Summary
Objective
To examine the variability of lesion characteristics and vocal function in female
speakers with phonotraumatic vocal fold lesions (PVFLs).
Study Design
Prospective Cohort Study
Methods
Thirty adult female speakers with PVFL who were participating in voice therapy were
recruited to complete a multidimensional voice analysis at four time points across
1 month. Analysis comprised self-ratings of effort and vocal function, expert ratings
of videostroboscopy and audio recordings, and instrumental evaluation by selected
aerodynamic and acoustic parameters. The degree of variability across time for each
individual was assessed against a minimal clinically important difference threshold.
Results
A high degree of variability across time was observed for participant self-ratings
of perceived effort and vocal function, and for instrumental parameters. The greatest
degree of variability was observed in aerodynamic measures of airflow and pressure,
and the acoustic parameter semitone range. Comparatively less variability was observed
in perceptual evaluation of speech, and lesion characteristics via stroboscopy still images. Findings suggest that individuals with all PVFL types and
sizes present with variability in function across time, with the greatest degree of
variability in function observed in participants with large lesions and vocal fold
polyps.
Conclusion
Variability is observed in voice characteristics of female speakers with PVFLs across
1 month despite general stability in lesion presentation, suggesting vocal function
can change despite the presence of laryngeal pathology. This study highlights the
need to explore individual functional and lesion responses across time to determine
potential for change and improvement in both aspects when selecting treatment options.
Key words
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References
- Vocal fold wound healing: a review for clinicians.J Voice. 2006; 20: 432-442
- Vocal exercise may attenuate acute vocal fold inflammation.J Voice. 2012; 26 (814, e811-813)
- Voice rest and phonotrauma in singers.Med Probl Perform Art. 2012; 27: 165-168
- Patterns of recurrence of phonotraumatic vocal fold lesions suggest distinct mechanisms of injury.Laryngoscope. 2021; 131: 2523-2529
- Exudative laryngeal diseases of Reinke's Space: a clinicohistopathological framing.J Otolaryngol. 2002; 31: 376-380
- Voice outcomes following treatment of benign midmembranous vocal fold lesions using a nomenclature paradigm.Laryngoscope. 2016; 126: 415-420
- A nomenclature paradigm for benign midmembranous vocal fold lesions.Laryngoscope. 2012; 122: 1335-1341
- Changes in voice during a day in normal voices without vocal loading.Logoped Phoniatr Vocol. 2002; 27: 118-123
- Time-of-day effects on voice range profile performance in young, vocally untrained adult female.J Voice. 1999; 13: 518-528
- Test-retest reliability for aerodynamic measures of voice.J Voice. 2013; 27: 674-684
- Sex hormones and the female voice.J Voice. 1999; 13: 424-446
- Acoustic variability in the healthy female voice within and across days: how much and why?.J Speech Lang Hear Res. 2021; 64: 3015-3031
- Aerodynamic and acoustic voice measurements of patients with vocal nodules: variation in baseline and changes across voice therapy.J Voice. 2003; 17: 269-282
- Does a hormonal vocal cord cycle exist in women? study of vocal prementrual syndrome in voice performers by videostroboscopy-glottography and cytology on 38 women.J Voice. 1989; 3: 157-162
- Management of benign vocal fold lesions: current perspectives on the role for voice therapy.Curr Opin Otolaryngol Head Neck Surg. 2019; 27: 185-190
- Trends in the incidence and treatment of benign vocal fold lesions in korea, 2006-2015: a nationwide population-based study.J Voice. 2020; 34: 100-104
- VoiSS: a patient-derived voice symptom scale.J Psychosomatic Research. 2003; 54: 483-489
- On the EAVE: a new scale for self-evaluation of the physical aspects of speaking voice function. IALP.Voice Composium. 2021;
- A review of vocal loading tasks in the voice literature.J Voice. 2017; 31 (388.e333-388.e339)
- Voice-vibratory assessment with laryngeal imaging (VALI) form: reliability of rating stroboscopy and high-speed videoendoscopy.J Voice. 2017; 31 (513.e511-513.e514)
- Assessment of phonation threshold pressure: a critical review and clinical implications.Am J Speech-Language Pathol. 2011; 20: 348-366
- Measurement of phonation threshold power in normal and disordered voice production.Ann Otol Rhinol Laryngol. 2013; 122: 555-560
- Adult normative data for the KayPENTAX phonatory aerodynamic system model 6600.J Voice. 2012; 26: 164-176
- Learning voice analysis using an interactive multi-media package: developmentand preliminary evaluation.J Voice. 1998; 12: 500-551
- Minimal clinically important difference defining what really matters to patients.JAMA. 2014; 312: 1313-1322
- Minimal clinically important differences: review of methods.J Rheumatology. 2001; 28: 406-412
- Speaking fundamental frequencies of adult speakers of australian english and effects of sex, age, and geographical location.J Voice. 2020; 36 (434.e1-434.e15)
- Speech and voice range profiles of adults with untrained normal voices: methodological implications.Logoped Phoniatr Vocol. 2014; 39: 62-71
- The effectiveness of the glottal to noise excitation ratio for the screening of voice disorders.J Voice. 2010; 24: 47-56
- Influence of obligatory mouth breathing, during realistic activities, on voice measures.J Voice. 2012; 26 (813.e819-813.e813)
- Effects of a vocally fatiguing task and systemic hydration on phonation threshold pressure.J Voice. 2000; 14: 341-362
- Reliability and applicability of aerodynamic measures in dysphonia assessment.Clin Linguist Phon. 2004; 18: 463-478
- Consistency of acoustic and aerodynamic measures of voice production over 28 days under various testing conditions.J Voice. 1999; 13: 477-483
- Aerodynamic and electroglottographic measures of normal voice production: intrasubject variability within and across sessions.J Speech Lang Hear Res. 1994; 37: 38-45
Peat J. Health Science Research: A Handbook Of Quantitative Methods. Sydney: Allen & Unwin; 2001.
- The impact of a vocal loading task on voice characteristics of female speakers with benign vocal fold lesions.J Voice. 2021;
- The immediate impact of targeted exercises on voice characteristics in female speakers with phonotraumatic vocal fold lesions.J Voice. 2022; 1997: 00396-00399
- Collision and phonation threshold pressures before and after loud, prolonged vocalization in trained and untrained voices.J Voice. 2013; 27: 527-530
- Loud speech in realistic environmental noise: phonetogram data, perceptual voice quality, subjective ratings, and gender differences in healthy speakers.J Voice. 2005; 19: 29-46
- Maximum phonation time: variability and reliability.J Voice. 2010; 24: 281-284
- Assessment of dysphonia due to benign vocal fold lesions by acoustic and aerodynamic indices: a multivariate analysis.Logoped Phoniatr Vocol. 2011; 36: 21-27
- Phonation threshold pressure measurements during phonation by airflow interruption.Laryngoscope. 1999; 109: 425-432
- Characterization of primary muscle tension dysphonia using acoustic and aerodynamic voice metrics.J Voice. 2021; 1997: 00190-00199
- Glottal aerodynamic measures in women with phonotraumatic and nonphonotraumatic vocal hyperfunction.J Speech Lang Hear Res. 2017; 60: 2159-2169
Article info
Publication history
Published online: February 20, 2023
Accepted:
January 17,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
