1
|
Perrin CE, Young VN, Ma Y, Rosen CA, Stockton SD, Schneider SL. Singing Voice Handicap Index-10 Minimal Clinically Important Difference: A Prospective Determination. Laryngoscope 2024. [PMID: 39363621 DOI: 10.1002/lary.31808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 08/16/2024] [Accepted: 09/16/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND/OBJECTIVES The Singing Voice Handicap Index-10 (SVHI-10) is a validated patient-reported outcome measure (PROM) that assesses patients' perception of handicap related to singing voice. A normative value has been established with a score ≥20 being abnormal. However, there is no defined minimal clinically important difference (MCID). This study prospectively determines the MCID of SVHI-10 among a diverse group of singers. METHODS 103 adult singers with and without voice complaints completed SVHI-10 twice, 30 days apart. MCID for the SVHI-10 was determined using distribution-based receiver-operating characteristic (ROC) curve analysis. RESULTS Twenty-two men (1 transgender), 75 women (1 transgender), and 6 nonbinary individuals participated. The most frequently reported singing genres were classical (44.7%), musical theater (17.5%), and pop (10.7%). Mean initial SVHI-10 score was 13.05 (standard deviation 7.397), and mean follow-up SVHI-10 was 13.13 (7.994). There was a significant positive correlation between initial and follow-up SVHI-10 scores (r = 0.879, p < 0.001). SVHI-10 scores were significantly higher among participants who reported voice changes in the past year (p < 0.001) or sought voice treatment (p = 0.001) compared with participants who did not. SVHI-10 scores varied significantly based on singing type. The area under the ROC curve for SVHI-10 was 0.700 (p = 0.003). The SVHI-10 MCID was determined to be 9.5. CONCLUSIONS An SVHI-10 score change ≥10 should be considered clinically meaningful. This definition has been missing from the literature and will improve understanding of patients' responses to treatment, which will help advance clinical care and track research outcomes. LEVEL OF EVIDENCE 4 Laryngoscope, 2024.
Collapse
Affiliation(s)
- Claire E Perrin
- Department of Otolaryngology-Head and Neck Surgery, UCSF Voice and Swallow Center, University of California San Francisco, San Francisco, California, U.S.A
| | - VyVy N Young
- Department of Otolaryngology-Head and Neck Surgery, UCSF Voice and Swallow Center, University of California San Francisco, San Francisco, California, U.S.A
| | - Yue Ma
- Department of Otolaryngology-Head and Neck Surgery, UCSF Voice and Swallow Center, University of California San Francisco, San Francisco, California, U.S.A
| | - Clark A Rosen
- Department of Otolaryngology-Head and Neck Surgery, UCSF Voice and Swallow Center, University of California San Francisco, San Francisco, California, U.S.A
| | | | - Sarah L Schneider
- Department of Otolaryngology-Head and Neck Surgery, UCSF Voice and Swallow Center, University of California San Francisco, San Francisco, California, U.S.A
| |
Collapse
|
2
|
Baylow HE, Esfandiarei M, Ratiu I. Voice Symptoms and Quality of Life in Individuals With Marfan Syndrome: A Cross-Sectional Study. J Voice 2024; 38:1254.e1-1254.e10. [PMID: 35525628 DOI: 10.1016/j.jvoice.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Marfan Syndrome (MFS) is a connective tissue disorder that affects skeletal, ocular, pulmonary, cardiovascular, and central nervous systems. Symptoms may lead to diminished quality of life (QoL) in individuals with MFS compared with healthy individuals. Currently, there is little evidence regarding the impact of MFS on voicing and QoL. This study examined perceptions of voicing difficulties and QoL among persons with MFS. METHOD A total of 356 participants with a self-reported diagnosis of MFS completed the Quality-of-Life Index (QLI) and voice handicap index-10 (VHI-10) and provided medication regime. RESULTS Some degree of voice handicap was reported by a majority of participants. Analyses assessing correlations between responses to the VHI-10, QLI scores, and reported medications were conducted. Specific medications and responses on the VHI-10 were significantly associated with QLI scores. Multiple regression analyses revealed that a summed VHI-10 score was the strongest predictor of QLI satisfaction, QLI importance, and overall QLI. CONCLUSIONS The findings of the current study suggest that individuals with MFS may experience self-perceived phonatory dysfunction which impact QoL. Specific classes of drugs may also be associated with reported voice handicap and QoL satisfaction in MFS. These findings have implications for physicians and clinicians who work with individuals with MFS.
Collapse
Affiliation(s)
- Hope E Baylow
- University of Scranton, Health and Human Performance, Scranton, Pennsylvania.
| | | | - Ileana Ratiu
- Midwestern University, Speech-Language Pathology, Glendale, Arizona
| |
Collapse
|
3
|
Rameau A, Tucker LH, Denham MW, Kang YJ, Choi N, Lachs M, Rosen T, Stewart M, Czaja S, Golub JS. Voice Disorders and Hearing Loss May Be Additive Risk Factors for Depression in a National Cohort. Laryngoscope 2024; 134:4060-4065. [PMID: 38804637 PMCID: PMC11305957 DOI: 10.1002/lary.31536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/18/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES Hearing loss (HL) (receptive communication impairment) is a known risk factor for depression. However, dysphonia (expressive communication impairment), has received little study. We study HL, self-reported voice disorder, and combined impairment as risk factors for depression in a large national cohort. METHODS This was a cross-sectional epidemiologic study. Data were analyzed from the Korean National Health and Nutrition Examination Survey (KNHANES) cycles 2008-2012 and 2019-2020. KNHANES uniquely contains both audiometry and voice disorder data. HL (yes/no) was defined as ≥25 dB pure tone average. Voice disorder (yes/no) was defined by self-report. Depression (yes/no) was defined by physician diagnosis. Odds ratios for depression were calculated using multivariable logistic regressions with HL and voice disorder. RESULTS 8,524 individuals aged 19 to 80 years old had complete data. The mean age was 57.3 years (SD = 13.4) and 64% were women. All regressions were controlled for age and sex. Those with HL, versus those without, had 1.27 times the odds (95% CI = 1.07-1.52, p = 0.007) of depression. Those with self-reported voice disorder, versus those without, had 1.48 times the odds (1.22-1.78, p < 0.001) of depression. Those with HL and self-reported voice disorder, versus those with neither, had 1.79 times the odds (1.27-2.48, p < 0.001) of depression. CONCLUSIONS This study demonstrates independent relationships between HL and depression and self-reported voice disorder and depression. Combined HL and self-reported voice disorder had nearly 1.8 times the odds of depression. This is likely due to the grossly additive effect of difficulty with incoming and outgoing communication streams. LEVEL OF EVIDENCE II Laryngoscope, 134:4060-4065, 2024.
Collapse
Affiliation(s)
- Anaïs Rameau
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College/NewYork-Presbyterian, Sean Parker Institute for the Voice, 240 East 59 Street, New York, NY 10022, USA
| | - Lauren H. Tucker
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center/NewYork-Presbyterian, 180 Fort Washington Avenue, HP8, New York, NY 10032, USA
| | - Michael W. Denham
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center/NewYork-Presbyterian, 180 Fort Washington Avenue, HP8, New York, NY 10032, USA
| | - Yung Jee Kang
- Department of Otolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, 81 Irwon-Ro Gangnam-gu, Seoul, Korea 06351
| | - Nayeon Choi
- Department of Otolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, 81 Irwon-Ro Gangnam-gu, Seoul, Korea 06351
| | - Mark Lachs
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College/NewYork-Presbyterian, 240 East 59 Street, New York, NY 10022, USA
| | - Tony Rosen
- Department of Emergency Medicine, Weill Cornell Medical College/NewYork-Presbyterian, 240 East 59 Street, New York, NY 10022, USA
| | - Michael Stewart
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College/NewYork-Presbyterian, Sean Parker Institute for the Voice, 240 East 59 Street, New York, NY 10022, USA
| | - Sara Czaja
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College/NewYork-Presbyterian, 240 East 59 Street, New York, NY 10022, USA
| | - Justin S. Golub
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center/NewYork-Presbyterian, 180 Fort Washington Avenue, HP8, New York, NY 10032, USA
| |
Collapse
|
4
|
Aghajanzadeh M, Dabirmoghaddam P, Soleimani M, Saeedi S. Comparing five-factor personality traits and psychological distress between dysphonic patients and individuals with vocally healthy voices. Brain Behav 2024; 14:e3641. [PMID: 39099382 PMCID: PMC11298687 DOI: 10.1002/brb3.3641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 08/06/2024] Open
Abstract
INTRODUCTION It was reported that voice can carry information about personality and psychological distress. In the current study, the relationship between five-factor personality traits and psychological distress with voice was enlightened from diverse aspects. METHODS A total of 119 participants (55 with and 64 without dysphonia) sustained vowels /a/ and /i/, read six standard sentences, and answered a question. Three raters auditory-perceptually evaluated the vocal samples using the Persian version of CAPE-V. The participants were distributed into four groups (vocally healthy, mild, moderate, and severe dysphonia). They completed two questionnaires: NEO Five-Factor Inventory (NEO-FFI) and Depression, Anxiety, and Stress Scale-21. RESULTS Results showed that the conscientiousness (U = 1146.500, z = -3.27, p = .001) in the dysphonia group was significantly less than the vocally healthy group. Depression (U = 1381.000, z = -2.03, p = .042) and anxiety (U = 1181.000, z = -3.10, p = .002) in the dysphonia group were significantly higher than in the vocally healthy group. In comparing different abnormal overall voice qualities, the mild dysphonia group revealed significantly lower conscientiousness (p = .001) and significantly higher anxiety (p = .002) relative to the vocally healthy group. CONCLUSIONS Findings indicated that the conscientiousness trait could play an influential role in persons with dysphonia and its psychological status. The voice care team should consider conscientiousness and psychological distress during the assessment and treatment of dysphonic patients.
Collapse
Affiliation(s)
- Mahshid Aghajanzadeh
- Department of Speech Therapy, School of RehabilitationTehran University of Medical SciencesTehranIran
| | | | - Mehdi Soleimani
- Department of Psychiatry, School of MedicineTehran University of Medical SciencesTehranIran
| | - Saeed Saeedi
- Department of Speech Therapy, School of RehabilitationTehran University of Medical SciencesTehranIran
| |
Collapse
|
5
|
Nazari MA, Saeedi S, Seifpanahi MS, Hadi N. Adaptation and Validation of the Persian Version of the Voice Handicap Index-10 (VHI-10). J Voice 2024:S0892-1997(24)00167-X. [PMID: 38960766 DOI: 10.1016/j.jvoice.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVES Voice disorders can profoundly impact health, quality of life, job performance, and social interactions. Traditional evaluations have expanded to include quality-of-life assessments, emphasizing self-reported outcomes. The Voice Handicap Index (VHI) stands out among relevant questionnaires, with the VHI-10 being a concise derivative. This study was conducted to translate and validate the Voice Handicap Index-10 (VHI-10) questionnaire for Persian speakers, enhancing clinical assessments of voice disorders and quality of life. METHODS This cross-sectional study, conducted in Iran, involved (1) translating the VHI-10 into Persian, (2) confirming face and content validity using Content Validity Ratio (CVR), and Content Validity Index (CVI), and (3) evaluating its reliability through a survey. A panel of experts confirmed the validity, and reliability of the study, which was assessed using Cronbach's alpha, Spearman-Brown, and Guttman coefficients. The survey involved 225 participants, including 150 healthy people and 75 patients with voice disorders, who were selected using a convenience sampling method. RESULTS All question items demonstrated a CVI greater than 0.79 and a CVR between 0.62 and 1. Reliability analysis yielded high Cronbach's alpha values for functional, physical, and emotional domains (0.909) and total (0.961). The mean overall scores of VHI-10 for healthy and disordered groups were 18.78 and 0.74, respectively. The VHI-10 effectively discriminated between healthy and disordered groups in all domains, with an accuracy of 97.33%. The determined cut-off point was 4.5, with a strong area under the Receiver Operating Characteristic (ROC) curve (0.989). CONCLUSION This study successfully adapted and validated the Persian version of the VHI-10. The questionnaire demonstrated high reliability and validity, distinguishing between individuals with and without voice disorders. This Persian version is now a valuable tool for speech and language pathologists conducting clinical voice evaluations in Iran and also it could be applied in studies to determine the effects of voice problems on participant's quality of life.
