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Gascon L, Belfiglio M, Nowacki AS, Adessa M, Hashmi AZ, Bryson PC. Prevalence of self-reported voice and swallowing complaints in an outpatient geriatric population. Laryngoscope Investig Otolaryngol 2024; 9:e70012. [PMID: 39257726 PMCID: PMC11382360 DOI: 10.1002/lio2.70012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 08/19/2024] [Accepted: 08/25/2024] [Indexed: 09/12/2024] Open
Abstract
Background Older adults suffer from increased rates of dysphagia and dysphonia, both of which have a profound effect on quality of life and are often underdiagnosed. We sought to better understand the prevalence of these complaints and the potential utility of a patient-reported screening program in a geriatrics clinic. Methods Using an IRB-approved cross-sectional survey and retrospective cohort design, we recruited participants from a population of new patients seeking care at an academic geriatrics clinic. We used three validated questionnaires to assess self-reported dysphagia, dysphonia, and pill dysphagia: the Eating-Assessment Tool-10 (EAT-10), the Voice Handicap Index-10 (VHI-10), and the PILL-5. Patients who screened positive on any questionnaire were offered referral to a laryngologist for additional evaluation. Patients who screened positive on the PILL-5 were also offered referral to our geriatric pharmacist. Results Among our 300 patients surveyed, the mean age was 76 (SD 8.46). A total of 82 (27.3%) patients screened positive (73 on EAT-10, 10 on PILL-5, 13 on VHI-10) and were offered referral, of which 36 accepted. These positive screening patients took more prescription medications (p = .024) and had a higher GDS score (p < .001) when compared to the patients who screened negative. Conclusions Many new patients seeking generalized care at our center screened positively for dysphagia and/or dysphonia on validated questionnaires. Geriatric patients may benefit from integrating screening for these disorders to identify the need of further evaluation. It is unknown if these survey tools are appropriate in a non-otolaryngology clinic. Level of evidence III.
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Affiliation(s)
- Laurence Gascon
- Department of Otolaryngology Cleveland Clinic Cleveland Ohio USA
| | - Mario Belfiglio
- Department of Otolaryngology Cleveland Clinic Cleveland Ohio USA
| | - Amy S Nowacki
- Department of Quantitative Health Sciences Cleveland Clinic Cleveland Ohio USA
| | - Michelle Adessa
- Department of Otolaryngology Cleveland Clinic Cleveland Ohio USA
| | - Ardeshir Z Hashmi
- Department of Internal Medicine and Geriatrics Cleveland Clinic Cleveland Ohio USA
| | - Paul C Bryson
- Department of Otolaryngology Cleveland Clinic Cleveland Ohio USA
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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.
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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
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Rocha MC, Nogueira BDFM, Nunes FB, de Medeiros AM. Self-perception of voice, hearing, and general health in screening for voice changes in older women. Codas 2024; 36:e20220063. [PMID: 38198297 PMCID: PMC10782509 DOI: 10.1590/2317-1782/20232022063pt] [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] [Accepted: 07/22/2022] [Indexed: 01/12/2024] Open
Abstract
PURPOSE To verify the association between sociodemographic factors, vocal behavior, morbidities, and self-perception of voice, hearing, and general health in older women with voice disorders. METHODS The sample had 95 older women aged 60 to 84 years (mean of 69,5). They were interviewed with a structured questionnaire on sociodemographic aspects, health, and vocal behavior. The Screening Protocol for Voice Disorders in Older Adults (RAVI) was used to identify the presence of voice disorders. RESULTS Participants who had finished high school and were retired predominated. The number of older women with voice disorders according to RAVI was 46.3%. Physical sensations such as dry throat, throat clearing, and itchy throat were the most common complaints. The group of older women with voice disorders had worse self-perception of voice quality, hearing, and general health and a higher frequency of upper airway infections than those without voice disorders (p ≤ 0.05). CONCLUSION The vocal self-assessment measured with RAVI was statistically associated with self-perception of voice quality, hearing, general health, sore throat, sinusitis, and respiratory allergies.
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Affiliation(s)
- Maria Clara Rocha
- Graduação em Fonoaudiologia, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Bárbara de Faria Morais Nogueira
- Programa de Pós-graduação em Ciências Fonoaudiológicas, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Flávio Barbosa Nunes
- Departamento de Otorrinolaringologia, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
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Kalsotra G, Mahajan Y, Saraf A, Kalsotra P. Role of Voice Handicap Index in Evaluation of Patients with Moderate to Severe Bilateral Sensorineural Hearing Loss. Indian J Otolaryngol Head Neck Surg 2023; 75:3320-3325. [PMID: 37974883 PMCID: PMC10646070 DOI: 10.1007/s12070-023-03996-8] [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: 04/05/2023] [Accepted: 06/16/2023] [Indexed: 11/19/2023] Open
Abstract
Background Our ability to hear and speak enables us to communicate with others, forming an integral part of our emotional and social well-being. Vocal problems in hearing-impaired patients have yet to be assessed in terms of subjective level of disability they cause. Present study aims to assess the different Voice Handicap Index (VHI) scores among patients with moderate to severe sensorineural hearing loss and compare them to those with normal hearing. Materials and Methods In this prospective case control study(n = 150), study group A (n = 100) consisted of subjects with bilateral moderate to profound hearing loss on Pure tone audiometry and control group B (n = 50) with normal hearing. Both groups were asked to fill out VHI form after a normal videostroboscopic assessment. Results Mean VHI score in group A was 57.5 ± 12.48 and 6.0 ± 3.24 in group B, difference being statistically significant. A strong positive correlation was found between severity of hearing loss and VHI total score. The difference between both groups was also statistically significant for each of the three subscales of VHI. Conclusion We infer that subjects with moderate and higher bilateral sensorineural hearing loss hearing have statistically significant higher VHI scores as compared to those with normal hearing. It was observed that perception of voice handicap increased with the severity of hearing loss. These findings emphasize the need for multilateral assessment and treatment of voice disorders in subjects with hearing loss.
