Voice-related Quality Of Life Research Articles

Voice handicap and voice-related quality of life in COVID-19 patients

ObjectivesIdentifying voice handicap and voice-related quality of life in patients presenting pulmonary impairment associated with COVID-19 infection, comparing pulmonary parameters between these patients and individuals in the control group, as well as correlating pulmonary parameters to self-assessment questionnaires (IDV-10 and QVV). MethodsThirty-five (35) patients presenting pulmonary impairment with COVID-19 infection were herein selected and compared to 35 individuals who were not affected by COVID-19 infection. Two self-assessment questionnaires were applied (vocal handicap index and voice quality of life protocol). Maximum phonation time Forced Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) were measured and videolaryngoscopy was performed. ResultsThere was statistically significant difference in scores recorded in voice self-assessment questionnaires (IDV-10 and QVV), Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) between patients with pulmonary impairment associated with COVID-19 infection and those in the control group. Correlation between PEF/PIF and scores recorded in voice self-assessment questionnaires was also observed. ConclusionPulmonary impairment associated with COVID-19 infection has worsened voice handicap and voice-related quality of life in the assessed patients, as well as reduced their forced expiratory and inspiratory pressure in comparison to the control group. Level of evidence4.

Effectiveness of a Voice Training Program for Religious Officials in Turkey.

This study examines the effectiveness of a voice training program designed for Islamic religious officials, who are occupational voice users with a significant vocal load. The participants included 34 healthy religious officials whose acoustic measures were within normal voice ranges for healthy adults (jitter < 1%; shimmer < 3%) and reported no voice complaints. Participants were randomly divided into two groups (experimental, n = 17; control, n = 17). The two-stage voice training program consisted of 32 sessions over 8 weeks with informative and voice exercise stages. Objective and subjective voice measurements were performed at the beginning and end of the research. Objective measurements included fundamental frequency, percentage of vocal pitch perturbation (jitter), percentage of vocal intensity perturbation (shimmer), and harmonics-to-noise ratio. Subjective voice measurements included the Singing Voice Handicap Index, Vocal Fatigue Index (VFI), and Voice-Related Quality of Life (V-RQoL) scores. All initial measurements other than VFI scores were within acceptable limits for both groups. There were no significant differences between the groups initially (p > 0.05) and no significant changes in the control group in the second evaluation (p > 0.05). However, there was significant improvement in the experimental group after the training program in all measures, including VFI scores (p < 0.05). This study shows the positive results of a voice training program. Voice training should be integrated into the formal education of occupational voice users or in-service training programs of relevant institutions.

Analysis of factors on voice quality in thyroidectomy patients.

Vocal cord paralysis (VCP) is a serious complication in thyroidectomy operations; however, its management remains unclear. The present study evaluated the voice parameters of patients who underwent surgery using Intraoperative Neurophysiologic Monitoring (IONM). A total of 52 patients (41 females and 11 males) who underwent a total thyroidectomy operation were evaluated using objective and subjective voice analysis examinations before and after surgery. Acoustic parameters, such as Fundamental Frequency (F0), Shimmer, Jitter, Noise-to-Harmonic ratio (NHR), and aerodynamic parameters, including S/Z ratio and maximum phonation time (MPT), were analyzed. Objective findings, including the VHI-10 (Voice Handicap Index) and V-RQOL (Voice-Related Quality of Life), were also analyzed. The relationship between voice parameters and IONM values was investigated. The objective analysis (acoustic and aerodynamic parameters) showed no difference (p>0.05). However, the subjective analysis, which involved the VHI-10 and V-RQOL measures, revealed a significant difference before and after the operation (p<0.05). The Spearman correlation analysis showed that the NHR postoperative 1st-month parameter negatively correlated (rho=-0.317, p<0.059), while the F0 postoperative 6th-month parameter positively correlated (rho=0.347) with the amplitude difference before and after dissection (Right R2-R1 difference) for the right RLN measured in IONM. Patients who are planning to undergo a thyroidectomy procedure should undergo voice assessment during both the preoperative and postoperative periods. IONM could improve voice quality outcomes.

