in cases of BAVFP.

Chronic Refractory Cough: Long-Term Outcomes Following Cough Suppression Therapy

ObjectiveThis study aimed to determine the long-term outcomes of patients with chronic refractory cough (CRC) following treatment for cough suppression therapy (CST). Currently, there is a lack of objective data regarding the long-term outcome of behavioral treatment for CRC. MethodsFrom the charts of 106 adult patients diagnosed with CRC, 24 patients were identified as having long-term data at least 3 months post-CST in the form of otolaryngologic examination, Voice Handicap Index-10 (VHI-10), and Cough Severity Index (CSI) scores. Patients underwent otolaryngologic evaluation and completed the VHI-10 and CSI assessments during pretreatment, posttreatment, and long-term follow-up visits. Patients were also divided into two groups based on their number of comorbidities. ResultsTwenty of the 24 patients had significant reduction in cough severity after completing CST (P < 0.001). A significant difference was also found in CSI scores from pretherapy to the long-term follow-up visits (P = 0.001). No significant difference was found in CSI scores from posttherapy to long-term follow-up visits (P = 0.93). No significant difference was found in VHI-10 scores over time (P = 0.83). No correlation was found between changes in cough and voice severity and number of comorbidities at the tested level. ConclusionsFindings of no significant change in CRC over the long term compared to posttherapy measures suggest that patients were able to maintain improvement in cough over the long term despite various comorbidities. The current results suggest that CST represents a satisfactory approach to treating CRC and provides patients with an ongoing tool to maintain reduced cough severity. No significant correlations between number of comorbidities and mean CSI or VHI-10 scores were found over the long term.

Impact of the Severity of Reinke's Edema on the Parameters of Voice.

This study aimed to classify the degree of edema in patients with Reinke's edema (RE) and examine its impact on their voice parameters using both objective and subjective assessment methods. Objective and subjective voice data of 104 patients diagnosed with RE between 2018 and 2021 were evaluated retrospectively. RE is classified into 4 groups (types 1, 2, 3, and 4). The evaluation included videolaryngostroboscopic examination, acoustic voice analysis, and aerodynamic measurements, GRBAS, Voice Handicap Index-10 (VHI-10), Voice-Related Quality of Life Scale (V-RQOL), and Reflux Septum Index (RSI). Patients with type 1 RE had a significantly lower mean age than those with types 3-4. Although there were no significant differences in acoustic and aerodynamic parameters between the groups, it was observed that F0 and the maximum phonation time decreased as the degree of edema increased. The GRBASTotal, G, and R scores of types 1 and 2 were significantly lower than those of types 3 and 4, as were the scores of type 1 S. There were no statistically significant differences between the RE groups in terms of VHI-10, V-RQOL, and RSI scores. It has been observed that as the severity of RE increases, voice perception and quality (especially types 3 and 4) are negatively affected. Determining the degree of edema will guide the clinician in both the planning of the intervention phase and the follow-up phase.

Analysis of the clinical efficacy and voice outcomes of CO2 laser resection versus laryngeal microsurgery for vocal cord polyps

Objective To compare CO2 laser resection and laryngeal microsurgery for vocal cord polyps and provide evidence for the optimal surgical method. Methods This was a retrospective cohort study that included 74 patients with vocal cord polyps who underwent either CO2 laser resection or laryngeal microsurgery in our hospital from August 2018 to December 2021. According to their preference, 77 patients were divided into two groups: a CO2 laser resection group (n = 35) and a laryngeal microsurgery group (n = 39). Patients were evaluated two days before surgery, and follow-ups were conducted one, two and four weeks after surgery. The voice handicap index (VHI-10) score, voice acoustic analysis results and electronic laryngoscopy results were collected for each patient, and the differences between the two groups were evaluated. Results The basic demographic characteristics of the 74 patients were comparable, and all patients completed postoperative follow-up observations. A total of 30 (85.71%) patients in the CO2 laser resection group and 22 (56.41%) patients in the laryngeal microsurgery group were healed. The total effectiveness rate of the CO2 laser resection group (94.29%) was significantly higher than that of the laryngeal microsurgery group (82.05%), and the difference between the two groups was statistically significant (p = .037). Both surgical methods had a positive effect on reducing VHI-10 scores with the effect of CO2 laser resection being more obvious. The difference between the two groups in this regard was statistically significant (p < .001). The effects of each surgical method on the average fundamental frequency perturbation (jitter), amplitude perturbation (shimmer), maximum phonation time and dysphonia severity index were not statistically significant (p > .05). Conclusion CO2 laser resection and laryngeal microsurgery have similar effects on voice quality, but CO2 laser resection has higher clinical efficacy.

