Pub Date : 2021-08-18DOI: 10.5005/jp-journals-10023-1195
Neha Raghuwanshi, Aparaajita Mundra, N. Dubey, Surbhi Godha, R. Mundra
A bstrAct Aims and objectives: Assessment of outcome of cases with benign vocal lesions treated by a combination of methods aimed at voice improvement, rather than only cure of lesion. Materials and methods: A prospective study was conducted in the Department of Otorhinolaryngology, MGM Medical College and Maharana Yashwant Rao Holkar Hospital, Indore from October 2018 to March 2020. We selected 85 patients in the age group of 18–60 years with complaints of hoarseness of voice and in whom benign vocal fold lesions were observed on stroboscopy. Pretreatment analysis was done by video-stroboscopy and voice analysis by a combination of simple subjective and objective parameters. Treatment was planned individually for each case from a variety of available modalities, with vocal fold exercises being the essential part of the plan in each case. After 2 months from the initiation of therapy, the analysis was repeated and compared with initial observations. The data were recorded and compared using paired t -test. Results: Statistically significant ( p < 0.05) improvement was observed in all the parameters of stroboscopic and voice analysis. Conclusion: The contemporary approach of benign vocal fold lesions is aimed at cure of lesion with the achievement of the best possible voice outcome. This makes voice therapy an essentially irreplaceable part of the treatment plan. Clinical significance: Establishment of the importance of voice therapy and patient cooperation in the treatment of hoarseness.
{"title":"Stroboscopic and Voice Analysis for Outcome Assessment of Intervention in Cases with Benign Vocal Fold Lesions","authors":"Neha Raghuwanshi, Aparaajita Mundra, N. Dubey, Surbhi Godha, R. Mundra","doi":"10.5005/jp-journals-10023-1195","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1195","url":null,"abstract":"A bstrAct Aims and objectives: Assessment of outcome of cases with benign vocal lesions treated by a combination of methods aimed at voice improvement, rather than only cure of lesion. Materials and methods: A prospective study was conducted in the Department of Otorhinolaryngology, MGM Medical College and Maharana Yashwant Rao Holkar Hospital, Indore from October 2018 to March 2020. We selected 85 patients in the age group of 18–60 years with complaints of hoarseness of voice and in whom benign vocal fold lesions were observed on stroboscopy. Pretreatment analysis was done by video-stroboscopy and voice analysis by a combination of simple subjective and objective parameters. Treatment was planned individually for each case from a variety of available modalities, with vocal fold exercises being the essential part of the plan in each case. After 2 months from the initiation of therapy, the analysis was repeated and compared with initial observations. The data were recorded and compared using paired t -test. Results: Statistically significant ( p < 0.05) improvement was observed in all the parameters of stroboscopic and voice analysis. Conclusion: The contemporary approach of benign vocal fold lesions is aimed at cure of lesion with the achievement of the best possible voice outcome. This makes voice therapy an essentially irreplaceable part of the treatment plan. Clinical significance: Establishment of the importance of voice therapy and patient cooperation in the treatment of hoarseness.","PeriodicalId":221737,"journal":{"name":"International Journal of Phonosurgery & Laryngology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115477473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-18DOI: 10.5005/jp-journals-10023-1197
J. Menon, Arya Raviraj, A. S. Mathew
Aim and objective: To determine the demographic and clinical characteristics, disease type, and appropriate treatment for laryngeal amyloidosis. Materials and methods: A retrospective descriptive study was conducted which included the data of 16 patients who had a laryngeal lesion which was excised and diagnosed as amyloidosis on histopathological examination, evaluated for systemic disease, and followed up. Demographic details, symptomatology, videolaryngoscopic examination findings, disease type, and treatment modality were analyzed. Results: The male:female ratio was 1:1.29. The mean age of patients was 35.19 ± 6.76 years, with 87.5% aged between 30 years and 40 years. The mean duration of symptoms was 5.44 ± 4.53 months, ranging from 2 to 12 months. Symptoms included hoarseness of voice (62.5%) and dyspnea (37.5%). Lesions were located in the supraglottis (50%), subglottis (37.5%), and glottis (12.5%). Macroscopically, 25% of lesions were polypoid and 75% were infiltrative. Microlaryngeal excision of the lesion was performed using cold steel instruments in 68.75% of cases and coblation assisted in 31.25% of cases. On immunohistochemistry, 93.75% were AL type and 6.25% were AA type. All cases were the primary localized type. All patients were followed up regularly. One recurrence and thus revision surgery aided with laser was recorded. Conclusion: The diagnosis of laryngeal amyloidosis requires a high index of suspicion based on its clinical features. The localized laryngeal disease can be successfully treated by endoscopic excision of the lesion using either cold steel instrumentation, laser or coblation, as was performed in our study with favorable results. The importance of continued long-term follow-up is emphasized in view of a high predilection for recurrence in amyloidosis.
