Consensus for voice quality assessment in clinical practice: guidelines of the European Laryngological Society and Union of the European Phoniatricians

Jerome R Lechien^#^{1

2

3

4}, Ahmed Geneid^#⁵, Jörg E Bohlender⁶, Giovanna Cantarella^{7

8}, Juan C Avellaneda⁹, Gauthier Desuter¹⁰, Elisabeth V Sjogren¹¹, Camille Finck¹², Stephane Hans^{13

14}, Markus Hess¹⁵, Haldun Oguz¹⁶, Marc J Remacle^{13

17}, Berit Schneider-Stickler¹⁸, Miroslav Tedla¹⁹, Antonio Schindler²⁰, Isabel Vilaseca^{21

22}, Michal Zabrodsky²³, Frederik G Dikkers^#²⁴, Lise Crevier-Buchman^#^{13

14}

Affiliations

¹ Department of Otolaryngology-Head Neck Surgery, Foch Hospital, University of Paris Saclay, Paris, France. jerome.lechien@umons.ac.be.
² Department of Otolaryngology-Head Neck Surgery, CHU Saint-Pierre, Brussels, Belgium. jerome.lechien@umons.ac.be.
³ Department of Laryngology and Broncho-Esophagology, EpiCURA Hospital, Anatomy Department of University of Mons, Mons, Belgium. jerome.lechien@umons.ac.be.
⁴ Phonetics and Phonology Laboratory (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3), Paris, France. jerome.lechien@umons.ac.be.
⁵ Department of Otolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
⁶ Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
⁷ Department of Otolaryngology and Head and Neck Surgery Fondazione, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
⁸ Department of Clinical Sciences and Community Health Università degli Studi di Milano, Milan, Italy.
⁹ Department of Surgery, Otolaryngology Service. Hospital Universitario Mayor Mederi, Universidad del Rosario, Bogotá, Colombia.
¹⁰ ENT, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.
¹¹ Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.
¹² Department of Otorhinolaryngology-Head and Neck Surgery, CHU de Liege, Université de Liège, Liège, Belgium.
¹³ Department of Otolaryngology-Head Neck Surgery, Foch Hospital, University of Paris Saclay, Paris, France.
¹⁴ Phonetics and Phonology Laboratory (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3), Paris, France.
¹⁵ Medical Voice Center (MEVOC), Hamburg, Germany.
¹⁶ Department of Otolaryngology, Fonomer, Ankara, Turkey.
¹⁷ Department of Otorhinolaryngology-Head and Neck Surgery, Center Hospitalier de Luxembourg, Eich, Luxembourg.
¹⁸ Department of Otorhinolaryngology Medical, University of Vienna, Vienna, Austria.
¹⁹ Department of Otolaryngology, Head and Neck Surgery, Comenius University, University Hospital, Bratislava, Slovakia.
²⁰ Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy.
²¹ Department of Otorhinolaryngology, Hospital Clínic, Barcelona, Spain.
²² University of Barcelona, Barcelona, Spain.
²³ Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, First Faculty of Medicine, Charles University, Prague, Czech Republic.
²⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands.

^# Contributed equally.

PMID: 37707614
DOI: 10.1007/s00405-023-08211-6

Free article

Consensus for voice quality assessment in clinical practice: guidelines of the European Laryngological Society and Union of the European Phoniatricians

Jerome R Lechien et al. Eur Arch Otorhinolaryngol. 2023 Dec.

Free article

. 2023 Dec;280(12):5459-5473.

doi: 10.1007/s00405-023-08211-6. Epub 2023 Sep 14.

