Voice-Related Quality Of Life Scores Research Articles

Psychometric Evaluation of Adapted Transsexual Voice Questionnaire for Turkish Trans Male Individuals

This study aims to evaluate the psychometric properties of the adapted transsexual voice questionnaire for male-to-female (a-TVQFtM) for trans male individuals in order to determine the suitability for use in research and clinical practice among Turkish trans male individuals. This study was conducted by the Gender Dysphoria Clinic and Voice Clinic of a tertiary hospital referral center. The a-TVQFtM, voice-related quality of life, and self-perception of voice masculinity rating scale were administered to 50 trans male individuals, of whom 27 were hormone naïve and 23 were undergoing hormone treatment. Psychometric properties were investigated with reliability and validity analysis. The a-TVQFtM showed a strong internal consistency; the Cronbach's alpha coefficient for overall a-TVQFtM was 0.975, anxiety and avoidance factor was 0.948, vocal identity factor was 0.940, and vocal function factor was 0.923. No item needed to be deleted following adaptation. The a-TVQFtM scores showed a significant strong inverse correlation with the overall voice-related quality of life scores and the self-perception of voice masculinity rating (r=-0.863, r=-0.715, and P<0.001, respectively). The a-TVQFtM scores were significantly reduced in trans male individuals undergoing hormone treatment when compared with hormone naïve individuals. Although not specifically designed for trans male individuals, the current results provide confidence as to the psychometric properties of a-TVQFtM and, therefore, its suitability for use with Turkish trans male individuals.

Impact of laryngeal sequelae on voice- and swallowing-related outcomes in paracoccidioidomycosis.

Background:The present study was carried out aiming to evaluate the impact of laryngeal sequelae on the quality of life of treated paracoccidioidomycosis (PCM) patients.Methods:This cross-sectional study was conducted at the Otorhinolaryngology Outpatient Clinic of the University Hospital, Federal University of Mato Grosso do Sul, Brazil. Thirty-two PCM patients considered clinically and immunologically cured were included: 16 with laryngeal involvement during the active phase of the disease (laryngeal PCM group) and 16 without laryngeal involvement (control group). They were submitted to structured interview, otorhinolaryngology examination, videolaryngoscopy, videoendoscopic swallowing study, completed two questionnaires for voice self-assessment - Voice-related Quality of Life (V-RQOL) and Voice Handicap Index (VHI) - and were asked to score their voices on a scale from zero to 10 (self-assessment of vocal quality).Results:Dysphonia was present in 50% of the cases. Patients with laryngeal PCM presented worse voice-related quality of life scores on the V-RQOL and poorer vocal quality self-assessment than the control group. No significant differences in the VHI were found between the groups. None of the participants developed dysphagic sequelae, although some minor changes were observed on videoendoscopic examination.Conclusion:There were no dysphagia complaints and only a few mild changes were found on the fiberoptic endoscopic evaluation of swallowing, suggesting that this evaluation should be performed only in specific cases. Patients with laryngeal involvement presented worse V-RQOL and self-assessment voice quality. This study contributes to the current knowledge of the functional assessment of the larynx affected by PCM and the impact of dysphonia on quality of life.

Influence of vocal and aerodynamics aspects on the voice-related quality of life of older adults.

The pursuit for quality of life urged a better understanding of aspects involved in ageing to minimize its consequences. Although many studies investigated older adults’ voice, aspects affecting this population voice-related quality of life have not yet been explored.ObjectiveTo investigate how aerodynamics and vocal aspects are associated with voice-related quality of life in older adults.Methodologyfifty-six older adults aged 60 years or above – 39 women and 17 men – were evaluated. The following procedures were performed: application of the Voice-Related Quality of Life (V-RQOL) protocol; vocal assessment, including auditory-perceptual and acoustic analysis, from which we obtained fundamental frequency (F 0 ), standard deviation of fundamental frequency (SDF 0 ), shimmer, amplitude perturbation quotient (APQ), jitter, pitch period perturbation quotient (PPQ), and harmonics to noise ratio (HNR); aerodynamic assessment using a spirometer; and maximum phonation time (MPT) for /a/, /s/, /z/ and number counting.Resultsolder adults tend to present high V-RQOL scores. Among women, roughness, APQ, and HNR parameters were negatively correlated with V-RQOL, whereas F 0 was positively. We found no correlation between spirometry measurements and V-RQOL. MPT for /a/, /z/, and number counting was positively correlated with V-RQOL solely among men.ConclusionVocal roughness and acoustic parameters have a negative impact on the quality of life of older women. Respiratory aspects related to the available air support for speaking affected the most the voice-related quality of life of older men.

