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See detailVoice related complaints in the pediatric population
Verduyckt, Ingrid; Remacle, Marc; Jamart, Jacques et al

in Journal of Voice (2011), 25(3), 373-380

Subjective evaluation of the voice by the patient is routinely assessed in the adult dysphonic population; this Q6 is, however, not the case in the pediatric population. There were three objectives of ... [more ▼]

Subjective evaluation of the voice by the patient is routinely assessed in the adult dysphonic population; this Q6 is, however, not the case in the pediatric population. There were three objectives of this study: the first goal was to study the ability of children aged 5–13 years to express themselves about physical, emotional, and sociofunctional aspects of their voice. The second goal was to explore if specific voice-related complaints were expressed by dysphonic children as compared with normophonic children. The third goal was to compare the dysphonic children’s voice-related complaints with those of their mothers. The overall objective was to set the grounds for the elaboration of a standardized questionnaire in French concerning subjective evaluation of voice in children. Twenty-five dysphonic children with vocal complaint (15 nodules, one polyp, one microweb, eight unspecified) and 55 normophonic children aged 5–13 years were interviewed. The interviews were semistructured based on a canvas of voice-related questions. The dysphonic children’s mothers were interviewed with the mean of a written questionnaire and were invited to discuss their answers orally with the examiner. The results were analyzed ualitatively and statistically.AChi-square test and the Fisher’s test were used to analyze the differences between the complaints expressed by the dysphonic and the normophonic children, and a binomial test was used to compare the children’s answers with their mothers’ answers. The qualitative analysis of the interviews suggests that children are capable of reflecting over their ownvoice and of giving autonomous information about different aspects of their voice. It also appeared that voice is a complex phenomenon and that it needs to be clearly and cautiously defined to the children.We identified 27 different complaints related to the voice, out of which 17 were significantly more expressed by dysphonic than by normophonic children (P < 0.05). Three of the 27 identified complaints show significant discordances between the mothers and the dysphonic children. The results suggest that children are capable of making a subjective and autonomous evaluation of their voice and that dysphonic children experience significantly more voicerelated discomfort than nondysphonic children. The complaints expressed by the dysphonic children and their mothers are not all in concordance. The main conclusion is that a standardized subjective evaluation of the voice, not only by the parents but also by the child itself, would be relevant in the assessment of pediatric dysphonia. [less ▲]

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See detailSerum IL-6 and IGF-1 improve clinical prediction of functional decline after hospitalization in older patients
de Saint-Hubert, Marie; Jamart, Jacques; Morrhaye, Gabriel et al

in Aging Clinical & Experimental Research (2011), 23

Background and aims: Although inflammatory and hormonal markers have been associated with further functional adverse outcomes in community-dwelling seniors, these markers have not been studied from this ... [more ▼]

Background and aims: Although inflammatory and hormonal markers have been associated with further functional adverse outcomes in community-dwelling seniors, these markers have not been studied from this perspective in acutely ill older patients. This prospective study was designed to determine whether biological markers can improve the predictive value of a clinical screening tool to assess the risk of functional decline in hospitalized older patients. Methods: Patients aged 75 years and over admitted for hip fracture, acute heart failure or infection (n=118) were recruited. The clinical screening tool SHERPA was filled in on admission, with concomitant measurement of interleukin-6 (IL-6), insulin-like growth factor 1 (IGF-1), C-reactive protein (CRP), white blood cells, urea, albumin, pre-albumin and total cholesterol. Functional decline was defined as a decrease of one point in the activities of daily living scale between pre-admission and 3-month post-discharge status. We compared the discrimination calibration of SHERPA vs SHERPA+, a logistic regression model including SHERPA and selected biomarkers. Results: Three months after discharge, functional decline had occurred in 46 patients. IL-6 and IGF-1 were selected, since their levels were significantly different between decliners and non-decliners, and were included in the new logistic regression model SHERPA+. Areas under the ROC curve [95% CI] for functional decline prediction were 0.73 [0.63-0.81] for SHERPA vs 0.79 [0.69-0.86] for SHERPA+ (p=0.14). However, SHERPA+ was better calibrated, as the average predicted risk of functional decline within subgroups matched the proportion which actually underwent functional decline (Brier score=0.185). Since functional decline was higher in patients with hip fracture, the SHERPA+ model was challenged by including the diagnosis. Only SHERPA, IGF-1 and diagnosis were significantly associated with functional decline. Conclusions: Selected biological markers may marginally improve the clinical prediction of post-discharge functional decline in hospitalized patients, and may allow to stratify them appropriately. The predictive value of these biomarkers is not fully independent of disease status. Further studies are needed to confirm these results in a cohort representative of older patients admitted through the emergency department. (Aging Clin Exp Res 2011; 23: 106-111) [less ▲]