{"title":"Laryngeal Amyloidosis: A Decadal Experience","authors":"J. Menon, Arya Raviraj, A. S. Mathew","doi":"10.5005/jp-journals-10023-1197","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1197","url":null,"abstract":"Aim and objective: To determine the demographic and clinical characteristics, disease type, and appropriate treatment for laryngeal amyloidosis. Materials and methods: A retrospective descriptive study was conducted which included the data of 16 patients who had a laryngeal lesion which was excised and diagnosed as amyloidosis on histopathological examination, evaluated for systemic disease, and followed up. Demographic details, symptomatology, videolaryngoscopic examination findings, disease type, and treatment modality were analyzed. Results: The male:female ratio was 1:1.29. The mean age of patients was 35.19 ± 6.76 years, with 87.5% aged between 30 years and 40 years. The mean duration of symptoms was 5.44 ± 4.53 months, ranging from 2 to 12 months. Symptoms included hoarseness of voice (62.5%) and dyspnea (37.5%). Lesions were located in the supraglottis (50%), subglottis (37.5%), and glottis (12.5%). Macroscopically, 25% of lesions were polypoid and 75% were infiltrative. Microlaryngeal excision of the lesion was performed using cold steel instruments in 68.75% of cases and coblation assisted in 31.25% of cases. On immunohistochemistry, 93.75% were AL type and 6.25% were AA type. All cases were the primary localized type. All patients were followed up regularly. One recurrence and thus revision surgery aided with laser was recorded. Conclusion: The diagnosis of laryngeal amyloidosis requires a high index of suspicion based on its clinical features. The localized laryngeal disease can be successfully treated by endoscopic excision of the lesion using either cold steel instrumentation, laser or coblation, as was performed in our study with favorable results. The importance of continued long-term follow-up is emphasized in view of a high predilection for recurrence in amyloidosis.","PeriodicalId":221737,"journal":{"name":"International Journal of Phonosurgery & Laryngology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124020146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-18DOI: 10.5005/jp-journals-10023-1196
S. Gala, Sanjay Gala, K. Gala
A laryngocele is an abnormal dilation of the laryngeal saccule going up into the false vocal fold that is usually air-filled and communicates with the laryngeal lumen with an incidence of about 1 in 2.5 million. These can be internal or combined laryngoceles and presentation depends on the type and size of the laryngocele. Small laryngoceles may be asymptomatic and may be incidentally detected. Management depends on the type, extent, and presentation and it ranges from close observation to surgical excision externally or microlaryngoscopically. We discuss a case of a large combined laryngocele that was managed using an external approach with complete resolution.
