ABSTRACT
The aim of this study was the elaboration of a basic voice protocol to discover which combination of tests and measures (multidimensional evaluation) provide decisive and essential data for the diagnosis of voice pathology and its prognosis. Voices of 21 patients with dysphonia and 21 subjects in a control group were evaluated and compared. Vocal function was assessed using a multiparametric set of videolaryngostroboscopic, perceptual, acoustic, spectrographic, aerodynamic, and subjective basic measurements (Multidimensional "Teatinos" Protocol). The dysphonic group received voice therapy for two sessions/week during 3 months. The results of the study were the following-(1) alterations in vocal function were reflected in the indicators: maximum phonation time (MPT) /a/, maximum exhalation time (MET) /s/, MPT during connect speech (MPTS), jitter, shimmer, harmonic-to-noise ratio, vocal well being (WB), self-voice assessment (SELF), vocal hygiene (HYGIENE), anxiety (ANX) and perceptual, laryngoscopic, and spectrographic explorations; (2) the indicators which are most sensitive to voice therapy are the following: MPT /a/, MET /s/, MPTS, jitter, WB, SELF, HYGIENE, ANX and perceptual, laryngoscopic, and spectrographic explorations; and (3) these positive effects were maintained or increased 4 months after termination of the treatment. Multidimensional "Teatinos" Protocol makes it possible to detect significant differences in mean values of subjective, qualitative, and objective voice assessments between dysphonic patients and control group at pre- and posttreatment stages. Therefore, multidimensional voice evaluation is a useful tool in the diagnostics of dysphonia in clinical and speech-language-therapy contexts.
Subject(s)
Dysphonia/diagnosis , Dysphonia/therapy , Voice Training , Adolescent , Adult , Aged , Anxiety , Exhalation , Female , Humans , Laryngoscopy , Male , Middle Aged , Phonation , Prognosis , Self Concept , Stroboscopy , Time Factors , Treatment Outcome , Video Recording , Young AdultABSTRACT
The study of voice disorders present some specific difficulties such as the aetiological variability of this kind of disorders or the heterogeneity and the poor data we have about the effectiveness of certain treatments used. Research has performed different types of questionnaires in this area to obtain data about the treatments used in clinical practice. These studies have shown lack or scarce of evaluation and control methods in the rehabilitation programs that the specialists commonly use. In this report, a screening questionnaire was sent to the Otorhinolaryngology Departments of the Spanish Hospitals to obtain information about evaluation and treatment resources in voice pathologies. The results show great variability in clinical voice disorders in Spain. However we can observe a full agreement in the need to systematize this evaluation and the collaboration of the speech-therapists in the treatment of the voice disorders.
Subject(s)
Hospitals , Otolaryngology/methods , Speech Therapy/methods , Voice Disorders/therapy , Humans , Otolaryngology/statistics & numerical data , Spain , Speech Therapy/statistics & numerical data , Surveys and Questionnaires , Voice Disorders/diagnosis , Voice TrainingABSTRACT
Este trabajo presenta los primeros resultados empíricos obtenidos al utilizar un protocolo interdisciplinar ("Teatinos") en la evaluación funcional de pacientes con trastornos de la voz. El objetivo es propiciar una mejor detección de las variables de pronóstico, recuperación y prevención de las disfonías. Los resultados del estudio, llevado a cabo en 8 pacientes con nódulos bilaterales y disfonía, muestran los efectos de los distintos parámetros e índices multidimensionales valorados en la fase pre-tratamiento. Todos los pacientes manifestaron tras la rehabilitación funcional (fase post-tratamiento) una mejoría subjetiva en el bienestar vocal, en el grado de satisfacción con su voz, además de una disminución de la ronquera y un aumento de la extensión vocal. Asimismo, se observa una desaparición o reducción de los nódulos vocales, un menor grado perceptual de la disfonía, una mejora de los parámetros acústicos y una recuperación significativa de los índices aerodinámicos. Por ejemplo, los resultados muestran una mejora de un 22,5 por ciento en el Tiempo Máximo de Fonación (TMF) al comparar la fase pre vs. resultados en la evaluación de la efectividad del tratamiento logopédico son tratados en la discusión (AU)