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See detailSubjective evaluation of the long-term efficacy of speech therapy on dysfunctional dysphonia.
Morsomme, Dominique ULg; Faurichon de la Bardonnie, Marie; Verduyckt, Ingrid et al

in Journal of Voice (2009)

The objective of the study was to measure the subjective long-term effects of vocal therapy (more than 6 months) in 29 patients suffering from dysfunctional dysphonia. Four subjective measurements were ... [more ▼]

The objective of the study was to measure the subjective long-term effects of vocal therapy (more than 6 months) in 29 patients suffering from dysfunctional dysphonia. Four subjective measurements were used: one visual analog scale ranging from 0 (not efficient at all) to 100 (very efficient); one question "Is the speech therapy still efficient?," answered by yes or no; the GRB parameters of the GRBAS scale (evaluated by the patient); and the VHI-10. The results show that 76% of the patients consider that the vocal therapy they received is still efficient. On the vocal quality (G), roughness (R), and breathiness (B) parameters, we observe a high degree of satisfaction on the G parameter (median=77). The scores on the R and B parameters are lower (median R=12, S=5). Roughness is significantly correlated to the Grade (Spearman coefficient r=0.516, P=0.004), whereas breathiness is not (P=0.251, NS). The comparison of the results on the VHI-10 pre and post treatment shows a significant decrease in the grade of perceived handicap (medians 15 vs 11, P=0.017). The correlations between the judgment of the treatment's efficacy and the vocal quality is significant (r=0.623, P<0.001) as well as the correlation between the VHI-10 and the length of the treatment (r=0.416, P=0.035). The conclusion can be made that speech therapy plays an important role in long-term treatment of dysfunctional dysphonias. [less ▲]

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See detailEvaluation subjective de la voix (VHI) chez 723 enseignants en région Bruxelloise.
Morsomme, Dominique ULg; Russel, Sophie; Jamart, Jacques et al

Conference (2008, October 14)

Les études montrent qu’en moyenne 20% des enseignants présentent des troubles vocaux. Les auteurs relèvent des symptômes fréquents comme la raucité, la fatigue vocale, l’aggravation de la voix, les ... [more ▼]

Les études montrent qu’en moyenne 20% des enseignants présentent des troubles vocaux. Les auteurs relèvent des symptômes fréquents comme la raucité, la fatigue vocale, l’aggravation de la voix, les douleurs péri-laryngées et la sensation d’inconfort physique. Ils rapportent que la dysphonie est plus fréquente chez les femmes. L’âge, le nombre d’années d’expérience, le type de cours enseigné les facteurs environnementaux, l’abus, le malmenage vocal et le stress ont un impact sur la voix. Ces facteurs amenuisent les performances vocales professionnelles des enseignants et ont des conséquences non négligeables en terme d’économie. Dans notre étude, nous avons évalué la voix de 723 enseignants (F :634/ H :89), exerçant en écoles ordinaires ou en écoles à discrimination positive, à l’aide du VHI. Nous avons établi un premier état des lieux dans 15 communes de la région bruxelloise. Des mesures de fiabilité, de pertinence et de cohérence ont été réalisées. Nous obtenons une bonne fiabilité test-retest (F : 0,774 ; E : 0.749 ; P : 0.806 ; G : 0.836 – p>0.001 pour tous). Les scores du re-test sont significativement inférieurs pour les 3 sous-échelles (F p<0.001 ; E p=0.003 et P p<0.001) et le score global (p<0.001). La corrélation entre les 3 sous échelles est élevée (FvsE : 0.434 ; FvsP :0.455 ; EvsP : 0.527). La prévalence des troubles vocaux a été calculée en tenant compte des variables antécédents ORL, logopédiques et des traitements logopédiques en cours. Elle s’élève à 10,5%. Les enseignants ayant été confronté à une difficulté vocale (vu par un ORL ou/et un logopède) présentent donc des scores plus élevés au VHI global. Par contre, nous observons que plus les sujets sont âgés et ont de l’expérience moins ils ont de troubles vocaux (p=0.026 et p=0.013). De même, les variables telles que le genre (p≥ 0.063), la matière enseignée (p≥ 0.468), le fait de fumer (p=0.757), le type (p≥ 0.867) et le degré d’enseignement (p≥ 0.212) n’influent pas de manière significative les scores aux V.H.I. [less ▲]