Acoustic outcomes and voice-related quality of life in male-to-female transsexuals undergoing Wendler glottoplasty: a single-centre experience.

Many transsexual women seek to feminise their voice through pitch elevation surgeries so that it becomes congruent with their gender identity. This study aims to determine the safety and effectiveness of Wendler glottoplasty (WG) in vocal feminisation through the assessment of acoustic and aerodynamic parameters of the voice, as well as voice-related quality of life (QoL) in male-to-female transsexuals. We retrospectively reviewed the medical records of transsexual women who underwent WG for voice feminisation at our institution between 2016 and 2023. All acoustic and aerodynamic analyses, a voice self-assessment, and a videolaryngostroboscopic evaluation were performed in the immediate preoperative period and at the follow-up visit 6 weeks after the procedure. A total of 11 patients with a mean age of 32.73 years were included. After WG, there was a significant fundamental frequency and speaking fundamental frequency increase of 109.64 Hz and 83.48 Hz, respectively (p < 0.001), representing an average rise by 9.71 semitones and 8.36 semitones (STs), respectively. No significant differences were found between the mean pre- and postoperative values of fundamental frequencies, frequency range, upper limit of the frequency range of spoken voice, and maximum phonation time. Contrarily, the mean lower limit of frequency range rose by 75.56 Hz (p < 0.001), representing an average increase of 10.56 STs. None of the assessed spirometric parameters changed significantly after WG (p > 0.05). The mean overall Voice Handicap Index (VHI) and Voice-Related Quality of Life (V-RQOL) scores significantly improved after the surgery, decreasing by 24.54 points (p = 0.008) and 11.5 points (p = 0.001), respectively. A significant improvement was observed in the functional and emotional domains of VHI. Additionally, significantly fewer patients considered the overall quality of their voice to be "poor" after WG. WG constitutes an effective method of surgical voice feminisation in male-to-female transsexuals with concurrent improvement in their voice-related QoL. Furthermore, it remains a safe procedure without persistent complications and negative influence on the acoustic-aerodynamic measures of the voice.

Impact of Wendler glottoplasty on acoustic measures and quality of voice in transgender women: a systematic review and meta-analysis.

Since new evidence regarding the impact of Wendler glottoplasty (WG) on the voice in transgender women became available in the literature in recent years, we aimed to perform an updated systematic review and meta-analysis to determine the actual safety and efficacy of WG in the process of vocal feminization. PubMed, Embase, and Cochrane were searched for English-language articles published until July 4, 2023. Studies were found eligible if they evaluated the impact of WG on the acoustic-aerodynamic measures and quality of voice in transgender women. Twenty-three studies were identified. After exclusion of three studies due to incomplete data, 20 studies including 656 patients were included in the meta-analysis. After WG, there was a significant increase of fundamental frequency, speaking fundamental frequency, and lower limit of the frequency range (p < 0.001). Concurrently, a significant reduction of frequency range and maximum phonation time was observed (p < 0.001). No significant differences were found between the pre- and postoperative values regarding the Grade, Roughness, Breathiness, Asthenia, and Strain scale score (p = 0.339). The overall score in the Trans Woman Voice Questionnaire (TWVQ) significantly improved after WG (p < 0.001). WG is an effective voice feminization method in transgender women, associated with a high procedural success and low risk of postoperative complications. Significantly improved TWVQ score after surgery suggests its positive impact on the voice-related quality of life. Postoperative decrease of maximum phonation time and frequency range does not seem to significantly impact the effectiveness of voice production.

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.

Systemic bevacizumab for treatment of recurrent respiratory papillomatosis.