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Wang LH, Doan TN, Chang FC, To TL, Ho WC, Chou LW. Prevalence of Voice Disorders in Older Adults: A Systematic Review and Meta-Analysis. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023:1-12. [PMID: 37285381 DOI: 10.1044/2023_ajslp-22-00393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Voice disorders significantly impair the ability to communicate effectively and reduce the quality of life in older adults; however, its prevalence has not been well established. The aim of our research was to investigate the prevalence and associated factors of voice disorders among the older population. METHOD Five medical databases were systematically searched for studies that reported the prevalence of voice disorders in older adults. The overall prevalence was exhibited in proportions and 95% confidence intervals (CIs) utilizing random-effects models. Heterogeneity was measured using I 2 statistics. RESULTS Of 930 articles screened, 13 fulfilled the eligibility criteria, including 10 studies in community-based settings and three in institutionalized settings. An overall prevalence of voice disorders in older adults was estimated to be 18.79% (95% CI [16.34, 21.37], I 2 = 96%). Subgroup analysis showed a prevalence of 33.03% (95% CI [26.85, 39.51], I 2 = 35%) in institutionalized older adults, which was significantly higher than that in the community-based older adults with 15.2% (95% CI [12.65, 17.92], I 2 = 92%). Some factors that influenced the reported prevalence were identified, including types of survey, the definition of voice disorders, sampling methods, and the mean age of the population among included studies. CONCLUSIONS The prevalence of voice disorders in the older population depends on various factors but is relatively common in older adults. The findings of this study accentuate the necessity for researchers to standardize the protocol for reporting geriatric dysphonia as well as for older adults to express their voice-related problems so that they will receive appropriate diagnosis and treatment.
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Affiliation(s)
- Liang-Hui Wang
- Department of Speech-Language Pathology and Audiology, Hungkuang University, Taichung, Taiwan
- PhD Program for Aging, China Medical University, Taichung, Taiwan
| | - Thanh-Nhan Doan
- Department of Public Health, China Medical University, Taichung, Taiwan
- Department of Rehabilitation, Quang Nam Northern Mountainous Region General Hospital, Vietnam
| | - Fei-Chun Chang
- PhD Program for Aging, China Medical University, Taichung, Taiwan
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan
| | - Thi-Lien To
- Faculty of Nursing, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Wen-Chao Ho
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Li-Wei Chou
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
- Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung, Taiwan
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Raj CK, Kim I, Reyes Orozco F, Ma HJ, Herrera K, Hur K. Impact of Age and Gender on Quality of Life Among General Otolaryngology Patients. Laryngoscope 2023; 133:801-806. [PMID: 35833627 DOI: 10.1002/lary.30295] [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: 01/11/2022] [Revised: 05/26/2022] [Accepted: 06/29/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The combined effects of age and gender on health-related quality of life (HRQoL) in otolaryngology patients are unclear. This study tested the hypothesis that the effect of age on HRQoL differs by gender in otolaryngology patients. METHODS Patients seen in a general otolaryngology clinic were included in this retrospective chart review. HRQoL was measured by the SF-6D score. Patient characteristics, including demographics and category of chief otolaryngology complaint, were extracted from medical records. A multivariable linear regression analysis was used to analyze the combined effect of age and gender on HRQoL. The model was adjusted for race, ethnicity, number of complaint categories, and number of medications. RESULTS The study included 728 patients (age mean = 52, SD = 18; 48% male). Multivariable linear regression models found a significant interaction effect between age and gender (β = 0.213, p < 0.05). For younger patients, female gender was protective; however, at age greater than 35 years, female gender was a risk factor for decreased HRQoL. Compared to Black patients, Asian and other race patients reported significantly greater HRQoL (β = 0.207, p < 0.05 for Asian; β = 0.126, p < 0.05 for other races). Additionally, an antagonistic interaction effect was found between age and number of category of otolaryngology complaints in moderating HRQoL (β = 0.468, p < 0.001). CONCLUSION Age affects HRQoL differently in men than in women. Among otolaryngology patients, women experience a greater decrease in HRQoL as they age. LEVEL OF EVIDENCE 4 Laryngoscope, 133:801-806, 2023.
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Affiliation(s)
- Christine K Raj
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A
| | - Ian Kim
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A
| | - Francis Reyes Orozco
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A
| | - Harrison J Ma
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A
| | - Kevin Herrera
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A
| | - Kevin Hur
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A
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Printz T, Mehlum CS, Godballe C, Iwarsson J, Pedersen SG, Christensen JH, Jørkov AS, Grøntved ÅM. Vocal Outcome After Cordectomy by Transoral CO 2 Laser Microsurgery in Patients With Laryngeal Intraepithelial Neoplasia and Non-neoplastic Lesions. J Voice 2022:S0892-1997(22)00129-1. [PMID: 35732537 DOI: 10.1016/j.jvoice.2022.04.018] [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: 12/09/2021] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study investigates vocal outcome after cordectomy by transoral CO2 laser microsurgery (TLM-cordectomy) in patients with laryngeal intra-epithelial neoplasia (LIN) or non-neoplastic lesions (NNL), for improved individual patient advice and potential adjustment of national treatment strategy by which patients suspected to have glottic LIN or T1a cancer are offered TLM-cordectomy, without prior biopsy. STUDY DESIGN Prospective, longitudinal, quasi-experimental time series. METHODS Consecutively included patients (n = 155) with LIN (n = 84) or NNL (n = 71) who underwent voice assessments before and after TLM-cordectomy. The multi-dimensional voice assessment protocol comprised voice and speech range profiles, aerodynamics, acoustic analysis, self-evaluated voice handicap, and perceptual auditory voice ratings. RESULTS Median follow-up time was 195 (range 50-1121) days for patients with LIN and 193 (range 69-1294) days for patients with NNL. Statistically significant changes, LIN: in voice handicap index (VHI) and breathiness after TLM-cordectomy. Statistically significant changes, NNL: voice range profile (voice range area, intensity range, and frequency range) and VHI after TLM-cordectomy. All group-wise changes were to less disordered voices. Previous smokers had the largest decreases in VHI and breathiness. Patients with baseline VHI scores >65 had smaller increases in VHI, however 13-19% of the patients had increases in VHI above the clinically relevant threshold after TLM-cordectomy. CONCLUSION Overall, TLM-cordectomy in patients with LIN and NNL improved vocal outcome and our study thus supports the current Danish treatment strategy and improves the basis for proper patient advice. Multi-dimensional voice assessment is suggested preoperatively and six-nine months postoperatively, with focus on individual vocal differences and voice demands.
