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See detailOn the accuracy of adults’ auditory perception of normophonic and dysphonic children’s personality.
Verduyckt, Ingrid; Remacle, Marc; Morsomme, Dominique ULg

in Logopedics, Phoniatrics, Vocology (in press)

We investigated the accuracy of auditory inferences of personality of Belgian children with vocal fold nodules (VFN). External judges (N=57) were asked to infer the personality of normophonic (NP ... [more ▼]

We investigated the accuracy of auditory inferences of personality of Belgian children with vocal fold nodules (VFN). External judges (N=57) were asked to infer the personality of normophonic (NP) children and children with VFN (N=10) on the basis of vowels and sentences. The auditory inferred profiles were compared to the actual personality of NP and VFN children. Positive and partly accurate inferences of VFN children’s personality were made on the basis of connected speech, while sustained vowels yielded negative and inaccurate inferences of personality traits of children with VFN. Dysphonic voice quality, as defined by the overall severity of vocal abnormality, conveyed inaccurate and low degrees of Extraversion. This effect was counterbalanced in connected speech by faster speaking rate that accurately conveyed higher degrees of Extraversion, a characteristic trait of VFN children’s actual personality. [less ▲]

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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 detailValidation d'un double questionnaire (enfant/parent) pour l'évaluation subjective de la voix chez l'enfant.
Verduyckt, Ingrid; Morsomme, Dominique ULg; Ferrara, Tamara et al

Conference (2010, October 18)

Contexte L’auto-évaluation des symptômes vocaux et de leur impact sur la vie quotidienne fait aujourd’hui partie de l’évaluation de la dysphonie. Pour les adultes, nous disposons de questionnaires validés ... [more ▼]

Contexte L’auto-évaluation des symptômes vocaux et de leur impact sur la vie quotidienne fait aujourd’hui partie de l’évaluation de la dysphonie. Pour les adultes, nous disposons de questionnaires validés (Woisard et al 2004, Morsomme et al 2005), il n’existe pas d’équivalent pour les enfants.Notre objectif est la validation d’un questionnaire dont la création à déjà fait l’objet d’une publication (Verduyckt et al, 2010) . Méthode Passation du questionnaire sur un mode test-retest (Enfants : N 168 (5,5 – 12,7 ans), Parents : N 118). La population est divisée en trois sous-groupes : 1. Dysphoniques avec plainte vocale (DAP), N : 27 enfants 2. Dysphoniques sans plaintes vocales (DSP), N : 22 enfants 3. Normophoniques (NP), N :73 enfants Résultats Nous observons une bonne cohérence interne Alpha de Cronbach >.85 ainsi qu’une fiabilité test-retest élevée: Pearson’s r : .68 (enfants) et .84 (parents), (p<.05) et une corrélation bonne à élevée entre le score total et la question adressant spécifiquement la présence d’un problème vocal ( Spearman’s r : .54 (enfants) et r :.64 (parents) (p<.05)). Nous observons également une différence significative entre le score total des trois sous-groupes pour les parents (DAP = DSP > NP) (p <.05). La corrélation entre les scores enfants et parents est faible (Pearson’s r <.25) et il existe une différence significative entre leurs scores totaux : enfants > parents (p<.05). Conclusions Notre questionnaire s‘est montré valide et fiable. Il est sensible avant tout aux plaintes des parents d’enfants dysphoniques. L’utilité d’un questionnaire qui s’adresse d’une part aux enfants et d’une part aux parents est confirmée, les réponses parentales n’étant que faiblement corrélées aux réponses des enfants et significativement différentes. [less ▲]

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See detailGlottoplasty for Male-to-Female Transsexualism: Voice Results
Remacle, Marc; Matar, Nayla; Morsomme, Dominique ULg et al

in Journal of Voice (2010), 25(1), 120-3

Summary: Objectives. The aim of this study was to evaluate the objective voice results ofWendler’s glottoplasty in male-to-female transsexuals. Method. We retrospectively reviewed our patients treated ... [more ▼]