{"title":"Combined Laryngocele: A Rare Case Report","authors":"S. Gala, Sanjay Gala, K. Gala","doi":"10.5005/jp-journals-10023-1196","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1196","url":null,"abstract":"A laryngocele is an abnormal dilation of the laryngeal saccule going up into the false vocal fold that is usually air-filled and communicates with the laryngeal lumen with an incidence of about 1 in 2.5 million. These can be internal or combined laryngoceles and presentation depends on the type and size of the laryngocele. Small laryngoceles may be asymptomatic and may be incidentally detected. Management depends on the type, extent, and presentation and it ranges from close observation to surgical excision externally or microlaryngoscopically. We discuss a case of a large combined laryngocele that was managed using an external approach with complete resolution.","PeriodicalId":221737,"journal":{"name":"International Journal of Phonosurgery & Laryngology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133853426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-18DOI: 10.5005/jp-journals-10023-1193
G. Kapre, N. Nerurkar, F. Dikkers
{"title":"Organizing a Webinar during a Viral Pandemic","authors":"G. Kapre, N. Nerurkar, F. Dikkers","doi":"10.5005/jp-journals-10023-1193","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1193","url":null,"abstract":"","PeriodicalId":221737,"journal":{"name":"International Journal of Phonosurgery & Laryngology","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124623369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-18DOI: 10.5005/jp-journals-10023-1191
R. Bradoo, A. Joshi, N. Dhorje, Kanchan R. Rupwate, Devika S Arora
Aims and objectives: (1) To examine vocal symptoms and acoustic changes perceived within 24 hours after endotracheal intubation and (2) to find the association between these changes and endotracheal tube (ET) parameters and determine which parameter affects voice the most. Materials and methods: A prospective analysis of 75 patients was done. They were examined preoperatively, and 2 and 24 hours postoperatively. The vocal symptoms of hoarseness, vocal fatigue, loss of voice, throat clearing (hawking), globus pharyngeus, throat pain, and the acoustic variables mainly average fundamental frequency, shimmer, harmonic noise ratio (HNR), and maximum phonation time (MPT) were assessed. The ET parameters considered were duration of anesthesia, number of attempts at intubation, size of the tube, ET cuff volume, and mean cuff pressure. Results: Approximately 60% of patients with cuff volume above 3 cm 3 and 80% of patients with more than two intubation attempts developed postoperative vocal fatigue, while 70% with mean cuff pressure above 20 cm of water developed postoperative hawking. Conclusion: The ET parameters, mean cuff pressure, and ET cuff volume are the most important variables that are associated with the increase in vocal symptoms. An increase in the value of these parameters is associated with more postoperative discomfort.
{"title":"Assessing the Short-term Effects of Endotracheal Intubation on Voice Change and Acoustic Parameters: A Prospective Observational Study","authors":"R. Bradoo, A. Joshi, N. Dhorje, Kanchan R. Rupwate, Devika S Arora","doi":"10.5005/jp-journals-10023-1191","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1191","url":null,"abstract":"Aims and objectives: (1) To examine vocal symptoms and acoustic changes perceived within 24 hours after endotracheal intubation and (2) to find the association between these changes and endotracheal tube (ET) parameters and determine which parameter affects voice the most. Materials and methods: A prospective analysis of 75 patients was done. They were examined preoperatively, and 2 and 24 hours postoperatively. The vocal symptoms of hoarseness, vocal fatigue, loss of voice, throat clearing (hawking), globus pharyngeus, throat pain, and the acoustic variables mainly average fundamental frequency, shimmer, harmonic noise ratio (HNR), and maximum phonation time (MPT) were assessed. The ET parameters considered were duration of anesthesia, number of attempts at intubation, size of the tube, ET cuff volume, and mean cuff pressure. Results: Approximately 60% of patients with cuff volume above 3 cm 3 and 80% of patients with more than two intubation attempts developed postoperative vocal fatigue, while 70% with mean cuff pressure above 20 cm of water developed postoperative hawking. Conclusion: The ET parameters, mean cuff pressure, and ET cuff volume are the most important variables that are associated with the increase in vocal symptoms. An increase in the value of these parameters is associated with more postoperative discomfort.","PeriodicalId":221737,"journal":{"name":"International Journal of Phonosurgery & Laryngology","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127147130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-18DOI: 10.5005/jp-journals-10023-1194
