The Experts below are selected from a list of 3243 Experts worldwide ranked by ideXlab platform
Gaelyn C Garrett - One of the best experts on this subject based on the ideXlab platform.
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factors associated with Voice Therapy outcomes in the treatment of presbyphonia
Laryngoscope, 2010Co-Authors: Barbara H Jacobson, Gaelyn C GarrettAbstract:Objectives/Hypothesis: Age, vocal fold atrophy, glottic closure pattern, and the burden of medical problems are associated with Voice Therapy outcomes for presbyphonia. Study Design: Retrospective. Methods: Records of patients seen over a 3-year period at a Voice center were screened. Inclusion criteria consisted of age over 55 years, primary complaint of hoarseness, presence of vocal fold atrophy on examination, and absence of laryngeal or neurological pathology. Videostroboscopic examinations on initial presentation were reviewed. Voice Therapy outcomes were assessed with the American Speech-Language-Hearing Association National Outcomes Measurement System scale. Statistical analysis was performed with Spearman rank correlation and χ2 tests. Results: Sixty-seven patients were included in the study. Of the patients, 85% demonstrated improvement with Voice Therapy. The most common type of glottic closure consisted of a slit gap. Gender or age had no effect on Voice Therapy outcomes. Larger glottic gaps on initial stroboscopy examination and more pronounced vocal fold atrophy were weakly correlated with less improvement from Voice Therapy. A weak correlation was also found between the number of chronic medical conditions and poorer outcomes from Voice Therapy. Conclusions: The degree of clinician-determined improvement in vocal function from Voice Therapy is independent of patient age but is influenced by the degree of vocal fold atrophy, glottic closure pattern, and the patient's burden of medical problems. Laryngoscope, 2010
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utility of Voice Therapy in the management of vocal fold polyps and cysts
Otolaryngology-Head and Neck Surgery, 2007Co-Authors: Seth M Cohen, Gaelyn C GarrettAbstract:Objective To evaluate the efficacy of Voice Therapy in the management of vocal fold polyps and cysts. Study Design and Setting Retrospective review of vocal fold cysts and polyps undergoing Voice Therapy in a tertiary care center. Symptom resolution or persistence resulting in surgical intervention was the main outcome measure. Results Fifty-seven patients were identified, of which 49.1% achieved symptom resolution with Voice Therapy alone. Patients with complete glottal closure and muscle tension dysphonia did not have a better response than those with incomplete glottal closure and without muscle tension dysphonia ( P = 0.1, χ 2 , respectively). Patients with translucent polyps more commonly responded to Voice Therapy than fibrotic, hyaline, or hemorrhagic polyps, 81.8% versus 15.4% and 25.0% response rate, respectively ( P = 0.002, χ 2 ). Conclusions Voice Therapy is an effective treatment modality for vocal fold polyps and cysts. Significance A multidisciplinary approach including a trial of Voice Therapy is warranted.
Seth M Cohen - One of the best experts on this subject based on the ideXlab platform.
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perceived control Voice handicap and barriers to Voice Therapy
Journal of Voice, 2019Co-Authors: Viann N Nguyenfeng, Patricia A Frazier, Seth M Cohen, Stephanie MisonoAbstract:SUMMARY Objective To characterize the associations of perceived control with Voice outcomes and self-reported likelihood of attending Voice Therapy using a national practice-based research network. Study design Cross-sectional study of prospectively enrolled adult patients seen for dysphonia. Setting Creating Healthcare Excellence through Education and Research (CHEER) network of community and academic practice sites. Subjects and methods Data collected included patient-reported demographics, outcome measures of Voice (Voice Handicap Index-10), perceived control (present control subscale of Voice-specific Perceived Control over Stressful Events Scale), personality (Ten Item Personality Inventory), likelihood of attending Voice Therapy if recommended, and barriers to attending Voice Therapy. Results Patients (N = 247) were enrolled over 12 months from 10 sites, of whom 170 received a recommendation for Voice Therapy. The majority (85%) of this group planned to attend Voice Therapy. Voice-specific perceived control and VHI-10 were inversely related (r = −0.31, P Conclusions Patients scoring higher on a Voice-specific measure of perceived control reported less Voice handicap, independent of personality, and higher perceived control was associated with having fewer concerns about Voice Therapy goals and process. Perceived control is a potential target for intervention in patients with Voice disorders.
