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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., (© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)

Objectives/hypothesis: Patients with muscle tension dysphonia often demonstrate an elevation in Reflux Symptom Index (RSI) and 10-item Voice Handicap Index (VHI-10) scores, and may be erroneously diagnosed with laryngopharyngeal reflux disease. In this study we assessed the effects of voice therapy on RSI and VHI-10 scores in patients with voice complaints not responsive to antireflux medications., Study Design: Retrospective cohort study., Methods: A study of patients was conducted at a single tertiary-care center over 1 year (January 2012-January 2013). Patients were included if they had dysphonia not responsive to proton pump inhibition, did not have neurologic or neoplastic disease, and participated in at least three voice-therapy sessions in the absence of antireflux therapy. Primary analysis assessed change in RSI scores between the initial and follow-up visits with a laryngologist., Results: A total of 18 patients were included (mean age = 49.9 ± 14.5 years, 89% female, 83% with a primary complaint of dysphonia). From initial to follow-up visit, the median RSI score (18.5 [interquartile range {IQR}, 9.5-22.8] vs. 10.5 [IQR, 4.5-14]; P = .02) and median VHI-10 score (25.5 [IQR, 11.3-30.0] vs. 13.5 [IQR, 9.5-20.8]; P = .03) significantly decreased. A significant inverse correlation was found between the number of voice therapy sessions/month and change in RSI score (r = -0.4; P = .05)., Conclusions: In this study of patients with muscle tension dysphonia or vocal hyperfunction not responsive to antireflux therapy, RSI and VHI-10 scores improved following voice therapy. Results suggest that self-reported symptoms typically attributed to laryngopharyngeal reflux disease may actually be secondary to inefficient voice use patterns or anxiety about dysphonia that are responsive to voice therapy., Level of Evidence: 4 Laryngoscope, 129:1169-1173, 2019., (© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)

Radiation-induced dysphonia can develop after radiation for primary laryngeal cancer or when the larynx is in the radiation field for nonlaryngeal malignancy. The effects are dose dependent and lead to variable degrees of dysphonia in both short- and long-term follow-up. Rehabilitation of the irradiated larynx can prove frustrating but can be facilitated through behavioral, pharmacologic, or surgical interventions., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Objective: Although high-speed imaging (HSI) has been identified as a valuable tool in phonatory biomechanics research, to date, there have only been a selected number of reports investigating the clinical utility of HSI. We aim to elucidate the role of HSI in the diagnosis of the dysphonic patient., Methods: The video files from 28 consecutive dysphonic patients with concurrently acquired videostroboscopy and HSI were retrospectively collected. Stroboscopy video files were edited to include vibratory motion only. Videos were then anonymously and randomly presented to four academic laryngologists. Experts were asked to assign a single best diagnosis for each video file. Assigned diagnoses were then compared with treatment diagnoses conferred based on medical history, phonatory evaluation, laryngeal examination, and response to treatment., Results: Interrater analysis for the four laryngologists demonstrated significant and meaningful correlations for the diagnoses of polyps, cysts, nodules, and normal examination using stroboscopy (kappa > 0.40, P < 0.001). The experts demonstrated significant and meaningful correlations for the diagnoses of polyps, presbyphonia, and normal examination using HSI (kappa > 0.40, P < 0.001). Combined intrarater analysis performed by comparing single rater's diagnosis for single patient across both modalities resulted in poor correlation without statistical significance (kappa = 0.30, P = 0.07). Both stroboscopy- and HSI-assigned diagnoses matched the treatment diagnoses at equal predicted frequencies (32.3%), as demonstrated through multivariate logistic regression analysis (P < 0.001)., Conclusion: Overall, HSI did not improve the diagnostic accuracy above stroboscopy alone. Although specific laryngeal states such as presbyphonia may be better diagnosed with HSI, further studies are required to define HSI's precise role in the clinical setting., (Copyright © 2013 The Voice Foundation. All rights reserved.)

Objectives: Although patient‐reported outcome measures (PROMs) can be useful for assessing quality of life, they can be complex and cognitively burdensome. In this study, we prospectively evaluated a simple patient‐reported voice assessment measure on a visual analog scale (VAS voice) and compared it with the Voice Handicap Index (VHI‐10). Study design: Prospective survey. Methods: An abbreviated voice measure was designed by a team of otolaryngologists, speech pathologists, and patients that consisted of four VAS questions related to (a) a global question of voice disturbance, (b) physical function of voice, (c) functional issues, and (d) emotional handicap. All English‐speaking patients presenting to an academic laryngology clinic for a voice complaint were included. Internal consistency and validity were assessed with comparison to the VHI‐10. Results: A total of 209 patients were enrolled. Ninety‐two percent of patients reported understanding the survey. The four‐item VAS survey was highly correlated with VHI‐10 score (Pearson correlation.81, P <.0001), and the Cronbach's alpha between all four VAS questions was.94. Age, gender, and diagnosis were not associated with either the global VAS or VHI‐10 tool. Conclusion: Reducing the complexity of instruments assessing voice‐related quality of life is feasible, and the VAS voice correlated with existing measures. Simplified assessments may offer advantages compared to more cumbersome PROMs. Level of Evidence: 2c [ABSTRACT FROM AUTHOR]

No abtracts. [ABSTRACT FROM AUTHOR]

Preservation of the vocal fold cover during laryngeal surgery should optimize vocal outcomes for patients with benign glottal lesions. The aim of this study was to evaluate changes in the quality of life, perceptual voice evaluation, and acoustic and aerodynamic measures of patients before and after endoscopic laryngeal microsurgery for true vocal fold cysts, polyps, and scarring. Pre-operative and postoperative Voice Handicap Index (VHJ) scores, Short Form 36 scores, and perceptual, acoustic, and aerodynamic voice measures were obtained prospectively from 42 patients who underwent phonomicrosurgery from February 2000 through May 2003. The mean (±SD) preoperative VHI was 49.6 ± 21. The mean postoperative VHI score at a minimum of 3 months after surgery decreased to 26.8 ± 21 (p < .001). When divided by lesion type, VHI scores improved significantly after surgery for vocal fold polyps and cysts. Although patients with vocal fold scarring demonstrated improvement in VHI scores after surgery, statistical significance was not achieved. For the entire group, the Short Form 36 scores were not significantly different from US norms either before or after operation. The acoustic data showed statistically significant decreases in jitter (2.05% to 1.26%), shimmer (7.06% to 4.03%), and noise-to-harmonics ratio (0.18 to 0.13) after surgery (p c .05) in female patients. The upper pitch limit increased after surgery in women (495.3 Hz to 654.9 Hz, p c .001). These results indicate that the voice-related quality of life and some acoustic parameters improve significantly for patients who have undergone laryngeal microsurgery for vocal fold cysts and polyps. Vocal fold scarring remains a difficult clinical problem with less favorable outcomes following surgical treatment in this patient set. [ABSTRACT FROM AUTHOR]

The article focuses on therapeutic treatment for patients in field of laryngology by laryngologists in an office based setting. Topics discussed include advantages in operating patients in upright position where they can phonate is to monitor voice quality, effect of office based procedure on safety and cost reduction, and technological advances in the field including chip-tip flexible endoscope, high-speed imaging, and new injection materials.