Short summary

Benign organic voice disorders can be assessed, and monitored before and after treatment, with a battery of voice assessments measuring five different parameters of the voice, e.g. hoarseness and voice capacity. But there are no exact guidelines as to which of the five parameters are relevant to measure for each diagnosis. Our study aims to find out which parameters are affected by each diagnosis, and which parameters there are likely to change after surgery. This way, we will know how to make a standardized diagnose specific clinical voice assessment. 

Rationale

Voice disorders can be separated into organic (benign/malign), structural, neurogenic and functional disorders. The primary focus of this study is the benign organic voice disorders and the voice assessments used for diagnosis and monitoring treatment results on the voice. Thus, patients with voice disorders are our primary interest.

Voice assessments in Odense University Hospital are handled according to a set of international guidelines. Due to the multidimensional nature of the voice, five voice parameters are measured: perceptual rating, video stroboscopy, acoustic voice analysis, aerodynamic measurements, and subjective self-evaluation (by the patient). The analysis can measure the disorders effect on the voice, and also effects and side effects of treatment results on the voice and vocal folds. But there are no exact guidelines as to which of the five parameters are relevant to measure for each diagnosis. Our study aims to find out: 1) which parameters are affected by each diagnosis, and 2) which parameters there are likely to change after surgery. This way, we will know how to make a standardized diagnose specific clinical voice assessment.

Most previous studies of how voice disorders, and the treatment hereof, affects the voice, only includes some of the five parameters, rarely differentiates the various diagnoses different effects on the voice, or only include few patients. A systematic review from 2013 concludes, that more research are needed to expand the evidence base for clinical voice assessments and a compiled set of methods (Roy N, Barkmeier-Kraemer J, Eadie T, et al. Evidence-Based Clinical Voice Assessment: A Systematic Review. American Journal of Speech-Language Pathology. 2013;22(2):212-226). The knowledge gap of the diagnosis specific voice assessment complicates selection of relevant clinical measurement parameters, and furthermore the interpretation of results are less effective, due to a lack of certainty about which parameters are relevant to conduct for a given diagnosis.

The purpose is to assess how the voice is affected by:

The following eigth benign vocal fold lesions:

• Reinkes oedema
• Noduli plica vocalis
• Paresis nervus recurrens
• Polypus, plica vocalis
• Cystis plica vocalis
• Atrofia plica vocalis
• Sulcus vergeture vocalis
• Scarificeret plica vocalis
• The treatment hereof

The rationale is to provide knowledge of which voice parameters are relevant to assess for each patient/diagnosis.

Description of the cohort

We include all patients aged 3+ from Odense University Hospital (Odense and Svendborg) in the period 01-01-2017 to 31-12-2021, who undergo surgery for benign vocal fold lesions, and therefore also voice assessment. Power calculations show, that 35 patients are needed in each of the eight groups.

Data and biological material

The following data are analysed:

• Assessment variables registered by routine at visits in phoniatric-/voice analysis clinic:
• Stroboscopy, anamnese.
• Phonetogram: Speech Range Profile and Voice Range Profiles.
• Voice Handicap Index questionnaire.
• Phonation time.
• Forced Vital Capacity.
• Multi Dimensional Voice Programme-analysis, MDVP (prolonged vowel).
• Recording of prolonged vowels and reading of the text "Vinden og Solen" ["The Wind and the Sun"] for auditive analysis.

Endpoints: voice changes measured by the above mentioned seven variables.

Collaborating researchers and departments

Department of Otolaryngology, Odense University Hospital

• Clinical Associate Professor and Consultant Ågot Møller Grøntved
• PhD-student Trine Printz