Translation, Cross-Cultural Adaptation, and Validation of the Dyspnea Index Into Brazilian Portuguese.

Objective: To perform the cross-cultural adaptation and validation of the Dyspnea Index (DI) in Brazilian Portuguese (BP).

Methods: This validation study followed the Consensus-based Standards for the Selection of Health Measurement Instruments recommendations. The translation was conducted in five stages: translation, synthesis, back translation, committee review, and pretest performance.

The Patient Experience: The Relationship Between Vocal Handicap, Congruency, Perceived Present Control, and Mood Across Four Voice Disorders.

Objective: The potential for negative sequalae in psychosocial well-being presents clinical importance to the assessment of voice disorders. Despite the impairment voice disorders cause in the psychosocial domain, the clinical assessment of these disorders relies heavily on visual perceptual judgments of the larynx, audio-perceptual, as well as acoustic and aerodynamic measures. While these measures aid in accurate diagnosis and are necessary for standard of care, they present little insight into the patient experience of having a voice disorder.

Vocal fold injection material does not preclude interpretation of laryngeal electromyography.

Introduction/aims: Temporary vocal fold injection (VFI) is a common treatment for acute and subacute vocal fold paralysis (VFP). Laryngeal electromyography (LEMG) is useful for diagnosing neurogenic causes of VFP. This study evaluated whether the presence of VFI material prevents interpretation of LEMG in patients with acute and subacute VFP.

Conversation Training Therapy: Let's Talk It Through.

This article introduces a novel approach to voice therapy called conversation training therapy (CTT). CTT is the first voice therapy approach to remove the therapeutic hierarchy common in most treatment programs. Rather, CTT uses patient-driven conversation as the sole stimuli in therapy to increase perceptual awareness of voice production in conversational speech.

Mapping Meta-Therapy in Voice Interventions onto the Rehabilitation Treatment Specification System.

Meta-therapy refers to the clinical dialogue via which direct and indirect voice treatments are introduced and discussed, and which helps build a useful conceptual framework for voice therapy. Meta-therapy was idiosyncratically defined in previous work. However, the current colloquial narrative of meta-therapy is not standardized or specific enough to be reliably taught, rigorously studied, or clinically delivered with high fidelity.

Phonation With a Variably Occluded Facemask: Effects of Task Duration.

Objective: Semioccluded vocal tract (SOVT) exercises are routinely included in many voice therapy programs because they have been shown to improve acoustic, aerodynamic, and patient-reported voice outcomes. One limitation of the traditional SOVT exercise is that the nature of phonation through straws or semioccluded oral postures allows only for single phoneme production. A variably occluded facemask (VOFM) allows for use of articulated connected speech beyond the production of single phonemes, while still providing occlusion and, presumably, the vocal efficiency benefits that arise from it.

The prevalence of cognitive impairment in laryngology treatment-seeking patients.

Objectives/hypothesis: The incidence of cognitive impairment (CI) in the elderly general population is 10% to 20%. The incidence of CI in the elderly laryngology treatment-seeking population is unknown, and CI may impact decision making for elective medical/surgical treatment and negatively impact the outcome of voice/swallowing therapy. We sought to determine the prevalence of CI in elderly patients who are seeking laryngology care and to evaluate the feasibility of administering a cognitive screening instrument.

Age at diagnosis, but not HPV type, is strongly associated with clinical course in recurrent respiratory papillomatosis.

Background: Recurrent Respiratory Papillomatosis (RRP) is a rare disease characterized by the growth of papillomas in the airway and especially the larynx. The clinical course is highly variable among individuals and there is poor understanding of the factors that drive an aggressive vs an indolent course.

Methods: A convenience cohort of 339 affected subjects with papillomas positive for only HPV6 or HPV11 and clinical course data available for 1 year or more, from a large multicenter international study were included.

Characteristics and Voice Outcomes of Ulcerative Laryngitis.

Objectives: Ulcerative laryngitis (UL) is challenging in terms of treatment and patient counseling, with few reports in the literature. This study describes UL patients and their clinical course including detailed voice and stroboscopic outcomes after treatment which have not been described in previous literature.

Methods: Single-institution, retrospective review of 23 UL patients.

Effects of a Variably Occluded Face Mask on the Aerodynamic and Acoustic Characteristics of Connected Speech in Patients With and Without Voice Disorders.

Objective: This study reports on experiments designed to examine the effects of a variably occluded face mask (VOFM) on (a) estimated subglottal pressure (P) in normophonic participants and (b) aerodynamic and acoustic characteristics of voice in dysphonic participants.

Design: A prospective design was used for experiment 1, and a prospective, randomized cohort design was used for experiment 2.

Methods: The outlet ports of disposable anesthesia face masks were fitted with plastic caps with variable diameter drilled openings (9.

Aging Voice Index (AVI): Reliability and Validity of a Voice Quality of Life Scale for Older Adults.

Changes in voice in aging adults impact their ability to use their voice to communicate in all situations and can lead to decreased quality of life (QOL). The primary objective of this study was to determine the validity and reliability of the Aging Voice Index (AVI)-a tool specifically designed for aging adults with voice disorders. A total of 92 older adults were asked to complete the Voice-Related Quality of Life Scale (VRQOL) and the AVI as well as provide their self-perceived voice severity rating of their voice problem and demographic information.

Innervation status in chronic vocal fold paralysis and implications for laryngeal reinnervation.

Objective: Treatment options for symptomatic unilateral vocal fold paralysis (VFP) include vocal fold augmentation, laryngeal framework surgery, and laryngeal reinnervation. Laryngeal reinnervation (LR) has been suggested to provide "tone" to the paralyzed VF. This implies a loss of tone as a result of denervation without reinnervation.

