Objective: 1) To describe patterns of Filipino Voice Handicap Index (VHI) scores in relation to the demographic data of dysphonic patients; 2) To describe patterns of Filipino VHI scores in relation to the different pathologies of dysphonia as determined by videostroboscopy. Methods: Design: Cross-sectional study. Setting: Tertiary Government Hospital. Population: Adult patients (?18 years old), proficient in Filipino. A group of 124 dysphonic patients seen at the Videostroboscopy Unit completed the Filipino VHI. Demographic data were collected. Videostroboscopy diagnoses were classified into six groups: normal, mass lesions, inflammatory, mucosal irregularities, functional and neurogenic. The T-test was used to determine differences in scores among the demographic parameters and the pathology groups. ANOVA one-way factor was used to determine difference of subscale scores within each pathology group, and to determine difference of pathology scores in each subscale. Differences were considered statistically significant if p<0.05. Results: Statistical analyses showed that Filipino VHI scores were affected by age, gender, educational status and occupation. Younger patients significantly scored higher than patients >40 years old. Females had significantly higher scores than males in the functional, physical and total subscales. Patients with lower educational status scored higher compared to college graduates. Voice professionals significantly scored higher than the non-voice professionals. Dysphonic patients significantly scored higher than normal volunteers. Among the pathological groups, neurogenic lesions had the highest scores. Physical subscale scores were significantly higher in all lesions except in functional lesions. Conclusion: The Filipino VHI is comparable to the other versions of the VHI, with patterns similar to other versions. It gives the clinician a measure of a dysphonic patient’s handicap, an is an invaluable tool in quantifying severity of dysphonia.
DYSPHONIA

Introduction: Bamboo node is a rare vocal cord pathology causing dysphonia among patients with autoimmune disorders. These “bamboo-joint-like” transverse deposits on the vocal cords interfere with the vibratory cycle during phonation leading to voice hoarseness. A review of Schwemmle from 1993-2009, showed seven cases of bamboo node among patients with mixed connective tissue disease (MCTD). With the patient’s consent, this case is presented to contribute to current knowledge about MCTD. Case Presentation: A 36-year-old Filipino female developed voice hoarseness one year after she was diagnosed with MCTD. Videostroboscopic findings revealed bilateral bamboo nodes, vibratory defects, and amplitude abnormalities. Treatment with prednisone, methotrexate, hydroxychloroquine, along with voice rest and speech therapy resulted in normalization of amplitude, mucosal wave and vibratory behavior during repeat videostroboscopy. Conclusion To date, this is the first known case of bamboo nodes associated with MCTD in a Filipino patient. This case highlights the importance of properly investigating the symptom of hoarseness among patients with rheumatologic diseases. A multidisciplinary approach involving the rheumatologist, otorhinolaryngologist, and speech therapist play an important role in the complete care of this patient.
Dysphonia

Characteristics of voice problems occurring with professional voice users are not too different from those with general public. However, they react sensitively to relatively subtle changes of voice and have strong demands for their treatments as well. Consequently, treatments for the professional voice users should be implemented in the form of team approach consisting of not only otolaryngologists with plenty of treatment experience and sufficient knowledge but also speech-language pathologist, vocal coach. While treating professional voice users is burdensome and a challenging problem even to otolaryngologists rich in experience, knowledge and experience obtained through treating them will be much help for voice treatments of other general public. In this article, the authors have reviewed approaches and treatment directions for voice problems occurring with professional voice users.
Dysphonia ; Voice

