Multimodal Evaluation of Voice Outcome in Early Glottic Cancers Treated With Definitive Radiotherapy.

Background/Aim: We employed a multimodal evaluation of voice outcome (MEVO) model to assess long-term voice outcome in early glottic cancer (EGC) patients treated with primary radiotherapy (RT). The model consisted of objective and subjective vocal evaluation during follow-up, by a dedicated Speech Pathologist and Speech Therapist. Patients and Methods: MEVO methodology includes Self-perception Voice Handicap Index (VHI-30), evaluation of parameters Grade (G), Roughness (R), Breathiness (B), Asthenia (A) and Strain (S) according to GRBAS scale, objective analysis and aerodynamics using the PRAAT software and laryngeal evaluation with videostroboscope (VS). Results: The MEVO methodology was described and tested on a sample of 10 EGCs submitted to definitive RT (total dose 66-70 Gy). Mean follow-up was 48.9 months (range=9-115). VHI was mild-moderate in 90% of patients; overall voice function (GRBAS) was normal-mildly impaired in 70% of patients; VS evaluation showed normal vocal cord motion in 90% of patients, but complete glottic closure in 60%. PRAAT scores confirmed these findings. Conclusion: A multidimensional voice evaluation is time consuming, but useful to objectify vocal impact of radiotherapy. The MEVO model allowed to quantify vocal dysfunction, showing a good objective vocal outcome.

Objective Evaluation of Presbyphonia: Spectroacoustic Study on 142 Patients with Praat.

OBJECTIVES: Presbyphonia is the sequence of physiological events related to the process of senility of the vocal folds. The aim of our analysis was to provide deeper knowledge of presbyphonia, raising awareness of this condition as well as giving basic suggestions on how to treat related vocal alterations. STUDY DESIGN: This is a randomized study. METHODS: In 2015, we conducted a study on 182 subjects. Each participant underwent an ENT examination (video-laryngo-stroboscopy and subjective acoustic analysis using the General degree of dysphonia; degree of voice Instability; degree of voice Roughness; degree of voice Breathiness; degree of voice Asthenia; degree of voice Strain (GIRBAS) scale) and a logopedic examination (anamnesis, medical history, and acoustic voice analysis using the free software Praat). RESULTS: The comparison between the voice of young people and the seniors showed significant differences for the following Praat-analyzed acoustic parameters: modal fundamental frequency (F0) in women (P < 0,0001), fraction of locally unvoiced frames (P < 0,0001), number of voice breaks (P < 0,0001), jitter local (P < 0,0001), jitter local abs (P < 0,0001), jitter rap (P < 0,0001), jitter ppq5 (P < 0,0001), shimmer local (P < 0,0001), shimmer local dB (P < 0,0001), shimmer apq3 (P < 0,0001), shimmer apq5 (P < 0,0001), mean N/H (P < 0,0001), and mean H/N (P < 0,001), for both sexes. CONCLUSIONS: The Praat was confirmed to be a useful tool to detect the existence of the variation of the speech parameters in relation to aging and to quantify statistically significant differences that show a general deterioration in the voice quality, defined numerically. This might lead to a phoniatric treatment or speech therapy, which could improve patients' quality of life, leading to better vocal performance and social and communicative interaction.