Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-26T07:23:54.991Z Has data issue: false hasContentIssue false
  • English
  • Français

Maximum vocal intensity as a primary outcome measure in unilateral vocal fold paralysis patients

Published online by Cambridge University Press:  14 December 2020

S F Johari ,
M Azman ,
A S Mohamed  and
M M Baki
S F Johari
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
M Azman
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
A S Mohamed
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
M M Baki*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
*
Author for correspondence: Professor Dr Marina Mat Baki, Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine, University Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia E-mail: [email protected] Fax: +60 3914 56675
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To evaluate voice intensity as the primary outcome measurement when treating unilateral vocal fold paralysis patients.

Methods

This prospective observational study comprised 34 newly diagnosed unilateral vocal fold paralysis patients undergoing surgical interventions: injection laryngoplasty or medialisation thyroplasty. Voice assessments, including maximum vocal intensity and other acoustic parameters, were performed at baseline and at one and three months post-intervention. Maximum vocal intensity was also repeated within two weeks before any surgical interventions were performed. The results were compared between different time points and between the two intervention groups.

Results

Maximum vocal intensity showed high internal consistency. Statistically significant improvements were seen in maximum vocal intensity, Voice Handicap Index-10 and other acoustic analyses at one and three months post-intervention. A significant moderate negative correlation was demonstrated between maximum vocal intensity and Voice Handicap Index-10, shimmer and jitter. There were no significant differences in voice outcomes between injection laryngoplasty and medialisation thyroplasty patients at any time point.

Conclusion

Maximum vocal intensity can be applied as a treatment outcome measure in unilateral vocal fold paralysis patients; it can demonstrate the effectiveness of treatment and moderately correlates with self-reported outcome measures.

Keywords

Unilateral Vocal Cord ParalysisDysphoniaVoiceOutcome MeasuresAcoustics
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 12 , December 2020 , pp. 1085 - 1093
Copyright
Copyright © JLO (1984) Limited, 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Professor Dr M M Baki takes responsibility for the integrity of the content of the paper

References

Singh, JM, Kwartowitz, G. Vocal Fold Paralysis Unilateral. Treasure Island, FL: StatPearls, 2019Google Scholar
Baki, MM, Yu, R, Rubin, JS, Chevretton, E, Sandhu, G, Birchall, MA. Patient perception of a randomised, controlled trial of laryngeal reinnervation versus thyroplasty for unilateral vocal fold paralysis. J Laryngol Otol 2015;129:693–701CrossRefGoogle Scholar
Ware, JE Jr, Snow, KK, Kosinski, M, Gandek, B. SF-36 Health Survey Manual and Interpretation Guide. Boston: Health Institute, New England Medical Center Hospitals, 1993Google Scholar
Fang, TJ, Li, HY, Gliklich, RE, Chen, YH, Wang, PC, Chuang, HF. Quality of life measures and predictors for adults with unilateral vocal cord paralysis. Laryngoscope 2008;118:1837–41CrossRefGoogle ScholarPubMed
Moy, FM, Hoe, VC, Hairi, NN, Chu, AH, Bulgiba, A, Koh, D. Determinants and effects of voice disorders among secondary school teachers in peninsular Malaysia using a validated Malay version of VHI-10. PLoS One 2015;10:e0141963CrossRefGoogle ScholarPubMed
Sataloff, RT. Professional Voice: The Science and Art of Clinical Care, 4th edn. San Diego: Plural Publishing, 2017Google Scholar
Misono, S, Merati, AL. Evidence-based practice: evaluation and management of unilateral vocal fold paralysis. Otolaryngol Clin North Am 2012;45:1083–108CrossRefGoogle ScholarPubMed
Behrman, A. Evidence-based treatment of paralytic dysphonia: making sense of outcomes and efficacy data. Otolaryngol Clin North Am 2004;37:75–104CrossRefGoogle ScholarPubMed
Dworkin, JP, Meleca, RJ. Vocal Pathologies: Diagnosis, Treatment, and Case Studies. San Diego: Singular Publishing, 1997Google Scholar
Rosen, CA, Lee, AS, Osborne, J, Zullo, T, Murry, T. Development and validation of the Voice Handicap Index-10. Laryngoscope 2004;114:1549–56CrossRefGoogle ScholarPubMed
Ong, FM, Hassan, NF, Azman, M, Sani, A, Baki, MM. Validity and reliability study of Bahasa Malaysia version of Voice Handicap Index-10. J Voice 2019;33:581.e17–581.e23CrossRefGoogle ScholarPubMed
Arffa, RE, Krishna, P, Gartner-Schmidt, J, Rosen, CA. Normative values for the voice handicap index-10. J Voice 2012;26:462–5CrossRefGoogle ScholarPubMed
Mat Baki, M, Wood, G, Alston, M, Ratcliffe, P, Sandhu, G, Rubin, JS et al. Reliability of OperaVOX against Multidimensional Voice Program (MDVP). Clin Otolaryngol 2015;40:22–8CrossRefGoogle Scholar
Walton, C, Carding, P, Conway, E, Flanagan, K, Blackshaw, H. Voice outcome measures for adult patients with unilateral vocal fold paralysis: a systematic review. Laryngoscope 2019;129:187–97CrossRefGoogle ScholarPubMed
Hsiung, MW, Pai, L, Wang, HW. Correlation between voice handicap index and voice laboratory measurements in dysphonic patients. Eur Arch Otorhinolaryngol 2002;259:97–9CrossRefGoogle ScholarPubMed
Wheeler, KM, Collins, SP, Sapienza, CM. The relationship between VHI scores and specific acoustic measures of mildly disordered voice production. J Voice 2006;20:308–17CrossRefGoogle ScholarPubMed
Woisard, V, Bodin, S, Yardeni, E, Puech, M. The voice handicap index: correlation between subjective patient response and quantitative assessment of voice. J Voice 2007;21:623–31CrossRefGoogle Scholar
Gillespie, AI, Gooding, W, Rosen, C, Gartner-Schmidt, J. Correlation of VHI-10 to voice laboratory measurements across five common voice disorders. J Voice 2014;28:440–8CrossRefGoogle ScholarPubMed
Vinson, KN, Zraick, RI, Ragland, FJ. Injection versus medialization laryngoplasty for the treatment of unilateral vocal fold paralysis: follow-up at six months. Laryngoscope 2010;120:1802–7CrossRefGoogle ScholarPubMed
Morgan, JE, Zraick, RI, Griffin, AW, Bowen, TL, Johnson, FL. Injection versus medialization laryngoplasty for the treatment of unilateral vocal fold paralysis. Laryngoscope 2007;117:2068–74CrossRefGoogle ScholarPubMed
Friedman, AD, Burns, JA, Heaton, JT, Zeitels, SM. Early versus late injection medialization for unilateral vocal cord paralysis. Laryngoscope 2010;120:2042–6CrossRefGoogle ScholarPubMed
Marques, JA, Marronnier, A, Crampon, F, Lagier, A, Marie, JP. Early management of acute unilateral vocal fold paralysis: update of the literature. J Voice 2020. Epub 2020 Apr 3Google ScholarPubMed