Voice Therapist Research Articles

Comparative Study of the Effect of Experience on Auditory Processing Abilities in Voice Therapists and Other Speech-Language Pathologist in Auditory Perceptual Judgment of Voice

This study aimed to compare the effect of experience on central auditory processing skills in voice therapists and other Speech-Language Pathologists in the auditory perceptual evaluation of voice. This research is a descriptive-analytical cross-sectional observational study. Our study population includes three groups; first-year speech-language pathology students who have not undergone any training or education in the evaluation of auditory samples (group 1; n=10), Speech-Language Pathologists who do not have any activity in the field of voice disorders (group 2; n=10), and therapists who have at least 2years of experience in auditory-perceptual judgment (group 3; n=10). Initially, the participants underwent a basic audiological evaluation (Pure Tone Audiometry, Speech Recognition Threshold, Speech Discrimination Score, tympanometry, and acoustic reflex) to assess peripheral hearing. In the next step, the auditory processing skills of the participants were evaluated with the Buffalo model (staggered spondaic word (SSW) test, phonemic synthesis test (PST), speech in noise (SPN) test). In the third step, four recorded voice samples of patients with voice disorders and healthy individuals were randomly selected for auditory perceptual judgment. These samples were the same for all participants. All the voices were previously subjected to auditory perceptual analysis by two Speech-Language Pathologist who had at least 6years of experience in the evaluation and treatment of voice disorders; the voices were played for participants to assess auditory perception using the grade, roughness, breathiness, asthenia, strain (GRBAS) scale. All subjects had normal hearing and auditory processing abilities but there were some differences among the groups in processing skills. A difference was found in the SSW-qualifier and SPN-R components between the three groups. The third group had significant differences with the other two groups in the evaluation of auditory perception in the components of R, B, and S (from the GRBAS scale) in voice number one, and the components of G, R, and A in voice number three. In voice number two, there was a correlation between the SSW order effect component and the G component, as well as between the PST component and the A component. In voice number three, there was a correlation between the SPN-L component and the G component, and between the SSW condition, SSW qualifier, and SSW All errors components with the S component. In voice number four, there was a correlation between the SSW-RC, SSW-LC, SSW condition, SSW competing, and SSW order effect components with the A component. Lastly, there was a correlation between the SSW order effect and SSW type A components with the R component in voice number three in group three. The results of the present study indicate that experience has an impact on auditory processing skills and the participants of the third group, who had more experience in the evaluation of voice disorders obtained better scores than the other two groups in the auditory processing skills. Additionally, the level of experience is related to the accuracy of auditory perceptual judgment of voice. The participants of the third group performed better than the other two groups, and the performance of the first and second groups was almost the same.

The use of oscillatory positive expiratory pressure devices for voice therapy

Over the last three years, a variety of oscillatory positive expiratory pressure (OPEP) devices have been commonly used by voice therapist and trainers (e.g. Acapella Choice, Shaker Deluxe, Shaker Medic Plus, New Shaker), even if they were not originally created for voice-treatment purposes. OPEP are intended to be used by physiotherapists to mobilize secretions from the lower airway when treating excessive sputum or secretion retention. The mechanism of oscillatory OPEP is based on a continuous and rapid shuttering of airflow, which in turn produces modulation of the oral and tracheal air pressure as patients blows into them. People diagnosed with cystic fibrosis and neurogenic diseases are usually recommended using OPEP devices [1, 2]. OPEP devices are different from expiratory/inspiratory muscle strength training devices, which have no oscillatory mechanisms inside.

Modes of Educating Teachers About Vocal Hygiene: A Comparative Study

Educating teachers about vocal hygiene can be a means of alleviation or prevention of voice problems in this population. The present study aimed to compare four modes of educating teachers in India (n=80) about vocal hygiene. Four groups of 20 teachers were exposed to educative material on the vocal hygiene program created for the present study. Each group received it either in audio mode delivered by the researcher posing as a voice therapist (VA); in audio mode delivered by a researcher posing as a teacher (TA); in written mode delivered by the researcher posing as a voice therapist (VW); or in written mode delivered by a researcher posing as a teacher (TW). The improvement in the knowledge of teachers before and after vocal hygiene education was gauged by administering a written questionnaire before and after the content that the teachers received. Results revealed that all four modes were effective in vocal hygiene education. However, no significant difference (P>0.05) in the improvement of knowledge in teachers across the four modes was seen although the relative mean difference was observed higher for TW mode than other modes. Individual item analyses revealed that some concepts were conveyed more effectively than others. This gave insights into improving the quality and efficacy of vocal hygiene programs in the future. Findings have implications in reaching out to remote areas and employing peer-to-peer teaching as an effective way of vocal hygiene education among teachers.

