1.Influence of voice training combined with active breathing and circulation technique on voice recovery after vocal cord polyp surgery.
Yajie GUAN ; Wen HE ; Xiaohui DU ; Ming WU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(4):324-332
Objective:To explore the influence of voice training combined with active breathing and circulation techniques on voice recovery following vocal cord polyp surgery. Methods:A total of 110 patients who underwent vocal cord polyp surgery at our hospital from May 2022 to November 2023 were selected and randomly divided into a control group (n=55) and a combination group (n=55) using a random number table method. During the recovery period, both groups received dietary control and aerosol treatment. The control group participated in voice training, while the combination group received active breathing and circulation techniques in addition to voice training for 2 months. Morphological changes, voice acoustic indicators (Shimmer, Jitter, Maximum Phonation Time[MPT]), and the Voice Handicap Index (VHI) were compared between the two groups, and clinical efficacy was evaluated. Results:The combination group demonstrated higher clinical efficacy after training compared to the control group, with a statistically significant difference (P<0.05). The proportion of incomplete closure, abnormal mucosal wave, and supraglottic compensation decreased in both groups after training (P<0.05). However, there was no significant difference in the proportions of incomplete closure and abnormal mucosal wave between the two groups (P>0.05). Notably, the proportion of patients with supraglottic compensation in the combination group was lower than in the control group (P<0.05). After training, the Shimmer and Jitter values decreased in both groups, with the combination group exhibiting lower values (P<0.05). Conversely, the MPT values increased in both groups, again with higher values in the combination group (P<0.05). Additionally, after training, the functional, physiological, and emotional scores of the VHI decreased in both groups, with the scores in the combination group lower than those in the control group, demonstrating statistical significance (P<0.05). Conclusion:Voice training combined with active breathing and circulation techniques has a beneficial effect on recovery following vocal cord polyp surgery. This combined approach significantly improves vocal cord morphology and acoustic indices, alleviates voice disorders, and enhances overall voice recovery.
Humans
;
Vocal Cords/surgery*
;
Polyps/surgery*
;
Voice Training
;
Male
;
Female
;
Voice Quality
;
Laryngeal Diseases/surgery*
;
Voice
;
Middle Aged
;
Adult
;
Respiration
2.Analysis of factors related to voice training compliance.
Caipeng LIU ; Jinshan YANG ; Wenjun CHEN ; Xin ZOU ; Yajing WANG ; Yiqing ZHENG ; Faya LIANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(7):610-623
Objective:To explore the factors influencing adherence to voice therapy among patients with voice disorders in China. Methods:Patients with voice disorders who visited the Voice Therapy Center at Sun Yat-sen Memorial Hospital, Sun Yat-sen University, from February to May 2022 were enrolled in the study. Adherence was assessed using the URICA-Voice scale, while influencing factors were assessed through the Voice Handicap Index(VHI) scale and a general information questionnaire. Correlation analysis was conducted using univariate and multivariate logistic regression analysis. Results:A total of 247 patients were included in the study, comprising 57 males(23.08%) and 190 females(76.92%). The results revealed that: ①Female patients demonstrated higher likelihood of being in the contemplation stage(OR=0.22) compared to males. ②Patients with a monthly family income per capita>6 000 yuan were more likely to be in the contemplation stage than those with<3 000 yuan with an OR = 13.94. ③High vocal-demand occupations increased contemplation stage probability(OR=7.70) compared to moderate-demand occupations. ④Residence within 30-minute commute predicted action/maintenance stages(OR=7.14) versus≥60-minute commute. ⑤Patients whose occupations had high voice demands were more likely to be in the action and maintenance stages than those with average voice demands, with an OR of 16.20. Conclusion:Gender, monthly family income per capita, occupational voice demands, and distance to the hospital significantly impact the URICA-Voice compliance stages of patients. Patients who are female, have higher family income, have occupations with high voice demands, and live closer to the hospital exhibit higher compliance with voice training.
