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.

Vocal Dynamic Studies before and after Laryngeal Microsurgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Perceptual acoustic measures are most often used to judge the outcomes and the objective analysis of phonosurgical results before and after the microlaryngeal surgery. However, they have rarely been reported in this country. The purpose of this study is to analyze aerodynamic and acoustic results before and after microlaryngeal surgery and to analyze the differences of the prognosis of various benign vocal cord lesions. MATERIALS AND METHODS: At Inha University Hospital, from June 1996 to August 1998, 245 microlaryngeal surgeries were done. Malignant lesions were excluded. And 118 (54 females and 64 males) out of 245 patients were followed up after the surgery: the acoustic and the aerodynamic studies before and 8 weeks after microlaryngeal surgery for benign lesions: vocal polyp, vocal nodule, Reinke's edema, intracordal cyst and hyperkeratosis. Seven measurements were performed: fundamental frequency, jitter, shimmer, noise to harmonic ratio as the acoustic analysis, maximal phonation time, mean flow rate and subglottal pressure as the aerodynamic analyses. RESULTS: Postoperative acoustic and aerodynamic data of vocal polyp, vocal nodule, Reinke's edema and intracordal cyst were improved, but those of hyperkeratosis were not improved. CONCLUSION: By comparing the acoustic and aerodynamic data before and after the microlaryngeal surgery, postoperative vocal function was defined more accurately and objectively. Jitter, shimmer, and MFR might be meaningful parameters accessing the quantitative changes in vocal quality before and after the microlaryngeal surgery.

Acoustic Analysis of Benign Vocal Cord Lesions: Before and after Microlaryngeal Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Benign vocal cord lesions that are not responsive to medical and/or speech therapy are often treated by microlaryngeal surgery. The purpose of this study is to measure selected acoustic parameters to document quantitative changes in vocal quality before and after microlaryngeal surgery and to analyze differences of prognosis for various benign vocal cord lesions, such as vocal cord polyp, vocal cord nodule, and Reinke's edema. MATERIALS AND METHODS: The authors used a computerized acoustic analysis program (CSL-MDVP) to measure mean fundamental frequency (Fo), jitter, shimmer, and noise to harmonics ratio (NHR) from voice samples of selected patients who had benign vocal cord lesions before and after at least 10 weeks of surgery. RESULTS: The values of Fo and NHR showed no significant difference in all three groups. There was significant improvement in nodule regarding jitter. Also, there was significant improvement in the vocal cord polyp regarding jitter and shimmer. CONCLUSION: Jitter and shimmer will be effective acoustic parameters in documenting the quantitative changes in vocal quality before and after microlaryngeal surgery.