Karaoke Theory / Karaoke Therapy

This article, an outcome of practice-based artistic research, concerns singing as a therapeutic performance and conveyor of knowledge. It arises from my project fugitive radio, which responds to the uptake of radio in contemporary art by pursuing experimental modes of “performance-radio.” Following a voicing event in Helsinki, a colleague suggested that singing had been “somehow civilized out of us”, prompting me to investigate connections between singing, therapy, and knowledge and in relation to the global phenomenon of karaoke singing. My considerations are framed by ideas from neuroscientist and popular writer Daniel J. Levitin, who argues that the human brain evolved with song, and ethnomusicologist and voice therapist Anne Tarvainen, who encourages her clients to pursue unconventional methods of singing so as to experience their bodies in relation to power. Singing forms discussed include samba and música popular brasileira, Sámi yoiking, Estonia’s Singing Revolution, and Aboriginal “Songlines”, the latter being exemplar of how knowledge is kept in song. Thus, my text turns to consider how (Western) knowledge is subordinate to discourse and how artistic research fits into this schema with reference to the writing of curator and theorist Simon Sheikh. Its final movement follows the “ontological turn” in anthropology and philosophy to addresses how different practices of “worlding” arise as struggles in contemporary art and artistic research.

Rapid Implementation of Teletherapy for Voice Disorders: Challenges and Opportunities for Speech-Language Pathologists

The COVID-19 pandemic necessitated a rapid restructuring of the clinical management of voice and upper airway disorders by speech-language pathologists (SLPs). As in-person therapy sessions were suspended, voice-specialized SLPs across healthcare settings shifted to online teletherapy. In this survey study, we queried voice therapists on their experiences with and opinions regarding the adoption of teletherapy into routine clinical practice. Voice-specialized SLPs were recruited nationwide to complete an online survey which included questions about the usability of software and hardware, patient management, the effectiveness of therapy, overall satisfaction, and suggestions for improvement. 48 participants completed the survey. The majority of respondents reported frequent technical difficulties and poor access to or understanding of appropriate equipment. Overall, participants endorsed better patient access, attendance, and compliance, as well as increased scheduling flexibility. While 95% of the respondents stated they would recommend teletherapy to another SLP, only 20% supported a shift to exclusively virtual sessions. Forty percent of respondents endorsed a hybrid model consisting of initial in-person sessions followed by virtual ones. Incorporating teletherapy into clinical voice practice has, for the most part, followed Carl May's normalization process theory framework, in that clinicians have invested understanding, training, time and effort, and appraisal into its implementation. However, the unusually rapid pace of change necessitated by the pandemic has presented its own set of challenges. Given the inherent conveniences of virtual therapy, the online modality is likely here to stay. It is critical that we understand the facilitators and barriers to its successful adoption.

Introduction to the Perspectives Forum on the Topic of Meta-Therapy in Speech-Language Pathology

Introduction to the <i>Perspectives</i> Forum on the Topic of Meta-Therapy in Speech-Language Pathology

Pre- and Postoperative Voice Therapy for Benign Vocal Fold Lesions: An International Electronic Delphi Consensus Study

