Voice quality after endoscopic laser surgery and radiotherapy for early glottic cancer: objective measurements emphasizing the Voice Handicap Index.

We analyzed the functional outcome and self-evaluation of the voice of patients with T1 glottic carcinoma treated with endoscopic laser surgery and radiotherapy. We performed an objective voice evaluation, as well as a physical, emotional and functional well being assessment of 19 patients treated with laser surgery and 18 patients treated with radiotherapy. Voice quality is affected both by surgery and radiotherapy. Voice parameters only show differences in the maximum phonation time between both treatments. Results in the Voice Handicap Index show that radiotherapy has less effect on patient voice quality perception. There is a reduced impact on the patient's perception of voice quality after radiotherapy, despite there being no significant differences in vocal quality between radiotherapy and laser cordectomy.

[Adaptation and validation to the Spanish of the Voice Handicap Index (VHI-30) and its shortened version (VHI-10)]. / Adaptación y validación del índice de incapacidad vocal (VHI-30) y su versión abreviada (VHI-10) al español.

INTRODUCTION: The Voice Handicap Index has been shown to be a valid instrument for assessing self-perceived handicap associated with dysphonia. OBJECTIVES: To test the psychometric properties of the Spanish version of the VHI-30 (Voice Handicap Index) and its shortened version VHI-10. SUBJECTS AND METHOD: The original VHI-30 was translated into Spanish and was completed by 232 dysphonic patients and 38 non-dysphonic individuals. Prospective instrument validation was performed. RESULTS: Results showed high test-retest reliability, and high item-total correlation for both Spanish VHI-30 and VHI-10. Internal consistency demonstrated a Cronbach's alpha of 0.93 and 0.86, respectively, and a significant correlation was found between the VHI scores and the patients' self-rated dysphonic severity. CONCLUSIONS: The present study supports the use of Spanish versions of VHI-30 and VHI-10 because of their validity and reliability.

Adaptación y validación del índice de incapacidad vocal (VHI-30) y su versión abreviada (VHI-10) al español / Adaptation and Validation to the Spanish of the Voice Handicap Index (VHI-30) and its Shortened Version (VHI-10)

Introducción y objetivos: El índice de incapacidad vocal (Voice Handicap Index) es un instrumento válido para la valoración del menoscabo asociado a la disfonía que percibe el paciente. El objetivo es valorar las propiedades psicométricas de la versión castellana del VHI-30 y su versión abreviada VHI-10. Sujetos y método: El VHI-30 original se tradujo al idioma español y lo contestaron 232 pacientes con disfonía y 38 sujetos sanos. Se realizó una validación prospectiva del instrumento. Resultados: Se encuentra una alta fiabilidad test-retest y altas correlaciones ítem-total tanto para el VHI-30 como para el VHI-10. La coherencia interna demuestra valores alfa de Cronbach de 0,93 y 0,86 respectivamente, y se encontró una correlación significativa entre las puntuaciones del VHI y la valoración de los pacientes de la severidad de su disfonía. Conclusiones: El presente estudio apoya el uso de las versiones en español del VHI-30 y del VHI-10 por su validez y fiabilidad

Introduction: The Voice Handicap Index has been shown to be a valid instrument for assessing self-perceived handicap associated with dysphonia. Objectives: To test the psychometric properties of the Spanish version of the VHI-30 (Voice Handicap Index) and its shortened version VHI-10. Subjects and method: The original VHI-30 was translated into Spanish and was completed by 232 dysphonic patients and 38 non-dysphonic individuals. Prospective instrument validation was performed. Results: Results showed high test-retest reliability, and high item-total correlation for both Spanish VHI-30 and VHI-10. Internal consistency demonstrated a Cronbach’s alpha of 0.93 and 0.86, respectively, and a significant correlation was found between the VHI scores and the patients’ self-rated dysphonic severity. Conclusions: The present study supports the use of Spanish versions of VHI-30 and VHI-10 because of their validity and reliability

[The diagnostic role of direct microlaryngoscopy]. / Papel diagnóstico de la microlaringoscopia directa.

Sulcus vocalis, vergetures, mucosal bridges, and cysts as intracordal lesions constitute a group of great diagnostic difficulty. We present 6 patients in whom microlaryngoscopy was the final diagnostic step in the evaluation of a lesion not recognized in the initial evaluation. The criteria selected were as follows: Severe GRABS. Stroboscopic parameters: glottal chink without mass lesion, asymmetry of amplitude, and irregularity of vibration, or when discrepancy between examination and quality of the voice exists. Acoustic and aerodynamic measures that demonstrate severe dysphonia. High scores on the Voice Handicap Index. We recommend carrying out a diagnostic microlaryngoscopy examination where the cause of dysphonia is unclear.

