Vocal Tract Discomfort Scale: Validation of the Argentine Version.

OBJECTIVE: The objective of this study was to validate the Vocal Tract Discomfort Scale (VTD) Argentine version. STUDY DESIGN: Nonrandomized, cross-sectional prospective study with control group. MATERIAL AND METHODS: The VTD Scale was culturally and linguistically adapted to Argentinian Spanish according to the recommended requirements of translation, closely observing the methodology that was suggested (translation, summary, review and back-translation). The scale Argentine version (Escala de disconfort del tracto vocal) was administered to 107 patients with muscle-tension dysphonia (MTD) (23 men and 84 women, mean ages being: 32.30 ± 9.09 years old for MTD type I, and 31.23 ± 8.45 years old for MTD type II) and 30 volunteers with no vocal pathology (9 men and 21 women, mean ages being: 44.3 ± 8.72 years old). All patients completed the Escala de disconfort del tracto vocal before and after Mathieson Laryngeal Manual Therapy. The results of the VTD Scale administered in both patients and vocally healthy subjects were initially compared; the changes arising from pre and post therapy were also compared in the second phase. The internal consistency of the VTD Scale was assessed using Cronbach alpha coefficient. RESULTS: The internal consistency assessed was considered acceptable for both subscales within the VTD Scale. The values obtained for frequency, severity, and total score of the Scale were similar in patients with MTD I and MTD II, marking a difference with those obtained in the control group of healthy volunteers. A lump feeling in the throat was one of the most frequent symptoms in both MTD and vocally healthy groups. CONCLUSION: The VTD Scale shows an acceptable consistency, so it is a highly reproducible, reliable, and valuable instrument of evaluation to assess Argentinian patients with voice disorders.

Musculoskeletal patterns in patients with voice disorders.

This study correlated the ear, nose, and throat (ENT) and physiotherapy input on 26 patients who presented with voice problems and were found by the ENT surgeon to have a degree of musculoskeletal issues. It also looked for patterns of musculoskeletal findings. Although all patients referred were found by the physiotherapist to have musculoskeletal abnormalities, the correlation proved to be excellent among the subgroup of performers, but only fair-to-good among the other voice professionals. Certain patterns of musculoskeletal abnormalities were frequently encountered, including a high held larynx, a shortening or contraction of the stylohyoid and sternocleidomastoid muscles, and a weak deep flexor mechanism. In this small group, most patients seemed to improve, although it must be noted that management was not limited to physiotherapy. In summary, physiotherapy input proved helpful in the evaluation and management of this group of patients presenting with voice problems.

Vocal tract discomfort in teachers: its relationship to self-reported voice disorders.

OBJECTIVE: To verify vocal tract discomfort (VTD) in teachers and determine its relationship to the presence of self-reported voice problems (S-rVPs), vocal signs and symptoms, voice self-assessment, and perceptual analysis of voice quality. METHODS: Thirty-two teachers with vocal complaints and 30 teachers with no complaints. PROCEDURES: Demographic questionnaire, signs and symptoms questionnaire, VTD scale, vocal self-assessment, and perceptual analysis of voice. RESULTS: The S-rVPs group was presented with higher frequency of all vocal signs and symptoms and also had greater frequency and intensity of discomfort than the teachers without complaint, for all the analyzed items (P<0.05). The group with S-rVPs experienced more than twice the level of discomfort than the group without S-rVPs (mean 6.3 vs 2.8 symptoms, P<0.05). Teachers with voice problems felt at least three symptoms of discomfort, whereas some teachers without complaint did not have any discomfort. We found a correlation between self-perceived voice and VTD. On the other hand, there is little correlation between discomfort and perceptual analysis of voice quality. VTD is also associated with specific voice signs/symptoms that might indicate an incipient voice disorder. CONCLUSION: This study reveals the importance of understanding the subjects' perception of their own problems so that issues experienced by patients that are not directly apparent to the clinician can be addressed in the treatment. Symptoms related to the vocal tract must therefore be given consideration to ensure a comprehensive and more relevant approach to the needs of patients.

The evidence for laryngeal manual therapies in the treatment of muscle tension dysphonia.

PURPOSE OF REVIEW: Clinicians involved in treating patients with voice disorders are showing an increasing interest in manual therapies aimed at reducing excessive tension in the perilaryngeal area. Studies investigating the effects of this treatment have been appearing in the literature since the early 1990s, but the evidence base remains extremely small. The purpose of this review is to provide the reader with current information about the types of laryngeal manual therapy in clinical use internationally and the evidence base for their use. RECENT FINDINGS: The results of studies undertaken recently reinforce the results of earlier studies, most of which have been conducted using individuals with muscle tension dysphonia. The various types of laryngeal manual therapy have all been shown to have positive effects. SUMMARY: There is evidence that laryngeal manual therapy, in various forms, can be a useful primary intervention in cases of muscle tension dysphonia, although this is based on very few studies. A higher level of evidence is required, including randomized controlled trials, to investigate its role in comparison with other interventions. Studies are also needed to verify or refute the clinical observation that it is also an effective treatment for all voice disorders, including those of organic aetiology, when phonatory hyperfunction is a feature.