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factors influencing likelihood of Voice Therapy attendance
Otolaryngology-Head and Neck Surgery, 2017Co-Authors: Stephanie Misono, Schelomo Marmor, Seth M CohenAbstract:ObjectiveTo identify factors associated with the likelihood of attending Voice Therapy among patients referred for it in the CHEER (Creating Healthcare Excellence through Education and Research) practice-based research network infrastructure.Study DesignProspectively enrolled cross-sectional study.SettingCHEER network of community and academic sites.MethodsData were collected on patient-reported demographics, Voice-related diagnoses, Voice-related handicap (Voice Handicap Index–10), likelihood of attending Voice Therapy (VT), and opinions on factors influencing likelihood of attending VT. The relationships between patient characteristics/opinions and likelihood of attending VT were investigated.ResultsA total of 170 patients with various Voice-related diagnoses reported receiving a recommendation for VT. Of those, 85% indicated that they were likely to attend it, regardless of Voice-related handicap severity. The most common factors influencing likelihood of VT attendance were insurance/copay, relief that...
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utility of Voice Therapy in the management of vocal fold polyps and cysts
Otolaryngology-Head and Neck Surgery, 2007Co-Authors: Seth M Cohen, Gaelyn C GarrettAbstract:Objective To evaluate the efficacy of Voice Therapy in the management of vocal fold polyps and cysts. Study Design and Setting Retrospective review of vocal fold cysts and polyps undergoing Voice Therapy in a tertiary care center. Symptom resolution or persistence resulting in surgical intervention was the main outcome measure. Results Fifty-seven patients were identified, of which 49.1% achieved symptom resolution with Voice Therapy alone. Patients with complete glottal closure and muscle tension dysphonia did not have a better response than those with incomplete glottal closure and without muscle tension dysphonia ( P = 0.1, χ 2 , respectively). Patients with translucent polyps more commonly responded to Voice Therapy than fibrotic, hyaline, or hemorrhagic polyps, 81.8% versus 15.4% and 25.0% response rate, respectively ( P = 0.002, χ 2 ). Conclusions Voice Therapy is an effective treatment modality for vocal fold polyps and cysts. Significance A multidisciplinary approach including a trial of Voice Therapy is warranted.
F Ottaviani - One of the best experts on this subject based on the ideXlab platform.
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multidimensional assessment of vocal changes in benign vocal fold lesions after Voice Therapy
Auris Nasus Larynx, 2013Co-Authors: Antonio Schindler, Francesco Mozzanica, P Maruzzi, Murat Atac, Valeria De Cristofaro, F OttavianiAbstract:Abstract Objective To evaluate through a multidimensional protocol Voice changes after Voice Therapy in patients with benign vocal fold lesions. Methods 65 consecutive patients affected by benign vocal fold lesions were enrolled. Depending on videolaryngostroboscopy the patients were divided into 3 groups: 23 patients with Reinke's oedema, 22 patients with vocal fold cysts and 20 patients with gelatinous polyp. Each subject received 10 Voice Therapy sessions and was evaluated, before and after Voice Therapy, through a multidimensional protocol including videolaryngostroboscopy, perception, acoustics, aerodynamics and self-rating by the patient. Data were compared using Wilcoxon signed-rank test. Kruskal–Wallis test was used to analyse the mean variation difference between the three groups of patients. Mann–Whitney test was used for post hoc analysis. Results Only in 11 cases videolaryngostroboscopy revealed an improvement of the initial pathology. However a significant improvement was observed in perceptual, acoustic and self-assessment ratings in the 3 groups of patients. In particular the parameters of G, R and A of the GIRBAS scale, and the noise to harmonic ratio, Jitter and shimmer scores improved after rehabilitation. A significant improvement of all the parameters of Voice Handicap Index after rehabilitation treatment was found. No significant difference among the three groups of patients was visible, except for self-assessment ratings. Conclusion Voice Therapy may provide a significant improvement in perceptual, acoustic and self-assessed Voice quality in patients with benign glottal lesions. Utilization of Voice Therapy may allow some patients to avoid surgical intervention.
