[Validation of the Acoustic Voice Quality Index in the Russian language]. / Validatsiya akusticheskogo indeksa kachestva golosa (the Acoustic Voice Quality Index) dlya russkogo yazyka.

THE AIM: Of this study was to validate the Acoustic Voice Quality Index (AVQI) in Russian language and determine threshold values to differentiate normal and dysphonic voices in russophone population. MATERIALS AND METHODS: 41 recordings of patients with laryngeal hemiplegia and hemiparesis appeared after thyroid carcinomas' surgical treatment and laryngeal cancer from the Tomsk Cancer Research Institute were used, as well as 10 new recordings of normophonic people, composing a control group. Voice samples included the first quatrain of the poem «Sail¼ written by M.Yu. Lermontov, and sustained vowel «a¼. Four specialists who work with voice disorders (three speech-language pathologists and one phoniatrist) rated degree of dysphonia for all voice sample. Moreover, the AVQI was calculated for each sample. RESULTS: There was a statistically significant correlation between auditory-perceptual assessment and the AVQI (r=0.74), this confirms that AVQI is effective in evaluating voice disorders. The group of people with normal voice had relatively low values of AVQI, whereas the group of patients with laryngeal diseases had relatively high values. Analysis of ROC-curve showed that AVQI has excellent diagnostic accuracy to differentiate normal and dysphonic voices (AUC=0.966). CONCLUSIONS: The AVQI is the excellent tool for objective assessment of voice disorders in the Russian population/.

[Restoration of the voice function after subtotal laryngectomy and formation of tracheopharyngeal shunt]. / Vosstanovlenie golosovoi funktsii posle subtotal'noi laringéktomii i formirovaniia trakheoglotochnogo shunta.

We introduce our newly designed voice restoration technique for patients who have undergone subtotal laryngectomy for laryngeal and pharyngolaryngeal cancer. To study the efficacy of this technique, we analyzed the voice rehabilitation results in 14 patients with laryngeal and pharyngolaryngeal cancer. Voice function was restored in 13 (92.9%) patients 6-12 days after starting speech therapy. The middle voice, voice of medium timbre, long speech (phrase of 4-5 words) and speech sufficient for communication in everyday life and on the phone were formed. An acoustic analysis of spectral components of the speech signal of the formed voice revealed that the main voice parameters were reduced (the frequency of the fundamental tone was 75-130 Hz and the time of maximum phonation varied from 1.5 to 2.7 s). At a follow-up of 12 months, the frequency of the fundamental tone increased up to 120-170 Hz and the time of maximum phonation increased up to 4-4.5 s. Our technique of voice restoration after subtotal laryngectomy with the formation of a tracheopharyngeal shunt allowed us to restore voice function in a short time, return the previous social status and significantly improve the quality of life of laryngectomized patients.

[Restoration of the vocal function in the patients with laryngeal cancer after organ-saving surgery].

The objective of the present study was to enhance the effectiveness of vocal rehabilitation and to improve the quality of life in the patients presenting with laryngeal cancer after organ-preserving surgical interventions. The study included 98 patients presenting with stage II-III laryngeal cancer who underwent organ-preserving surgery and postoperative vocal rehabilitation. The comprehensive approach to the restoration of the vocal function has been developed and clinically applied that includes rational psychotherapy, respiratory gymnastics for the correction of physiological and phonation breathing, activation of the neuromuscular apparatus of the external and the residual internal larynx and neck muscles , coordination of the vocal apparatus at the expense of compensation of the remaining part of the larynx taking advantage of the biological feedback mechanism based on the results of mathematical simulation. The application of this approach in clinical settings made it possible to increase the effectiveness of vocal rehabilitation up to 93%, reduce the number of disabled subjects, restore the working abilities in the patients of the employable age, significantly promote their social adaptation, and improve the life quality.

[Quality of life in laryngectomized patients after vocal rehabilitation].

The study included patients with laryngeal cancer (stage III-IV) after laryngectomy. They underwent vocal rehabilitation assisted by biological monitoring using mathematical modeling and computer technology. EORTS QLQ-C30 questionnaires 30 (version 3.0) were used to assess quality of life as a tool of rehabilitative effect evaluation (special QLQ-N&N35 for head and neck tumor patients). Physical, psychological, social and symptomatic parameters were followed through the stages of vocal rehabilitation. On completion of therapy, patients spoke freely; 68% of them recovered their social and professional status.