Voice therapy management of benign vocal fold lesions (BVFLs) is variable and there are currently no clinical guidelines. Poor descriptions of voice therapy interventions lead to unwarranted variation in treatment. Triangulation of the current evidence identifies a number of potential best practice elements, but also a number of outstanding questions to be explored. The aim of this study was to refine and gain global consensus on "best practice" for a pre- and postoperative voice therapy intervention for adults with BVFLs. An international sample of expert voice therapists (n=42) were recruited to take part in this three-round electronic modified Delphi study. Participants were presented with statements concerning a pre- and postoperative voice therapy intervention. Statements were developed from previous research and based on the TIDieR checklist (eg, why, when, what, how?) Participants rated the extent to which they agreed or disagreed with a statement and gave comments to support their response. Consensus was defined as >75% of participants agreeing or strongly agreeing with a given statement. If consensus was not reached, participant comments were used to generate new statements and were rated in the next round. Stability of consensus between rounds was assessed. The 42 international experts achieved consensus on 33 statements relating to components of a best practice pre- and postoperative voice therapy intervention for patients with BVFLs. Consensus on statements ranged from 81% to 100%. These statements were explicitly mapped to the TIDieR checklist to ensure that all aspects of the intervention were considered and the questions of "why, what, how, when and individual tailoring" were addressed. This study has significantly enhanced our understanding of what should be in a best practice pre- and postoperative voice therapy intervention. It is important to now test these findings for acceptability and feasibility, prior to considering effectiveness research.

A comparative study of the voice-related quality of life among Egyptian elderly with and without voice complaints

BackgroundThis study focuses on the self-perception of the voice in the elderly as assessed by the Voice-Related Quality of Life (V-RQOL) questionnaire. This work aimed to compare differences in the voice-related quality of life outcomes between (1) elderly with and without voice disorders, (2) female and male elderly with voice disorders, and (3) different types of voice disorders, and to explore the correlation between the V-RQOL and perceptual analysis done by the clinician. Forty-three dysphonic and 44 non-dysphonic elderly filled out the Voice-Related Quality of Life (V-RQOL) protocol that analyzes the impact of dysphonia on life quality. Vocal perceptual assessment of each subject with dysphonia was made by three voice therapists, followed by a flexible nasofibrolaryngoscope.ResultsA significant statistical difference was found between the means of total V-RQOL scores and its subdomains for each group (dysphonic and non-dysphonic). No significant differences were found between male and female elderly with dysphonia. The statistical analysis showed a significant correlation with the vocal assessment made by the clinicians and the V-RQOL self-assessment made by the subjects.ConclusionsThis study provides valuable information regarding the risk factors that contribute to vocal quality in the elderly population. Our results revealed that different types of voice disorders are common among the elderly population with significant negative effects on quality of life. It was observed that the poorest score on the V-RQOL was for functional voice disorders, followed by neoplastic lesions, whereas MAPLs had the best score on the V-RQOL.

Pre- and Postoperative Voice Therapy for Benign Vocal Fold Lesions: Factors Influencing a Complex Intervention

(1) To describe factors influencing the content, timing, and intensity of pre- and postoperative voice therapy for patients undergoing phonosurgery for benign vocal fold lesions. (2) To understand experts' rationale for decisions made. (3) To critically analyze factors influencing intervention in relation to the wider literature in order to contribute to the development of a complex intervention. Qualitative interview study. Multidisciplinary voice clinics in England. Ten expert voice therapists with a mean of 22 years experience. Participants were asked to describe factors influencing their current practice and views on optimum treatment for patients undergoing phonosurgery for benign vocal fold lesions. Data were analyzed using the Framework Method of thematic analysis. Factors influencing intervention related to four key themes. Pathophysiological, Patient, Therapist, and Service factors influenced the content, timing, and duration of the voice therapy provided. Consensus on core elements included delivering indirect and direct therapy preoperatively to manage underlying causative factors and address patient expectations. Postoperative intervention focused on indirect therapy to facilitate wound healing and direct therapy to improve vibratory characteristics of the vocal fold. Elements of therapy were highly individualized within participants according to the four themes above, but similarity between participants on broad parameters of intervention was high. Expert voice therapists use direct and indirect methods pre- and postoperatively to treat patients with benign vocal fold lesions. Optimizing wound healing and mobilization of the epithelium postoperatively are concerns for expert voice therapists which distinguish postoperative patients from other dysphonic patients. This study provides an insight into the factors influencing clinician's intervention provision which can contribute to the development of an optimal pre- and postoperative voice therapy intervention. Further research to refine and test the effectiveness of an intervention is now required.