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See detailEvaluation of the aging patient’s voice by means of the VHI correlated to the DS16 and the SF-36
Morsomme, Dominique ULg; Provin, Sarah; Verduyckt, Ingrid et al

Conference (2008, May 31)

Objective vocal changes linked to the age have been largely studied these last 20 years. However, few authors have showed an interest in the subjective evaluation of the aging voice. Our research aimed ... [more ▼]

Objective vocal changes linked to the age have been largely studied these last 20 years. However, few authors have showed an interest in the subjective evaluation of the aging voice. Our research aimed the study of the aging voice by means of the Voice Handicap Index (VHI) Jacobson et al., (1997) in 90 subjects divided into three groups: « 30 elderly subjects in a nursing home », « 30 elderly subjects living at home » and « 30 young subjects » as the control group. We compared the results from these three groups and controlled for several variables such as age, living place, personality, dependency and repetition, that can have an impact on the VHI score. The DS16 (Denollet, 1998) and the SF-36 (Ware et al, 1993) were used to test personality and dependency. Our results showed that the scores on the global and physical scales are higher for all groups at the retest (p=0,046; p=0,015). Although the VHI seems adapted to the aging subject, some improvements are suggested concerning the items addressing the professional life and social life (F8, F16, F22, E24 et E29). We also observe correlations between the three subscales (p<0,001). Concerning the DS16, the personality trait « negative affect » and « social inhibition » are correlated to the global score at the test and the retest (P=0,002 ; P =0,001 and P=0,048 ; P=0,015). Type-D personality raises the physical scores (P=0,018 ; P=0,006) and the global scores (P=0,014 ; P=0,003). Moreover, the VHI is correlated to 6 dimensions of general health related quality of life and with the global score of the SF-36 (P<0,001). The elderly subjects obtain higher functional (P=0,007 ; P=0,006), physical (P=0,009 ; P<0,001) and global (P=0,003 ; P<0,001) scores than the young subjects. Moreover, the subjects living in a nursery home obtain a higher emotional score on the univariate analysis (P=0,008 ; P=0,02) than those living at home. At the multivariate analysis, the variable « nursery home » has a significant impact on the functional score (P=0,02). Finally, a multivariate linear regression shows that the variable sex increases all the scores at the VHI (P=0,048 ; P=0,044 ; P=0,03 ; P=0,023) and the variable « dependency » (P<0,001) increases the emotional, physical and global score. Although vocal quality in the elderly might seem only slightly altered, age is a factor that increases functional, physical and global scores at the VHI. However, sex, dependency and personality type are also influencing vocal self-evaluation and can moderate the effect of age. [less ▲]

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See detailSubjective Evaluation of the Voice by the V.H.I. and Estimation of the Prevalence of Vocal Disorders among 723 Teachers
Morsomme, Dominique ULg; Russel, Sophie; Verduyckt, Ingrid et al

Conference (2008, May 31)

The literature shows that 20% of the teachers suffer from a vocal disorder. The researchers find frequent symptoms such as roughness, vocal fatigue and aggravation of the mean F0, peri-laryngeal pain and ... [more ▼]

