Grade of Dysphonia: Correlation with Patient Self-Assessment Questionnaire and Acoustic Measures

Abstract

Background:The vocal assessment process should consider the multidimensionality involved in the demonstration of a voice disorder. Auditory perceptual assessment is the most commonly used clinical voice assessment method (gold standard) for evaluation of voice disorders. However, it has been heavily criticized because it is subjective and classifies severity of vocal disorders but does not address the impact of the vocal disorder has on quality of life which may go beyond the level of perceived voice change. So, it is possible that self-assessment instruments capture a different aspect of the vocal function that cannot be derived from auditoryperceptual or acoustic analysis. Aim of Study:The aim of this work is to investigate the correlation between grade of dysphonia obtained by auditory perceptual assessment, acoustic measures and the degree of handicap a patient experiences (as measured by the Arabic VHI) as a result of their voice disorder. Study Design:This was a descriptive cross-sectional study.Patients and Methods: 70 adult patients with voice complaints referred for voice evaluation in the Unite of Phoniatrics, Ain Shams University were included in this study aged 18 years-60 years and 35 normal adult subjects as a control group. Auditory perceptual assessment, acoustic analysis, and application of Arabic VHI questionnaire were done for all cases.Results: A significant correlation was found between grade of dysphonia and functional subscale of the Arabic VHI. Significant correlation was found between grade of dysphonia and amplitude perturbation quotient (APQ%) and shimmer percent (Shim%).Significant correlation was found between Arabic VHI total score and average fundamental frequency (F0), significant correlation between functional subscale of the Arabic VHI and average fundamental frequency (F0) and jitter percent (Jitt%) and near significant correlation between physical subscale of the Arabic VHI and average fundamental frequency.Conclusion: Auditory perceptual assessment, acoustic analysis and patient's vocal self-assessment measure different aspects of the voice and are not interchangeable. These measures provide complementary rather than redundant information.