Clinical implementation of a multidimensional basic protocol for assessing functional results of voice therapy. A preliminary study.

45 patients with various kinds of organic benignant voice pathology (vocal fold nodules, polyp, Reinke's oedema, unilateral paralysis, sulcus/scar) and/or with muscle tension disorders, for which a (pre-operative) functional voice therapy was indicated, were evaluated before and after this short period of voice therapy (4-26 sessions), in order to check a basic multidimensional protocol for assessing functional results of voice treatments, developed by the Committee on Phoniatrics of the ELS. Perception: Grade, Breathiness and Roughness from the GRBAS-scale, as rated by two experienced judges (0 = normal or absent; 3 = severely deviant or present). Acoustics: Jitter % and Shimmer % as computed by the MDVP program of Kay Elemetrics on a /a:/, at comfortable loudness and pitch. Also Fo-range and softest possible intensity were registered. Videostroboscopy: Glottal closure, regularity, mucosal wave and symmetry, as rated separately on visual analog scales of 10 cm by 2 experienced laryngologists. Phonation quotient: computed by dividing the vital capacity (ml) by the maximum phonation time (s) (best value of 2 x 3 trials). Self rating by the patient: voice quality in itself and general social/occupational handicap due to the voice problem were rated on 2 visual analog scales. Results show that there is a large variation in the interindividual and interdimensional results of the voice therapy: in a same patient, one dimension may be significantly improved while another one is significantly worsened. The 5 considered dimensions may be considered as low redundant.