Assessment of Dysphonia Using the Japanese Version of the Voice Handicap Index and Determination of Cutoff Points for Screening.

INTRODUCTION: The Voice Handicap Index (VHI) is recognized as a useful subjective assessment method for dysphonia. The original VHI has been translated into numerous other languages, including Japanese (J-VHI). Although the reliability and validity of the J-VHI have already been established, the cutoff point has not been determined. The aims of this study were to investigate the relationship between the J-VHI and other voice laboratory measurements, and determine the cutoff point. METHOD: This study included 167 dysphonic patients and 55 healthy volunteers. All patients and volunteers completed the J-VHI at the initial visit, and the following outcomes were determined: VHI scores of patients with dysphonia and healthy volunteers, VHI scores according to disease, cutoff point, and correlations between VHI scores and other voice laboratory measurements. RESULTS: Both the total VHI (VHI-T) and individual domain (functional domain [VHI-F], emotional domain [VHI-E], physical domain [VHI-P]) scores were significantly higher in the dysphonia group compared to the healthy volunteer group. VHI-T, VHI-F, and VHI-E scores were significantly lower in the benign mucosal lesion subgroup, compared to the other disease subgroups. The G scale and B scale of the grade-roughness-breathiness-asthenia-strain scale showed a significant association with VHI-T, VHI-F, and VHI-P scores. Similarly, the A scale showed a significant association with VHI-T, VHI-F, and VHI-E scores. The cutoff point (12) for VHI-T was chosen from the receiver operating characteristic curve to maximize sensitivity and specificity. Similarly, the cutoff points for VHI-F (5), VHI-P (5), and VHI-E (3) were also obtained. Significant differences in maximum phonation time, pitch range, G scale, and B scale were observed between the VHI-T negative (VHI ≤ 12) and positive (VHI-T > 13) groups. CONCLUSION: These findings suggest that self-evaluation using the VHI could serve as an independent assessment and screening tool for patients with dysphonia.

Efficacy of Nasal Airflow-Inducing Maneuver in Laryngectomy Patients: A Retrospective Cohort Study.

OBJECTIVE: To evaluate the effectiveness of the nasal airflow-inducing maneuver (NAIM) using the Sniffin' Sticks (Burghart, Wedel, Germany) olfactory threshold test, Open Essence (OE, FUJIFILM Wako Pure Chemical Corporation, Osaka, Japan) olfactory identification test, and self-administered odor questionnaire (SAOQ) for olfactory perception in NAIM experienced and NAIM first-time groups. For NAIM first-time group, the relationships between time from laryngectomy to first NAIM, olfactory threshold, and identification ability were also evaluated. STUDY DESIGN: Retrospective cohort study. METHODS: Sixty-six patients who had undergone laryngectomy (NAIM experienced group: 23; NAIM first-time group: 43) underwent the threshold test, OE, and SAOQ. RESULTS: Mean results of the threshold test were 2.7 (±2.3) and 2.5 (±3.0) for the NAIM experienced and NAIM first-time groups, respectively, indicating no significant differences (P = .35). The mean number of correct responses in OE was 4.5 (±2.7) and 3.2 (±3.0) in the NAIM experienced and nonrehabilitation groups, respectively, indicating a higher number in the NAIM experienced group (P = .06). Mean result of SAOQ was 47.9% (±30.9%) and 25.5% (±27.0%) in the NAIM experienced and NAIM first-time groups, respectively, indicating a significantly higher result in the NAME experienced group (P = .003). There were no correlations of threshold test and identification test scores with time from laryngectomy to the first NAIM (threshold test: r = 0.03, P = .87; OE: r = -0.03, P = .87). CONCLUSION: NAIM enabled odor perception in patients who underwent laryngectomy, and SAOQ was an effective method for evaluating this. Further, olfactory tests in both groups showed that NAIM might restore olfaction irrespective of time elapsed since laryngectomy. LEVEL OF EVIDENCE: 4. Laryngoscope, 130: 2013-2018, 2020.