title: The clinical utility of vocal dosimetry for assessing voice rest.
abstract: OBJECTIVE
  Voice rest is frequently recommended following surgical disruption of vocal fold epithelium, but patients report variable adherence to voice rest recommendations. The objective of this study was to assess the clinical utility of an ambulatory vocal dosimeter for measuring adherence to voice rest recommendations.
  
  
  METHODS
  Outcomes research.
  
  
  METHODS
  Part 1: To determine the utility of the dosimeter in nonclinical use, the relationship between self-reported voice use and dosimeter measurements was examined in normal subjects (n = 11) who prospectively logged voice use while wearing the dosimeter. Part 2: To determine clinical utility of the dosimeter, patients undergoing vocal fold surgery for which postoperative voice rest was recommended (n = 11) wore a dosimeter for 2 days prior to and 2 days after surgery. Phonation percent and sound level were compared at baseline and during voice rest.
  
  
  RESULTS
  The dosimeter performed as hypothesized with both normal subjects and patients. A moderate correlation (r = 0.62) was noted between self-reported voice use and dosimeter measurements in normal subjects. In patients on voice rest, a statistically and clinically significant decrease was observed in measured voice use, both in phonation time (P = .002) and intensity of phonation (P = .004).
  
  
  CONCLUSIONS
  Ambulatory vocal dosimetry may have clinical utility for assessing adherence to voice rest recommendations. This information will be useful for the design of future studies on voice rest.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Misono
authors.forename: Kathryn
authors.initials: K
authors.lastname: Banks
authors.forename: Philippe
authors.initials: P
authors.lastname: Gaillard
authors.forename: George S
authors.initials: GS
authors.lastname: Goding
authors.forename: Bevan
authors.initials: B
authors.lastname: Yueh
mesh_terms: D061725:Accelerometry / Q000295:instrumentation*; D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D010699:Phonation / Q000502:physiology*; D011182:Postoperative Care; D011237:Predictive Value of Tests; D012016:Reference Values; D012146:Rest / Q000502:physiology*; D057566:Self Report; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D014827:Vocal Cords / Q000503:physiopathology* / Q000601:surgery*
keywords: Voice; adherence; compliance; laryngeal surgery; vocal accumulator; vocal dosimeter; voice rest