Voice Data on Female Smokers: Coherence between the Voice Handicap Index and Acoustic Voice Parameters
Eugenia I. Toki
Department of Speech & Language Therapy, School of Health and Welfare Professions, Technological Educational Institute of Epirus, Ioannina, Greece
Voice disorders are common in the general population, affecting daily communication for nearly one-third. Prevalence of voice disorders has been studied extensively in certain professions, such as teachers, as well as students. The impact on voice characteristics of different risk factors has been studied and also correlated to cigarette smoking. This study was designed to examine the relationship between Voice Handicap Index and acoustic parameters of voice university student smokers in Greece. One hundred and ten female non-dysphonic students (aged 18 to 34) that smoked were recruited. Participants answered the Voice Handicap Index and their voice was recorded. Acoustic analysis of voice characteristics was performed with Dr. Speech software system. Results indicated that some measures were predictive of overall, functional and emotional Voice Handicap Index scores. Other voice parameters had no cohesive or predictable pattern on Voice Handicap Index scores. Significant relationships between Voice Handicap Index individual statements and smokers’ voice characteristics were also observed. Lack of correlation and subsequent clinical implications are discussed, as well as the direction for future research.
1. Bruckert L, Liénard, JS, Lacroix A, et al. (2006) Women use voice parameters to assess men's characteristics. P Roy Soc Lond B Bio 273: 83-89.
2. Roy N, Merrill RM, Thibeault S, et al. (2004) Prevalence of voice disorders in teachers and the general population. J Spee Lan Hear Res 47: 281-293.
3. Sala E, Laine A, Simberg S, et al. (2001) The prevalence of voice disorders among day care center teachers compared with nurses: a questionnaire and clinical study. J Voice 15: 413-423.
4. Vilkman E (2004) Occupational safety and health aspects of voice and speech professions. Folia Phoniatr Logo 56: 220-253.
5. Titze IR, Lemke J, Montequin D (1997) Populations in the US workforce who rely on voice as a primary tool of trade: a preliminary report. J Voice 11: 254-259.
6. Awan SN, Morrow DL (2007) Videostroboscopic characteristics of young adult female smokers vs. nonsmokers. J Voice 21: 211-223.
7. Damborenea TJ, Fernández LR, Llorente AE, et al. (1998) The effect of tobacco consumption on acoustic voice analysis. Acta Otor Esp 50: 448-452.
8. Gonzalez J, Carpi A (2004) Early effects of smoking on the voice: a multidimensional study. Med Sci Mon 10: CR649-CR656.
9. Byeon H (2015) Relationships among smoking, organic, and functional voice disorders in Korean general population. J Voice 29: 312-316.
10. Garnett JD (2001) Tobacco and laryngeal pathology. West Virg Med J 97: 13.
11. Gnjatić M, Stanković P, Đukić V (2009) The effect of smoking and forced use of the voice to development of the vocal polyps. Acta Chir Yug 56: 27-32.
12. Marcotullio D, Magliulo G, Pezone T (2002) Reinke's edema and risk factors: clinical and histopathologic aspects. Am J Otolaryngol 23: 81-84.
13. de Las Casas BR, Ramada RJ (2011) Functional dysphonia and benign vocal cord lesions in professional voice users. Archivos Prev Ries Lab 15: 21-26.
14. Espinosa J, Bravo P, Baron MG (1991) Influence of tobacco on laryngeal carcinoma in Spain. Neoplasma 39: 319-322.
15. Haque MR, Abdullah M, Alauddin M, et al. (2002) Carcinoma larynx-topographical distribution. Mymen Med J 11: 15-21.
16. Schultz P (2011) Vocal fold cancer. Eur Annals Otor Head Neck Dis 128: 301-308.
17. Chai L, Sprecher AJ, Zhang Y, et al. (2011) Perturbation and nonlinear dynamic analysis of adult male smokers. J Voice 25: 342-347.
18. Fitzpatrick TM, Blair EA (2000) Upper airway complications of smoking. Clin Chest Med 21: 147-157.
19. Hirabayashi H, Koshii K, Uno K, et al. (1990) Laryngeal epithelial changes on effects of smoking and drinking. Auris Nasus Larynx 17: 105-114.
20. Murphy CH, Doyle PC (1987) The effects of cigarette smoking on voice-fundamental frequency. Otolaryngol Head Neck Surg 97: 376-380.
21. Sorensen D, Horii Y (1982) Cigarette smoking and voice fundamental frequency. J Commun Disor 15: 135-144.
22. Roy N, Merrill RM, Gray SD, et al. (2005) Voice disorders in the general population: prevalence, risk factors, and occupational impact. The Laryngoscope 115: 1988-1995.
