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Gonçalves, Bruna Franciele da Trindade, Gabriele Rodrigues Bastilha, Cintia da Conceição Costa, and Renata Mancopes. "Utilização de protocolos de qualidade de vida em disfagia: revisão de literatura." Revista CEFAC 17, no. 4 (August 2015): 1333–40. http://dx.doi.org/10.1590/1982-0216201517418014.
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Resumo:O objetivo deste estudo foi identificar os protocolos existentes sobre qualidade de vida (QV) em disfagia e verificar a utilização dos mesmos no tratamento fonoaudiológico. Realizou-se pesquisa teórica e exploratória com a técnica de revisão da literatura nas bases de dados SCOPUS, Trip Database, LILACS, PubMed, SciELO, Google Schoolar, periódicos Capes e MedLine. O período de busca compreendeu os anos entre 2004 e 2014 e foram utilizados os seguintes descritores: deglutição; transtornos da deglutição; qualidade de vida; questionários e os seus respectivos termos em inglês deglutition; deglutition disorders; quality of Life; questionnaires. Foram encontrados na literatura o protocolo Quality of life in Swallowing Disorders-SWAL-QOL, o qual estabelece o comprometimento da deglutição independente da etiologia; o MD Anderson Dysphagia Inventory, que é específico para sujeitos submetidos à tratamento de câncer de cabeça e pescoço e o Dysphagia Handicap Index,que avalia os efeitos da disfagia sobre a qualidade de vida (QV) em sujeitos com diferentes patologias de base e pode ser utilizado em níveis mais baixos de escolaridade. A literatura propõe diferentes protocolos que avaliam a QV em disfagia, sendo que os mais utilizados avaliam a QV de forma geral, relacionada ao câncer de cabeça e pescoço e de sujeitos com diferentes diagnósticos médicos. A utilização desses protocolos pode auxiliar e complementar a avaliação clínica e objetiva da deglutição, uma vez que, retratam a autoavaliação referida pelo sujeito, sendo este ponto de vista de extrema importância para o tratamento fonoaudiológico.
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Falewee, Marie Noëlle, Christophe Hebert, Karen Benezery, Alexandre Bozec, Joël Guigay, Emmanuel Chamorey, and Cécile Michel. "Contribution of long-term dysphagia monitoring to first line treatment of head and neck cancer patients." International Journal of Otorhinolaryngology and Head and Neck Surgery 4, no. 6 (October 24, 2018): 1331. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20184346.
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<p class="abstract"><strong>Background:</strong> Dysphagia is a serious sequel of head and neck cancer (HNC) and its treatment. This dysfunction is frequent and likely underreported by clinical exam. It seems necessary to assess its global burden during the pre, per and post treatment periods (up to 18 months), regardless of the treatment received.</p><p class="abstract"><strong>Methods:</strong> This was a prospective cohort study assessing the rate of dysphagia in first-time treated HNC patients, using the deglutition handicap index questionnaire (DHI) and the clinician reporting. Time to occurrence, severity and length of the dysfunction were recorded. The benefit of an evaluation by the patient himself was investigated. </p><p class="abstract"><strong>Results:</strong> Of 134 evaluable patients: 22 were treated by surgery alone (16.4%), 16 by radiotherapy (RT) alone (11.9%), 3 by chemotherapy (CT) alone (2.2%), 28 by RTCT (20.9%), 31 by induction chemotherapy followed by RTCT (23.1%), 11 by surgery+RT (8.2%) and 23 by surgery+RTCT (17.2%). Patients completed 87.9% of the expected DHI. The dysphagia frequency reported was 92.2% by patient-reporting and 80.9% by clinicians-reporting, whatever the intensity. Self-perceived moderate to severe dysphagia was reported in 69.8% of patients.</p><p class="abstract"><strong>Conclusions:</strong> Given the strong impact of dysphagia on the quality of life and prognosis of HNC patients, it appears essential to perform screening and systematic monitoring. Using a simple and well accepted questionnaire, such as DHI, which is also well correlated with clinical evaluation, we demonstrated a significant frequency of dysphagia. The use of real-time patient-reported outcomes for its early detection would be an asset, particularly during long-term follow-up.</p><p class="abstract">Registered under ClinicalTrials.gov Identifier no. NCT03068559.</p>
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Menon, Unnikrishnan, VS Sheejamol, and Meera P. Cherian. "Validation of Malayalam Version of the Voice Handicap Index." International Journal of Phonosurgery & Laryngology 2, no. 1 (2012): 1–4. http://dx.doi.org/10.5005/jp-journals-10023-1025.
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ABSTRACT Background It is important to have a subjective measure of hoarseness. This can be best achieved if the questionnaire is in the patient's own language. Objective To translate the voice handicap index (VHI) into the Malayalam language, and to evaluate its clinical validity and internal consistency. Materials and methods One hundred and six patients with dysphonia and 20 asymptomatic subjects were included in the study. Internal consistency was analyzed through Cronbach's alpha coefficient. For the clinical validity assessment, the scores obtained in the patient group were compared with those found in asymptomatic individuals through the Mann-Whitney U-test. Also, comparison between the VHI scores before and after phonomicrosurgery on 14 out of the studied 106 patients was done using the nonparametric Wilcoxon signed ranks test. Spearman rank correlation was used to find the effect of patient's age on VHI scores. Finally, the gender-wise average VHI score and its three subsets was analyzed using Wilcoxon signed ranks test. Results The internal consistency was found to be excellent (α = 0.946). The control group scored significantly lower than the patients group (p < 0.001). Similarly, significant improvement was seen in the postoperative average VHI scores (p < 0.004). All of the preceding proves the validity of the translated questionnaire. Age showed a significant negative correlation for the overall VHI and their three domains (p < 0.001) in the dysphonic patients. There was no such correlation between male and female patient groups. Conclusion This Malayalam language version of the VHI questionnaire is a valid instrument for use in the voice clinic. Clinical implication: Encouragement to all voice clinicians in India to develop and use the VHI in their native tongues. How to cite this article Menon U, Sheejamol VS, Cherian MP. Validation of Malayalam Version of the Voice Handicap Index. Int J Phonosurg Laryngol 2012;2(1):1-4.
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Zaouali, Hasna, Béatrice Vaxelaire, Christian Debry, and Rudolph Sock. "Étude de l’auto-évaluation de la qualité de parole et du ressenti (SHI) après glossectomie partielle ou totale." SHS Web of Conferences 78 (2020): 09013. http://dx.doi.org/10.1051/shsconf/20207809013.
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Étude de l’auto-évaluation de la qualité de parole et du ressenti (SHI) après glossectomie partielle ou totale. Cette étude consiste en une analyse des réponses recueillies auprès de patients glossectomisés après la passation du questionnaire d’auto-évaluation de la parole et du ressenti (Speech Handicap Index ou SHI) de (Rinkel & coll,.2008), traduit en français par Degroote et al. (2012) et adapté du VHI (Voice Handicap Index de Jacobson et al., 1997). Le SHI est un outil d’évaluation du degré du handicap provoqué par les troubles de la parole. Il est constitué d’une échelle d’auto–évaluation cotée sur 120 points et comporte 30 items. Ce questionnaire est constitué de deux sous échelles dont une consacrée à l’aspect Psycho-sociale(Ps) et l’autre à l’aspect Parole (s). L’objectif d’évaluer le handicap d’un patient glossectomisé est de mieux comprendre les dysfonctionnements sur le plan linguistique pour une meilleure prise en charge thérapeutique. Nous avons examiné, à travers des phases de passations pré et post-chirurgicales, les réponses collectées auprès de chaque patient. Une analyse statistique est présentée afin de rendre compte de la sévérité du handicap entre les phases de passations du questionnaire d’auto évaluation de la parole et du ressenti.
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Balaguer, M., J. Percodani, and V. Woisard. "Le Carcinologic Handicap Index (CHI) : questionnaire d’autoévaluation du handicap à destination des patients traités pour cancer des VADS." Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale 134, no. 6 (December 2017): 382–87. http://dx.doi.org/10.1016/j.aforl.2016.07.021.
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Webb, A. L., P. N. Carding, I. J. Deary, K. MacKenzie, I. N. Steen, and J. A. Wilson. "Optimising outcome assessment of voice interventions, I: reliability and validity of three self-reported scales." Journal of Laryngology & Otology 121, no. 8 (March 29, 2007): 763–67. http://dx.doi.org/10.1017/s0022215107007177.
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AbstractBackground:There is an increasing choice of voice outcome research tools, but good comparative data are lacking.Objective:To evaluate the reliability and validity of three voice-specific, self-reported scales.Design:Longitudinal, cohort comparison study.Setting:Two UK voice clinics: the Freeman Hospital, Newcastle upon Tyne, and the Glasgow Royal Infirmary.Participants:One hundred and eighty-one patients presenting with dysphonia.Main outcome measures:All patients completed the vocal performance questionnaire, the voice handicap index and the voice symptom scale. For comparison, each patient's voice was recorded and assessed perceptually using the grade–roughness–breathiness–aesthenia–strain scale. The reliability and validity of the three self-reported vocal performance measures were assessed in all subjects, while 50 completed the questionnaires again to assess repeatability.Results:The results of the 170 participants with completed data sets showed that all three questionnaires had high levels of internal consistency (Cronbach's alpha = 0.81–0.95) and repeatability (voice handicap index = 0.83; vocal performance questionnaire = 0.75; voice symptom scale = 0.63). Concurrent and criterion validity were also good, although, of the grade–roughness–breathiness–aesthenia–strain subscales, roughness was the least well correlated with the self-reported measures.Conclusion:The vocal performance questionnaire, the voice handicap index and the voice symptom scale are all reliable and valid instruments for measuring the patient-perceived impact of a voice disorder.