Does CPAP Affect Patient-Reported Voice Outcomes?

Upper aerodigestive tract symptoms are common in patients with obstructive sleep apnea (OSA). It remains unclear whether continuous positive airway pressure (CPAP) improves or worsens these otolaryngology symptoms. As therapy-related side effects limit CPAP adherence, this study aimed to determine if CPAP negatively affects voice, sinonasal, and reflux symptoms of the upper airway.

Multidose Botulinum Toxin A for Intralaryngeal Injection: A Cost Analysis.

Objectives: Botulinum toxin A (BtxA) injection is the mainstay treatment for laryngeal dystonias. BtxA product labeling states that reconstituted toxin should be used within 4 hours on a single patient despite several studies that have demonstrated multidose BtxA to be safe and effective. Many insurance carriers mandate the use of an outside pharmacy which necessitates a single-use approach.

Minimal clinically important difference of voice handicap index-10 in vocal fold paralysis.

Objectives/hypothesis: The Voice Handicap Index-10 (VHI-10) is commonly used to measure patients' perception of vocal handicap. Clinical consensus has previously defined clinically meaningful improvement as a decrease ≥5. This study determines the minimal clinically important difference (MCID) for VHI-10 in patients with unilateral vocal fold paralysis (UVFP) using anchor-based methodology.

Adult normative data for phonatory aerodynamics in connected speech.

Objectives/hypothesis: To establish normative values for phonatory aerodynamic measurements in connected speech across adult ages and gender.

Study Design: Prospective data collection across group design.

Methods: One hundred fifty adults aged >18 years without voice complaints were stratified into three equal-age groups (group 1 [ages 18-39 years]; group 2 [ages 40-59 years], and group 3 [ages 60 + years]) and two equal-gender groups (male and female) resulting in 25 participants in each category.

Voice-Specialized Speech-Language Pathologist's Criteria for Discharge from Voice Therapy.

Objective: No standard protocol exists to determine when a patient is ready and able to be discharged from voice therapy. The aim of the present study was to determine what factors speech-language pathologists (SLPs) deem most important when discharging a patient from voice therapy. A second aim was to determine if responses differed based on years of voice experience.

Weaning of proton pump inhibitors in patients with suspected laryngopharyngeal reflux disease.

Objective: To evaluate the feasibility of a proton pump inhibitor (PPI) weaning protocol in a cohort of patients following successful empiric treatment for suspected laryngopharyngeal reflux disease (LPRD).

Study Design: Retrospective chart review.

Methods: LPRD patients were weaned from PPIs using a standardized weaning protocol.

Laryngeal distribution of recurrent respiratory papillomatosis in a previously untreated cohort.

Objectives/hypothesis: To describe the distribution of recurrent respiratory papillomatosis (RRP) lesions across 21 laryngeal anatomic regions in previously untreated patients at initial presentation to provide insight regarding the natural history of RRP.

Study Design: Multi-institutional, retrospective case series.

Methods: Initial laryngoscopic examination videos of 83 previously untreated patients with adult-onset RRP were reviewed.

An Examination of Pre- and Posttreatment Acoustic Versus Auditory Perceptual Analyses of Voice Across Four Common Voice Disorders.

Objective: The objective, instrumental acoustic measure of Cepstral Spectral Index of Dysphonia (CSID) correlates with audio-perceptual measures, is sensitive in detecting voice abnormalities, and tracks change following treatment. The goals of the current study were to (1) test the agreement between CSID versus auditory perceptual measures of pre- versus posttreatment voice change, and (2) investigate whether change in scores is based on voice disorder or phonemic structure of sentence stimuli.

Methods: Forty patients with benign voice disorders produced sentences and a sustained /a/ vowel from the Consensus Auditory Perceptual Evaluation of Voice protocol before and after treatment.

Effect of intralaryngeal muscle synkinesis on perception of voice handicap in patients with unilateral vocal fold paralysis.

Objectives/hypothesis: Intralaryngeal muscle synkinesis associated with unilateral vocal fold paralysis (UVFP) is thought to preserve thyroarytenoid-lateral cricoarytenoid muscle complex tone, resulting in a better voice despite the presence of vocal fold paralysis (VFP). This study compares voice handicap in patients with unilateral VFP (UVFP) with and without evidence of adductory synkinesis on laryngeal electromyography (LEMG).

Study Design: Retrospective review of LEMG data and Voice Handicap Index-10 (VHI-10) scores of patients diagnosed with permanent UVFP.

Evaluation of Vocal Fold Motion Abnormalities: Are We All Seeing the Same Thing?

Objectives: Flexible laryngoscopy is the principle tool for the evaluation of vocal fold motion. As of yet, no consistent, unified outcome metric has been developed for vocal fold paralysis/immobility research. The goal of this study was to evaluate vocal fold motion assessment (inter- and intra-rater reliability) among general otolaryngologists and fellowship-trained laryngologists.

False Vocal Fold Characteristics in Presbylarynges and Recurrent Laryngeal Neuropathy.

Objective: Conflicting data exist regarding false vocal fold (FVF) anatomy; it is unclear if this structure is an extension of the thyroarytenoid muscle or an independent muscle system. This confusion is amplified by diverse clinical findings in the setting of unilateral recurrent laryngeal neuropathy and presbylarynges. We sought to characterize FVF behavior in these contexts.

Singing voice outcomes following singing voice therapy.

Objectives/hypothesis: The objectives of this study were to describe singing voice therapy (SVT), describe referred patient characteristics, and document the outcomes of SVT.

Study Design: Retrospective.

Methods: Records of patients receiving SVT between June 2008 and June 2013 were reviewed (n = 51).