Voice Disorders in Children: Experience in the Voice Unit at Universidad Católica Clinical Hospital

Dysphonia in children is a common symptom, its prevalence varies between 6% and 23%. There is a broad differential diagnosis and the recommendation is to evaluate dysphonic children with an adequate laryngeal visualization method to achieve an accurate diagnosis and treatment. To describe the experience in the diagnosis of dysphonia in children in the voice unit at Universidad Católica Clinical Hospital Santiago, Chile. A retrospective chart review was conducted of all new pediatric patients treated in the voice unit at Universidad Católica Clinical Hospital between 2012 and 2019. Demographic data, diagnosis, and in-office laryngoscopies were reviewed. All patients were evaluated by the same work team consisting of two Otolaryngologists specialized in vocal pathology and a speech voice therapist. A total of 126 new pediatric patients between the ages of 0 to 18 years were evaluated in the voice unit at Universidad Católica Clinical Hospital Santiago, Chile. The majority were males (54%) with an average age of 9 years. 40% of the diagnosis corresponded to vocal nodules, 26% to vocal cord cysts, the remaining to a group of less frequent diagnosis. Two different groups were studied, the first group evaluated during the years 2012-2015 with flexible fibre-optic laryngoscopy and rigid videolaryngostroboscopy (VLS); the second group evaluated between the years 2015-2019 with distal chip flexible videolaryngoscopy, distal chip flexible VLS and rigid VLS. In the second group, the diagnosis of vocal nodules decreased, and the diagnosis of vocal cord cysts increased in comparison to the first group. Pediatric patients with dysphonia must be evaluated by a multidisciplinary team of experts and adequate equipment. VLS should be considered the gold standard in the diagnosis of vocal cord pathology in pediatric population.

Acoustic Voice Quality Index as a Potential Tool for Voice Screening

To diminish the risk of voice disorders in people who are highly dependent on their voices, such as teachers, vocal screening is important already at the beginning of such individuals' professional studies. A reliable, specified screening tool is needed. The Acoustic Voice Quality Index (AVQI) has been found to differentiate normal voices from abnormal voices and to serve as a treatment outcome measure. This study investigated whether AVQI could be a screening tool in combination with auditory- and self-perception of the voice to discriminate normal from slightly poor voices. Experimental. Some 128 female teaching students (mean age 26.39 years, SD 9.80 years) with no diagnosed voice disorders participated in this study. They read aloud a text in Finnish, sustained the vowel /a:/, and filled the Voice Handicap Index (VHI) questionnaire. Voice samples were recorded with an AKG C544L headset microphone, iFocusrite soundcard, and Praat software using a 44100 sample rate and 16-bit amplitude quantization. Five expert voice therapists evaluated the samples to determine the grade of dysphonia (G) using a scale of 0-0.5 (=normal), 0.5-1 (=mild), 1-2 (=moderate), and 2-3 (=severe). Three medial seconds of [a:] and the first 31 syllables of the text were analyzed using AVQI script version 03.01 in Praat (5.3.55). The analysis gives one AVQI score per participant (scale 0-10). The AVQI threshold of normal and disordered voices for Finnish speakers is 1.83; a Gmean = 0.0-0.5 and VHI score <19 were considered normal. Statistical analysis was done using the receiver operating characteristic (ROC) curve, Spearman's correlation coefficient, and the independent samples t test. According to the AVQI results, the area under the curve (AROC) was 0.554, which is fair. The Youden index gave a cutoff value of 0.30 with a sensitivity of 85% and a specificity of 81.1%. There were weak but significant correlations between Gmean and AVQI and two AVQI parameters, smoothed cepstral peak prominence and harmonic-to-noise ratio (r = 0.27; --0.24; -0.20, respectively; |P < 0.05); and between total VHI and AVQI score and cepstral peak prominence (r = 0.21; 0.20, respectively; P < 0.05). Furthermore, the AVQI scores differed significantly between the groups with a VHI total score <19 and ≥19. AVQI did not differentiate between voices that had been perceptually judged as normal or slightly abnormal, but a combination of perceptual assessment in the form of AVQI and VHI could better screen slightly deviant voices.

