A Descriptive Study of Benign Vocal Cord Lesions with Speech Prameters Operated with Microlaryngoscopy

Background:Humanity has appreciated the importance and power of the human voice. Voice disorders like benign, malignant lesions of vocal cord affect the voice quality and also can have a devastating effect on daily functioning and quality of life. These lesions can be diagnosed and treated with microlaryngoscopy. Micro-laryngoscopy is a procedure for visualization of a magnified view of the voice box (larynx) with the help of a laryngoscope assisted with an operating microscope for precise laryngeal surgery. Speech parameters helps in voice quality assessment for vocal cord lesions.Method:We have studied 30 cases of benign vocal cord lesion by simple random sampling for two years which got operated with microlaryngoscopic conventional surgery. Their pre and post-operative assessment is done with respect to speech parameters like Maximum Phonation Time, Voice Handicap Index and GRBAS Score. Clinical history and rigid Hopkins 700 also helped in diagnosing of benign vocal cord lesions. Result: After conventional microlaryngeal surgery helps in improvement in MPT, VHI score, GRBAS Score post-operatively that of 3 months follow up. The effectiveness was seen more along with voice rest, corticosteroids and most important speech therapy.

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Impact of speech therapy on the improvement of voice quality in patients with unilateral vocal fold paralysis

Polski Przegląd Otorynolaryngologiczny ◽

10.5604/01.3001.0012.7783 ◽

2018 ◽

Vol 7 (4) ◽

pp. 1-7

Author(s):

Anna Kuligowska ◽

Barbara Jamróz ◽

Joanna Chmielewska ◽

Katarzyna Jędra ◽

Tomasz Czernicki ◽

...

Keyword(s):

Vocal Fold ◽

Speech Therapy ◽

Acoustic Analysis ◽

Vocal Tract ◽

Voice Quality ◽

Maximum Phonation Time ◽

Before And After ◽

Vocal Fold Palsy ◽

The Voice

Aim of study: Evaluation of the speech therapy on voice quality in patients with unilateral vocal fold palsy. Material and methods: The study group included 11 patients, 8 women and 3 men, in age between 16 to 72 years, with unilateral vocal fold palsy, diagnosed in ENT Department of Warsaw Medical University between 2017-2018. Each person completed questionnaires: the voice disability self-assessment scale (VHI), the voice-based quality of life (VRQoL) scale, the vocal tract discomfort scale (VTD). All questionnaires were completed twice, before and after the voice therapy. In addition, the acoustic analysis of the voice, the assessment of the maximum phonation time and the breathing tract were performed twice in each patient. Each of the patients had a voice rehabilitation consisting of a series of 10 meetings. Results: Statistical analysis of the results of maximum phonation time, the self-assessment of voice disability, the quality of life depending on the voice, discomfort of the vocal tract voice acoustic analysis showed statistically significant differences in the results before and after rehabilitation (p <0.005). In addition, the improvement of the respiratory tract was observed in the majority of patients. Conclusions: Speech therapy significantly affects the voice quality of patients with unilateral laryngeal nerve palsy.

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S179 – Voice Self-evaluation after Treatment for T1 Glottic Cancer

Otolaryngology ◽

10.1016/j.otohns.2008.05.353 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P136-P136

Author(s):

Faustino Nunez ◽

Maria Jesus Caminero ◽

Jose-Luis Llorente-Pendas ◽

Carlos Suarez-Nieto

Keyword(s):

