Publications by authors named "Woisard V"

Article Synopsis
  • Videofluoroscopic swallowing studies (VFSS) and flexible endoscopic evaluation of swallowing (FEES) are essential tools for diagnosing swallowing disorders, outlined in recently developed best practice guidelines.
  • An expert panel, including various healthcare professionals, created 18 consensus statements using an online Delphi method to standardize VFSS practices, covering aspects like planning, equipment, and radiation safety.
  • These guidelines aim to improve the quality of VFSS assessments across different regions by providing structured recommendations based on expert consensus from the European Society of Swallowing Disorders and the European Society of Gastrointestinal and Abdominal Radiology.
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Introduction: Salivary carcinomas of the tongue represent a therapeutic challenge as their radical excision is particularly mutilating. We aimed to study the oncologic and functional outcomes of advanced stages salivary carcinomas of the tongue.

Materials And Methods: This retrospective multicentric study, based on the French national network on rare head and neck cancers (REFCOR), included all patients with a T3-T4 salivary carcinoma of the tongue, diagnosed between January 2009 and December 2018.

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Perceptual measures, such as intelligibility and speech disorder severity, are widely used in the clinical assessment of speech disorders in patients treated for oral or oropharyngeal cancer. Despite their widespread usage, these measures are known to be subjective and hard to reproduce. Therefore, an M-Health assessment based on an automatic prediction has been seen as a more robust and reliable alternative.

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Background: Perceptual measures such as speech intelligibility are known to be biased, variant and subjective, to which an automatic approach has been seen as a more reliable alternative. On the other hand, automatic approaches tend to lack explainability, an aspect that can prevent the widespread usage of these technologies clinically.

Aims: In the present work, we aim to study the relationship between four perceptual parameters and speech intelligibility by automatically modelling the behaviour of six perceptual judges, in the context of head and neck cancer.

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Article Synopsis
  • Researchers wanted to see how well a special swallowing test called VFSS can find leaks in the throat after surgery to remove parts of the throat and voice box.
  • They looked at 248 patients who had this surgery and took the swallowing test about a week to two weeks later.
  • The test was pretty good at spotting leaks; it helped prevent future problems for many patients who had a positive test result.
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To date, no consensus exists on the complex clinical decision-making processes involved in oropharyngeal dysphagia, or swallowing disorders. This study aimed to develop an international consensus on a clinical decision tree for the disease trajectory of oropharyngeal dysphagia in adults, taking into account physiological impairments of swallowing, risk factors for the development of complications from oropharyngeal dysphagia, and prognostic factors for treatment outcomes. Using the Delphi technique, consensus was achieved among dysphagia experts across 31 countries, resulting in a total of 10 physiological impairments, 23 risk factors and 21 prognostic factors identified as relevant factors in the clinical decision-making process.

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The provision of quality healthcare relies on scales and measures with robust evidence of their psychometric properties. Using measurement instruments with poor reliability, validity, or feasibility, or those that are not appropriate for the target diagnostic group or construct/dimension under consideration, may be unfavorable for patients, unproductive, and hinder empirical advancement. Resources from the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) group can assist in identifying and developing psychometrically sound measures.

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Background: Multiple System Atrophy (MSA) dysphagia is routinely assessed by the Unified Multiple System Atrophy Rating Scale (UMSARS) part I-item 2.

Objective: To compare the UMSARS part I-item 2 with an ear/nose/throat (ENT) expert physician assessment.

Methods: We retrospectively analyzed the data of MSA patients who underwent an ENT assessment (nasofibroscopic and radioscopic exam) and an annual UMSARS assessment.

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Patients with chronic cough experience major alteration in their quality of life. Given its numerous etiologies and treatments, this disease is a complex entity. To help clinicians involved in patient management of patients, guidelines have been issued by a group of French experts.

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This article reports on vowel clarity metrics based on spectrotemporal modulations of speech signals. Motivated by previous findings on the relevance of modulation-based metrics for speech intelligibility assessment and pathology classification, the current study used factor analysis to identify regions within a bi-dimensional modulation space, the magnitude power spectrum, as in Elliott and Theunissen [(2009). PLoS Comput.

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Swallowing is a complex function that relies on both brainstem and cerebral control. Cerebral neurofunctional evaluations are mostly based on functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), performed with the individual laying down; which is a non-ecological/non-natural position for swallowing. According to the PRISMA guidelines, a review of the non-invasive non-radiating neurofunctional tools, other than fMRI and PET, was conducted to explore the cerebral activity in swallowing during natural food intake, in accordance with the PRISMA guidelines.

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Background: In head and neck cancer, many tools exist to measure speech impairment, but few evaluate the impact on communication abilities. Some self-administered questionnaires are available to assess general activity limitations including communication. Others are not validated in oncology.

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Introduction: Flexible endoscopic procedures (FEP) using a working channel allowed otolaryngologists to perform more procedures on the pharynx and the larynx under local anesthesia. The purpose of this work is to demonstrate the feasibility and safety of this technique by studying the adverse effects of this practice in an office-based setting.