Summary: Objectives. The aim of this study was to evaluate the objective voice results ofWendler’s glottoplasty in male-to-female transsexuals. Method. We retrospectively reviewed our patients treated with Wendler’s technique with minor modifications. Glottoplasty consisted in CO2-laser epithelial ablation of the anterior commissure and the two vocal folds in anterior third, suturing of the two vocal folds with two stitches of 3.0 resorbable thread, and application of fibrin sealant to strengthen the suture. Voice assessment was based mainly on fundamental frequency (F0), frequency range, jitter, maximum phonation time, phonation quotient, estimated subglottic pressure (ESGP) grade of dysphonia (G), and voice handicap index (VHI). These measures were taken before surgery and on the last follow-up visit. Results. Our series included 15 patients with a mean age of 36 years. The mean follow-up period was 7.2 months.We did not observe any early complications related to the technique. The comparison between the preoperative and the postoperative measurements, using Wilcoxon signed rank test, showed a significant improvement of median F0 from 139 to 191 Hz (P ¼ 0.006) with an increase in the grade of dysphonia (Gpre ¼ 0.2, Gpost ¼ 1, P ¼ 0.013) and ESGP (ESGPpre ¼ 8.1 ± 3.2, ESGPpost ¼ 12.0 ± 3.8, P ¼ 0.002). Other measurements, including VHI, did not show any significant differences pre- and postoperatively. Conclusion. Wendler’s glottoplasty can contribute to feminize the voice. [less ▲]

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See detailVoice Feminization in case of gender reassignment: effect of Wendler glottopasty
Remacle, Marc; Morsomme, Dominique ULg; Lawson, George

in Journal of Voice (2009, July 04)

Summary: Objectives. The aim of this study was to evaluate the objective voice results ofWendler’s glottoplasty in male-to-female transsexuals. Method. We retrospectively reviewed our patients treated ... [more ▼]

Summary: Objectives. The aim of this study was to evaluate the objective voice results ofWendler’s glottoplasty in male-to-female transsexuals. Method. We retrospectively reviewed our patients treated with Wendler’s technique with minor modifications. Glottoplasty consisted in CO2-laser epithelial ablation of the anterior commissure and the two vocal folds in anterior third, suturing of the two vocal folds with two stitches of 3.0 resorbable thread, and application of fibrin sealant to strengthen the suture. Voice assessment was based mainly on fundamental frequency (F0), frequency range, jitter, maximum phonation time, phonation quotient, estimated subglottic pressure (ESGP) grade of dysphonia (G), and voice handicap index (VHI). These measures were taken before surgery and on the last follow-up visit. Results. Our series included 15 patients with a mean age of 36 years. The mean follow-up period was 7.2 months.We did not observe any early complications related to the technique. The comparison between the preoperative and the postoperative measurements, using Wilcoxon signed rank test, showed a significant improvement of median F0 from 139 to 191 Hz (P ¼ 0.006) with an increase in the grade of dysphonia (Gpre ¼ 0.2, Gpost ¼ 1, P ¼ 0.013) and ESGP (ESGPpre ¼ 8.1 ± 3.2, ESGPpost ¼ 12.0 ± 3.8, P ¼ 0.002). Other measurements, including VHI, did not show any significant differences pre- and postoperatively. Conclusion. Wendler’s glottoplasty can contribute to feminize the voice. [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 detailApport de la caméra à haute vitesse en comparaison avec la stroboscopie.
Remacle, Marc; Morsomme, Dominique ULg

Conference (2008, October 14)

Introduction:La stroboscopie est indispensable au bilan des troubles de la voix affectant les cordes vocales. Elle est toutefois basée sur la reconstitution d'une image de représentant pas la réalité. Sur ... [more ▼]