Laser Surgery ◽

Voice Quality ◽

Well Being ◽

Voice Handicap Index ◽

Glottic Cancer ◽

Glottic Carcinoma ◽

Subjective Analysis ◽

Maximum Phonation Time ◽

Self Evaluation ◽

The Voice

Objectives 1) To present the objective and subjective analysis of voice quality following treatment of an early epidermoid glottic carcinoma. 2) Results from the objective evaluation of the voice, along with the self-evaluation of voice quality quantified using the Voice Handicap Index of a group of patients treated with endoscopic laser surgery, are compared with patients treated with radiotherapy. Methods We performed an objective voice evaluation, as well as a physical, emotional, and functional well-being assessment of 19 patients treated with laser surgery and 18 patients treated with radiotherapy. The data obtained was gathered in the statistical database SPSS 12.0. The statistical analysis used was the “Student t test” in order to compare averages and the Chi-squared test for comparing proportions. The statistical differences were considered significant when p was lower than 0.05. Results Voice quality is affected both by surgery and radiotherapy. Voice parameters only show differences in the maximum phonation time between both treatments (p < 0,005). Patients Self-Perception Analysis (Voice Handicap Index) Upon completing the comparison between the two groups, the statistical difference is significant, in favor of the radiotherapy patients in functional and emotional ratings, as well as the global scores (p < 0,005). No significant differences were found in the physical scales. Conclusions There is a reduced impact in patient's perception of voice quality after radiotherapy, despite no significant differences in vocal quality between radiotherapy and laser cordectomy.

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The Dysphonia Severity Index

Journal of Speech Language and Hearing Research ◽

10.1044/jslhr.4303.796 ◽

2000 ◽

Vol 43 (3) ◽

pp. 796-809 ◽

Cited By ~ 319

Author(s):

Floris L. Wuyts ◽

Marc S. De Bodt ◽

Geert Molenberghs ◽

Marc Remacle ◽

Louis Heylen ◽

...

Keyword(s):

Multivariate Analysis ◽

Voice Quality ◽

Severity Index ◽

Voice Handicap Index ◽

Objective Measures ◽

Maximum Phonation Time ◽

Vocal Quality ◽

The Voice ◽

Weighted Combination

The vocal quality of a patient is modeled by means of a Dysphonia Severity Index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following selected set of voice measurements: highest frequency (F 0 -High in Hz), lowest intensity (I-Low in dB), maximum phonation time (MPT in s), and jitter (%). The DSI is derived from a multivariate analysis of 387 subjects with the goal of describing, purely based on objective measures, the perceived voice quality. It is constructed as DSI=0.13 x MPT + 0.0053 x F 0 -High – 0.26 x I-Low – 1.18 x Jitter (%) + 12.4. The DSI for perceptually normal voices equals +5 and for severely dysphonic voices –5. The more negative the patient's index, the worse is his or her vocal quality. As such, the DSI is especially useful to evaluate therapeutic evolution of dysphonic patients. Additionally, there is a high correlation between the DSI and the Voice Handicap Index score.

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Acoustic, perceptual and aerodynamic voice evaluation in an obese population

The Journal of Laryngology & Otology ◽

10.1017/s0022215113001916 ◽

2013 ◽

Vol 127 (10) ◽

pp. 987-990 ◽

Cited By ~ 10

Author(s):

S Celebi ◽

K Yelken ◽

O N Develioglu ◽

M Topak ◽

O Celik ◽

...

Keyword(s):

Standard Deviation ◽

Acoustic Analysis ◽

Voice Quality ◽

Normal Weight ◽

Voice Handicap Index ◽

Maximum Phonation Time ◽

The Mean ◽

Vocal Quality ◽

And Control ◽

The Voice

AbstractObjective:To investigate perceptual, acoustic and aerodynamic voice parameters in obese individuals.Methods:Twenty obese and 20 normal-weight volunteers underwent voice evaluation by laryngoscopy, acoustic analysis, aerodynamic measurement and perceptual analysis (using the grade-roughness-breathiness-asthenia-strain (‘GRBAS') scale and the Voice Handicap Index 10 scale). Data from both subject groups were compared.Results:No difference was found in acoustic analysis parameters between the two groups (p > 0.05). Maximum phonation time in the obese group (mean ± standard deviation, 19.6 ± 4.9 seconds) was significantly shorter than in controls (26.4 ± 4.1 seconds) (p < 0.001), although the s/z ratio was very similar between the two groups. In the obese and control groups, the mean ± standard deviation grade-roughness-breathiness-asthenia-strain scores were 1 ± 1.3 and 0.2 ± 0.6 (p = 0.002) and the mean ± standard deviation Voice Handicap Index 10 scores were 0.5 ± 1.2 and 1.2 ± 1.7 (p = 0.27), respectively.Conclusion:Obese individuals had poorer vocal quality as judged by the grade-roughness-breathiness-asthenia-strain scale, and reduced maximum phonation time. However, there was no change in voice quality as assessed by acoustic analysis and Vocal Handicap Index 10 score, compared with controls.

