Objective: The aim of the study was to assess the applicability of the Voice Handicap Index (VHI) in the screening diagnostics of voice dysfunction and in the evaluation of the level of handicap due to dysphonia. Patients andMethods: A total of 165 patients with voice disorders (vocal paresis, benign vocal fold masses, and functional dysphonia) and 65 healthy controls completed the VHI questionnaire. All the participants were subjected to maximum phonation time (MPT) assessment, the patients also to laryngovideostroboscopy. Results: The VHI scores for the patients and controls differed significantly (p < 0.001). A significant correlation (p < 0.05) was found when MPT and VHI were compared. The cutoff point, at which VHI sensitivity (for distinguishing between subjects with voice dysfunction and with vocal health) reached its maximal value (98%) at the highest level of specificity (95%), was assumed to be 12. Conclusions: The study revealed that the VHI is a reliable tool for identifying patients who experience vocal dysfunction and should be used in multidimensional diagnostics of voice disorders. The level of 12 points in the VHI test should be considered to be a threshold for rating the biopsychosocial impact of dysphonia.
Objective: The aim of this study was to investigate the relationship between acoustic analysis and biopsychosocial implications of voice problems, evaluated by the Voice Handicap Index (VHI). Materials and Methods: The study comprised 120 female teachers with voice disorders, evaluated by videolaryngostroboscopy. 60.8% of this group were diagnosed as having functional dysphonia and 39.2% had dysphonia with benign vocal fold masses (nodules and polyps). The controls consisted of 30 euphonic women. The correlations between VHI and acoustic analysis were assessed in both groups using the Pearson correlation coefficient and regression analysis. Results: In teachers, the total VHI score was over 5 times as high as in controls (p < 0.001). Moreover, in teachers, significant positive correlations were found between the total VHI score and the frequency perturbation parameters and amplitude perturbation parameters when both statistical methods were used. These acoustic parameters also significantly correlated with the score on the functional and emotional subscales, but rarely with the physical subscale of the VHI. Conclusions: The study revealed a significant relationship between the objective voice measurements and the VHI. The results confirmed that VHI can be a valuable tool for assessing biopsychosocial implications of occupational dysphonia and should be incorporated in multidimensional voice evaluation.
Objectives: Occupational voice disorders are accompanied by increased tension of the external laryngeal muscle which changes the position of the larynx and consequently disturbs the conditions of functioning of the vocal tract. The aim of the study is to assess the use of osteopathic procedures in the diagnosis and treatment of occupational dysphonia. Material and Methods: Study subjects included 40 teachers with chronic diseases of the voice organ (38 women and 2 men) aged from 39 to 59 (mean age: 48.25). Before and after the voice therapy the osteopathic examination according to Libermann's protocol was performed as well as phoniatric examination including laryngovideostroboscopy (LVSS), assessment of the maximum phonation time (MPT) and the Voice Handicap Index (VHI) score. The voice therapy, scheduled and supervised by a laryngologist-phoniatrician and conducted by a speech-language pathologist, was supplemented with osteopathic myofascial rehabilitation of the larynx. The chisquare McNemar test and non-parametric Wilcoxon matched pairs test were applied in the statistical assessment. Results: The applied interdisciplinary treatment including osteopathic and vocal therapy resulted in a statistically significant decrease in tenderness of muscles raising the larynx (cricothyroid ligament, sternocleidomastoid muscles, and pharyngeal constrictor muscles) and in lowering the tonus (geniohyoid muscles, pharyngeal constrictor muscles and sternocleidomastoid muscles). A significant improvement was also observed in the case of dysfunction of the cricothyroid joint examined during glissando and yawning, as well as in asymmetry of the thyrohyoid apparatus. Moreover, the therapy resulted in significantly better normalization of the head position and better control of the centre of gravity of the body. Statistically significant post-therapy improvement was observed in the phoniatric examination, including VHI scores, MPT results and parameters of videostroboscopic examination. Conclusions: The use of osteopathic therapy helps significantly improve the functions of the vocal tract in patients with occupational dysphonia.
The European project EMFnEAR was undertaken to assess potential changes in human auditory function after a short-term exposure to radiofrequency (RF) radiation produced by UMTS (Universal Mobile Telecommunication System) mobile phones. Participants were healthy young adults with no hearing or ear disorders. Auditory function was assessed immediately before and after exposure to radiofrequency radiation, and only the exposed ear was tested. Tests for the assessment of auditory function were hearing threshold level (HTL), distortion product otoacoustic emissions (DPOAE), contralateral suppression of transiently evoked otoacoustic emission (CAS effect on TEOAE), and auditory evoked potentials (AEP). The exposure consisted of speech at a typical conversational level delivered via an earphone to one ear, plus genuine or sham RF-radiation exposure produced by a commercial phone controlled by a personal computer. Results from 134 participants did not show any consistent pattern of effects on the auditory system after a 20-min UMTS exposure at the maximum output of the phone with 69 mW/kg SAR in the cochlea region in a double blind comparison of genuine and sham exposure. An isolated effect on the hearing threshold at high frequencies was identified, but this was statistically nonsignificant after correction for multiple comparisons. It is concluded that UMTS short-term exposure at the maximum output of consumer mobile phones does not cause measurable immediate effects on the human auditory system.
Occupational dysphonia is mainly of hyperfunctional origin, expressed by complaints experienced in the vocal tract. The aim of the paper was to evaluate the applicability of the Polish Vocal Tract Discomfort (VTD) scale in the diagnostics of occupational dysphonia. Patients with occupational dysphonia (n = 218) and controls (n = 140) were subjected to the VTD scale, VHI evaluation, and maximum phonation time (MPT) measurement. The patients also underwent videostroboscopy. The comparison of the frequency and severity of VTD symptoms showed that the results of the study group were significantly higher (P = 0.000). The VTD scale is characterized by high values of Cronbach's alpha. This study results indicate that the VTD scale can be a valuable tool, useful in the diagnostics of occupational dysphonia.
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