Voice Evaluation includes (8):
- Patient history
- Voice sample
- Perceptual analysis
- Acoustic analysis
- Stroboscopic assessment
- Respiratory assessment
- Resonance/vp assessment
- Recommendations/POC
Which types of voice samples are recorded (2):
sustained
connected
The perceptual analysis is (subjective or objective)
subjective
Types of Perceptual analyses we do (2):
- VHI (voice handicap index) (their perception)
2. CAPE-V (our perception)
The Acoustic analysis is (subjective or objective)
objective
Type of Acoustic analysis we do (1):
MDVP (Multi-Dementional Voice Profile)
Types of Respiratory assessment tools (3):
- spirometry
- manometry
- pneumotachometry
Type of Resonance/vp assessments (2):
- nasopharyngoscopy
2. nasometer
What do you have the patient do/say when getting a connected and sustained voice sample? (3 things)
- state name
- sing aaa (high and low pitch)
- then count to 10
What is recorded from the case history and present problem? (10 things)
- Origin (When problem first began, vocal abuse + medical history)
- Duration (vocal use, vocal abuse/misuse)
- Present Problem (severity)
- Reflux symptoms
- Pain?
- Swallowing problems?
- Smoking history
- Alcohol use
- Caffeine consumption
- Hydration
What is included on the Voice Handicap Index (VHI) (3)?
- Functional
- Physical
- emotional
(questions about how they feel about their voice)
How is the Voice Handicap Index (VHI) recorded?
Likert scale 0-4/best to worst
Score each section to see if they are having a problem in that section
How do you interpret the scores from the VHI?
1-30 = mildly disruptive voice
31-60 = moderately disruptive
61-120 = severely disruptive
What is included on the CAPE-V (Consensus Auditory Perceptual Evaluation of Voice) (9)?
- Roughness
- Breathiness
- Strain
- Pitch (Nature of abnormality)
- Loudness (Nature of abnormality)
- Resonance
- Additional features
- Overall severity
- Is the problem consistent or intermittent for each
*rated on a line: mild, moderate, severe
Other things that can be included in a voice evaluation:
- Oral-facial exam (oral mech exam)
- Hearing assessment
- Instrumentation (EMG + EGG)
Why would you do a hearing assessment?
If a patient is not hearing well, they might increase their volume of their voice which can cause damage
What does an EMG (Elctro-myography) measure?
muscle activity in volts
surface electrodes measure muscles
what does an EGG (eletroglottal graph) measure?
Mean flow rate (MFR) of airflow at glottis