23. Coyle SM, Weinrich BD, Stemple JC (2001) Shifts in relative prevalence of laryngeal pathology in a treatment-seeking population. J Voice 15: 424-440.
24. Stemple JC, Glaze LE, Gerdeman BK (2000) Clinical voice pathology: Theory and management San Diego: Cengage Learning, 25-37.
25. Russell A, Oates J, Greenwood KM (1998) Prevalence of voice problems in teachers. J Voice 12: 467-479.
26. Verdolini K, Ramig LO (2001) Review: occupational risks for voice problems. Logoped Phoniatr Vocol 26: 37-46.
27. Titze IR, Lemke J, Montequin D (1997) Populations in the US workforce who rely on voice as a primary tool of trade: a preliminary report. J Voice 11: 254-259.
28. Roy N, Merrill RM, Thibeault S, et al. (2004) Prevalence of voice disorders in teachers and the general population. J Speech, Lang Hear Res 47: 281-293.
29. Chong EY, Chan AH (2010) Subjective health complaints of teachers from primary and secondary schools in Hong Kong. Int J Occup Safe Ergon 16: 23-39.
30. Gottliebson RO, Lee L, Weinrich B, et al. (2007) Voice problems of future speech-language pathologists. J Voice 21: 699-704.
31. Simberg S, Laine A, Sala E, et al. (2000) Prevalence of voice disorders among future teachers. J Voice 14: 231-235.
32. Simberg S, Sala E, Rönnemaa AM (2004) A comparison of the prevalence of vocal symptoms among teacher students and other university students. J Voice 18: 363-368.
33. Van Lierde KM, D'haeseleer E, Wuyts FL, et al. (2010) The objective vocal quality, vocal risk factors, vocal complaints, and corporal pain in Dutch female students training to be speech-language pathologists during the 4 years of study. J Voice 24: 592-598.
34. Thomas G, De Jong FICRS, Kooijman PGC, et al. (2006) Voice complaints, risk factors for voice problems and history of voice problems in relation to puberty in female student teachers. Folia Phoniatr Logo 58: 305-322.
35. Thomas G, Kooijman PG, Donders ART, et al. (2007) The voice handicap of student-teachers and risk factors perceived to have a negative influence on the voice. J Voice 21: 325-336.
36. De Jong FICRS, Kooijman PGC, Thomas G, et al. (2006) Epidemiology of voice problems in Dutch teachers. Folia Phoniatr Logo 58: 186-198.
37. Force ALT (2003) Laryngeal electromyography: an evidence-based review. Muscle Nerve 28: 767-772.
38. Woo P (1996) Quantification of Videostrobolaryngoscopic Findings Measurements of the Normal Glottal Cycle. The Laryngoscope 106: 1-27.
39. Baken RJ, Orlikoff RF (2000) Clinical measurement of speech and voice. San Diego: Cengage Learning, 225-284.
40. Granqvist S, Hertegård S, Larsson H, et al. (2003) Simultaneous analysis of vocal fold vibration and transglottal airflow: exploring a new experimental setup. J Voice 17: 319-330.
41. Yamaguchi H, Shrivastav R, Andrews ML, et al. (2003) A comparison of voice quality ratings made by Japanese and American listeners using the GRBAS scale. Folia Phoniatr Logo 55: 147-157.
42. Deary IJ, Wilson JA, Carding PN, et al. (2003) VoiSS: a patient-derived voice symptom scale. J Psych Res 54: 483-489.
43. Murry T, Medrado R, Hogikyan ND, et al. (2004) The relationship between ratings of voice quality and quality of life measures. J Voice 18: 183-192.
44. Deary IJ, Webb A, Mackenzie K, et al. (2004) Short, self-report voice symptom scales: psychometric characteristics of the voice handicap index-10 and the vocal performance questionnaire. Otolaryng Head Neck 131: 232-235.
45. Jacobson BH, Johnson A, Grywalski C, et al. (1997) The voice handicap index (VHI) development and validation. Amer J Speech Lang Path 6: 66-70.
46. Behlau M, dos Santos LDMA, Oliveira G (2011) Cross-cultural adaptation and validation of the voice handicap index into Brazilian Portuguese. J Voice 25: 354-359.
47. Guimaraes I, Abberton E (2004) An investigation of the Voice Handicap Index with speakers of Portuguese: preliminary data. J Voice 18: 71-82.
48. Hsiung MW, Lu P, Kang BH, et al. (2003) Measurement and validation of the voice handicap index in voice-disordered patients in Taiwan. J Laryng Otol 117: 478-481.
49. Nawka T, Wiesmann U, Gonnermann U (2003) Validation of the German version of the Voice Handicap Index. Hno 51: 921-930.