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Endoszkópos arytaenoid abdukciós lateropexia foniátriai eredményei átmeneti kétoldali gégebénulás esetén

Orvosi Hetilap ◽

10.1556/650.2018.31099 ◽

2018 ◽

Vol 159 (29) ◽

pp. 1188-1192 ◽

Cited By ~ 1

Author(s):

Vera Matievics ◽

Balázs Sztanó ◽

Ádám Bach ◽

László Rovó

Keyword(s):

Minimally Invasive ◽

Vocal Cord ◽

Voice Quality ◽

Surgical Techniques ◽

Vocal Cord Palsy ◽

Invasive Technique ◽

Normal Voice ◽

Respiratory Outcomes ◽

The Voice

Abstract: Introduction: Dyspnea caused by bilateral vocal cord paralysis often requires surgical intervention to prevent acute asphyxiation. The regeneration of the laryngeal nerves may last weeks or months and it is difficult to predict the outcome. In the past decades, several open and endoscopic surgical techniques have been introduced for treatment to avoid tracheostomy, however, these procedures with resection of the glottis resulted in irreversible changes in the laryngeal structure, thus the voice quality decreased over a long-term period. Aim: Endoscopic arytenoid abduction lateropexy is an accepted reversible, minimally invasive technique that provides an immediate patent airway by the lateralisation of the arytenoid cartilage with a suture. The aim of our study was to analyze the phonatory and respiratory outcomes of this treatment concept. Method: Two patients suffering from bilateral vocal cord palsy were treated with endoscopic arytenoid abduction lateropexy. After recovery of the vocal cord movements, the sutures were removed. Spirometric and phoniatric results of the two patients were analysed after suture removal. Results: Good spirometric parameters and normal voice quality were detected in both cases. Conclusions: These results prove the high reversibility of the minimally invasive endoscopic arytenoid abduction lateropexy. Lateralization suture can be removed in the case of vocal cord movement recovery, and phonation may be physiological. Orv Hetil. 2018; 159(29): 1188–1192.

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The Efficacy of Treatment for Vocal Fold Bowing with Pulsed Dye Laser

International Journal of Phonosurgery & Laryngology ◽

10.5005/jp-journals-10023-1035 ◽

2012 ◽

Vol 2 (1) ◽

pp. 46-48

Author(s):

Yong Cheol Koo ◽

Hyo Jin Chung ◽

Michelle J Suh ◽

Hong-Shik Choi

Keyword(s):

Quality Improvement ◽

Vocal Cord ◽

Vocal Fold ◽

Speech Therapy ◽

Voice Quality ◽

Vocal Folds ◽

Dye Laser ◽

Liquid Silicon ◽

Pulsed Dye Laser ◽

Efficacy Of Treatment

ABSTRACT Bowing of the vocal folds can result from aging, atrophy or idiopathic causes, such as an injudicious vocal cord surgery. Bowing results in dysphonia due to inadequate approximation of the vocal folds. A number of treatments have been proposed for this condition. Intracordal injection of biological materials including liquid silicon and Teflon and various types of thyroplasty have been utilized. However, full voice recovery has never been fully achieved. We present a case involving a 64-year-old Asian man with dysphonia for 30 years. The patient's vocal fold bowing was examined on laryngoscopy. The disease was effectively treated with pulsed dye laser (PDL) followed by speech therapy. Observation of the patient over 1 year did not show any signs of recurrence. Our analysis revealed voice quality improvement. How to cite this article Koo YC, Chung HJ, Suh MJ, Choi HS. The Efficacy of Treatment for Vocal Fold Bowing with Pulsed Dye Laser. Int J Phonosurg Laryngol 2012;2(1):46-48.