Collapse
Affiliation(s)
- Mohammad-Amin Nazari
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Soheila Saeedi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad-Sadegh Seifpanahi
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Niloofar Hadi
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
6
|
White A, Carding P, Booth V, McGlashan J, Van Stan J, Logan P, Awad R. Pre- and post-operative voice therapy for benign vocal fold lesions: protocol for a non-randomised, multicentre feasibility trial with embedded process evaluation. Pilot Feasibility Stud 2024; 10:84. [PMID: 38783383 PMCID: PMC11112800 DOI: 10.1186/s40814-024-01508-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Management of benign vocal fold lesions (BVFLs) is variable with individuals receiving surgery, voice therapy, or a combination of these approaches. Some evidence suggests that the best outcomes may be achieved when patients are offered pre- and post-operative voice therapy in addition to phonosurgery, but what constitutes pre- and post-operative voice therapy is poorly described. The pre- and post-operative voice therapy (PAPOV) intervention has been developed and described according to the TIDieR checklist and Rehabilitation Treatment Specification System (RTSS) for voice. The PAPOV intervention is delivered by specialist speech and language therapists trained in the intervention and comprises 7 essential and 4 additional components, delivered in voice therapy sessions with patients who are having surgery on their vocal folds for removal of BVFLs. STUDY DESIGN Non-randomised, multicentre feasibility trial with embedded process evaluation. METHOD Forty patients from two sites who are due to undergo phonosurgery will be recruited to receive the PAPOV intervention. Measures of feasibility, including recruitment, retention, and adherence, will be assessed. The feasibility of gathering clinical and cost effectiveness data will be measured pre-treatment, then at 3 and 6 months post-operatively. An embedded process evaluation will be undertaken to explain feasibility findings. DISCUSSION This study will assess the feasibility of delivering a described voice therapy intervention protocol to patients who are undergoing surgery for removal of BVFLs. Findings will be used to inform the development and implementation of a subsequent effectiveness trial, should this be feasible. TRIAL REGISTRATION This trial has been prospectively registered on ISRCTN (date 4th January 2023), registration number 17438192, and can be viewed here: https://www.isrctn.com/ISRCTN17438192 .
Collapse
Affiliation(s)
- Anna White
- Centre for Rehabilitation & Ageing Research, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
- Nottingham University Hospitals NHS Trust, Nottingham, UK.
| | - Paul Carding
- Oxford Institute of Applied Health Research, Oxford, UK
| | - Vicky Booth
- Centre for Rehabilitation & Ageing Research, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | | | - Pip Logan
- Centre for Rehabilitation & Ageing Research, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Rehab Awad
- University Hospital Lewisham NHS Trust, London, UK
- Kasr Al-Aini Hospital, Cairo University, Cairo, Egypt
| |
Collapse
|
7
|
Gartling GJ, van Mersbergen M, Crow K, Lewandowski A, Smith LJ, Gartner-Schmidt JL. The Patient Experience: The Relationship Between Vocal Handicap, Congruency, Perceived Present Control, and Mood Across Four Voice Disorders. J Voice 2024; 38:244.e15-244.e27. [PMID: 34615615 DOI: 10.1016/j.jvoice.2021.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The potential for negative sequalae in psychosocial well-being presents clinical importance to the assessment of voice disorders. Despite the impairment voice disorders cause in the psychosocial domain, the clinical assessment of these disorders relies heavily on visual perceptual judgments of the larynx, audio-perceptual, as well as acoustic and aerodynamic measures. While these measures aid in accurate diagnosis and are necessary for standard of care, they present little insight into the patient experience of having a voice disorder. DESIGN Retrospective between-subject, non-experimental design. METHODS Data from 335 patients from the University of Pittsburgh Voice Center were collected from scores of the Voice Handicap Index-10 (VHI-10) and two recent questionnaires, the Voice Present Perceived Control scale (VPPC), and the Vocal Congruency Scale (VCS). Examining how these voice-specific scales related to three mental health screeners for stress (Perceived Stress Scale-4), anxiety (Generalized Anxiety Disorder-7) and depression (Patient Health Questionnaire-9) were also examined. Patient diagnoses included primary muscle tension dysphonia (pMTD), unilateral vocal fold paralysis (UVFP), vocal fold atrophy, and mid membranous vocal fold lesions. RESULTS There were significant differences in scores from the voice-specific scales between diagnostic groups with UVFP being the highest (worst) in VHI-10 and UVFP being the lowest (worst) in VCS compared to healthy controls. There was no significant difference in VPPC scores between diagnostic groups. Results showed statistically significant inverse relationships between the VHI-10 and the VPPC and between the VHI-10 and VCS for all diagnostic groups. A significant direct relationship was found between the VPPC and the VCS for patients diagnosed with MTD, UVFP and Lesions. In sum, patients with UVFP presented with the most frequent and sometimes strongest relationships between voice and mental health measures. DISCUSSION This study marks an initial investigation into the nuanced patient experience of having a voice disorder. Three theoretically unrelated voice constructs: handicap, perceived control, and sense of self, were measured via self-report. Results from this study describe the patient experience correlating to these constructs with weak correlations to stress, anxiety, and depression. Findings also clearly suggest that patient experience varies among diagnostic groups, as well as varying constructs. Measures of multiple constructs of patient perception provide valuable insight into a patient's experience of their voice disorder, guidance on the direction of voice treatment, and justification for such treatments.
Collapse
Affiliation(s)
- Gary J Gartling
- Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, Tennessee
| | - Karen Crow
- Louisville Center for Voice Care, Louisville, Kentucky
| | - Ali Lewandowski
- University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Libby J Smith
- University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jackie L Gartner-Schmidt
- Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania; University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
| |
Collapse
|
8
|
Santos M, Azevedo S, Sousa F, Machado AS, Santos PC, Freitas SV, Almeida E Sousa C, da Silva ÁM. Presbylarynx: Is It a Sign of the Health Status of the Elderly? J Voice 2023; 37:304.e1-304.e7. [PMID: 33461883 DOI: 10.1016/j.jvoice.2020.12.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/14/2020] [Accepted: 12/21/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Only a full understanding of how different diseases affect the same or different anatomical/functional entities, may provide a clue on how comorbidity should be taken into consideration. The aim of this study was to evaluate the chronic medical illnesses of an elderly population, in order to analyze potential correlation of specific comorbidities with presbylarynx. METHODS This case-control, prospective, observational, and cross-sectional study was carried out on consecutive subjects observed by otorhinolaryngology, in a tertiary center, from January to September 2020. The inclusion criteria were ability to report an accurate medical history and ≥65 years of age. The exclusion criteria were neurologic diagnoses, autoimmune disease, history of thoracic or head and neck surgery, cancer, radiotherapy, thyroid pathology, vocal fold mass lesions, acute laryngitis, or vocal fold paralysis. Based on videostroboscopy of the larynx, the patients were subdivided into two main groups: presbylarynx versus no presbylarynx. Health status was assessed by evaluation of chronic medical illnesses (individual diagnoses of chronic conditions plus Charlson comorbidity index [CCI]), functional status (Katz index of independence in activities of daily living and functional Ambulation ambulation classification), and emotional status (Geriatric Depression Scale). RESULTS A total of 174 subjects (60 males; 114 females) were included (mean age = 73.99 years; range 65-95 years). Presbylarynx was identified in 71 patients (41%). A statistically significant difference was found concerning diabetes mellitus type 2 (T2DM); P< 0.001), asthma or chronic obstructive pulmonary disease (COPD; P< 0.001), and psychiatric disorder (P< 0.001). The mean score of CCI between "presbylarynx" and "no presbylarynx" groups was statistically different (P= 0.021). Results showed an association between some functional dependence (P< 0.001), and mild or severe depression (P< 0.001) and the presence of presbylarynx. CONCLUSIONS Presbylarynx may be considered a sign of the health status of the elderly. Based on CCI, It was found that patients with higher probability of 10-year mortality exhibit more endoscopic signs of presbylarynx. It was also found that patients with better scores in functionality scales exhibited less endoscopic findings compatible with presbylarynx. Among chronic medical illnesses, T2DM, asthma, or COPD may be considered risk factors for noticeable endoscopic signs of presbylarynx.
Collapse
Affiliation(s)
- Mariline Santos
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
| | - Sara Azevedo
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Francisco Sousa
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - André Sousa Machado
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Pedro Carvalho Santos
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Susana Vaz Freitas
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal; LIAAD - Laboratório de Inteligência Artificial e Apoio à Decisão, INESCTEC, Porto, Portugal
| | - Cecília Almeida E Sousa
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Álvaro Moreira da Silva
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| |
Collapse
|
9
|
Santos M, Sousa F, Azevedo S, Casanova M, Freitas SV, E Sousa CA, da Silva ÁM. Presbylarynx: Is it Possible to Predict Glottal Gap by Cut-Off Points in Auto-Assessment Questionnaires? J Voice 2023; 37:268-274. [PMID: 33384247 DOI: 10.1016/j.jvoice.2020.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine cut-off points in auto-assessment questionnaires to predict the presence and extent of presbylarynx signs. METHOD This case control, prospective, observational, and cross-sectional study was carried out on consecutive subjects observed by Otorhinolaryngology, in a tertiary center, in 2020. Each subject underwent fiberoptic videolaryngoscopy with stroboscopy, and presbylarynx was considered when it was identified two or more of the following endoscopic findings: vocal fold bowing, prominence of vocal processes in abduction, and a spindle-shaped glottal gap. Each subject completed three questionnaires: the Voice Handicap Index (VHI), with 30 and 10 questions, and the "Screening for voice disorders in older adults questionnaire" (RAVI). RESULTS The studied population included 174 Caucasian subjects (60 males; 114 females), with a mean age of 73.99 years (standard deviation = 6.37; range 65-95 years). Presbylarynx was identified in 71 patients (41%). Among patients with presbylarynx, a glottal gap was identified in 22 patients (31%). The mean score of VHI-30 between "no presbylarynx" and "presbylarynx" groups was statistically different (P < 0.001), with a higher score for subjects with signs of presbylarynx. The presence of glottal gap was associated to a higher mean score of VHI-30 (41.64 ± 11.87) (P < 0.001). The mean score of VHI-10 between "no presbylarynx" and "presbylarynx" groups was statistically different (P < 0.001), with a higher score for subjects with signs of presbylarynx. Among patients with presbylarynx, the presence of glottal gap was associated to higher mean score of VHI-10 (14.04 ± 3.91) (P < 0.001). There was a strong positive correlation between VHI-30 and VHI-10 (rs = 0.969; P < 0.001). The mean score of RAVI between "no presbylarynx" and "presbylarynx" groups was statistically different (P < 0.001), with a higher score for subjects with signs of presbylarynx. Among patients with presbylarynx, the presence of glottal gap was associated to a higher mean score of RAVI (11.68 ± 1.61) (P < 0.001). There was a strong positive correlation not only between RAVI and VHI-30 (rs = 0.922; P < 0.001), but also between RAVI and VHI-10 (rs = 0.906; P < 0.001). The optimal cut-off points to discriminate "no presbylarynx" from "presbylarynx", obtained by the Youden' index, were 3.5 for RAVI, 4.5 for VHI-30 and 1.5 for VHI-10. RAVI had the highest sensitivity and specificity. The optimal cut-off points to predict glottal gap, obtained by the Youden' index, were 9.5 for RAVI, 21 for VHI-30 and 7.5 for VHI-10. CONCLUSION The optimal cut-off points do discriminate "no presbylarynx" from "presbylarynx" were 3.5 for RAVI, 4.5 for VHI-30 and 1.5 for VHI-10. RAVI had the highest sensitivity and specificity, probably because it was designed specifically for vocal complaints of the elderly. Among patients with presbylarynx, cut-off points of 9.5 for RAVI, 21 for VHI-30 and 7.5 for VHI-10 were determined to predict patients with and without glottal gap. It was found a strong positive correlation between RAVI, VHI-30 and VHI-10. Thus, VHI-10 can be preferred to VHI-30 to assess voice impairment in clinical practice, because for elderly patients it is easier to answer. However, to predict endoscopic signs of presbylarynx, RAVI should be preferred.
Collapse
Affiliation(s)
- Mariline Santos
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal.
| | - Francisco Sousa
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal
| | - Sara Azevedo
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal
| | - Maria Casanova
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal
| | - Susana Vaz Freitas
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal; Faculdade de Ciências da Saúde - Universidade Fernando Pessoa, Porto, Portugal; LIAAD - Laboratório de Inteligência Artificial e Apoio à Decisão - INESCTEC, Porto, Portugal
| | - Cecília Almeida E Sousa
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal
| | - Álvaro Moreira da Silva
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Portugal
| |
Collapse
|
10
|
Psychological Distress in a Sample of Adult Italian Patients Affected by Vocal Nodules and Muscle-Tension Dysphonia: Preliminary Results. J Voice 2023; 37:300.e21-300.e29. [PMID: 33388226 DOI: 10.1016/j.jvoice.2020.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To evaluate the correlation between voice disorders and psychological distress, in terms of anxiety, stress, and depression, in a sample of adult Italian patients and to compare our results with those obtained in a group of adult healthy controls matched by age, sex, geographic distribution, and occupation. METHODS This prospective-controlled study included 100 adults with Vocal nodules (VN) and Muscle Tension Dysphonia (MTD1), aged between 18 and 65 years, as Experimental Group (EG) and 100 age-matched subjects without any voice disorders as a Control Group (CG). All patients in the EG underwent a phoniatric evaluation, including the administration of the Voice Handicap Index (VHI) and laryngeal examination. Both patients of EG and CG underwent a Psychological evaluation by means of standardized tests; Beck's Depression Inventory, State Anxiety Inventory (STAI 1-State Anxiety), Trait Anxiety Inventory (STAI 2- Trait Anxiety), and Perceived Stress Scale (PSS-10) were completed by patients. Fisher's exact test and chi-squared test were used to compare all categorical variables, whereas numerical variables were compared either with the nonparametric Mann-Whitney-Wilcoxon or with Kruskal Wallis test. General linear models were used to study continuous variables between patients and controls and between different groups within the sample. RESULTS In the study group, the Physical domain (P score) of the VHI was more affected than the Emotional (E score) and Functional ones (F score) both in patients with MTD1 and VN; patients with VN presented a significant difference in P score, E score and VHI total score than patients with isolated MTD 1 (P < 0.005). Psychological assessment showed a significant difference (P < 0.005) between VN and MTD 1 regarding PSS-10 and STAI-1 scores. Low Beck's Depression Inventory scores were present in our sample without significant differences between patients with VN and those with MTD 1. Scores related to psychological distress in the EG were far superior to those obtained by the healthy CG, with markedly significant values especially for PSS-10 (P < 0.0001) and STAI 2 (P < 0.01). Finally, younger patients (18-35 years) with VN showed a highest risk of psychosocial distress. CONCLUSION the present study identified a high prevalence of psychological distress among patients with vocal disorders without any prior specific psychiatric diagnosis, especially in terms of anxiety and perceived stress. For this reason both these symptoms should be taken into consideration in the diagnostic, therapeutic, and follow-up process of patients with MTD1 and VN.
