Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 209
Filtrar
1.
Laryngoscope ; 130(5): 1243-1248, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32034963

RESUMO

OBJECTIVES: Voice patients with voice disorders have a high prevalence of distress and mental health (MH) comorbidities, but it is unknown to what extent distress precedes or follows voice disorder diagnoses. Objectives were to compare 1) proportions of voice patients with MH diagnoses who received MH diagnoses first versus voice-related diagnoses first, 2) voice-related diagnoses and care utilization, and 3) time to specialty evaluation in each group. METHODS: Patients with voice and MH diagnoses were identified using International Classification of Diseases, Ninth and Tenth Revisions codes in a large health system data repository from January 2005 through July 2017. Sociodemographics, comorbidities, MH- and voice-related diagnoses, and voice-related care utilization were analyzed using descriptive statistics and multivariable regression modeling. RESULTS: Among the 11,419 patients with both voice and MH diagnoses, 63% (n = 7,251) received MH diagnoses prior to voice diagnoses, compared with 37% with a voice diagnosis first (P < 0.0001). The latter group received more specific voice-related diagnoses (e.g., laryngeal cancer [odds ratio (OR) 4.27], benign laryngeal neoplasm [OR 1.60]), and were more likely to ever see an otolaryngologist than those receiving MH diagnoses first (P < 0.0001). CONCLUSION: Most patients with voice and MH diagnoses received a MH diagnosis first. Patients who receive MH diagnoses first appeared to have different voice-related healthcare compared to those who received voice diagnoses first. LEVEL OF EVIDENCE: NA Laryngoscope, 130:1243-1248, 2020.


Assuntos
Disfonia/complicações , Disfonia/psicologia , Transtornos Mentais/complicações , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos
2.
Ann Otol Rhinol Laryngol ; 129(4): 333-339, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31731878

RESUMO

OBJECTIVES: Hearing loss has been implicated in dysphonia secondary to voice misuse, although the data supporting this claim are scant. Determining the prevalence of hearing loss in patients with dysphonia and correlating it with self-perception of vocal handicap may help clarify the value of audiometry in evaluation of patients with dysphonia. METHODS: This is a retrospective chart review of all new voice patients (n = 405) presenting with dysphonia to the primary investigator between 2015 and 2018. Each new patient routinely undergoes audiometric and voice objective analyses. Main outcomes measured include prevalence, severity of hearing loss, and voice handicap index-10 (VHI-10). RESULTS: Of the 405 subjects reviewed, mean age was 49.0 years (SD = 17.4). 60.7% of subjects were female and 39.3% male. Patients with hearing loss defined as >25 dB in worse ear with pure tone average (PTA) thresholds at 0.5, 1, 2, and 3 kHz (PTA-S) accounted for 18% of the total cohort. The prevalence of previously undiagnosed hearing loss in this cohort was 13.1% (53 of 405 subjects). Of these subjects, 62.3% (33 subjects) reported no perception of hearing loss while 37.7% (20 subjects) suspected they had some hearing loss, yet never sought evaluation. Only increased PTA-S, speech discrimination, Reflux Symptom Index, and female gender demonstrated a significant relationship with VHI-10 when analyzed with multivariate linear regression analysis. CONCLUSIONS: The prevalence of hearing loss in patients presenting with dysphonia in this cohort is similar to normative population data. This study has also demonstrated that the majority of these patients did not perceive any hearing loss. The reasons behind this may be a result of or associated with the patients' dysphonia. Furthermore, clinicians should consider performing audiometric evaluation in patients with abnormal VHI-10 scores in the appropriate clinical context.


Assuntos
Audiometria/métodos , Disfonia , Perda Auditiva , Percepção da Fala , Qualidade da Voz , Avaliação da Deficiência , Disfonia/diagnóstico , Disfonia/epidemiologia , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Estudos Retrospectivos , Medição de Risco , Autoimagem , Índice de Gravidade de Doença , Estados Unidos/epidemiologia
3.
J Voice ; 34(1): 160.e15-160.e23, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30055984

RESUMO

PURPOSE: The purpose of the current study is to determine the relation of frailty syndrome to acoustic measures of voice quality and voice-related handicap. METHODS: Seventy-three adults (52 community-dwelling participants and 21 assisted living residents) age 60 and older completed frailty screening, acoustic assessment, cognitive screening, and the Voice Handicap Index-10 (VHI-10). Factor analysis was used to consolidate acoustic measures. Statistical analysis included multiple regression, analysis of variance, and Tukey post-hoc tests with alfa of 0.05. RESULTS: Montreal Cognitive Assessment (MoCA) and exhaustion explained 28% of the variance in VHI-10. MoCA and sex explained 27% of the variance in factor 1 (spectral ratio), age and MoCA explained 13% of the variance in factor 2 (cepstral peak prominence for speech), and slowness explained 10% of the variance in factor 3 (cepstral peak prominence for sustained /a/). There were statistically significant differences in two measures across frailty groups: VHI-10 and MoCA. Acoustic factor scores did not differ significantly among frailty groups (P > 0.05). CONCLUSIONS: Voice-related handicap and cognitive status differed among robust and frail older adults, yet vocal function measures did not. The components of frailty most related to VHI-10 were exhaustion and weight loss rather than slowness, weakness, or inactivity. Based on these findings, routine screening of physical frailty and cognition are recommended as part of a complete voice evaluation for older adults.


