Usefulness of Voice Handicap Index in Patients with Hoarseness

Choi, Doo Young; Choi, Sun Myung; Lim, Gil Chai; Nam, Soon Yuhl

Abstract

BACKGROUND AND OBJECTIVES: The Voice Handicap Index (VHI) was developed to assess patients' perception on the severity of their voice disorders. The purpose of this study was to determine the severity of handicap expressed by patients with various voice disorders, and to help clinicians in making future treatment plan. VHI may also be used as a guideline in making diagnosis according to different factors of voice quality.
SUBJECTS AND METHOD
The people who had visited the Asan Medical Center with hoarseness from August 2000 to August 2001 were studied. They filled out the questionnaire composed of 30 questions about their voice disorders. The subjects were consisted of 6 groups; 50 patients with vocal cord nodule, 43 patients with laryngitis, 42 patients with vocal cord polyp, 25 patients with glottic cancer and 14 patients with unilateral vocal cord paralysis. Descriptive statistics were used to analyze the data and mean value of VHI scores.
RESULTS
The mean score of VHI was found to be statistically higher in the subjects with the history of voice abuse (p<0.002). Overall, the group with unilateral vocal cord paralysis showed the highest VHI score that was statistically significant (p<0.001). When the functional factor is considered, groups with unilateral vocal cord paralysis and glottic cancer had shown higher scores compared to the other groups. When the physical factor is considered, groups with unilateral vocal cord paralysis and vocal cord polyp had shown higher scores. When the emotional factor is considered, groups with unilateral vocal cord paralysis had shown higher scores.
CONCLUSION
Measurement of VHI in patients with voice disorders provides a measure of self-perception on the severity of the problems that cannot be assessed through visual perception or objective acoustic and aerodynamic measures. In addition, the measurement of VHI score was easy to perform, non-invasive, and inexpensive. In using this method, we expect to reveal the efficacy of the treatment for voice disorders.