Gender-specific reference ranges of the vocal extent measure in young and healthy adults.

Objective: The recently developed vocal extent measure (VEM) quantifies a patient's vocal capacity as documented in the voice range profile (VRP). This study presents the first reference ranges of the VEM for young subjects without voice complaints. Furthermore, this study investigates the influence of gender on the VEM as well as the correlation of the VEM with the dysphonia severity index (DSI).Patients and methods: Reference ranges were captured by combining a retrospective analysis of subjects who received a medical fitness certificate of a healthy voice (n = 135) and a prospective analysis of adult volunteers without voice complaints (n = 67). Every participant obtained a standardized voice assessment comprising videolaryngostroboscopy, auditory-perceptual analysis, acoustic analysis, VRP, and the Voice Handicap Index (VHI-9i).Results: A total of 202 subjects were recruited and investigated. Due to our stringent selection criteria, 51 participants had to be excluded from further analysis. The remaining data of 151 participants (52 males, 99 females), aged 18-39 years (mean 24, SD 5), were analysed in more detail. The mean of the VEM amounted to 123.7 (SD 12.6) for males and 114.4 (SD 13.3) for females. The values differed significantly between both sexes and correlated significantly with the corresponding DSI values.Conclusion: By introducing the first reference values, this study represents the next step of implementing the VEM in daily phoniatric diagnostics. These values serve as a basis to interpret the VEM regarding the degree of severity of voice disorders and to evaluate treatment success.

Efficacy of microsurgery in Reinke's oedema evaluated by traditional voice assessment integrated with the Vocal Extent Measure (VEM).

SUMMARY: There are few data analysing to what specific extent phonomicrosurgery improves vocal function in patients suffering from Reinke's oedema (RE). The recently introduced parameter vocal extent measure (VEM) seems to be suitable to objectively quantify vocal performance. The purpose of this clinical prospective study was to investigate the outcomes of phonomicrosurgery in 60 RE patients (6 male, 54 female; 56 ± 8 years ([mean ± SD]) by analysing its effect on subjective and objective vocal parameters with particular regard to VEM. Treatment efficacy was evaluated at three months after surgery by comparing pre- and postoperative videolaryngostroboscopy (VLS), auditory-perceptual assessment (RBH-status), voice range profile (VRP), acoustic-aerodynamic analysis and patient's self-assessment using the voice handicap index (VHI-9i). Phonomicrosurgically, all RE were carefully ablated. VLS revealed removal or substantial reduction of oedema with restored periodic vocal fold vibration. All subjective and most objective acoustic and aerodynamic parameters significantly improved. The VEM increased on average from 64 ± 37 to 88 ± 25 (p #x003C; 0.001) and the dysphonia severity index (DSI) from 0.5 ± 3.4 to 2.9 ± 1.9. Both parameters correlated significantly with each other (rs = 0.70). RBH-status revealed less roughness, breathiness and overall grade of hoarseness (2.0 ± 0.7 vs 1.3 ± 0.7). The VHI-9i-score decreased from 18 ± 8 to 12 ± 9 points. The average total vocal range enlarged by 4 ± 7 semitones, and the mean speaking pitch rose by 2 ± 4 semitones. These results confirm that: (1) the use of VEM in RE patients objectifies and quantifies their vocal capacity as documented in the VRP, and (2) phonomicrosurgery is an effective, objectively and subjectively satisfactory therapy to improve voice in RE patients.