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Affiliation(s)
- Trine Printz
- Department of Oto-Rhino-Laryngology - Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Camilla Slot Mehlum
- Department of Oto-Rhino-Laryngology - Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark.
| | - Christian Godballe
- Department of Oto-Rhino-Laryngology - Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
| | - Jenny Iwarsson
- Department of Scandinavian Studies and Linguistics, University of Copenhagen, Copenhagen, Denmark
| | - Solveig Gunvor Pedersen
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | | | - Andreas Schellerup Jørkov
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - Ågot Møller Grøntved
- Department of Oto-Rhino-Laryngology - Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark
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Ou H. A Pilot Study to Develop the Rapid Estimate of Adult Literacy in Audiology. Health Lit Res Pract 2022; 6:e88-e95. [PMID: 35522858 PMCID: PMC9126057 DOI: 10.3928/24748307-20220418-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: Health literacy describes an individuals' ability to maximize their potential in health care, including one's ability to understand information needed to make informed health decisions. A variety of general and condition-specific health literacy assessment tools have been created to help health professionals assess patients' health literacy skills and tailor the need for health care communication or education; however, there are no such tools available for the audiology field. Objective: The purpose of the study was to develop an objective reading recognition audiology-related health literacy assessment tool, the Rapid Estimate of Adult Literacy in Audiology (REALA). Methods: This was a cross-sectional study (N = 200). The initial version of the REALA contained 99 words specifically related to audiology. The final version, revised to have improved clinical utility, contained a total of 48 words that were selected based on item difficulty, item discrimination score, and point-biserial index using classical item analysis. Key Results: The total pass rate for the final version of the 48-word REALA was 0.72 (standard deviation = 0.45) and the Cronbach coefficient alpha was 0.93. Once the comprehension component is added to the tool, the REALA can be a valuable health literacy assessment tool that health professionals use to evaluate patients' audiology-related health literacy. Conclusion: Once the comprehension component is added to the tool, the REALA can be a valuable health literacy assessment tool that health professionals use to evaluate patients' audiology-related health literacy. [HLRP: Health Literacy Research and Practice. 2022;6(2):e88–e95.] Plain Language Summary: A health literacy assessment tool, the REALA, was developed in the study. The final version of REALA contained 48 words relative to hearing healthcare. The results suggested that REALA can help health professionals assess patients' hearing related health literacy and tailor the need for hearing health care communication or education.
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Affiliation(s)
- Hua Ou
- Address correspondence to Hua Ou, MD, PhD, National Institute on Deafness and Communication Disorders, 6001 Executive Boulevard, Bethesda, MD 20892;
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Coprevalence of Presbycusis and Its Effect on Outcome of Voice Therapy in Patients With Presbyphonia. J Voice 2020; 36:877.e9-877.e14. [PMID: 33067119 DOI: 10.1016/j.jvoice.2020.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/28/2020] [Accepted: 09/30/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To identify the coprevalence of presbycusis and presbycusis and analyze the effect of presbycusis on compliance and result of voice therapy in presbycusis patients. METHODS This cross-sectional, prospective cohort study initially screened patients aged ≥65 years who visited our hospital from February 2019 to January 2020. Unaided pure tone audiometry was performed in these subjects to determine the presence of presbycusis. Perceptual voice assessment by an examiner was conducted for screening of presbycusis, and its diagnosis was confirmed through the voice handicap index-10 (VHI-10) questionnaire and a laryngoscopic exam. Patients with presbycusis underwent voice therapy and were assessed for their compliance and outcomes of the treatment according to the coexistence of presbycusis. RESULTS Among the 221 patients, presbycusis and presbycusis were diagnosed in 125 (56.6%) and 110 (49.8%) patients, respectively. The copresence of these two disorders were identified in 87 (39.4%) patients, and there was a significant correlation between presbycusis and presbycusis. The effects of voice therapy were examined in the consecutive 40 patients who were diagnosed with presbycusis. There were 21 patients without presbycusis and 19 patients with presbycusis. The average pretreatment voice handicap index-10 score was significantly higher in presbycusis patients; there was no significant difference in the incidence of dropout from voice therapy between the groups. The patients without presbycusis showed a significant improvement in the functional communication measurement (FCM) level and maximum phonation time (MPT) compared with those of patients with presbycusis after voice therapy. CONCLUSIONS Presbyphonia and presbycusis coexisted in many elderly people. The improvement in the FCM level and MPT after voice therapy was relatively low if patients with presbycusis accompanied by presbycusis. The copresence of presbycusis did not significantly affect compliance with voice therapy in the patients.
