Summary
Objective
Neck muscle dysfunction has been considered as risk factor or consequence of voice
disorders. This study investigates the correlation between neck and voice-related
subjective symptoms in patients with voice disorders.
Study Design
Retrospective case-control study.
Methods
100 adult patients (59 female and 41 male) over 18 years with a mean age of 50.01
years (SD 16, range 24–87), of which 68 were under 60 years, were included. 50 patients
had organic voice pathologies and 50 functional dysphonia. Outcome measures were the
Voice Handicap Index 9 international (VHI-9i) and the Neck Disability Index (NDI-G).
Spearman rank order coefficient was applied to determine the correlation between overall
and single item VHI and NDI results. Subanalyses were done for functional vs. organic
disorder, gender and age ± 60 years.
Results
Mean overall VHI-9i (13.93, SD = 7.81, range = 0–31) and mean NDI-G (6.07, SD = 7.71,
range = 0–43) showed a significant mild correlation (rs = 0.220, P = 0.02). Split into subgroups the relation was stronger in patients with organic
pathologies (rs = 0.297, P = 0.03), but not significant in functional disorders (r = 0.148, P = 0.30). There was a moderate relation in men (rs = 0.317, P = 0.04). Single item correlation was highest between VHI-9i item P4 (physiological)
and NDI-G item reading (cognitive functioning) (rs = 0.480, P = 0.002).
Conclusion
Specifically patients with organic voice disorders showed increased voice symptoms
with the presence of neck dysfunction. This indicates a risk for a functional imbalance
of the muscles surrounding the larynx, which in extreme cases may hinder functional
voice rehabilitation even after phonosurgery. Therefore, neck dysfunction should be
considered in voice diagnostics.
Key Words
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Article info
Publication history
Published online: December 12, 2018
Accepted:
October 29,
2018
Identification
Copyright
© 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.