Montgomery T-tube for management of tracheomalacia: Impact on voice-related quality of life.

Tracheostomy is a common procedure for management of tracheomalacia. However, the limitation to speak related to tracheostomy cannula could affect the quality of life. we reported a new minimally invasive procedure to replace tracheostomy cannula with Montgomery T-tube to improve the ability of speaking. This is a single center study including all consecutive patients undergoing the replacement of standard tracheostomy cannula with T-tube for management of tracheomalacia. The end-points were to evaluate (a) the changes in Voice-related quality of Life (V-RQOL) before and after T-tube placement; and (b) the complications related to T-tube. Eleven patients were included in the study. T-tube was placed using flexible bronchoscopy and laryngeal mask airway. A suture was inserted through the proximal end of T-tube. Once the stent was introduced with a clamp into the trachea, a traction was applied on the suture to facilitate the alignment of the upper end of the stent. The comparison of V-RQOL values before and after T-tube insertion showed a significant improvement in social/emotional (39.2±6.1 vs 66.8±1.9; P=.0001); physical functioning (21±5.7 vs 56.4±5.3; P=0.0001) and total V-RQOL scores (33.9+5.4 vs 61.3+6.1; P=0.0001). No complications were seen during the insertion of the stent. In two patients, T-tube was obstructed by mucus that resolved with aspiration using flexible bronchoscopy (mean follow-up: 18±10months). Our technique is simple and safe, not needing specific skills and/or cumbersome devices. The replacement of tracheostomy cannula with T-tube seems to improve the quality of voice without adding major complications.

Voice-Related Quality of Life Increases With a Talking Tracheostomy Tube: A Randomized Controlled Trial.

The primary objective of our study was to determine the quality of life (QOL) using a talking tracheostomy tube. Randomized clinical trial (NCT2018562). Adult intensive care unit patients who were mechanically ventilated, awake, alert, attempting to communicate, English-speaking, and could not tolerate one-way speaking valve were included. Intervention comprised a Blue Line Ultra Suctionaid (BLUSA) talking tracheostomy tube (Smiths Medical, Dublin, OH, US). Outcome measures included QOL scores measured using Quality of Life in Mechanically Ventilated Patients (QOL-MV) and Voice-Related Quality of Life (V-RQOL), Speech Intelligibility Test (SIT) scores, independence, and satisfaction. The change in V-RQOL scores from pre- to postintervention was higher among patients using a BLUSA (Smiths Medical) compared to those who did not (P = 0.001). The QOL-MV scores from pre- to postintervention were significantly higher among patients who used a BLUSA (Smiths Medical) compared to patients who did not use BLUSA (Smiths Medical) or a one-way speaking valve (P = 0.04). SIT scores decreased by 6.4 points for each 1-point increase in their Sequential Organ Failure Assessment scores (P = 0.04). The overall QOL-MV scores correlated moderately with the overall V-RQOL scores (correlation coefficient = 0.59). Cronbach alpha score for overall QOL-MV was 0.71. Seventy-three percent of the 22 intervention patients reported the ability to use the BLUSA (Smiths Medical) with some level of independence, whereas 41% reported some level of satisfaction with the use of BLUSA (Smiths Medical). The lengths of stay was longer in the intervention group. Our study suggests that BLUSA (Smiths Medical) talking tracheostomy tube improves patient-reported QOL in mechanically ventilated patients with a tracheostomy who cannot tolerate cuff deflation. I Laryngoscope, 130:1249-1255, 2020.