Indranil Chatterjee, Lorna Das, Aniruddha Majumdar, Susmi Pani, B. P. Hota
Introduction: Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive muscular tension in the perilaryngeal areas (Roy and Leeper). Laryngeal manual therapy (LMT) is one of the direct approaches of voice therapy that involves kneading the laryngeal area without voicing to reduce hyperfunction of the muscles and improve the quality of voice. Aims and objectives: The present study was conducted to determine the outcome of LMT in females with MTD by comparing assessment data between pre-therapy, immediate post-LMT, and 1 week after LMT. Materials and methods: Ten females (20–40 years) with MTD were taken. Palpatory assessment, Dr Speech (Version 4), GRBAS scale, and voice handicap index (VHI) were used for voice evaluation. First, a pre-therapy assessment of all the voice parameters was collected. Second, LMT was carried out. Immediately after LMT, post-LMT data collection was done. No intervention was given following LMT. After 1 week of LMT, again data collection was done. Results: A significant reduction in vocal parameters of jitter, shimmer, and NNE ( p < 0.05) were found after LMT except for Mean Fo ( p > 0.05). Hoarseness was reduced. A significant difference was found between VHI measures ( p < 0.05), GRBAS scale ( p < 0.05), and palpatory assessment ( p < 0.05) in pre-LMT, immediate post-LMT, and 1-week post-LMT. Conclusion: The present study would assist to determine the therapeutic efficacy of direct voice therapy and in predicting voice therapy outcomes in persons with MTD.
{"title":"Determining the Outcome of Laryngeal Manual Therapy in Female Subjects with Muscle Tension Dysphonia: An Experimental Study","authors":"Indranil Chatterjee, Lorna Das, Aniruddha Majumdar, Susmi Pani, B. P. Hota","doi":"10.5005/jp-journals-10023-1194","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1194","url":null,"abstract":"Introduction: Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive muscular tension in the perilaryngeal areas (Roy and Leeper). Laryngeal manual therapy (LMT) is one of the direct approaches of voice therapy that involves kneading the laryngeal area without voicing to reduce hyperfunction of the muscles and improve the quality of voice. Aims and objectives: The present study was conducted to determine the outcome of LMT in females with MTD by comparing assessment data between pre-therapy, immediate post-LMT, and 1 week after LMT. Materials and methods: Ten females (20–40 years) with MTD were taken. Palpatory assessment, Dr Speech (Version 4), GRBAS scale, and voice handicap index (VHI) were used for voice evaluation. First, a pre-therapy assessment of all the voice parameters was collected. Second, LMT was carried out. Immediately after LMT, post-LMT data collection was done. No intervention was given following LMT. After 1 week of LMT, again data collection was done. Results: A significant reduction in vocal parameters of jitter, shimmer, and NNE ( p < 0.05) were found after LMT except for Mean Fo ( p > 0.05). Hoarseness was reduced. A significant difference was found between VHI measures ( p < 0.05), GRBAS scale ( p < 0.05), and palpatory assessment ( p < 0.05) in pre-LMT, immediate post-LMT, and 1-week post-LMT. Conclusion: The present study would assist to determine the therapeutic efficacy of direct voice therapy and in predicting voice therapy outcomes in persons with MTD.","PeriodicalId":221737,"journal":{"name":"International Journal of Phonosurgery & Laryngology","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115164814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-18DOI: 10.5005/jp-journals-10023-1192
A. Agarwal, Shruti Dhingra, Ruchika Juneja
Aim and objective: To discuss a rare case of supraglottic paraganglioma presenting as stridor and its management. Background: Paragangliomas are tumors anatomically arising from the dispersed neuroendocrine system (paraganglia), derived from the neural crest of the autonomic ganglia and characterized by similar neurosecretory cells. They are rarely seen in larynx. Most cases have polypoidal presentation in the endolarynx and diagnosis is usually confirmed after histopathology. Case description: We present a rare case of laryngeal paraganglioma in which the patient presented with stridor and was successfully treated by open laryngofissure approach leading to excision of the tumor with complete preservation of laryngeal function. Conclusion: Paragangliomas of the larynx are vascular benign tumors and can have varied presentations. Familiarity with these rare masses is essential for the treating otolaryngologist to prevent an inadvertent biopsy. A carefully selected surgical approach helps preserve adequate laryngeal function and decreases the risk of recurrence.