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Assessment of pre and postoperative voice quality in cases of vocal fold polyp

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200150 ◽

2020 ◽

Vol 6 (2) ◽

pp. 352

Author(s):

Sachana Prasad ◽

Ranjan Raychowdhury ◽

Amitabha Roychoudhury

Keyword(s):

Vocal Fold ◽

Vocal Communication ◽

Voice Quality ◽

Maximum Phonation Time ◽

Flap Technique ◽

Wide Range ◽

Significant Impairment ◽

Benign Tumours ◽

Microlaryngeal Surgery

Background: Benign vocal fold lesions comprise of a wide range of conditions resulting from vocal misuse or abuse (vocal nodules, polyps, cysts etc.), acute and chronic inflammatory changes, congenital vocal fold anomalies, vocal fold trauma and benign tumours. It results in significant impairment of vocal communication with major psychosocial impact.Methods: The prospective study was conducted in Department of Otolaryngology, Vivekananda Institute of Medical Sciences, Kolkata from January 2016 to January 2018. All forty patients diagnosed with vocal fold polyp underwent phonomicrosurgery using micro-flap technique followed by voice therapy. Detailed pre-operative and post-operative (3 weeks, 6 weeks, 12 weeks follow up) voice assessment including fibre optic laryngoscopy and laryngovideo-stroboscopic findings were recorded. Results: Voice quality of the 40 patients with vocal fold polyps who underwent cold steel phonomicrosurgery had a statistically significant improvement at each follow up visit (3 weeks, 6 weeks and 12 weeks) as assessed by the subjective variables of voice handicap index score, visual analogue scale score and grade, roughness, breathiness, asthenia, strain score and objective variables of jitter, shimmer, harmonic-to-noise ratio, maximum phonation time and fibreoptic laryngoscopy and videolaryngostroboscopic findings. Fundamental frequency in females had statistically improved results but in males, though there was an improvement, the values were not statistically significant.Conclusions: Cold steel microlaryngeal surgery using micro-flap technique offers excellent results in patients with vocal fold polyps. Perceptual, aerodynamic, acoustic, self-analysis and videolaryngostroboscopic parameters together allow multidimensional assessment of voice characteristics.

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The Vocal Cord Nodule: Complication of Severe COVID-19 Infection

Archives of Anesthesia and Critical Care ◽

10.18502/aacc.v6i4.4627 ◽

2020 ◽

Author(s):

Mohammad Hashim ◽

Sneha Venkatesan ◽

Ashutosh Kaushal ◽

Sana Kausar

Keyword(s):

Vocal Cord ◽

Speech Therapy ◽

Risk Mitigation ◽

Voice Quality ◽

Upper Airway ◽

Flexible Endoscopy ◽

Multiple Organ ◽

Early Prediction ◽

Organ Systems ◽

Airway Symptoms

Severe acute respiratory syndrome corona virus 2 acts through ACE-2 receptors and involves multiple organ systems. Also associated with many upper airway symptoms, we reported an unnoticed complication of the upper airway, which presented as hoarseness of voice and throat discomfort during ICU stay, the upper airway flexible endoscopy was performed, which showed vocal cord nodule. The patient was managed conservatively, by improving hydration, steam inhalation, voice rest, and speech therapy. Gradually, there was a significant improvement in patient's symptoms and voice quality. An early prediction and risk mitigation can prevent this complication.