To characterize treatment response of recurrent respiratory papillomatosis (RRP) including adult-onset RRP (AORRP) and juvenile-onset RRP (JORRP) to systemic bevacizumab (bev), and share our treatment regimen experience. Patients were enrolled in bev treatment based on a pathologically confirmed diagnosis of squamous papilloma. According to lesion characteristics and medical history, systemic bev was used as preoperative adjuvant therapy, postoperative adjuvant therapy, or primary therapy. The assessment of treatment response relied on the morphological changes of lesions. Vocalization and voice-related quality of life were evaluated using the voice handicap index-30 (VHI-30) for adults and the pediatric VHI (pVHI) for children. Adverse effect was monitored through patient self-reported symptoms and regular follow-ups. This study included 24 patients, comprising nine AORRP and 15 JORRP cases. In AORRP, all patients (100%) exhibited various degrees of response to systemic bev, with 5 (55.56%) achieving complete response (CR). Among JORRP patients, 14 (93.33%) showed a response to systemic bev, with 8 (53.33%) achieving CR and currently being followed up. No instances of aggravation were observed during systemic bev treatment. A total of 21 patients (21/24, 87.50%) reported voice improvement, accompanied by reduced VHI-30 or pVHI scores across all aspects, including total, functional, physical, and emotional dimensions. No grade 3 or higher adverse events occurred. The most common adverse events were grade 1 gum bleeding (n = 4, 16.67%) and grade 1 proteinuria (n = 4, 16.67%). Systemic bev can be used as a powerful therapy for both AORRP and JORRP. The findings provide a reference to the systemic bev treatment for RRP.

Factors associated with voice-related quality of life among patients with temporomandibular disorders.

Research would be important for obtaining a better understanding of voice complaints among patients with temporomandibular disorders (TMD). The identification of predictors of voice disorders associated with TMD pain was made according to Diagnostic Criteria for TMD (DC/TMD) Axis I. Functional limitations were measured using the Jaw Functional Limitation Scales for mastication (JFLS-M), jaw mobility (JFLS-JM), and verbal and emotional expression (JFLS-VEE). Patients also completed the Hospital Anxiety and Depression Scale (HADS). The primary outcome was social-emotional and physical functioning as indicated by scores on the Voice-Related Quality of Life (V-RQOL) questionnaire. Multiple linear regression was used to model the relationship between the domains on the V-RQOL questionnaire and scores on the HADS and JFLS after adjusting for age, gender, DC/TMD diagnosis, pain intensity, and time since pain onset. The HADS-D (B=-1.15; 95% CI, -1.718 to -0.587; p<.001) and JFLS-VEE (B=-0.22; 95% CI, -0.40 to -0.06; p=.008) were significant predictors of scores on the V-RQOL questionnaire. Higher scores on depression measures and limitations in verbal and emotional expression could exacerbate voice problems among TMD pain patients. Future research should promote multidisciplinary treatments for TMD pain-related voice disorders.

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.

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.

Vocal Tract Discomfort Scale: Adaptation, Validity, and Reliability of the Turkish Version

Currently, there is no Turkish assessment tool available for the evaluation of vocal tract discomfort. The objective of this study is to cross-cultural adaptation of the Vocal Tract Discomfort Scale (VTDS) to Turkish and assess its validity and reliability. The study was conducted with a total of 214 participants, consisting of 121 individuals with voice disorders and 93 individuals without voice disorders. All participants completed the Voice Handicap Index (VHI), Voice-Related Quality of Life (VRQOL), and VTDS. To conduct a test-retest reliability assessment, the VTDS was administered again to 54 participants within 7-14days. The internal consistency of VTDS was evaluated using Cronbach's alpha coefficient. The Cronbach's alpha coefficient for the scale was calculated at 0.964, while it was 0.922 for the frequency subscale and 0.930 for the severity subscale. It was found that there was a high degree of correlation (rho=0.868, frequency rho=0.847, severity rho=0.875, P<0.001) between the two administrations, indicating the reliability of the test-retest assessment. To assess the criterion validity of the scale, correlations between VTDS total scores and VHI and VRQOL scales were examined. Accordingly, it was found that there was a high degree of correlation between VTDS and VHI (rho=0.631, frequency rho=0.635, severity rho=0.616, P<0.001). It was also observed that there was a high degree of negative correlation between VTDS and VRQOL (rho=-0.701, frequency rho=-0.702, severity rho=-0.692, P<0.001). It was assumed that there would be statistically significant differences in VTDS total scores among the diagnostic groups, and it was found that there was a significant difference between the two groups (U=1095.000, z=-10.110, P<0.001). These findings support the discriminative validity of VTDS. The Turkish version of VTDS is a valid and reliable scale that can assess perceptible symptoms and sensations in the vocal tract in terms of both frequency and severity.

