Comparison of the Results of Voice Handicap Index and Computer-Assisted Voice Analysis in Patients with Benign Vocal Cord Lesions before and after Microlaryngeal Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The Voice Handicap Index (VHI) subjectively evaluates the severity of voice disorders. On the other hand, computer-assisted voice analysis objectively evaluates the severity of voice disorders. The purpose of this study was to compare the results of these two different tests in patients with benign vocal cord lesions and to measure the correlation between parameters of these two tests. MATERIALS AND METHODS: From January 2002 to December 2003, 76 patients who underwent microlaryngeal surgery for benign vocal cord lesions in the Asan Medical Center were included in this study. They all filled out the VHI questionnaires, which were composed of 30 questions about before and after surgery. For 32 out of 76 patients, we also performed preoperative and postoperative acoustic analysis (jitter, shimmer, noise to harmonic ratio) and aerodynamic analysis (maximum phonation time, mean flow rate, mean subglottic pressure). All VHI and voice analysis parameters were entered into a statistical program and analyzed using a Pearson correlation. RESULTS: All the parameters of VHI showed significant improvement after surgery. The values of jitter, shimmer, noise to harmonic ratio, and maximal phonation time showed a significant change after surgery, but the mean flow rate and the mean subglottic pressure didn't. Each VHI parameter provided a significant level of reliability (p0.05) after surgery. CONCLUSION: The VHI provides a measure of self-perception on the severity of the voice disorders that cannot be assessed through objective acoustic and aerodynamic measures. No objective parameters show strong correlation with VHI parameters when compared across other testing methods after surgery. This discrepancy indicates that no objective parameters can yet be regarded as a prognostic factor to evaluate subjective perception.

Comparative Analysis of Diagnostic Tools for Parapharyngeal Tumors / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The parapharyngeal tumors are rare and treated mostly by surgical removal. The preoperative diagnosis of parapharyngeal tumors is very important because the surgical removal of neurogenic tumor, which is the main mass in the parapharyngeal space, can induce severe complications. There are many diagnostic tools for parapharyngeal tumors and their effectiveness are variable. In this study, we focused on the diagnostic accuracy of each diagnostic tool. SUBJECTS AND METHOD: We compared the preoperative diagnostic results with the final pathologic reports of 56 parapharyngeal tumors. Diagnostic tools used were computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US), and fine needle aspiration biopsy (FNAB). RESULTS: The diagnostic accuracy of MRI, CT and US was 68.2%, 51.6% and 42.8%, respectively. The sensitivity (83%) and specificity (87.5%) of FNAB for neurogenic tumor are higher than those of MRI (75%, 50%). CONCLUSION: These results suggest that FNAB is the most precise and reliable diagnostic tool and MRI is the most reasonable and effective imaging study.