scholarly journals Multi-institutional Study of Voice Disorders and Voice Therapy Referral

2016 ◽  
Vol 155 (1) ◽  
pp. 33-41 ◽  
Author(s):  
Stephanie Misono ◽  
Schelomo Marmor ◽  
Nelson Roy ◽  
Ted Mau ◽  
Seth M. Cohen
Keyword(s):  
Vocal Fold ◽  
Research Network ◽  
Voice Therapy ◽  
Symptom Duration ◽  
Cross Sectional ◽  
Academic Practice ◽  
Benign Vocal Fold Lesions ◽  
Patient Reported ◽  
Vocal Strain ◽  
Voice Problem

Objectives To assess perspectives of patients with voice problems and identify factors associated with the likelihood of referral to voice therapy via the CHEER (Creating Healthcare Excellence through Education and Research) practice-based research network infrastructure. Study Design Prospectively enrolled cross-sectional study of CHEER patients seen for a voice problem (dysphonia). Setting The CHEER network of community and academic sites. Methods Patient-reported demographic information, nature and severity of voice problems, clinical diagnoses, and proposed treatment plans were collected. The relationship between patient factors and voice therapy referral was investigated. Results Patients (N = 249) were identified over 12 months from 10 sites comprising 30 otolaryngology physicians. The majority were women (68%) and white (82%). Most patients reported a recurrent voice problem (72%) and symptom duration >4 weeks (89%). The most commonly reported voice-related diagnoses were vocal strain, reflux, and benign vocal fold lesions. Sixty-seven percent of enrolled patients reported receiving a recommendation for voice therapy. After adjusting for sociodemographic and other factors, diagnoses including vocal strain/excessive tension and vocal fold paralysis and academic practice type were associated with increased likelihood of reporting a referral for voice therapy. Conclusions The CHEER network successfully enrolled a representative sample of patients with dysphonia. Common diagnoses were vocal strain, reflux, and benign vocal fold lesions; commonly reported treatment recommendations included speech/voice therapy and antireflux medication. Recommendation for speech/voice therapy was associated with academic practice type.

scholarly journals Factors Influencing Likelihood of Voice Therapy Attendance: Report from the CHEER Network

2016 ◽  
Vol 156 (3) ◽  
pp. 518-524 ◽  
Author(s):  
Stephanie Misono ◽  
Schelomo Marmor ◽  
Nelson Roy ◽  
Ted Mau ◽  
Seth M. Cohen
Keyword(s):  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Research Network ◽  
Voice Therapy ◽  
Patient Counseling ◽  
Cross Sectional ◽  
Factors Associated ◽  
Factors Influencing ◽  
Patient Reported ◽  
Practice Based Research

Objective To identify factors associated with the likelihood of attending voice therapy among patients referred for it in the CHEER (Creating Healthcare Excellence through Education and Research) practice-based research network infrastructure. Study Design Prospectively enrolled cross-sectional study. Setting CHEER network of community and academic sites. Methods Data were collected on patient-reported demographics, voice-related diagnoses, voice-related handicap (Voice Handicap Index–10), likelihood of attending voice therapy (VT), and opinions on factors influencing likelihood of attending VT. The relationships between patient characteristics/opinions and likelihood of attending VT were investigated. Results A total of 170 patients with various voice-related diagnoses reported receiving a recommendation for VT. Of those, 85% indicated that they were likely to attend it, regardless of voice-related handicap severity. The most common factors influencing likelihood of VT attendance were insurance/copay, relief that it was not cancer, and travel. Those who were not likely to attend VT identified, as important factors, unclear potential improvement, not understanding the purpose of therapy, and concern that it would be too hard. In multivariate analysis, factors associated with greater likelihood of attending VT included shorter travel distance, age (40-59 years), and being seen in an academic practice. Conclusions Most patients reported plans to attend VT as recommended. Patients who intended to attend VT reported different considerations in their decision making from those who did not plan to attend. These findings may inform patient counseling and efforts to increase access to voice care.

Multidimensional assessment of vocal changes in benign vocal fold lesions after voice therapy

2013 ◽  
Vol 40 (3) ◽  
pp. 291-297 ◽  
Author(s):  
Antonio Schindler ◽  
Francesco Mozzanica ◽  
Patrizia Maruzzi ◽  
Murat Atac ◽  
Valeria De Cristofaro ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Voice Therapy ◽  
Multidimensional Assessment ◽  
Benign Vocal Fold Lesions

08:02 AM: Use of Voice Therapy in Benign Vocal Fold Lesions

2006 ◽  
Vol 135 (2_suppl) ◽  
pp. P195-P195
Author(s):  
Seth M Cohen ◽  
C Gaelyn Garrett
Keyword(s):  
Vocal Fold ◽  
Voice Therapy ◽  
Benign Vocal Fold Lesions

scholarly journals The Role of Oral Steroids in the Treatment of Phonotraumatic Vocal Fold Lesions in Women

2018 ◽  
Vol 160 (3) ◽  
pp. 512-518 ◽  
Author(s):  
Milan R. Amin ◽  
Stratos Achlatis ◽  
Shirley Gherson ◽  
Yixin Fang ◽  
Binhuan Wang ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Care Center ◽  
Primary Outcome Measure ◽  
Voice Therapy ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Benign Vocal Fold Lesions ◽  
Short Course ◽  
Oral Steroids