Investigation of the Relationship Between Vocal Fatigue, Quality of Life, and Compliance With Vocal Hygiene in Professional Voice Users.

Intensive voice use may lead to the development of voice disorders or voice complaints, such as vocal fatigue, for professional voice users (teachers, academics, call center workers, actors, singers, speech and language therapists, voice trainers, and religious officials). Vocal fatigue has a detrimental effect on occupational, emotional, and social performance, besides the quality of life of the individual. The effect of voice hygiene interventions on voice fatigue is not fully known. The results of studies conducted with different occupational groups are inconsistent. The present study aims to analyze the relationship between vocal fatigue and voice-related quality of life (V-RQOL) in professional voice users, and the impact of vocal hygiene on vocal fatigue. Participants (24 male, 90 female), who were professional voice users without any diagnosis of voice disorders or voice complaints were divided into two groups low vocal hygiene compliance (LVH; n=66) and high vocal hygiene compliance (HVH; n=48). In this study, vocal fatigue was measured by the vocal fatigue index (VFI), and V-RQOL was measured by the voice handicap index (VHI-10) and V-RQOL. VFI subscales (tiredness, avoidance, physical discomfort) have a moderate positive correlation with VHI-10 and V-RQOL, which indicates that there is a significant relationship between vocal fatigue and quality of life amongst professional voice users. While there was no significant difference between the LVH and HVH groups in terms of quality of life, it was found that the vocal fatigue level of the LVH group was higher. This study of professional voice users with healthy voices reveals a relationship between vocal fatigue and V-RQOL. Vocal hygiene compliance may affect professional voice users' vocal fatigue symptoms; the low-compliant group has higher levels of tiredness, avoidance, and physical discomfort. The findings highlight the importance of raising awareness ofthe problems of professional voice users, even though they have healthy voices and the need for vocal hygiene education programs that target them.

Development and Validation of the Children’s Voice Questionnaire (CVQ)

This study developed and validated the children's voice questionnaire (CVQ), a new self-administered instrument for children, and evaluated its internal consistency and reliability. Observational, prospective, cross-sectional study. The initial preparation of the CVQ was conducted in four steps. First, individual interviews were conducted with dysphonic and non-dysphonic children and their parents, teachers, and speech pathologists. Second, the responses collected from the interviews were arranged into a comprehensive list of 175 items. Third, this list was reduced to a preliminary 21-item version of the questionnaire, which was tested as a pilot with 254 children. Fourth, a further reduction to 18 items was performed to construct the final version of the CVQ. The questionnaire was then administered to 342 children (73 dysphonic, 269 non-dysphonic) aged 6-18. Simultaneously, the parents of these children completed the pediatric voice handicap index (pVHI). Finally, after 2 weeks, 30 randomly selected children (nine dysphonic, 21 non-dysphonic) completed the CVQ again to evaluate test-retest reliability. High reliability was found for the CVQ (Cronbach's α=0.94). Test-retest revealed strong and statistically significant reliability (r=0.79, P<0.001). A highly significant group difference was found between the CVQ scores obtained for the dysphonic and non-dysphonic groups (t[78.25]=6.22, P<0.001). In addition, significant medium-to-strong positive correlations were found between the children's evaluations using the CVQ and their parents' evaluations using the pVHI (0.59<r<0.66, P<0.01). The newly developed CVQ is a valid and reliable instrument. Findings reveal general agreement between children and their parents, but also show that children's perspective on their dysphonia is not equivalent to the parent's perspective. This demonstrates that combining both perspectives provides a more holistic and complete overview of dysphonic children's voice-related quality of life. The self-administered CVQ reliably differentiates dysphonic from non-dysphonic children and may serve as a valuable tool for the initial or ongoing evaluation of children with voice disorders in clinical and research settings.