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Chandra, Navshika, Kevin Chang, Arier Lee, Giriraj S. Shekhawat, and Grant D. Searchfield. "Psychometric Validity, Reliability, and Responsiveness of the Tinnitus Functional Index." Journal of the American Academy of Audiology 29, no. 07 (July 2018): 609–25. http://dx.doi.org/10.3766/jaaa.16171.
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AbstractThe effects of treatments on tinnitus have been difficult to quantify. The Tinnitus Functional Index (TFI) has been proposed as a standard questionnaire for measurement of tinnitus treatment outcomes. For a questionnaire to achieve wide acceptance, its psychometric properties need to be confirmed in different populations.To determine if the TFI is a reliable and valid measure of tinnitus, and if its psychometric properties are suitable for use as an outcome measure.A psychometric evaluation of the TFI from secondary data obtained from a cross-sectional clinic survey and a clinical trial undertaken in New Zealand.Confirmatory factor analysis and evaluation of internal consistency reliability were undertaken on a sample of 318 patients with the primary complaint of tinnitus. In a separate sample of 40 research volunteers, test–retest reliability, convergent and divergent validity were evaluated. Both samples consisted of predominantly older Caucasian male patients with tinnitus.The internal structure of the original US TFI was confirmed. The Cronbach’s Alpha and Intraclass correlation coefficients were >0.7 for the TFI overall and each of its subscales, indicating high internal consistency and test–retest reliability. Strong Pearson correlations with the Tinnitus Handicap Questionnaire and tinnitus numerical rating scales indicated excellent convergent validity, and a moderate correlation with the Hearing Handicap Inventory, indicated moderate divergent validity. Evaluation of the clinical trial showed good test–retest reliability and agreement between no-treatment baselines with a smallest detectable change of 4.8 points.The TFI is a reliable and valid measure of tinnitus severity in the population tested and is responsive to treatment-related change. Further research as to the TFI’s responsiveness to treatment is needed across different populations.
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Krishnamurthy, Rahul, and Radish Kumar Balasubramanium. "Translation and Validation of Kannada Version of the Dysphagia Handicap Index." American Journal of Speech-Language Pathology 29, no. 1 (February 7, 2020): 255–62. http://dx.doi.org/10.1044/2019_ajslp-19-00122.
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Background The Dysphagia Handicap Index (DHI) is a 25-item questionnaire that assesses the quality of life among individuals with dysphagia. The aim of this study was to translate and validate the Kannada version of DHI (DHI-K). Method Eighty-eight individuals with dysphagia and an equal number of healthy individuals filled out the DHI-K. Internal consistency and test–retest reproducibility were used for reliability testing. Validity was established by comparing DHI-K scores of patients with dysphagia and healthy controls. Results The overall Cronbach's α for DHI-K was .81, indicating good internal consistency. Cohen's κ agreement for test–retest reliability of self-perceived severity was found to be .9. Correlation between subscales of DHI and self-perceived severity was analyzed using Spearman correlation coefficient and was found to very high. The control group has significantly lower scores for all scales when compared to the dysphagia group (physical: t (174) = 31.74, p < .001; functional: t (174) = 32.65, p < .001; emotional: t (174) = 36.3, p < .001; total: t (174) = 34.08, p < .001). Conclusions This study demonstrates that DHI-K has good internal consistency, test–retest reliability, and concurrent validity. The results of the study also reveal that it is a reliable and valid tool for assessment of handicap in Kannada-speaking dysphagia population.
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Wang, Chen-Chi, Jia-Shiou Liao, Hsiu-Chin Lai, and Yi-Hsuan Lo. "The Mandarin Voice Handicap Index for Laryngectomees With Pneumatic Artificial Laryngeal and Esophageal Speech." American Journal of Speech-Language Pathology 30, no. 4 (July 14, 2021): 1781–92. http://dx.doi.org/10.1044/2021_ajslp-20-00241.
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Purpose The Voice Handicap Index (VHI) questionnaire assesses the impact of total laryngectomy on voice-related quality of life. This study evaluates the Mandarin VHI, including its internal consistency, test–retest reliability, content validity, and differences in scores for Mandarin alaryngeal patients with pneumatic artificial laryngeal (PA) and esophageal (ES) speech. Method Translation and validation of the VHI questionnaire was performed through the forward–backward translation technique. This study used a sample of 78 PA and 23 ES participants from Taiwan who completed the Mandarin VHI. Forty-two of the alaryngeal participants completed the Mandarin VHI twice over a period of 7–63 days. Results The measurement of the internal consistency of the Mandarin VHI showed a high Cronbach's alpha coefficient for the total score (.975) and the functional (.930), physical (.939), and emotional (.938) subscales. Based on the results of the intraclass correlation coefficients, good test–retest reliability for the total and domain scores was found (intraclass correlation coefficient = .827–.863). Conclusion The Mandarin VHI was validated as an instrument with proper internal consistency and reliability, which supports the Mandarin VHI as a valid instrument for the self-evaluation of handicaps related to voice problems in PA and ES speakers.
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Seol, Hye Yoon, Ga-Young Kim, Mini Jo, Soojin Kang, Young Sang Cho, Sung Hwa Hong, and Il Joon Moon. "Content validity of the tinnitus outcome questionnaire for sound management." PLOS ONE 16, no. 5 (May 6, 2021): e0251244. http://dx.doi.org/10.1371/journal.pone.0251244.
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Standardized instruments are often used to monitor one’s progress in tinnitus relief although they were developed to screen and diagnose tinnitus. The need for the development for a tinnitus outcome assessment tool is high in the field of audiology and otolaryngology. The purpose of this study was to develop a tinnitus outcome questionnaire for sound management (listening to sound stimuli for tinnitus relief) and assess its content validity. A total of 32 questions with six domains (Tinnitus characteristics, the impact of tinnitus, tinnitus and hearing issues, handedness, tinnitus management, and sound management outcome) were generated after closely investigating major tinnitus questionnaires used worldwide (i.e. Tinnitus Handicap Inventory and Tinnitus Handicap Questionnaire) as well as literature. Ten healthcare professionals evaluated the appropriateness of the questionnaire items on a five-point Likert scale, where 1 is strongly inappropriate and 5 is strongly appropriate. Content relevance was assessed by computing the content validity index with the cut-off value of 0.75. Each response was first weighted as follows: 1 = 0; 2 = 0.25; 3 = 0.5; 4 = 0.75; and 5 = 1.0. The weighted average was then calculated. Items with a content validity index less than 0.75 were discarded and some items were revised according to the experts’ feedback. As a result, 31 out of the 32 items had the content validity index higher than 0.75, indicating that the items are appropriate to obtain information about the six domains. Reflecting the experts’ feedback, some questions were revised to be more specific. The study provides a baseline structure regarding potential questions to be included in a tinnitus outcome questionnaire for sound management. Development and standardization of such questionnaire would be a pathway to validating tinnitus relief via sound therapy.
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Kwok, T., X. Jin, F. Yeung, J. Cheng, RSK Lo, CLK Lam, HJ Yuan, and J. Woo. "A Comparison of the Long-term Health Related Quality of Life and Handicap of Stroke Patients in Mainland China and Hong Kong." Health Services Insights 3 (January 2010): 117863291000300. http://dx.doi.org/10.1177/117863291000300001.
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Purpose To compare health related quality of life (HRQOL) and handicap of stroke survivors in Hong Kong (HK) and Chengdu (CD) in Mainland China. Method Fifty-four pairs of first ever stroke patients in CD and in HK matched by age, sex and Modified Barthel Index (MBI) were interviewed using a structured questionnaire at 16–36 months after stroke. HRQOL and handicap outcomes were evaluated by the Chinese version of the Short-Form Health Survey (SF-36) and London Handicap Scale (LHS) respectively. Results Compared to stroke patients in CD, HK subjects reported significantly greater handicap, especially in the occupation domain. HK subjects also had significantly lower HRQOL Z scores in domains of role limitations due to emotional or physical problems, and bodily pain. CD subjects had more social support, but had more difficulties in meeting medical costs, and were less likely to have regular medical follow-up and dysphagia symptom. After adjusting for social and health related factors, the site differences in handicap and the role limitation (physical) domain of SF36 became insignificant. Conclusions CD stroke survivors had better scores in HRQOL and fewer handicaps than their counterparts in HK, because of social and health related factors.
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Balaguer, M., J. Percodani, and V. Woisard. "The Carcinologic Handicap Index (CHI): A disability self-assessment questionnaire for head and neck cancer patients." European Annals of Otorhinolaryngology, Head and Neck Diseases 134, no. 6 (December 2017): 399–403. http://dx.doi.org/10.1016/j.anorl.2017.06.010.
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Yäce, İmdat, Sedat Çaglı, Ali Bayram, Fatih Karasu, Işıl Satı, and Ercihan Gäney. "The Effect of Arytenoid Resection on Functional Results of Cricohyoidopexy." Otolaryngology–Head and Neck Surgery 141, no. 2 (August 2009): 272–75. http://dx.doi.org/10.1016/j.otohns.2009.04.012.