Effect of diabetes mellitus on voice: a systematic review

AbstractA systematic review of literature was conducted to identify the influence of diabetes mellitus on voice. The search was carried out on PubMed, Scopus, CINAHL and Cochrane databases. Articles that discussed the effect of diabetes mellitus on voice were included in the review. Five studies were found to be suitable for inclusion. There is limited literature available on the effect of diabetes mellitus on voice. The studies pointed to a higher prevalence (12.5%) of voice problems among individuals with diabetes mellitus as compared to the general population, and higher gastro‐oesophageal reflux disorder related symptoms. Further, higher reflux symptom index and voice handicap index scores have been reported in these individuals. The other voice related changes reported across the studies include the presence of laryngeal involvement, hoarseness, and increased strained voice. Even though there is limited literature available, it points towards the presence of voice changes among people with diabetes. This information would help professionals to better counsel and refer patients with diabetes to laryngologists or voice therapists if they complain of voice changes. Copyright © 2019 John Wiley &amp; Sons. Practical Diabetes 2019; 36(5): 177–180

Calentamiento vocal en locutores comerciales

IntroductionThe announcers are professionals of the voice that are characterized by presenting high vocal demand. The objective of this research was to measure the acoustic changes that could be attributed to a routine of vocal warm-up on the quality of the voice in commercial radio and television announcers in Chile. Material and methodThirteen commercial announcers were selected and a vocal warm-up routine was applied. The parameters of fundamental frequency, jitter, shimmer, noise, maximum time of phonation and articulatory agility were measured. All parameters were measured before and after the exercise routine. On the other hand, 6 experts voice therapist analyzed through a visual analog scale changes in the narrow band spectrograms of the emissions before and after the vocal warm-up routine. ResultsSignificant changes were found in the fundamental frequency and maximum phonation time. In the analysis of the spectrograms performed by the experts, in 11 cases there was improvement between the before and after the routine. In addition to the above, in 6 of these cases the changes were significant. ConclusionsThe vocal warm-up can be an effective tool for the care of the voice in commercial announcers.

A Study of Vocal Facilitating Techniques Compared to Manual Circumlaryngeal Therapy in Teachers With Muscle Tension Dysphonia

There are several voice therapy techniques been suggested in patients with muscle tension dysphonia (MTD), however a few studies are compared between them. The purpose of present study was to compare the effect of vocal facilitating techniques (VFTs) and manual circumlaryngeal therapy (MCT) in teachers with MTD. This is a randomized clinical trial study. Sixteen teachers with MTD (female; mean age: 38.6 ± 4.6 years) participated in this study. The participants allocated to two treatment groups: the first group received VFTs (n: 8) and MCT was presented to the second one (n: 8). In each group, the voice therapy techniques were given for 10 individual sessions twice a week. The effect of both techniques was assessed using voice handicap index (VHI) and dysphonia severity index (DSI). Within group comparison, the VHI, DSI, and theirs components showed significantly better results after both treatment groups (P ≤ 0.05). Although, effect size was strong for all target features (η2 > 0.36); the greatest magnitude was obtained on the physical subscale of VHI following MCT and for the DSI after VFTs (η2 = 0.92 and 0.90, respectively). Moreover, the interactive effect of time and treatment groups indicated that there was significant main effect on the physical and functional subscales of VHI (P = 0.00 and 0.02, respectively) as well as I-low and DSI (P = 0.01 and 0.02, respectively). VFTs and MCT are two effective techniques in voice therapy of teachers with MTD. However, the greatest improvement obtained on the DSI following VFTs and for the physical aspect of VHI after MCT demonstrated voice therapist can use appropriate technique based on the voice complaints and results of voice assessments in MTD.

Vocal Fatigue—Do Young Speech-Language Pathologists Practice What They Preach?