Humans
;
Male
;
Female
;
Voice Disorders/therapy*
;
Patient Compliance
;
Voice Training
;
Surveys and Questionnaires
;
China
;
Middle Aged
;
Adult
;
Voice Quality
;
Logistic Models
;
Aged
3.Advances in the assessment and management of voice disorders.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(8):699-702
Over the past decade, the assessment and management of voice disorders have witnessed remarkable progress. The assessment framework encompasses a multidimensional system that includes subjective audio-perceptual assessment, objective acoustic analysis, voice-related quality of life assessment, laryngoscopy and vocal fold vibration evaluation, aerodynamic analysis and laryngeal electromyography. In China, the Expert Consensus for Assessment of Vocal Function was published in 2024. Therapeutically, continuous refinement of phonomicrosurgical techniques, injection laryngoplasty, laryngeal framework surgery, and laryngeal reinnervation procedures has yielded favorable functional outcomes in phonation and swallowing. Voice therapy delivered either as an adjunct to surgery or as a standalone intervention-now plays an indispensable role in comprehensive voice care. In the future, voice disorders will be assessed more precisely, treated more effectively, and supported by more comprehensive rehabilitation.
Humans
;
Voice Disorders/diagnosis*
;
Quality of Life
;
Laryngoscopy
;
Voice Training
;
Voice Quality
;
Vocal Cords
;
Electromyography
;
Laryngoplasty
4.Analysis of vocal characteristics in hypopharyngeal cancer patients with vocal cord dysfunction.
Xiaohong LIU ; Guoyuan MU ; Nan CAO ; Na LI ; Minjuan YANG ; Yangjuan CHEN ; Xiaoying DU ; Xiaoyong REN ; Huanan LUO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(11):1056-1065
Objective:To analyze the acoustic characteristics of patients with hypopharyngeal cancer accompanied by vocal cord dysfunction. Methods:A retrospective analysis was conducted on the data of patients with hypopharyngeal cancer who were initially treated at The Second Affiliated Hospital of Xi'an Jiaotong University from January 2018 to April 2024. Patients who had completed electronic laryngoscopy, stroboscopic laryngoscopy, and voice analysis were selected from the data. Among them, patients with hypopharyngeal cancer who had unilateral vocal cord activity disorders were selected as the experimental group, while patients with symmetrical bilateral vocal cord activity were assigned to the control group. Then the clinical characteristics, the vocal parameters, and the stroboscopic laryngoscopy results of patients with hypopharyngeal cancer in the experimental group and the control group were analyzed and compared. Results:Compared with that in the control group, the proportion of lesions located on the inner wall of the piriform fossa in the experimental group increased(83.3% vs 53.8%), and the difference was statistically significant(P<0.05). There was no significant difference in vocal parameters such as SPL, Jitter, Shimmer, MPT, DSI, F0, sound intensity, electroglottic value and VHI between the experimental group and the control group(P>0.05). However, the values of F0, Jitter, Shimmer and VHI in the experimental group were higher than those in the control group. In addition, in terms of the results of stroboscopic laryngoscopy, the proportion of glottic insufficiency(42.9% vs 18.8%) and asymmetric arytenoid cartilage(64.3% vs 0) in the experimental group was significantly higher than that in the control group(P<0.05). However, the mucosal waves of the vocal cords on the affected side did not weaken in patients in both the experimental group and the control group. In the experimental group of 18 patients with hypopharyngeal cancer who received induction chemotherapy(nituzumab+nedaplatin+5-fluorouracil), 13 of them had improved vocal cord activity(improvement rate of 72.2%). Conclusion:Hypopharyngeal cancer in the medial wall of the pyriform fossa is more prone to vocal cord dysfunction, but vocal cord dysfunction has little effect on the vocal parameters of patients with hypopharyngeal cancer.
Humans
;
Hypopharyngeal Neoplasms
;
Retrospective Studies
;
Male
;
Female
;
Laryngoscopy
;
Middle Aged
;
Vocal Cord Dysfunction/etiology*
;
Vocal Cords/physiopathology*
;
Stroboscopy
;
Voice Quality
;
Aged
5.Voice health throughout the entire lifespan.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(12):1100-1103
Objective:Voice is a vital tool for human communication, and its health spans across various stages of an individual's life cycle. This article discuss the importance of voice health from a lifecycle perspective, exploring the needs of voice, phonatory organ changes, the main etiologies and their incidence, the impact on social function, and treatment of voice disorders at different stages (childhood, adolescence, adulthood, and old age). During childhood, due to incomplete vocal cords development and weak behavioral control, the incidence of voice disorders is high, which adversely affects children's psychological and social function development. The most common condition is vocal nodules, and there has been insufficient attention to the treatment of voice disorders in this stage. Voice disorders during adolescence are mainly related to physiological development and hormonal changes. In the elderly, the larynx undergoes structural and functional aging, which can be delayed with active intervention and treatment. Therefor, maintaining voice health should focus on preventing and managing voice problems throughout the entire life cycle, with targeted voice care and intervention at each stage. Establishing a comprehensive voice health management framework thereby upholds an individual's optimal health status and social function.