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OBJECTIVE: The aim of this study was to evaluate the influence of arytenoid resection on voice and swallowing function in patients who undergo supracricoid laryngectomy with cricohyoidopexy. STUDY DESIGN: A case series with chart review. According to the arytenoid number, patients were divided into two groups: 11 patients with two arytenoids and 9 patients with one arytenoid. The decannulation, nasogastric tube removal, and hospitalization times were noted. Maximum phonation time, average fundamental frequency, percent jitter, percent shimmer, and noise-to-harmonic ratio were measured. Grade, roughness, breathiness, asthenicity and strain scale (for the perceptual evaluation of vocal quality), Voice Handicap Index (for self-assessment of the voice), and dysphagia score were used. RESULTS: The mean decannulation, nasogastric tube removal, and hospitalization time was 18.4, 40.2, and 32.7 days in patients with one arytenoid, whereas 8.8, 20.8, and 25.3 days in patients with two arytenoids, respectively. The differences were statistically significant. For all of the parameters that are associated with voice function and dysphagia, there was no statistically significant difference between one arytenoid and two arytenoids. CONCLUSION: Arytenoid resection may affect the swallowing function in the early postoperative period, but for voice and deglutition functions there was no difference between cricohyoidopexy with one arytenoid and two over the course of time.
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Hurtado-Ruzza, Rafael, Óscar Álvarez-Calderón Iglesias, Ricardo Becerro-de-Bengoa-Vallejo, César Calvo-Lobo, Marta San-Antolín, Marta Elena Losa-Iglesias, Carlos Romero-Morales, and Daniel López-López. "Self-Perceived Handicap Associated With Dysphonia and Health-Related Quality of Life of Asthma and Chronic Obstructive Pulmonary Disease Patients: A Case–Control Study." Journal of Speech, Language, and Hearing Research 64, no. 2 (February 17, 2021): 433–43. http://dx.doi.org/10.1044/2020_jslhr-20-00473.
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Purpose The association between voice alterations, health-related quality of life (HRQL), and chronic respiratory diseases, such as asthma and chronic obstructive pulmonary disease (COPD), has previously been reported. The aim of this study was to test the hypothesis that HRQL and dysphonia-associated handicap of patients diagnosed with asthma or COPD are worse than healthy controls. Method A case–control study in which participants were recruited by a consecutive sampling method from a single institution was conducted. Three groups were created: (a) asthma (51 patients), (b) COPD (52 patients), and (c) 50 healthy controls. Self-reported handicap associated with dysphonia was assessed using the 30-item Voice Handicap Index (VHI-30); meanwhile, HRQL was tested via the European Quality of Life (EQ) Questionnaire and the EQ–visual analog scale. Also, aerodynamic assessment applied to phonation was assessed, and maximum phonation time and s/e index were registered. Results VHI scores were higher for asthma and COPD (7.19 ± 8.31 and 11.80 ± 15.18, respectively) than in the control group (3.72 ± 6.78). The EQ index was lower in asthma and COPD patients than in controls. The EQ–visual analog scale showed lower scores in asthma and COPD than in the controls. Conclusions HRQL was worse in COPD patients than in asthma patients. Even though the patient groups showed worse VHI and HRQL scores than the healthy controls, the scores fell within the normal variation range. No significant variations in the maximum phonation time index between groups were noted.
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Bauch, Christopher D., Susan G. Lynn, Donald E. Williams, Michael W. Mellon, and Amy L. Weaver. "Tinnitus Impact: Three Different Measurement Tools." Journal of the American Academy of Audiology 14, no. 04 (April 2003): 181–87. http://dx.doi.org/10.1055/s-0040-1715725.
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The impact of tinnitus and overall levels of distress were measured with three assessment tools for patients with tinnitus. The Tinnitus Handicap Inventory (THI), the Symptom Checklist-90-Revised (SCL-90-R) and an activities limitations questionnaire were administered to 53 audiology patients reporting tinnitus. Forty-three percent of these patients experienced either quality of life reductions associated with tinnitus, substantial perceived handicap, and/or a high level of distress. Results from the General Severity Index (GSI) of the SCL-90-R indicated that 25% of these patients displayed distress greater than that of the general medical population. The SCL-90-R can be a useful tool for audiologists working with tinnitus patients in assessing needs for referral for psychological or psychiatric counseling.
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Valenzuela, Dianne, Joel Singer, Terry Lee, and Amanda Hu. "The Impact of Socioeconomic Status on Voice Outcomes in Patients With Spasmodic Dysphonia Treated With Botulinum Toxin Injections." Annals of Otology, Rhinology & Laryngology 128, no. 4 (January 7, 2019): 316–22. http://dx.doi.org/10.1177/0003489418823013.
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Objectives: To determine the impact of socioeconomic status (SES) on voice outcomes for spasmodic dysphonia (SD) patients treated with botulinum toxin injections. Methods: This was a prospective cross-sectional study in a tertiary care, academic voice clinic in Canada. Adult SD patients returning to the voice clinic for their botulinum toxin injections were recruited from October 2017 to April 2018. Patients completed a questionnaire on demographic data, the Hollingshead Four-Factor Index for socioeconomic status (validated instrument based on education, occupation, gender, and marital status), and the Voice-Handicap Index 10 (VHI-10) (validated instrument on self-reported vocal handicap). Primary outcome was the association between VHI-10 and Hollingshead Index. Secondary variables were median household income by postal code, duration of disease, gender, age, and professional voice user. Descriptive statistics and multiple linear regression were conducted. Results: One hundred and one patients (age = 62.8 ± 13.7 years, 20.8% male) were recruited with VHI-10 of 22.1 ± 8.1 (out of 40) and Hollingshead Index of 46.3 ± 11.7 (range, 8-66). Median household income was $75 875 ± $16 393, which was above the Canadian average of $70 336. About 91.1% were Caucasian, 54.4% had university degree, 86.1% spoke English, and 43.5% were employed. In multiple linear regression, there was mild to moderate negative correlation (r = −.292, P = .004) between VHI-10 and Hollingshead Index when controlling for disease duration, age, gender, and professional voice use. Conclusion: SD patients treated with botulinum toxin were mostly affluent, Caucasian, well educated, and English speakers. Lower self-perceived vocal handicap was associated with higher socioeconomic status.
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Speyer, Renée, Bas J. Heijnen, Laura W. Baijens, Femke H. Vrijenhoef, Elsemieke F. Otters, Nel Roodenburg, and Hans C. Bogaardt. "Quality of Life in Oncological Patients with Oropharyngeal Dysphagia: Validity and Reliability of the Dutch Version of the MD Anderson Dysphagia Inventory and the Deglutition Handicap Index." Dysphagia 26, no. 4 (January 29, 2011): 407–14. http://dx.doi.org/10.1007/s00455-011-9327-3.
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Hallak, Bassel, Frédéric Olivier, Pedro S. Teiga, Salim Bouayed, Sonia von Wihl, and Kishore Sandu. "Subjective Voice Assessment after Endoscopic Surgery for an Obstructive Reinke Edema Using Voice Handicap Index." Advances in Otolaryngology 2015 (October 19, 2015): 1–5. http://dx.doi.org/10.1155/2015/207085.
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Voice disorders exert a dramatic influence on patients’ quality of life (QOL). The physical, functional, and emotional impact can be accurately assessed using the conventional questionnaire of “voice handicap index” (VHI) or its shorter version, the VHI-10. We evaluated the VHI scores of patients suffering from obstructive Reinke’s edema, a benign laryngeal disorder, before and after endoscopic treatment. Comparison of pre- and postoperative VHI scores showed the treatment efficacy. The scores achieved were similar to asymptomatic individuals (control group), thus improving their quality of life. Furthermore, both VHI and VHI-10 tests yielded similar scores. We suggest routine systematic incorporation of the VHI-10 test for pre- and postoperative routine evaluation of patients with Reinke’s edema. The results are faster and reliable.
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Ashari, Asma, and Alizae M. Mohamed. "Relationship of the Dental Aesthetic Index to the oral health-related quality of life." Angle Orthodontist 86, no. 2 (May 27, 2015): 337–42. http://dx.doi.org/10.2319/121014-896.1.
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ABSTRACT Objective: To assess the impact of malocclusion on the quality of life. Materials and Methods: This cross-sectional study involved 150 subjects attending the Primary Care Unit with no history of orthodontic treatment. The Dental Aesthetic Index (DAI) with 10 occlusal characteristics were measured on study models. Oral health-related quality of life (OHRQoL) was assessed with the Malaysian version of the Oral Health Impact Profile questionnaire (OHIP-14). The Spearman rank-order correlation coefficient was used to evaluate the relationship between the malocclusion and quality of life. Results: Significantly weak correlations (r = .176) were found between the DAI and the OHRQoL. Females and the younger age group (12–19 years) tended to score higher on the OHIP-14 than their counterparts. For males, domain 3 (psychological discomfort; r = .462), domain 4 (physical disability; r = .312), domain 7 (handicap; r = .309), and overall score (r = .289) were weak correlates but significant to the DAI compared with females. The older age group showed a significant weak correlation in domain 3 (psychological discomfort; r = .268) and domain 7 (handicap; r = .238), whereas the younger age group showed no correlation with any domain. Conclusions: The DAI score does not predict the effect of malocclusion on the OHRQoL.
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Vardonikolaki, Aikaterini, Vassilis Pavlopoulos, Konstantinos Pastiadis, Nikolaos Markatos, Ilias Papathanasiou, Georgios Papadelis, Miltos Logiadis, and Athanasios Bibas. "Musicians' Hearing Handicap Index: A New Questionnaire to Assess the Impact of Hearing Impairment in Musicians and Other Music Professionals." Journal of Speech, Language, and Hearing Research 63, no. 12 (December 14, 2020): 4219–37. http://dx.doi.org/10.1044/2020_jslhr-19-00165.
