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At least 145 records · Page 8Linked to original sources

Psychometric evaluation of disease specific quality of life instruments in voice disorders.

The objective of this study was to compare the psychometric properties of voice disordered quality of life (VQOL) instruments. Nine VQOL instruments were identified through a comprehensive literature search. Based on specific criteria, four were selected for comprehensive review: Voice Handicap Index (VHI), Voice Activity and Participation Profile (VAPP), Voice-Related Quality of Life (V-RQOL) and Voice Outcome Survey (VOS). Selected instruments were evaluated based on 11 measurement standards related to item information, versatility, practicality, breadth and depth of health measure, reliability, validity, and responsiveness. VHI and V-RQOL each met 7 of 11 criteria, with VHI showing additional preferable item information, practicality, and reliability over V-RQOL and V-RQOL showing preferable responsiveness properties over VHI. These study results do not support the Social Security Administration's recent conclusion that the VHI meets reliability and validity standards for individual decision making. Nevertheless, the present results do support the use of VHI total scores for clinical use with individual patients, and the use of V-RQOL total scores or individual dimension scores for use with groups of patients.

Humans↗

Treating voice disorders in the school-based setting: working within the framework of IDEA.

The role of the speech-language pathologist (SLP) has developed considerably over the last 10 years given the medical and technological advances in lifesustaining procedures. Over time, children born with congenital, surgical, or "medically fragile" conditions hav become mainstreamed into regular school-based settings, thus extending the traditional role of the SLP and multidisciplinary team. Understanding the impact of these voice disorders on the child's educational performance has been a struggle for many clinicians because the eligibility decisions for students in school-based settings must be made within the framework of federal legislation and regulations governing the provision of services for students with disabilities. This article discusses how to identify children with voice disorders under the Individuals With Disabilities Education Act (IDEA) definition, the role of the SLP in assigning priority in various voice management scenarios, and how models of therapy can be incorporated in the school-based setting.

Adolescent↗

Functional voice disorders. A review of 109 patients.

The records of 109 patients, presenting with functional voice disorder during the years 1977-1981, have been reviewed. The mean age was 45 years and the F : M ratio is 2 : 1. Excess voice use was not obviously an aetiological factor. Sixty-one of the 109 patients (56 per cent) were cured by speech therapy, in that their voices returned to their pre-morbid state, and a further 28 (26 per cent) were improved by therapy; seven patients (6 per cent) did not improve and 13 (12 per cent) were lost to follow-up. Of the patients that were 'cured', 54 per cent were discharged after three months' treatment and 72 per cent after six months' treatment. Eight per cent required treatment for more than a year.

Adolescent↗

[Use of standard protocols in the evaluation of voice disorders].

The purpose of this paper is to present a protocol for the use of standard forms in the evaluation of laryngeal structure and function in patients with voice disorders. The forms are designed to cover all the essential parameters needed to reach an accurate descriptive diagnosis which allows us to have an appropriate therapy plan according to the individual's detailed observations. It also gives us a consistent standardized evaluation form to measure changes after therapy whether behavioral, medical or surgical, and to compare different observations across patients. Reporting observations in this consistent manner will make characteristic patterns of different vocal behaviors readily obvious to the researcher or the clinician and reduce the possibility of missing any important details. The protocols are: indirect laryngoscopy, video-stroboscopic-evaluation form, functional voice and auditory perceptual voice evaluation.

Adult↗

pH monitoring in patients with benign voice disorders.

The aim of this study was to compare oesophageal pH-metry with laryngeal signs and symptoms in patients suspected of laryngeal reflux disease. A total of 60 patients with voice disorders, who were suspected of laryngeal reflux, were tested by single probe oesophageal pH monitoring. Thirty-two suffered from reflux laryngitis. A comparison of symptoms in patients with proven reflux to patients with no reflux was made. The symptoms were more frequent in the patients in the reflux group than in the non-reflux group. There was a significant difference between the groups with regard to dysphonia, sore throat, thick mucus and heartburn. Clinical signs appeared more frequently in the reflux group than in the non-reflux group. A significant difference was found between the groups regarding oedema of the vocal cords and hyperaemia and oedema of the posterior commisure, contact granuloma, posterior wall granulation and increased muscle tension. The patients in the reflux group were given medical treatment using omeprazole, and 76% logopedic voice training program. More than 50% of the laryngeal reflux patients were treated for more than 4 months before their voice problems had resolved. It is important to realize that signs of reflux laryngitis are not confined to the posterior commisure.

Adult↗

[Spectrographic study of voice disorders: subharmonics].

The presence of subharmonics in abnormal adult voices (polyps, polypoid degeneration, plicae ventricularis) was investigated. Subharmonics are low-frequency modulations located between two consecutive harmonics in the spectrum. Spectrum analysis was performed on 115 abnormal voices, of which 36 (31%) had subharmonics. Thirteen of the 36 voices with subharmonics had normal jitter and shimmer, so the rough voice was characterized acoustically not only by jitter and shimmer but by the presence of subharmonics in the spectrum. Subharmonics may correspond to a qualitative change in the behavior of the vibratory system.

Adult↗

Pathogenesis of voice disorders in childhood.

The aim of this article is to review: The specific features of phonatory structures in childhood and their functional correlations. The causal factors of voice disorders in the pediatric patient: chromosomal defects, congenital deformities, mass laryngeal lesions, inflammations and infections, traumata, neurologic disorders, metabolic and endocrine disorders, deafness, velopharyngeal insufficiency, adolescent voice change, vocal abuse and misuse, and musculoskeletal tension disorders.