Collapse
|
11
|
Sugito R, Yamauchi A, Sato T, Goto T, Ueha R, Nito T, Yamasoba T. Sex-and Age-Based Etiological Analysis of 2901 Patients With Dysphonia in a Japanese Tertiary Medical Institute. J Voice 2022:S0892-1997(22)00236-3. [PMID: 36085095 DOI: 10.1016/j.jvoice.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Societal aging is a grave concern in Japan, and its impact on voice clinics has not been investigated. This study aimed to clarify recent demographic features of geriatric dysphonia at a tertiary medical institute in Japan. STUDY DESIGN Retrospective study. METHODS The medical records of 2901 patients newly referred to the Voice Outpatient Clinic of the University of Tokyo Hospital between 2003 and 2020 were analyzed for age, sex, and etiology. RESULTS The mean ± standard deviation age of all patients was 53.2 ± 20.7 (median, 58; range, 0-95) years. The aging rate (ratio of patients aged ≥65 years) increased continuously during the study period, and the recent aging rate was the highest in the world (43%). However, its rate of increase has slowed over the past 10 years. The etiologies of dysphonia associated with the largest number of older patients were vocal fold immobility (32%), vocal fold atrophy (23%), and benign vocal fold lesions (11%). The highest aging rate was detected in patients with laryngeal cancer/leukoplakia, vocal tremor, vocal fold atrophy, sulcus vocalis, and vocal fold immobility. CONCLUSIONS Societal aging substantially increased the aging rate of patients with dysphonia in a Japanese voice clinic. The incidence of vocal fold immobility and atrophy is expected to continue to increase, whereas that of benign vocal fold lesions is expected to decrease.
Collapse
Affiliation(s)
- Ryosuke Sugito
- Department of Otolaryngology, Japanese Red Cross Medical Center, Shibuya-ku, Tokyo, Japan
| | - Akihito Yamauchi
- Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
| | - Taku Sato
- Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takao Goto
- Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Rumi Ueha
- Swallowing Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Takaharu Nito
- Department of Otolaryngology, Saitama Medical Center, Kawagoe-shi, Saitama, Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| |
Collapse
|
12
|
Alonso LAR, Fabbron EMG, Giacheti CM. Voice and Behavior of Children and Adolescents With Obesity: Integrative Literature Review. J Voice 2022:S0892-1997(22)00152-7. [PMID: 35810046 DOI: 10.1016/j.jvoice.2022.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To verify the relationship between obesity, voice and behavior in childhood and adolescence, through an integrative review. METHODS The researchers surveyed the articles indexed in the following databases: Embase, Web of Science, Scopus and Pubmed, using uniterms found in the Medical Subject Headings, related to the subject of the study, combined by the Boolean operators "and" and "or", published until January 2022. In the end, three reviewers selected the articles. RESULTS When searching for studies related to voice, obesity and behavior, 62 articles were found that did not meet the selection criteria and were excluded. Given this result, new searches were carried out with the following crossing strategies: voice and obesity and; Voice, Behavior and Child Behavior Checklist (CBCL). After the evaluation of the reviewers, two articles were selected referring to the intersection "voice and obesity in children and adolescents" and, two studies, in the intersection between "voice, behavior and CBCL". The first study on voice and obesity showed that the greater the abdominal circumference, the greater the maximum expiratory force and sound pressure found. The second study showed high Jitter and NHR values in obese children. Furthermore, studies on voice, behavior and CBCL showed that children with vocal nodules were more sociable than children without vocal nodules, and had behaviors described as "screams a lot" and "teases a lot". On the other hand, another study found potential risks of behavioral changes in the face of vocal complaints. CONCLUSIONS Although this literature review did not find studies associating obesity with vocal and behavioral disorders, the literature found showed the presence of vocal alteration in some acoustic parameters in obese children. Regarding voice, behavior and CBCL, two studies were found reporting the presence of behavioral changes in children with voice-related complaints, according to the opinion of their parents.
Collapse
Affiliation(s)
- Letícia Alvieri Riato Alonso
- Speech Language Pathology department, São Paulo State University (UNESP), Marília (SP), Brazil; São Paulo State University (UNESP), School of Philosophy and Sciences, Marília, Brazil.
| | - Eliana Maria Gradim Fabbron
- Speech Language Pathology department, São Paulo State University (UNESP), Marília (SP), Brazil; São Paulo State University (UNESP), School of Philosophy and Sciences, Marília, Brazil
| | - Célia Maria Giacheti
- Speech Language Pathology department, São Paulo State University (UNESP), Marília (SP), Brazil; São Paulo State University (UNESP), School of Philosophy and Sciences, Marília, Brazil
| |
Collapse
|
13
|
Desjardins M, Apfelbach C, Rubino M, Verdolini Abbott K. Integrative Review and Framework of Suggested Mechanisms in Primary Muscle Tension Dysphonia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1867-1893. [PMID: 35446683 PMCID: PMC9559660 DOI: 10.1044/2022_jslhr-21-00575] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/14/2021] [Accepted: 01/12/2022] [Indexed: 05/26/2023]
Abstract
PURPOSE Despite the high prevalence of primary muscle tension dysphonia (MTD-1), its underlying mechanisms and their interrelationships have yet to be fully identified. The objectives of this integrative review were (a) to describe and classify the suggested underlying mechanisms for MTD-1, (b) to appraise the empirical evidence supporting each of the proposed mechanisms, and (c) to summarize the information in an integrative model. METHOD PubMed, Scopus, and CINAHL were searched for all publications pertaining to muscle tension dysphonia. Papers were retained if they included theoretical or empirical data pertaining to underlying mechanisms of MTD-1. A total of 921 papers initially qualified for screening, of which 100 remained for consideration in this review. Underlying mechanisms of MTD-1 were extracted using a consensus approach. RESULTS Seven broad categories of putative mechanisms involved in MTD-1 were identified: psychosocial, autonomic, sensorimotor, respiratory, postural, inflammatory, and neuromuscular. These categories were further divided into 19 subcategories detailed in the body of this review article. Based on the reviewed evidence, our proposed integrative model presents MTD-1 as an idiosyncratic motor adaptation to physiological perturbation or perceived threat. Under this model, physiologically or psychologically aversive stimuli can instigate a series of motor adaptations at multiple levels of the nervous system, ultimately disturbing muscle activation patterns and their biomechanical outcomes. Importantly, these adaptations appear to have the potential to become chronic even after threatening stimuli are withdrawn. CONCLUSIONS The proposed model highlights the importance of personalized rehabilitation in MTD-1 treatment. Limitations of the literature are discussed to provide guidance for future research aimed at improving our understanding of MTD-1. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19586065.
Collapse
Affiliation(s)
- Maude Desjardins
- Department of Communication Sciences & Disorders, University of Delaware, Newark
| | | | - Marianna Rubino
- Department of Communication Sciences & Disorders, University of Delaware, Newark
| | | |
Collapse
|
14
|
White SW, Bock JM, Blumin JH, Friedland DR, Adams JA, Tong L, Osinski K, Luo J. Analysis of socioeconomic factors in laryngology clinic utilization for treatment of dysphonia. Laryngoscope Investig Otolaryngol 2022; 7:202-209. [PMID: 35155799 PMCID: PMC8823153 DOI: 10.1002/lio2.715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/08/2021] [Accepted: 11/16/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To evaluate the association between patient socioeconomic and demographic factors and tertiary care utilization for dysphonia in a localized metropolitan area of the American Midwest. METHODS Multivariate regression analysis was used to correlate patient demographics and population level data (e.g., age, gender, race, insurance, median income, education level) with tertiary laryngology utilization for dysphonia care at our institution between 2000 and 2019. Initial analyses characterized tertiary laryngology utilization rates for all regional ZIP codes and correlated these data with census information for household income and education. Dysphonia patient demographics were compared among populations cared for in our entire academic Otolaryngology department, our health system, and the regional population. RESULTS Among 1,365,021 patients in our health system, there were 7066 tertiary laryngology visits with a diagnosis of dysphonia. Dysphonia patients as compared to the overall health system were older (62.0 vs. 50.8 years), more likely to be female (63.7 vs. 50.2%) and more likely to have insurance (98.4 vs. 87.5%, all p < .001). Patient and population-level factors including insurance status, education, and black race showed positive correlation with laryngology utilization while median income did not. CONCLUSIONS AND RELEVANCE Insurance status, education level, and race correlated with utilization of tertiary laryngology services for the evaluation of dysphonia in our community, while median income did not. Black patients utilized tertiary laryngology care at higher rates compared to departmental and regional population utilization data. These results underscore important demographic and disease-specific factors that may affect utilization of subspecialty care in Otolaryngology. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Shane W. White
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jonathan M. Bock
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Joel H. Blumin
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - David R. Friedland
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jazzmyne A. Adams
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Ling Tong
- Department of Health Informatics and AdministrationUniversity of Wisconsin – MilwaukeeMilwaukeeWisconsinUSA
| | - Kristen Osinski
- Clinical and Translational Science InstituteMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jake Luo
- Department of Health Informatics and AdministrationUniversity of Wisconsin – MilwaukeeMilwaukeeWisconsinUSA
| |
Collapse
|
15
|
Presbylarynx: is diabetes mellitus a risk factor for vocal atrophy? A prospective case control study. The Journal of Laryngology & Otology 2021; 136:871-874. [PMID: 34819185 DOI: 10.1017/s0022215121003637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
16
|
Rodrigues Dias D, Santos M, Sousa F, Azevedo S, Sousa E Castro S, Freitas S, Almeida E Sousa C, Moreira da Silva Á. How do presbylarynx and presbycusis affect the Voice Handicap Index and the emotional status of the elderly? A prospective case-control study. J Laryngol Otol 2021; 135:1-6. [PMID: 34579801 DOI: 10.1017/s0022215121002528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the influence of presbylarynx and presbycusis on Voice Handicap Index and emotional status. METHODS A case-control, prospective, observational, cross-sectional study was conducted of patients aged 65 years or older referred to an otorhinolaryngology department from January to September 2020. Presbycusis was assessed by pure tone and vocal audiometry. Each subject underwent fibre-optic videolaryngoscopy with stroboscopy, and presbylarynx was considered when two or more of the following endoscopic findings were identified: vocal fold bowing, prominence of vocal processes in abduction, and a spindle-shaped glottal gap. Each subject completed two questionnaires: Voice Handicap Index and Geriatric Depression Scale (short-form). RESULTS The studied population included 174 White European subjects, with a mean age of 73.99 years, of whom 22.8 per cent presented both presbylarynx and presbycusis. Multivariate linear regression revealed that only presence and severity of presbylarynx had an influence on Voice Handicap Index-30 scores. However, both spindle-shaped glottal gap and presbycusis influenced Geriatric Depression Scale scores. CONCLUSION Presbylarynx has a strong association with the impact of voice on quality of life. Presbylarynx and presbycusis seem to have a cumulative effect on emotional status.