Comparison of Functional Organ Preservation by Concomitant Boost Radiotherapy Versus Concurrent Chemoradiation in Locally Advanced Carcinoma of Larynx or Hypopharynx: A Prospective Randomized Study

Functional organ preservation is a major challenge in management of advanced laryngeal and hypopharyngeal carcinoma. Although ideal approach is a subject of much debate, radiotherapy with or without chemotherapy is most commonly used modality. This randomized study was conducted to compare functional organ preservation by chemoradiation (CRT) versus concomitant boost radiotherapy (CBRT). A total of 40 patients with advanced (stage III/stage IVa) laryngeal and hypopharyngeal cancer were randomized to receive either CRT (n = 20) to a dose of 66Gy in 33 fractions over 6.5weeks with concurrent cisplatin (100mg/m2 on days 1, 22 and 43) or CBRT (n = 20) to a dose of 67.5Gy in 40 fractions over 5weeks. Patients were assessed for organ preservation rate, toxicities, voice and swallowing functions utilizing Voice Related Quality of Life (VRQOL) and MD Anderson Dysphagia Inventory (MDADI) scores, respectively, for minimum follow up of 6months. Organ preservation rate (intact disease free larynx) at 6months post treatment was observed in 100% in CRT arm and 95% in CBRT arm. There was no significant difference in mucositis and dermatitis in two arms (p = 0.82 and 0.78, respectively). Dysphagia was observed more in CRT arm (n = 12 vs n = 6). Late toxicities grade 3 xerostomia, grade 2 dysguesia, were seen significantly more in CRT arm. There was no statistical difference between the two arms in terms of VRQOL (p = 0.55) and MDADI scores (p = 0.13). In CRT arm 13 patients complete response and in CBRT arm 12 patients had complete response. Accelerated fractionation with concomitant boost schedule is as effective as CRT in anatomical and functional preservation of larynx. The toxicities, voice and dysphagia related quality of life is comparable.

Geriatric Dysphonia: Characteristics of Diagnoses in Age-Based Cohorts in a Tertiary Voice Clinic.

An aging population has increased focus on geriatric otolaryngology. Those ≥65 years old are not a uniform population, however, and recent gerontology literature recognizes important physiologic differences between the young-old (ages 65-74 years), middle-old (75-84), and old-old (≥85). This study evaluates differences within these groups among dysphonia patients ≥65 years relative to diagnosis and voice-related quality of life (V-RQOL). Chart review of all new patients ≥65 years presenting to the Johns Hopkins Voice Center between April 2015 and March 2017 identified chief complaint, diagnosis, and self-reported voice handicap. Etiology of dysphonia diagnoses were classified. Diagnostic categories and V-RQOL were evaluated as functions of patient age and gender. Of 839 new patients ≥65 years, 463 (55.2%) reported chief complaint of dysphonia, with the most common etiologies being vocal fold immobility (28.3%) and atrophy (21.6%). Younger cohorts were more likely to present with benign vocal fold lesion and vocal fold immobility, while older cohorts were more likely to present with atrophy ( P = .016). The odds of having a diagnosis of vocal fold atrophy increased 7% with each year of life (odds ratio = 1.07; 95% CI, 1.03-1.11). V-RQOL scores were similar across gender and age categorization. Dysphonia patients ≥65 years are not a uniform group, and important differences exist in terms of diagnosis as a function of age. Knowledge of these differences may inform further investigations in the growing field of geriatric otolaryngology.

Laryngeal manifestations of cranial nerve IX/X compression at the brainstem.

We report an association between lower cranial nerve (CN IX/X) vascular compression at the brainstem with laryngeal symptoms utilizing a stepwise algorithm that systematically evaluates and eliminates all other common etiologies. Our experiences with retromastoid craniectomy with lower cranial nerve (LCN) decompression versus non-neurosurgical treatments are detailed. Retrospective chart review at a tertiary care academic medical center with follow-up telephone survey. Baseline demographics, clinical characteristics, quality-of-life surveys, and treatment outcomes were recorded for patients with laryngeal symptoms associated with LCN compression at the brainstem. Forty-nine patients demonstrated LCN compression at the brainstem on imaging and presented with chief complaints of dysphonia (25 of 49, 51%), chronic cough (19 of 49, 39%), dysphoric breathing (3 of 49, 6%), and dysphagia (2 of 49, 4%). Poor initial scores were noted for Voice-Related Quality of Life (V-RQOL), Reflux Symptom Index, and Glottal Closure Index. Twenty-four patients underwent LCN decompression, of which 21 of 24 (88%) reported partial, near-complete, or complete improvement. Major perioperative complications occurred in four of 24 patients (17%). Patients who had undergone decompression were more likely to obtain complete/near-complete symptom resolution (10 of 24 patients, 42%) compared to those undergoing conservative treatments (2 of 25 patients, 8%) (P = 0.02). V-RQOL scores improved more in surgical patients [mean change score, 33.0 (standard deviation [SD], 31.2) than nonsurgical patients (mean change score 9.6, SD 20.9) (P = 0.03) (mean follow-up 3.0 years, SD 2.0). Lower cranial nerve compression at the brainstem should be considered when all other etiologies are excluded. Retromastoid craniectomy with LCN decompression demonstrates an acceptable safety profile. 4 Laryngoscope, 129:2105-2111, 2019.