Objectives (1) To determine the short-term effectiveness of oral steroids in women with benign vocal fold lesions and (2) to determine the effectiveness of adjuvant oral steroids in women undergoing voice therapy for benign vocal fold lesions. Study Design Randomized, double-blind, placebo-controlled clinical trial. Setting Tertiary voice care center. Subjects and Methods Thirty-six patients undergoing voice therapy for the treatment of phonotraumatic vocal fold lesions randomly received either a 4-day course of oral steroids or a placebo prior to initiating voice therapy. Voice Handicap Index–10 (VHI-10) scores, video and audioperceptual analyses, acoustic and aerodynamic analyses at baseline, and patient perception of improvement after a short course of steroids or a placebo and at the conclusion of voice therapy were collected. Results Thirty patients completed the study, of whom 27 (only female) were analyzed. The primary outcome measure, VHI-10, did not improve after the 4-day course of steroids or placebo. Secondary measures similarly showed no improvement with steroids relative to placebo. Voice therapy demonstrated a positive effect on both VHI-10 and patient-perceived improvement of voice in all subjects. Conclusion A short course of oral steroids did not benefit women with phonotraumatic vocal fold lesions. In addition, steroids had little beneficial effect when used adjunctively with voice therapy in this patient cohort.

scholarly journals Multimorbidity and patient-reported diagnostic errors in the primary care setting: multicentre cross-sectional study in Japan

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039040
Author(s):  
Takuya Aoki ◽  
Satoshi Watanuki
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Diagnostic Errors ◽  
Cross Sectional Study ◽  
Research Network ◽  
Diagnostic Process ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patient Reported

ObjectivesThere is lack of evidence for the association between multimorbidity and diagnostic errors. Information on diagnostic errors from patients’ perspectives is crucial to improve the diagnostic process. In this study, we aimed to investigate patient-reported diagnostic errors and to examine the relationship between multimorbidity and patient-reported diagnostic errors in the primary care setting.DesignMulticentre cross-sectional study.SettingA primary care practice-based research network in Japan (25 primary care facilities).ParticipantsAdult outpatients filled out a standardised questionnaire.Primary outcome measurePatient-reported diagnostic errors.ResultsData collected from 1474 primary care outpatients were analysed. The number of participants who reported diagnostic errors was 57 (3.9%). Most of the missed diagnoses were common conditions in primary care, such as cancer, dermatitis and hypertension. After adjustment for possible confounders and clustering within facilities, multimorbidity was positively associated with patient-reported diagnostic errors (adjusted OR=1.83, 95% CI 1.01 to 3.31). The results of the sensitivity analysis were consistent with those of the primary analysis.ConclusionsThe present study showed a lower proportion of patients reporting experiences of diagnostic errors in primary care than those reported in previous studies in other countries. However, patients with multimorbidity are more likely to report diagnostic errors in primary care; thus, further research is necessary to improve the diagnostic process for patients with multimorbidity.

scholarly journals Unilateral Vocal Fold Paralysis and Voice Therapy: Does Age Matter? A Prospective Study With 100 Consecutive Patients

2019 ◽  
pp. 014556131988211 ◽  
Author(s):  
Mariline Santos ◽  
Susana Vaz Freitas ◽  
Pedro Santos ◽  
Isabel Carvalho ◽  
Miguel Coutinho ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Cross Sectional Study ◽  
Vocal Fold Paralysis ◽  
Voice Therapy ◽  
Unilateral Vocal Fold Paralysis ◽  
Self Assessment ◽  
Cross Sectional ◽  
Recent Onset ◽  
Before And After ◽  
A Prospective Study

Objective: To use a multidimensional assessment to analyze potential influence of “aging” in the functional outcomes achieved by a group of patients with recent onset of unilateral vocal fold paralysis (UVFP) who underwent voice therapy. Design: Prospective, observational, and cross-sectional study. Setting: Otolaryngology department, Centro Hospitalar do Porto. Participants: Patients with UVFP who underwent voice therapy. Main Outcome Measures: Data regarding gender, age, side and position of the paralyzed vocal fold, etiology, comorbidities, and Voice Handicap Index (VHI)—30 questions, before and after voice therapy, were collected. Glottal insufficiency was also evaluated, by endoscopic laryngoscopy, before and after voice therapy. Results: A total of 100 patients (76 females and 24 males) with UVFP were included. Mean age was 61.04 years (range: 21-88 years). The mean score of VHI, before and after voice therapy, was statistically different ( P < .001) with a lower score after therapy. The score of VHI was not influenced by age ( P = .717). However, for each 10-year increase in age, the score of VHI, before and after voice therapy, increased 1.91 and 2.86 units, respectively. As concerns endoscopic findings, 80% of patients exhibited better glottis closure after voice therapy ( P < .001), and this was not influenced by age. Nevertheless, for each 10-year increase in age, the chance of endoscopic improvement reduced 3%. Conclusions: A clear and significant improvement was visible in the endoscopic and self-assessment ratings after rehabilitation by isolated voice therapy. Despite possible anatomical and physiological aging changes in the phonatory system, age did not compromise the successful rate obtained by voice therapy.

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