Cross-Cultural Adaptation, Validation, and Diagnostic Accuracy of the Voice Fatigue Handicap Questionnaire-Persian Version.

OBJECTIVE: The current study aimed to determine the psychometric characteristics of a translated version of the Voice Fatigue Handicap Questionnaire in Persian by examining the validity, reliability, and diagnostic accuracy using data collected from people with and without dysphonia. STUDY DESIGN: Cross-sectional study. METHOD: The original questionnaire was translated from Italian to Persian using the International Quality of Life Assessment criteria. The translated version was completed by 122 people with dysphonia and 49 people without dysphonia. The validity, reliability, and diagnostic accuracy of the Voice Fatigue Handicap Questionnaire Persian-version were evaluated. A panel of five voice-specializing Speech and Language Pathologists and 20 native Persian speakers (with dysphonia) in a pilot study confirmed the translated version for content and face validity, respectively. The internal consistency was evaluated by Cronbach's alpha and McDonald omega coefficients. The intraclass correlation coefficient was used to examine the test-retest reliability. For discriminant validity, the mean total and subscale scores of respondents with and without dysphonia were compared through independent t tests. Finally, sensitivity, specificity, and ideal cut-off value were determined using the receiver-operating characteristic curve. RESULTS: Cronbach's alpha coefficient was 0.965 for the total score (functional: α = 0.883, emotional: α = 0.944, physical: α = 0.917). Also, the McDonald omega coefficient was 0.966 for the total score (functional: ω = 0.889, emotional: ω = 0.933, physical: ω = 0.920). The intraclass correlation coefficient for measuring the test-retest reliability was 0.971 for the total score (functional: ICC=0.937, emotional: ICC=0.954, physical ICC=0.976). The results of the independent samples t tests indicated that the dysphonia group obtained significantly higher mean scores (total and subscale scores) than the group without dysphonia. The cutoff value of 13.5 was determined based on the optimal balance of sensitivity (0.992) and specificity (0.918). CONCLUSION: The Voice Fatigue Handicap Questionnaire-Persian version is a valid and reliable questionnaire to identify individuals at high risk of vocal fatigue and subsequent dysphonia.

The Impact of Language on Voice: An LTAS Study.

OBJECTIVES: The present study investigates possible differences in sound characteristics associated with Farsi and Qashqai produced by Farsi-Qashqai bilinguals. STUDY DESIGN: This is a descriptive-analytical and cross-sectional study. METHODS: Thirty-two Farsi-Qashqai bilinguals (16 men and 16 women) participated in the study. Mean spectral energy (MSE) and spectral tilt (ST) obtained from long-term average speech spectra were extracted from continuous speech samples of Farsi-Qashqai bilingual speakers. MSE and ST were calculated using Praat and then compared between Farsi and Turkish. RESULTS: Results showed that bilingual speakers had higher MSE and lower ST in Farsi than in Turkish. CONCLUSIONS: Findings show that even with the same phonatory apparatus, spoken language affects the speaker's voice quality.

Computerized Analysis of Acoustic Characteristics of Patients with Internal Nasal Valve Collapse Before and After Functional Rhinoplasty.

Acoustic analysis of sounds produced during speech provides significant information about the physiology of larynx and vocal tract. The analysis of voice power spectrum is a fundamental sensitive method of acoustic assessment that provides valuable information about the voice source and characteristics of vocal tract resonance cavities. The changes in long-term average spectrum (LTAS) spectral tilt and harmony to noise ratio (HNR) were analyzed to assess the voice quality before and after functional rhinoplasty in patients with internal nasal valve collapse. Before and 3 months after functional rhinoplasty, 12 participants were evaluated and HNR and LTAS spectral tilt in /a/ and /i/ vowels were estimated. It was seen that an increase in HNR and a decrease in LTAS spectral tilt existed after surgery. Mean LTAS spectral tilt in vowel /a/ decreased from 2.37 ± 1.04 to 2.28 ± 1.17 (P = 0.388), and it was decreased from 4.16 ± 1.65 to 2.73 ± 0.69 in vowel /i/ (P = 0.008). Mean HNR in the vowel /a/ increased from 20.71 ± 3.93 to 25.06 ± 2.67 (P = 0.002), and it was increased from 21.28 ± 4.11 to 25.26 ± 3.94 in vowel /i/ (P = 0.002). Modification of the vocal tract caused the vocal cords to close sufficiently, and this showed that although rhinoplasty did not affect the larynx directly, it changes the structure of the vocal tract and consequently the resonance of voice production. The aim of this study was to investigate the changes in voice parameters after functional rhinoplasty in patients with internal nasal valve collapse by computerized analysis of acoustic characteristics.

The occurrence of laryngeal penetration and aspiration in patients with glottal closure insufficiency.

Glottal closure during the pharyngeal phase of swallowing is one of the important steps in protecting the airway. Generally, it is believed that any deficiency in this process can lead to laryngeal penetration and aspiration. This study investigated the incidence of laryngeal penetration and aspiration among 44 patients with glottal closure insufficiencies that were referred for voice and swallowing evaluation to our institution. The videostroboscopy and 3 oz water swallow test were performed for all of the patients and dysphagic patients were screened and referred for videofluoroscopy. Overall, 15.90% of patients demonstrated signs of laryngeal penetration (13.63%) and aspiration (2.27%). The patients with the pattern of incomplete closure illustrated the highest percentage of penetration-aspiration (21.73%, 4.34%) among other GCI patterns. Thus, early interventions for these patients' swallowing condition seem necessary.