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Research Article| Volume 34, ISSUE 3, P371-379, May 2020

Cervical Spine Disability in Correlation with Subjective Voice Handicap in Patients With Voice Disorders: A Retrospective Analysis

  • Anke Langenfeld
    Affiliations
    Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Integrative Spinal Research ISR, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland
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  • Jörg E. Bohlender
    Affiliations
    Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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  • Jaap Swanenburg
    Affiliations
    Physiotherapy Occupational Therapy Research, Directorate of Research and Education, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Integrative Spinal Research ISR, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland
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  • Meike Brockmann-Bauser
    Correspondence
    Address correspondence and reprint requests to Meike Brockmann-Bauser, Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland.
    Affiliations
    Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
    Search for articles by this author
Published:December 12, 2018DOI:https://doi.org/10.1016/j.jvoice.2018.10.013

      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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