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Purpose We aimed to develop and validate the Musicians' Hearing Handicap Index (MHHI), a new self-evaluation tool for quantifying occupation-related auditory difficulties in music professionals. Although pure-tone audiometry is often considered the “gold standard” and is usually employed as the main instrument for hearing assessment, it cannot fully describe the impact of hearing dysfunction. The MHHI is an attempt to complement the hearing impairment assessment toolbox and is based on a unique approach to quantify the effects of hearing-related symptoms or hearing loss on the performance of musicians and other music industry professionals. Method An initial set of 143 questionnaire items was successively refined through a series of critical appraisals, modifications, and suggestions. This yielded an intermediate questionnaire consisting of 43 items, which was administered to 204 musicians and sound engineers. After exploratory factor analysis, the final form of the MHHI questionnaire was obtained, consisting of 29 items. The questionnaire's test–retest reliability, internal consistency, discriminating power, content validity, criterion validity, and aspects of construct validity and inherent conceptual structure were assessed. Results Exploratory factor analysis revealed a combination of four common factors for the 29 validated questionnaire items. They were named “impact on social and working lives,” “difficulties in performance and sound perception,” “communication difficulties,” and “emotional distress.” The MHHI was shown to be a valid and reliable instrument to assess musicians' and sound engineers' occupational difficulties due to hearing impairment and related symptoms. Conclusion The ability of the MHHI to discriminate between groups of music professionals with different auditory symptoms or pure-tone audiometry thresholds suggests that auditory symptoms might influence a professional's performance to an extent that cannot be assessed by a pure-tone audiogram.
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Bridhikitti, Jidapa, Chanticha Chotigavanich, and Nantakan Apiwarodom. "Voice Outcomes after Radiotherapy for Laryngeal Cancer." Asian Journal of Oncology 07, no. 02 (April 29, 2021): 096–104. http://dx.doi.org/10.1055/s-0041-1729497.
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Abstract Objective The study was aimed to assess changes in voice outcomes after radiotherapy in laryngeal cancer patients. Materials and Methods The study included 60 laryngeal cancer patients treated with definitive radiotherapy or chemoradiotherapy between 2005 and 2012. The primary endpoint of this study was to assess abnormalities of the patients’ voices after the treatment. The Thai version of the Voice Handicap Index (VHI) and xerostomia questionnaire were conducted by telephone. Videostroboscopic examination was done to objectively assess voice outcomes. Results The median age of patients was 63 years. Most patients had glottic cancer (84.1%) and T1–2 disease (84.1%). The median time from treatment to the study was 46 months. In terms of the total VHI score, most patients were in the normal and slight handicap groups (22% and 71.4%, respectively). Only 4.8% and 1.6% of the patients were in moderate and severe handicap group, respectively. Twenty-eight patients had significant xerostomia. Videostroboscopy examination was done in 23 patients and most common findings were telangiectasia (95.7%), abnormal mucosal wave (47.8%), and abnormal glottic closure configuration (34.8%). Regarding total VHI score, lower radiation dose, conventional radiation dose per fraction, longer period after treatment, and significant xerostomia status were significantly correlated with worse voice outcomes. There were no statistically significant correlations between the videostroboscopic findings and VHI scores. Conclusion Voice outcomes in most of laryngeal cancer patients treated with radiotherapy had a normal or mild handicap at more than 1 year of follow-up. Only 4.8% and 1.6% of the patients had moderate and severe voice outcome handicap, respectively.
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Yusuf, Muhammad, Anna Mailasari Kusuma Dewi, Kanthi Yunika, Willy Yusmawan, Farokah Farokah, Rery Budiarti, and Muyassaroh Muyassaroh. "Determinant of Voice Handicap Index Degree as Dysphonia Patients’ Quality of Life Indicator." Journal of Health Education 6, no. 1 (April 30, 2021): 34–38. http://dx.doi.org/10.15294/jhe.v6i1.42118.
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Background: Dysphonia will interfere with communication which will have an impact on social life such as depression, disrupt activities, work and can affect the quality of life. Dysphonia risk factors such as age, sex, duration of illness and etiology will affect the course of it. The purpose of this study was to identify risk factors for with the degree of Voice Handicap Index (VHI) as an indicator of dysphonia patients.Methods: Analytical descriptive study with cross-sectional design in dysphonia patients, the sample was determined as many as 62 who met the inclusion criteria. Quality of life was assessed by the VHI questionnaire. VHI degrees are classified into mild and moderate-severe. Data analysis using chi-square test and multivariate logistic regression. Results:Thirty-two (51.6%) subjects were women. Mean age was 47.26 +12.2. The most common causes of dysphonia (85.5%) were due to organic disorders and laryngopharyngeal reflux (LPR) is the most common cause (37.1%) of all organic dysphonia disorders. Analysis of risk factors for age, gender, etiology of dysphonia and duration of illness with VHI degree were p = 0.282, p =0.76, p= 0.067, p= 0.001, respectively. Duration of illness ≥2 weeks has a 38.3x risk to severity VHI compared to <2 weeks. Conclusion: The duration of illness is a determinan related to of the degree of VHI that quality of life indicator in dysphonia patients.
Key Words: Risk factors, Dysphonia, Voice Handicap Index
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Forghieri, M., D. Monzani, G. M. Galeazzi, C. Gherpelli, and M. Rigatelli. "Anger, Social Dysfunction and Psychopathological Distress in Hearing- Impaired Patients." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71477-4.
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It has been demonstrated that subjects suffering from hearing impairment present significant emotional reactions and socio-situational limitations when compared to controls (Monzani et al., 2008).Aim:To evaluate the relationship between hearing loss severity, anger expression, perceived handicap, social dysfunction and psychopathological distress in adult patients suffering from acquired hearing loss.Method:297 hearing impaired subjects were consecutively recruited by the ENT Clinic of the Modena and Reggio Emilia University from 1/1/07. Each patient were submitted to pure-tones audiometry and the pure tone average threshold (PTA) was calculated over 0.5,1, 2, 4 kHz. Socio-demographic data were collected (age, educational level, employment, marital status). Every patient was also administered the following questionnaire in their Italian validated version: Social Functioning Questionnaire, Brief Symptom Inventory, Hearing Handicap Inventory for Adults, State-Trait Anger Expression Inventory-2. Descriptive statistics were used to assess sociodemographic data; Pearson correlation coefficient was used to investigate relationships between test scores and hearing loss level.Results:Mean age was 53.79 (SD ±13.65); 44.8% were males. Hearing impairment level didn't significantly relate with objective social functioning level (p=.311), but with the subjective emotional and socio-situational perceived handicap (p=.000); moreover it significantly correlates with individual psychopathological tendency to phobic reaction (p=.006) and to anger general expression index (p=.021). Furthermore it directly relates with state anger (p=.021) and inversely relates with external expressed anger (p=.023).Conclusion:Anger felt but not expressed might be a key element in determining subjective social impairment in hearing loss patients and contribute to their well-known psychological distress.
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Keefe, M. A. "Short, Self-report Voice Symptom Scales: Psychometric Characteristics of the Voice Handicap Index-10 and the Vocal Performance Questionnaire." Yearbook of Otolaryngology-Head and Neck Surgery 2006 (January 2006): 127–29. http://dx.doi.org/10.1016/s1041-892x(08)70112-4.
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Deary, Ian J., Alison Webb, Kenneth Mackenzie, Janet A. Wilson, and Paul N. Carding. "Short, Self-Report Voice Symptom Scales: Psychometric Characteristics of the Voice Handicap Index-10 and the Vocal Performance Questionnaire." Otolaryngology–Head and Neck Surgery 131, no. 3 (September 2004): 232–35. http://dx.doi.org/10.1016/j.otohns.2004.02.048.
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Hyodo, Masamitsu, Kaori Nishikubo, Aki Taguchi, Kazuyo Mise, and Osamu Shiromoto. "Prevalence of Voice Disorders in School Teachers-A Questionnaire Survey in Association with Use of the Voice Handicap Index-." Japan Journal of Logopedics and Phoniatrics 51, no. 4 (2010): 305–10. http://dx.doi.org/10.5112/jjlp.51.305.
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Aazh, Hashir, Christina Bryant, and Brian C. J. Moore. "Patients' Perspectives About the Acceptability and Effectiveness of Audiologist-Delivered Cognitive Behavioral Therapy for Tinnitus and/or Hyperacusis Rehabilitation." American Journal of Audiology 28, no. 4 (December 16, 2019): 973–85. http://dx.doi.org/10.1044/2019_aja-19-0045.
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Objective The aim of this study was to evaluate the views of patients who completed audiologist-delivered cognitive behavioral therapy (CBT) about (a) the effectiveness of the treatment, (b) the acceptability of receiving CBT from audiologists, and (c) the most effective treatment components. Design This was a service evaluation survey with a cross-sectional design. Study Sample The study population comprised 40 consecutive adult patients who received a full course of audiologist-delivered CBT for tinnitus and/or hyperacusis management at a Tinnitus and Hyperacusis Therapy Specialist Clinic in the United Kingdom over a 1-year period. Thirty-one of 40 patients who attended their final session as planned completed the survey questionnaire. Data Collection and Analysis As a part of their routine care, all patients completed a wide range of questionnaires before and after receiving audiologist-delivered CBT. These comprised Tinnitus Handicap Inventory ( Newman, Sandridge, & Bolek, 2008 ); Hyperacusis Questionnaire ( Khalfa et al., 2002 ); Insomnia Severity Index ( Bastien, Vallieres, & Morin, 2001 ); Visual Analogue Scale ( Maxwell, 1978 ) for tinnitus loudness, tinnitus annoyance, and effect of tinnitus on life; Generalized Anxiety Disorder ( Spitzer, Kroenke, Williams, & Lowe, 2006 ) questionnaire; and Patient Health Questionnaire ( Kroenke, Spitzer, & Williams, 2001 ). In addition, patients were asked to complete the survey questionnaire at their final session to provide feedback with regard to their therapy. Results The majority of patients reported that it was very acceptable to them to receive CBT focused on tinnitus and hyperacusis from a specialist audiologist; the median response was 10/10. The majority of patients felt that the CBT was very effective (median response 8/10) and that they were able to manage their tinnitus and/or hyperacusis well (median response 9/10). The effect sizes of treatment based on pre- and postintervention comparison of scores for the Tinnitus Handicap Inventory, Visual Analogue Scale of tinnitus annoyance and effect on life, Hyperacusis Questionnaire, Insomnia Severity Index, Generalized Anxiety Disorder, and Patient Health Questionnaire were large. Conclusions Audiologist-delivered CBT is acceptable to patients and is effective in the management of tinnitus and/or hyperacusis from the patients' perspectives.
