A prospective study to evaluate the etiologies and parameters of voice assessment in patients of vocal cord paralysis
Keywords:Unilateral vocal cord paralysis, Voice disorders, Voice handicap index
Background: Evaluation of voice disorders are performed using multiple approaches but there is no single standard method. Our study compared the various voice assessment measures and their clinical relevance for unilateral vocal cord palsy (uVCP).
Methods: 30 patients of uVCP were assessed and followed up on day 15, 30 and 90 of diagnosis. At each visit, perceptual analysis of voice, grade (G), rigid 700 Hopkins laryngoscopy to measure the phonatory gap (PG), maximum phonation time (MPT), and voice handicap index (VHI) were noted.
Results: The results were analysed in two ways, one on the basis of improvement in VHI and the other on the basis of PG. When two groups (‘improved group 1’ and ‘unimproved group 1’) were formed and compared on the basis of VHI; MPT, Grade and ‘change in PG’ of the improved group showed a significant difference as compared to the unimproved group. Whereas when two groups (‘improved group 2’ and ‘unimproved group 2’) were formed and compared on the basis of improvement in PG, none of the parameters of the improved group showed a significant difference as compared to the unimproved group.
Conclusions: All parameters correlate well with VHI than with PG, hence VHI alone can be sufficient to assess the improvement in voice. Although rigid laryngoscopy is essential initially for diagnosis, it need not be necessary to for further evaluation for improvement in voice.
Gupta J, Varshney S, Bist SS, Bhagat S. Clinico-etiolological study of vocal cord paralysis. Indian Journal of Otolaryngology and Head & Neck Surgery. 2013;65(1):16-9.
Ahmad S, Muzamil A, Lateef M. A study of incidence and etiopathology of vocal cord paralysis. Indian Journal of Otolaryngology and Head and Neck Surgery. 2002;54(4):294-6.
Amir O, Ashkenazi O, Leibovitzh T, Michael O, Tavor Y, Wolf M. Applying the Voice Handicap Index (VHI) to dysphonic and nondysphonic Hebrew speakers. J Voice. 2006;20(2):318-24.
Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jacobson G, Benninger MS, Newman CW. The voice handicap index (VHI) development and validation. Am J Speech-Language Pathol. 1997;6(3):66-70.
Rosen CA, Murry T. Voice handicap index in singers. Journal of Voice. 2000;14(3):370-7.
Hirano M. Clinical examination of voice. Springer; 1981.
Rudolf R, Sibylle B. Laryngoplasty with hyaluronic acid in patients with unilateral vocal fold paralysis. J Voice. 2012;26(6):785-91.
Datta R, Sethi A, Singh S, Nilakantan A, Venkatesh MD. Translation and validation of VHI in Hindi. J Laryngol Voice. 2011;1(1):12-7.
Gandhi S, Rai S, Bhowmick N. Etiological profile of unilateral vocal cord paralysis: A single institutional experience over 10 years. J Laryngol Voice. 2014;4:58-62.
Pavithran J, Menon JR. Unilateral Vocal cord palsy: an etiopathological study. International J Phonosurgery Laryngol. 2011;1(1)-5:10.
Al-Khtoum N, Shawakfeh N, Al-Safadi E, Al-Momani O, Hamasha K. Acquired unilateral vocal fold paralysis: Retrospective analysis of a single institutional experience. North Am J Med Sci. 2013;5(12):699.
Nerurkar N, Tandon S. Unilateral Vocal Fold Paralysis-An Indian Scenario. Bombay Hospital J. 2006;48:4.
Reiter R, Brosch S. Erratum: Laryngoplasty With Hyaluronic Acid in Patients with Unilateral Vocal Fold Paralysis. J Voice. 2013;27(2):131.
Li AJ, Johns MM, Jackson-Menaldi C, Dailey S, Heman-Ackah Y, Merati A, Rubin AD. Glottic closure patterns: type I thyroplasty versus type I thyroplasty with arytenoid adduction. J Voice. 2011;25(3):259-64.
Ortega J. Computerized acoustic voice analysis and subjective scaled evaluation of the voice can avoid the need for laryngoscopy after thyroid surgery. Available at: https://docslide.net/documents/
computerized-acoustic-voice-analysis-and-subjective-scaled-evaluation-of-the.html. Accessed on 10 September 2016.
Ziwei Y, Zheng P, Pin D. Multiparameter Voice Assessment for Voice Disorder Patients: A Correlation Analysis Between Objective and Subjective Parameters. J Voice. 2014;28(6):770-4.
Dehqan A, Yadegari F, Scherer RC, Dabirmoghadam P. Correlation of VHI-30 to Acoustic Measurements Across Three Common Voice Disorders. J Voice. 2017;31(1):34-40.
Woisard V, Bodin S, Yardeni E, Puech M. The Voice Handicap Index: Correlation Between Subjective Patient Response and Quantitative Assessment of Voice. J Voice. 2007;21(5):623-31.
Schindler A, Mozzanica F, Vedrody M, Maruzzi P, Ottaviani F. Correlation between the Voice Handicap Index and voice measurements in four groups of patients with dysphonia. Otolaryngol Head Neck Surg. 2009;141(6):762-9.