Assuntos
Cognição , Disfonia/diagnóstico , Fragilidade/diagnóstico , Avaliação Geriátrica , Qualidade da Voz , Acústica , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Fragilidade/fisiopatologia , Fragilidade/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular , Debilidade Muscular/diagnóstico , Debilidade Muscular/fisiopatologia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Comportamento Sedentário , Medida da Produção da Fala , Perda de Peso
4.
J Voice ; 34(1): 158.e1-158.e7, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30205918

RESUMO

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.


Assuntos
Autoavaliação Diagnóstica , Disfonia/diagnóstico , Prega Vocal/fisiopatologia , Qualidade da Voz , Adulto , Argentina , Percepção Auditiva , Estudos Transversais , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Adulto Jovem
5.
Laryngoscope ; 130(4): E177-E182, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31219628

RESUMO

OBJECTIVES: Formal evaluation of health states related to dysphonia have not been rigorously evaluated in affected patients. The objective of this project was to evaluate the health states of mild, moderate, and severe dysphonia using formal health state preference evaluation, and to compare these outcomes with the degree of voice handicap. DESIGN: Prospective health state preference assessment. METHODS: A convenience sample of patients presenting with voice complaints were enrolled from an academic voice center. Demographic and voice handicap index (VHI-10) data were obtained, and an assessment of preference for five health states (monocular blindness, binocular blindness, mild dysphonia, moderate dysphonia, and severe dysphonia) was performed. Utility scores were calculated on a scale from 0 (death) to 1 (perfect health). Analysis was performed with ANOVA testing with post-hoc comparisons and correlation statistics. RESULTS: Of 209 assessments, 149 (75.6%) met quality criteria. Relative to monocular blindness (score 0.61 [CI 0.57-0.64]), moderate dysphonia (0.58 [0.54-0.62]) was rated equivalently, with severe dysphonia (0.33 [0.29-0.37]) ranking significantly worse and mild dysphonia (0.96 [0.95-0.98]) significantly better. Binocular blindness (0.18 [0.15-0.21]) was the worst-ranked health state. There was a weak inverse correlation of VHI-10 with dysphonia-related preference scores; with worsening reported voice handicap, scores decreased. CONCLUSION: This study demonstrated that dysphonia had a significant impact of quality of life, with moderate dysphonia ranking equivalently with monocular blindness. These numerical estimates may be used for ongoing research into the value and cost-effectiveness of medical, therapeutic, and surgical interventions for voice disorders. LEVEL OF EVIDENCE: 2c (outcomes research) Laryngoscope, 130:E177-E182, 2020.


Assuntos
Disfonia/fisiopatologia , Disfonia/psicologia , Indicadores Básicos de Saúde , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Qualidade da Voz
6.
Otolaryngol Pol ; 73(4): 14-20, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-31474620

RESUMO

Psychogenic dysphonia is defined as disturbances in voice and speech quality with emotional background with lack of organic changes in the larynx. Mental condition has significant impact on the process of producing voice, functioning of respiratoryphonatory- articulation mechanism and speech prosody. The aim of the study was visual, acoustic, perceptual assessment as well as self-assessment of voice and speech quality using subjective and objective methods in patients with psychogenic dysphonia. The study included 50 patients with psychogenic dysphonia diagnosed in the Department of Clinical Fonoaudiology and Logopedics, Medical University of Bialystok and treated at the Foniatric Outpatient Clinic, University Hospital in Bialystok in 2017-2018. The control group consisted of 30 subjects with euphonic voice. All patients underwent subjective and objective assessment of voice and speech quality. The GRBAS scale, breathing pathway assessment, respiratory-phonatory-articulation analysis, voice and speech intensity evaluation have been performed. Speech prosody has also been examined. Patient selfassessment of voice has been conducted using Voice Handicap Index (VHI). Objective evaluation of larynx included vibrations of vocal folds visualization using High Speed Digital Imaging (HSDI). Acoustic analysis of voice quality has been performed using DiagNova Technologies. The maximum phonation time (MPT) has been determined. Hyperfunctional dysphonia is the most common clinical form of psychogenic dysphonia. Abnormal breathing pathway influence the reduction of MPT and disturbance of respiratory-phonatory-articulation coordination in patients with psychogenic dysphonia. In psychogenic dysphonia intonation and speech rate disorders are observed. Results of voice self-assessment in the majority of examined patients indicates a mild voice disability.