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Amir-Behghadami, Mehrdad, Ali Janati, and Masoumeh Gholizadeh. "“Self-assessment of voice outcomes after total thyroidectomy using the Voice Handicap Index questionnaire: Results of a prospective multicenter study”; methodological issues on questionnaire validation." Surgery 168, no. 1 (July 2020): 205–6. http://dx.doi.org/10.1016/j.surg.2019.12.013.
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Steen, I. N., K. MacKenzie, P. N. Carding, A. Webb, I. J. Deary, and J. A. Wilson. "Optimising outcome assessment of voice interventions, II: sensitivity to change of self-reported and observer-rated measures." Journal of Laryngology & Otology 122, no. 1 (May 14, 2007): 46–51. http://dx.doi.org/10.1017/s0022215107007839.
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AbstractObjectives:A wide range of well validated instruments is now available to assess voice quality and voice-related quality of life, but comparative studies of the responsiveness to change of these measures are lacking. The aim of this study was to assess the responsiveness to change of a range of different measures, following voice therapy and surgery.Design:Longitudinal, cohort comparison study.Setting:Two UK voice clinics.Participants:One hundred and forty-four patients referred for treatment of benign voice disorders, 90 undergoing voice therapy and 54 undergoing laryngeal microsurgery.Main outcome measures:Three measures of self-reported voice quality (the vocal performance questionnaire, the voice handicap index and the voice symptom scale), plus the short form 36 (SF 36) general health status measure and the hospital anxiety and depression score. Perceptual, observer-rated analysis of voice quality was performed using the grade–roughness–breathiness–asthenia–strain scale. We compared the effect sizes (i.e. responsiveness to change) of the principal subscales of all measures before and after voice therapy or phonosurgery.Results:All three self-reported voice measures had large effect sizes following either voice therapy or surgery. Outcomes were similar in both treatment groups. The effect sizes for the observer-rated grade–roughness–breathiness–asthenia–strain scale scores were smaller, although still moderate. The roughness subscale in particular showed little change after therapy or surgery. Only small effects were observed in general health and mood measures.Conclusion:The results suggest that the use of a voice-specific questionnaire is essential for assessing the effectiveness of voice interventions. All three self-reported measures tested were capable of detecting change, and scores were highly correlated. On the basis of this evaluation of different measures' sensitivities to change, there is no strong evidence to favour either the vocal performance questionnaire, the voice handicap index or the voice symptom scale.
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Herbst, Christian T., Jinook Oh, Jitka Vydrová, and Jan G. Švec. "DigitalVHI—a freeware open-source software application to capture the Voice Handicap Index and other questionnaire data in various languages." Logopedics Phoniatrics Vocology 40, no. 2 (September 19, 2013): 72–76. http://dx.doi.org/10.3109/14015439.2013.830769.
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Borel, Frédéric, Christophe Tresallet, Antoine Hamy, Muriel Mathonnet, Jean-Christophe Lifante, Laurent Brunaud, Olivier Marret, et al. "Self-assessment of voice outcomes after total thyroidectomy using the Voice Handicap Index questionnaire: Results of a prospective multicenter study." Surgery 167, no. 1 (January 2020): 129–36. http://dx.doi.org/10.1016/j.surg.2019.05.090.
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Aazh, Hashir, and Brian C. J. Moore. "Effectiveness of Audiologist-Delivered Cognitive Behavioral Therapy for Tinnitus and Hyperacusis Rehabilitation: Outcomes for Patients Treated in Routine Practice." American Journal of Audiology 27, no. 4 (December 6, 2018): 547–58. http://dx.doi.org/10.1044/2018_aja-17-0096.
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Objective The aim was to assess the effectiveness of cognitive behavioral therapy (CBT) for tinnitus and/or hyperacusis delivered by audiologists working in the National Health Service in the United Kingdom. Design This was a retrospective study, based on questionnaires assessing tinnitus and hyperacusis and insomnia before and after CBT. Study Sample Data were gathered for 68 consecutive patients (average age = 52.5 years) who enrolled for CBT. Results All measures showed significant improvements after CBT. Effect sizes for patients who completed CBT were 1.13 for Tinnitus Handicap Inventory scores; 0.76 for Hyperacusis Questionnaire scores; 0.71, 0.95, and 0.93 for tinnitus loudness, annoyance, and effect on life, respectively, measured using the Visual Analog Scale; and 0.94 for the Insomnia Severity Index score. An analysis including those who dropped out also showed significant improvements for all measures. Conclusion Audiologist-delivered CBT led to significant improvements in self-report measures of tinnitus and hyperacusis handicap and insomnia. The methods described here may be used when designing future randomized controlled trials of efficacy.
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Borel, Frédéric, Claire Blanchard, Jean-Benoit Hardouin, and Eric Mirallié. "Reply to: "Self-assessment of voice outcomes after total thyroidectomy using the Voice Handicap Index questionnaire: Results of a prospective multicenter study": Methodological issues on questionnaire validation." Surgery 168, no. 3 (September 2020): 567–68. http://dx.doi.org/10.1016/j.surg.2020.04.039.
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Shekhawat, Giriraj Singh, Grant D. Searchfield, and Cathy M. Stinear. "Role of Hearing Aids in Tinnitus Intervention: A Scoping Review." Journal of the American Academy of Audiology 24, no. 08 (September 2013): 747–62. http://dx.doi.org/10.3766/jaaa.24.8.11.
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Background: Tinnitus can have a devastating impact on the quality of life of the sufferer. Although the mechanisms underpinning tinnitus remain uncertain, hearing loss is often associated with its onset, and hearing aids are among the most commonly used tools for its management. Purpose: To conduct a scoping review to explore the role of hearing aids in tinnitus management. Research Design: Scoping review based on the six-stage framework of Arksey and O'Malley (2005). Study Sample: Relevant studies were identified using various databases (Scopus, Google Scholar, SpringerLink, and PubMed) and hand searching of journals and a reference list of articles. Out of 277 shortlisted articles, 29 studies (18 research studies and 11 reviews) were chosen for charting of data based on their abstracts. Data Collection and Analysis: Tinnitus assessment measures used in studies were recorded along with changes in their scores. Measures used in studies included the Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionnaire (THQ), Tinnitus Severity Index (TSI), Tinnitus Reaction Questionnaire (TRQ), German version of Tinnitus Questionnaire (TQ), Beck Depression Inventory (BDI), and visual analogue scale (VAS) of tinnitus intensity. Where possible Cohen's d effect size statistic was calculated. Results: Although the quality of evidence for hearing aids' effect on tinnitus is not strong, the weight of evidence (17 research studies for, 1 against) suggests merit in using hearing aids for tinnitus management. Conclusions: The majority of studies reviewed support the use of hearing aids for tinnitus management. Clinicians should feel reassured that some evidence shows support for the use of hearing aids for treating tinnitus, but there is still a need for stronger methodology and randomized control trials.
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Vozel, Domen, Nejc Steiner, Nina Božanić Urbančič, Dejan Mladenov, and Saba Battelino. "Slovenian Cross-Cultural Adaptation and Validation of Health-Related Quality of Life Measures for Chronic Otitis Media (COMQ-12), Vertigo (DHI, NVI) and TINNITUS (THI)." Slovenian Journal of Public Health 59, no. 3 (June 25, 2020): 120–27. http://dx.doi.org/10.2478/sjph-2020-0016.
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AbstractPurposeTo provide physicians and patients with the tools needed to evaluate patients’ problems and health-related quality of life by cross-culturally adapting and validating the Chronic Otitis Media Questionnaire 12 (COMQ-12), the Dizziness Handicap Inventory (DHI), the Neuropsychological Vertigo Inventory (NVI) and the Tinnitus Handicap Inventory (THI).Materials and methodsCOMQ-12, DHI, NVI and THI were translated into the Slovenian language and completed by patients treated at our department for chronic otitis media, vertigo or tinnitus. The control group for each questionnaire consisted of healthy volunteers. Internal consistency, test-retest reliability, discriminant validity, diagnostic accuracy and cut-off value were determined for each questionnaire.ResultsTest-retest reliability was excellent for DHI (ICC A=0.946) and NVI (p=0.315, ICC A=0.975), good to excellent for COMQ-12 (p=0.680, ICC A=0.858) and satisfactory for THI (p=0.120). Discriminant validity was confirmed for each questionnaire (p>0.05) using the Mann-Whitney U test (COMQ-12, DHI, THI) or the Welch t-test (NVI). COMQ-12 had acceptable (α=0.796) and DHI (α=0.910), NVI (α=0.950) and THI (α=0.924) perfect internal consistency. COMQ-12 and DHI had excellent, NVI acceptable and THI perfect diagnostic accuracy (AUC=0.987, AUC=0.999, AUC=0.781 and AUC=1.000 respectively). Cut-off values determined by Youden’s index were 7, 7, 9 and 56 for COMQ-12, THI, DHI and NVI, respectively.ConclusionSlovenian COMQ-12, DHI, NVI and THI are a valid and accurate tool for the diagnosis and measurement of health-related quality of life in patients with chronic otitis media, vertigo and tinnitus. They could aid general practitioners, occupational health specialists, neurologists and otorhinolaryngologists.