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A descriptive study of benign vocal cord lesions

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200516 ◽

2020 ◽

Vol 6 (3) ◽

pp. 478

Author(s):

Bhoomi Bhadesia ◽

Rashmi Sorathiya ◽

Hetal Joshi ◽

Nisarg Desai ◽

Narendra Hirani

Keyword(s):

Vocal Cord ◽

Speech Therapy ◽

Economic Status ◽

Tertiary Care ◽

Etiological Factor ◽

Contributing Factors ◽

Factors Affecting ◽

Poor General Health ◽

Drinking Habits ◽

Microlaryngeal Surgery

Background: Various vocal cord lesions have a significant influence on vocalization. In India and other developing countries, the prevailing lower economic status, poor general health of population, different food habits, vocal habits, smoking and drinking habits, unhealthy environment and different social customs definitely influence the incidence of various vocal cord lesions. Objective of this was study was to find out the incidence of various vocal cord lesions, factors affecting the voice and treatment.Methods: This is a prospective study carried out in ENT Department from June 2018 to September 2019 at a tertiary care teaching hospital of Western Gujarat. We evaluated 48 patients who had various lesions on vocal cord. Incidence, age, gender, occupational factors, contributing factors, clinical features, histopathological findings were studied. Results: Vocal cord lesions were more common in males (64.58%), 21 to 40 years of age group. Change of voice (100%) was the most common presenting symptom. Vocal abuse (83.33%) was most common etiological factor. Students (27.08%) were most commonly affected. Maximum cases were of vocal cord nodules (39.58%). All vocal cord lesions (except papilloma) had good recovery with no recurrence.Conclusions: Vocal cord lesions were more common in males and in 3rd and 4th decades of life. Change of voice was the most common presenting symptom. Vocal abuse was most common etiological factor. Students were more affected in vocal cord lesions. Vocal cord nodules were the most common lesions. Microlaryngeal surgery, voice rest and speech therapy are the mainstay of the treatment for benign lesions.

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The Effect of Voice Therapy for the Treatment of Functional Aphonia: A Preliminary Study

Journal of The Korean Society of Laryngology Phoniatrics and Logopedics ◽

10.22469/jkslp.2021.32.2.75 ◽

2021 ◽

Vol 32 (2) ◽

pp. 75-80

Author(s):

No Eul Kim ◽

Jun Seok Kim ◽

Jae Hwan Oh ◽

Dong Young Kim ◽

Joo Hyun Woo

Keyword(s):

Behavioral Therapy ◽

Voice Quality ◽

Retrospective Chart Review ◽

Clinical Information ◽

Voice Therapy ◽

Maximum Phonation Time ◽

Perceptual Evaluation ◽

Before And After ◽

Cepstral Peak Prominence ◽

The Voice

Background and Objectives Functional aphonia refers to in which by presenting whispering voice and almost producing very high-pitched tensed voices are produced. Voice therapy is the most effective treatment, but there is a lack of consensus for application of voice therapy. The purpose of this study was to examine the vocal characteristics of functional aphonia and the effect of voice therapy applied accordingly.Materials and Method From October 2019 to December 2020, 11 patients with functional aphonia were treated using voice therapy which was processing three stages such as vocal hygiene, trial therapy, and behavioral therapy. Of these, 7 patients who completed the voice evaluation before and after voice therapy was enrolled in this study. By retrospective chart review, clinical information such as sex, age, symptoms, duration, social and medical history, process of voice therapy, subjective and objective findings were analyzed. Voice parameters before and after voice therapy were compared.Results In GRBAS study, grade, rough, and asthenic, and in Consensus Auditory-Perceptual Evaluation of Voice, overall severity, roughness, pitch, and loudness were significantly improved after voice therapy. In Voice handicap index, all of the scores of total and sub-categories were significantly decreased. In objective voice analysis, jitter, cepstral peak prominence, and maximum phonation time were significantly improved.Conclusion The voice therapy was effective for the treatment of functional aphonia by restoring patient’s vocalization and improving voice quality, pitch and loudness.

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