Collapse
Affiliation(s)
- D Rodrigues Dias
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - M Santos
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - F Sousa
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - S Azevedo
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - S Sousa E Castro
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - S Freitas
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal
| | - C Almeida E Sousa
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - Á Moreira da Silva
- Department of Intensive Care Unit, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| |
Collapse
|
17
|
Chung TK, Hu A, Sardesai MG, Wilcox H, Jiang L, Meyer TK. Evaluating the Effect of Recurrent Respiratory Papillomatosis on Work Productivity. Ann Otol Rhinol Laryngol 2021; 131:709-714. [PMID: 34416839 DOI: 10.1177/00034894211040900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Patients with recurrent respiratory papillomatosis (RRP) have significant vocal dysfunction which affects their performance at work. This study aimed to evaluate voice-related work productivity before and after ablative treatment for RRP. METHODS This is a prospective case series conducted at 2 academic laryngology outpatient clinics. Adult employed patients with RRP completed the Work Productivity & Activity Impairment instrument (WPAI), Voice Handicap Index (VHI-10), WorkHoarse, Hospital Anxiety and Depression Scale (HADS), and a demographics questionnaire immediately before and 1 month after ablative treatment of papilloma. The primary outcome measure was the change in work productivity impairment domain of the WPAI, and changes in ratings before and after ablation were compared using a Wilcoxon Signed-Rank test. RESULTS The 32 participants (mean age 45, 84% male) had a median (interquartile range) voice-related work productivity impairment score of 48.8% (30.0) at baseline which was improved to 5.0% (10.0) at 1 month after surgical ablation of papillomata (difference 30.0% (30.0) improvement). For the secondary outcome measures, there were significant improvements in VHI-10 (P < .001), self-reported voice quality (P = .002), and Workhoarse (P = .001), but no significant change in HADS. CONCLUSION Patients with RRP experience significant voice-related work productivity impairment, and ablation of papillomata significantly improves work productivity.
Collapse
Affiliation(s)
- Thomas K Chung
- Department of Otolaryngology & Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Amanda Hu
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Maya G Sardesai
- Department of Otolaryngology Head and Neck Surgery, University of Washington, Seattle, WA, USA
| | - Haley Wilcox
- Department of Otolaryngology Head and Neck Surgery, University of Washington, Seattle, WA, USA
| | - Lan Jiang
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt Medical Center, Nashville, TN, USA
| | - Tanya K Meyer
- Department of Otolaryngology Head and Neck Surgery, University of Washington, Seattle, WA, USA
| |
Collapse
|
18
|
Vilaseca I, Hidalgo J, Cámara A, Compta Y, Martí MJ. Non-motor symptoms in spasmodic dysphonia: A case control-study. Auris Nasus Larynx 2021; 49:100-105. [PMID: 34092434 DOI: 10.1016/j.anl.2021.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/30/2021] [Accepted: 05/18/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Non-motor symptoms (NMS) have been identified in some focal adult-onset dystonia. In the present study we aimed to evaluate the presence of NMS in patients with spasmodic dysphonia (SD), a focal action-induced dystonia that affects intrinsic laryngeal muscle control. METHODS Seventeen SD patients and 17 control subjects not significantly different in age and sex were evaluated for the presence of NMS. Additionally, voice handicap index (VHI-10), reflux symptom index, neuropsychiatric symptoms and QoL were assessed by validated scales and questionnaires. RESULTS Patients' group significantly differed from control group in mild depressive symptoms (4.35 ± 3.9 vs. 1.47 ± 2; p=0.01), insomnia (35.3% vs. 14.7%; p=0.016), smell and taste loss (11.8% vs. 0%; p=0.033), swallowing difficulties (17.6% vs. 0%; p=0.007) and throat pain (17.6% vs. 0%; p=0.007). In the group of SD, there was no correlation between voice perception evaluated by VHI-10, number of NMS or QoL. CONCLUSION Patients with SD have a greater burden of depressive, smell, taste, and sleep NMS than control subjects.
Collapse
Affiliation(s)
- Isabel Vilaseca
- Otorhinolaryngology Department, Hospital Clínic, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Agustí Pi Sunyer (IDIBAPS), Barcelona, Spain; CIBERNED: CB06/05/0018-ISCIII, ERN-RND (ID No 739510), Barcelona, Spain.
| | - Judit Hidalgo
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Ana Cámara
- Institut d'Investigació Biomèdica Agustí Pi Sunyer (IDIBAPS), Barcelona, Spain; CIBERNED: CB06/05/0018-ISCIII, ERN-RND (ID No 739510), Barcelona, Spain; Parkinson's disease and Movement Disorders Unit, Neurology Service, Hospital Clinic Barcelona, Universitat de Barcelona
| | - Yaroslau Compta
- Institut d'Investigació Biomèdica Agustí Pi Sunyer (IDIBAPS), Barcelona, Spain; CIBERNED: CB06/05/0018-ISCIII, ERN-RND (ID No 739510), Barcelona, Spain; Parkinson's disease and Movement Disorders Unit, Neurology Service, Hospital Clinic Barcelona, Universitat de Barcelona
| | - María José Martí
- Institut d'Investigació Biomèdica Agustí Pi Sunyer (IDIBAPS), Barcelona, Spain; CIBERNED: CB06/05/0018-ISCIII, ERN-RND (ID No 739510), Barcelona, Spain; Parkinson's disease and Movement Disorders Unit, Neurology Service, Hospital Clinic Barcelona, Universitat de Barcelona
| |
Collapse
|
19
|
Nguyen-Feng VN, Frazier PA, Roy N, Cohen S, Misono S. Perceived Control, Voice Handicap, and Barriers to Voice Therapy. J Voice 2021; 35:326.e13-326.e19. [PMID: 31604609 PMCID: PMC7138698 DOI: 10.1016/j.jvoice.2019.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To characterize the associations of perceived control with voice outcomes and self-reported likelihood of attending voice therapy using a national practice-based research network. STUDY DESIGN Cross-sectional study of prospectively enrolled adult patients seen for dysphonia. SETTING Creating Healthcare Excellence through Education and Research (CHEER) network of community and academic practice sites. SUBJECTS AND METHODS Data collected included patient-reported demographics, outcome measures of voice (Voice Handicap Index-10), perceived control (present control subscale of voice-specific Perceived Control over Stressful Events Scale), personality (Ten Item Personality Inventory), likelihood of attending voice therapy if recommended, and barriers to attending voice therapy. RESULTS Patients (N = 247) were enrolled over 12 months from 10 sites, of whom 170 received a recommendation for voice therapy. The majority (85%) of this group planned to attend voice therapy. Voice-specific perceived control and VHI-10 were inversely related (r = -0.31, P < 0.001), even when controlling for personality. No study variables were associated with self-reported likelihood of attending voice therapy, but perceived control was the most consistent correlate of specific barriers to attending voice therapy (eg, "hard to translate into everyday use") and was inversely related to these barriers. CONCLUSIONS Patients scoring higher on a voice-specific measure of perceived control reported less voice handicap, independent of personality, and higher perceived control was associated with having fewer concerns about voice therapy goals and process. Perceived control is a potential target for intervention in patients with voice disorders.
Collapse
Affiliation(s)
| | - Patricia A Frazier
- Department of Psychology, College of Liberal Arts, University of Minnesota Twin Cities, Minneapolis, Minnesota
| | - Nelson Roy
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah
| | - Seth Cohen
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina
| | - Stephanie Misono
- Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota.
| |
Collapse
|
20
|
Piersiala K, Akst LM, Hillel AT, Best SR. Chronic Pain Syndromes and Their Laryngeal Manifestations. JAMA Otolaryngol Head Neck Surg 2021; 146:543-549. [PMID: 32352483 DOI: 10.1001/jamaoto.2020.0530] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), and chronic fatigue syndrome (CFS) are traditionally considered as distinct entities grouped under chronic pain syndrome (CPS) of an unknown origin. However, these 3 disorders may exist on a spectrum with a shared pathophysiology. Objective To investigate whether the clinical presentation of FMS, IBS, and CFS is similar in a population presenting with voice and laryngeal disorders. Design, Setting, and Participants This case series was a retrospective review of the medical records and clinical notes of patients treated between January 1, 2016, and December 31, 2017, at the Johns Hopkins Voice Center in Baltimore, Maryland. Patients with at least 1 CPS of interest (FMS, IBS, or CFS) were included (n = 215), along with patients without such diagnoses (n = 4034). Diagnoses, demographic, and comorbidity data were reviewed. Diagnoses related to voice and laryngeal disorders were subdivided into 5 main categories (laryngeal pathology, functional voice disorders, airway problems, swallowing problems, and other diagnoses). Main Outcomes and Measures Prevalence and odds ratios of 45 voice and laryngeal disorders were reviewed. Odds ratios (ORs) were calculated by comparing patients with CPS with control patients. Results In total, 4249 individuals were identified; 215 (5.1%) had at least 1 CPS and 4034 (94.9%) were control participants. Patients with CPS were 3 times more likely to be women compared with the control group (173 of 215 [80.5%] vs 2318 of 4034 [57.5%]; OR, 3.156; 95% CI, 2.392-4.296), and the CPS group had a mean (SD) age of 57.80 (15.30) years compared with the mean (SD) age of 55.77 (16.97) years for the control group. Patients with CPS were more likely to present with functional voice disorders (OR, 1.812; 95% CI, 1.396-2.353) and less likely to present with laryngeal pathology (OR, 0.774; 95% CI, 0.610-0.982) or airway problems (OR, 0.474; 95% CI, 0.285-0.789). Conclusions and Relevance The voice and airway presentation of patients with FMS, IBS, and/or CFS appears to be indistinguishable from each other. This finding suggests that these 3 diseases share upper airway symptoms.
Collapse
Affiliation(s)
- Krzysztof Piersiala
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland.,Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Lee M Akst
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Alexander T Hillel
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Simon R Best
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
21
|
Korean Voice Catastrophization Index (K-VCI): Validation of the Voice Catastrophization Index for Koreans. J Voice 2021; 35:160.e7-160.e13. [DOI: 10.1016/j.jvoice.2019.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 11/22/2022]
|
22
|
Ryu CH, Kwon TK, Kim H, Kim HS, Park IS, Woo JH, Lee SH, Lee SW, Lim JY, Kim ST, Jin SM, Choi SH. Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics. Clin Exp Otorhinolaryngol 2020; 13:340-360. [PMID: 32877965 PMCID: PMC7669319 DOI: 10.21053/ceo.2020.00409] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/13/2020] [Indexed: 01/08/2023] Open
Abstract
The Korean Society of Laryngology, Phoniatrics and Logopedics appointed a task force to establish clinical practice guidelines for the management of unilateral vocal fold paralysis (UVFP). These guidelines cover a comprehensive range of management-related factors, including the diagnosis and treatment of UVFP, and provide in-depth information based on current, up-to-date knowledge. Detailed evidence profiles are provided for each recommendation. The CORE databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers, using a predefined search strategy. When insufficient evidence existed, expert opinions and Delphi questionnaires were used to fill the evidence gap. The committee developed 16 evidence-based recommendations in six categories: initial evaluation (R1–4), spontaneous recovery (R5), medical treatment (R6), surgical treatment (R7–14), voice therapy (R15), and aspiration prevention (R16). The goal of these guidelines is to assist general otolaryngologists and speech-language pathologists who are primarily responsible for treating patients with UVFP. These guidelines are also intended to facilitate understanding of the condition among other health-care providers, including primary care physicians, nurses, and policy-makers.
Collapse
Affiliation(s)
| | | | - Chang Hwan Ryu
- Department of Otorhinolaryngology-Head Neck Surgery, National Cancer Center, Goyang, Korea
| | - Tack-Kyun Kwon
- Department of Otorhinolaryngology-Head Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Heejin Kim
- Department of Otorhinolaryngology-Head Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Han Su Kim
- Department of Otorhinolaryngology-Head Neck Surgery, Ewha Womans University College of Medcine, Seoul, Korea
| | - Il-Seok Park
- Department of Otorhinolaryngology-Head Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Joo Hyun Woo
- Department of Otorhinolaryngology-Head Neck Surgery, Gachon University College of Medicine, Incheon, Korea
| | - Sang-Hyuk Lee
- Department of Otorhinolaryngology-Head Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Won Lee
- Department of Otorhinolaryngology-Head Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology-Head Neck Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Seong-Tae Kim
- Department of Speech-Language Pathology, Dongshin University, Naju, Korea
| | - Sung-Min Jin
- Department of Otorhinolaryngology-Head Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Ho Choi
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
23
|
Sheyona V, Devadas U. The Prevalence and Impact of Voice Problems in Nonprofessional Voice Users: Preliminary Findings. J Voice 2020; 36:383-388. [PMID: 32660848 DOI: 10.1016/j.jvoice.2020.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/30/2020] [Accepted: 06/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Studies reporting the prevalence of voice problems in the non-professional voice users are rare. Thus, the objective of this preliminary investigation was to explore; (1) the prevalence of self-reported voice problems, and (2) its impact on the nonprofessional voice users. METHOD This was a cross-sectional survey that was distributed to 500 nonprofessional voice users working in different educational institutions in the Manipal city of Karnataka state, India. The results of the study are discussed based on the 426 qualified questionnaire responses. RESULTS The lifetime prevalence of voice problem was 21.6% (n = 92), with 4.9% (n = 21) of the participants reporting it on the day of the survey. The self-reported prevalence of voice problems was significantly higher (P = 0.001) in female (64%, n = 59) as compared to male participants (35.8%, n = 33). Voice problems affected job performance by 34.7% (n = 32) and caused work absenteeism in 11.9% (n = 11). CONCLUSIONS The results of this preliminary study indicated that a significant number of nonprofessional voice users suffer from voice problems, and it has a significant impact on their job performance. Hence, in future large scale, epidemiological studies are needed with randomly selected samples of different age groups, gender, income status, educational level, area of residence to understand the possible risk factors, and impact of voice problem on the quality of life in general working and not working nonprofessional voice users in India.