Assuntos
Disfonia/psicologia , Comunicação não Verbal , Transtornos Psicofisiológicos/psicologia , Qualidade da Voz , Adulto , Comunicação , Avaliação da Deficiência , Disfonia/diagnóstico , Feminino , Humanos , Comunicação Interdisciplinar , Masculino , Pessoa de Meia-Idade , Transtornos Psicofisiológicos/diagnóstico , Recuperação de Função Fisiológica , Prega Vocal/fisiopatologia , Adulto Jovem
7.
Int J Pediatr Otorhinolaryngol ; 127: 109663, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31526934

RESUMO

OBJECTIVE: Voice disorders are very common in the pediatric population, with 6% and 23% of all children presenting with some form of dysphonia [1,2]. For many years, these patients have been underdiagnosed. There has been increasing awareness and interest in the study of voice alterations in children, and, most importantly, their impact in their quality of life. To do this, an instrument capable of measuring the quality of life in pediatric patients with vocal pathology is required, which can be used extensively in the scientific community. The objective of our study is to carry out the translation, transculturalization and validation of pVHI (Pediatric Voice Handicap Index) to Argentinian Spanish-speakers. MATERIAL AND METHODS: A study was carried out in the Hospital de Pediatria Dr. JP Garrahan in the city of Buenos Aires, Argentina. It included patients between 3 and 18 years old. The pVHI was translated and transculturalized for said population and for its validation, a survey was carried out in two groups of patients: one group being children with a background of both reconstructive larynx surgery, and dysphonia (n = 35) and the other group being control patients, without any voice pathology (n = 35). The survey was conducted among either parents or caregivers of the children in question. RESULTS: A significant difference was found between both groups, for both overall pVHI score and survey subgroups score (p < 0.001) with an optimal internal confidence and a good Alpha Cronbach for each of the subgroups (functional 0,92; organic 0,87 and emotional 0,88). Test-retest for reliability revealed "p-values" without any significant difference (p > 0.05) for each of all subgroups (functional 0,68; organic 0,32 and emotional 0,72). CONCLUSION: The validation and transculturalization of the rate of pediatric vocal impairment to Argentinian Spanish population presented an adequate validity and reliability. The rate of pediatric vocal impairment was identified through this simple and practical survey, offering additional information on the child's own vocal perception by part of the caregiver. We recommend this survey being included as a valuable tool in the evaluation of pediatric dysphonia in Spanish-speaking families.


Assuntos
Disfonia/diagnóstico , Qualidade de Vida , Inquéritos e Questionários , Adolescente , Argentina , Criança , Pré-Escolar , Disfonia/psicologia , Emoções , Feminino , Humanos , Idioma , Masculino , Pais , Estudos Prospectivos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Traduções
8.
Int J Pediatr Otorhinolaryngol ; 125: 11-14, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31229853

RESUMO

BACKGROUND: The pediatric voice handicap index (pVHI) questionnaire was developed in 2006 to provide parental information regarding the impact of a voice disorder on their child's life. OBJECTIVES: The aim of this study was to make a Danish version of the original American pVHI and to validate the Danish pVHI by evaluating its internal consistency and reliability. MATERIALS AND METHODS: The original version of the pVHI was translated into Danish. Nineteen parents of dysphonic children, diagnosed in a tertiary otolaryngology hospital department, and 43 parents of children without known voice disorder (control group) completed the questionnaire. The internal consistency, content validity including comparisons of the scores in the two groups and the test-retest reliability were assessed through statistical analysis. RESULTS: The total pVHI scores significantly differed between the group of parents with dysphonic children and the group of parents with children without known voice disorder (p < 0.001). The internal consistency showed an excellent consistency (Chronbach's α > 0.9) of the three subdomains score and the total pVHI score. The test-re-test reliability of the total pVHI score was "strong" with a Pearson's correlation coefficient of 0.97. CONCLUSIONS AND SIGNIFICANCE: The Danish pVHI is a valid and reliable instrument to assess the parents' perception of the impact of a voice disorder on a child's physical, social and emotional well-being.