50. Ohlsson AC, Dotevall H (2009) Voice handicap index in Swedish. Logoped Phoniatr Vocol 34: 60-66.
51. Verdonck-de Leeuw IM, Kuik DJ, De Bodt M, et al. (2008) Validation of the voice handicap index by assessing equivalence of European translations. Folia Phoniatr Logo 60: 173-178.
52. Woisard V, Bodin S, Puech M (2003) The voice handicap index: impact of the translation in French on the validation. Rev Laryng Otolo Rhinol 125: 307-312.
53. Helidoni ME, Murry T, Moschandreas J, et al. (2010) Cross-cultural adaptation and validation of the voice handicap index into Greek. J Voice 24: 221-227.
54. Gelfer MP, Fendel DM (1995) Comparisons of jitter, shimmer, and signal-to-noise ratio from directly digitized versus taped voice samples. J Voice 9: 378-382.
55. Zhang Y, Jiang JJ, Wallace SM, et al. (2005) Comparison of nonlinear dynamic methods and perturbation methods for voice analysis. J Acoust Soc Am 118: 2551-2560.
56. Pinar D, Cincik H, Erkul E, et al. (2015) Investigating the Effects of Smoking on Young Adult Male Voice by Using Multidimensional Methods. J Voice 30: 721-725.
57. ASHA (Ed.). Voice Evaluation Template, 2014. Available from: http://www.asha.org/uploadedFiles/SLTs/healthcare/AATVoiceEvaluation.pdf
58. Schutte HK, Seidner W (1983) Recommendation by the Union of European Phoniatricians (UEP): standardizing voice area measurement/phonetography. Folia Phoniatr Logop 35: 286-288.
59. Stemple JC, Stanley J, Lee L (1995) Objective measures of voice production in normal subjects following prolonged voice use. J Voice 9: 127-133.
60. Titze IR (1995) Workshop on acoustic voice analysis: summary statement. National Center for Voice and Speech.
61. Rosen CA, Murry T, Zinn A, et al. (2000) Voice handicap index change following treatment of voice disorders. J Voice 14: 619-623.
62. Spector BC, Netterville JL, Billante C, et al. (2001) Quality-of-life assessment in patients with unilateral vocal cord paralysis. Otolaryng Head Neck 125: 176-182.
63. Wheeler KM, Collins SP, Sapienza CM (2006) The relationship between VHI scores and specific acoustic measures of mildly disordered voice production. J Voice 20: 308-317.
64. Taguchi A, Mise K, Nishikubo K, et al. (2012) Japanese version of voice handicap index for subjective evaluation of voice disorder. J Voice 26: 668-e15.
65. Hsiung MW, Pai L, Wang HW (2002) Correlation between voice handicap index and voice laboratory measurements in dysphonic patients. Eur Arch Oto-rhino-laryng 259: 97-99.
66. Woisard V, Bodin S, Yardeni E, et al. (2007) The voice handicap index: correlation between subjective patient response and quantitative assessment of voice. J Voice 21: 623-631.
67. Tarazani M, Khoddami SM, Jalaie S, et al. (2013) The correlation between voice handicap index and specific acoustic measures in patients with muscle tension dysphonia. Thrita 2: 24-28.
68. Awan SN, Roy N, Cohen SM (2014) Exploring the relationship between spectral and cepstral measures of voice and the Voice Handicap Index (VHI). J Voice 28: 430-439.
69. Schindler A, Mozzanica F, Vedrody M,et al. (2009) Correlation between the Voice Handicap Index and voice measurements in four groups of patients with dysphonia. Otolaryng Head Neck 141: 762-769.
70. Ziwei Y, Zheng P, Pin D (2014) Multiparameter voice assessment for voice disorder patients: a correlation analysis between objective and subjective parameters. J Voice 28: 770-774.
71. Fulljames N, Harris S (2006) Voice outcome measures: correlations with patients' assessment of their condition and the effectiveness of voice therapy. Logoped Phoniatr Vocol 31: 23-35.
72. Bonetti A, Bonetti L (2013) Cross-cultural adaptation and validation of the Voice Handicap Index into Croatian. J Voice 27: 130-e7.
73. Hakkesteegt MM, Wieringa MH, Gerritsma EJ, et al. (2006) Reproducibility of the Dutch version of the Voice Handicap Index. Folia Phoniatr Logo 58: 132-138.
74. Moradi N, Pourshahbaz A, Soltani M, et al. (2012) Cutoff point at voice handicap index used to screen voice disorders among Persian speakers. J Voice 27: 130-e1.
Niebudek-Bogusz E, Kuzańska A, Woznicka E, et al. (2011) Assessment of the voice handicap index as a screening tool in dysphonic patients. Folia Phoniatr Logop 63: 269-272.
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