The proposal of this basic protocol is an attempt to reach better agreement and uniformity concerning the methodology for functional assessment of pathologic voices. The purpose is to allow relevant comparisons with the literature when presenting/publishing the results of voice treatment, e.g. a phonosurgical technique, or a new/improved instrument or procedure for investigating the pathological voice. Meta-analyses of the results of voice treatments are generally limited and may even be impossible owing to the major diversity in the ways functional outcomes are assessed. A multidimensional set of minimal basic measurements suitable for all "common" dysphonias is proposed. It includes five different approaches: perception (grade, roughness, breathiness), videostroboscopy (closure, regularity, mucosal wave and symmetry), acoustics (jitter, shimmer, Fo-range and softest intensity), aerodynamics (phonation quotient), and subjective rating by the patient. The protocol is elaborated on the basis of an exhaustive review of the literature, of the experience of the Committee members, and of plenary discussions within the European Laryngological Society. Instrumentation is kept to a minimum, but it is considered essential for professionals performing phonosurgery.
In GH-treated girls with TS, we discourage the use of the conventional Ox dosage (0.06 mg/kg . d) because of its low benefit to risk ratio. The addition of Ox 0.03 mg/kg . d modestly increases adult height gain and has a fairly good safety profile, except for some deceleration of breast development.
A standardized, perceptually based description of hoarseness is of importance for clinical purposes (e.g. therapy evaluation) as well as in research on voice disorders. The reliability and relevance of perceptual parameters are investigated. The GRBAS scale parameters quite well fit the criteria: low intrajudge and interjudge variance but high intervoice variance. The best correlation between judges (0.7) is found for the overall grade of severity. Impressions of the asthenicstrained voice quality are less consistent, but still show a significant interjudge correlation. The overall grade of severity seems to be mainly determined by the component breathiness. Roughness and breathiness are negatively correlated with each other. Tonus is correlated neither with roughness nor breathiness. The GRBAS profiles significantly differ between the different pathological groups.
A low correlation between the nasalance and the perceptual rating of hypernasality was found. The parameter overall grade of severity appeared to be determined mainly by the parameter intelligibility. Expertise in rating of cleft palate speech does not guarantee a high correlation between instrumental measurement and perceptual rating.
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