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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]
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Correlating Undiagnosed Hearing Impairment with Hyperfunctional Dysphonia. J Voice 2020; 34:616-621. [DOI: 10.1016/j.jvoice.2019.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/01/2019] [Accepted: 02/06/2019] [Indexed: 11/24/2022]
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Samlan RA, Black MA, Abidov M, Mohler J, Fain M. Frailty Syndrome, Cognition, and Dysphonia in the Elderly. J Voice 2020; 34:160.e15-160.e23. [DOI: 10.1016/j.jvoice.2018.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 01/18/2023]
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Ross J, Valentino WL, Calder A, Bigly D, Othman S, McKinnon B, Sataloff RT. Utility of Audiometry in the Evaluation of Patients Presenting with Dysphonia. Ann Otol Rhinol Laryngol 2019; 129:333-339. [DOI: 10.1177/0003489419889373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objectives: Hearing loss has been implicated in dysphonia secondary to voice misuse, although the data supporting this claim are scant. Determining the prevalence of hearing loss in patients with dysphonia and correlating it with self-perception of vocal handicap may help clarify the value of audiometry in evaluation of patients with dysphonia. Methods: This is a retrospective chart review of all new voice patients (n = 405) presenting with dysphonia to the primary investigator between 2015 and 2018. Each new patient routinely undergoes audiometric and voice objective analyses. Main outcomes measured include prevalence, severity of hearing loss, and voice handicap index-10 (VHI-10). Results: Of the 405 subjects reviewed, mean age was 49.0 years (SD = 17.4). 60.7% of subjects were female and 39.3% male. Patients with hearing loss defined as >25 dB in worse ear with pure tone average (PTA) thresholds at 0.5, 1, 2, and 3 kHz (PTA-S) accounted for 18% of the total cohort. The prevalence of previously undiagnosed hearing loss in this cohort was 13.1% (53 of 405 subjects). Of these subjects, 62.3% (33 subjects) reported no perception of hearing loss while 37.7% (20 subjects) suspected they had some hearing loss, yet never sought evaluation. Only increased PTA-S, speech discrimination, Reflux Symptom Index, and female gender demonstrated a significant relationship with VHI-10 when analyzed with multivariate linear regression analysis. Conclusions: The prevalence of hearing loss in patients presenting with dysphonia in this cohort is similar to normative population data. This study has also demonstrated that the majority of these patients did not perceive any hearing loss. The reasons behind this may be a result of or associated with the patients’ dysphonia. Furthermore, clinicians should consider performing audiometric evaluation in patients with abnormal VHI-10 scores in the appropriate clinical context.
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Affiliation(s)
- Justin Ross
- Department of Otolaryngology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | | | - Alyssa Calder
- College of Medicine, Drexel University, Philadelphia, PA, USA
| | - David Bigly
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Sammy Othman
- College of Medicine, Drexel University, Philadelphia, PA, USA
| | - Brian McKinnon
- Department of Otolaryngology—Head and Neck Surgery, College of Medicine, Drexel University, Philadelphia, PA, USA
| | - Robert T. Sataloff
- Department of Otolaryngology—Head and Neck Surgery, Clinical Academic Specialties, College of Medicine, Drexel University, Philadelphia, PA, USA
- Otolaryngology and Communication Sciences Research, Lankenau Institute for Medical Research
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Hengen J, Hammarström IL, Stenfelt S. Perceived Voice Quality and Voice-Related Problems Among Older Adults With Hearing Impairments. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:2168-2178. [PMID: 30167670 DOI: 10.1044/2018_jslhr-s-17-0383] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 05/07/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of this study was to investigate problems relating to phonation and self-perceived voice sound quality in older adults based on hearing ability and the use of hearing aids. METHOD This was a cross-sectional study, with 290 participants divided into 3 groups (matched by age and gender): (a) individuals with hearing impairments who did not use hearing aids (n = 110), (b) individuals with hearing impairments who did use hearing aids (n = 110), and (c) individuals with no hearing impairments (n = 70). All participants underwent a pure-tone audiometry exam; completed standardized questionnaires regarding their hearing, voice, and general health; and were recorded speaking in a soundproof room. RESULTS The hearing aid users surpassed the benchmarks for having a voice disorder on the Voice Handicap Index (VHI; Jacobson et al., 1997) at almost double the rate predicted by the Swedish normative values for their age range, although there was no significant difference in acoustical measures between any of the groups. Both groups with hearing impairments scored significantly higher on the VHI than the control group, indicating more impairment. It remains inconclusive how much hearing loss versus hearing aids separately contribute to the difference in voice problems. The total scores on the Hearing Handicap Inventory for the Elderly (Ventry & Weinstein, 1982), in combination with the variables gender and age, explained 21.9% of the variance on the VHI. Perceiving one's own voice as being distorted, dull, or hollow had a strong negative association with a general satisfaction about the sound quality of one's own voice. In addition, groupwise differences in own-voice descriptions suggest that a negative perception of one's voice could be influenced by alterations caused by hearing aid processing. CONCLUSIONS The results indicate that hearing impairments and hearing aids affect several aspects of vocal satisfaction in older adults. A greater understanding of how hearing impairments and hearing aids relate to voice problems may contribute to better voice and hearing care.