Adolescent↗

Efficacy of videostroboscopy in the diagnosis of voice disorders.

While videostrobolaryngoscopy is not a new technique, its acceptance as a routine part of the voice evaluation has not been as forthcoming. Many are in agreement that the rigid fiberoptic telescopes in combination with standard VHS equipment provide a clear, magnified image that can be recorded and used for pretreatment and post-treatment comparisons, documentation, teaching, and research. Yet, some skepticism persists with regard to the ability of videolaryngoscopy and/or videostrobolaryngoscopy in changing the diagnosis and treatment outcome of patients with voice disorders as compared to indirect laryngoscopy. Two hundred ninety-two dysphonic patients were identified who underwent indirect as well as videolaryngoscopy with and without stroboscopic examination. Videostrobolaryngoscopy was found to alter the diagnosis and treatment outcome in 14% of the patients. It is most useful in patients with a diagnosis of functional dysphonia and vocal fold paralysis by indirect laryngoscopy. The increased illumination and magnification afforded by rigid fiberoptic telescopes during videolaryngoscopy, combined with the detailed assessment of glottic closure, mucosal wave, and amplitude characteristics provided by stroboscopic examination, allowed detection of subtle vocal fold pathology, otherwise missed by indirect laryngoscopy.

Adolescent↗

[Analysis of voice disorders in teachers treated in the Phoniatric Laboratory of the Otolaryngology Department AM in Wrocław].

Analysis of voice disorders in 898 teachers was performed. In all cases otolaryngologic, videostroboscopic and phoniatric examinations were completed. There was prevalence of women at the age ranged from 46 to 56 years. Majority of morphologic changes included Reinkes oedema (120 cases), chronic simple laryngitis (109 cases), vocal nodules (95 cases), chronic hypertrophic laryngitis (70 cases) and laryngeal polyps (35 cases). In 175 cases vocal insufficiency of glottis and in 57 cases functional disorders were diagnosed. In 131 cases no morphologic and functional changes were found. In the group of teachers the incidence of vocal insufficiency was higher than in control group. The analysis of the examined teachers revealed that professional disease was confirmed in 33% of cases. Majority of them included vocal nodules and chronic hypertrophic laryngitis.

Case-Control Studies↗

Laryngeal aerodynamics associated with selected voice disorders.

Measures of estimated subglottal air pressure and laryngeal air flow during speech production are compared for adults with normal laryngeal function and those with laryngeal abnormalities. The most traditional measure, air flow during sustained vowel production, is not a strong predictor of laryngeal function during speech production. Subglottal air pressure and laryngeal air flow offer insight into voice disorders and provide directions for therapy as well as a method for the quantitative assessment of treatment outcomes.

Air Pressure↗

An integrated tool for the diagnosis of voice disorders.

A PC-based integrated aid tool has been developed for the analysis and screening of pathological voices. With it the user can simultaneously record speech, electroglottographic (EGG), and videoendoscopic signals, and synchronously edit them to select the most significant segments. These multimedia data are stored on a relational database, together with a patient's personal information, anamnesis, diagnosis, visits, explorations and any other comment the specialist may wish to include. The speech and EGG waveforms are analysed by means of temporal representations and the quantitative measurements of parameters such as spectrograms, frequency and amplitude perturbation measurements, harmonic energy, noise, etc. are calculated using digital signal processing techniques, giving an idea of the degree of hoarseness and quality of the voice register. Within this framework, the system uses a standard protocol to evaluate and build complete databases of voice disorders. The target users of this system are speech and language therapists and ear nose and throat (ENT) clinicians. The application can be easily configured to cover the needs of both groups of professionals. The software has a user-friendly Windows style interface. The PC should be equipped with standard sound and video capture cards. Signals are captured using common transducers: a microphone, an electroglottograph and a fiberscope or telelaryngoscope. The clinical usefulness of the system is addressed in a comprehensive evaluation section.

Computer Graphics↗

Acoustic analysis in the diagnosis of voice disorders in children.

The main aim of this study was to describe the changes in acoustic analysis in diagnosing voice disorders in children. The secondary goal was the attempt at differentiation of organic and functional disorders by means of acoustic analysis. The study included 112 children in treated due to laryngeal papilloma, gastro-esophageal reflux, atopic disease and noduli vocales. The following values have been determined: basic frequency F(o), jitter, shimmer, F(o) tremor and the harmonics to noise ratio (HNR). The study results confirmed that the HNR value was the most sensitive indicator of changes in the voice organ.

Adolescent↗

Influence of body position on breathing and its implications for the evaluation and treatment of speech and voice disorders.

This paper examines how breathing differs in the upright and supine body positions. Passive and active forces and associated chest wall motions are described for resting tidal breathing and speech breathing performed in the two positions. Clinical implications are offered regarding evaluation and treatment of breathing behavior in clients with speech and voice disorders.

Abdominal Muscles↗

Voice disorders without organic diseases of the larynx. A 10-year review of 62 patients.

We reviewed the clinical records of 62 patients with voice disorders without organic diseases of the larynx who were examined in the Department of Otolaryngology, Kurume University Hospital during the 10 years from 1971 to 1980. There were 9 patients with psychogenic dysphonia, 24 with vocal abuse, 4 with spastic dysphonia, 9 with mutational voice disturbance, 8 with virilization of voice, 7 with dysphonia attributed to diseases of other organs than the larynx, and 1 with senile change of voice. The clinical service to the patients with these kinds of dysphonia has been poor in Japan for lack of trained voice pathologists. This has been also the case with our department. Recognition for the necessity of voice pathologists is strongly demanded.

Adolescent↗