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vocal improvement after Voice Therapy in the treatment of benign vocal fold lesions
Acta Otorhinolaryngologica Italica, 2012Co-Authors: Antonio Schindler, D Ginocchio, Francesco Mozzanica, P Maruzzi, Murat Atac, F OttavianiAbstract:Benign vocal fold lesions are common in the general population, and have important public health implications and impact on patient quality of life. Nowadays, phonomicrosurgery is the most common treatment of these lesions. Voice Therapy is generally associated in order to minimize detrimental vocal behaviours that increase the stress at the mid-membranous vocal folds. Nonetheless, the most appropriate standard of care for treating benign vocal fold lesion has not been established. The aim of this study was to analyze Voice changes in a group of dysphonic patients affected by benign vocal fold lesions, evaluated with a multidimensional protocol before and after Voice Therapy. Sixteen consecutive patients, 12 females and 4 males, with a mean age of 49.7 years were enrolled. Each subject had 10 Voice Therapy sessions with an experienced speech/language pathologist for a period of 1-2 months, and was evaluated before and at the end of Voice Therapy with a multidimensional protocol that included self-assessment measures and videostroboscopic, perceptual, aerodynamic and acoustic ratings. Videostroboscopic examination did not reveal resolution of the initial pathology in any case. No improvement was observed in aerodynamic and perceptual ratings. A clear and significant improvement was visible on Wilcoxon signed-rank test for the mean values of Jitt%, Noise to Harmonic Ratio (NHR) and Voice Handicap Index (VHI) scores. Even if it is possible that, for benign vocal fold lesions, only a minor improvement of Voice quality can be achieved after Voice Therapy, rehabilitation treatment still seems useful as demonstrated by improvement in self-assessment measures. If Voice Therapy is provided as an initial treatment to the patients with benign vocal fold lesions, this may lead to an improvement in the perceived Voice quality, making surgical intervention unnecessary. This is one of the first reports on the efficacy of Voice Therapy in the management of benign vocal fold lesions; further studies are needed to confirm these preliminary data.
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vocal improvement after Voice Therapy in unilateral vocal fold paralysis
Journal of Voice, 2008Co-Authors: Antonio Schindler, Alessandro Bottero, Pasquale Capaccio, D Ginocchio, Fulvio Adorni, F OttavianiAbstract:Summary Unilateral vocal fold paralysis (UVFP) is associated with changes in acoustic and aerodynamic Voice measurements and can have a significant impact on a patient's quality of life. Few objective data regarding the efficacy of Voice Therapy for UVFP exist. The aim of this study was to retrospectively analyze Voice modifications in a group of patients with UVFP before and after Voice Therapy. Forty patients with UVFP of different etiology were included in the study. Each subject had Voice Therapy with an experienced speech/language pathologist twice a week; the mean number of sessions was 12.6. A multidimensional assessment protocol was used; it included videoendoscopy, the maximum phonation time (MPT), the GIRBAS scale, spectrograms and a perturbation analysis, and the Voice Handicap Index (VHI). Pre- and posttreatment data were compared by means of the Wilcoxon and Student's t tests. A complete glottal closure was seen in 8 patients before Voice Therapy and in 14 afterward. Mean MPT increased significantly. In the perceptual assessment, the difference was significant for five out of six parameters. A significant improvement was found on spectrographic analysis; as for perturbation analysis, the differences in jitter, shimmer, and noise-to-harmonic ratio values were significant. VHI values showed a clear and significant improvement. A significant improvement of Voice quality and quality of life after Voice Therapy is an often reached and reasonable goal in patients with UVFP.
Susan Miller - One of the best experts on this subject based on the ideXlab platform.