PurposeSpeech-Language Pathologists can be categorized as Level II professional voice users who play the roles of voice therapist or vocal coach to treat voice problems. SLPs may be at the risk of experiencing vocal fatigue due to vocal loading and other contributing factors. The present study was undertaken to find the percentage of SLPs reporting vocal fatigue, the probable factors resulting in vocal fatigue, the measures that are taken to avoid/reduce the occurrence of vocal fatigue, its effect on their professional and personal life and the measures taken to tackle it. ResultsThe results of this study are based on data collected from 142 SLPs and 50 controls using a questionnaire. 71.13% SLPs reported that they experience vocal fatigue. Some of the contributing factors that are mainly reported are long durations of voice use, voice use for recreational purposes, speaking loudly, frequent throat clearing, lack of adequate hydration and working in noisy or air-conditioned environments. The major symptoms reported were dryness in throat, tightness in neck and shoulder, choking sensation, effortful speech and pain in the throat. 59% SLPs reported that vocal fatigue affected their professional life while 44% SLPs reported that it affects their personal life also to varying degrees. Measures taken to avoid/ reduce the occurrence of vocal fatigue included vocal warm up, break in between sessions, and play activities. Only a few SLPs took intervention measures like ENT consultation, voice therapy, and home remedies. ConclusionSLPs are inevitably at high risk of experiencing vocal fatigue which, if left untreated, will lead to organic voice problems. However, many young SLPs who experience vocal fatigue reported vocal abuse, do not follow vocal hygiene program and do not follow evidence-based preventive or intervention practices to treat vocal fatigue.

Guía para el fonoaudiólogo en evaluación e intervención de la disfonía por tensión muscular: Revisión y caso

La disfonía por tensión muscular es uno de los diagnósticos comunes en la clínica de voz y el fonoaudiólogo o vocólogo es parte fundamental del equipo multidisciplinar encargado de su manejo. El propósito de este artículo es realizar una descripción de la disfonía por tensión muscular dentro del espectro de las denominadas disfonías funcionales. En la primera parte se presentan las diversas denominaciones, clasificaciones y características de las disfonías por tensión muscular que pueden servir como guía para el terapeuta en el proceso de evaluación e intervención terapéutica de las personas con alteraciones vocales por tensión muscular. En la segunda parte se presenta un caso para el cual se describe la intervención terapéutica realizada analizando los factores asociados, se discuten los resultados y la eficacia del tratamiento. La terapia basada en la coordinación y balance de los sistemas fisiológicos vocales puede ser una herramienta efectiva en la resolución de casos de disfonía por tensión muscular

Utility of preoperative voice therapy on the voice recovery of vocal cord polyps patients undergoing the microsurgery

To evaluate the therapeutic effect on the voice recovery of patients with vocal cord polyps undergoing the microsurgery of preoperative voice therapy. Twenty-six patients diagnosed with unilateral vocal cord polyp under stroboscope, who needed to undergo vocal cord loss resection under supportive laryngoscope, were randomly divided into control group (non-voice training) and treatment group (voice training), with each group of 13 patients. Patients in control group were just treated with surgical operation. Apart from surgical treatment, patients in treatment group received 6 hours intensive vocal therapy one week before the surgery. The therapy courses consist of the propaganda and education of voice care, postoperative vocal instruction and the patients' self-training under the guidance of voice therapists. The acoustic parameters (irregularity, breathiness, grade, jitter and shimmer) of the same patient were collected 24 to 48 hours before the surgery and 14 days after the surgery with Ling WAVES. The results were analyzed with SPSS 19.0. The differences of all the five preoperative voice parameters between control group and treatment group are not significant; but postoperative breathiness and jitter in treatment group were significantly lower than that in control group, while the differences of irregularity, overall severity and shimmer were not significant between control group and treatment group. In control group, breathiness and jitter were significantly improved after surgery, while the differences of irregularity, breathiness and shimmer were not significant between preoperation and postoperation. In treatment group, all the five voice parameters were significantly improved after surgery. According to the laryngostroboscopic examination, the vocal fold polyps were excised completely in both groups. Preoperative voice therapy contributes to the recovery of voice quality of the patients with vocal cord polyps. Combined intervention of surgery and voice therapy is an effective method to treat the patients with vocal cord polyps.

Characteristics of a Treatment-seeking Population in a Private Practice Community Voice Clinic: An Epidemiologic Study