Long-term changes in vocal function after supracricoid partial laryngectomy with cricohyoidoepiglottopexy for laryngeal cancer.

The purpose of this study was to assess changes in vocal function over time following supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCL-CHEP). A total of 17 patients who underwent SCL-CHEP for laryngeal squamous cell carcinoma between 2007 and 2015 were reviewed. We examined maximum phonation time (MPT), mean airflow rate (MFR), voice intensity, the grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, Voice Handicap Index-10 (VHI-10), and voice-related quality of life (V-RQOL) scores. To assess changes over time in these parameters, we set 3 evaluation periods after surgery: within the first 12 months (term A), 13-36 months (term B), and after 37 months (term C). The mean MPT, MFR, G and B GRBAS subscale, VHI-10, and V-RQOL scores improved significantly over time postoperatively. Multiple vocal function parameters improved significantly with time due to self-adaptation to a newly created glottis after surgery.

Validation of the OMNI vocal effort scale in the treatment of adductor spasmodic dysphonia

To establish the validity of the OMNI Vocal Effort Scale (OMNI-VES) for resistance exercise, a single-question pictorial scale, in voice-related perceived exertion. Additionally, the study aimed to assess the role of the OMNI-VES as an outcome measurement in the treatment of adductor spasmodic dysphonia (ADSD). A prospective validation study was conducted on 226 participants. The case group was comprised of 178 patients receiving botulinum toxin (BTX) injections for ADSD and 48 controls without a voice disorder. Prior to a planned injection, the participants were asked to complete the OMNI-VES and the Voice-Related Quality-of-Life (V-RQOL) questionnaires, and the clinician completed the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). A subgroup of 17 patients were administered a repeat assessment 1 month after injection. There was a weak correlation between the OMNI-VES and the V-RQOL score (Tau-b = -0.252, P < 0.001), and no significant correlation with the CAPE-V. Participants with ADSD had significantly higher OMNI-VES scores compared with normal controls, 5.07 ± 2.18 and 1.47 ± 2.28, respectively (P value < 0.0001). The average OMNI-VES score significantly improved 1 month following a BTX injection, from 6 ± 2.4 to 3.4 ± 2.8 (P value = 0.0003). Eighty-eight percent of the patients demonstrated a decrease in the OMNI-VES score following injection, whereas only 47% demonstrated an improvement in the V-RQOL score. The OMNI-VES is a validated tool for rating perceived voice-related exertion in people with ADSD and can be used for evaluating response to BTX injection treatment. 2b Laryngoscope, 129:448-453, 2019.

Assessment of Clinical and Social Characteristics That Distinguish Presbylaryngis From Pathologic Presbyphonia in Elderly Individuals

An aging population experiences an increase in age-related problems, such as presbyphonia. The causes of pathologic presbyphonia are incompletely understood. To determine what distinguishes pathologic presbyphonia from presbylaryngis. This was a cohort study at an outpatient otolaryngology subspecialty clinic of a tertiary academic referral center. Participants were consecutive consenting adults older than 74 years without laryngeal pathologic abnormalities who visited the clinic as participants or companions. Patient questionnaires, otolaryngologic, video stroboscopic, and voice examinations were compiled. Patients were divided into groups based on whether they endorsed a voice complaint. Three blinded authors graded stroboscopic examinations for findings consistent with presbylaryngis (vocal fold bowing, vocal process prominence, glottic insufficiency). Voice Handicap Index-10, Reflux Symptom Index, Cough Severity Index, Dyspnea Index, Singing Voice Handicap Index-10 , Eating Assessment Tool -10, Voice-Related Quality of Life (VRQOL), and Short-Form Health Survey; face-sheet addressing social situation, work, marital status, education, voice use, transportation; acoustic and aerodynamic measures; and a full otolaryngologic examination, including videostroboscopic imaging. A total of 31 participants with dysphonia (21 were female; their mean age was 83 years [range, 75-97 years]) and 26 control participants (16 were female; their mean age was 81 years [range, 75-103 years]) completed the study. Presbylaryngis was visible in 27 patients with dysphonia (87%) and 22 controls (85%). VHI-10 and VRQOL scores were worse in patients with pathologic presbyphonia (median [range] VHI-10 scores, 15 (0-40) vs 0 (0-16) and median VRQOL score, 19 [0-43] vs 10 [10-23]). All other survey results were indistinguishable, and no social differences were elucidated. Acoustic measures revealed that both groups averaged lower than normal speaking fundamental frequency (mean [SD], 150.01 [36.23] vs 150.85 [38.00]). Jitter was 3.44% (95% CI, 2.46%-4.61%) for pathologic presbyphonia and 1.74% (95% CI, 1.35%-2.14%) for controls (d = 0.75). Shimmer means (95% CI) were 7.8 2 (6.08-10.06) for the pathologic presbyphonia group and 4.84 (3.94-5.72) for controls (d = 0.69). Aerodynamic measures revealed an odds ratio of 3.03 (95% CI, 0.83-11.04) for patients with a maximum phonation time of less than 12 seconds who had complaints about dysphonia. Presbylaryngis is present in most ambulatory people older than 74 years. Some will endorse pathologic presbyphonia that has a negative effect on their voice and quality of life. Pathologic presbyphonia seems to be influenced by respiratory capacity and sex. Further study is required to isolate other social, physiologic, and general health characteristics that contribute to pathologic presbyphonia.