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Voice Therapy for vocal fold paralysis
Otolaryngologic Clinics of North America, 2004Co-Authors: Susan MillerAbstract:: There is no doubt that vocal fold paralysis is a debilitating condition affecting an individual's general health and quality of life. Optimal management of a patient with vocal fold dysfunction by an otolaryngologist, speech scientist, and speech language pathologist results in detailed objective videostroboscopic evaluation of glottal configuration during phonation, acoustic and aerodynamic measures, laryngeal EMG (if appropriate), and the patient's self-rating of vocal disability. Profound glottal incompetence is typically managed surgically with a few Voice Therapy sessions after surgery to ensure optimal vocal function. Patients with more adequate glottal closure are often seen for Voice Therapy and lost to follow-up when their Voices improve enough to satisfy their vocal needs. It is essential that a complete battery of assessments, including perceptual, aerodynamic, acoustic, and stroboscopic measures, be obtained at periodic intervals in surgical and nonsurgical patients so as to evaluate vocal function over time. One of the few rigorous studies of perceptual, acoustic, aerodynamic, and videofiberscopic findings in patients after medialization with fat and thyroplasty assessed patients before surgery and at short (1-3 months),middle (4-6 months), and long (7-12 months) intervals after surgery. Improvement in most parameters at short- and long-term intervals was noted but not in the middle interval. The best results were obtained in women. Continued difficulty in increasing and maintaining subglottal pressure for high-intensity phonation was observed in both male and female patients. This fine study raises a number of questions as follows. What objective phonatory measures should be assessed before and after intervention and at what time intervals? Why were the women's results better than the men's results when no correlation of age, pulmonary function, or severity of preoperative Voice and aerodynamic impairment was observed? Should Voice Therapy be initiated at the 4- to 6-month interval when Voice quality diminished or within 1 to 2 months after surgery so that the decrement in vocal function might not occur? Why did vocal function ultimately improve after 7 to 12 months? Heuer et al and Colton and Casper found similar outcome satisfaction in patients electing surgery compared with those that were seen for Voice Therapy; however, the patients with lesser glottal incompetence in both studies opted for Therapy. Can we better define vocal parameters that help to predict which patients may need surgery rather than Therapy? Should all patients with high airflow measures but near-normal subglottal pressures and MPT greater than 10 seconds undergo 6 weeks of Voice Therapy rather than medical intervention? If all surgical patients were seen for 6 weeks of postoperative Therapy, would Voice satisfaction ratings increase to greater than 70%? Can we perceptively or objectively differentiate patients whose postoperative Voices will be excellent from those whose Voices will be merely adequate? These questions can only be answered by the development and implementation of a rigorous protocol studying women and men of varying ages with unilateral vocal fold paralysis choosing medialization surgery and electing Voice Therapy. Standardized assessments must include perceptual,aerodynamic, acoustic, stroboscopic, and patient satisfaction measures during soft- and loud-intensity tasks before and at periodic intervals after the two interventions.
Antonio Schindler - One of the best experts on this subject based on the ideXlab platform.
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multidimensional assessment of vocal changes in benign vocal fold lesions after Voice Therapy
Auris Nasus Larynx, 2013Co-Authors: Antonio Schindler, Francesco Mozzanica, P Maruzzi, Murat Atac, Valeria De Cristofaro, F OttavianiAbstract:Abstract Objective To evaluate through a multidimensional protocol Voice changes after Voice Therapy in patients with benign vocal fold lesions. Methods 65 consecutive patients affected by benign vocal fold lesions were enrolled. Depending on videolaryngostroboscopy the patients were divided into 3 groups: 23 patients with Reinke's oedema, 22 patients with vocal fold cysts and 20 patients with gelatinous polyp. Each subject received 10 Voice Therapy sessions and was evaluated, before and after Voice Therapy, through a multidimensional protocol including videolaryngostroboscopy, perception, acoustics, aerodynamics and self-rating by the patient. Data were compared using Wilcoxon signed-rank test. Kruskal–Wallis test was used to analyse the mean variation difference between the three groups of patients. Mann–Whitney test was used for post hoc analysis. Results Only in 11 cases videolaryngostroboscopy revealed an improvement of the initial pathology. However a significant improvement was observed in perceptual, acoustic and self-assessment ratings in the 3 groups of patients. In particular the parameters of G, R and A of the GIRBAS scale, and the noise to harmonic ratio, Jitter and shimmer scores improved after rehabilitation. A significant improvement of all the parameters of Voice Handicap Index after rehabilitation treatment was found. No significant difference among the three groups of patients was visible, except for self-assessment ratings. Conclusion Voice Therapy may provide a significant improvement in perceptual, acoustic and self-assessed Voice quality in patients with benign glottal lesions. Utilization of Voice Therapy may allow some patients to avoid surgical intervention.
