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The aim of the present study was to translate the Singing Voice Handicap Index (SVHI) into Japanese and validate the Japanese version of the SVHI. The SVHI was translated into Japanese from the validated original version, and the questionnaire was administered to 102 singers with voice problems and 88 healthy singers. Internal consistency and test-retest methods were implemented to evaluate the reliability of this index. The internal consistency method assessed validity via Cronbach's α, and test-retest reliability was analyzed by the intraclass correlation coefficient (ICC) and limits of agreement (LoA) according to the Bland Altman method. Construct validity was verified by confirming correlations between SVHI scores and visual analog scale (VAS) scores for disability in singing using Spearman correlation. Discriminant validity was evaluated by comparing SVHI scores between singers with voice problems and healthy singers using t tests. Using the Tukey's honestly significant difference (HSD) test, we also compared the Voice Handicap Index (VHI) and SVHI scores among three groups: healthy singers, singers with voice problems solely during singing, and singers with voice problems during both speaking and singing. The Japanese version of the SVHI showed excellent internal consistency (Cronbach's α = 0.981) and test-retest reliability (ICC: 0.93). The 95 percent LoA was calculated to be between -20.8 and 33.9. Construct validity was verified through correlated SVHI and VAS scores (r = 0.736, P < 0.001). Discriminant validity was verified as the SVHI scores of singers with voice problems were higher than those of healthy singers (77.8±37.5 vs. 30.0±26.5, P < 0.001). There were no statistically significant differences in VHI scores between singers with voice problems solely during singing and healthy singers; however, the SVHI scores of singers with voice problems solely during singing were significantly higher than those of healthy singers (63.4±36.8 vs. 30.0±26.5, P < 0.001). We confirmed that the Japanese version of the SVHI is a valid and reliable self-rated questionnaire for measuring the patient-perceived impact of singing voice problems among Japanese singers. [ABSTRACT FROM AUTHOR]

Summary Objective The purpose of this study was to clarify the sex differences in pitch range (PR) and speech fundamental frequency (SFF) after arytenoid adduction (AA) combined with type 1 thyroplasty (TP1) in patients with unilateral vocal fold paralysis (UVFP) and to assess the cause of these differences. Study Design This is a retrospective review of clinical records. Methods The records of 50 patients with UVFP for whom PR, SFF, and maximum phonation time (MPT) had been evaluated before and 1 year after AA combined with TP1 were analyzed. Patients consisted of 36 men and 14 women. In particular, in the 37 patients (24 men and 13 women) who had ≥2 semitones (STs) in preoperative PR (pre-PR), the differences and correlations between the pre-PR and the postoperative PR (post-PR), SFF, and MPT were compared between the sexes. We also discussed cases of post-PR deterioration and abnormal SFF. Results The characteristics of PR in men are narrow pre-PR (14.7 ± 11.5 STs) and significant extension of post-PR (22.6 ± 6.3 STs). MPT extended from 4.6 ± 2.5 seconds to 14.8 ± 7.2 seconds. In contrast, women had a wide pre-PR (18.1 ± 7.2 STs) and showed no significant post-PR extension (21.7 ± 7.8 STs). MPT extended from 5.1 ± 1.9 seconds to 16.8 ± 7.2 seconds. Although there were no significant changes in average SFF, as well as the highest and lowest pitch after the operation, the variance of the pre-SFF tended to converge into the physiological range in the post-SFF ( P = 0.08). Compared with the SFF data of normal adult controls, post-SFF in the normal range was 46.0% (23/50). In patients who showed a >20% improvement in PR, normal post-SFF appeared in 68.8% of the patients (11/16). Particularly in those women, 83.3% (5/6) showed a normal post-SFF. Men showed greater difficulty in recovery of normal PR, SFF, and MPT; however, there were fewer patients (4.2%; 1/24) with a PR deterioration of >20%. Regarding women, although some patients showed a parallel recovery in PR and SFF to the normal range, there was a high rate of patients showing PR deterioration (30.8%; 4/13). Conclusions AA combined with TP1 resulted in the recovery of not only MPT but also PR and SFF. In addition, sex differences in operative effects were suggested. In men, although MPT is difficult to be fully recovered, PR deterioration was mild. In women, although MPT was more easily extended, PR deterioration occurred more readily because of operative effects such as hypermedialization of their smaller larynx. The post-PR variation appeared to be associated with SFF. Our results indicate the necessity to assess patients' PR and SFF even if their MPTs recover, particularly in patients with postoperative voice insufficiency. [ABSTRACT FROM AUTHOR]

Summary: Introduction: The cases consisted of three men with mutational dysphonia, who were aged 37, 35, and 38 years. The speaking fundamental frequencies (SFFs) at the time of the initial diagnosis were 174.6, 170.2, and 180.0Hz. Methods: In all three patients, voice therapy proved ineffective; therefore, surgery was considered. In the anterior-posterior compression test performed preoperatively in the three patients, the voice became low-pitched. Results: The SFFs decreased postoperatively to 106.9, 115.4, and 87.5Hz, respectively, in the three patients. Conclusions: Type 3 thyroplasty (TP3) is effective for the treatment of patients with mutational dysphonia in whom voice therapy proved unsuccessful. Objective: The SFF of men is high in childhood. At the time of the second pubescent sexual orientation, the frequency usually decreases. However, in some cases, the high-pitched voice of childhood may persist without successful switch to a low-pitched voice during puberty. Thus, there are rare cases of adults with a high-pitched boyish voice. Voice therapy is usually effective for the treatment; however, it may fail in some cases. We performed TP3 for subjects in whom voice therapy proved ineffective. With TP3, the tension of the vocal folds decreases, and the voice becomes low-pitched. [Copyright &y& Elsevier]

Summary: Objective: The purpose of this study was to figure out the application of pitch range (PR) evaluation subsequent to arytenoid adduction (AA) combined with type 1 thyroplasty (TP1) in unilateral vocal fold paralysis (UVFP). Study Design: Retrospective review of clinical records. Methods: Subjects were 50 patients with UVFP for whom PR and maximum phonation time (MPT) could be evaluated before and 1 year after AA + TP1. Subjects were divided into two groups based on preoperative PR (pre-PR) (group 1: ≤1 semitone (ST); group 2: ≥2 ST). Correlations among pre-PR and post-PR, MPT, and age were assessed. We also evaluated PRs in subjects with PR deterioration and PRs by causative diseases. Results: PR was significantly extended from a median of 17.0–22.0 ST in all subjects. Pre-PR was correlated with post-PR. Post-PR correlated with post-MPT in group 2 but not in group 1. There was no correlation between post-PR and age or causative diseases. The mean change in PR among subjects with PR deterioration (28.0%, 14/50) was −3.6 ST. Pre-PR and the improvement of post-PR were negatively correlated in group 2. Conclusion: PR evaluation can be useful for predicting post-PR. The effects of age and causative diseases were small compared with other factors, such as pre-PR width and surgical effects. The successful surgery may improve both PR and MPT. However, several cases showed obvious discrepancy of those postoperative improvements. It will be necessary to assess this discrepancy, particularly in subjects with postoperative voice insufficiency. [Copyright &y& Elsevier]