Voice deviation, dysphonia risk screening and quality of life in individuals with various laryngeal diagnoses

OBJECTIVES:To characterize the voice quality of individuals with dysphonia and to investigate possible correlations between the degree of voice deviation (D) and scores on the Dysphonia Risk Screening Protocol-General (DRSP), the Voice-Related Quality of Life (V-RQOL) measure and the Voice Handicap Index, short version (VHI-10).METHODS:The sample included 200 individuals with dysphonia. Following laryngoscopy, the participants completed the DRSP, the V-RQOL measure, and the VHI-10; subsequently, voice samples were recorded for auditory-perceptual and acoustic analyses. The correlation between the score for each questionnaire and the overall degree of vocal deviation was analyzed, as was the correlation among the scores for the three questionnaires.RESULTS:Most of the participants (62%) were female, and the mean age of the sample was 49 years. The most common laryngeal diagnosis was organic dysphonia (79.5%). The mean D was 59.54, and the predominance of roughness had a mean of 54.74. All the participants exhibited at least one abnormal acoustic aspect. The mean questionnaire scores were DRSP, 44.7; V-RQOL, 57.1; and VHI-10, 16. An inverse correlation was found between the V-RQOL score and D; however, a positive correlation was found between both the VHI-10 and DRSP scores and D.CONCLUSION:A predominance of adult women, organic dysphonia, moderate voice deviation, high dysphonia risk, and low to moderate quality of life impact characterized our sample. There were correlations between the scores of each of the three questionnaires and the degree of voice deviation. It should be noted that the DRSP monitored the degree of dysphonia severity, which reinforces its applicability for patients with different laryngeal diagnoses.

Development and Validation of the Voice Catastrophization Index

Catastrophization is a cognitive distortion that has been studied in pain patients and found to be a significant factor in their disability and response to treatment. Dysphonia patients may demonstrate a similar behavior, suggesting the existence of voice catastrophization. To establish the validity of the Voice Catastrophization Index (VCI), a new instrument estimating voice symptoms catastrophization. A prospective study. Patients with and without voice conditions were administered with the VCI, Voice-Related Quality of Life (V-RQOL), and the Generalized Anxiety Disorder-7 (GAD-7)questionnaires. Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) rating was determined for patients with voice conditions. Ninety-one patients participated, 65 with voice conditions and 26 without. 61.5% were females; mean age was 49.8 ± 15.7 years. The VCI score for patients with voice conditions was significantly higher, 22.46 ± 16.56, compared with 3.96 ± 10.79, respectively (P value < 0.0001). The VCI demonstrated moderate correlation with both V-RQOL and GAD-7 scores: -0.562 and 0.560, respectively (P value < 0.000001); however, it showed no correlation with the CAPE-V. The VCI's internal consistency with each of its three dimensions and 13 items was acceptable to strong. The reproducibility and stability was demonstrated in a subgroup of 26 patients; 81% of these patients had a difference of 10 or less points between the two evaluations. The VCI accomplished the requirements of a scale's validity for estimation of voice symptoms catastrophization in voice patients. The potential role of voice catastrophization as a predictor of treatment response and tailoring can now be investigated using the VCI.