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Husain, Fatima T., Sara A. Schmidt, Yihsin Tai, Elsa C. Granato, Pedro Ramos, Paul Sherman, and Carlos Esquivel. "Replicability of Neural and Behavioral Measures of Tinnitus Handicap in Civilian and Military Populations: Preliminary Results." American Journal of Audiology 28, no. 1S (April 22, 2019): 191–208. http://dx.doi.org/10.1044/2019_aja-ttr17-18-0039.
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Purpose In the past decade, resting-state functional connectivity, acquired using functional magnetic resonance imaging (fMRI), has emerged as a popular measure of tinnitus, especially as related to self-reported handicap or psychological reaction. The goal of this study was to assess replicability of neural correlates of tinnitus, namely, resting-state functional connectivity, in the same individuals acquired over 2 sessions. Method Data were collected at 2 different sites (University of Illinois at Urbana–Champaign and Joint Base San Antonio Wilford Hall Ambulatory Surgical Center) using similar 3T magnets and similar data acquisition paradigms. Thirty-six patients (all civilians) were scanned using resting-state fMRI at the University of Illinois at Urbana–Champaign. Ten patients, active-duty Service members and Veterans, were scanned at the Wilford Hall Ambulatory Surgical Center and the Department of Defense Hearing Center of Excellence. Each participant was scanned twice, a week apart, using identical protocols of 10 min resting-state fMRI. Results Tinnitus handicap scores using the Tinnitus Functional Index and the Tinnitus Primary Function Questionnaire ranged between no or mild handicap to moderately severe handicap but did not significantly differ between visits. We examined the default mode, dorsal attention, and auditory resting-state networks and found that the strength of the within-network functional connections across visit was similar for the attention and default mode networks but not for the auditory network. In addition, the functional connection between the attention network and precuneus, a region of the default mode network, was also replicable across visits. Conclusions Our results show that resting-state fMRI measures are replicable and reliable in patients with a subjective condition, although some networks and functional connections may be more stable than others. This paves the way for using resting-state fMRI to measure the efficacy of tinnitus interventions and as a tool to help propose better management options.
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Henry, James A., Martin A. Schechter, Tara L. Zaugg, Susan Griest, Pawel J. Jastreboff, Jack A. Vernon, Christine Kaelin, Mary B. Meikle, Karen S. Lyons, and Barbara J. Stewart. "Outcomes of Clinical Trial: Tinnitus Masking versus Tinnitus Retraining Therapy." Journal of the American Academy of Audiology 17, no. 02 (February 2006): 104–32. http://dx.doi.org/10.3766/jaaa.17.2.4.
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A controlled clinical study was conducted to evaluate prospectively the clinical efficacy of tinnitus masking (TM) and tinnitus retraining therapy (TRT) in military veterans having clinically significant tinnitus. Qualifying patients were placed into the two groups in an alternating manner (to avoid selection bias), and treatment was administered at 0, 3, 6, 12, and 18 months. Outcomes of treatment were evaluated using three self-administered tinnitus questionnaires (Tinnitus Handicap Inventory, Tinnitus Handicap Questionnaire, Tinnitus Severity Index) and the verbally administered TRT interview forms. Findings are presented from the three written questionnaires, and from two of the interview questions (percentage time aware of, and annoyed by, tinnitus). Outcomes were analyzed on an intent-to-treat basis, using a multilevel modeling approach. Of the 123 patients enrolled, 118 were included in the analysis. Both groups showed significant declines (improvements) on these measures, with the TRT decline being significantly greater than for TM. The greater declines in TRT compared to TM occurred most strongly in patients who began treatment with a "very big" tinnitus problem. When patients began treatment with a "moderate" tinnitus problem, the benefits of TRT compared to TM were more modest.
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Best, Simon R., Julie Ahn, Shannon Langmead, Vaninder Dhillon, Alexander T. Hillel, Lee M. Akst, and Jaishri O. Blakeley. "Voice and Swallowing Dysfunction in Neurofibromatosis 2." Otolaryngology–Head and Neck Surgery 158, no. 3 (November 21, 2017): 505–10. http://dx.doi.org/10.1177/0194599817741839.
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Objective Neurofibromatosis 2 (NF2) is a neuro-oncologic condition that presents with bilateral vestibular schwannomas of the cerebellopontine angle (CPA). Voice and swallowing impairment can occur from direct involvement or compression of the vagus nerve or as the result of surgical excision of CPA tumors. The objectives in this study are to (1) assess the prevalence of voice and swallowing impairments and (2) analyze the effects of vagal dysfunction in patients with NF2. Study Design Cross-sectional. Setting Academic tertiary care center. Subjects and Methods Patients at a neurofibromatosis center were mailed Voice Handicap Index and Sydney Swallow Questionnaire surveys. Stroboscopic, voice, and swallowing evaluations were performed for patients who elected to participate in screening exams. Results There were high rates of self-assessed and objective voice and swallowing handicaps in this population. Fourteen of 40 (35%) patients had a self-assessed voice handicap, and 20 of 40 (50%) patients had a self-assessed swallow handicap. Vocal fold motion impairment (VFMI) was observed in 22 of 31 (71%) patients examined, with 27 of 62 (44%) possible vocal cords affected. Velopharyngeal insufficiency (45%) and piriform sinus pooling or residue (39%) were seen in a significant percentage of patients. There was a significant relationship between vocal cord motion impairment and CPA surgical intervention ipsilateral to the impairment ( P = .002). The presence of VFMI was strongly associated with voice ( P = .002) and swallowing ( P = .01) impact on quality of life. Conclusion Speech and swallowing impairments are highly prevalent in patients with NF2, cause significant impact on quality of life, and are most commonly related to surgical interventions in the CPA region.
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Teale, Elizabeth A., and John B. Young. "A review of stroke outcome measures valid and reliable for administration by postal survey." Reviews in Clinical Gerontology 20, no. 4 (July 27, 2010): 338–53. http://dx.doi.org/10.1017/s0959259810000213.
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SummaryCollecting outcome measures by patient or proxy-completed postal survey in stroke research offers a pragmatic and cost-effective alternative to interview-based assessments. The psychometric properties of outcome measures cannot be assumed to be equivalent across methods of questionnaire administration. Many stroke outcome measures have variable or unproven psychometric properties when administered by post. The validity of stroke research that uses postal surveys may be improved through the adoption of questionnaires with acceptable postal psychometric properties. This review identifies 60 reports of quantitative stroke studies using one or more of 36 instruments to collect stroke outcome data by postal survey. Three of these instruments have acceptable psychometric properties for postal administration in stroke populations (the Frenchay Activities Index (FAI), Subjective Index of Physical and Social Outcome (SIPSO) and the EuroQoL (EQ5D)). Two further instruments lack evidence to support proxy reliability (Nottingham Extended Activities of Daily Living and London Handicap Score), but have otherwise acceptable properties.
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Kubba, Haytham, Iain R. C. Swan, and Stuart Gatehouse. "Measuring Quality of Life in Preschool Children with Sore Throats and Otitis Media Using the Tapqol Questionnaire." Otolaryngology–Head and Neck Surgery 132, no. 4 (April 2005): 647–52. http://dx.doi.org/10.1016/j.otohns.2005.01.028.
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OBJECTIVES: TNO-AZL Preschool Quality of Life Questionnaire (TAPQOL) is one of the few instruments designed to assess health-related quality of life in preschool children but its applicability to otolaryngology is unknown. STUDY DESIGN AND SETTING: We studied a consecutive series of children aged 1 to 5 years referred to hospital with recurrent sore throats, recurrent acute otitis media, or otitis media with effusion. RESULTS: TAPQOL domain scores were not influenced by age, sex, or socio-economic class, but correlated with markers of disease severity (frequency of sore throat or pyrexia, time off school), ear-related handicap (assessed with the OM6 questionnaire), and other measures of health-related quality of life (visual analogue scale, 5-point rating scale and the Health Utilities Index mark III). Comparison with published data from healthy children suggests that these common otolaryngologic problems have a large impact on a child's quality of life. CONCLUSIONS: TAPQOL seems to be appropriate for use in this context. Marked ceiling effects in some domains, however, may limit their sensitivity.
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Lucieer, F. M. P., R. Van Hecke, L. van Stiphout, S. Duijn, A. Perez-Fornos, N. Guinand, V. Van Rompaey, H. Kingma, M. Joore, and R. van de Berg. "Bilateral vestibulopathy: beyond imbalance and oscillopsia." Journal of Neurology 267, S1 (October 8, 2020): 241–55. http://dx.doi.org/10.1007/s00415-020-10243-5.
