The clinical utility of vocal dosimetry for assessing voice rest

Abstract

Objective Voice rest is frequently recommended following surgical disruption of vocal fold epithelium, but patients report variable adherence to voice rest recommendations. The objective of this study was to assess the clinical utility of an ambulatory vocal dosimeter for measuring adherence to voice rest recommendations. Study Design Outcomes research Methods Part 1: To determine the utility of the dosimeter in non-clinical use, the relationship between self-reported voice use and dosimeter measurements was examined in normal subjects (n=11) who prospectively logged voice use while wearing the dosimeter. Part 2: To determine clinical utility of the dosimeter, patients undergoing vocal fold surgery for which post-operative voice rest was recommended (n=11) wore a dosimeter for two days prior to and two days after surgery. Phonation percent and sound level were compared at baseline and during voice rest. Results The dosimeter performed as hypothesized with both normal subjects and patients. A moderate correlation (r=0.62) was noted between self-reported voice use and dosimeter measurements in normal subjects. In patients on voice rest, a statistically and clinically significant decrease was observed in measured voice use, both in phonation time (p=0.002) and intensity of phonation (p=0.004). Conclusions Ambulatory vocal dosimetry may have clinical utility for assessing adherence to voice rest recommendations. This information will be useful for the design of future studies on voice rest. Level of evidence 2c

Role of voice rest following laser resection of vocal fold lesions: A randomized controlled trial

“…Previous studies have shown that subjects are typically tolerant of wearing a vocal dosimeter such as the Vocalog for prolonged periods of time . A feasibility study looked at employing the Vocalog device as a measure of gauging patient compliance following vocal cord surgery . This study with 11 patients showed the voice dosimeter was an effective means of measuring compliance to postoperative voice rest prescription …”

“…A feasibility study looked at employing the Vocalog device as a measure of gauging patient compliance following vocal cord surgery . This study with 11 patients showed the voice dosimeter was an effective means of measuring compliance to postoperative voice rest prescription …”

“…Phonatory and nonphonatory voicing would register on the device in decibel measurements per second. Only those readings of 60 dB or greater were used to define a positive event as described previously . We quantified patients voice use as a percentage of time with readings over 60 dB per hour for the entire total recording time measured by the dosimeter.…”

Effect of Noise on Vocal Loudness and Pitch in Natural Environments: An Accelerometer (Ambulatory Phonation Monitor) Study

“…17,18 This instrument is marketed as Ambulatory Phonation Analyzer and has been used rather extensively to study the voice use in student singers 19 ; monitoring and logging voice use in call center operators, 20 teachers, 21 after surgery 22 ; and for clinical use with patients with voice disorders. 18 With the attachment of the accelerometer to the neck above the sternal notch, the accelerometer detects the skin vibration during phonation.…”

Accuracy of Self-Reported Estimates of Daily Voice Use in Adults With Normal and Disordered Voices

“…Of direct relevance to the current study, Ohlsson, Brink, and Löfqvist (1989) reported large discrepancies between self-reported speaking time (62%-71%) and phonation time derived from a contact-microphone-based ambulatory voice monitor (5%-7%); in that study, however, only speakers with normal voices were monitored, and a quantitative statistical analysis between self-reported and voice-monitor data was not carried out. In more recent work, Misono, Banks, Gaillard, Goding, and Yueh (2015) report that phonation times measured with a VocaLog (Griffin Laboratories, Temecula, CA) voice dosimeter correlated moderately (r = .62) with self-reported estimates of voice use by subjects with normal voices. However, subjects were monitored for only 2 hr, and there is some evidence that the VocaLog tends to overestimate phonation times (Van Stan, Gustafsson, Schalling, & Hillman, 2014).…”