Papel diagnóstico de la microlaringoscopia directa / The diagnostic role of direct microlaryngoscopy

Los sulcus vocalis, vergetures, puentes mucosos y quistes son lesiones intracordales que constituyen un grupo de lesiones de difícil diagnóstico. Presentamos a 6 pacientes en los que la microlaringoscopia fue el paso diagnóstico definitivo en la evaluación de una lesión que no había sido apreciada en la evaluación en el consultorio. Los criterios para indicar una microlaringoscopia directa diagnóstica son altas puntuaciones del índice GRABS; los defectos de cierre glótico sin lesión tipo masa y la asimetría de fase y amplitud entre las ondas mucosas de ambas cuerdas; la desproporción entre los hallazgos de la estroboscopia o la endoscopia con la intensidad percibida de la disfonía; la disfonía severa objetivada mediante análisis acústico y aerodinámico, y las puntuaciones altas en el índice de incapacidad vocal. Recomendamos la realización de una microlaringoscopia diagnóstica en los casos de disfonía de origen incierto

Sulcus vocalis, vergetures, mucosal bridges, and cysts as intracordal lesions constitute a group of great diagnostic difficulty. We present 6 patients in whom microlaryngoscopy was the final diagnostic step in the evaluation of a lesion not recognized in the initial evaluation. The criteria selected were as follows: Severe GRABS. Stroboscopic parameters: glottal chink without mass lesion, asymmetry of amplitude, and irregularity of vibration, or when discrepancy between examination and quality of the voice exists. Acoustic and aerodynamic measures that demonstrate severe dysphonia. High scores on the Voice Handicap Index. We recommend carrying out a diagnostic microlaryngoscopy examination where the cause of dysphonia is unclear

Voice quality assessment after laryngeal cancer radiotherapeutic treatment at initial stages.

INTRODUCTION: The voice quality resulting from the radiotherapeutic treatment is a relevant factor to take into consideration at the time of evaluating the results. In this study the results of an objective assessment in relation to the vocal function and the patients' voice self-evaluation are presented. MATERIALS AND METHODS: 18 glottic tumour patients, at initial stage, treated with radiotherapy, were studied. There were made an objective analysis on the voice and a study on the perceived quality both by the examiners and the patients. RESULTS: Normal voices were observed in the 11%, slight dysphonias in 44.4%, moderate dysphonias in 27.8% and severe dysphonias in 16.7% of the cases. Spectrographically, the 18 samples were classified as Grade I one case (5.5%), Grade II 7 (38.8%), Grade III 5 (27.7%) and Grade IV 5 (27.7%). The questionnaire Voice Handicap Index which was completed by the patients themselves, gave out results values very close to normality. CONCLUSIONS: the patients voice acoustic analysis of the series shows the damage thereof after the radiotherapeutic treatment is minimum as well as the handicap feeling of the T1 laryngeal carcinoma patients treated with radiotherapy.

Voice quality assessment after laryngeal cancer radiotherapeutic treatment at initial stages

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Introduction. The voice quality resulting from theradiotherapeutic treatment is a relevant factor totake into consideration at the time of evaluating theresults. In this study the results of an objective assessmentin relation to the vocal function and thepatients’ voice self-evaluation are presented.Materials and methods. 18 glottic tumour patients,at initial stage, treated with radiotherapy, werestudied. There were made an objective analysis onthe voice and a study on the perceived quality bothby the examiners and the patients.Results. Normal voices were observed in the 11%,slight dysphonias in 44.4%, moderate dysphonias in27.8% and severe dysphonias in 16.7% of the cases.Spectrographically, the 18 samples were classified asGrade I one case (5.5%), Grade II 7 (38.8%), Grade III5 (27.7%) and Grade IV 5 (27.7%). The questionnaireVoice Handicap Index which was completed bythe patients themselves, gave out results valuesvery close to normality.Conclusions. the patients voice acoustic analysis ofthe series shows the damage thereof after the radiotherapeutictreatment is minimum as well as thehandicap feeling of the T1 laryngeal carcinoma patientstreated with radiotherapy