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Abstract Objective To optimize the current diagnostic and treatment procedures for patients with bilateral vestibulopathy (BV), this study aimed to determine the complete spectrum of symptoms associated with BV. Method A prospective mixed-method study design was used. Qualitative data were collected by performing semi-structured interviews about symptoms, context, and behavior. The interviews were recorded and transcribed until no new information was obtained. Transcriptions were analyzed in consensus by two independent researchers. In comparison to the qualitative results, quantitative data were collected using the Dizziness Handicap Inventory (DHI), Hospital Anxiety and Depression Scale (HADS) and a health-related quality of life questionnaire (EQ-5D-5L). Results Eighteen interviews were transcribed. Reported symptoms were divided into fourteen physical symptoms, four cognitive symptoms, and six emotions. Symptoms increased in many situations, such as darkness (100%), uneven ground (61%), cycling (94%) or driving a car (56%). These symptoms associated with BV often resulted in behavioral changes: activities were performed more slowly, with greater attention, or were avoided. The DHI showed a mean score of severe handicap (54.67). The HADS questionnaire showed on average normal results (anxiety = 7.67, depression = 6.22). The EQ-5D-5L demonstrated a mean index value of 0.680, which is lower compared to the Dutch age-adjusted reference 0.839 (60–70 years). Conclusion BV frequently leads to physical, cognitive, and emotional complaints, which often results in a diminished quality of life. Importantly, this wide range of symptoms is currently underrated in literature and should be taken into consideration during the development of candidacy criteria and/or outcome measures for therapeutic interventions such as the vestibular implant.
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de Paiva, Sofia Margarida Marques, João Simões, António Paiva, Craig Newman, Francisco Castro e Sousa, and Jean-Pierre Bébéar. "Validity and Reliability of the Hearing Handicap Inventory for Elderly: Version Adapted for Use on the Portuguese Population." Journal of the American Academy of Audiology 27, no. 08 (September 2016): 677–82. http://dx.doi.org/10.3766/jaaa.15146.
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Background: The use of the Hearing Handicap Inventory for the Elderly (HHIE) questionnaire enables us to measure self-perceived psychosocial handicaps of hearing impairment in the elderly as a supplement to pure-tone audiometry. This screening instrument is widely used and it has been going through adaptations and validations for many languages; all of these versions have kept the validity and reliability of the original version. Purpose: To validate the HHIE questionnaire, translated into Portuguese of Portugal, on the Portuguese population. Research Design: This study is a descriptive correlational qualitative study. The authors performed the translation from English into Portuguese, the linguistic adaptation, and the counter translation. Study Sample: Two hundred and sixty patients from the Ear, Nose, and Throat (ENT) Department of Coimbra University Hospitals were divided into a case group (83 individuals) and a control group (177 individuals). Intervention: All of the 260 patients completed the 25 items in the questionnaire and the answers were reviewed for completeness. Data Collection and Analysis: The patients volunteered to answer the 25-item HHIE during an ENT appointment. Correlations between each individual item and the total score of the HHIE were tested, and demographic and clinical variables were correlated with the total score, as well. The instrument’s reproducibility was assessed using the internal consistency model (Cronbach’s alpha). Results: The questions were successfully understood by the participants. There was a significant difference in the HHIE-10 and HHIE-25 total scores between the two groups (p < 0.001). Positive correlations can be seen between the global question and HHIE-10 and HHIE-25. In the regression study, a relationship was observed between the pure-tone average and the HHIE-10 (p < 0.001). Reliability of the instrument was proven by a Cronbach alpha index of 0,79. Conclusions: The HHIE translation into Portuguese of Portugal maintained the validity of the original version and it is useful to assess the psychosocial handicap of hearing impairment in the elderly.
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Sundar, Krishna M., Amanda Carole Stark, Nan Hu, and Julie Barkmeier-Kraemer. "Is laryngeal hypersensitivity the basis of unexplained or refractory chronic cough?" ERJ Open Research 7, no. 1 (January 2021): 00793–2020. http://dx.doi.org/10.1183/23120541.00793-2020.
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Refractory chronic cough (RCC) and unexplained chronic cough (UCC) are common problems seen in primary care and subspecialty clinics. The role of cough hypersensitivity and laryngeal dysfunction in contributing to the persistence of cough in RCC/UCC is not well recognised.Data of patients with RCC and UCC evaluated in 2019 by an interdisciplinary cough clinic led by a pulmonologist and speech–language pathology team was reviewed. Patients completed validated questionnaires including the Leicester cough questionnaire (LCQ), voice handicap index (VHI) and dyspnoea index (DI) questionnaire at initial encounter. Presence of cough hypersensitivity was based upon a history of allotussia and hypertussia. Laryngeal dysfunction was diagnosed in those with a history of laryngeal paresthesias, throat clearing, voice abnormalities, upper airway dyspnoea and documentation of functional or anatomic laryngeal abnormalities on nasoendoscopy.Of the 60 UCC/RCC patients analysed, 75% of patients were female and 85% were over 40 years of age. Cough hypersensitivity was documented in all patients and multiple cough triggers occurred in 75% of patients. 95%, 50% and 25% of patients reported laryngeal paresthesias, voice abnormalities and upper airway dyspnoea, respectively. Significant associations between LCQ and VHI and DI scores occurred when adjusting for age, sex, ethnicity and body mass index. Laryngeal functional abnormalities were documented on 44 out of 60 patients on nasoendoscopy.Hypertussia, allotussia and laryngeal dysfunction are common in patients with RCC and UCC. Evaluation of UCC and RCC can delineate laryngeal hypersensitivity and allows appropriate treatment to be directed at this phenotype.
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Hartke, Vance, Amanda Gillespie, Libby J. Smith, and Ryan J. Soose. "Does CPAP Affect Patient-Reported Voice Outcomes?" Otolaryngology–Head and Neck Surgery 158, no. 4 (January 16, 2018): 685–87. http://dx.doi.org/10.1177/0194599817752639.
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Upper aerodigestive tract symptoms are common in patients with obstructive sleep apnea (OSA). It remains unclear whether continuous positive airway pressure (CPAP) improves or worsens these otolaryngology symptoms. As therapy-related side effects limit CPAP adherence, this study aimed to determine if CPAP negatively affects voice, sinonasal, and reflux symptoms of the upper airway. Case series with planned data collection was performed at an academic otolaryngology sleep center. Newly diagnosed patients with OSA were evaluated before and 6 months after initiating CPAP therapy. Data collected included CPAP data download, Reflux Symptom Index (RSI), Epworth Sleepiness Scale (ESS), Voice Handicap Index 10 (VHI-10), Sino-Nasal Questionnaire (SNQ), and oral dryness visual analog scale (VAS). For the 11 CPAP-adherent participants, the RSI significantly improved with CPAP (mean RSI, 22.0-9.5; P = .002); however, the VAS, VHI-10, and SNQ did not change after 6 months of CPAP therapy. In a small sample size, patient-reported voice outcomes (VHI-10) and other upper aerodigestive tract symptoms did not worsen with CPAP; rather, CPAP therapy was associated with a reduction in reflux symptoms.
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Moring, John, Anne Bowen, Jenifer Thomas, and Jeremy Joseph. "Acceptance Mediates the Relationship Between Tinnitus-Related Cognitions and Anxiety Sensitivity." American Journal of Audiology 24, no. 2 (June 2015): 235–42. http://dx.doi.org/10.1044/2015_aja-15-0006.
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Purpose Negative cognitions related to tinnitus sensation have been previously shown to affect the level of emotional distress. Anxiety sensitivity is another psychological factor that influences individuals to more closely monitor their own bodily sensations, resulting in increased negative cognitions and negative emotional responses among tinnitus patients. However, increasing acceptance of tinnitus sensation may attenuate emotional distress. The goal of this research was to investigate the relationship between negative tinnitus-related cognitions, acceptance, and anxiety sensitivity. Method Two hundred sixty-seven participants completed online measures of the Tinnitus Handicap Inventory (Newman, Jacobson, & Spitzer, 1996), Acceptance and Action Questionnaire (Hayes, Follette, & Linehan, 2004), and the Anxiety Sensitivity Index–3 (Taylor et al., 2007). Results Hierarchical regression analyses indicated that acceptance fully mediated the relationship between negative tinnitus-related cognitions and anxiety sensitivity. Conclusions On the basis of these results, it is suggested that practitioners improve acceptance of tinnitus sensation, duration, and intensity. More research is warranted on the clinical techniques to improve acceptance.
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Searchfield, Grant D. "A Client Oriented Scale of Improvement in Tinnitus for Therapy Goal Planning and Assessing Outcomes." Journal of the American Academy of Audiology 30, no. 04 (April 2019): 327–37. http://dx.doi.org/10.3766/jaaa.17119.
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AbstractThere is a need to develop methods to help clinicians work with clients to select and personalize tinnitus therapies. The use of validated measures to determine treatment success is also essential for research and clinical practice. A goal planning method widely used in audiologic rehabilitation is the client oriented scale of improvement (COSI). A modified version of the COSI has been used to identify tinnitus treatment goals and outcomes (client oriented scale of improvement in tinnitus [COSIT]).The aims of this study were to identify treatment goals in a clinic sample and ascertain the convergent validity of the COSIT to three widely used standardized questionnaires.A retrospective evaluation of client treatment goals using thematic analysis and correlational analysis of secondary research data comparing the COSIT to tinnitus handicap questionnaire (THQ), tinnitus handicap inventory (THI), and tinnitus functional index (TFI).One hundred and twenty-two adult patients and research participants attending the University of Auckland Hearing and Tinnitus Clinic.Specific treatment goals were categorized into 11 themes. The most common treatment goals (>10% of responses) were: (1) Reducing tinnitus’ effects on Hearing. (2) Improved wellbeing and being less depressed. (3) Coping with or controlling the tinnitus. (4) Managing the effect of the environment (context) on tinnitus. (5) Improving sleep. (6) Understanding tinnitus. Individuals differed in their complaints and priorities for treatment. The COSIT showed moderate convergent validity with the THQ, THI, and TFI indicating that the total scores measured similar constructs.The COSIT is a pragmatic method for determining tinnitus treatment goals and priorities in a format that should be familiar to audiologists.
