Morphometric Correlations of the Voice Category (VC) in Professional Singers with Oropharyngeal and Laryngeal Anatomy Using Stroboscopy and Cervical Posteroanterior Radiography

Objective(s): The aim of this study is to explore if there is a correlation between the typical voice classification and the oropharyngeal and laryngeal morphology, using video laryngeal stroboscopy and cervical posterior-anterior radiography on professional singers in Greece. Methods: 55 professional singers (28 females: 7 sopranos, 12 mezzo-sopranos, and 9 contraltos;27 males: 8 tenors, 12 baritones and 7 basses) were recruited for this study. All participants underwent stroboscopic and cervical posterior-anterior radiographic imaging of their oral pharyngeal and laryngeal area. Additionally, the voice classification and features (e.g., height, weight) of individuals were correlated statistically. Results: Statistically significant correlations were observed between the VC of the participants with the Phonetic Area (PA) (r = −0.451, p = 0.001) and the VC with the Oral-pharyngeal Cavity (OPC) area (r = −0.402, p = 0.001) in the total sample. Specifically, in male singers, the PA and VC correlation was r = −0.319, p = 0.047, and the VC and OPC area was r = −0.328, p = 0.044. Likewise, in female singers, the PA area and VC and PA were r = −0.336, p = 0.041 and the OPC area and VC were r = −0.344, p = 0.039. The analysis confirmed no correlations between VC and height and body weight. Conclusions: The cervical posteroanterior radiography in conjunction with laryngeal stroboscopy provided new morphometric correlations of the VC of professional singers with their Oropharyngeal and Laryngeal Anatomy.

A Preliminary Receiver Operating Characteristic Analysis on Voice Handicap Index Results of the Greek Voice-Disordered Patients

Objective(s): The cutting-edge assessment of voice disorders includes objective and subjective methods in the daily clinical practice. The latter assessment is usually performed through the administration of self-reported questionnaires. Voice Handicap Index (VHI) is one of the most widely used tools both in clinical practice and in research level. This tool-questionnaire was employed in this research along with the Voice Evaluation Template (VEF). In turn, the aim of this study was to analyse and produce the cut-off points of VHI for voice-disordered patients in Greece by using Receiver Operating Characteristic Curves (ROC Curves). Methods: Sixty-three participants (40 non-dysphonic and 23 with different types of dysphonia) were classified by ENT (Ear, Nose, and Throat) doctors and SLPs (Speech-Language Pathologists). The Hellenic VHI along with the translated Greek version of the VEF was administered to the subjects of this research. Results: The voice-disordered subjects exhibited higher overall VHI scores (in total and in its 3 subdomains) compared to the control group. Statistical significant differences were found between dysphonic and non-dysphonic participants for all VHI’s construct domains. The cut-off point of VHI total score was estimated at the value of 14.50 (sensitivity: 0.870, 1-specificity: 0.000). Moreover, the cut-off points of the three subdomains were computed as 7.50 for functional (sensitivity: 0.783, 1-specificity: 0.000), 8.50 for physical (sensitivity: 0.739, 1-specificity: 0.000) and 8.50 for emotional domain (sensitivity: 0.783, 1-specificity: 0.050). Conclusion: The preliminary statistical and ROC data analysis of VHI concluded that by using this type of assessment method, populations with or without voice disorders (in Greece) can be distinguished. Albeit this tool is a non-interventional method it could consequently offer an adequate screening and monitoring capability.

Preliminary Receiver Operating Characteristic Analysis on Voice Handicap Index of Laryngeal Inflammation in Greek Patients

Objective(s): Laryngeal inflammations lead to voice disorders. Medical conditions such as chronic laryngitis, gastroesophageal reflux, laryngopharyngeal reflux, Reinke edema and/or vocal folds hemorrhage, result in diverse symptoms including chronic cough, throat cleaning and dysphonia (e.g. hoarseness). In turn, the dysphonic symptoms can be evaluated via subjective and objective procedures. The objective procedures usually include self-perceived questionnaires like the Voice Handicap Index (VHI). Studies reported that VHI can distinguish objectively dysphonic and non-dysphonic populations using the cut-off points of Receiver Operating Characteristic Curves. The purpose of this study was to calculate the cut-off points for individuals exhibiting voice symptoms which had been developed from laryngeal inflammatory diseases in Greece. Methods: One hundred and twelve participants (90 non-dysphonic and 22 dysphonic) filled in the Hellenic Voice Handicap Index (VHI) and the Greek translated version of Voice Evaluation Template (VEF) were administrated. All subjects were evaluated by an Otolaryngologist and a Speech-Language Pathologist. Results: The group with voice disorders exhibited higher VHI scores (in total and in its 3 subdomains) compared to non-dysphonic subgroup. Statistical significant differences were found for all VHI’s total cut-off point of 19.50 (sensitivity: 0.882, 1-specificity: 0.011) and for its three subdomains [functional 6.50 (sensitivity = 0.636, and 1-specificity = 0.022);physical 9.50 (sensitivity = 0.636, and 1-specificity = 0.000);emotional 6.50 (sensitivity = 0.455, and 1-specificity = 0.133)]. Conclusion: The preliminary results showed that VHI could discriminate individuals having voice disorders from laryngeal inflammations. The Voice Handicap Index can be used as a primary health care tool and a self-monitoring procedure in acute and sub-acute phases of the laryngeal inflammation.