Assuntos
Disfonia/fisiopatologia , Disfonia/psicologia , Índice de Gravidade de Doença , Inquéritos e Questionários , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Dinamarca , Feminino , Humanos , Masculino , Pais , Qualidade de Vida , Reprodutibilidade dos Testes
9.
Ann Ig ; 31(3): 230-235, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31069367

RESUMO

BACKGROUND: Acoustic pollution is generally analysed in relation to the risks for the hearing apparatus, omitting the extra-auditory effects, such as the damage that the noise can cause to the speaker's voice and listening to the learning of the vocal message. These damages are mainly found in school environments among teachers. OBJECTIVE: A cross-sectional study was carried out to verify the influence that the noise of the classrooms can have on the physical and mental health of the teachers examined. METHODS: This study involved four schools of Rome, for a total of 60 teachers, who were interviewed via online questionnaires, which consisted of a socio-demographic data section and 3 other sections: Vocal Handicap Index (VHI), SF-12, Job Content Questionnaire. RESULTS: 50 responses were received. 68% of teachers exceeded the normative value of 2.83 and perceived a disorder of the voice, and only 32% had a value lower than the standard considered (mean=7.34; median=5). The medians of MCS12 and PCS12 scores (52.9 and 54.2) were very close to those of the general population, as well as the distribution of the scores obtained from the Job Content Questionnaire. Furthermore, there was a direct association between the VHI-10 score and the age (B=0.321 p=0.016), the marital status (B=0.345 p= 0.009), and an indirect association with the MCS12 (B=-0.283 p=0.033). CONCLUSIONS: In general, the teachers examined are exposed in the classrooms to a high acoustic climate (median=75 dB) and, consequently, to a vocal effort during the didactic activities. Although it has not been possible to verify whether teachers with a high vocal disturbance were in the classrooms with a worse acoustic climate, the descriptive analyses provide a solid basis for further studies on the association between noise pollution and vocal effort.


Assuntos
Ruído Ocupacional/efeitos adversos , Ruído/efeitos adversos , Berçários para Lactentes , Doenças Profissionais/epidemiologia , Professores Escolares/estatística & dados numéricos , Instituições Acadêmicas , Distúrbios da Voz/epidemiologia , Adulto , Fatores Etários , Estudos Transversais , Autoavaliação Diagnóstica , Disfonia/epidemiologia , Disfonia/etiologia , Disfonia/psicologia , Humanos , Satisfação no Emprego , Casamento , Pessoa de Meia-Idade , Ruído Ocupacional/estatística & dados numéricos , Doenças Profissionais/psicologia , Qualidade de Vida , Fatores de Risco , Professores Escolares/psicologia , Distúrbios da Voz/etiologia , Distúrbios da Voz/psicologia
10.
Ann Otol Rhinol Laryngol ; 128(9): 802-810, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31007044

RESUMO

OBJECTIVE: Chemoradiation (CRT) for nonlaryngeal head and neck cancer (HNC) can lead to voice and swallowing dysfunction. The purpose of this study was to examine voice and swallowing from the patient's perspective at least 5 years after treatment. DESIGN: Patient survey. METHODS: Twenty-eight patients treated with primary or adjuvant CRT at least 5 years ago (mean = 10.7 years, SD = 5.5, range, 5-28) completed a survey created based on previously validated questionnaires (the Patient Perception of Swallowing Function Questionnaire, PPSFQ; the Eating Assessment Tool, EAT-10; the Voice Handicap Index, VHI-10; the Voice Related Quality of Life, V-RQOL). RESULTS: Patients reported some voice and swallowing dysfunction (39% of V-RQOL scores in categories of fair, poor, or worst possible and 32% of VHI-10 scores ≥20 or greater than 50% of the maximum; 39% of PPSFQ scores greater than 50% of the maximum and 32% of EAT-10 scores ≥20 or 50% of the maximum). There was a correlation between V-RQOL and VHI-10 scores (Pearson product moment correlation coefficient r = .96, calculated probability value p = 0), PPSFQ and EAT-10 scores (r = 0.87, p = 0.8 × 10-8), as well as between V-RQOL and PPSFQ/EAT-10 scores (r = .94, p = 0), VHI-10 and PPSFQ/EAT-10 scores (r = .97, p = 0). CONCLUSIONS: Perceived voice and swallowing dysfunction following CRT for nonlaryngeal HNC can persist or worsen beyond 5 years.


Assuntos
Quimiorradioterapia Adjuvante/efeitos adversos , Transtornos de Deglutição , Disfonia , Neoplasias de Cabeça e Pescoço , Neoplasias Orofaríngeas , Qualidade de Vida , Adulto , Idoso , Quimiorradioterapia Adjuvante/métodos , Deglutição , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/psicologia , Avaliação da Deficiência , Disfonia/diagnóstico , Disfonia/etiologia , Disfonia/psicologia , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Orofaríngeas/patologia , Neoplasias Orofaríngeas/terapia , Inquéritos e Questionários , Resultado do Tratamento , Voz , Qualidade da Voz
11.
J Laryngol Otol ; 133(3): 236-240, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30803456

RESUMO

OBJECTIVE: The Assessing and Caring for Patients' Expectations in Laryngology ('ACaPELa') questionnaire was developed to guide laryngology clinic consultations. This study aimed to audit its use, revise it depending on outcomes and validate it. METHODS: The questionnaire was completed by all new patients attending a laryngology clinic over one year. The questionnaire was refined and validated in a new cohort of patients over a six-month period. RESULTS: Thirty-seven of 242 patients (15.3 per cent) incorrectly gave the same ranking to more than one question. Questions with similar content were collapsed to cover broader themes, and an outcome question was added, resulting in the five-item Assessing and Caring for Patients' Expectations in Laryngology - Revised ('ACaPELa-R') questionnaire. Using this revised questionnaire, there was a significant reduction in the number of same-ranked questions (4.4 vs 15.3 per cent; p = 0.003) and high patient satisfaction post-consultation (95.7 per cent). CONCLUSION: The Assessing and Caring for Patients' Expectations in Laryngology - Revised questionnaire makes patients' rank ordering of questions easier. It can be used to inform how different topics should be approached during the consultation and utilised for clinician self-audit.