Collapse
Affiliation(s)
- Valson Sheyona
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Usha Devadas
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| |
Collapse
|
24
|
The Aging Voice. CURRENT OTORHINOLARYNGOLOGY REPORTS 2020. [DOI: 10.1007/s40136-020-00285-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
25
|
Lee YC, Chen VCH, Yang YH, Kuo TY, Hung TH, Cheng YF, Huang KY. Association Between Emotional Disorders and Speech and Language Impairments: A National Population-Based Study. Child Psychiatry Hum Dev 2020; 51:355-365. [PMID: 31802296 DOI: 10.1007/s10578-019-00947-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Anxiety and depression are common emotional problems in children and adolescents. This study used a long-term tracking large database to investigate whether the proportion of children who were diagnosed with speech and language impairments were later diagnosed with anxiety or depression were significantly greater than that of matched group of the same age and gender without speech and language impairments. More than 4300 eligible children with speech and language impairments and matched controls were identified and assessed for anxiety and depression. The risk of anxiety and depressive disorders in children with speech and language impairments were examined with Cox regression analyses and adjusting for covariables (gender, age, and comorbidities). The results showed that speech and language impairments were positively associated with anxiety disorders (adjusted hazard ratio [AHR] 2.87, 95% confidence interval [CI] 2.20-3.76) and depressive disorders (AHR 2.51, 95% CI 1.52-4.13). The number of boys with speech and language impairments was more than twofold that of girls, but boys did not different from girls in the risk of anxiety disorders (AHR 0.95, 95% CI 0.75-1.20) and depressive disorders (AHR 0.72, 95% CI 0.47-1.11). Infantile autism and intellectual disabilities were positively associated with anxiety (AHR 1.54, 95% CI 1.07-2.21; AHR 1.47, 95% CI 1.09-1.98), and the latter was positively associated with depression (AHR 1.83, 95% CI 1.06-3.17). In addition to speech and language impairments interventions, our findings supported the necessity of identification and interventions in anxiety and depressive disorders among children with speech and language impairments from elementary school until youth.
Collapse
Affiliation(s)
- Yi-Chen Lee
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yao-Hsu Yang
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ting-Yu Kuo
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Tai-Hsin Hung
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Chang Gung Institute of Technology, Taoyuan, Taiwan
| | - Yu-Fang Cheng
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Applied Science (Occupational Therapy), University of Western Sydney, Sydney, Australia
| | - Kuo-You Huang
- Department of Speech Language Pathology and Audiology, Chung Shan Medical University and Hospital, No. 110, Sec. 1, Jianguo N. Rd, Taichung, 40201, Taiwan.
- Speech and Language Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan.
| |
Collapse
|
26
|
Liu DT, Besser G, Leonhard M, Bartosik TJ, Parzefall T, Brkic FF, Mueller CA, Riss D. Seasonal Variations in Public Inquiries into Laryngitis: An Infodemiology Study. J Voice 2020; 36:98-105. [PMID: 32439216 DOI: 10.1016/j.jvoice.2020.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Acute laryngitis is a common disease with self-limiting nature. Since the leading cause is attributed to viral infections and thus self-limiting, many affected individuals do not seek professional medical help. However, because the major symptom of hoarseness imposes a substantial burden in everyday life, it might be speculated that web-based search interest on this condition follows incidence rates, with highest peaks during winter months. The aim of this study was to evaluate global public health-information seeking behaviour on laryngitis-related search terms. METHODS We utilized Google Trends to assess country-specific, representative laryngitis-related search terms for English and non-English speaking countries of both hemispheres. Extracted time series data from Australia, Brazil, Canada, Germany, the United Kingdom, and the United States of America, covering a timeframe between 2004 and 2019 were first assessed for reliability, followed by seasonality analysis using the cosinor model. RESULTS Direct comparisons revealed different, representative laryngitis-related search terms for English- and non-English speaking countries. Extracted data showed a trend of higher reliability in countries with more inhabitants. Subsequent graphical analysis revealed winter peaks in all countries from both hemispheres. Cosinor analysis confirmed these seasonal variations to be significant (all P < 0.001). CONCLUSION Public interest in laryngitis-related, online health information displayed seasonal variations in countries from both hemispheres, with highest interest during winter months. These findings emphasize the importance to optimize the distribution of reliable, web-based health education in order to prevent the spread of misinformation and to improve health literacy among general populations.
Collapse
Affiliation(s)
- David Tianxiang Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
| | - Gerold Besser
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Matthias Leonhard
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Tina Josefin Bartosik
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Thomas Parzefall
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Faris F Brkic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Christian Albert Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Dominik Riss
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
27
|
Santos M, Freitas SV, Dias D, Costa J, Coutinho M, Sousa CA, da Silva ÁM. Presbylarynx: Does Body Muscle Mass Correlate With Vocal Atrophy? A Prospective Case Control Study. Laryngoscope 2020; 131:E226-E230. [PMID: 32401382 DOI: 10.1002/lary.28685] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/19/2020] [Accepted: 03/27/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To analyze the potential association between body muscle mass and presbylarynx. METHODS Study performed on subjects referred to the otorhinolaryngology department in a tertiary center between January and September 2019 . Based on endoscopic findings of the larynx, the patients were subdivided into two main groups: presbylarynx versus no presbylarynx. Data regarding gender, body composition, self-assessment of vocal complaints, and functional assessment were collected. STUDY DESIGN Case control, prospective, observational and cross-sectional. RESULTS The study population included a total of 115 Caucasian subjects (43 males; 72 females). Presbylarynx was identified in 43 patients (37, 39%) with no statistically predilection by gender (P = .668). The mean age of the patients with presbylarynx was slightly higher, but differences between groups were not statistically significant (P = .072). Results showed an association between functional impairment (score 4 of Katz Index and score 5 of Functional Ambulation Classification) and presence of presbylarynx (P < .001). Additionally, a positive association between the absence of presbylarynx and sport activity was also observed (P < .001). The mean value of muscle mass between presbylarynx and no presbylarynx groups was statistically different (P < .01), with a lower mean for subjects with presbylarynx. CONCLUSION This case control prospective study confirms that the general age-related degeneration of body muscle mass might play an important role in the course of presbylarynx. In the future, preventing strategies based on regular sport activities and improvements on functional status can play an important role in the management of aging voice. LEVEL OF EVIDENCE 2b Laryngoscope, 131:E226-E230, 2021.
Collapse
Affiliation(s)
- Mariline Santos
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Susana V Freitas
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.,Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal
| | - David Dias
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Joana Costa
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Miguel Coutinho
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Cecília A Sousa
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Álvaro M da Silva
- Serviço de Cuidados Intensivos do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| |
Collapse
|
28
|
Jordan VA, Cohen S, Lunos S, Horvath KJ, Sieger G, Misono S. Mental Health and Dysphonia: Which Comes First, and Does That Change Care Utilization? Laryngoscope 2020; 130:1243-1248. [PMID: 32034963 PMCID: PMC7269068 DOI: 10.1002/lary.28203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/22/2019] [Accepted: 07/09/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Voice patients with voice disorders have a high prevalence of distress and mental health (MH) comorbidities, but it is unknown to what extent distress precedes or follows voice disorder diagnoses. Objectives were to compare 1) proportions of voice patients with MH diagnoses who received MH diagnoses first versus voice-related diagnoses first, 2) voice-related diagnoses and care utilization, and 3) time to specialty evaluation in each group. METHODS Patients with voice and MH diagnoses were identified using International Classification of Diseases, Ninth and Tenth Revisions codes in a large health system data repository from January 2005 through July 2017. Sociodemographics, comorbidities, MH- and voice-related diagnoses, and voice-related care utilization were analyzed using descriptive statistics and multivariable regression modeling. RESULTS Among the 11,419 patients with both voice and MH diagnoses, 63% (n = 7,251) received MH diagnoses prior to voice diagnoses, compared with 37% with a voice diagnosis first (P < 0.0001). The latter group received more specific voice-related diagnoses (e.g., laryngeal cancer [odds ratio (OR) 4.27], benign laryngeal neoplasm [OR 1.60]), and were more likely to ever see an otolaryngologist than those receiving MH diagnoses first (P < 0.0001). CONCLUSION Most patients with voice and MH diagnoses received a MH diagnosis first. Patients who receive MH diagnoses first appeared to have different voice-related healthcare compared to those who received voice diagnoses first. LEVEL OF EVIDENCE NA Laryngoscope, 130:1243-1248, 2020.
Collapse
Affiliation(s)
| | - Seth Cohen
- Duke Voice Care Center, Division of Otolaryngology – Head & Neck Surgery, Duke University Medical Center, Durham, NC
| | - Scott Lunos
- University of Minnesota, Clinical and Translational Science Institute, Biostatistical Design and Analysis Center
| | - Keith J. Horvath
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health
| | - Gretchen Sieger
- University of Minnesota, Clinical and Translational Science Institute, Best Practices Integrated Informatics Core
| | - Stephanie Misono
- University of Minnesota, Dept of Otolaryngology- Head and Neck Surgery
| |
Collapse
|
29
|
Chen Y, Li Z, Chang S, Rousseau B, Luo H. A reduced-order flow model for vocal fold vibration: from idealized to subject-specific models. JOURNAL OF FLUIDS AND STRUCTURES 2020; 94:102940. [PMID: 32210520 PMCID: PMC7093056 DOI: 10.1016/j.jfluidstructs.2020.102940] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We present a reduced-order model for fluid-structure interaction (FSI) simulation of vocal fold vibration during phonation. This model couples the three-dimensional (3D) tissue mechanics and a one-dimensional (1D) flow model that is derived from the momentum and mass conservation equations for the glottal airflow. The effects of glottal entrance and pressure loss in the glottis are incorporated in the flow model. We consider both idealized vocal fold geometries and subject-specific anatomical geometries segmented from the MRI images of rabbits. For the idealized vocal fold geometries, we compare the simulation results from the 1D/3D hybrid FSI model with those from the full 3D FSI simulation based on an immersed-boundary method. For the subject-specific geometries, we incorporate previously estimated tissue properties for individual samples and compare the results with those from the high-speed imaging experiment of in vivo phonation. In both setups, the comparison shows good agreement in the vibration frequency, amplitude, phase delay, and deformation pattern of the vocal fold, which suggests potential application of the present approach for future patient-specific modeling.
Collapse
Affiliation(s)
- Ye Chen
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235-1592
| | - Zheng Li
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235-1592
| | - Siyuan Chang
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235-1592
| | - Bernard Rousseau
- Department of Communication Science and Disorders, University of Pittsburgh
| | - Haoxiang Luo
- Department of Mechanical Engineering, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235-1592
| |
Collapse
|
30
|
Jordan VA, Lunos S, Sieger G, Horvath KJ, Cohen S, Misono S. Association of voice and mental health diagnoses with differences in voice-related care utilization. Laryngoscope 2019; 130:1496-1502. [PMID: 31508825 DOI: 10.1002/lary.28277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/25/2019] [Accepted: 08/19/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To compare healthcare utilization in voice patients with versus without mental health (MH) diagnoses STUDY DESIGN: Retrospective study using electronic medical records from large regional healthcare system. METHODS We examined data on sociodemographic characteristics, comorbidities, voice-related diagnoses, and patterns of healthcare utilization (including medication use, tests and procedures, and outpatient visits). The study period spanned January 2005 through June 2017. RESULTS A total of 24,672 patients had at least one voice-related diagnosis. Of these, 11,483 (47%) also had at least one MH diagnosis compared to 14% in the overall repository (P < 0.0001). The most common voice-related diagnoses were nonspecific dysphonia (80%), acute laryngitis (30%), and vocal fold paresis/paralysis (7%). The 11,483 patients with both voice-related and MH diagnoses were more likely to have acute laryngitis and/or nonspecific dysphonia; less likely to have laryngeal cancer and/or paresis/paralysis; and more likely to have seen a primary care provider, to have received medications, and to have undergone radiology studies. In contrast, the 13,189 patients with only voice-related diagnoses had more overall voice-related visits, were more likely to have seen an otolaryngologist, and were more likely to have undergone a voice evaluation with a speech language pathologist. CONCLUSION Voice patients with MH diagnoses were less likely to see otolaryngology and more likely to have radiology studies than voice patients without MH diagnoses. Further study is warranted to characterize temporal sequences of care in this group of patients and determine whether these differences are attributable to referral patterns from primary care. LEVEL OF EVIDENCE 4 Laryngoscope, 130:1496-1502, 2020.