{"title":"Supraglottic Laryngeal Paraganglioma: A Rare Entity","authors":"A. Agarwal, Shruti Dhingra, Ruchika Juneja","doi":"10.5005/jp-journals-10023-1192","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1192","url":null,"abstract":"Aim and objective: To discuss a rare case of supraglottic paraganglioma presenting as stridor and its management. Background: Paragangliomas are tumors anatomically arising from the dispersed neuroendocrine system (paraganglia), derived from the neural crest of the autonomic ganglia and characterized by similar neurosecretory cells. They are rarely seen in larynx. Most cases have polypoidal presentation in the endolarynx and diagnosis is usually confirmed after histopathology. Case description: We present a rare case of laryngeal paraganglioma in which the patient presented with stridor and was successfully treated by open laryngofissure approach leading to excision of the tumor with complete preservation of laryngeal function. Conclusion: Paragangliomas of the larynx are vascular benign tumors and can have varied presentations. Familiarity with these rare masses is essential for the treating otolaryngologist to prevent an inadvertent biopsy. A carefully selected surgical approach helps preserve adequate laryngeal function and decreases the risk of recurrence.","PeriodicalId":221737,"journal":{"name":"International Journal of Phonosurgery & Laryngology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130506737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-27DOI: 10.5005/JP-JOURNALS-10023-1190
J. Mathew, M. Gowri, Swapna Sebastian, R. Sundaresan, Rajiv C. Micheal
Introduction: Communication plays a dynamic role in human life in developing a relationship with others. Laryngectomy can limit the effectiveness in communication and in turn result in limitation of activities and active participation in social life. Of the three methods for voice restoration after total laryngectomy followed today, tracheoesophageal (TE) speech which is a surgical voice restoration (SVR) method has become the standard of care. Literature review reveals that there are conflicting results regarding the quality of speech produced using TE speech. Materials and methods: The present investigation was designed to explore the speech intelligibility and communication-related quality of life (QOL) in TE speakers and also to examine correlations between speech intelligibility scores and QOL in tracheoesophageal puncture (TEP) speakers. Results: Speech intelligibility ratings of our patients revealed that on average the rating score was 2.13 which places them into the category— “connected speech could be understood with little effort”. Speech (word) intelligibility score revealed a mean of 94.73%. There was a positive correlation between speech (word) intelligibility score, and scores obtained on the speech intelligibility rating scale. Scores obtained on Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) by our patients fall between the scores for well-adjusted and poorly adjusted according to original SECEL data. There was no positive correlation between speech intelligibility (word) scores or the speech intelligibility rating scale scores with SECEL. Discussion/conclusion: Our study revealed that TE speech by SVR helps the patients in producing speech with sufficient intelligibility to communicate well with their family and friends but more challenging with strangers. The fact that no correlation was found between SECEL scores with the speech intelligibility measurements points toward the fact that speech intelligibility measures are assessed under quiet conditions and do not consider the effect of background noise in communication situations encountered in everyday environments. In addition, it reflects that even though good communication skills are important for socialization with the community around them, other factors like the self-esteem and person’s personality, family, education, wealth, religious beliefs, and the environment may also contribute to the overall QOL and hence it is essential that these psychosocial aspects are also addressed during rehabilitation. International Journal of Phonosurgery & Laryngology (2020):