Humans
;
Voice Disorders/etiology*
;
Adolescent
;
Child
;
Adult
;
Voice/physiology*
;
Voice Quality
;
Vocal Cords
;
Aging/physiology*
;
Aged
6.The influence of vowel and sound intensity on the results of voice acoustic formant detection was analyzed.
Bing XIE ; Zhe LI ; Hongxing WANG ; Xuyuan KUANG ; Wei NI ; Runqi ZHONG ; Yan LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(12):1149-1153
Objective:This study aims to explore the influence of vowels and sound intensity on formant, so as to provide reference for the selection of sound samples and vocal methods in acoustic detection. Methods:Thirty-eight healthy subjects, 19 male and 19 female, aged 19-24 years old were recruited. The formants of different vowels(/a/, //, /i/ and /u/) and different sound intensities(lowest sound, comfort sound, highest true sound and highest falsetto sound) were analyzed, and pairings were compared between groups with significant differences. Results:①The vowels /a/ and // in the first formant were larger than /i/ and /u/, and /i/ was the largest in the second formant. The minimum value of the first formant is the lowest sound of /i/ and the maximum is the highest sound of /a/. ②In the first formant, the chest sound area increases with the increase of sound intensity, while the second formant enters the highest falsetto and decreases significantly. Conclusion:Different vowels and sound intensity have different distribution of formant, that is, vowel and sound intensity have different degree of influence on formant. According to the extreme value of the first formant, the maximum normal range is determined initially, which is helpful to improve the acoustic detection.
Humans
;
Male
;
Female
;
Young Adult
;
Speech Acoustics
;
Voice Quality
;
Phonetics
;
Voice/physiology*
;
Adult
7.Validation of the Filipino Voice Handicap Index-10 (FVHI-10)
Melfred L. Hernandez ; Diane Clarice M. Atienza ; Daryl Anne D. Madrid ; Michael C. Valdez
Philippine Journal of Surgical Specialties 2023;78(2):31-39
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
8.The effect of Wendler Glottoplasty to elevate vocal pitch in transgender women.
Chi ZHANG ; Qian HOU ; Ting Ting GUO ; Jing Ting ZHONG ; Hui REN ; Ge Lin LI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(2):139-144
Objective: To evaluate the effect of Wendler Glottoplasty to elevate vocal pitch in transgender women. Methods: The voice parameters of pre-and 3-month post-surgery of 29 transgender women who underwent Wendler Glottoplasty in department of otorhinolaryngology head and neck surgery of Beijing Friendship Hospital from January, 2017 to October, 2020 were retrospectively analyzed. The 29 transgender women ranged in age from 19-47 (27.0±6.3) years old. Subjective evaluation was performed using Transsexual Voice Questionnaire for Male to Female (TVQMtF). Objective parameters included fundamental frequency (F0), highest pitch, lowest pitch, habitual volume, Jitter, Shimmer, maximal phonation time (MPT), noise to harmonic ratio (NHR) and formants frequencies(F1, F2, F3, F4). SPSS 25.0 software was used for statistically analysis. Results: Three months after surgery, the score of TVQMtF was significantly decreased [(89.9±14.7) vs. (50.4±13.6), t=11.49, P<0.001]. The F0 was significantly elevated [(152.7±23.3) Hz vs. (207.7±45.9) Hz, t=-6.03, P<0.001]. Frequencies of F1, F2 and F3 were significantly elevated. No statistical difference was observed in the frequencies of F4. The highest pitch was not significantly altered while the lowest pitch was significantly elevated [(96.8±17.7) Hz vs. (120.0±28.9) Hz, t=-3.71, P=0.001]. Habitual speech volume was significantly increased [(60.0±5.2) dB vs. (63.6±9.6) dB, t=-2.12, P=0.043]. Jitter, Shimmer, NHR and MPT were not obviously altered (P>0.05). Conclusions: Wendler Glottoplasty could notably elevate the vocal pitch, formants frequencies and degree of vocal femininity in transgender women without affecting phonation ability and voice quality. It can be an effective treatment modality for voice feminization.