Collapse
Affiliation(s)
- Victoria A Jordan
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Gretchen Sieger
- Best Practices Integrated Informatics Core, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Keith J Horvath
- Department of Psychology at San Diego State University, San Diego, Minnesota, CA
| | - Seth Cohen
- Duke Voice Care Center, Division of Otolaryngology-Head & Neck Surgery, Duke University Medical Center, Durham, North Carolina, U.S.A
| | - Stephanie Misono
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
| |
Collapse
|
31
|
Stachler RJ, Francis DO, Schwartz SR, Damask CC, Digoy GP, Krouse HJ, McCoy SJ, Ouellette DR, Patel RR, Reavis CCW, Smith LJ, Smith M, Strode SW, Woo P, Nnacheta LC. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update) Executive Summary. Otolaryngol Head Neck Surg 2019; 158:409-426. [PMID: 29494316 DOI: 10.1177/0194599817751031] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective This guideline provides evidence-based recommendations on treating patients presenting with dysphonia, which is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication and/or quality of life. Dysphonia affects nearly one-third of the population at some point in its life. This guideline applies to all age groups evaluated in a setting where dysphonia would be identified or managed. It is intended for all clinicians who are likely to diagnose and treat patients with dysphonia. Purpose The primary purpose of this guideline is to improve the quality of care for patients with dysphonia, based on current best evidence. Expert consensus to fill evidence gaps, when used, is explicitly stated and supported with a detailed evidence profile for transparency. Specific objectives of the guideline are to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm. For this guideline update, the American Academy of Otolaryngology-Head and Neck Surgery Foundation selected a panel representing the fields of advanced practice nursing, bronchoesophagology, consumer advocacy, family medicine, geriatric medicine, internal medicine, laryngology, neurology, otolaryngology-head and neck surgery, pediatrics, professional voice, pulmonology, and speech-language pathology. Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should assess the patient with dysphonia by history and physical examination to identify factors where expedited laryngeal evaluation is indicated. These include but are not limited to recent surgical procedures involving the head, neck, or chest; recent endotracheal intubation; presence of concomitant neck mass; respiratory distress or stridor; history of tobacco abuse; and whether the patient is a professional voice user. (2) Clinicians should advocate voice therapy for patients with dysphonia from a cause amenable to voice therapy. The guideline update group made recommendations for the following KASs: (1) Clinicians should identify dysphonia in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces quality of life (QOL). (2) Clinicians should assess the patient with dysphonia by history and physical examination for underlying causes of dysphonia and factors that modify management. (3) Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected. (4) Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/communicate the results to the speech-language pathologist (SLP). (5) Clinicians should advocate for surgery as a therapeutic option for patients with dysphonia with conditions amenable to surgical intervention, such as suspected malignancy, symptomatic benign vocal fold lesions that do not respond to conservative management, or glottic insufficiency. (6) Clinicians should offer, or refer to a clinician who can offer, botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia. (7) Clinicians should inform patients with dysphonia about control/preventive measures. (8) Clinicians should document resolution, improvement or worsened symptoms of dysphonia, or change in QOL of patients with dysphonia after treatment or observation. The guideline update group made a strong recommendation against 1 action: (1) Clinicians should not routinely prescribe antibiotics to treat dysphonia. The guideline update group made recommendations against other actions: (1) Clinicians should not obtain computed tomography (CT) or magnetic resonance imaging (MRI) for patients with a primary voice complaint prior to visualization of the larynx. (2) Clinicians should not prescribe antireflux medications to treat isolated dysphonia, based on symptoms alone attributed to suspected gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR), without visualization of the larynx. (3) Clinicians should not routinely prescribe corticosteroids in patients with dysphonia prior to visualization of the larynx. The policy level for the following recommendation about laryngoscopy at any time was an option: (1) Clinicians may perform diagnostic laryngoscopy at any time in a patient with dysphonia. Differences from Prior Guideline (1) Incorporating new evidence profiles to include the role of patient preferences, confidence in the evidence, differences of opinion, quality improvement opportunities, and any exclusion to which the action statement does not apply (2) Inclusion of 3 new guidelines, 16 new systematic reviews, and 4 new randomized controlled trials (3) Inclusion of a consumer advocate on the guideline update group (4) Changes to 9 KASs from the original guideline (5) New KAS 3 (escalation of care) and KAS 13 (outcomes) (6) Addition of an algorithm outlining KASs for patients with dysphonia.
Collapse
Affiliation(s)
| | | | | | | | - German P Digoy
- 5 Oklahoma State University, Oklahoma City, Oklahoma, USA
| | - Helene J Krouse
- 6 University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | | | | | | | | | - Libby J Smith
- 11 University of Pittsburgh Medical, Pittsburgh, Pennsylvania, USA
| | - Marshall Smith
- 12 University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | - Peak Woo
- 14 Icahn School of Medicine at Mt Sinai, New York, New York, USA
| | - Lorraine C Nnacheta
- 15 Department of Research and Quality, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| |
Collapse
|
32
|
Nguyen-Feng VN, Frazier PA, Stockness A, Narayanan A, Merians AN, Misono S. Web-Based Perceived Present Control Intervention for Voice Disorders: A Pilot Study. J Voice 2018; 34:300.e1-300.e9. [PMID: 30227981 DOI: 10.1016/j.jvoice.2018.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/05/2018] [Accepted: 08/09/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Voice disorders are common and negatively affect various life domains such as occupational functioning and emotional well-being. Perceived present control, a factor that is amenable to change, may reduce the effect of voice disorders on these outcomes. This pilot study aimed to (1) establish the feasibility, usability, and acceptability of a web-based perceived present control intervention for individuals with voice disorders and (2) gather preliminary data on the effectiveness of the intervention. This study is the first to assess whether a web-based psychological intervention would decrease self-reported voice handicap in this population. METHODS Participants (N = 20) were recruited from an otolaryngology clinic at a large, Midwest university and the surrounding urban community, and completed a 3-week web-based intervention that incorporated psychoeducation and written exercises on increasing perceived present control. RESULTS Supporting feasibility, the intervention components had high completion rates (75%-95%). Most participants planned to continue the perceived control exercises after study completion and would recommend the intervention to others, demonstrating usability and acceptability. There was a significant decrease in self-reported voice handicap (Voice Handicap Index-10) from pretest (M = 18.38, standard deviation = 4.41) to post-test (M = 15.22, standard deviation = 4.55) with a large effect size (within-group d = -0.86, P < 0.05). CONCLUSIONS Focusing on perceived present control as a teachable skill may be a useful addition to voice disorder treatment armamentarium. Future studies will incorporate a comparison group and larger sample sizes to assess further the role of perceived present control interventions in voice care.
Collapse
Affiliation(s)
- Viann N Nguyen-Feng
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota; Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Patricia A Frazier
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota; Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Ali Stockness
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota; Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Arvind Narayanan
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota; Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Addie N Merians
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota; Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Stephanie Misono
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota; Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota.
| |
Collapse
|
33
|
Hu A, Hillel A, Zhao W, Meyer T. Anxiety and depression in spasmodic dysphonia patients. World J Otorhinolaryngol Head Neck Surg 2018; 4:110-116. [PMID: 30101219 PMCID: PMC6074012 DOI: 10.1016/j.wjorl.2018.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 04/17/2018] [Indexed: 12/01/2022] Open
Abstract
Objective/Hypothesis Experts used to believe that spasmodic dysphonia (SD) was a psychogenic disorder. Although SD is now established as a neurological disorder, the rates of co-morbid anxiety and depression range from 7.1% to 62%. Our objective was to study the prevalence and risk factors associated with these mood disorders in SD patients. Study design Retrospective. Methods SD patients who presented for botulinum toxin injections were recruited. Demographic data, Hospital Anxiety and Depression Scale (HADS), Voice Handicap Index-10 (VHI-10), General Self-Efficacy scale (GSES), Disease Specific Self-Efficacy in Spasmodic Dysphonia scale (DSSE), and Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) were collected. Results One hundred and forty two patients (age (59.2 ± 13.6) years, 25.4% male) had VHI-10 of 26.3 ± 6.9 (mean ± standard deviation), GSES 33.2 ± 5.8, CAPE-V 43.9 ± 20.9, HADS anxiety 6.7 ± 3.7, and HADS depression 3.6 ± 2.8. About 19 (13.4%) and 4 (2.8%) had symptoms of anxiety and depression respectively. Final linear regression model for HADS anxiety (R2 = 32.90%) showed that patients who were less likely to have anxiety symptoms were older age (p < 0.001), male (p = 0.002), have higher GSES (p < 0.001) and lower VHI-10 (p = 0.004). Final linear regression model for HADS depression score (R2 = 34.42%) showed that patients who were less likely to have depressive symptoms had high DSSES (p < 0.001). Conclusions Prevalence of anxiety (13.4%) and depression (2.8%) in SD were lower than previously reported in the literature. Risk factors for anxiety were: younger age, female gender, lower general self-efficacy, and higher perceived vocal handicap. The main risk factor for depression was lower disease specific self-efficacy.
Collapse
Affiliation(s)
- Amanda Hu
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada
| | - Al Hillel
- Department of Otolaryngology - Head & Neck Surgery, University of Washington, Seattle, WA, USA
| | - Wei Zhao
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Tanya Meyer
- Department of Otolaryngology - Head & Neck Surgery, University of Washington, Seattle, WA, USA
| |
Collapse
|
34
|
Ong FM, Husna Nik Hassan NF, Azman M, Sani A, Mat Baki M. Validity and Reliability Study of Bahasa Malaysia Version of Voice Handicap Index-10. J Voice 2018; 33:581.e17-581.e23. [PMID: 29793874 DOI: 10.1016/j.jvoice.2018.01.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/18/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study aimed to determine the validity and reliability of Bahasa Malaysia version of Voice Handicap Index-10 (mVHI-10). MATERIALS AND METHODS This cross-sectional study was carried out in the Otorhinolaryngology, Head and Neck Surgery Department of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from June 2015 to May 2016. The mVHI-10 was produced following a rigorous forward and backward translation. One hundred participants, including 50 healthy volunteers (17 male, 33 female) and 50 patients with voice disorders (26 male, 24 female), were recruited to complete the mVHI-10 before flexible laryngoscopic examinations and acoustic analysis. The mVHI-10 was repeated in 2 weeks via telephone interview or clinic visit. Its reliability and validity were assessed using interclass correlation. RESULTS The test-retest reliability for total mVHI-10 and each item score was high, with the Cronbach alpha of >0.90. The total mVHI-10 score and domain scores were significantly higher (P < 0.001) in the pathology groups (20.92 ± 8.74) than healthy volunteers (1.54 ± 1.97), depicting excellent discriminant validity. The Kaiser-Meyer-Olkin measure was 0.92, which depicted excellent construct validity. There was a significant positive correlation between the mVHI-10 score and jitter and shimmer result (P < 0.001). CONCLUSIONS The present study showed good reliability and validity of the mVHI-10 when applied to both healthy volunteers and patients with voice disorders. We recommend the use of the mVHI-10 in daily clinical practice among Bahasa Malaysia-speaking population.
