[On the Evaluation of Therapeutic Success in Dysphonic Patients]

INTRODUCTION

Multidimensional voice evaluation is considered as gold standard in voice medicine. In this respect, the European Laryngological Society recommended a protocol for standardized evaluation (ELS-Protocol). However, there are only rare data analyzing changes during therapeutical follow-up.

MATERIAL AND METHODS

Using this protocol, 276 patients (136 after phonosurgery, 81 after voice therapy and as a control group 59 patients without voice impairment) were evaluated with regard to their vocal capacity before and after voice therapy or phonosurgery, respectively.

RESULTS

The parameters of the ELS-protocol showed significant improvement under therapy with respect to DSI, VHI, and RBH-scale. It has been confirmed, that these measurements are suitable for the assessment of dysphonic patients with organic as well as functional voice disorders. However, detailed analysis of all the obtained parameters showed only weak or no correlation between all regarding parameters, which should be expected to provide comparable information, such as perturbation parameters or such parameters, that are derived from the acoustical spectrum.

DISCUSSION

Multidimensional evaluation of the voice as recommended by the ELS protocol is independent from the therapeutical approach able to document therapeutical success. The lack of sufficient correlations of values which should provide comparable information shows that an optimization or standardization of measuring instruments, computer hardware and software is necessary.

[Change of vocal capacity due to different vocal loading tests]

BACKGROUND

Vocal loading tests are an important element in the evaluation of vocal function. In Germany mostly tests with changes of loading intensity between 75 and 80 dB(A) or tests with continuous intensity of 80 dB(C) are used.

MATERIAL AND METHODS

17 subjects with healthy vocal function were analyzed in 3 test conditions (1. continuous loading of 80 dB(A), 2. loading with changes of intensity between 75 and 80 dB(A) and 3. without loading for 10 min) concerning DSI and visual analog scale in their time course. The measurements were performed pre, directly after and 20, 40 and 60 min after the loading. The loading test was performed using the German text “Das tapfere Schneiderlein”.

RESULTS

The data show that the deviation and percentages of lower values of the intended dB loading were much greater for the test with changes of intensity compared to the test with continuous loading. There were no significant differences of the DSI between both loading conditions. After the loading there was a drop of the DSI followed by a short recovery and a drop after 60 min.

CONCLUSION

The loading test with continuous intensity appears more stable for healthy subjects and can be fulfilled more easily. Both tests show comparable courses concerning the DSI after the loading tests.