The literature shows that 20% of the teachers suffer from a vocal disorder. The researchers find frequent symptoms such as roughness, vocal fatigue and aggravation of the mean F0, peri-laryngeal pain and physical discomfort. Dysphonia is more frequent in female teachers. Age, years of experience, type of subject taught and environmental factors, vocal abuse, and stress have an impact on voice. They diminish the vocal performances of these professionals which has negative financial consequences. In our study, the voice of 723 teachers were evaluated by means of the VHI (F: 634, M: 89), teaching in ordinary schools or in positive discrimination schools. Fifteen municipality in the Brussel area participated in the study. We obtain a good test retest reliability for the whole group (F: 0,774 ; E: 0.749 ; P: 0.806 ; G : 0.836 – p>0.001). The scores at the retest are significantly lower for the global scores and the three subscales (G p<0.001, F p<0.001 ; E p=0.003 et P p<0.001). Intra-scale correlation is high (F versus E : 0.434 ; F vs P :0.455 ; E vs P : 0.527). The prevalence of vocal disorders was computed with regard to past ENT and speech pathology history and actual treatments, it was evaluated to 10,5%. Teachers who had been consulting an ENT or a speech language pathologist had higher scores at the global VHI. The elder the subjects are and the more teaching experience they have, the lesser they report vocal disorders (p=0.026 et p=0.013). The variables sex (p≥ 0.063), subject taught (p≥ 0.468), smoking (p=0.757), type of school (p≥ 0.867) and class grade (p≥ 0.212) do not have a significant impact on the VHI scores. [less ▲]

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See detailVoice Handicap Index Adapted to the Singing Voice
Morsomme, Dominique ULg; Gaspar, Martine; Verduyckt, Ingrid et al

Conference (2008, May 31)

The present study is the outcome of 5 former studies aiming at the adaptation of the V.H.I. to singers. We propose in this last version a V.H.I. valid for all types of singer, dysodic or not. The ... [more ▼]

The present study is the outcome of 5 former studies aiming at the adaptation of the V.H.I. to singers. We propose in this last version a V.H.I. valid for all types of singer, dysodic or not. The reliability, validity and internal coherence was evaluated on a population of 192 classical singers and 27 non singers. The comparison of the mean scores at the test and the retest shows that the results at the retest are significantly inferior for the functional scale (p=0.013) and for the global score (p=0.006). The test/re-test stability is good (ICC : Functional scale (F) : 0.869, Emotional scale (E) : 0.846, Physical scale (P) : 0.85, Global score (G) : 0.878/ Spearman’s rho F : 0.855, E : 0.834, P : 0.858, G : 0.886). The internal coherence of each sub scale is good (Cronbach’s alpha : >0.80). The correlation between the 3 subscales is quite high (FvsE : 0,613 /EvsP : 0,737/ FvsP : 0,693) which means that each scale measures a specific dimension but that they are still homogeneous. The test/re-test difference between the singers and the controls are not significant but the control group has a greater variability in their answers (Levene test : F : p<0 .001; P : p=0.009 ; G : p=0.02). Three variables increase the results : being a solist (F : p=0.046; E : p=0.002; P : p=0.056; G : p=0.006), being an amateur (F : p<0.001; E : p=0.019; P : p<0.001; G : p=0.001), having a vocal complaint (F, E, P et G : p<0.001). In conclusion, this version of the V.H.I is reliable, valid and adapted to the population of classical singers. [less ▲]

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See detailLong term Subjective Evaluation of the Effects of Vocal Therapy on Dysfunctional Dysphonia.
Morsomme, Dominique ULg; Faurichon de la Bardonnie, Marie; Verduykt, Ingrid et al

Conference (2008)

The goal of this study is the evaluation of the long-term efficiency of voice therapy (> to 6 months) in the treatment of dysfunctional dysphonia . Four subjective measurements were performed on 29 ... [more ▼]

The goal of this study is the evaluation of the long-term efficiency of voice therapy (> to 6 months) in the treatment of dysfunctional dysphonia . Four subjective measurements were performed on 29 patients: -A visual analogical scale (VAS) ranging from 0 (not efficient at all) to 100 (very efficient). -A question “Is the speech therapy still efficient?” Yes or no. -The G(rade), R(oughness) and B(reathiness) parameters from the GRBAS perceptual scale (evaluated by the patient measured on VAS). -The Voice Handicap Index-10 (VHI-10). The results show that 76% of the patients consider that the voice therapy is still efficient. In regard to G.R.B., we observe a high score for G (median: 77). The score for R is lower (median R: 12). G and R are significantly correlated (r Spearman=0.516, p=0.004), but the satisfaction of the vocal quality does not seem correlated to B (p=0,251, NS). The median values of VHI 10 shows a significant improvement from 15 to 10 (p=0,017). In addition, the correlations between the judgment on the treatment efficiency and vocal quality (r=0,623, p<0,001) and between VHI-10 and the length of treatment (r=0.416, p=0,035) are significant. The first correlation shows that the most satisfied patients when it comes to the vocal therapy are also the most satisfied when it comes to their vocal quality. The second correlation specifies that the longer the treatment, the higher the grade of vocal handicap. Voice therapy is efficient in the long term and is worth to be prolonged for difficult cases [less ▲]