{"title":"Speech Intelligibility and Communication-related Quality of Life in Tracheoesophageal Speakers","authors":"J. Mathew, M. Gowri, Swapna Sebastian, R. Sundaresan, Rajiv C. Micheal","doi":"10.5005/JP-JOURNALS-10023-1190","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10023-1190","url":null,"abstract":"Introduction: Communication plays a dynamic role in human life in developing a relationship with others. Laryngectomy can limit the effectiveness in communication and in turn result in limitation of activities and active participation in social life. Of the three methods for voice restoration after total laryngectomy followed today, tracheoesophageal (TE) speech which is a surgical voice restoration (SVR) method has become the standard of care. Literature review reveals that there are conflicting results regarding the quality of speech produced using TE speech. Materials and methods: The present investigation was designed to explore the speech intelligibility and communication-related quality of life (QOL) in TE speakers and also to examine correlations between speech intelligibility scores and QOL in tracheoesophageal puncture (TEP) speakers. Results: Speech intelligibility ratings of our patients revealed that on average the rating score was 2.13 which places them into the category— “connected speech could be understood with little effort”. Speech (word) intelligibility score revealed a mean of 94.73%. There was a positive correlation between speech (word) intelligibility score, and scores obtained on the speech intelligibility rating scale. Scores obtained on Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) by our patients fall between the scores for well-adjusted and poorly adjusted according to original SECEL data. There was no positive correlation between speech intelligibility (word) scores or the speech intelligibility rating scale scores with SECEL. Discussion/conclusion: Our study revealed that TE speech by SVR helps the patients in producing speech with sufficient intelligibility to communicate well with their family and friends but more challenging with strangers. The fact that no correlation was found between SECEL scores with the speech intelligibility measurements points toward the fact that speech intelligibility measures are assessed under quiet conditions and do not consider the effect of background noise in communication situations encountered in everyday environments. In addition, it reflects that even though good communication skills are important for socialization with the community around them, other factors like the self-esteem and person’s personality, family, education, wealth, religious beliefs, and the environment may also contribute to the overall QOL and hence it is essential that these psychosocial aspects are also addressed during rehabilitation. International Journal of Phonosurgery & Laryngology (2020):","PeriodicalId":221737,"journal":{"name":"International Journal of Phonosurgery & Laryngology","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130375425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-27DOI: 10.5005/JP-JOURNALS-10023-1189
A. Joshi, Susan P Chacko, V. Dave
Ab s t r Ac t Introduction: Acoustic measurements are the most widely studied of all voice measures. Our study aimed to determine the accuracy of acoustic analysis as an objective tool for evaluating patients with voice disorders. Materials and methods: A descriptive cross-sectional study with a total of 73 patients was analyzed using Dr Speech software. Results: When the vocal parameters were compared between normal subjects and patients with vocal cord diseases, significant differences were seen in most of the parameters like jitter, shimmer, Normalized Noise Energy (NNE), Harmonic to Noise Ratio (HNR), Signal to Noise Ratio (SNR) along with a statistically significant difference in voice quality scores like harsh voice, hoarse voice, and breathy voice. Conclusion: Hence, from our study, it can be said that acoustic analysis is a reliable objective tool for evaluating voice disorders.