Collapse
Affiliation(s)
- Fei Ming Ong
- Faculty of Medicine-Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nik Fariza Husna Nik Hassan
- Pusat Pengajian Sains Kesihatan, Universiti Sains Malaysia, Kampus Kesihatan, Kota Bharu, Kelantan, Malaysia
| | - Mawaddah Azman
- Faculty of Medicine-Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Abdullah Sani
- Faculty of Medicine-Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Marina Mat Baki
- Faculty of Medicine-Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| |
Collapse
|
35
|
|
36
|
Stachler RJ, Francis DO, Schwartz SR, Damask CC, Digoy GP, Krouse HJ, McCoy SJ, Ouellette DR, Patel RR, Reavis C(CW, Smith LJ, Smith M, Strode SW, Woo P, Nnacheta LC. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngol Head Neck Surg 2018; 158:S1-S42. [DOI: 10.1177/0194599817751030] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective This guideline provides evidence-based recommendations on treating patients who present with dysphonia, which is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication and/or quality of life. Dysphonia affects nearly one-third of the population at some point in its life. This guideline applies to all age groups evaluated in a setting where dysphonia would be identified or managed. It is intended for all clinicians who are likely to diagnose and treat patients with dysphonia. Purpose The primary purpose of this guideline is to improve the quality of care for patients with dysphonia, based on current best evidence. Expert consensus to fill evidence gaps, when used, is explicitly stated and supported with a detailed evidence profile for transparency. Specific objectives of the guideline are to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm. For this guideline update, the American Academy of Otolaryngology—Head and Neck Surgery Foundation selected a panel representing the fields of advanced practice nursing, bronchoesophagology, consumer advocacy, family medicine, geriatric medicine, internal medicine, laryngology, neurology, otolaryngology–head and neck surgery, pediatrics, professional voice, pulmonology, and speech-language pathology. Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should assess the patient with dysphonia by history and physical examination to identify factors where expedited laryngeal evaluation is indicated. These include, but are not limited to, recent surgical procedures involving the head, neck, or chest; recent endotracheal intubation; presence of concomitant neck mass; respiratory distress or stridor; history of tobacco abuse; and whether the patient is a professional voice user. (2) Clinicians should advocate voice therapy for patients with dysphonia from a cause amenable to voice therapy. The guideline update group made recommendations for the following KASs: (1) Clinicians should identify dysphonia in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces quality of life (QOL). (2) Clinicians should assess the patient with dysphonia by history and physical examination for underlying causes of dysphonia and factors that modify management. (3) Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected. (4) Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/communicate the results to the speech-language pathologist (SLP). (5) Clinicians should advocate for surgery as a therapeutic option for patients with dysphonia with conditions amenable to surgical intervention, such as suspected malignancy, symptomatic benign vocal fold lesions that do not respond to conservative management, or glottic insufficiency. (6) Clinicians should offer, or refer to a clinician who can offer, botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia. (7) Clinicians should inform patients with dysphonia about control/preventive measures. (8) Clinicians should document resolution, improvement or worsened symptoms of dysphonia, or change in QOL of patients with dysphonia after treatment or observation. The guideline update group made a strong recommendation against 1 action: (1) Clinicians should not routinely prescribe antibiotics to treat dysphonia. The guideline update group made recommendations against other actions: (1) Clinicians should not obtain computed tomography (CT) or magnetic resonance imaging (MRI) for patients with a primary voice complaint prior to visualization of the larynx. (2) Clinicians should not prescribe antireflux medications to treat isolated dysphonia, based on symptoms alone attributed to suspected gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR), without visualization of the larynx. (3) Clinicians should not routinely prescribe corticosteroids for patients with dysphonia prior to visualization of the larynx. The policy level for the following recommendation about laryngoscopy at any time was an option: (1) Clinicians may perform diagnostic laryngoscopy at any time in a patient with dysphonia. Disclaimer This clinical practice guideline is not intended as an exhaustive source of guidance for managing dysphonia (hoarseness). Rather, it is designed to assist clinicians by providing an evidence-based framework for decision-making strategies. The guideline is not intended to replace clinical judgment or establish a protocol for all individuals with this condition, and it may not provide the only appropriate approach to diagnosing and managing this problem. Differences from Prior Guideline (1) Incorporation of new evidence profiles to include the role of patient preferences, confidence in the evidence, differences of opinion, quality improvement opportunities, and any exclusion to which the action statement does not apply (2) Inclusion of 3 new guidelines, 16 new systematic reviews, and 4 new randomized controlled trials (3) Inclusion of a consumer advocate on the guideline update group (4) Changes to 9 KASs from the original guideline (5) New KAS 3 (escalation of care) and KAS 13 (outcomes) (6) Addition of an algorithm outlining KASs for patients with dysphonia
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Libby J. Smith
- University of Pittsburgh Medical, Pittsburgh, Pennsylvania, USA
| | - Marshall Smith
- University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | - Peak Woo
- Icahn School of Medicine at Mt Sinai, New York, New York, USA
| | - Lorraine C. Nnacheta
- Department of Research and Quality, American Academy of Otolaryngology—Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| |
Collapse
|
37
|
Shoffel-Havakuk H, Chau S, Hapner ER, Pethan M, Johns MM. Development and Validation of the Voice Catastrophization Index. J Voice 2017; 33:232-238. [PMID: 29132807 DOI: 10.1016/j.jvoice.2017.09.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/29/2017] [Accepted: 09/29/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION 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. OBJECTIVE To establish the validity of the Voice Catastrophization Index (VCI), a new instrument estimating voice symptoms catastrophization. METHODS 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. RESULTS 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. CONCLUSIONS 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.
Collapse
Affiliation(s)
- Hagit Shoffel-Havakuk
- Department of Otolaryngology-Head and Neck Surgery, USC Voice Center, University of Southern California, Los Angeles, California
| | - Steven Chau
- Department of Otolaryngology-Head and Neck Surgery University of California Irvine Medical Center, Orange, California
| | - Edie R Hapner
- Department of Otolaryngology-Head and Neck Surgery, USC Voice Center, University of Southern California, Los Angeles, California
| | | | - Michael M Johns
- Department of Otolaryngology-Head and Neck Surgery, USC Voice Center, University of Southern California, Los Angeles, California.
| |
Collapse
|
38
|
Functional Voice Disorders: The Importance of the Psychologist in Clinical Voice Assessment. J Voice 2017; 31:507.e13-507.e22. [DOI: 10.1016/j.jvoice.2016.10.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/12/2016] [Accepted: 10/20/2016] [Indexed: 11/17/2022]
|
39
|
Joo YH, Song YS, Pae CU. Relationship between Depression and Laryngopharyngeal Reflux. Psychiatry Investig 2017; 14:226-229. [PMID: 28326123 PMCID: PMC5355023 DOI: 10.4306/pi.2017.14.2.226] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 02/26/2016] [Accepted: 04/04/2016] [Indexed: 01/12/2023] Open
Abstract
This study investigated the relationship between depression, somatization, anxiety, personality, and laryngopharyngeal reflux (LPR). We prospectively analyzed 231 patients with symptoms with LPR using the laryngopharyngeal reflux symptom index and the reflux finding score. Seventy nine (34.2%) patients were diagnosed with LPR. A significant correlation was detected between the presence of LPR and total scores on the Patient Health Questionnaire-9 (5.6±5.3 vs. 4.0±4.6, p=0.017) and the 7-item Generalized Anxiety Disorder Scale (4.3±4.9 vs. 3.0±4.5, p=0.041). LPR was significantly more frequent in those with depression than in those without (45.6% vs. 27.0%, p=0.004). A multivariate analysis confirmed a significant association between the presence of LPR and depression (odds ratio, 1.068; 95% confidence interval, 1.011-1.128; p=0.019). Our preliminary results suggest that patients with LPR may need to be carefully evaluated for depression.
Collapse
Affiliation(s)
- Young-Hoon Joo
- Department of Otolaryngology-Head & Neck Surgery, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Youn-Su Song
- Department of Otolaryngology-Head & Neck Surgery, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Chi-Un Pae
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
40
|
Saltürk Z, Arslanoğlu A, Özdemir E, Yıldırım G, Aydoğdu İ, Kumral TL, Berkiten G, Atar Y, Uyar Y. How do voice restoration methods affect the psychological status of patients after total laryngectomy? HNO 2016; 64:163-8. [PMID: 26923487 DOI: 10.1007/s00106-016-0134-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study investigated the relationship between psychological well-being and different voice rehabilitation methods in total laryngectomy patients. METHODS The study enrolled 96 patients who underwent total laryngectomy. The patients were divided into three groups according to the voice rehabilitation method used: esophageal speech (24 patients); a tracheoesophageal fistula and Provox 2 voice prosthesis (57 patients); or an electrolarynx (15 patients). The participants were asked to complete the Turkish version of the Voice Handicap Index-10 (VHI-10) to assess voice problems. They were also asked to complete the Turkish version of the Perceived Stress Scale (PSS), and the Hospital Anxiety and Depression Scale (HADS). The test scores of the three groups were compared statistically. RESULTS Patients who used esophageal speech had a mean VHI-10 score of 10.25 ± 3.22 versus 19.42 ± 5.56 and 17.60 ± 1.92 for the tracheoesophageal fistula and Provox 2 and electrolarynx groups respectively, reflecting better perception of their voice. They also had a PSS score of 11.38 ± 3.92, indicating that they felt less stressed in comparison with the tracheoesophageal fistula and Provox 2 and electrolarynx groups, which scored 18.84 ± 5.50 and 16.20 ± 3.49 respectively. The HADS scores of the groups were not different, indicating that the patients' anxiety and depression status did not vary. CONCLUSION Patients who used esophageal speech perceived less stress and were less handicapped by their voice.
Collapse
Affiliation(s)
- Z Saltürk
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey.
| | - A Arslanoğlu
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - E Özdemir
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - G Yıldırım
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - İ Aydoğdu
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - T L Kumral
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - G Berkiten
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - Y Atar
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| | - Y Uyar
- Okmeydanı Training and Research Hospital ENT Clinic, Darülaceze cad. Şişli/Istanbul, Istanbul, Turkey
| |
Collapse
|
41
|
Mattei A, Revis J, Giovanni A. Personality traits inventory in patients with vocal nodules. Eur Arch Otorhinolaryngol 2016; 274:1911-1917. [DOI: 10.1007/s00405-016-4421-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/02/2016] [Indexed: 10/20/2022]
|
42
|
Hu A, Hillel A, Meyer T. Factors Associated With Patient-perceived Hoarseness in Spasmodic Dysphonia Patients. J Voice 2015; 30:769.e23-769.e26. [PMID: 26704415 DOI: 10.1016/j.jvoice.2015.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 11/10/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES/HYPOTHESIS The American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guidelines on Hoarseness distinguishes between hoarseness, which is a symptom perceived by the patient, and dysphonia, which is a diagnosis made by the clinician. Our objective was to determine factors that are associated with patient-perceived hoarseness in spasmodic dysphonia (SD) patients. STUDY DESIGN Retrospective study. METHODS Adductor SD patients who presented for botulinum toxin injections from September 2011 to June 2012 were recruited. The main outcome variable, Voice Handicap Index-10 (VHI-10), was used to quantify patient-perceived hoarseness. Clinical data, Hospital Anxiety and Depression Scale (HADS), and VHI-10 were collected. Clinician-perceived dysphonia was measured by a speech-language pathologist with Consensus Auditory Perceptual Evaluation of Voice (CAPE-V). Statistical analysis included univariate analyses and multiple linear regression. RESULTS One hundred thirty-nine SD patients had VHI-10 score of 26.0 ± 7.2 (mean ± standard deviation), disease duration of 10.5 + 7.0 years, CAPE-V overall score of 43.2 ± 21.8, HADS anxiety score of 6.7 ± 3.8, and HADS depression score of 3.6 ± 2.8. In univariate analyses, there were positive correlations (P < 0.05) between VHI-10 and female gender, CAPE-V overall, older age, HADS anxiety, and depression. There was no correlation with professional voice use and disease duration. In multiple linear regression (R2 = 0.178, P < 0.001), age, HADS anxiety, female gender, and CAPE-V were significant. CONCLUSIONS Older age, higher anxiety levels, female gender, and clinician-perceived dysphonia are associated with higher levels of patient-perceived hoarseness in SD patients. Hoarseness is a very personal symptom. Multiple factors determine its self-perception.
Collapse
Affiliation(s)
- Amanda Hu
- Department of Otolaryngology-Head & Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
| | - Al Hillel
- Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington
| | - Tanya Meyer
- Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle, Washington
| |
Collapse
|
43
|
Marmor S, Horvath KJ, Lim KO, Misono S. Voice problems and depression among adults in the United States. Laryngoscope 2015; 126:1859-64. [PMID: 26691195 DOI: 10.1002/lary.25819] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 10/27/2015] [Accepted: 11/13/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Prior studies have observed a high prevalence of psychosocial distress, including depression, in patients with voice problems. However, these studies have largely been performed in care-seeking patients identified in tertiary care voice clinics. The objective of this study was to examine the association between depression and voice problems in the U.S. STUDY DESIGN Cross-sectional analysis of National Health Interview Survey (NHIS) data. METHODS We identified adult cases reporting a voice problem in the preceding 12 months in the 2012 NHIS. Self-reported demographics and data regarding healthcare visits for voice problems, diagnoses given, severity of the voice problem, and depression symptoms were analyzed. RESULTS The total weighted sample size was 52,816,364. The presence of depressive symptoms was associated with a nearly two-fold increase (odds ratio = 1.89, 95% confidence interval = 1.21-2.96) in the likelihood of reporting a voice problem in the past year. Patients who reported feeling depressed were less likely to receive care for the voice problem and less likely to report that treatment had helped than those who did not feel depressed. CONCLUSION These findings indicate that the co-occurrence of voice problems and depressive symptoms is observed in the general population, not only in care-seeking patients, and that depressive symptoms may influence reported likelihood of receiving voice treatment and effectiveness. This suggests that voice care providers should take mental health symptoms into account when treating patients, and also indicates a need for further investigation. LEVEL OF EVIDENCE NA. Laryngoscope, 126:1859-1864, 2016.
Collapse
Affiliation(s)
- Schelomo Marmor
- Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota, U.S.A.,Department of Surgery, School of Medicine, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Keith J Horvath
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Kelvin O Lim
- Department of Psychiatry, School of Medicine, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Stephanie Misono
- Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota, U.S.A
| |
Collapse
|
44
|
Veltishchev D, Zeltyn A, Seravina O, Romanenko S. [The anxiety-depressive spectrum disorders in patients with larynx diseases]. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:15-19. [PMID: 26356155 DOI: 10.17116/jnevro20151155115-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To perform a psychopathological and clinical/psychological analysis of anxiety-depressive spectrum disorders (ADSD) in inflammatory otorhinolaryngological disease - larynx granuloma. MATERIAL AND METHODS We examined 30 patients, aged 33-65 years, including 13 patients with post-surgical recurrence of granuloma and 17 patients diagnosed for the first time with granuloma. RESULTS AND CONCLUSION The relationship between larynx granuloma and ADSD, predominantly of chronic type was shown. Prolonged psychotraumatic factors play a significant role in the development of ADSD. A role of anxiety in the ADSD structure as well as an importance of their diagnosis for a choice of therapeutic tactics was confirmed. Psychopharmacotherapy has led to a reduction in the frequency of granuloma relapses. The results confirmed the productivity of affective-stress model, based on the type of affectivity, in the analysis of ADSD.