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Lovato, Andrea, Maria Rosaria Barillari, Luciano Giacomelli, Lisa Gamberini, and Cosimo de Filippis. "Predicting the Outcome of Unilateral Vocal Fold Paralysis: A Multivariate Discriminating Model Including Grade of Dysphonia, Jitter, Shimmer, and Voice Handicap Index-10." Annals of Otology, Rhinology & Laryngology 128, no. 5 (January 29, 2019): 447–52. http://dx.doi.org/10.1177/0003489419826597.
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Objectives: The aim of this study was to investigate if any clinical and phoniatric characteristics or quality-of-life measures could predict the outcome of unilateral vocal fold paralysis (UVFP) initially managed with speech therapy. Methods: Forty-six patients with UVFP were evaluated using laryngostroboscopy, the GIRBAS (grade, instability, roughness, breathiness, asthenia, and strain) scale, acoustic analysis, and the Voice Handicap Index-10 (VHI-10) questionnaire. Treatment was speech therapy according to a 3-phase protocol. The main outcome measure was incomplete vocal fold mobility 12 months after symptom onset. Univariate and multivariate modeling ( k-nearest neighbors model) were applied. Results: Fifteen patients had incomplete motion recovery 12 months after the onset of UVFP. On univariate analysis, time to diagnosis (0.01), global grade of dysphonia (0.018), jitter (0.01), shimmer (0.012), and VHI-10 score (0.006) were associated with the outcome of vocal fold paralysis. Using a k-nearest neighbors multivariate discriminating model, the best discrimination of UVFP outcome was achieved with 4 parameters: global grade of dysphonia 2 or 3, jitter > 2.46%, shimmer > 6.97%, and VHI-10 score > 13. The model’s misclassification rate for incomplete motion recovery was only 6%. The model showed sensitivity of 93% and specificity of 74%. Conclusions: Delayed diagnosis and speech therapy was associated with negative outcomes. Higher grade of dysphonia, jitter, shimmer, and VHI-10 score on initial phoniatric assessment may help clinicians in predicting the outcomes of UVFP patients.
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Cocuzza, Salvatore, Antonino Maniaci, Calogero Grillo, Salvatore Ferlito, Giacomo Spinato, Salvatore Coco, Federico Merlino, et al. "Voice-Related Quality of Life in Post-Laryngectomy Rehabilitation: Tracheoesophageal Fistula’s Wellness." International Journal of Environmental Research and Public Health 17, no. 12 (June 26, 2020): 4605. http://dx.doi.org/10.3390/ijerph17124605.
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(1) Introduction: Laryngeal cancer is one of the most common types of cancer affecting the upper aerodigestive tract. Despite ensuring good oncological outcome in many locoregionally advanced cases, total laryngectomy is associated with relevant physical and psychological sequelae. Treatment through tracheo-esophageal speech, if promising, can lead to very variable outcomes. Not all laryngectomee patients with vocal prosthesis benefit from the same level of rehabilitation mainly due to the development of prosthetic or fistula related problems. The relating sequelae in some cases are even more decisive in the patient quality of life, having a higher impact than communicational or verbal skills. (2) Material and Methods: A retrospective study was conducted on 63 patients initially enrolled with a history of total laryngectomy and voice rehabilitation, treated at the University Hospital of Catania from 1 January 2010 to 31 December 2018. Quality of life (QoL) evaluation through validated self-administrated questionnaires was performed. (3) Results: The Voice-Related Quality of Life questionnaire revealed significantly better outcomes in both socio-emotional and functional domains of the tracheoesophageal patient group compared to the esophageal group (p = 0.01; p = 0.01, respectively), whereas in the Voice Handicap Index assessment, statistically significant scores were not achieved (p = 0.33). (4) Discussion: The significant differences reported through the V-RQOL and Voice Handicap Index scales in the presence of fistula related problems and device lifetime reduction when compared to the oesophageal speech group have demonstrated, as supported by the literature, a crucial role in the rehabilitative prognosis. (5) Conclusions: The criteria of low resistance to airflow, optimal tracheoesophageal retention, prolonged device life, simple patient maintenance, and comfortable outpatient surgery are the reference standard for obtaining good QoL results, especially over time. Furthermore, the correct phenotyping of the patient based on the main outcomes achieved at clinical follow-up guarantees the primary objective of the identification of a better quality of life.
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Sadeghi, Zahra, Mohammadreza Afshar, Abbas Ebadi, Kowsar Baghban, and Zahra Sadat Qureshi. "Swallowing Disorder in Multiple Sclerosis: Modified Version of the Screening Tool." Journal of Rehabilitation 21, no. 2 (July 1, 2020): 236–55. http://dx.doi.org/10.32598/rj.21.2.3036.1.
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Objective: Dysphagia is commonly encountered in Multiple Sclerosis (MS). It can consequently cause severe complications such as the increased risk of dehydration, malnutrition and aspiration pneumonia that associated with an increased risk of death in the late stages of the disease. These complications can be prevented with an effective screening protocol. The Dysphagia in Multiple Sclerosis (DYMUS) is the only questionnaire developed specifically for patients with MS. The aim of the present study was translation and cross-culturally adaptation of DYMUS for the Persian population and estimation of the questionnairechr('39')s reliability and validity. Also, we investigated the frequency and severity of dysphagia in the patients referring to the Tehran MS Society and its association with the course of MS, disease duration, and Expanded Disability Status Scale (EDSS). Materials & Methods: This is a methodological and descriptive-analytic study. The statistical populations consist of the patients with MS referring to the Tehran Multiple Sclerosis Society in 2018. The study sample consisted of 108 patients who were selected through a convenient sampling method. The research instruments consisted of 10-items DYMUS questionnaire (in the first part of the study, translated and its psychometric properties examined), Dysphagia Handicap Index and a demographic information questionnaire. In methodological section, translation and cross-cultural adaptation were fulfilled and the Confirmatory Factor Analysis (CFA) was used to assess the construct validity and to test the goodness-of-fit of the presented model. The association between the DYMUS and Dysphagia Handicap Index (DHI) scores investigated to convergent validity. The inter-item correlation matrix was calculated to assess the homogeneity of the questionnaire items. Kuder - Richardson (KR-20) was measured to assess the internal consistency of the questionnaire. Also, the test-retest procedure was conducted on the 19 subjects understudy to assess the reliability. Finally, the frequency and severity of dysphagia and its association with the course of MS, disease duration, and EDSS was investigated. KR-20 reliability coefficient, Intraclass Correlation Coefficient (ICC), inter-item correlation matrix, Mann-Whitney U test and rank correlation coefficient or Spearmanchr('39')s were used to inferential statistical analysis. Results: Analysis of the inter-item correlations matrix indicated a positive correlation between all items, exception item 10. Based on the results of the inter-item correlation, item 10 had the lowest correlation coefficient that was deleted from the questionnaire. CFA results confirmed the two-factor model of DYMUS, “dysphagia for solids” and “dysphagia for liquids”, and revealed that the item 10 was minimally contributing to the measurement of "dysphagia of solids" and internal consistency increased after the deletion of this item. Also, the solution of the 9-item Model was the best goodness-of-fit indicator for the sample. The obtained results from the convergent validity indicated a positive significant correlation between the DYMUS and DHI (rs=0.693, P<0.001). A KR-20 reliability coefficient of the DYMUS was 0.856, indicating high internal consistency of the Persian translation of the questionnaire items. Test-retest reliability was excellent with 0.965 value. The results also showed that 65.7% of multiple sclerosis patients had a swallowing disorder. In terms of the dysphagia severity, 25.9% of participants had mild dysphagia, and 39.8% of participants had alarming dysphagia. DYMUS values were significantly correlated with disease duration (rs=0.198, P= 0.040), and EDSS (rs=0.235, P= 0.014) and significantly higher mean scores were observed in the patients with secondary progressive than the other subgroups of multiple sclerosis. Conclusion: The Persian adjusted 9-item questionnaire was demonstrated to be a simple, consistent, valid and reliable tool for the detection of patients who need more specific instrumental evaluations of swallowing. Also, about the dysphagia is very frequent in these patients, it is important that clinicians monitor these patients carefully even in early stages of the disease for early detection and planning a rehabilitation program to the prevention of serious subsequence complications.
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Soto-Varela, A., A. Faraldo-García, M. Del-Río-Valeiras, M. Rossi-Izquierdo, I. Vaamonde-Sánchez-Andrade, P. Gayoso-Diz, A. Lirola-Delgado, and S. Santos-Pérez. "Adherence of older people with instability in vestibular rehabilitation programmes: prediction criteria." Journal of Laryngology & Otology 131, no. 3 (January 16, 2017): 232–38. http://dx.doi.org/10.1017/s0022215116009932.
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AbstractObjective:To determine whether demographic characteristics or balance examination findings can predict the adherence of older people with instability to a vestibular rehabilitation programme.Methods:A prospective case–control study was conducted of 120 patients aged 65 years or more (mean age, 77.3 ± 6.33 years). Two groups were classified according to patients’ adherence with the follow-up post-rehabilitation protocol. Analysed variables included: age, sex, body mass index, Timed Up and Go test findings, computerised dynamic posturography, Dizziness Handicap Inventory scores and Short Falls Efficacy Scale – International questionnaire results, number of falls, and type of vestibular rehabilitation.Results:Two groups were established: adherents (99 individuals) and non-adherents (21 individuals). There were differences between the groups regarding: sex (female-to-male ratio of 4.8:1 in adherents and 1.63:1 in non-adherents), age (higher in non-adherents) and voluntary movement posturographic test results (non-adherents had poorer scores).Conclusion:The patients most likely to abandon a vestibular rehabilitation programme are very elderly males with low scores for centre of gravity balancing and limits of stability.