Issue N# 5 - 2003
Implementation of the European Laryngological Society (ELS)- Basic protocol for assessing voice treatment effect
Authors : DeJonckere PH, Crevier-Buchman L, Marie JP, Moerman M, Remacle M, Woisard V. (European Research Group on the Larynx)
Ref. : Rev Laryngol Otol Rhinol. 2003;124,5:279-283.
Article published in english
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Objectives: 93 patients with various kinds of organic benign voice pathology (vocal fold nodules, polyp, Reinke’s oedema, unilateral paralysis, sulcus/scar) and/or with muscle tension dysphonia, were evaluated before and after their voice treatment (phonosurgery with voice therapy, antireflux medication, or voice therapy alone) in order to check the clinical relevance of a basic multidimensional protocol for assessing functional results of voice treatments, as developed by the Committee on Phoniatrics of the ELS. Materiel and method: The protocol has been used in different university voice clinics. It comprises 5 dimensions: Perception: Grade, Breathiness and Roughness from the GRBAS-scale, rated by two experienced judges: a phoniatrician/laryngologist and a speech therapist. Acoustics: Jitter % and Shimmer % computed on a /a:/, at comfortable loudness and pitch. Also Fo-range and softest possible intensity. Videostroboscopy: Glottal closure, regularity, mucosal wave and symmetry, rated separately. Phonation quotient: computed by dividing the vital capacity (ml) by the maximum phonation time (s) (best value of 2x3 trials). Self rating by the patient: voice quality in itself and general social/ occupational handicap due to the voice problem rated separately. Results: Results show that, at group level, the overall effects for each parameter indicate a significant improvement after treatment. However, the correlations between the pre/post changes for the different parameters are weak (low redundancy). Conclusion: The assessment of voice pathology needs to be multidimensional, as these multidimensional informations about voice changes lead to a better understanding of the actual way in which a treatment works.
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