Changes in a daily phonotrauma index after laryngeal surgery and voice therapy: Implications for the role of daily voice use in the etiology and pathophysiology of phonotraumatic vocal hyperfunction

Jarrad H. Van Stan, Daryush D. Mehta, Andrew J. Ortiz, James A. Burns, Katherine L. Marks, Laura E. Toles, Tara Stadelman-Cohen, Carol Krusemark, Jason Muise, Tiffiny Hron, Steven M. Zeitels, Annie B. Fox, Robert E. Hillman

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Purpose: This study attempts to gain insights into the role of daily voice use in the etiology and pathophysiology of phonotraumatic vocal hyperfunction (PVH) by applying a logistic regression-based daily phonotrauma index (DPI) to predict group-based improvements in patients with PVH after laryngeal surgery and/or postsurgical voice therapy. Method: A custom-designed ambulatory voice monitor was used to collect 1 week of pre-and postsurgery data from 27 female patients with PVH; 13 of these patients were also monitored after postsurgical voice therapy. Normative weeklong data were obtained from 27 matched controls. Each week was represented by the DPI, standard deviation of the difference between the first and second harmonic amplitudes (H1–H2). Results: Compared to pretreatment, the DPI significantly decreased in the patient group after surgery (Cohen’s d effect size = −0.86) and voice therapy (d = −1.06). The patient group DPI only normalized after voice therapy. Conclusions: The DPI produced the expected pattern of improved ambulatory voice use across laryngeal surgery and postsurgical voice therapy in a group of patients with PVH. The results were interpreted as providing new objective information about the role of daily voice use in the etiology and pathophysiology of PVH. The DPI is viewed as an estimate of potential vocal fold trauma that relies on combining the long-term distributional characteristics of two parameters representing the magnitude of phonatory forces (neck-surface acceleration magnitude) and vocal fold closure dynamics (H1–H2). Further validation of the DPI is needed to better understand its potential clinical use.

Original languageEnglish (US)
Pages (from-to)3934-3944
Number of pages11
JournalJournal of Speech, Language, and Hearing Research
Volume63
Issue number12
DOIs
StatePublished - Dec 2020
Externally publishedYes

ASJC Scopus subject areas

  • Language and Linguistics
  • Linguistics and Language
  • Speech and Hearing

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