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Affiliation(s)
- Johanna Hengen
- Department of Clinical and Experimental Medicine, Linköping University, Sweden
- Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Sweden
| | | | - Stefan Stenfelt
- Department of Clinical and Experimental Medicine, Linköping University, Sweden
- Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Sweden
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Braun LH, Braun K, Frey B, Wolpert SM, Löwenheim H, Zips D, Welz S. Unilateral cochlea sparing in locoregionally advanced head and neck cancer: a planning study. Strahlenther Onkol 2018; 194:1124-1131. [PMID: 30109361 DOI: 10.1007/s00066-018-1344-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 07/19/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cochlea sparing can reduce late ototoxicity in head and neck cancer patients treated with cisplatin-based radiochemotherapy. In this situation, a mean cochlear dose (MCD) constraint of 10 Gy has been suggested by others based on the dose-effect relationship of clinical data. We aimed to investigate whether this is feasible for primary and postoperative radiochemotherapy in locoregionally advanced tumors without compromising target coverage. PATIENTS AND METHODS Ten patients treated with definitive and ten patients treated with adjuvant intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy were investigated. The cochleae and a planning risk volume (PRV) with a 3 mm margin were newly delineated, whereas target volumes and other organs at risk were not changed. The initial plan was recalculated with a constraint of 10 Gy (MCD) on the low-risk side. The quality of the resulting plan was evaluated using the difference in the equivalent uniform dose (EUD). RESULTS A unilateral MCD of below 10 Gy could be achieved in every patient. The mean MCD was 6.8 Gy in the adjuvant cohort and 7.6 Gy in the definitive cohort, while the non-spared side showed a mean MCD of 18.7 and 30.3 Gy, respectively. The mean PRV doses were 7.8 and 8.4 Gy for the spared side and 18.5 and 29.8 Gy for the non-spared side, respectively. The mean EUD values of the initial and recalculated plans were identical. Target volume was not compromised. CONCLUSION Unilateral cochlea sparing with an MCD of less than 10 Gy is feasible without compromising the target volume or dose coverage in locoregionally advanced head and neck cancer patients treated with IMRT. A prospective evaluation of the clinical benefit of this approach as well as further investigation of the dose-response relationship for future treatment modification appears promising.
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Affiliation(s)
- L H Braun
- Universitätsklinik für Radioonkologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - K Braun
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Tübingen, Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Germany.
| | - B Frey
- Universitätsklinik für Radioonkologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - S M Wolpert
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Tübingen, Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Germany
| | - H Löwenheim
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Tübingen, Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Germany
| | - D Zips
- Universitätsklinik für Radioonkologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - S Welz
- Universitätsklinik für Radioonkologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
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Gois ACB, Pernambuco LDA, Lima KCD. Factors associated with voice disorders among the elderly: a systematic review. Braz J Otorhinolaryngol 2018; 84:506-513. [PMID: 29331352 PMCID: PMC9449164 DOI: 10.1016/j.bjorl.2017.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/23/2017] [Accepted: 11/24/2017] [Indexed: 11/30/2022] Open
Abstract
Introduction During the aging process, natural modifications occur in the larynx and the structures involved in phonation which explain the specific characteristics found in the voices of elderly persons. When, at any moment, a voice fails and there is interference with communication, a voice disorder has occurred. This can generate disadvantages in communicative efficiency and have a negative impact on quality of life, compromising mechanisms of socialization, the maintenance of autonomy, and the sense of well-being. Nevertheless, there appears to be little clarity about which factors are associated with voice disorders in this population, especially from an epidemiological perspective. Objective The present study is a literature review to identify factors associated with voice disorders among the elderly described in population-based studies. Methods A systematic review of electronic databases was carried out. The methodological quality of the studies was analyzed with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. The research was conducted independently by two researchers. Results Although two articles met the eligibility criteria, none fulfilled all the criteria for the evaluation of methodological quality. According to the two studies selected for this review, factors associated with voice disorders among the elderly included both physical and psychosocial aspects. However, the methodological discrepancies between the studies, particularly in relation to sample selection and the instruments used indicate great variability and compromise the reliability of the results. Conclusion Further prevalence studies and investigations of factors associated with voice disorders in the elderly from an epidemiological perspective, and which involve different cultures, should be carried out.
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Góis ACB, Pernambuco L, de Lima KC. Prevalence and Associated Factors With Voice Disorders in Brazilian Community-dwelling Older Adults. J Voice 2018; 33:806.e1-806.e7. [PMID: 29678439 DOI: 10.1016/j.jvoice.2018.02.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 02/28/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to estimate the prevalence and factors associated with voice disorders (VDs) in Brazilian community-dwelling older adults. STUDY DESIGN This is a cross-sectional study. METHODS The sample comprised 463 older adults (60 years or more) of both sexes living in a Brazilian northeastern city. Variables were related to socioeconomic and demographic profile, lifestyle, and general health conditions, in addition to the validated "Screening for Voice Disorders in Older Adults" (RAVI) questionnaire. A bivariate analysis was performed using the Pearson chi-square test or the Fisher exact test, and the magnitude of the association was the prevalence ratio (PR). Poisson regression model was performed, considering only the variables with a critical value of P < 0.20. The significance level was 5%. RESULTS There was a prevalence of women (60.9%), and the average age of participants was 70 (±7.74) years. The prevalence of VDs was 51.4% (95% confidence interval [CI]: 46.8-55.9). The most common symptoms were throat sensation of phlegm (46.9%) and dry throat (46.7%), both related to physical sensations of laryngeal discomfort. Multivariate analysis indicated that the prevalence of VDs was independently associated with hyposalivation (PR = 2.28, 95% CI = 1.80-2.88), smoking (PR = 2.04, 95% CI = 1.65-2.52), self-reported hearing loss (PR = 1.51, 95% CI = 1.28-1.78), and not seeking a physician or other health professional care for VDs (PR = 0.73, 95% CI = 0.60-0.88). CONCLUSION VDs are prevalent among Brazilian community-dwelling older adults and are associated with variables related to general health and lifestyle.