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See detailAdaptation du Voice Handicap Index à la voix chantée
Morsomme, Dominique ULg; Gaspar, Martine; Jamart, Jacques et al

Conference (2007, October 16)

Le V.H.I. de Jacobson et al. ne traduit pas les difficultés éprouvées par le chanteur. L’étude présentée ici est l’aboutissement de 5 travaux visant à l’adaptation de l’index à la voix chantée. Chaque ... [more ▼]

Le V.H.I. de Jacobson et al. ne traduit pas les difficultés éprouvées par le chanteur. L’étude présentée ici est l’aboutissement de 5 travaux visant à l’adaptation de l’index à la voix chantée. Chaque étude a évalué la fiabilité et la cohérence des items. Morsomme et Gaspar ont proposé une nouvelle version dont les items ont été reformulés dans le but de rendre cet outil accessible à tous les chanteurs dysodiques ou non. Nous avons évalué la fiabilité et la cohérence interne de cette dernière mouture, sur une population de 192 chanteurs classiques et 27 non chanteurs. Pour la validation de l’échelle, la comparaison des scores moyens aux deux tests montrent que les résultats du retest est significativement inférieurs pour la sous échelle fonctionnelle (p=0.013) et le score global (p=0.006). Nous observons une bonne stabilité test/retest (ICC: E Fonctionnelle:0.869, E Emotionnelle: 0.846, E Physique: 0.85, Score Global: 0.878/ Rho de Spearman F: 0.855, E: 0.834, P: 0.858, G: 0.886). La cohérence interne de chaque sous échelle (Cronbach’s alpha) est bonne (>0.80). Les corrélations entre les 3 sous échelles sont assez élevées (FvsE: 0,613 /EvsP: 0,737/ FvsP: 0,693). Chaque sous échelle mesure une dimension particulière tout en restant homogène entre-elles. La différence test-retest entre les chanteurs et les contrôles est non significative. Au test de Levene le groupe contrôle a une plus grande variabilité de réponses pour le score globale (p=0.02), les E fonctionnelle (p<0 .001) et physique (p=0.009). Trois variables font augmenter significativement les résultats: être soliste (F:p=0.046; E: p=0.002; P: p=0.056; G: p=0.006), être amateur (F:p<0.001; E: p=0.019; P: p<0.001; G: p=0.001), et avoir une plainte vocale (F, E, P et G: p<0.001). En conclusion, le V.H.I. adapté aux chanteurs se révèle fiable, valide et adapté à la population de chanteurs classiques. [less ▲]

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See detailAdaptation of the voice handicap index to the laryngectomized patient
Morsomme, Dominique ULg; Toledo, Angeline; Verduyckt, Ingrid et al

Conference (2007, May 24)

Objective: The aim of our study was to adapt the VHI to the tracheo-oesophageal voice patients and to evaluate its coherence and reproducibility. Method: Firstly, 9 items from the original VHI, identified ... [more ▼]

Objective: The aim of our study was to adapt the VHI to the tracheo-oesophageal voice patients and to evaluate its coherence and reproducibility. Method: Firstly, 9 items from the original VHI, identified in a former study as lacking pertinence to the patient group, were rejected. Secondly, the 21 items left were modified and 9 new items were created based on a review of the literature and on the opinion of clinicians. Lastly, following the opinion of laryngectomised patients we created and added another 10 items to the scale, resulting in 39 items. The reliability and reproducibility of this new scale were investigated on a population of 18 laryngectomised patients. Results: The statistical analyses permitted us to reduce the scale to 30 items. The mean scores obtained on the new adapted VHI are respectively 17.7 ± 10.2 (SD) for the functional scale, 11.5 ± 7.1 for the emotional scale, 17.0 ± 7.3 for the physical scale and 46.2 ± 20.4 for the global score. The test-retest correlations for the global score and for the three sub scales are strong and very significant (Global: r = 0.808; F: r = 0.803; E: r = 0.712, P: r = 0.883, p<0.001). The test-retest stability is thus excellent. The results of the tracheo-oesophageal voice subjects on this scale are revealing a moderate impact of their vocal impairment in their daily life. [less ▲]

