PROSPECTIVE STUDY OF VOICE THERAPY EFFECTIVENESS IN PATIENTS WITH DYSPHONIA: CASE SERIES

PROSPECTIVE STUDY OF VOICE THERAPY EFFECTIVENESS IN PATIENTS WITH DYSPHONIA: CASE SERIESAuthor: Alise Adovia1Scientific research supervisors: MD Dins Sumerags1,2, BD Mra Lokenbaha21 Rga Stradi University, Latvia2 P. Stradins Clinical University Hospital, Latvia

Dysphonia - voice disorder characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication or reduces voice-relatedquality of life.

Hoarseness affects nearly 1/3 of thepopulation at some point in their lives.

Seth R. Schwartz et al, Clinical practice guideline: Hoarseness (Dysphonia) OtolaryngologyHead and Neck Surgery, Vol 141, No 3S2, September 2009

Aim

Evaluate the effectiveness of voice therapy in patients, who used only this method for dysphonia treatment in Pauls Stradins Clinical University Hospital in year 2015

5 patients with different diagnosis were observed

1st therapeutic course 4 females, 1 male Non-smokers 4 6 workshops

At least 2 weeks period, 4 undrerwnt workshops4

Patient evaluationObjectiveMicrophone + PCInventis program DaisyFundamental frequencyJitter and shimmerHarmonics to noise ratioSpectrogramPhonetogramMax phonation time

SubjectiveQuestionnaire Voice handicap indexFuncionalPhysicalEmotionalGRBAS scoreGradeRoughnessBreathiness Asthenia Strain

Paresis n.recurrens dextra

BeforeAfter

----------------------------------------------------------------------------------Lucas Leon Oller, Analysis of Voice Signals for the Harmonics-to-Noise Crossover Frequency, 2008

Fundamental frequency (Fo) Jitter (Jt) Shimmer (Sh) Harmonics to noise ratio (HNR)

Amplitude/ distance7

BeforeAfter

Normal

Abnormal

BeforeAfter

Saturation/ fulfilment of overtones

9

Phonetogram voice range profileBefore

After

dBHzdBHz

Voice field10

Results Objective parameters have improved in all patients Most difficult vowel is [a - latvian] MPT was normal in 3 patients4 patients raised VHI score by self-assessment Different value of GRBAS score of patient and researcher

For a pure soundGRBAS tend to be the same kind after therapy11

Conclusions Voice therapy could be effective also as a single therapeutic method Objective and subjective values demonstrate improvement It is reasonable to include voice therapy in the therapeutic strategy Patient collaboration and motivation is essential

Due to the fact, that in this case study were evaluated small number of patients who has chosen voice therapy as a single therapeutic method and there are a lot of co-factors, that can change the results (e.g. patient attitude, individual practise, lifestyle) it is rather impossible to evaluate this therapy effectiveness in statistically significant way.

12

Thank you!

Alise Adovia