Assuntos
Disfonia/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Disfonia/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Satisfação do Paciente , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
12.
Ann Otol Rhinol Laryngol ; 128(4): 316-322, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30614248

RESUMO

OBJECTIVES:: To determine the impact of socioeconomic status (SES) on voice outcomes for spasmodic dysphonia (SD) patients treated with botulinum toxin injections. METHODS:: This was a prospective cross-sectional study in a tertiary care, academic voice clinic in Canada. Adult SD patients returning to the voice clinic for their botulinum toxin injections were recruited from October 2017 to April 2018. Patients completed a questionnaire on demographic data, the Hollingshead Four-Factor Index for socioeconomic status (validated instrument based on education, occupation, gender, and marital status), and the Voice-Handicap Index 10 (VHI-10) (validated instrument on self-reported vocal handicap). Primary outcome was the association between VHI-10 and Hollingshead Index. Secondary variables were median household income by postal code, duration of disease, gender, age, and professional voice user. Descriptive statistics and multiple linear regression were conducted. RESULTS:: One hundred and one patients (age = 62.8 ± 13.7 years, 20.8% male) were recruited with VHI-10 of 22.1 ± 8.1 (out of 40) and Hollingshead Index of 46.3 ± 11.7 (range, 8-66). Median household income was $75 875 ± $16 393, which was above the Canadian average of $70 336. About 91.1% were Caucasian, 54.4% had university degree, 86.1% spoke English, and 43.5% were employed. In multiple linear regression, there was mild to moderate negative correlation (r = -.292, P = .004) between VHI-10 and Hollingshead Index when controlling for disease duration, age, gender, and professional voice use. CONCLUSION:: SD patients treated with botulinum toxin were mostly affluent, Caucasian, well educated, and English speakers. Lower self-perceived vocal handicap was associated with higher socioeconomic status.


Assuntos
Toxinas Botulínicas , Disfonia , Classe Social , Qualidade da Voz , Idoso , Atitude Frente a Saúde , Toxinas Botulínicas/administração & dosagem , Toxinas Botulínicas/efeitos adversos , Canadá/epidemiologia , Estudos Transversais , Avaliação da Deficiência , Disfonia/epidemiologia , Disfonia/fisiopatologia , Disfonia/psicologia , Disfonia/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neurotoxinas/administração & dosagem , Neurotoxinas/efeitos adversos , Estudos Prospectivos , Autorrelato/estatística & dados numéricos
13.
J Voice ; 33(1): 103-109, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29097010

RESUMO

OBJECTIVE: The purpose of this study was to evaluate the reliability and validity of the Mandarin (simplified) Chinese version of Voice Activity and Participation Profile (MC-VAPP) in mainland China. METHODS: This study enrolled 786 subjects from February 2015 to March 2017, including 456 individuals with voice disorders (dysphonic group) and 330 vocally healthy individuals (nondysphonic group). The internal consistency (Cronbach alpha coefficient), test-retest reliability (intraclass correlation coefficient [ICC]), and differences in the MC-VAPP scores were compared between the two groups. Exploratory factor analysis was performed. The receiver operating characteristic curve and cutoff point were calculated. RESULTS: The MC-VAPP had a high internal consistency. Cronbach alpha coefficients for the subsection scores were from 0.86 and 0.96, with 0.98 for the total score. Test-retest reliability was high for the total score (ICC = 0.98). The four factors' cumulative contribution was determined to be 74.68%. The dysphonic participants displayed significantly higher total score and subsection scores than the nondysphonic participants (P < 0.001). There were significant differences in total activity limitation scores and the total participation restriction scores between the two groups (P < 0.001). The cutoff point for screening between the two groups was 36.5, with a sensitivity of 76.80% and specificity of 80.30%. CONCLUSION: The MC-VAPP is a reliable and valid instrument for the evaluation of voice-related quality of life in Chinese-speaking individuals. It is also recommended that the MC-VAPP would be a useful tool for screening individuals with and without voice disorders based on the cutoff value of 36.5.