{"title":"Acoustic Analysis: An Objective Tool in Evaluating Patients with Voice Disorders","authors":"A. Joshi, Susan P Chacko, V. Dave","doi":"10.5005/JP-JOURNALS-10023-1189","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10023-1189","url":null,"abstract":"Ab s t r Ac t Introduction: Acoustic measurements are the most widely studied of all voice measures. Our study aimed to determine the accuracy of acoustic analysis as an objective tool for evaluating patients with voice disorders. Materials and methods: A descriptive cross-sectional study with a total of 73 patients was analyzed using Dr Speech software. Results: When the vocal parameters were compared between normal subjects and patients with vocal cord diseases, significant differences were seen in most of the parameters like jitter, shimmer, Normalized Noise Energy (NNE), Harmonic to Noise Ratio (HNR), Signal to Noise Ratio (SNR) along with a statistically significant difference in voice quality scores like harsh voice, hoarse voice, and breathy voice. Conclusion: Hence, from our study, it can be said that acoustic analysis is a reliable objective tool for evaluating voice disorders.","PeriodicalId":221737,"journal":{"name":"International Journal of Phonosurgery & Laryngology","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121872827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.5005/jp-journals-10023-1170
S. Saha, X. A. Dev
Ab s t r Ac t Aim: To assess the preference of the different modalities of post-laryngectomy speech rehabilitation in patients and review the outcome parameters of esophageal speech and tracheoesophageal puncture (TEP) prosthesis modalities in comparison with the corresponding existing data. Materials and methods: A longitudinal prospective study conducted over a period of 1 year in the Department of ENT and Head-Neck Surgery in a tertiary care hospital. Patients of advanced laryngeal malignancies that were planned for total laryngectomy were included in this surgery. Based on the patients’ choice different modalities were adopted and the patients were followed up with regular training. Maximum takers were for esophageal speech followed by TE puncture and prosthesis insertion, and the outcomes in these two modalities were evaluated in detail. Six outcome parameters were assessed for the patients and consolidated. Then they were compared with the corresponding values obtained from previous studies to arrive at the results. Results: A total of ten cases of total laryngectomy was studied during the period of study. It was found that greater patient preference was for the TEP prosthesis modality. The mean frequency of phonation, mean intensity for vowels, and word production per minute in the TEP prosthesis were almost 80% of that seen in the esophageal prosthesis group. The most significant difference was in mean maximum phonation time which was only 37% of that seen in the TEP prosthesis group. Conclusion: In the present scenario until more advanced modalities of post-laryngectomy speech rehabilitation become more easily accessible to and affordable for the economically weaker sections of the society, esophageal speech modality is a dependable alternative. Further with proper training and follow-up, results with esophageal prosthesis are promising.
{"title":"A Study of Rehabilitation of Speech in Post-laryngectomy Cases, as Seen in a Tertiary Care Institution of Esophageal Speech vs Speech with Tracheoesophageal Puncture Prosthesis","authors":"S. Saha, X. A. Dev","doi":"10.5005/jp-journals-10023-1170","DOIUrl":"https://doi.org/10.5005/jp-journals-10023-1170","url":null,"abstract":"Ab s t r Ac t Aim: To assess the preference of the different modalities of post-laryngectomy speech rehabilitation in patients and review the outcome parameters of esophageal speech and tracheoesophageal puncture (TEP) prosthesis modalities in comparison with the corresponding existing data. Materials and methods: A longitudinal prospective study conducted over a period of 1 year in the Department of ENT and Head-Neck Surgery in a tertiary care hospital. Patients of advanced laryngeal malignancies that were planned for total laryngectomy were included in this surgery. Based on the patients’ choice different modalities were adopted and the patients were followed up with regular training. Maximum takers were for esophageal speech followed by TE puncture and prosthesis insertion, and the outcomes in these two modalities were evaluated in detail. Six outcome parameters were assessed for the patients and consolidated. Then they were compared with the corresponding values obtained from previous studies to arrive at the results. Results: A total of ten cases of total laryngectomy was studied during the period of study. It was found that greater patient preference was for the TEP prosthesis modality. The mean frequency of phonation, mean intensity for vowels, and word production per minute in the TEP prosthesis were almost 80% of that seen in the esophageal prosthesis group. The most significant difference was in mean maximum phonation time which was only 37% of that seen in the TEP prosthesis group. Conclusion: In the present scenario until more advanced modalities of post-laryngectomy speech rehabilitation become more easily accessible to and affordable for the economically weaker sections of the society, esophageal speech modality is a dependable alternative. Further with proper training and follow-up, results with esophageal prosthesis are promising.","PeriodicalId":221737,"journal":{"name":"International Journal of Phonosurgery & Laryngology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116875949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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