Voice in early glottic cancer compared to benign voice pathology

Abstract

The purpose of this study is to compare (Dutch) Voice Handicap Index (VHIvumc) scores from a selected group of patients with voice problems after treatment for early glottic cancer with patients with benign voice disorders and subjects from the normal population. The study included a group of 35 patients with voice problems after treatment for early glottic cancer and a group of 197 patients with benign voice disorders. Furthermore, VHI scores were collected from 123 subjects randomly chosen from the normal population. VHI reliability was high with high internal consistency and test-retest stability. VHI scores of glottic cancer patients were similar to those of patients with voice problems due to benign lesions. Both groups of patients were clearly deviant from the normal population. Within the normal population, 16% appeared to have not-normal voices. Based on ROC curves a cut-oV score of 15 points was deWned to identify patients with voice problems in daily life. A clinical relevant diVerence score of 10 points was deWned to be used for individual patients and of 15 points to be used in study designs with groups. Patients with voice problems after treatment for early glottic cancer encounter the same amount of problems in daily life as the other voiceimpaired patients. The VHI proved to be an adequate tool for baseline and eVectiveness measurement of voice.

Long-Term Efficacy of Voice Therapy in Patients With Voice Problems After Treatment of Early Glottic Cancer

“…Recent studies revealed equivalence of various European translations and the original American VHI and confirmed the validity of a Dutch translation of the VHI in Dutch. 32,33 In the previous study, we confirmed that the VHI is an adequate tool for baseline and effectiveness measurement of voice problems in daily life. Regarding clinical relevant difference scores, a difference score of 10 points was found to be useful for individuals in clinical practice and 15 points to be useful in study group designs.…”

“…Regarding clinical relevant difference scores, a difference score of 10 points was found to be useful for individuals in clinical practice and 15 points to be useful in study group designs. 33 Applied to the results of this former study, we see that immediately after completion of voice therapy in 7 of the 12 patients, the improvement on the VHI was clinically relevant with an amelioration of more than 10 points. Two of them even managed to obtain a VHI score well within the normal range (below 15) immediately after completion of voice therapy.…”

“…Two of them even managed to obtain a VHI score well within the normal range (below 15) immediately after completion of voice therapy. 33 Even more, another three patients showed further improvement into the VHI range of normal voices during the study period in the long term.…”

Assessment of the Voice Handicap Index as a Screening Tool in Dysphonic Patients

“…These authors considered this level to be clinically relevant and useful for distinguishing patients with voice disorders from controls. Their conclusion differs only slightly from the one drawn by Van Gogh et al [17] , who postulated that the level of 15 points should indicate the borderline of the VHI test.…”

Voice Handicap and Health-Related Quality of Life in Laryngectomees: Assessments with the Use of VHI and EORTC Questionnaires

“…According to a study by Van Gogh et al [28] , differences regarding VHI scores in group comparisons should be more than 15 points to be statistically and clinically relevant. In the present study no significant VHI differences were found between the age groups, or between groups that differed with respect to the postoperative period.…”