Assuntos
Disfonia/diagnóstico , Adulto , Grupo com Ancestrais do Continente Asiático , Estudos Transversais , Disfonia/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
14.
J Voice ; 33(2): 256.e1-256.e16, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29361337

RESUMO

OBJECTIVE: This study aims to propose and analyze the effect of a voice therapy program (VTP) in women with behavioral dysphonia. MATERIALS AND METHODS: This is a controlled, blinded, and nonrandomized cohort study. Participants of this study were 22 women with behavioral dysphonia divided into two groups: G1, 11 women with behavioral dysphonia who received the VTP, and G2, 11 women with behavioral dysphonia who did not receive any intervention. Before and after 6 weeks, the outcome variables evaluated in both groups were auditory-perceptual evaluation of the global degree of vocal quality (vowel /a/ and counting), instrumental acoustic parameters, Voice-Related Quality of Life, vocal and larynx symptoms, and musculoskeletal pain. The statistical analysis used the Wilcoxon, chi-square, and Mann-Whitney tests (P < 0.05). RESULTS: After 6 weeks, we observed a significantly higher improvement in the general degree of vocal deviation in vowels, a reduced F0 and symptom of "fatigue while talking" in G1, and an increased "shoulder" pain intensity in G2. Both groups showed improvement in the socioemotional domain of Voice-Related Quality of Life. In addition, the comparison between the groups showed a significantly greater reduction in fundamental frequency and the "voice loss" symptom in G1 compared with G2. CONCLUSIONS: The VTP using semioccluded vocal tract exercises obtained a positive effect on voice quality, symptoms, and musculoskeletal pain in women with behavioral dysphonia. The proposal, based on the taxonomy of voice therapy, seems to have promoted a phonatory balance, muscle relaxation, and improvement in the vocal resistance of this population.


Assuntos
Disfonia/terapia , Emoções , Fonação , Terminologia como Assunto , Qualidade da Voz , Treinamento da Voz , Acústica , Adulto , Percepção Auditiva , Estudos de Casos e Controles , Disfonia/diagnóstico , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Humanos , Julgamento , Dor Musculoesquelética/fisiopatologia , Dor Musculoesquelética/psicologia , Dor Musculoesquelética/terapia , Medição da Dor , Qualidade de Vida , Medida da Produção da Fala , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento
15.
J Voice ; 33(4): 581.e17-581.e23, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29793874

RESUMO

OBJECTIVES: This study aimed to determine the validity and reliability of Bahasa Malaysia version of Voice Handicap Index-10 (mVHI-10). MATERIALS AND METHODS: This cross-sectional study was carried out in the Otorhinolaryngology, Head and Neck Surgery Department of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from June 2015 to May 2016. The mVHI-10 was produced following a rigorous forward and backward translation. One hundred participants, including 50 healthy volunteers (17 male, 33 female) and 50 patients with voice disorders (26 male, 24 female), were recruited to complete the mVHI-10 before flexible laryngoscopic examinations and acoustic analysis. The mVHI-10 was repeated in 2 weeks via telephone interview or clinic visit. Its reliability and validity were assessed using interclass correlation. RESULTS: The test-retest reliability for total mVHI-10 and each item score was high, with the Cronbach alpha of >0.90. The total mVHI-10 score and domain scores were significantly higher (P < 0.001) in the pathology groups (20.92 ± 8.74) than healthy volunteers (1.54 ± 1.97), depicting excellent discriminant validity. The Kaiser-Meyer-Olkin measure was 0.92, which depicted excellent construct validity. There was a significant positive correlation between the mVHI-10 score and jitter and shimmer result (P < 0.001). CONCLUSIONS: The present study showed good reliability and validity of the mVHI-10 when applied to both healthy volunteers and patients with voice disorders. We recommend the use of the mVHI-10 in daily clinical practice among Bahasa Malaysia-speaking population.


Assuntos
Avaliação da Deficiência , Disfonia/diagnóstico , Inquéritos e Questionários , Qualidade da Voz , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Qualidade de Vida , Reprodutibilidade dos Testes , Tradução
16.
J Voice ; 33(6): 945.e37-945.e45, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30115579