Introduction:La stroboscopie est indispensable au bilan des troubles de la voix affectant les cordes vocales. Elle est toutefois basée sur la reconstitution d'une image de représentant pas la réalité. Sur ce plan la caméra à haute vitesse permettant d'observer des cycles vibratoires réels lui est supérieure. Les problèmes techniques: coût, stockage et traitements des images .. n'ont pas permis sa diffusion et son emploi en phoniatrie clinique.Nous présentons la comparaison des enregistrements obtenus avec la caméra à haute vitesse Wolf avec ceux acquis avec le stroboscope (strobobase) de la même firme.Matériels et méthodes: La caméra à haute vitesse Wolf (Knittlige, Allemagne) permet d'enregistrer des séquences de 2 sec soit de 4000 ou de 2000 images/s. L'enregistrement est en couleur. L'examinateur peut choisir parmi ces 2 sec une séquence pertinente pour stockage dans le disque dur et analyse complémentaire. Les analyses complémentaires sont essentiellement la kimographie et la mesure de l'écartement du bord libre des cordes vocales au cours de la séquence. Cette dernière mesure est traduite de manière graphique, évoquant l'électroglottographie. La mesure est faite simultanément à la partie antérieure médiane et postérieure des cordes vocales. Le strobosbase est basé sur un système de shutter activé classiquement par un microphone de contact. Trente cinq patients représentant l'ensemble de la pathologie bénigne des cordes vocales ont été enregistrés successivement avec les deux systèmes. La qualité de l'image, la contribution au diagnostic et au traitement ont été observées avec les deux systèmes. Résultats: Dans tous les cas, la qualité de l'image stroboscopique est nettement supérieure à celle de la caméra à haute vitesse. Celle-ci ne disposant pas d'assez de pixels. Dans aucun cas la caméra à haute vitesse n'a modifié le diagnostic. La caméra à haute vitesse apporte toutefois des renseignements supérieurs à la stroboscopie en cas de béance glottique (paralysie, encoche, presbyphonie, ...). Grâce à la kymographie et à l'analyse de l'écartement des cordes vocales. Sur dix sept cas de béances glottiques, la décision thérapeutique a été modifiée 4 fois après examen à la caméra à haute vitesse. Discussion: La caméra à haute vitesse de modèle Wolf ne peut remplacer la stroboscopie dans l'état présent. Elle est un complément utile pour l'étude des béances glottiques en permettant une meilleure observation des phases d'ouverture et de fermeture. Elle contribue ainsi à la décision thérapeutique. Le choix subjectif d'une séquence parmi les deux enregistrées peut être un biais important. [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 detailLa presbyphonie - Le vieillissement de la voix
Remacle, Marc; Zaarour, Stéphanie; Soh-Ping, Eng et al

in Klein-Dallant, Carine (Ed.) Voix parlée et chantée (2006)

Les changements causés par le vieillissement se déroulent à un rythme différent pour chaque personne et dépendent de facteurs comme le style de vie, les activités et l'environnement ainsi que des facteurs ... [more ▼]

Les changements causés par le vieillissement se déroulent à un rythme différent pour chaque personne et dépendent de facteurs comme le style de vie, les activités et l'environnement ainsi que des facteurs comme le bagage génétique et l'état de santé.La presbyphonie est le terme employé pour définir le vieillissement de la voix. Elle s'observe le plus souvent après 60 ans et touche les deux sexes. Ce trouble vocal est la conséquence d'altérations morphologiques et fonctionnelles des systèmes pneumo-phono-articulatoires qui résultent d'une modification hormonale (thyroïdienne et sexuelles), d'une altération de l'état musculaire, vasculaire, nerveux ou respiratoire, ou encore d'un manque d'exercice vocal. [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 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 detailMicro-phonochirurgie assistée au laser CO2 des lésions bénignes des cordes vocales
Remacle, Marc; Giovanni, Antoine; Lawson, George et al

in Cahiers d'Oto-rhino-laryngologie, de Chirurgie Cervico-faciale et d'Audiophonologie (Les) (2000), 35(6), 293-300

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