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Affiliation(s)
- Amanda C B Góis
- Post-Graduate Program in Public Health (PPgSCol-UFRN), Universidade Federal do Rio Grande do Norte (UFRN), Rio Grande do Norte, Brazil
| | - Leandro Pernambuco
- Department of Speech, Language and Hearing Sciences, Universidade Federal da Paraíba (UFPB), Paraíba, Brazil; Post-Graduate Program in Speech, Language and Hearing Sciences (PPgFon-UFPB/UFRN), Paraíba, Brazil.
| | - Kenio Costa de Lima
- Post-Graduate Program in Public Health (PPgSCol-UFRN), Universidade Federal do Rio Grande do Norte (UFRN), Rio Grande do Norte, Brazil
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Aghadoost O, Moradi N, Dabirmoghaddam P, Aghadoost A, Naderifar E, Dehbokri SM. Voice Handicap Index in Persian Speakers with Various Severities of Hearing Loss. Folia Phoniatr Logop 2017. [DOI: 10.1159/000455230] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Auditory Processing Abilities of Parkinson's Disease Patients. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2618587. [PMID: 28546963 PMCID: PMC5435898 DOI: 10.1155/2017/2618587] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/03/2017] [Accepted: 04/16/2017] [Indexed: 11/18/2022]
Abstract
Since Parkinson's Disease (PD) primarily affects older people, a majority of PD patients have age-related hearing loss (HL) that will worsen over time. The goal of this study was to assess peripheral and central auditory functions in a population of PD patients and compare the results with a group of age-matched control subjects. Study participants included 35 adults with PD (mean age = 66.9 ± 11.2 years) and a group of 35 healthy control subjects (mean age = 65.4 ± 12.3 years). Assessments included questionnaires, neuropsychological tests, audiometric testing, and a battery of central auditory processing tests. Both study groups exhibited patterns of sensorineural hearing loss (slightly worse in the PD group) which were typical for their age and would contribute to difficulties in communication for many participants. Compared to the control group, PD patients reported greater difficulty in hearing words people are speaking. Although 27 PD patients (77%) were good candidates for amplification, only 7 (26%) of these hearing aid candidates used the devices. Because it is important for PD patients to optimize communication with their family members, caregivers, friends, and clinicians, it is vital to identify and remediate auditory dysfunction in this population as early as possible.
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Pernambuco L, Espelt A, Góis ACB, de Lima KC. Voice Disorders in Older Adults Living in Nursing Homes: Prevalence and Associated Factors. J Voice 2017; 31:510.e15-510.e21. [PMID: 28069466 DOI: 10.1016/j.jvoice.2016.11.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 11/16/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To estimate the prevalence and the associated factors with voice disorders (VDs) in older adults living in nursing homes. STUDY DESIGN Cross-sectional. METHODS A sample of 117 Brazilian individuals of both sexes and preserved cognitive function, aged >59 years, living in 10 nursing homes, was studied. VDs were screened using the validated tool "Rastreamento de Alterações Vocais em Idosos" (RAVI-Screening for Voice Disorders in Older Adults). Associated factors included variables related to socioeconomic and demographic profile; nursing home; general health; ear, nose, and throat conditions; lifestyle; functionality; and psychosocial status. Bivariate analysis was performed by Pearson's chi-square or Fisher's exact test. Multivariate analysis was performed by multiple binomial regression. The significance level was 5%. RESULTS The prevalence of VDs was 39.3% (95% confidence interval [CI] = 30.4-48.1). There was no significant difference in prevalence according to age and sex. Multivariate analysis revealed that the prevalence of VDs were independently associated with anxiety symptoms (prevalence ratio [PR] = 1.97, 95% CI = 1.17-3.29), smoking (PR = 1.56, CI = 1.02-2.38), general daily inactivity (PR = 1.62, CI = 1.10-2.38), temporomandibular disorder (PR = 1.68, CI = 1.11-2.54), choking (PR = 1.53, CI = 1.06-2.20), and self-reported hearing loss (PR = 1.52, CI = 1.04-2.21). CONCLUSION VDs are common among older adults with preserved cognitive function living in nursing homes. The associated factors with VDs in this population can be prevented, diagnosed, controlled, or treated. Screening procedures and early intervention should be considered.
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Affiliation(s)
- Leandro Pernambuco
- Department of Speech, Language and Hearing Sciences, Federal University of Paraíba (UFPB), Paraíba, Brazil.
| | - Albert Espelt
- Customer Service and Drug Addiction Prevention, Public Health Agency of Barcelona (ASPB), Barcelona, Spain; School of Psychology, Department of Psychobiology and Methodology of Health Sciences, Autonomous University of Barcelona (UAB), Bellaterra, Spain; Carlos III Health Institute, CIBER in Epidemiology and Public Health, Madrid, Spain
| | - Amanda C B Góis
- Post-Graduate Program in Public Health (PPGSCol-UFRN), Federal University of Rio Grande do Norte (UFRN), Rio Grande do Norte, Brazil
| | - Kenio Costa de Lima
- Post-Graduate Program in Public Health (PPGSCol-UFRN), Federal University of Rio Grande do Norte (UFRN), Rio Grande do Norte, Brazil
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Bainbridge KE, Roy N, Losonczy KG, Hoffman HJ, Cohen SM. Voice disorders and associated risk markers among young adults in the United States. Laryngoscope 2016; 127:2093-2099. [PMID: 28008619 DOI: 10.1002/lary.26465] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 11/10/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS To examine the prevalence of voice disorders in young adults and identify sociodemographic factors, health conditions, and behaviors associated with voice disorder prevalence. STUDY DESIGN Cross-sectional analysis of data from the National Longitudinal Study of Adolescent to Adult Health. METHODS During home interviews, 14,794 young adults, aged 24 to 34 years, reported their health conditions and behaviors. Presence and duration of voice disorders were reported over the past 12 months. We computed overall and stratified prevalence estimates by age, gender, race/ethnicity, medical conditions, smoking, and alcohol use. Multiple logistic regression was used to identify independent risk factors for a voice disorder while accounting for the complex sample design. RESULTS Six percent of participants reported a voice disorder lasting at least 3 days. Females had 56% greater odds of voice disorders than males. Number of days drinking alcohol was associated with voice disorders, but number of smoking days was not. Conditions that increased the likelihood of voice disorders included hypertension (OR = 1.42 [95% confidence interval {CI}: 1.07-1.89]), tinnitus (OR = 1.53 [95% CI: 1.06-2.20]), and anxiety/panic disorder (OR = 1.26 [95% CI: 1.00-1.60]). Results were independent of gender, alcohol consumption, upper respiratory symptoms, and lower respiratory conditions including asthma, bronchitis/emphysema, and gastrointestinal symptoms (diarrhea/nausea/vomiting). CONCLUSIONS Voice disorders in young adulthood were associated with hypertension, tinnitus, and anxiety. Greater awareness of these relationships may facilitate voice evaluation among people who seek healthcare for these chronic conditions. LEVEL OF EVIDENCE 2b Laryngoscope, 127:2093-2099, 2017.