The Role of Occupational Voice Demand and Patient-Rated Impairment in Predicting Voice Therapy Adherence

Examine the relationship among the severity of patient-perceived voice impairment, perceptual dysphonia severity, occupational voice demand, and voice therapy adherence. Identify clinical predictors of increased risk for therapy nonadherence. A retrospective cohort study of patients presenting with a chief complaint of persistent dysphonia at an interdisciplinary voice center was done. The Voice Handicap Index-10 (VHI-10) and the Voice-Related Quality of Life (V-RQOL) survey scores, clinician rating of dysphonia severity using the Grade score from the Grade, Roughness Breathiness, Asthenia, and Strain scale, occupational voice demand, and patient demographics were tested for associations with therapy adherence, defined as completion of the treatment plan. Classification and Regression Tree (CART) analysis was performed to establish thresholds for nonadherence risk. Of 166 patients evaluated, 111 were recommended for voice therapy. The therapy nonadherence rate was 56%. Occupational voice demand category, VHI-10, and V-RQOL scores were the only factors significantly correlated with therapy adherence (P < 0.0001, P = 0.018, and P = 0.008, respectively). CART analysis found that patients with low or no occupational voice demand are significantly more likely to be nonadherent with therapy than those with high occupational voice demand (P < 0.001). Furthermore, a VHI-10 score of ≤29 or a V-RQOL score of >40 is a significant cutoff point for predicting therapy nonadherence (P < 0.011 and P < 0.004, respectively). Occupational voice demand and patient perception of impairment are significantly and independently correlated with therapy adherence. A VHI-10 score of ≤9 or a V-RQOL score of >40 is a significant cutoff point for predicting nonadherence risk.

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.

Qualidade de vida em voz e sintomas vocais de cantores solistas amadores da Igreja Batista Palavra Viva de Florianópolis

Objetivo: analisar a qualidade de vida relacionada à voz de cantores solistas de uma igreja evangélica e sua relação com eventuais queixas vocais. Métodos: estudo de caráter transversal descritivo e quantitativo, cuja população é formada por 49 cantores amadores de igreja evangélica. Os participantes foram esclarecidos quanto aos objetivos da pesquisa e assinaram o Termo de Consentimento Livre e Esclarecido. Em seguida, responderam a um questionário de identificação e, preencheram os seguintes instrumentos: Qualidade de Vida em Voz (QVV), Índice de Triagem para Distúrbio de Voz (ITDV) e Índice de Desvantagem para o Canto Moderno (IDVM). Resultados: da população total, 28,7%(14) homens e 71,4%(35) mulheres com idade média de 26 anos (+6,3). A média do escore geral do QVV foi 84,9 (+ 13,7), do IDCM de 30,9 (+20,9). O escore médio no ITDV foi de 1,7As queixas referidas por esta população foram:30,6% (35) quebras na voz; 26,5% (13) pigarro; 20,3% (10) voz grossa; 18,4% (9) garganta seca; 16,3%(8) cansaço ao falar; 14,3%(7) perda da voz; 14,3% (7) rouquidão; 14,3%(7) tosse seca; 4,1%(2) dor ao falar; 4,1%(2) secreção/catarro na garganta; e 2%(1) dor ao engolir. Conclusão: os cantores amadores de igreja deste estudo possuem queixas pouco frequentes. Quando presentes, seu impacto é percebido apenas na atividade do canto. No entanto, as alterações causadas pelas queixas não afetam a sua qualidade de vida relacionada à voz. Sugere-se que seja realizado um seguimento para monitorar a saúde vocal desses cantores.

Reliability and Validity of the Turkish Version of the Voice-Related Quality of Life Measure

