The vocal quality of a patient is modeled by means of a Dysphonia Severity Index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following selected set of voice measurements: highest frequency (F(0)-High in Hz), lowest intensity (I-Low in dB), maximum phonation time (MPT in s), and jitter (%). The DSI is derived from a multivariate analysis of 387 subjects with the goal of describing, purely based on objective measures, the perceived voice quality. It is constructed as DSI = 0.13 x MPT + 0.0053 x F(0)-High - 0.26 x I-Low - 1.18 x Jitter (%) + 12.4. The DSI for perceptually normal voices equals +5 and for severely dysphonic voices -5. The more negative the patient's index, the worse is his or her vocal quality. As such, the DSI is especially useful to evaluate therapeutic evolution of dysphonic patients. Additionally, there is a high correlation between the DSI and the Voice Handicap Index score.
Objective: The aim of this study was to define patient characteristics of a dysphonic population in terms of voice disorder, gender, age, and subjective and objective vocal parameters and to explore the relevant characteristics of the most frequent groups of voice disorders. Patients and Methods: Patient records from 4,447 subjects referred for voice assessment and/or voice therapy were analyzed. Results: Significantly more cases of dysphonia were structural as compared to nonstructural. This significant difference was found in almost all age groups. Significantly more women were diagnosed with dysphonia than men. The most common symptom was light-to-moderate hoarseness. The average voice handicap index was 31 and the average dysphonia severity index was -0.6. Vocal fold nodules (VFN), functional voice disorders (FVD) and vocal fold paralysis (VFP) were the three most frequently diagnosed vocal pathologies and were analyzed in detail. Women were found to be significantly more vulnerable to FVD, VFN and cysts, whereas men were significantly more often diagnosed with carcinoma, hyperkeratosis, laryngitis, papillomatosis, presbyphonia, puberphonia and VFP. Conclusions: The results of this study allow a better estimation of the clinical needs and costs for a specific dysphonic population looking for help and highlight the gender-related risks of specific voice disorders.
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