Rationale/Objective: The Voice Handicap Index (VHI) is a selfassessment tool that evaluates the patient’s reaction and perception to a vocal disorder. This study aimed to establish, validate and assess the reliability of the Filipino translation of the Voice Handicap Index 10 (FVHI-10). Methods: The VHI-10 was translated and adapted to the Filipino language and culture with the help of the Sentro ng Wikang Filipino- University of the Philippines Manila. A self-assessment of voice quality and FVHI-10 were performed by the patients and their GRBAS scale scoring was rated by a speech language pathologist. The Spearman’s correlation between the FVHI-10 and the self-assessment and GRBAS scale scores was obtained to test for validity. To evaluate the reliability of the FVHI-10, testing through determining internal consistency was conducted through the use of Chronbach α coefficient, inter-item correlation, item-total correlation and Cronbach α coefficient if tool item was deleted. Results: Fifty five individuals participated in the study (29 males, 26 females, age range: 30-55 years) with the diagnosis of voice disorder based on complaints of hoarseness or dysphonia and laryngoscopic findings. Convergent validity was confirmed with moderate to strong correlation between the FVHI-10 and self-assessment (r=-.893, p<.05) and GRBAS scale scores (r=.427, p<.05). Reliability as measured through internal consistency was confirmed (Cronbach α=.874) (average ρ<.5) (corrected item-total correlation>0.3) (average interitem correlation=.15-.85). Conclusion The FVHI-10 was determined to be a valid and reliable instrument that can be utilized in the assessment of Filipino patients with voice disorders.
Dysphonia ; Voice Disorders ; Quality of Life

This article addresses the roles of the speech language pathologist (SLP) for singers who require prompt and effective treatment when a voice problem arises. The causes of voice problem are often vocal abuse/misuse/overuse, muscle tension dysphonia and inappropriate singing technique. The SLP should conduct voice counseling and voice assessment for maintaining healthy voice of singer constantly.
Counseling ; Dysphonia ; Muscle Tonus ; Singing* ; Voice*

Dysphonia ; Humans ; Vocal Cords ; Voice Disorders

OBJECTIVES: We aimed to describe objectively the voice features of sulcus vocalis, thereby setting up some useful guidelines for its treatment. MATERIALS AND METHODS: The voices of thirty-seven sulcus vocalis pateints were analyzed. RESULTS: In the acoustic analysis, the fundamental frequency, jitter, and shimmer were significantly increased. Noise to harmonic ratio was also increased although it was not statistically significant. In the aerodynamic study, we found that maximal phonation time was decreased, whereas the mean air flow rate and subglottic pressure were increased. The glottic insuffiency on phonation, small vibratory mucosal wave and amplitude were frequently observed by videostroboscopy. CONCLUSION: The bowing of vocal fold edge results in an incomplete glottic closure during vibratory cycles. The increase in stiffness of the vocal fold edge during phonation results in small mucosal wave and small vibratory amplitude. Glottic insufficiency and stiffness of vibratory movement contribute to dysphonia of sulcus vocalis.
Acoustics ; Dysphonia ; Noise ; Phonation ; Vocal Cords ; Voice*

Botulinum toxin (BTX) has been widely used to treat muscle spasms in many voice disorders. Most commercially available forms of BTX require reconstitution before use, which may increase the risk of contamination and requires careful titration. Recently, a liquid-type BTX type A (BTX-A) has been developed, which should simplify the procedure and enhance its efficacy. In this session, I will discuss about the differences of BTX-A from existing types and the practical issues associated with it.
Botulinum Toxins ; Dysphonia ; Spasm ; Voice Disorders

Dysphonia/therapy* ; Humans ; Laryngeal Muscles/surgery*

Vocal fold injection is a procedure that has over a 100 year history but was rarely done as short as 20 years ago. A renaissance has occurred with respect to vocal fold injection due to new technologies (visualization and materials) and new injection approaches. Awake, un-sedated vocal fold injection offers many distinct advantages for the treatment of glottal insufficiency (vocal fold paralysis, vocal fold paresis, vocal fold atrophy and vocal fold scar). A review of materials available and different vocal fold injection approaches is performed. A comparison of vocal fold injection to laryngeal framework surgery is also undertaken. With proper patient and material selection, vocal fold injection now plays a major role in the treatment of many patients with dysphonia.
Atrophy ; Ceramics ; Dysphonia ; Humans ; Paralysis ; Paresis ; Vocal Cords