This study aims to test the validity and reliability of the Turkish version of the Voice-Related Quality of Life (V-RQOL) questionnaire. This is a nonrandomized, prospective study with control group. The questionnaire was administered to 249 individuals-130 with vocal complaint and 119 without-with a mean age of 37.8 ± 12.3 years. The Turkish version of the Voice Handicap Index (VHI) and perceptual voice evaluation measures were also administered at 2-14 days for retest reliability. The instrument was submitted to validity and reliability evaluation. The V-RQOL measure showed a strong internal consistency and test-retest reliability; the Cronbach's alpha coefficient for the overall V-RQOL was 0.969, the physical functioning domain was 0.949, and the social-emotional domain was 0.940. In the test-retest reliability test, the overall V-RQOL was found to be 0.989. The construct validity of the V-RQOL was determined based on the strength and direction of its relation to the VHI and the perceptual voice evaluation measure. The higher the VHI level, the lower the physical functioning, social-emotional, and overall score levels of the V-RQOL (r = -0.927, r = -0.912, r = -0.944, respectively; P < 0.001). Following the perceptual voice self-assessment, a statistically significant difference was found between the V-RQOL scores of individuals who defined their voices as good, very good, and perfect, and those who defined their voices as bad and very bad (P < 0.001). The results suggest that the Turkish version of the V-RQOL measure has reliability and validity and may play a crucial role in evaluating Turkish-speaking patients with voice disorders.

Acoustic Characteristics of Voice Before and After Endoscopic Partial Laryngectomy in Early Glottic Cancer

To evaluate the voice changes after narrow-margin endoscopic partial laryngectomy in subjects with T1N0M0 glottic cancer. Uncontrolled retrospective comparison of preoperative and postoperative mean phonation time; fundamental frequency, jitter, shimmer, and noise-to-harmonic ratio; and voice-related quality of life (V-RQOL) survey scores. Seventeen adults diagnosed with T1N0M0 glottic cancer who underwent narrow-margin endoscopic partial laryngectomy were included. All subjects had preoperative and postoperative acoustic evaluation and V-RQOL scores. Subjects were separated into three groups based on age and depth of resection. Group A (mean age, 52 years) consisted of seven subjects who underwent superficial resection (superficial layer of lamina propria) and were younger than 60years. Group B (mean age, 76 years) consisted of six subjects who were older than 60 years and underwent superficial resection (superficial layer of lamina propria). The four subjects in group C were older than 60 years and underwent deep resection (into the vocal ligament and/or into the thyroarytenoid muscle). There was a statistically significant improvement in V-RQOL in group A. The acoustic measures did not change after surgery (no P<0.05). For early-stage cancer, patients younger than 60 years and superficial resection of cancer are predictive for better voice.

自覚的評価法“VHI”と“V-RQOL”

The study introduced methods that allow for the subjective evaluation of dysphonia patients using the Japanese recommended versions of evaluation tools such as the Voice Handicap Index (VHI) and the VoiceRelated Quality of Life (V-RQOL). The results were reported at our department. The VHI and V-RQOL scores of healthy subjects were the same as those in previous reports. In addition, a negative correlation between the VHI and V-RQOL scores was recognized. In the dysphonia cases, female patients and patients in their 20s and 30s showed poor VHI and V-RQOL scores. Patients with functional dysphonia and vocal cord paralysis showed poor VHI and V-RQOL scores. The scores were recognized to improve after treatment and were useful for the evaluation of treatment effect. Based on the results of the present study, it was considered that both the VHI and V-RQOL could be objectively-effective tools that allow for the subjective evaluation of dysphonia, and that they should be implemented in a proactive manner.

Voice, stress, work and quality of life of soccer coaches and physical trainers.

To assess aspects related to work, stress and quality of life related to voice in soccer coaches (C) and physical trainers (T), comparing the categories. Qualitative and quantitative studies with 13 C and 13 T of teams competing in Phase One of the highest level (Série A ) of the 2012 Campeonato Paulista (São Paulo State Soccer Championship). The questions were open ended and related to complaints, difficulties, and/or problems regarding voice use during work and to the relations between voice, work, stress, and quality of life. Stress at work was analyzed by the Job Stress Scale (JSS) questionnaire. The perception of the impact of the voice on quality of life was evaluated by the Voice-Related Quality of Life (V-RQOL) protocol. The answers to the questions were transcribed and submitted to content analysis, and regarding the questionnaire, descriptive data and analytical statistics were used. Content analysis showed lack of preparation for voice care; voice complaints; and intense vocal use demand under stressful work, in addition to the absence of healthy habits and social/family support. The JSS dimensions showed that the Active Work situation and the high V-RQOL scores are compatible with vocal health without complaints. There were no statistical differences between the categories. Both categories reported complaints/problems linked to professional voice use and stressful workload. However, the perception of vocal impact on the quality of life was positive, and the analysis of stress at work resulted in "good" and favorable conditions. The relationship between voice, work, stress, and quality of life in both the categories require further investigations.