Humans
;
Male
;
Female
;
Young Adult
;
Adult
;
Middle Aged
;
Transgender Persons
;
Retrospective Studies
;
Speech Acoustics
;
Voice Quality
;
Phonation
9.Advances in application research on assessment methods of vocal fatigue.
Miao LI ; Jinlian ZENG ; Bixia LIANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(11):934-938
Vocal fatigue(VF) is the common clinical symptom of voice diseases. It can also be a separate symptom and is considered to be a signal for the body to rest and to avoid pathological damage to the vocal cords. Therefore, the early identification and evaluation of vocal fatigue is of great value to the early prevention and treatment of vocal diseases. In recent years, there are many researches on the evaluation methods of vocalization fatigue. We searched the relevant literature and summarized the application status of vocal fatigue assessment methods, in order to provide reference for the selection and development of vocal fatigue assessment tools in clinical practice.
Humans
;
Voice Quality
;
Voice Disorders/diagnosis*
;
Vocal Cords
;
Surveys and Questionnaires
;
Dysphonia/diagnosis*
10.Clinical analysis of 102 cases of pediatric vocal fold nodules.
Yihua NI ; Wenxia CHEN ; Zhengmin XU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):943-947
Objective:To evaluate the impact of vocal fold nodules on the quality of life of children, and to compare the efficacy between conservative management(voice hygiene education, etc.) and laryngeal microsurgery. Methods:A retrospective study was performed on 102 children with vocal fold nodules, who received treatment in Children's Hospital of Fudan University during the period from January 2020 to December 2022. According to the regime, the patients were divided into conservative management group and surgical treatment group; Cases are divided into pre-school age group (2-5 years old) and school-age group (6-12 years old) based on age. The pediatric voice-related quality of life (pVRQOL) was used to evaluate the impact of vocal fold nodules on the quality of life of children and differences in efficacy between two treatment regimens. Results:The pVRQOL scores of vocal fold nodule grades 1, 2, and 3 were 91.58±8.17, 78.87±12.49, 72.50±12.08, respectively. There were statistical differences between grade 1 and grade 2, and between grade 2 and grade 3. There were statistical differences between grade 1 grade 2, grade 2 and grade 3 (P<0.001), suggesting that the higher the rating of vocal cord nodules, the lower the pVRQOL score of patients was. The pVRQOL score of the school-age group was 69.83±11.11, which is lower than that of the preschool group(87.59±8.63), and the difference was statistically significant (P=0.042). Vocal fold nodules had a significant impact on the pVRQOL score of school-age children. In the conservative management group, the pVRQOL scores before and after treatment were 83.99±12.66 and 87.26±9.58, respectively, and there was significant difference between the two groups(P=0.046). Indirect voice therapy such as voice hygiene education could improve children's pVRQOL scores and was more effective for school-age children(P<0.001). The microsurgical treatment had a more significant improvement in the pVRQOL score of children. Conclusion:The higher the rating of vocal fold nodules, the greater the impact on the quality of life of patients. Vocal fold nodules had a greater impact on the quality of life of school-age children than that of preschool children. Voice hygiene education could improve the quality of life of children, which was more evident in the school-age group. Compared with voice hygiene therapy, laryngeal microsurgery had a more significant effect on improving the pVRQOL score of patients. It is recommended to undergo laryngeal microsurgery for the treatment of vocal fold nodules for the requirement of improving the quality of life related to voice. During the 6-month follow-up period after surgery in this study, the short-term efficacy of laryngeal microsurgery in treating vocal cord nodules in children is clear, but the long-term efficacy needs further research.
Child
;
Humans
;
Child, Preschool
;
Vocal Cords/pathology*
;
Quality of Life
;
Retrospective Studies
;
Voice Quality
;
Laryngeal Diseases/surgery*
;
Polyps/pathology*


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