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-repo...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.展开更多
Background: This is a retrospective study on a group of patients with early glottic carcinoma, treated with curative radiotherapy. The aim of the study is to assess voice quality after treatment. We also evaluated loc...Background: This is a retrospective study on a group of patients with early glottic carcinoma, treated with curative radiotherapy. The aim of the study is to assess voice quality after treatment. We also evaluated local recurrence, overall survival, disease free survival and toxicity. Material and Methods: We examined a total of 36 patients, out of which 27 were smokers: 10 females/5 smokers;26 males/22 smokers. The sample was observed from January 2007 to July 2012 (average follow-up period: 33.5 months, range 12 - 76). Diagnosis of early glottic carcinoma was eight during the two-year period 2007/2008, nine during 2009/2010, eleven during year 2011 and eight during year 2012. All patients suffering from early glottic carcinoma, histopathologically confirmed, were classified as follows: 24 patients T1a, 3 patients T1b, 6 patients T2 and 3 patients had a carcinoma in situ. They were treated only with conventional radiotherapy. After the treatment (total dose 70 Gy), patients were asked to fill out the Voice Handicap Index (VHI) questionnaire, composed of 30 questions that covered physical, emotional and functional areas. Results: The global VHI was evidenced with good voice quality (62% of patients: VHI < 30;34% of patients: VHI 31 - 60). Vocal disability was mild in over 70% of patients within the physical area and over 80% within the emotional area. We observed two local recurrences, one occurred five years after the end of radiation therapy and one six months after. In terms of toxicity, we observed that acute reactions, such as dysphonia, dysphagia and erythema, were relatively limited. Conclusions: The VHI index suggests that radiotherapy produces acceptable functional results, with limited repercussion on life quality. In line with literature, our data confirmed good cure rates and larynx preservation (94.4%).展开更多
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 di...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.展开更多
文摘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.
文摘Background: This is a retrospective study on a group of patients with early glottic carcinoma, treated with curative radiotherapy. The aim of the study is to assess voice quality after treatment. We also evaluated local recurrence, overall survival, disease free survival and toxicity. Material and Methods: We examined a total of 36 patients, out of which 27 were smokers: 10 females/5 smokers;26 males/22 smokers. The sample was observed from January 2007 to July 2012 (average follow-up period: 33.5 months, range 12 - 76). Diagnosis of early glottic carcinoma was eight during the two-year period 2007/2008, nine during 2009/2010, eleven during year 2011 and eight during year 2012. All patients suffering from early glottic carcinoma, histopathologically confirmed, were classified as follows: 24 patients T1a, 3 patients T1b, 6 patients T2 and 3 patients had a carcinoma in situ. They were treated only with conventional radiotherapy. After the treatment (total dose 70 Gy), patients were asked to fill out the Voice Handicap Index (VHI) questionnaire, composed of 30 questions that covered physical, emotional and functional areas. Results: The global VHI was evidenced with good voice quality (62% of patients: VHI < 30;34% of patients: VHI 31 - 60). Vocal disability was mild in over 70% of patients within the physical area and over 80% within the emotional area. We observed two local recurrences, one occurred five years after the end of radiation therapy and one six months after. In terms of toxicity, we observed that acute reactions, such as dysphonia, dysphagia and erythema, were relatively limited. Conclusions: The VHI index suggests that radiotherapy produces acceptable functional results, with limited repercussion on life quality. In line with literature, our data confirmed good cure rates and larynx preservation (94.4%).
文摘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.
文摘目的探讨嗓音障碍指数(voice handicap index,VHI)用于嗓音障碍性疾病患者自我评估的临床意义及与声学参数间的相关性。方法对嗓音障碍性患者114例(患者组)及嗓音正常者40例(对照组)采用多维嗓音软件(multi dimensional voice program,MDVP)进行嗓音声学分析和VHI调查,嗓音声学分析指标包括基频、基频微扰、振幅微扰、噪声/谐和比(noise to harmonic ratio,NHR),VHI调查包括功能(function,F)、生理(physiology,P)、情感(emotion,E)3个范畴,记录3方面得分及总分(total scores of the VHI,TVH)分值。结果患者组的基频微扰、振幅微扰、NHR均高于正常组,差异有统计学意义(P<0.01);患者组与对照组间VHI差异有统计学意义(P<0.01)。VHI中P与E之间(r=0.863),F与TVH之间(r=0.818)、P与TVH之间(r=0.929)、E与TVH之间(r=0.910)均有良好相关性(P<0.01);VHI各范畴与嗓音各参数之间无显著相关性(P>0.05)。结论临床上不能以嗓音声学分析为标准来预测主观评估结果;VHI可用于主观反映患者的嗓音障碍程度。
