Neumann, K., Kell, C., DeJonckere, P.
Neuronale Korrelate der spasmodischen Dysphonie vor und nach Botulinumtoxin-Therapie, dargestellt mit fMRI
In M. Gross & A. am Zehnhoff-Dinnesen (Hrsg.) (2008). Aktuelle phoniatrisch-pädaudiologische Aspekte, Band 18. Norderstedt: Books on Demand, 186-189.
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Neumann, K. & DeJonckere, P. H.
Voice related quality of life in spasmodic dysphonia. A detailed VHI-analysis before and after botulinum treatment.
In C. Manfredi (Ed.), Models and analysis of vocal emissions for biomedical applications (pp. 65-69). Firenze, Italy: Firenze Univ. Press
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Kommentar: Patienten mit spasmodischer Dysphonie berichten eine signifikante Minderung ihrer Behinderung nach Injektion von Botulin in die Stimmlippen.
Abstract: The Voice Handicap Index (VHI) is a widespread self-evaluation instrument for measuring the psycho-social handicapping effect of a voice disorder over 3 domains, the physical (P), the emotional (E) and the functional (F) domain. It consists of 30 items/statements to be scored from 0 to 4 . An abridged version (VHI-10) has been proposed and validated. Patients with SD report a severe psycho-social handicapping effect of their disease, but a significant reduction after treatment with Botulinum toxin. Both VHI-30 and VHI-10 appear to be (equally) sensitive instruments within this scope. Factor and principal component analysis fail to identify the 3 domains of the VHI-30. Statements P14 (I feel as though I have to strain to produce voice) and E30 (I am ashamed of my voice problem) show the strongest changes after treatment.

Neumann, K. & DeJonckere, P. H.
Voice related quality of life in spasmodic dysphonia. Treatment effects and correlation with voice assessment.
Proceedings of the 3rd Advanced Voice Function Assessment International Workshop (AVFA2009), Madrid, May 18 to 20, 2009
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Kommentar: Patienten mit spasmodischer Dysphonie zeigen hohe Werte auf der subjektiven Voice Handicap Index Skala. Die Verbesserungen auf dieser Skala durch Botulin-Injektionen korrelierten nicht signifikant mit der Bewertung der Stimme durch verblindete unabhängige Personen und auch nicht mit objektiven akustischen Parametern. Dies zeigt, dass bei spasmodischer Dysphonie die subjektive Bewertung der eigenen Stimme einen besonderen Stellenwert hat.
Abstract: Spasmodic Dysphonia (SD) patients (adductor type) are known to score very high on the Voice Handicap Index (VHI). 28 VHI analyses were performed in patients diagnosed with spasmodic dysphonia (SD), before and after treatment with botulinum toxin. Patient's voices were also analyzed perceptually and acoustically : 7 perceptual parameters (traditional and dedicated) were blindly rated by a panel of 3 experienced speech therapists and 9 acoustic measures (mainly based on voicing evidence and periodicity) were achieved by a special analysis program suited for strongly irregular signals. After treatment, the average VHI total score is reduced by 15.41 points (from 64,17 to 48,75), which may be considered as clinically relevant for a group design. A paired comparison pre-/post also demonstrates a significant improvement in voice-related quality of life (p = .039). The effect size is to be considered as medium to large (Cohen's d = .7). However, as well in pre- as in post-situation, there is no significant correlation between the VHI score and either the perceptual ratings or the acoustic measurements. Even the pre-/post differences in perception, acoustics or VHI do not correlate with each other. This points out that the patient's self-evaluation is a different dimension from the perceptual and the physical ones.

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