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- Diagnostics (1)
- Phonomicrosurgery (1)
- Reinke’s oedema (1)
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- Vocal Extent Measure (VEM) (1)
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There are few data analysing to what specific extent phonomicrosurgery improves vocal function in patients suffering from Reinke's oedema (RE). The recently introduced parameter vocal extent measure (VEM) seems to be suitable to objectively quantify vocal performance. The purpose of this clinical prospective study was to investigate the outcomes of phonomicrosurgery in 60 RE patients (6 male, 54 female; 56 ± 8 years ([mean ± SD]) by analysing its effect on subjective and objective vocal parameters with particular regard to VEM. Treatment efficacy was evaluated at three months after surgery by comparing pre- and postoperative videolaryngostroboscopy (VLS), auditory-perceptual assessment (RBH-status), voice range profile (VRP), acoustic-aerodynamic analysis and patient's self-assessment using the voice handicap index (VHI-9i). Phonomicrosurgically, all RE were carefully ablated. VLS revealed removal or substantial reduction of oedema with restored periodic vocal fold vibration. All subjective and most objective acoustic and aerodynamic parameters significantly improved. The VEM increased on average from 64 ± 37 to 88 ± 25 (p #x003C; 0.001) and the dysphonia severity index (DSI) from 0.5 ± 3.4 to 2.9 ± 1.9. Both parameters correlated significantly with each other (rs = 0.70). RBH-status revealed less roughness, breathiness and overall grade of hoarseness (2.0 ± 0.7 vs 1.3 ± 0.7). The VHI-9i-score decreased from 18 ± 8 to 12 ± 9 points. The average total vocal range enlarged by 4 ± 7 semitones, and the mean speaking pitch rose by 2 ± 4 semitones. These results confirm that: (1) the use of VEM in RE patients objectifies and quantifies their vocal capacity as documented in the VRP, and (2) phonomicrosurgery is an effective, objectively and subjectively satisfactory therapy to improve voice in RE patients.
Der Singing Voice Handicap Index (SVHI) wurde zur Selbstbeurteilung einer Stimmstörung für Sänger in den USA entwickelt. Eine deutsche Übersetzung wurde erstellt und einer Reliabilitäts- und Validitätsprüfung unterzogen. Es wurden 54 dysphone Sänger (35 weiblich, 19 männlich), Patienten einer phoniatrischen Klinik, befragt. 130 stimmgesunde Opern- und Rundfunkchorsänger (74 weiblich, 56 männlich) bildeten die Kontrollgruppe. Die Reliabilität ergibt sich aus einer hochsignifikanten Test-Retest-Reliabilität (r = 0,960; p <= 0,001, Pearson-Korrelation) und einem Cronbach-? von 0,975. Eine Hauptkomponentenanalyse mit Varimaxrotation und die Ergebnisse des Screeplots legen die Interpretation des SVHI als einfaktorielle Skala nahe. Die Validität zeigt sich in einem hochsignifikanten Zusammenhang zwischen dem vom Patienten selbst eingeschätzten Schweregrad der Stimmstörung und dem SVHI-Gesamtscore. Patienten haben einen signifikant höheren SVHI-Gesamtscore als die Kontrollgruppe gesunder Sänger. Der SVHI ist als diagnostisches Instrument für den deutschsprachigen Raum geeignet.