The purpose of this study was to evaluate epidemiologic characteristics of a treatment-seeking population referred to a private practice community voice clinic. This is a retrospective cohort study. Patient files representing evaluation referrals over a 28-month period were reviewed. Variables tabulated from records included disorder diagnosis, age, gender, perceptual voice quality ratings, and self-perceived voice handicap at initial evaluation. Descriptive statistics were used to evaluate the diagnosis category and demographic patterns. Parametric statistics were applied to quantitative clinical measurements to test the effect of voice disorder category on perceptual voice quality ratings and self-perceived voice handicap. A total of 216 consecutive patient files were reviewed. Collectively, the most common disorder diagnosis was "other," consisting of a varied cluster of etiologies, including reflux laryngitis, chronic cough, bilateral paralysis or paresis, leukoplakia, and polypoid degeneration. The most common diagnosis in women was midmembranous lesions, and that in men was the "other" category followed by atrophy and bowing associated with presbylaryngis. The greatest severity and handicap measures were found in patients with unilateral paralysis. Collectively, the demographic patterns reported in this study align with those from specialty voice clinics housed in academic medical centers and community voice clinics led by laryngologists and general otolaryngologists. Translating these findings to professional practice, the data support the notion that speech-language pathologists specializing as voice therapists who seek to establish private practice clinics should possess competencies in the knowledge and skills required to serve treatment-seeking populations with a wide variety of voice impairments.

Is OperaVOX a clinically useful tool for the assessment of voice in a general ENT clinic?

BackgroundObjective acoustic analysis is a key component of multidimensional voice assessment. OperaVOX is an iOS app which has been shown to be comparable to Multi Dimensional Voice Program for most principal measures of vocal function. As a relatively cheap, portable and easily accessible form of acoustic analysis, OperaVOX may be more clinically useful than laboratory-based software in many situations. This study aims to determine whether correlation exists between acoustic measurements obtained using OperaVOX, and perceptual evaluation of voice.MethodsForty-four voices from the multidisciplinary voice clinic were examined. Each voice was assessed blindly by a single experienced voice therapist using the GRBAS scale, and analysed using OperaVOX. The Spearman rank correlation co-efficient was calculated between each element of the GRBAS scale and acoustic measurements obtained by OperaVOX.ResultsSignificant correlations were identified between GRBAS scores and OperaVOX parameters. Grade correlated significantly with jitter (ρ = 0.495, p < 0.05), shimmer (ρ = 0.385, p < 0.05), noise-to-harmonic ratio (NHR; ρ = 0.526, p < 0.05) and maximum phonation time (MPT; ρ = −0.415, p < 0.05). Roughness did not correlate with any of the measured variables. Breathiness correlated significantly with jitter (ρ = 0.342, p < 0.05), NHR (ρ = 0.344, p < 0.05) and MPT (ρ = −0.336, p < 0.05). Aesthenia correlated with NHR (ρ = 0.413, p < 0.05) and MPT (ρ = −0.399, p < 0.05). Strain correlated with Jitter (ρ = 0.560, p < 0.05), NHR (ρ = 0.600, p < 0.05) and MPT (ρ = −0.356, p < 0.05).ConclusionsOperaVOX provides objective acoustic analysis which has shown statistically significant correlation to perceptual evaluation using the GRBAS scale. The accessibility of the software package makes it possible for a wide range of health practitioners, e.g. general ENT surgeons, vascular surgeons, thyroid surgeons and cardiothoracic surgeons to objectively monitor outcomes and complications of surgical procedures that may affect vocal function. Given the increasing requirement for surgeons to monitor their outcomes as part of the move towards ‘surgeon reported outcomes’ this may become an invaluable tool towards that goal.

Assessment of Grade of Dysphonia and Correlation With Quality of Life Protocol

The main objective of this study is to check the correlation between vocal self-assessment and results of the Voice-Related Quality of Life (V-RQOL) protocol, and whether there is a correlation between perceptual vocal assessment made by voice therapists and the results from the V-RQOL protocol. The study included 245 subjects with vocal complaints. This was a prospective analytical clinical study. Vocal perceptual assessment of each subject with dysphonia was made by three voice therapists, followed by self-assessment made by the subjects themselves, and the application of the V-RQOL protocol. The results have shown poor level of agreement between vocal assessment made by the voice therapists and self-assessment made by the subjects. The statistical analysis indicated that the results of V-RQOL protocol showed significant correlation with the vocal assessment made by the voice therapists and the self-assessment by the subjects. The agreement between the assessments was low and variable; age, gender, professional voice use, and clinical laryngoscopic diagnosis did not influence the agreement level. Protocol V-RQOL is sensitive to vocal assessment made by the voice therapists and self-assessment made by the patient.