The Value of Vocal Extent Measure (VEM) Assessing Phonomicrosurgical Outcomes in Vocal Fold Polyps.
OBJECTIVE
This study aimed to present vocal extent measure (VEM), demonstrate its changes with phonomicrosurgical treatment in patients with vocal fold polyps (VFPs), and to compare its performance to that of established vocal parameters.


METHODS
This is an individual cohort study.


METHODS
Microlaryngoscopic ablation was executed in 61 patients with manifestation of VFP (28 male, 33 female; 45 ± 13 years [mean ± SD]). Analysis of treatment outcome was based on pre- and postoperative voice function diagnostics and videolaryngostroboscopy. Examination instruments were: auditory-perceptual voice assessment (roughness, breathiness, and overall hoarseness [RBH]-status), voice range profile (VRP), acoustic-aerodynamic analysis, and patients' self-assessment of voice using the voice handicap index. The VEM, a parameter not yet commonly established in phoniatric diagnostics, was calculated from area and shape of the VRP to be compared with the dysphonia severity index (DSI) concerning diagnostic suitability.


RESULTS
All polyps were completely excised. Three months postoperatively, mucosal wave propagation had recovered. All subjective and most objective acoustic and aerodynamic parameters showed highly significant improvement. The VHI-9i-score decreased from 15 ± 8 to 6 ± 7 points. The average total vocal range extended by 4 ± 5 semitones, the mean speaking pitch decreased by 1 ± 2 semitones. The DSI increased on average from 2.6 ± 2.1 to 4.0 ± 2.2, VEM from 83 ± 28 to 107 ± 21 (P < 0.01). VEM and DSI correlated significantly with each other (rs= 0.65; P < 0.01).


CONCLUSIONS
Phonomicrosurgery of VFP is an objectively and subjectively satisfactory therapy for voice improvement. The VEM represents a comprehensible and easy-to-use unidimensional measure for objective VRP evaluation. This positive measure of vocal function seems to be a compelling diagnostic addition for objective quantification of vocal performance.
Department of Audiology and Phoniatrics; Charité-University Medicine Berlin, Campus Charité Mitte, Charitéplatz 1, D-10117 Berlin, Germany.
Tatjana
T
Salmen
Department of Information and Communication Management, Technical University Berlin, Straße des 17. Juni 135, D-10623 Berlin, Germany.
Tatiana
T
Ermakova
Max-Planck Institute for Plasma Physics, Wendelsteinstraße 1, D-17491 Greifswald, Germany.
Andreas
A
Möller
Department of Audiology and Phoniatrics; Charité-University Medicine Berlin, Campus Charité Mitte, Charitéplatz 1, D-10117 Berlin, Germany.
Matthias
M
Seipelt
Department of Audiology and Phoniatrics; Charité-University Medicine Berlin, Campus Charité Mitte, Charitéplatz 1, D-10117 Berlin, Germany.
Sebastian
S
Weikert
Department of Audiology and Phoniatrics; Charité-University Medicine Berlin, Campus Charité Mitte, Charitéplatz 1, D-10117 Berlin, Germany.
Julius
J
Rummich
Department of Audiology and Phoniatrics; Charité-University Medicine Berlin, Campus Charité Mitte, Charitéplatz 1, D-10117 Berlin, Germany.
Manfred
M
Gross
Department of Audiology and Phoniatrics; Charité-University Medicine Berlin, Campus Charité Mitte, Charitéplatz 1, D-10117 Berlin, Germany.
Tadeus
T
Nawka
Department of Audiology and Phoniatrics; Charité-University Medicine Berlin, Campus Charité Mitte, Charitéplatz 1, D-10117 Berlin, Germany. Electronic address: philipp.caffier@charite.de.
Philipp P
PP
Caffier
D055011:Ablation Techniques / Q000009:adverse effects; D000162:Acoustics; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007600:Judgment; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007828:Laryngoscopy / Q000009:adverse effects; D008297:Male; D008866:Microsurgery / Q000009:adverse effects; D008875:Middle Aged; D010898:Pitch Perception; D011127:Polyps / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D020127:Recovery of Function; D013061:Speech Acoustics; D013067:Speech Perception; D013068:Speech Production Measurement; D049489:Stroboscopy; D013997:Time Factors; D016896:Treatment Outcome; D014741:Video Recording; D014827:Vocal Cords / Q000503:physiopathology / Q000601:surgery*; D014833:Voice Quality; D055815:Young Adult
Phonomicrosurgery; Videolaryngostroboscopy; Vocal extent measure; Vocal fold polyp; Vocal function