Effect of Aging on Vocal Outcomes After Laryngeal Reinnervation Combined With Arytenoid Adduction

To evaluate the impact of aging on vocal function following laryngeal reinnervation combined with arytenoid adduction (AA) in the treatment of paralytic dysphonia. Sixty-eight patients with unilateral vocal fold paralysis who underwent refined nerve-muscle pedicle flap (NMP) implantation and AA were classified into four groups according to age: under 50 years (-50), in their 50s, 60s, and 70 years and older (70+). These groups consisted of 15, 14, 22, and 17 patients, respectively. Their vocal function was followed periodically for 24 months after surgery. Vocal function in all groups showed significant improvement after surgery. Significant improvements in vocal function were observed during a 24-month follow-up period: maximum phonation time in the -50 and 50seconds groups; pitch range and voice handicap index-10 in the -50, 50s, and 60s groups; "Grade" in the -50, 50s, and 70+groups; and "Breathiness" and voice-related quality of life in all groups. There were no significant differences in vocal function among the four groups, except for pitch range, at the 24-month postoperative assessment. Although the younger groups tended to exhibit better vocal function compared to the older groups 24 months postoperatively, the refined NMP+AA proved effective in the treatment of breathy dysphonia resulting from unilateral vocal fold paralysis, not only in the younger population but also in the older population.

Meta-Analysis of Validated Quality of Life Outcomes Following Voice Feminization in Transwomen.

For transwomen undergoing voice feminization interventions, fundamental frequency (F 0 ; vocal pitch) is a commonly reported functional outcome measure in the literature. However, F 0 may not correlate well with improvement in quality of life (QoL). Several validated voice-related QoL instruments have been used to assess QoL improvement in these patients, yet there is no consensus on the most appropriate instrument. This systematic review and meta-analysis aimed to assess the relationship between change in F 0 and QoL improvement following voice feminization, and to compare validated QoL instruments commonly used in this population. PubMed, Cochrane, and Embase. A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Primary studies of transwomen undergoing voice feminization, reporting validated QoL outcomes were included. Meta-analyses for associations between mean change in QoL score and mean change in F 0 , as well as variations in mean change in QoL score by QoL instrument, were performed using a multilevel mixed effects model. No statistically significant correlation was found between change in F 0 and QoL score improvement post-intervention. Different validated instruments showed statistically significant variation in QoL score change, with the Trans Women Voice Questionnaire (TWVQ) capturing a greater improvement in QoL score relative to other instruments. Lack of correlation between changes in F 0 and QoL improvement further supports that F 0 alone is insufficient to assess the efficacy of voice feminizing interventions. Validated QoL measures are useful adjuncts. Of these, the TWVQ appears to be the most sensitive for measurement of QoL improvement following voice feminization.

Voice outcomes in high-grade Reinke's edema: Comparing microflap excision and microdebrider surgery.

