Voice therapy used to test a basic protocol for multidimensional assessment of dysphonia

The aim of this study was the elaboration of a basic voice protocol to discover which combination of tests and measures (multidimensional evaluation) provide decisive and essential data for the diagnosis of voice pathology and its prognosis. Voices of 21 patients with dysphonia and 21 subjects in a control group were evaluated and compared. Vocal function was assessed using a multiparametric set of videolaryngostroboscopic, perceptual, acoustic, spectrographic, aerodynamic, and subjective basic measurements (Multidimensional "Teatinos" Protocol). The dysphonic group received voice therapy for two sessions/week during 3 months. The results of the study were the following-(1) alterations in vocal function were reflected in the indicators: maximum phonation time (MPT) /a/, maximum exhalation time (MET) /s/, MPT during connect speech (MPTS), jitter, shimmer, harmonic-to-noise ratio, vocal well being (WB), self-voice assessment (SELF), vocal hygiene (HYGIENE), anxiety (ANX) and perceptual, laryngoscopic, and spectrographic explorations; (2) the indicators which are most sensitive to voice therapy are the following: MPT /a/, MET /s/, MPTS, jitter, WB, SELF, HYGIENE, ANX and perceptual, laryngoscopic, and spectrographic explorations; and (3) these positive effects were maintained or increased 4 months after termination of the treatment. Multidimensional "Teatinos" Protocol makes it possible to detect significant differences in mean values of subjective, qualitative, and objective voice assessments between dysphonic patients and control group at pre- and posttreatment stages. Therefore, multidimensional voice evaluation is a useful tool in the diagnostics of dysphonia in clinical and speech-language-therapy contexts.