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See detailAdaptation du Voice Handicap Index à la voix chantée
Morsomme, Dominique ULg; Gaspar, Martine; Jamart, Jacques et al

in Revue de Laryngologie - Otologie - Rhinologie (2007), 128(5), 305-314

The present study is the outcome of 5 former studies aiming at the adaptation of the V.H.I. to singers. We propose in this last version a V.H.I. valid for all types of singer, dysodic or not. The ... [more ▼]

The present study is the outcome of 5 former studies aiming at the adaptation of the V.H.I. to singers. We propose in this last version a V.H.I. valid for all types of singer, dysodic or not. The reliability, validity and internal coherence was evaluated on a population of 192 classical singers and 27 non singers. The comparison of the mean scores at the test and the retest shows that the results at the retest are significantly inferior for the functional scale (p=0.013) and for the global score (p=0.006). The test/re-test stability is good (ICC : Functional scale (F) : 0.869, Emotional scale (E) : 0.846, Physical scale (P) : 0.85, Global score (G) : 0.878/ Spearman’s rho F : 0.855, E : 0.834, P : 0.858, G : 0.886). The internal coherence of each sub scale is good (Cronbach’s alpha : >0.80). The correlation between the 3 subscales is quite high (FvsE : 0,613 /EvsP : 0,737/ FvsP : 0,693) which means that each scale measures a specific dimension but that they are still homogeneous. The test/re-test difference between the singers and the controls are not significant but the control group has a greater variability in their answers (Levene test : F : p<0 .001; P : p=0.009 ; G : p=0.02). Three variables increase the results : being a solist (F : p=0.046; E : p=0.002; P : p=0.056; G : p=0.006), being an amateur (F : p<0.001; E : p=0.019; P : p<0.001; G : p=0.001), having a vocal complaint (F, E, P et G : p<0.001). In conclusion, this version of the V.H.I is reliable, valid and adapted to the population of classical singers. [less ▲]

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See detailReconstruction of glottic defects after endoscopic cordectomy: voice outcome.
Remacle, Marc; Lawson, Georges; Morsomme, Dominique ULg et al

in Otolaryngologic Clinics of North America (2006), 39(1), 191-204

Medialization thyroplasty for correction of glottic gap, keel placement after laser-assisted section, and topical application of mitomycin-C for anterior glottic synechiae are effective procedures for ... [more ▼]

Medialization thyroplasty for correction of glottic gap, keel placement after laser-assisted section, and topical application of mitomycin-C for anterior glottic synechiae are effective procedures for voice restoration after endoscopic cordectomy. Only a minority of patients (16.4% of the authors’ patients after total or extended cordectomies) request this voice restoration. In this regard, self-evaluation questionnaires (eg, VHI) probably are the most useful tools, along with stroboscopy, for voice assessment. Careful elevation of the fibrous tissue from the inner surface of the thyroid cartilage is a tedious and lengthy step, but is critical in successful medialization after cordectomy; therefore, general anesthesia is preferable. Transoral keel placement is still advisable in cases of thick synechiae. The Lichtenberger technique has been a major advancement to the transoral approach, and is the preferred technique of the authors. [less ▲]

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See detailProposition d'adaptation du Voice Handicap Index a la voix chantee.
Morsomme, Dominique ULg; Simon, Charlotte; Jamart, Jacques et al

in Revue de Laryngologie - Otologie - Rhinologie (2005), 126(5), 305-13

OBJECTIVES: The voice handicap index by Jacobson et al doesn't render the difficulties experienced by singers. The aim of this study is to adapt the V.H.I. to the singing voice and evaluate it's ... [more ▼]