Authors

Affiliations

¹ Department of Otolaryngology-Head Neck Surgery, Foch Hospital, University of Paris Saclay, Paris, France. jerome.lechien@umons.ac.be.
² Department of Otolaryngology-Head Neck Surgery, CHU Saint-Pierre, Brussels, Belgium. jerome.lechien@umons.ac.be.
³ Department of Laryngology and Broncho-Esophagology, EpiCURA Hospital, Anatomy Department of University of Mons, Mons, Belgium. jerome.lechien@umons.ac.be.
⁴ Phonetics and Phonology Laboratory (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3), Paris, France. jerome.lechien@umons.ac.be.
⁵ Department of Otolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
⁶ Department of Phoniatrics and Speech Pathology, Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
⁷ Department of Otolaryngology and Head and Neck Surgery Fondazione, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
⁸ Department of Clinical Sciences and Community Health Università degli Studi di Milano, Milan, Italy.
⁹ Department of Surgery, Otolaryngology Service. Hospital Universitario Mayor Mederi, Universidad del Rosario, Bogotá, Colombia.
¹⁰ ENT, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.
¹¹ Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.
¹² Department of Otorhinolaryngology-Head and Neck Surgery, CHU de Liege, Université de Liège, Liège, Belgium.
¹³ Department of Otolaryngology-Head Neck Surgery, Foch Hospital, University of Paris Saclay, Paris, France.
¹⁴ Phonetics and Phonology Laboratory (UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3), Paris, France.
¹⁵ Medical Voice Center (MEVOC), Hamburg, Germany.
¹⁶ Department of Otolaryngology, Fonomer, Ankara, Turkey.
¹⁷ Department of Otorhinolaryngology-Head and Neck Surgery, Center Hospitalier de Luxembourg, Eich, Luxembourg.
¹⁸ Department of Otorhinolaryngology Medical, University of Vienna, Vienna, Austria.
¹⁹ Department of Otolaryngology, Head and Neck Surgery, Comenius University, University Hospital, Bratislava, Slovakia.
²⁰ Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy.
²¹ Department of Otorhinolaryngology, Hospital Clínic, Barcelona, Spain.
²² University of Barcelona, Barcelona, Spain.
²³ Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, First Faculty of Medicine, Charles University, Prague, Czech Republic.
²⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands.

^# Contributed equally.

PMID: 37707614
DOI: 10.1007/s00405-023-08211-6

Abstract

Introduction: To update the European guidelines for the assessment of voice quality (VQ) in clinical practice.

Methods: Nineteen laryngologists-phoniatricians of the European Laryngological Society (ELS) and the Union of the European Phoniatricians (UEP) participated to a modified Delphi process to propose statements about subjective and objective VQ assessments. Two anonymized voting rounds determined a consensus statement to be acceptable when 80% of experts agreed with a rating of at least 3/4. The statements with ≥ 3/4 score by 60-80% of experts were improved and resubmitted to voting until they were validated or rejected.

Results: Of the 90 initial statements, 51 were validated after two voting rounds. A multidimensional set of minimal VQ evaluations was proposed and included: baseline VQ anamnesis (e.g., allergy, medical and surgical history, medication, addiction, singing practice, job, and posture), videolaryngostroboscopy (mucosal wave symmetry, amplitude, morphology, and movements), patient-reported VQ assessment (30- or 10-voice handicap index), perception (Grade, Roughness, Breathiness, Asthenia, and Strain), aerodynamics (maximum phonation time), acoustics (Mean F0, Jitter, Shimmer, and noise-to-harmonic ratio), and clinical instruments associated with voice comorbidities (reflux symptom score, reflux sign assessment, eating-assessment tool-10, and dysphagia handicap index). For perception, aerodynamics and acoustics, experts provided guidelines for the methods of measurement. Some additional VQ evaluations are proposed for voice professionals or patients with some laryngeal diseases.

Conclusion: The ELS-UEP consensus for VQ assessment provides clinical statements for the baseline and pre- to post-treatment evaluations of VQ and to improve collaborative research by adopting common and validated VQ evaluation approach.

Keywords: Assessment; Consensus; Dysphonia; European; Evaluation; Guidelines; Head; Neck; Otolaryngology; Surgery; Voice.

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References

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Consensus for voice quality assessment in clinical practice: guidelines of the European Laryngological Society and Union of the European Phoniatricians

Affiliations

Consensus for voice quality assessment in clinical practice: guidelines of the European Laryngological Society and Union of the European Phoniatricians

Authors

Affiliations

Abstract

References

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MeSH terms

LinkOut - more resources

Full Text Sources