Revue de laryngologie - otologie - rhinologie 

About: Revue de laryngologie - otologie - rhinologie is an academic journal. The journal publishes majorly in the area(s): Cholesteatoma & Middle ear. It has an ISSN identifier of 0035-1334. Over the lifetime, 1609 publications have been published receiving 8508 citations.

Differentiated perceptual evaluation of pathological voice quality: reliability and correlations with acoustic measurements.

Abstract: The perceptual GRBAS scale for deviant voice quality (completed with a "I" parameter: Instability = fluctuation of voice quality over time) was tested in 5 different institutes on 943 voice patients. Each voice was evaluated separately by 2 professionals. The interrater correlation reaches 0.87 for G (grade), 0.70 for R (roughness), 0.69 for B (breathiness) and 0.65 for A/S (asthenicity/strain). Experience with the scale significantly improves the interrater agreement. The intrarater correlation (80 voices; time interval 2-6 months) is systematically slightly stronger than the interrater correlation. Further, GIRBAS/acoustical correlations were investigated on 80 pathological voices, by using the Multidimensional Voice Program (MDVP) of Kay. Principal component analysis allows reduction of 21 MDVP parameters to 5 clinically relevant aspects, with a typical acoustical measurement for each of them. The strongest correlations are found between G and Shimmer/Noise to harmonics ratio, R and Jitter, and B and Shimmer. As tremor and diplophonia are easily identified perceptually and acoustically, it seems useful to add this information respectively to AS and R. The GIRBAS scale seems to be a valuable instrument for clinical practice.

[The Voice Handicap Index: impact of the translation in French on the validation].

Abstract: The aim of this prospective investigation was to validate a French version of the Voice Handicap Index (VHI). A population of 52 normal subjects and 63 patients with voice disorders replied to the questionnaire at the day of their first consultation and ten to thirty days after the consultation (before any treatment). Reproducing the methodology of the American authors, the test-retest reliability and the internal consistency reliability were measured. The validity and the sensibility related to a non dysphonic population were also analysed. Regarding the normal subjects, the maximum scores for total score and subscale scores were 20 (total), 12 (physical), 7 (functional), 6 (Emotional). These scores are statistically different when compared with pathological subjects (p 0.87). From this data set, the critical difference scores were derived for the VHI total score (15 points), for the physical subscale (9 points) and for the functional and emotional.subscales (6 points each). As for as the internal consistency reliability, Cronbach's alpha is correct (r > 7) for the pathological subjects. Yet, the analysis of the validity reply by reply, reveals some abnormalities. In conclusion, the validity of the French translation of the VHI is confirmed but the results prompt us to improve the quality of the translation.

Implementation of the European Laryngological Society (ELS) basic protocol for assessing voice treatment effect.

Abstract: Objectives 93 patients with various kinds of organic benign voice pathology (vocal fold nodules, polyp, Reinke's oedema, unilateral paralysis, sulcus/scar) and/or with muscle tension dysphonia, were evaluated before and after their voice treatment (phonosurgery with voice therapy, antireflux medication, or voice therapy alone) in order to check the clinical relevance of a basic multidimensional protocol for assessing functional results of voice treatments, as developed by the Committee on Phoniatrics of the ELS. Material and method The protocol has been used in different university voice clinics. It comprises 5 dimensions: Perception: Grade, Breathiness and Roughness from the GRBAS-scale, rated by two experienced judges: a phoniatrician/laryngologist and a speech therapist. Acoustics: Jitter % and Shimmer % computed on a /a:/, at comfortable loudness and pitch. Also Fo-range and softest possible intensity. Videostroboscopy: Glottal closure, regularity, mucosal wave and symmetry, rated separately. Phonation quotient: computed by dividing the vital capacity (ml) by the maximum phonation time (s) (best value of 2x3 trials). Self rating by the patient: voice quality in itself and general social/occupational handicap due to the voice problem rated separately. Results Results show that, at group level, the overall effects for each parameter indicate a significant improvement after treatment. However, the correlations between the pre/post changes for the different parameters are weak (low redundancy). Conclusion The assessment of voice pathology needs to be multidimensional, as these multidimensional informations about voice changes lead to a better understanding of the actual way in which a treatment works.

Benign paroxysmal vertigo: a comparative prospective study of the efficacy of Brandt and Daroff exercises, Semont and Epley maneuver.

Abstract: We performed a prospective study to evaluate the efficacy of three physical treatments for benign paroxysmal positional vertigo: Brandt & Daroff habituation exercises, the Semont manoevre (intended as a statoconia-detachment maneuver), and the Epley maneuver (intended as a statoconia-repositioning maneuver). A total of 106 BPPV patients were randomly assigned to one of the three treatment groups, and responses were evaluated one week, one month and three months after the initial treatment. At the one-week follow-up, similar cure rates were obtained with the Semont and Epley maneuver (74% and 71% respectively), both cure rates being significantly higher than that obtained with Brandt & Daroff exercises (24%). By the three-month follow-up, the cure rate obtained with the Epley maneuver was higher (93%) than that obtained with the Semont maneuver (77%), though both remained higher than that obtained with the Brandt & Daroff maneuver (62%). However, the proportion of initially responding patients showing subsequent relapse was lower among patients treated by the Semont maneuver than among patients treated by the Epley maneuver. In view of these findings, we propose a treatment algorithm for patients with BPPV.

Voice and emotion

Abstract: Voice and emotion are partly linked. The voice reacts to and translates emotion, but can also be seen as an instrument to release emotion. Emotion is a source of wealth for the voice, bringing it to life, giving it meaning and content. The voice, by serving emotion, enriches and enhances it.