OBJECTIVES: The voice handicap index by Jacobson et al doesn't render the difficulties experienced by singers. The aim of this study is to adapt the V.H.I. to the singing voice and evaluate it's reliability and coherence. In order to obtain this first scale, we went through three stages. MATERIAL ET METHOD: The first consisted in the modification of the existing items and the creation of new ones. The second was to measure the stability by a test - retest and the coherence of the adapted and the new items. This was done on groups of dysodic singers and professional voice users. The third stage consisted in evaluating the reliability and the coherence of 31 items on a homogeneous population of 132 classical singers with and without vocal impairment. The subjects were divided in three groups. The first group was composed of 95 normophonic singers, the second included 37 dysphonic singers and the third group was the control group, composed of 20 non singers without vocal complaints. RESULTS: The statistical results show a good stability of the test - retest (ICC=0.949; Rho: 0.912; Bland et Altman [-010.19, +13.23]). The internal coherence of each sub scale (Cronbach's alpha) is good (>0.70). The correlations between the three sub scales are moderate between the functional and the emotional sub scale: 0.58; between the emotional and the physical: 0.64; and between the functional and the physical: 0.78). Each sub scale is measuring a specific dimension; still they are homogeneous between one another. Four variables have a significative influence on the results: the pathology (p<0.001), being a professional singer (p<0.001), the repetition (p=0.003), being a chorister (p=0.002). CONCLUSION: The VH.I adapted to the singers, appears to be reliable, valid and adapted to the population of dysodic classical singers. [less ▲]

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See detailPrognosis of hematologic malignancies does not predict intensive care unit mortality.
MASSION, Paul ULg; Dive, Alain M; Doyen, Chantal et al

in Critical Care Medicine (2002), 30(10), 2260-70

OBJECTIVE: To evaluate the correlation between specific prognosis of hematologic malignancies on the one hand and intensive care unit and hospital mortality in critically ill patients with hematologic ... [more ▼]

OBJECTIVE: To evaluate the correlation between specific prognosis of hematologic malignancies on the one hand and intensive care unit and hospital mortality in critically ill patients with hematologic malignancies on the other hand. DESIGN: Observational study during a 10-yr period. SETTING: A 22-bed medical-surgical intensive care unit. PATIENTS: A total of 84 consecutive patients with nonterminal hematologic malignancies with medical complications requiring intensive care. INTERVENTIONS: None. MEASUREMENTS: Demographic factors, acute physiology and organ dysfunction scores, microbiology, therapeutic support, and hematologic factors data on admission and during the intensive care unit stay were collected, together with mortality follow-up. Based on specific-disease prognostic factors and related published survival curves, the prognosis of hematologic malignancies was assessed and defined as good, intermediate, or poor according to a 3-yr survival probability of >50%, 20-50%, or <20%, respectively. MAIN RESULTS: Prognosis of hematologic malignancies does not predict intensive care unit or hospital mortality and almost reaches significance for 6-mo mortality (53%, 71%, and 84% rate for patients with good, intermediate, and poor prognosis, respectively, p =.058), but it determines long-term survival (p =.008). Intensive care unit, hospital, and 6-mo overall mortality rates were 38%, 61%, and 75%, respectively. Using multivariate analysis, intensive care unit mortality was best predicted on admission by respiratory failure and fungal infection, whereas hospital mortality was predicted by the number of organ failures, the bone marrow transplant status, and the presence of fungal infection. The Acute Physiology and Chronic Health Evaluation II and the Simplified Acute Physiology Score II had no prognostic value, whereas the difference of the Multiple Organ Dysfunction Score between at the time of admission and at day 5 allowed quick prediction of hospital mortality. Diseases with the poorest 6-mo prognosis were acute myeloid leukemia and non-Hodgkin lymphoma. CONCLUSION The severity of the underlying hematologic malignancies does not influence intensive care unit or hospital mortality. Short-term prognosis is exclusively predicted by acute organ dysfunctions and by a pathogen's aggressiveness. Therefore, reluctance to admit patients with nonterminal hematologic malignancies to the intensive care unit based only on the prognosis of their underlying hematologic malignancy does not seem justified. [less ▲]

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See detailComparison between the GIRBAS Scale and the Acoustic and Aerodynamic Measures Provided by EVA for the Assessment of Dysphonia following Unilateral Vocal Fold Paralysis.
Morsomme, Dominique ULg; Jamart, Jacques; Wery, Carine et al

in Folia Phoniatrica et Logopaedica (2001), 53(6), 317-25

The aim of this study is to establish relevant objective parameters for evaluating dysphonia following unilateral vocal fold paralysis. To do so, the study compares objective and perceptual voice measures ... [more ▼]