Collapse
Affiliation(s)
| | - A Zeltyn
- Moscow Research Institute of Psychiatry, Moscow
| | - O Seravina
- Moscow Research Institute of Psychiatry, Moscow
| | - S Romanenko
- Sverzevsky Otorhinolaryngology Research Centre, Moscow
| |
Collapse
|
45
|
Ryu CH, Ryu J, Ryu YM, Lee YJ, Lee EK, Kim SK, Kim TS, Kim TH, Lee CY, Park SY, Chung KW, Jung YS. Administration of Radioactive Iodine Therapy Within 1 Year After Total Thyroidectomy Does Not Affect Vocal Function. J Nucl Med 2015; 56:1480-6. [PMID: 26272814 DOI: 10.2967/jnumed.115.161463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 07/24/2015] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The purpose of this study was to evaluate the impact of radioactive iodine therapy (RIT) on vocal function during the early follow-up period after total thyroidectomy (TT) using perceptive and objective measurements, questionnaires regarding subjective symptoms, and data on vocal function in a prospectively enrolled and serially followed thyroid cancer cohort. METHODS Of 212 patients who underwent TT and were screened between January and December 2010 at our hospital, 160 were included in the final analysis. Patients with the following histories were excluded: lateral neck dissection, organic vocal fold disease, external radiotherapy, and voice evaluation during thyroxine withdrawal. Patients were stratified into 3 groups: TT, TT with low-dose RIT (1.1-2.2 GBq), and TT with high-dose RIT (≥3.7 GBq). Voice evaluations were performed before surgery and at 1, 6, and 12 mo after TT. RESULTS Vocal characteristics were altered after TT, including changes on the grade, roughness, and strain scale; increased amplitude perturbation; decreased fundamental frequency; narrowed pitch range; and global disturbances in subjective functional parameters on the voice handicap index. However, the degree of vocal changes among the 3 groups did not significantly differ within the 1-y postoperative follow-up period. According to the results of subgroup analyses of patients who demonstrated good voice outcomes after TT, there were no significant functional differences among the 3 groups. CONCLUSION RIT at any dose does not affect vocal function within 1 y of TT.
Collapse
Affiliation(s)
- Chang Hwan Ryu
- Department of Otolaryngology-Head and Neck Surgery, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - Junsun Ryu
- Department of Otolaryngology-Head and Neck Surgery, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - Youn Mi Ryu
- Department of Otolaryngology-Head and Neck Surgery, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - You Jin Lee
- Department of Internal Medicine, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - Eun-Kyung Lee
- Department of Internal Medicine, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - Seok-Ki Kim
- Department of Nuclear Medicine, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - Tae-Sung Kim
- Department of Nuclear Medicine, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - Tae Hyun Kim
- Department of Radiation Oncology, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - Chang Yoon Lee
- Department of Radiology, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - Seog Yun Park
- Department of Pathology, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Korea; and
| | - Ki Wook Chung
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yuh-S Jung
- Department of Otolaryngology-Head and Neck Surgery, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| |
Collapse
|
46
|
Ryu CH, Han S, Lee MS, Kim SY, Nam SY, Roh JL, Ryu J, Jung YS, Choi SH. Voice Changes in Elderly Adults: Prevalence and the Effect of Social, Behavioral, and Health Status on Voice Quality. J Am Geriatr Soc 2015; 63:1608-14. [PMID: 26140657 DOI: 10.1111/jgs.13559] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To estimate the prevalence of dysphonia and the effect of several risk factors on vocal quality in a representative population of older adults. DESIGN Cross-sectional. SETTING Korea. PARTICIPANTS Individuals aged 65 and older who underwent laryngoscopy from 2008 to 2010 (N = 3,759). MEASUREMENTS The prevalence of dysphonia and the effect of potential risk factors on voice quality in elderly adults were measured. RESULTS The mean age of participants was 72.4. The prevalence of dysphonia was 8.5% (95% confidence interval (CI) = 7.4-9.8). There was no significant difference in prevalence according to age. Multivariable analysis after adjusting for age, sex, vocal fold disease, and all variables that were identified in the univariate analysis revealed that urban residence (odds ratio (OR) = 1.83, 95% CI = 1.11-3.04), underweight (OR = 2.79, 95% CI = 1.45-5.38) or normal weight (OR = 1.63, 95% CI = 1.03-2.59), poor (OR = 2.00, 95% CI = 1.19-3.34) or intermediate (OR = 2.08, 95% CI = 1.15-3.78) subjective health status, asthma (OR = 2.08, 95% CI = 1.12-3.86), chronic obstructive pulmonary disease (OR = 2.49, 95% CI = 1.10-5.62), thyroid disease (OR = 3.08, 95% CI = 1.50-6.34), and vocal fold disease (OR = 3.72, 95% CI = 2.16-6.42) were independently associated with dysphonia in elderly adults. CONCLUSION This study provides valuable information regarding the prevalence of dysphonia and the risk factors that contribute to vocal quality in older adults. These factors are mostly associated with social, behavioral, and underlying health status variables. Multidisciplinary treatment should be considered to improve voice conditions in elderly adults.
Collapse
Affiliation(s)
- Chang Hwan Ryu
- Specific Organs Cancer Branch, Department of Otolaryngology, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Gyeonggi, Korea
| | - Seungbong Han
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Moo-Song Lee
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.,Department of Preventive Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Sang Yoon Kim
- Department of Otolaryngology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Soon Yuhl Nam
- Department of Otolaryngology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Jong-Lyel Roh
- Department of Otolaryngology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Junsun Ryu
- Specific Organs Cancer Branch, Department of Otolaryngology, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Gyeonggi, Korea
| | - Yuh-S Jung
- Specific Organs Cancer Branch, Department of Otolaryngology, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Gyeonggi, Korea
| | - Seung-Ho Choi
- Department of Otolaryngology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| |
Collapse
|
47
|
Salturk Z, Kumral TL, Aydoğdu I, Arslanoğlu A, Berkiten G, Yildirim G, Uyar Y. Psychological effects of dysphonia in voice professionals. Laryngoscope 2015; 125:1908-10. [PMID: 25892054 DOI: 10.1002/lary.25319] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the psychological effects of dysphonia in voice professionals compared to non-voice professionals and in both genders. STUDY DESIGN Cross-sectional analysis. METHODS Forty-eight 48 voice professionals and 52 non-voice professionals with dysphonia were included in this study. All participants underwent a complete ear, nose, and throat examination and an evaluation for pathologies that might affect vocal quality. Participants were asked to complete the Turkish versions of the Voice Handicap Index-30 (VHI-30), Perceived Stress Scale (PSS), and the Hospital Anxiety and Depression Scale (HADS). HADS scores were evaluated as HADS-A (anxiety) and HADS-D (depression). Dysphonia status was evaluated by grade, roughness, breathiness, asthenia, and strain (GRBAS) scale perceptually. The results were compared statistically. RESULTS Significant differences between the two groups were evident when the VHI-30 and PSS data were compared (P = .00001 and P = .00001, respectively). However, neither HADS score (HADS-A and HADS-D) differed between groups. An analysis of the scores in terms of sex revealed that females had significantly higher PSS scores (P = .006). The GRBAS scale revealed no difference between groups (P = .819, .931, .803, .655, and .803, respectively). No between-sex differences in the VHI-30 or HADS scores were evident CONCLUSIONS We found that voice professionals and females experienced more stress and were more dissatisfied with their voices. LEVEL OF EVIDENCE 4.
Collapse
Affiliation(s)
- Ziya Salturk
- ENT Clinic, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | | | - Imran Aydoğdu
- ENT Clinic, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Arslanoğlu
- ENT Clinic, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Güler Berkiten
- ENT Clinic, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Güven Yildirim
- ENT Clinic, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Yavuz Uyar
- ENT Clinic, Okmeydani Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
48
|
New Perspective on Psychosocial Distress in Patients with Dysphonia: The Moderating Role of Perceived Control. J Voice 2015; 30:172-6. [PMID: 25795347 PMCID: PMC4573772 DOI: 10.1016/j.jvoice.2015.02.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 02/03/2015] [Indexed: 12/19/2022]
Abstract
Objectives Although an association between psychosocial distress (depression, anxiety, somatization, and perceived stress) and voice disorders has been observed, little is known about the relationship between distress and patient-reported voice handicap. Further, the psychological mechanisms underlying this relationship are poorly understood. Perceived control plays an important role in distress associated with other medical disorders. The objectives of this study were to 1) characterize the relationship between distress and patient-reported voice handicap and 2) examine the role of perceived control in this relationship. Study Design Cross-sectional study in tertiary care academic voice clinic. Methods Distress, perceived stress, voice handicap, and perceived control were measured using established assessment scales. Association was measured with Pearson’s correlation coefficient; moderation was assessed using multiple hierarchical regression. Results 533 patients enrolled. 34% met criteria for clinically significant distress (i.e., depression, anxiety, and/or somatization). A weak association (r=0.13, p=0.003) was observed between severity of psychosocial distress and vocal handicap. Present perceived control was inversely associated with distress (r=−0.41, p<0.0001), stress (r=−0.30, p<0.0001), and voice handicap (r=−0.30, p<0.0001). The relationship between voice handicap and psychosocial distress was moderated by perceived control (b for interaction term −0.15, p<0.001); greater vocal handicap was associated with greater distress in patients with low perceived control. Conclusions Severity of distress and vocal handicap were positively related, and the relation between them was moderated by perceived control. Vocal handicap was more related to distress among those with low perceived control; targeting this potential mechanism may facilitate new approaches for improved care.
Collapse
|
49
|
G Nichols B, Varadarajan V, Bock JM, Blumin JH. Dysphonia in nursing home and assisted living residents: prevalence and association with frailty. J Voice 2014; 29:79-82. [PMID: 25499517 DOI: 10.1016/j.jvoice.2014.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 06/06/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Previous studies of geriatric dysphonia prevalence have been limited to ambulatory outpatient and senior communities. Our goal was to identify prevalence of dysphonia in nursing home residents and assisted living residents and search for correlations between indices of dysphonia and indices of frailty. STUDY DESIGN Prospective epidemiological survey. METHODS Residents of a vertically integrated senior care organization who were 65 or older and able to understand and complete the questionnaire were recruited to complete the voice handicap index 10 (VHI-10) to assess for dysphonia (VHI-10 > 10 = dysphonia) and Vulnerable Elders Survey 13 (VES-13), a validated instrument to assess for frailty (VES > 3 = frailty). RESULTS A total of 119 residents were surveyed. Thirty-three percent of nursing home residents, and 25% of assisted living residents reported dysphonia with 29% of all respondents reporting dysphonia. The mean VHI-10 was 7.4, the median was 5, and the interquartile range was 2-12.5. There was a significant relationship between VHI-10 and VES-13 score (P = 0.029). There were no statistically significant relationships between frailty, age, or type of living and dysphonia or VHI-10. CONCLUSION There is a high prevalence of voice dysfunction in assisted living and nursing home residents. The correlation between VHI-10 and VES-13 suggests that voice declines as frailty increases.
Collapse
Affiliation(s)
- Brent G Nichols
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Varun Varadarajan
- Department of Otolaryngology, University of Florida, Gainesville, Florida
| | - Jonathan M Bock
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Joel H Blumin
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin.
| |
Collapse
|
50
|
Psychosocial distress in patients presenting with voice concerns. J Voice 2014; 28:753-61. [PMID: 24930373 DOI: 10.1016/j.jvoice.2014.02.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 02/21/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To assess the prevalence of psychosocial distress (depression, anxiety, somatization, and perceived stress) in a consecutive sample of patients presenting with voice concerns and to qualitatively analyze patient comments on challenges associated with voice problems. STUDY DESIGN Cross-sectional study. METHODS New patients presenting to a multidisciplinary voice clinic with voice concerns were invited to participate. Respondents (n = 197) completed the Brief Symptom Inventory 18-item scale, the 4-item Perceived Stress Scale, and the Voice Handicap Index 10-item scale. Qualitative analysis was performed of responses to an open-ended question about challenges associated with a voice problem. RESULTS Approximately one-third (32%) of the patients met the strict case criteria for depression, anxiety, and/or somatic concerns based on the Brief Symptom Inventory 18-item scale. Most patients had no prior diagnosis of depression or anxiety, and the degree of distress was not predicted by the type of voice-related diagnosis. Perceived stress was higher among female patients (P = 0.02). As expected, scores on the Voice Handicap Index 10-item scale were indicative of concurrent voice-related handicap (mean, 19.5; standard deviation, 9.4). In qualitative analysis of responses regarding challenges associated with a voice problem, 19 themes were identified (eg, threat to occupational functioning). CONCLUSIONS These findings identify a high prevalence of multiple types of distress among patients with voice disorders, presenting an opportunity to provide more comprehensive care to this patient population.
Collapse
|