Prediction of Voice Outcomes After Hemithyroidectomy Using Skin Electrode Intraoperative Neuromonitoring

Background and Objectives This study focused on predicting voice outcomes following hemithyroidectomy using skin electrode intraoperative neuromonitoring (IONM).Subjects and Method The study involved 82 patients who underwent hemithyroidectomy. During the surgery, the researchers recorded skin IONM values for the vagus nerve and recurrent laryngeal nerve. Voice quality evaluations were conducted before the surgery and at various intervals after the surgery (one week, one month, three months, six months, and one year) using the multidimensional voice program (MDVP), voice handicap index (VHI), and the grade, roughness, breathiness, asthenia, strain (GRBAS) scale. The study aimed to correlate perioperative skin IONM values with subjective and objective voice outcomes.Results The VHI scores increased up to three months post-surgery, with statistically significant changes observed at one week post-surgery. The GRBAS scale scores also increased significantly at one month post-surgery. Similar trends were observed in the MDVP data, including a decrease in the maximum pitch between one week and three months post-surgery. Additionally, the study found that lower delta-V values (difference between the preoperative and postoperative signal amplitude of vagus nerve stimulation) were associated with higher F0 values at one week and three months post-surgery, while jitter and noise-to-harmonic ratio were higher in the group with higher delta-V values at three months post-surgery.Conclusion Greater differences between the preoperative and postoperative signal amplitude of vagus nerve stimulation during surgery were linked to worse postoperative voice outcomes. Voice parameters worsened for up to 3 months after hemithyroidectomy but showed signs of recovery afterwards. These findings offer insights into predicting and managing voice outcomes after hemithyroidectomy.

Long-term Outcome of Autologous Lipoinjection Medialization Laryngoplasty versus Type I Thyroplasty

Adult voice center patients who had undergone surgical vocal fold medialization with autologous lipoinjection or with type I thyroplasty for glottic insufficiency were included in this retrospective study. The primary outcome measures were the need for further medialization surgery and improvement in the glottic gap. There were 172 subjects included in this study: 100 subjects underwent type I thyroplasty and 72 subjects underwent autologous lipoinjection medialization. Neither age nor gender differed significantly between thyroplasty and lipoinjection groups. The rate of further medialization surgery did not differ significantly between thyroplasty and lipoinjection groups, but further medialization surgery was performed longer after the initial operation in the thyroplasty group Baseline glottic gap did not differ significantly between thyroplasty and lipoinjection groups. When improvement from baseline was compared between thyroplasty and lipoinjection subjects, the improvement from baseline was similar for both groups at 6 months and at 12 months. Voice handicap index scores improved significantly after thyroplasty or after lipoinjection, and the improvement from baseline was similar in both cohorts. Both autologous lipoinjection medialization and type I thyroplasty provide effective medialization for patients with glottic insufficiency. Both techniques yield similar reoperation rates, and the benefit of surgery appears to last for at least 1 year for most patients.

Reliability and validity of the Turkish voice handicap index-partner (VHI-P-TR)

