Do Talkativeness and Vocal Loudness Correlate With Laryngeal Pathology? A Study of the Vocal Overdoer/Underdoer Continuum



      Assess the correlation between self-rating scales of talkativeness and loudness with various types of voice disorders.


      This is a retrospective study.


      A total of 974 patients were analyzed. The cohort study included 430 consecutive patients presenting to the senior author with voice complaints from December 1995 to December 1998. The case-control study added 544 consecutive patients referred to the same examiner from January 1988 to December 1998 for vocal fold examination before thyroid, parathyroid, and carotid surgery. Patient responses on seven-point Likert self-rating scales of talkativeness and loudness were compared with laryngeal disease.


      Mucosal lesions clearly associated with vibratory trauma are strongly associated with a high self-rating of talkativeness. Laryngeal deconditioning disorders were associated with a low self-rating of talkativeness.


      Use of a simple self-rating scale of vocal loudness and talkativeness during history taking can reliably orient the examiner to the types of voice disorders likely to be diagnosed subsequently during vocal capability testing and visual laryngeal examination. The high degree of talkativeness and loudness seen in vocal overdoers correlates well with mucosal disorders such as nodules, polyps, capillary ectasia, epidermoid inclusion cysts, and hemorrhage. A lower degree of talkativeness correlates with muscle deconditioning disorders such as vocal fold bowing, atrophy, presbyphonia, and vocal fatigue syndrome.

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        • Dikkers F.G.
        • Nikkels P.G.
        Benign lesions of the vocal folds: histopathology and phonotrauma.
        Ann Otol Rhinol Laryngol. 1995; 104: 698-703
        • Karkos P.D.
        • McCormick M.
        The etiology of vocal fold nodules in adults.
        Curr Opin Otolaryngol Head Neck Surg. 2009; 17: 420-423
        • Williams N.R.
        Occupational groups at risk of voice disorders: a review of the literature.
        Occup Med (Lond). 2003; 53: 456-460
        • Yano J.
        • Ichimura K.
        • Hoshino T.
        • Nozue M.
        Personality factors in pathogenesis of polyps and nodules of vocal cords.
        Auris Nasus Larynx. 1982; 9: 105-110
        • Ratajczak J.
        • Grzywacz K.
        • Wojdas A.
        • Rapiejko P.
        • Jurkiewicz D.
        Otolaryngol Pol. 2008; 62: 758-763
        • Roy N.
        • Holt K.I.
        • Redmond S.
        • Muntz H.
        Behavioral characteristics of children with vocal fold nodules.
        J Voice. 2007; 21: 157-168
        • Bastian R.W.
        Vocal fold microsurgery in singers.
        J Voice. 1996; 10: 389-404
        • El Uali Abeida M.
        • Fernandez Liesa R.
        • Valles Varela H.
        • Garcia Campayo J.
        • Rueda Gormedino P.
        • Ortiz Garcia A.
        Study of the influence of psychological factors in the etiology of vocal nodules in women.
        J Voice. 2013; 27: 129.e15-129.e20
        • Bastian R.W.
        The Vocal overdoer syndrome.
        Voice Speech Rev. 2001; 2: 135-138
        • Bastian R.W.
        Factors leading to successful evaluation and management of patients with voice disorders.
        Ear Nose Throat J. 1988; 67 (414-416, 418-20): 411-412
        • Milutinovic Z.
        • Vasiljevic J.
        Contribution to the understanding of the etiology of vocal fold cysts: a functional and histologic study.
        Laryngoscope. 1992; 102: 568-571
        • Bastian R.W.
        Chapter 62—benign vocal fold mucosal disorders.
        (1600 John F. Kennedy Blvd, Suite 1800)in: Flint P.W. Haughey B.H. Lund V.J. Niparko J.K. Richardson M.A. Robbins K.T. Thomas J.R. Cummings Otolaryngology Head and Neck Surgery. 6th ed. Mosby Elsevier, Philadelphia, PA2015 (19103-2899)
        • Tanaka S.
        • Hirano M.
        • Chijiwa K.
        Some aspects of vocal fold bowing.
        Ann Otol Rhinol Laryngol. 1994; 103: 357-362
        • D'Haeseleer E.
        • Depypere H.
        • Claeys S.
        • Baudonck N.
        • Van Lierde K.
        The impact of hormone therapy on vocal quality in postmenopausal women.
        J Voice. 2012; 26: 671.e1-671.e7
        • Bastian R.W.
        • Keidar A.
        • Verdolini-Marston K.
        Simple vocal tasks for detecting vocal fold swelling.
        J Voice. 1990; 4: 172