RESUMO

OBJECTIVES: The aim of this study was to describe the laryngeal anatomy, perceptual, acoustic, and aerodynamic vocal characteristics of school-aged children with and without Attention Deficit Hyperactivity Disorder (ADHD). The predisposition that children with ADHD have for laryngeal injuries are recurrent in nature and are more often than not overlooked as laryngitis. Previous studies have reported varied results on the prevalence rates of pediatric vocal fold nodules within the school-aged ADHD population. STUDY DESIGN: A static, two-group comparison was used in the study to investigate the clinical, perceptual, acoustic, and aerodynamic vocal characteristics of children between 7 and 9 years old with and without ADHD. METHODS: The study replicated the protocol as executed by Barona-Lleo and Fernandez (2016) with additions. The Multidimensional Voice Program and the Voice Range Profile as additions to the assessment of vocal parameters were used with which comparable dysphonia severity index scores were calculated. Once-off clinical, perceptual, acoustic, and aerodynamic voice assessments were conducted on 20 age-gender matched participants (Control group mean age [months] = 98.80, standard deviation = 10.379; ADHD group mean age [months] = 108.00, standard deviation = 10.873). It was hypothesized that children with ADHD would have more hyperfunctional vocal characteristics; leading to laryngeal injuries, than their control group peers. RESULTS: Forty-five percent (n = 9) of the total sample population (both groups combined) had laryngeal pathology. Similar parent reported etiological voice symptoms and vocal habits were seen across both groups. Both groups performed similarly across both perceptual and aerodynamic voice assessments. Acoustically, the control group achieved significantly higher producible pitches than the ADHD group (P = 0.028) and were found to have more dysphonic dysphonia severity index scores than their ADHD group peers (P = 0.034). CONCLUSION: Prepubertal, school-aged children with or without ADHD may have similar vocal characteristics than previously thought. This is in support of the null hypothesis. The authors of the current study recommend that vocal screening in all school-aged children be carried out as an effective measure to monitor voice disorders in the pediatric population. Future research into larger sample sizes with this population with a special focus on the effect that central nervous system stimulants may have on the voice is recommended.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Comportamento Infantil , Disfonia/etiologia , Laringe/fisiopatologia , Qualidade da Voz , Fatores Etários , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Estudos de Casos e Controles , Criança , Disfonia/diagnóstico , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Hábitos , Humanos , Masculino , Fatores de Risco , Índice de Gravidade de Doença
17.
J Voice ; 33(3): 381.e11-381.e22, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-29680222

RESUMO

OBJECTIVE: To analyze the effectiveness of vocal therapy associated with electromyographic biofeedback in women with behavioral dysphonia. MATERIALS AND METHODS: This is a randomized placebo-controlled double-blind clinical trial. Twenty-two adult women with behavioral dysphonia were randomly divided into two groups: Experimental Group-11 women participated in vocal therapy associated with the application of electromyographic biofeedback; Placebo Group-11 women participated in vocal therapy associated with the application of placebo electromyographic biofeedback. Both groups performed eight therapy sessions, twice a week, lasting 30 minutes. The vocal therapy of both groups was composed of semioccluded vocal tract exercises (trill, humming, and fricative). The evaluations were performed at four time points-before, after, one, and three months after the vocal therapy-and will consist of the following assessments: auditory-perceptual evaluation of voice, acoustic evaluation of voice, and surface electromyographic. The data were analyzed statistically comparing the groups and the time of evaluation (P < 0.05). RESULTS: The proposed vocal therapy promoted positive results in vocal quality and muscular electrical activity during rest in women with behavioral dysphonia for both groups. Electromyographic biofeedback promoted additional positive results in muscle electrical activity during phonatory tasks in women with behavioral dysphonia. CONCLUSION: In this study, the vocal therapy associated with electromyographic biofeedback had equivalent efficacy to traditional therapy in the voice. The biofeedback was more effective than traditional therapy on muscular electrical activity and had effects that remained for a longer time in women with behavioral dysphonia.


Assuntos
Disfonia/terapia , Neurorretroalimentação , Fonação , Qualidade da Voz , Treinamento da Voz , Adolescente , Adulto , Brasil , Método Duplo-Cego , Disfonia/diagnóstico , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Fatores Sexuais , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
18.
J Voice ; 33(2): 232-238, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29132807

RESUMO

INTRODUCTION: Catastrophization is a cognitive distortion that has been studied in pain patients and found to be a significant factor in their disability and response to treatment. Dysphonia patients may demonstrate a similar behavior, suggesting the existence of voice catastrophization. OBJECTIVE: To establish the validity of the Voice Catastrophization Index (VCI), a new instrument estimating voice symptoms catastrophization. METHODS: A prospective study. Patients with and without voice conditions were administered with the VCI, Voice-Related Quality of Life (V-RQOL), and the Generalized Anxiety Disorder-7 (GAD-7)questionnaires. Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) rating was determined for patients with voice conditions. RESULTS: Ninety-one patients participated, 65 with voice conditions and 26 without. 61.5% were females; mean age was 49.8 ± 15.7 years. The VCI score for patients with voice conditions was significantly higher, 22.46 ± 16.56, compared with 3.96 ± 10.79, respectively (P value < 0.0001). The VCI demonstrated moderate correlation with both V-RQOL and GAD-7 scores: -0.562 and 0.560, respectively (P value < 0.000001); however, it showed no correlation with the CAPE-V. The VCI's internal consistency with each of its three dimensions and 13 items was acceptable to strong. The reproducibility and stability was demonstrated in a subgroup of 26 patients; 81% of these patients had a difference of 10 or less points between the two evaluations. CONCLUSIONS: The VCI accomplished the requirements of a scale's validity for estimation of voice symptoms catastrophization in voice patients. The potential role of voice catastrophization as a predictor of treatment response and tailoring can now be investigated using the VCI.