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vocal improvement after Voice Therapy in the treatment of benign vocal fold lesions
Acta Otorhinolaryngologica Italica, 2012Co-Authors: Antonio Schindler, D Ginocchio, Francesco Mozzanica, P Maruzzi, Murat Atac, F OttavianiAbstract:Benign vocal fold lesions are common in the general population, and have important public health implications and impact on patient quality of life. Nowadays, phonomicrosurgery is the most common treatment of these lesions. Voice Therapy is generally associated in order to minimize detrimental vocal behaviours that increase the stress at the mid-membranous vocal folds. Nonetheless, the most appropriate standard of care for treating benign vocal fold lesion has not been established. The aim of this study was to analyze Voice changes in a group of dysphonic patients affected by benign vocal fold lesions, evaluated with a multidimensional protocol before and after Voice Therapy. Sixteen consecutive patients, 12 females and 4 males, with a mean age of 49.7 years were enrolled. Each subject had 10 Voice Therapy sessions with an experienced speech/language pathologist for a period of 1-2 months, and was evaluated before and at the end of Voice Therapy with a multidimensional protocol that included self-assessment measures and videostroboscopic, perceptual, aerodynamic and acoustic ratings. Videostroboscopic examination did not reveal resolution of the initial pathology in any case. No improvement was observed in aerodynamic and perceptual ratings. A clear and significant improvement was visible on Wilcoxon signed-rank test for the mean values of Jitt%, Noise to Harmonic Ratio (NHR) and Voice Handicap Index (VHI) scores. Even if it is possible that, for benign vocal fold lesions, only a minor improvement of Voice quality can be achieved after Voice Therapy, rehabilitation treatment still seems useful as demonstrated by improvement in self-assessment measures. If Voice Therapy is provided as an initial treatment to the patients with benign vocal fold lesions, this may lead to an improvement in the perceived Voice quality, making surgical intervention unnecessary. This is one of the first reports on the efficacy of Voice Therapy in the management of benign vocal fold lesions; further studies are needed to confirm these preliminary data.
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vocal improvement after Voice Therapy in unilateral vocal fold paralysis
Journal of Voice, 2008Co-Authors: Antonio Schindler, Alessandro Bottero, Pasquale Capaccio, D Ginocchio, Fulvio Adorni, F OttavianiAbstract:Summary Unilateral vocal fold paralysis (UVFP) is associated with changes in acoustic and aerodynamic Voice measurements and can have a significant impact on a patient's quality of life. Few objective data regarding the efficacy of Voice Therapy for UVFP exist. The aim of this study was to retrospectively analyze Voice modifications in a group of patients with UVFP before and after Voice Therapy. Forty patients with UVFP of different etiology were included in the study. Each subject had Voice Therapy with an experienced speech/language pathologist twice a week; the mean number of sessions was 12.6. A multidimensional assessment protocol was used; it included videoendoscopy, the maximum phonation time (MPT), the GIRBAS scale, spectrograms and a perturbation analysis, and the Voice Handicap Index (VHI). Pre- and posttreatment data were compared by means of the Wilcoxon and Student's t tests. A complete glottal closure was seen in 8 patients before Voice Therapy and in 14 afterward. Mean MPT increased significantly. In the perceptual assessment, the difference was significant for five out of six parameters. A significant improvement was found on spectrographic analysis; as for perturbation analysis, the differences in jitter, shimmer, and noise-to-harmonic ratio values were significant. VHI values showed a clear and significant improvement. A significant improvement of Voice quality and quality of life after Voice Therapy is an often reached and reasonable goal in patients with UVFP.