ObjectiveThis study examines the Turkish validity, reliability and diagnostic performance of the Voice Handicap Index-Partner (VHI-P-TR), which is used to obtain the perceptions of communication partners of individuals with dysphonia about the functional, physical and emotional handicap resulting from the patient experiencing dysphonia. MethodThe study included 160 individuals with dysphonia and their communication partners. First, translation, back translation, expert validity and pilot study were performed in the scale adaptation process. Then, a confirmatory factor analysis (CFA) was conducted to assess the construct validity of the VHI-P-TR. Correlations between the VHI-P-TR and Voice Handicap Index (VHI-TR) scores of dysphonic individuals were examined to evaluate the concurrent validity of the VHI-P-TR. To assess the reliability of the VHI-P-TR, a test-retest analysis was performed, and internal consistency coefficients (α) were calculated. A receiver operating characteristic (ROC) analysis was conducted to determine the cut-off point for the VHI-P scores. ResultsA high positive correlation was found between the participants’ VHI-P-TR and VHI-TR total and subscales mean scores (r's > 0.782; p < 0.01). The VHI-P-TR had high internal consistency regarding for its subscales and total score (α's > 0.94; p < 0.01). Factor loadings of all VHI-P-TR items were higher than 0.30 and their error variances were lower than 0.90. In addition, factor loadings were statistically significant for all the items (p < 0.05). The data fit the model well according to all CFA indices except for GFI (scale = 0.69). An adequate sensitivity and specificity were achieved for the VHI-P-TR, and the cut-off point was found as 11.50 for the total score and ranged from 2.50 to 5.50 for the subscales. ConclusionThe VHI-P-TR is a valid and reliable measurement tool with high diagnostic performance in all subscales and total score, and has high levels of agreement with the VHI-TR.

Complete Vocal Technique-Voice Therapy as a Novel Intervention for Rehabilitation of Laryngeal-Phonatory Dysfunction in Acquired Brain Injury Patients—An Exploratory Retrospective Study

Purpose: The purpose of this study was to explore the use of Complete Vocal Technique (CVT) voice therapy in acquired brain injury (ABI) patients Study: This study is an exploratory retrospective study. Method: Five ABI patients (two female and three male) with an average age of 20.6 years ( SD = 3.5) received CVT voice therapy from an authorized CVT teacher at a neurorehabilitation facility in conjunction with physical rehabilitation therapy and speech and language therapy. Pre- and postmeasures included Voice Handicap Index, Maximum Phonation Time, electroglottography, and acoustic measures. Results: All voice measures improved for all five patients after receiving CVT voice therapy. Voice Handicap Index scores decreased from an average of 48.4 to 22.8. Maximum Phonation Time improved while the electroglottography and acoustic data showed improved phonation stability in jitter and shimmer measures. Overall, following the intervention, patients demonstrated improved loudness range, improved range in contact quotient for different sound conditions, faster-paced speech, extended functional pitch range, and decrease in unwanted creaking and breathiness. Conclusions: The findings suggest that CVT may be used as therapy in ABI populations with promising results. Both patient self-assessment and objective voice measures demonstrate improved voice function. Given the longitudinal nature of recovery in ABI patients, more studies are needed to qualify at which stage(s) of recovery the CVT interventions are most effective and beneficial. Randomized controlled trials for specific patient populations of ABI are needed to assess the interventions' effectiveness in specific ABI diagnoses.

Comparison between Voice Disorders among Female Professional and Nonprofessional Voice Users Dealing with Early School Aged Children

Abstract Background Voice disorders are common among females; a main cause is their continuous communication with children as their caregivers. Teachers are exposed to voice abuse and misuse and so also housewives, both of them use their voice excessively to deal with children. Aim of the Work The aim of this study is to compare between voice disorders among female professional and non-professional voice users, in order to identify voice problems affecting nonprofessional voice users for prevention, early detection and proper management to avoid serious vocal health injuries. Study Design a comparative cross-sectional study. Patients and Methods This study included 100 adult female patients who complained of symptoms of voice disorders and were subjected for voice evaluation at the Phoniatrics Unit, Ain Shams University Hospitals. The participated patients were aged between 20 years to 50 years and were divided into 2 groups 50 in each group, group I (teachers) and group II (housewives). Detailed history taking, auditory perceptual assessment of voice (APA), video-laryngoscopic examination, documentation of the auditory perceptual assessment, acoustic analysis and application of Arabic VHI (voice handicap index) were done for all cases. Results The duration of the voice complaint was longer in teachers than housewives. There was nonsignificant difference between both groups regarding the presence of phonasthenic symptoms. The impact of compliant regarding patients own rating of the severity and effect on daily life was higher` in housewives than in teachers, but there was non-significant difference between both groups regarding the listener reaction. There was non-significant difference between teachers and housewives as regard the APA in the overall grade of dysphonia and voice quality. The most prevalent diagnosis of voice disorders among teachers was the vocal fold nodules, while phonasthenia was the most prevalent in housewives. There was a significant difference between the teachers and housewives as regard the total score, functional and emotional subscales of VHI. Results of the acoustic analysis revealed a significant difference between teachers and housewives as regard average F0, jitter % where teachers had higher scores than housewives. While there was non-significant difference as regard RAP, shimm%, APQ and NHR between both groups. A significant positive correlation was found between number of children and functional, emotional and total VHI score in housewives group. There was a significant positive correlation between number of students and patient’s own rating of severity and years of teaching in teachers group. Moreover, there was a highly significant positive relation between having children and emotional subscale of VHI in teachers group. Also, there was a significant positive relation between number of children and functional subscale of VHI in housewives group. Conclusion Voice disorders are common among housewives (Nonprofessional voice users) the same as in teachers (Professional voice users) especially when dealing with early school aged children. Recommendation There is need to increase awareness among the housewives about the importance of voice in their daily life, risk factors for voice problems, how to protect themselves from developing vocal pathologies and when to consult the medical professional.