Assuntos
Catastrofização , Disfonia/diagnóstico , Inquéritos e Questionários , Qualidade da Voz , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Efeitos Psicossociais da Doença , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Valor Preditivo dos Testes , Estudos Prospectivos , Qualidade de Vida , Reprodutibilidade dos Testes , Adulto Jovem
19.
J Voice ; 33(5): 682-690, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29759920

RESUMO

OBJECTIVES: The purpose of this qualitative study was to examine relationships between psychological factors, particularly perceived control, and voice symptoms in adults seeking treatment for a voice problem. METHODS: Semistructured interviews of adult patients with a clinical diagnosis of muscle tension dysphonia were conducted and transcribed. Follow-up interviews were conducted as needed for further information or clarification. A multidisciplinary team analyzed interview content using inductive techniques. Common themes and subthemes were identified. A conceptual model was developed describing the association between voice symptoms, psychological factors, precipitants of ongoing voice symptoms, and perceived control. RESULTS: Thematic saturation was reached after 23 interviews. No participants reported a direct psychological cause for their voice problem, although half described significant life events preceding voice problem onset (eg, miscarriage and other health events, interpersonal conflicts, and family members' illnesses, injuries, and deaths). Participants described psychological influences on voice symptoms that led to rapid exacerbation of their voice symptoms. Participants described the helpfulness of speech therapy and sometimes also challenges of applying techniques in daily life. They also discussed personal coping strategies that included behavioral (eg, avoiding triggers and seeking social support) and psychological (eg, mind-body awareness and emotion regulation) components. Voice-related perceived control was associated with adaptive emotional and behavioral responses, which appeared to facilitate symptom improvement. CONCLUSIONS: In this qualitative pilot study, participant narratives suggested that psychological factors and emotions influence voice symptoms, facilitating development of a preliminary conceptual model of how adaptive and maladaptive responses develop and how they influence vocal function.


Assuntos
Disfonia/psicologia , Emoções , Acontecimentos que Mudam a Vida , Autocontrole , Estresse Psicológico/psicologia , Qualidade da Voz , Adaptação Psicológica , Adulto , Idoso , Disfonia/diagnóstico , Disfonia/fisiopatologia , Disfonia/terapia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Pesquisa Qualitativa , Estresse Psicológico/diagnóstico , Estresse Psicológico/fisiopatologia , Estresse Psicológico/terapia , Fatores de Tempo , Treinamento da Voz , Adulto Jovem
20.
J Voice ; 33(6): 851-859, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30143332

RESUMO

PURPOSE: The pitch-shift reflex (PSR) is the adaptation of the fundamental frequency during phonation and speech and describes the auditory feedback control. Speakers without voice and speech disorders mostly show a compensation of the pitch change in the auditory feedback and adapt their fundamental frequency to the opposite direction. Dysphonic patients often display problems with the auditory perception and control of their voice during therapy. Our study focuses on the auditory and kinesthetic control mechanisms of patients with muscle tension dysphonia (MTD) and speakers without voice and speech problems. Main purpose of the study is the analysis of the functionality of the control mechanisms within phonation and speech between patients with MTD and normal speakers. METHOD: Sixty-one healthy subjects (17 male, 44 female) and 22 patients with MTD (7 male, 15 female) participated following two paradigms including a sustained phonation (vowel /a/) and speech (['mama]). Within both paradigms the fundamental frequency of the auditory feedback was increased synthetically. For the analysis of the PSR the electroencephalogram, electroglottography, the voice signal, and the high-speed endoscopy data were recorded simultaneously. The PSR in the electroencephalogram was detected via the N100 and the mismatch negativity. Statistical tests were applied for the detection of the PSR in the physiological response within the electroglottography, voice, and high-speed endoscopy signals. The results were compared between both groups. RESULTS: No differences were found between the controls and patients with MTD regarding latency and magnitude of the perception of the pitch shift in both paradigms, but for the magnitude of the behavioral response. Differences also could be found for both groups between the "no pitch" and "pitch" condition of the two paradigms regarding vocal fold dynamics and voice quality. Patients with MTD showed more vibrational irregularities during the PSR than the controls, especially regarding the symmetry of vocal fold dynamics. CONCLUSION: Patients with MTD seem to have a disturbed interaction between the auditory and kinesthetic feedback inducing the execution of an overriding behavioral response.


Assuntos
Disfonia/fisiopatologia , Retroalimentação Sensorial , Fonação , Nível de Percepção Sonora , Acústica da Fala , Qualidade da Voz , Adaptação Psicológica , Adulto , Disfonia/diagnóstico , Disfonia/psicologia , Feminino , Humanos , Masculino , Tempo de Reação , Fatores de Tempo , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...