Patients presenting with hoarseness and diagnosed with high-grade Reinke's edema (RE) will often require surgical intervention for polypoid changes of the true vocal folds. We compared patient outcomes in patients who had microflap or microdebrider excision surgeries. Patients with the diagnosis of grade II or grade III RE based on laryngoscopy or videostroboscopy who failed conservative management underwent surgery using the standard excision practice of the primary surgeon. Voice outcomes were compared using VHI-30 (Voice Handicap Index), V-RQOL (Voice-Related Quality of Life), and MPT (maximum phonation time) preoperatively and at 1-month and 6-months postoperatively. Of the 115 patients included, there were 46 RE grade II patients and 69 RE grade III patients with 52 patient undergoing microflap surgery and 63 patients undergoing microdebrider surgery. Both procedures resulted in significant improvement in VHI-30, V-RQOL, and MPT at 1-month and 6-months postoperatively. The microdebrider group had better 6-month VHI scores (40.84) than the microflap group (44.54) (CI -7.27 to -0.12). The microdebrider group also had better 6-month V-RQOL measures (62.56) than the microflap group (57.79) (CI 0.38-9.16). Both microflap excision and microdebrider excision for high-grade RE lesions resulted in significant improvement in VHI-30, V-RQOL, and MPT at 1-month and 6-months postoperatively with the microdebrider excision group scoring statistically significantly better at 6 months in comparison to the microflap group. Overall, the results support the use of both surgical modalities for treating high-grade RE patients. 3.

Temporomandibular Dysfunction and Voice-Related Quality of Life Impairment.

Muscle tension in the head and neck may co-occur with temporomandibular dysfunction (TMD) possibly leading to voice change. Several studies have reported a correlation between TMD and dysphonia. However, literature on TMD and voice-related quality of life (QOL) is scant. This study aimed to investigate the relationship between TMD and self-perceived voice-related QOL impairment. Patients from TMD clinic were prospectively surveyed on voice-related quality of life using the Voice Handicap Index (VHI) questionnaire. Patients were queried using paper and pen upon initial evaluation in dentistry clinic for temporomandibular disorders by a single dentist or dental assistant in the otolaryngology department. A total of 53 patients completed the VHI. 80% of patients presenting to TMD clinic had VHI scores above zero, but most had minimal to mild impairment. Forty-two patients had scores between 1 and 86, (average 10.98); 11 patients had a score of zero (20.75%). Total average score: 8.70, range: 0-86, median: 4. Functional average score: 3.13, range: 0-29, median: 1. Physical average score: 3.58. range: 0-25, median: 2. Emotional average score: 1.98, range: 0-32, median: 0; these averages did not differ from historical controls. The majority of patients presenting to TMD clinic also presented with some level of voice-related QOL impairment, although minimal and consistent with historical VHI controls. Data indicates that TMD disease may be primarily defined as functionally and physically uncomfortable. Incorporation of interdisciplinary care, with laryngology, speech pathology, physical therapy, counseling, and pain management may be warranted. 4 Laryngoscope, 134:315-317, 2024.

Mandarin Chinese version of the Aging Voice Index.

This study developed the Mandarin Chinese version of the Aging Voice Index (AVI), with preliminary validation of the scale for potential clinical applications. Scale development. The experimental procedure involved: (1) cross-cultural adaptation of the original AVI into the Mandarin Chinese version (CAVI); (2) evaluation by expert panel; (3) back translation; (4) pilot testing; (5) development of the final CAVI; (6) scale validation with 68 older adults of 60-89 years old (29 females and 39 males), 34 with voice disorders and 34 age-matched with normal voice. Internal consistency reliability, test-retest reliability, content validity, criterion-related validity, and discriminatory ability (diagnostic accuracy) of the CAVI were evaluated. There were high internal consistency (Cronbach's alpha = 0.9733), high test-retest reliability (intraclass correlation coefficient = 0.9578, p < 0.01), high content validity (content validity index = 0.9710), high criterion-related validity (Pearson's r = 0.9439, p < 0.01 between CAVI and Voice Handicap Index-10; r = 0.8070, p < 0.01 between CAVI and voice-related quality of life [V-RQOL]), and significant difference in CAVI scores between the two groups with huge effect size (t(34.69) = -11.59, Cohen's d = 2.81, p < 0.001). Receiver operating characteristic analysis revealed a high diagnostic accuracy of the CAVI, with an area under the curve of 0.9974 (p < 0.001) and a cut-off score of 12.0 with 100% sensitivity and 97.1% specificity. Our findings suggested that the CAVI could be a reliable and valid standardized self-assessment questionnaire tool for clinical evaluation of the impact of voice problems specifically for Mandarin-speaking older adults. Further studies should explore a full-scale validation of the CAVI for being a standard clinical tool, including for older adults in Mainland China. 3b (case-control study).