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Affiliation(s)
- Kathleen E Bainbridge
- Epidemiology and Statistics Program, Division of Scientific Programs, The University of Utah, Salt Lake City, Utah
| | - Nelson Roy
- National Institute on Deafness and Other Communication Disorders, Bethesda, Maryland; Department of Communication Sciences and Disorders, and Division of Otolaryngology-Head and Neck Surgery (Adjunct), The University of Utah, Salt Lake City, Utah
| | - Katalin G Losonczy
- Epidemiology and Statistics Program, Division of Scientific Programs, The University of Utah, Salt Lake City, Utah
| | - Howard J Hoffman
- Epidemiology and Statistics Program, Division of Scientific Programs, The University of Utah, Salt Lake City, Utah
| | - Seth M Cohen
- Duke Voice Care Center, Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina, U.S.A
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Roy N, Kim J, Courey M, Cohen SM. Voice disorders in the elderly: A national database study. Laryngoscope 2015; 126:421-8. [DOI: 10.1002/lary.25511] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Nelson Roy
- Department of Communication Sciences and Disorders, and Division of Otolaryngology-Head & Neck Surgery; The University of Utah; Salt Lake City, Utah
| | - Jaewhan Kim
- Division of Public Health & Study Design and Biostatistics Center; Duke University Medical Center; Durham North Carolina
| | - Mark Courey
- Department of Otolaryngology-Head & Neck Surgery; University of California-San Francisco; San Francisco California U.S.A. The University of Utah, Salt Lake City, Utah
| | - Seth M. Cohen
- Duke Voice Care Center, Division of Otolaryngology-Head & Neck Surgery
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Chiossi JSC, Roque FP, Goulart BNGD, Chiari BM. Impacto das mudanças vocais e auditivas na qualidade de vida de idosos ativos. CIENCIA & SAUDE COLETIVA 2014; 19:3335-42. [DOI: 10.1590/1413-81232014198.07642013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 05/23/2013] [Indexed: 11/22/2022] Open
Abstract
O objetivo do artigo é verificar a autopercepção de idosos ativos sobre o impacto de mudanças vocais e auditivas senescentes em sua vida diária, e a influência desta autopercepção na qualidade de vida. Realizou-se um estudo transversal com 72 idosos de uma Universidade Aberta à Terceira Idade paulistana. Aplicaram-se os questionários HHIE-S; IDV e WHOQoL-Old. Utilizou-se a correlação de Pearson adotando-se como significante o p-valor de 0,05. O impacto das dificuldades auditivas na vida diária foi percebido por 45,8%, e a desvantagem vocal moderada ou severa, por 9,7% dos idosos. A autopercepção de impacto auditivo na vida diária correlacionou-se com o índice de desvantagem vocal. A qualidade de vida foi influenciada negativamente pelo aumento da autopercepção de dificuldades auditivas e vocais no cotidiano. O perfil da amostra é típico da velhice bem-sucedida, com a aceitação das mudanças senescentes e, assim, com menor impacto dessas no seu cotidiano do que o hipotetizado. Os achados sugerem impacto da restrição da participação decorrente da voz e audição na qualidade de vida, embora essa tenha apresentado índices elevados, reforçando a característica de adaptação da amostra à senescência. Os resultados justificam a necessidade de ações de autocuidado e empoderamento para os idosos.
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Dion GR, Miller CL, O'Connor PD, Howard NS. Correlation of otologic complaints in soldiers with speech disorders after traumatic brain injury. J Voice 2013; 28:88-91. [PMID: 24275459 DOI: 10.1016/j.jvoice.2013.08.005] [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: 06/01/2013] [Accepted: 08/12/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine the prevalence of otologic complaints in subjects with dysphonia and traumatic brain injury (TBI) in a sample population of the US Army. STUDY DESIGN Cross-sectional study. METHODS A total of 292 subjects were identified with a new diagnosis of voice disorder during a 3.5-year period at three large military medical centers. Of them, 70 subjects were also identified with TBI and had no history of dysphonia before this time period. In those with voice disorders and TBI, documentation of hearing complaints, hearing loss, tinnitus, or vertigo was recorded. Time to visit an otolaryngologist and audiologist were also recorded. RESULTS A total of 70 soldiers were identified with a diagnosis of a voice disorder and TBI. Of these soldiers, 83% had at least one otologic complaint and 50% had more than one. Approximately 60%, 39%, and 44% of the subjects reported tinnitus, hearing loss, or vertigo, respectively. A total of 62% of the subjects with otologic complaints, TBI, and dysphonia were seen by an otolaryngologist. Time until an otolaryngologist evaluated these soldiers varied widely, with an average of 17 months and standard deviation of 12.5 months. CONCLUSIONS Otologic manifestations are common in soldiers with dysphonia and TBI. Careful consideration of communication impairment from otologic dysfunction in those with speech disorders after TBI is warranted.