Methods: This is a monocentric retrospective cohort study.

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Standard reading passages allow for the study of the integrated functions of speech and voice components in contextual, running speech, with target stimuli in a controlled environment. In both clinical practice and research, these texts provide rapid insight into the characteristics of the patient's speech, with fewer hesitations than in conversational speech and better predictability by the evaluator. Although a plethora of texts exist in different languages, they present various limitations.

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Purpose: The constitution of social circles around patients treated for cancer of the upper aerodigestive tract (UADT) has a major influence on factors that affect quality of life (QOL) but is poorly assessed, mainly due to a lack of tools. The objective of this study is to develop a questionnaire that assesses the constitution of social circles in a population treated for UADT cancer and to analyze the construct (structural and clinical validity) and criterion validity.

Methods: The Evaluation of the Constitution of Social Circles (ECSC) questionnaire was developed in French by a committee of experts.

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Introduction: Multiple system atrophy (MSA) is a rare degenerative neurological disorder in adults. It induces parkinsonian and/or cerebellar syndrome associated with dysautonomia. Pharyngolaryngeal symptoms are common.

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Background: Speech disorders impact quality of life for patients treated with oral cavity and oropharynx cancers. However, there is a lack of uniform and applicable methods for measuring the impact on speech production after treatment in this tumor location.

Objective: The objective of this work is to (1) model an automatic severity index of speech applicable in clinical practice, that is equivalent or superior to a severity score obtained by human listeners, via several acoustics parameters extracted (a) directly from speech signal and (b) resulting from speech processing and (2) derive an automatic speech intelligibility classification (i.

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Background: Intelligibility and comprehensibility in speech disorders can be assessed both perceptually and instrumentally, but a lack of consensus exists regarding the terminology and related speech measures in both the clinical and scientific fields.

Aims: To draw up a more consensual definition of intelligibility and comprehensibility and to define which assessment methods relate to both concepts, as part of their definition.

Methods & Procedures: A three-round modified Delphi consensus study was carried out among clinicians, researchers and lecturers engaged in activities in speech disorders.

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Objectives: Loss of intelligibility is a major complaint for patients with speech disorders, as it affects their everyday communication and thus contributes to a decrease in their quality of life. Several tests are available to measure intelligibility, but these tests do not take into account the evaluators' ability to restore distorted sequences. Due to this ability, the evaluator will tend to recognize words despite phonetic distortions, and speech production deficit can go undetected.

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Assessing the intelligibility of speech-disordered individuals generally involves asking them to read aloud texts such as word lists, a procedure that can be time-consuming if the materials are lengthy. This paper seeks to optimize such elicitation materials by identifying an optimal trade-off between the quantity of material needed for assessment purposes and its capacity to elicit a robust intelligibility metrics. More specifically, it investigates the effect of reducing the number of pseudowords used in a phonetic-acoustic decoding task in a speech-impaired population in terms of the subsequent impact on the intelligibility classifier as quantified by accuracy indexes (AUC of ROC, Balanced Accuracy index and F-scores).

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This White Paper by the European Society for Swallowing Disorders (ESSD) reports on the current state of screening and non-instrumental assessment for dysphagia in adults. An overview is provided on the measures that are available, and how to select screening tools and assessments. Emphasis is placed on different types of screening, patient-reported measures, assessment of anatomy and physiology of the swallowing act, and clinical swallowing evaluation.

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Objectives: To describe the diagnostic performance of Narrow Band Imaging (NBI) combined with White Light Imaging (WLI) in the diagnosis of mucosal lesions at each location of the upper aerodigestive tract, for detection of primary tumor in case of carcinoma of unknown primary, for determination of intraoperative resection margins, and to describe its main diagnostic pitfalls.

Material And Methods: A PubMed search was carried out according to the PRISMA method.

Results: Four hundred and seventy-seven articles published between 2007 and 2020 were identified, 133 of which met the study inclusion criteria and were assessed.

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The Deglutition Handicap Index (DHI) is a self-report measure for patients at risk of oropharyngeal dysphagia on deglutition-related aspects of functional health status (FHS) and health-related quality of life (HR-QoL). The DHI consists of 30 items which are subsumed within the Symptom, Functional and Emotional subscales. The purpose of this study was to evaluate the psychometric properties of the DHI using Classic Test Theory according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria.

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Article Synopsis
  • Speech assessment methods in clinical practice for adults vary greatly, with a heavy reliance on perceptual and motor evaluations, highlighting the importance of reliable measurements for effective treatment planning.
  • A survey of French-speaking speech and language pathologists (SLPs) revealed that many clinicians use a combination of informal assessments rather than standardized tests, with significant gaps noted in the use of pseudo-words and questionnaires.
  • Key shortcomings identified include a lack of objectivity, reproducibility, and comprehensive assessment tools, leading to general dissatisfaction among clinicians regarding the adequacy of current speech assessment practices.
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