The aim of this study is to establish relevant objective parameters for evaluating dysphonia following unilateral vocal fold paralysis. To do so, the study compares objective and perceptual voice measures. The objective measures were obtained using a voice analysis software (Evaluation Vocale Assistee), whereas the perceptual measures were established with the GIRBAS Scale (grade, instability, roughness, breathiness, asthenia, and strain). All measurements were performed on 40 voice samples: 28 dysphonic subjects with unilateral laryngeal paralysis, and 12 control subjects. The intra- and inter-judge agreements were fairly good, at least for control subjects. The six GIRBAS measures obtained from the pathological voices were higher than those from the control voices (p < 0.001) and the correlation between both groups was good. Grade, breathiness and asthenia correlated with the objective parameters that express the aperiodicity of the phonatory signal (p < 0.01), namely, the coefficient of variability of the fundamental frequency, the coefficient of variability of intensity, and jitter. Our findings suggest that the perceptual reality of laryngeal paralysis-induced dysphonia depends more on grade, breathiness and asthenia than it does on roughness or instability. [less ▲]

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See detailA study of vibrato : assessment by panel of judges compared to spectral analysis.
Morsomme, Dominique ULg; Orban, Andrée; Jamart, Jacques et al

in Revue de Laryngologie - Otologie - Rhinologie (1999), 120(4), 239-244

Experts in voice singing and voice training were asked to judge the vibrato of 30 singers (4 samples per singer: a sung [a] held without vibrato; a sung [a] with vibrato; a self selected passage and an ... [more ▼]

Experts in voice singing and voice training were asked to judge the vibrato of 30 singers (4 samples per singer: a sung [a] held without vibrato; a sung [a] with vibrato; a self selected passage and an imposed passage. In the first part, they ticked the type of oscillations (vibrato, straight tone, tremolo, quavering, ...). In the second part, they appraised various criteria. Intra-judge and inter-judge consistencies were determined. The subjective parameters were thereafter correlated with the measurements of six parameters of the MDVP (Multi Dimensional Voice Program). The measurements were carried out on each task. Intra-judge consistency was good for only one judge (67-87% consistency). Since jdge 2 and 3 were hardly reproducible (45-73%; 28-57%) measurement of the inter-judge consistency was pointless. The results of jusge 1 were correlated with the Fundamental Tremor, Frequency Index, the jitter and the shimmer. [less ▲]

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See detailA study of Vibrato: assessment by panel of judges compared to spectral voice analysis.
Morsomme, Dominique ULg; Orban, Andrée; Jamart, Jacques et al

Conference (1998, August 27)

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See detailA study of vibrato, assessment by a panel of judges compared to spectral voice analysis.
Morsomme, Dominique ULg; Orban, Andrée; Jamart, Jacques et al

Conference (1997, June 18)

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See detailPresbyphonia voice differencies between the secties in the elderly. comparison by maximum phonation time, phonation quotient and spectral analysis
Morsomme, Dominique ULg; Jamart, Jacques; Boucquey, Donatienne et al

in Logopedics, Phoniatrics, Vocology (1997), 22

This study of 40 elderly subjects (30 women and 10 men) between the ages of 70 to 90, attempts to qualify and quantify their voices and to compare the results with a young population and to establish any ... [more ▼]

This study of 40 elderly subjects (30 women and 10 men) between the ages of 70 to 90, attempts to qualify and quantify their voices and to compare the results with a young population and to establish any differences between the two sexes. The measurements concerned the Vital Capacity (VC), the Maximum Phonation Time (MPT) and the Phonation Quotient (PQ). The equivalent values for a young population were compiled from the literature. Spectral voice analysis was also included in the study. The mean speaking fundamental frequency (Fo) of the voice changes with age; it increases in men and decreases in women (158 Hz in elderly men vs a normal value of 120 Hz; 205 Hz in elderly women vs a normal value of 225 Hz). Ageing influences the vital capacity to the advantage of men (median VC = 2.61 vs 1.61 in elderly men and women, respectively). For sustaining a vowel a, the Maximum Phonation Time (MPT) is significantly better in elderly men (median MPT = 16 sec in elderly men and 12 sec for women). Phonation Quotient does not differ significantly between sexes (median PQ = 153 ml/sec in elderly men and 152 ml/sec in elderly women). Although, the physical capacity of elderly women decreases, their vocal output remains very good when compared to young women. In elderly men, however, there is a phonation quotient decrease of 25 per cent compared to young men. [less ▲]

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