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Affiliation(s)
- Gregory R Dion
- Department of Otolaryngology, San Antonio Military Medical Center, Fort Sam Houston, Texas.
| | - Courtney L Miller
- Department of Otolaryngology, San Antonio Military Medical Center, Fort Sam Houston, Texas
| | - Peter D O'Connor
- Department of Otolaryngology, San Antonio Military Medical Center, Fort Sam Houston, Texas
| | - N Scott Howard
- Department of Otolaryngology, San Antonio Military Medical Center, Fort Sam Houston, Texas
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Miranda SVDV, Mello RJVD, Silva HJD. Correlação entre o envelhecimento e as dimensões das pregas vocais. REVISTA CEFAC 2011. [DOI: 10.1590/s1516-18462011005000029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: avaliar as dimensões das pregas vocais em ambos os sexos e correlacioná-las com o envelhecimento. MÉTODO: foram estudados 30 cadáveres (15 mulheres e 15 homens) na faixa etária de 60 a 102 anos. Para isto foram seguidas quatro etapas sequenciais: 1ª) História clínica do cadáver; 2ª) Remoção da laringe; 3ª) Dissecação da laringe; 4ª) Morfometria das dimensões das pregas vocais. Trata-se de um estudo experimental. RESULTADOS: o comprimento da prega vocal masculina com média de 15,90 mm foi maior que o da feminina com 10,39 mm. A largura da prega vocal masculina foi maior com média de 2,37 mm que a feminina com 2,31 mm. A média geral da espessura também foi maior no sexo masculino com média de 2,55 mm em comparação com a feminina com 2,38 mm. Não foram encontradas diferenças estatísticas entre a idade e o comprimento, largura e espessura das pregas vocais em ambos os sexos. CONCLUSÃO: as dimensões de comprimento, largura e espessura das pregas vocais foram maiores no sexo masculino. Entretanto, não houve diferença, estatisticamente significante, entre as três dimensões das pregas vocais durante o envelhecimento em ambos os sexos.
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Nguyen NP, Smith-Raymond L, Vinh-Hung V, Sloan D, Davis R, Vos P, Abraham D, Stevie M, Krafft SP, Ly BH, Ries T, Karlsson U, Ceizyk M. Feasibility of Tomotherapy to spare the cochlea from excessive radiation in head and neck cancer. Oral Oncol 2011; 47:414-9. [DOI: 10.1016/j.oraloncology.2011.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 03/10/2011] [Accepted: 03/10/2011] [Indexed: 11/27/2022]
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Cohen SM. Self-reported impact of dysphonia in a primary care population: an epidemiological study. Laryngoscope 2010; 120:2022-32. [PMID: 20830762 DOI: 10.1002/lary.21058] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study's objectives are to 1) to assess the prevalence of dysphonia in the primary care community, 2) evaluate the severity of dysphonia, 3) explore potential risk factors for dysphonia, 4) examine the treatment of dysphonic patients, and 5) assess treatment-related barriers. The hypotheses are that 1) dysphonia is common in the primary care community, 2) it adversely impacts patients' quality of life (QOL), and 3) patients are underevaluated and experience obstacles with respect to seeking treatment. STUDY DESIGN Cross-sectional, practice-based study in the primary care population. METHODS English-speaking patients 18 years of age and older were recruited from a primary care research network. Patients presenting to their primary care practices were given a packet of questionnaires to complete that documented demographic information, risk factors, presence of dysphonia, prior treatment, and reasons for not seeking treatment. The Voice-Related Quality of Life (VRQOL) and Center for Epidemiological Studies-Depression Scale (CES-D) served as quality-of-life outcome measures. A priori sample size calculations were performed indicating a sample size of 780. Univariate analyses, descriptive statistics, odds ratios and 95% confidence intervals, and multivariate analyses were performed. RESULTS A total of 789 patients with a mean age of 49.9 years and range of 18 to 94 years participated. Lifetime prevalence of dysphonia was 29.1%, point prevalence of dysphonia 7.5%, and 4.3% had had dysphonia for >4 weeks. Of those with current dysphonia, only 46% had not missed work. Of those with current dysphonia, 73.3% had had dysphonia more than once. Patients with dysphonia had lower VRQOL scores and higher CES-D scores (t test, P ≤.001). Risk factors for dysphonia and impaired VRQOL on multivariate analysis included neurologic disease, dry mouth, family history of dysphonia, college or postgraduate level education, allergies or sinus problems, neck pain, medication for depression/anxiety, more than three upper respiratory infections per year, gastroesophageal reflux at least monthly, and asthma or lung disease. Of the patients who had ever had dysphonia, 22.1% received treatment. Common treatment modalities included antireflux treatment, antiallergy treatment, and antibiotics. Speech-language pathology evaluation was rare. Compared to those not interested in treatment, patients wanting treatment were more likely to have chronic dysphonia >4 weeks (30.6% vs. 8.1%; χ(2), P ≤.001), more likely to have dysphonia more than once (85.1% vs. 58.0%; χ(2), P ≤.001), and lower VRQOL scores (median 67.5 vs. 97.5; rank sum test, P <.001). Reasons for not seeking treatment included thinking the dysphonia would go away, physicians did not ask about voice problems, and being unaware of treatment options. CONCLUSIONS At the time one in 13 primary care patients had dysphonia resulting in significant functional impairment with reduced voice-specific QOL and greater depression scores. Risk factors for dysphonia and voice-specific QOL impairment were identified and might be useful for identifying patients at risk for dysphonia. Barriers exist that prevent dysphonic patients from receiving evaluation and treatment. Whether improved methods of dysphonia screening leads to better outcomes and reduced societal impact needs investigation. Laryngoscope, 2010.
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Affiliation(s)
- Seth M Cohen
- Duke Voice Care Center, Duke Otolaryngology-Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
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