Reinke's Edema: Cold Steel Versus Radiofrequency Coblation.

This study compared the effects of radiofrequency (RF) coblation and cold steel (CS) surgery for the treatment of Reinke's edema (RE). A retrospective analysis was conducted on 61 patients with RE, with 33 (54.1%) in the CS surgery group and 28 (45.9%) in the RF coblation group. The primary endpoints were the bilateral operation time and dyspnea severity, assessed preoperatively and at 1 and 3 months postoperatively. Secondary endpoints included subjective and objective vocal assessments, laryngovideostroboscopy (LVS) images, and Voice Handicap Index-10 (VHI-10) scores obtained before and at 1 and 3 months postoperatively. The average bilateral operation time was significantly shorter in the RF coblation group (24.2 ± 3.9 min) compared to the CS group (38.4 ± 5.2 min) (P = .041). All patients experienced a decrease in their Dyspnea Severity Index (DSI) scores postoperatively, with no significant differences observed between the two groups at any time point. However, improvements in the grade of hoarseness, roughness, and asthenia were significantly greater in the RF coblation group than in the CS group (P < .001). There were no statistically significant differences in breathiness and strain between the two groups. The average VHI-10 score significantly decreased from preoperative values in both groups (P < .001), with no significant differences observed between the two groups at any time point. The RF coblation procedure is a reliable and safe method for RE surgery, offering an effective treatment choice for RE.

Laryngological Complaint Prevalence in Hypermobile Ehlers-Danlos or Hypermobility Spectrum Disorders.

The aim was to study laryngological complaints in patients with hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorders (HSD). A total of 363 patients met inclusion for the study by completing questions related to voice, upper airway, and swallowing between July 7, 2020 and July 13, 2022. Demographic data, voice-related questions, and hypermobility diagnosis were analyzed retrospectively. From those, 289 patients were diagnosed with hEDS or HSD with 74 that did not meet the diagnostic criteria for either diagnosis serving as controls. There were no statistically significant differences between patients with hEDS and HSD regarding Voice Handicap Index (VHI-10) scores, voice, upper airway, or swallow complaints. However, more hEDS/HSD patients answered positively to the laryngeal dysfunction question versus controls (p = 0.031). 22.5% of hEDS/HSD patients (n = 65) reported hoarseness, of which 52.3% reported hoarseness >2 days/month. 33.9% (n = 98) with hEDS/HSD reported symptoms of dysphagia, and 27.0% (n = 78) reported laryngeal dysfunction symptoms. Controls demonstrated 20.3% prevalence of hoarseness, of which 46.7% reported hoarseness >2 days/month. 24.3% of controls had dysphagia and 14.9% laryngeal dysfunction symptoms. Of the 363 patients, VHI-10 scores >11 were more likely in patients reporting >2 days of hoarseness/month (p = 0.001) versus those with <2 days of hoarseness/month. There was an increased prevalence of voice, upper airway, and dysphagia symptoms in hEDS/HSD patients compared with previously reported prevalence data in the general population. A significant proportion of patients diagnosed with hypermobility due to hEDS or HSD were found to have voice, upper airway, and dysphagia symptoms. These rates are higher than those previously reported in the general population. 3 Laryngoscope, 134:773-778, 2024.