Vocal health of parents of children with hearing assistive devices.

VH (Vocal health) is the need of the hour. VH of parents of children with hearing assistive devices (HAD) reveals a literature gap, during the habilitation process of their children. To explore the vocal health of parents of children with hearing assistive devices. This cross-sectional study was conducted at Riphah International University from September to December 2021. Study recruited N=384 parents of Hearing Impaired children (HIC) using HAD for at least two years, of both genders and aged 2-9 years using convenience sampling. Voice-related quality of life (V-RQOL), and vocal health Index (VHI) -10 were used for data collection. Data was analyzed on SPSS Version 25. Descriptive statistics, Anova and t-test were utilized to see difference between means of groups. P<0.05 shows significant-results. Parents of children using hearing assistive devices had excellent V-RQOL score in 350(91.14%) parents. There was no significant difference in V=RQOL as regards type of hearing assistive device use (p=0.102), laterality of device use (p=0.918) and degree of hearing loss (p=0.143). However, type of hearing loss revealed significant difference (p=0.021). Also VHI score revealed significantly (p=0.008) lower means in parents of children with cochlear implants. Current study concludes that the parents raising hearing impaired children with hearing assistive devices, possess good vocal health as determined by VHI and V-RQOL scores with only a very small number of parents reporting vocal symptoms.

The Study of Vocal Function in Patients With Early Laryngeal Carcinoma After Transoral Laser Microsurgery

Objective Today transoral laser microsurgery is considered as one of the first options to control early laryngeal cancer, and voice disorder is one of the inevitable complications of this therapeutic component. This study aimed to compare the vocal function in patients with early-stage laryngeal cancer following laser surgery with healthy individuals with normal voice quality using acoustic analysis and the voice handicap index and to examine the correlation between the results of these two evaluations in each group. Materials &amp; Methods The current research is a descriptive-correlational and comparative study that was cross-sectioned using convenience sampling into two groups consisting of 60 men (Mean±SD of age 59.18±5.170 years) with early laryngeal cancer undergoing laser surgery as a patient group and 60 men (Mean±SD of age 56.68±5.491 years) with normal voice quality, and without any history of voice disorder as a control. The vocal function of participants was assessed using acoustic parameters (including jitter, shimmer, harmonic to noise ratio, fundamental frequency, smoothed cepstral peak prominence) and a 30-item Persian version of the voice handicap index questionnaire (including overall score and scores of physical, emotional and functional subscale). Then, data were analyzed using SPSS software, version 20, descriptive statistics, Kolmogorov-Smirnov, independent t-test, and Pearson correlation coefficient at the P&lt;0.05. Results The results show that the acoustic parameters and voice handicap index in the group undergoing laser surgery are significantly different from the control group (P&lt;0.001). Also, a significant direct correlation between jitter and shimmer with total score and physical subscale of VHI, a significant inverse correlation between the harmonic-to-noise ratio and total score, functional and physical subscales of VHI, as well as between smoothed cepstral peak prominence with total score and all subscales of VHI (P&lt;0.05). In addition, in the control group, there is no significant correlation between the acoustic parameters and the subscales of the voice handicap index (P&lt;0.05). Conclusion The findings of the acoustic analysis and the voice handicap index show impairment in vocal function and a decrease in voice-related quality of life (QoL) in patients with early laryngeal cancer after laser surgery. Furthermore, a significant correlation between the scores of the voice handicap index and acoustic analysis parameters, especially cepstral analysis indicates the necessity to pay attention to frequency-based analysis. Therefore the results of the present study emphasize the need for a comprehensive assessment of vocal function, providing voice therapy programs, and attention to psychological problems in patients with early laryngeal cancer after laser surgery.