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Otolaryngology--head and Neck Surgery :... May 2008To evaluate the effectiveness of interventions for treating functional dysphonia or preventing voice disorders in adults. (Review)
Review
OBJECTIVE
To evaluate the effectiveness of interventions for treating functional dysphonia or preventing voice disorders in adults.
DATA SOURCES
We searched MEDLINE (1950 to 2006), EMBASE (1974 to 2006), CENTRAL (Issue 2 2006), CINAHL (1983 to 2006), PsychINFO (1967 to 2006), Science Citation Index (1986 to 2006), and the Occupational Health databases OSH-ROM (February 2006).
REVIEW METHODS
Systematic review and meta-analysis of randomized controlled trials. Included studies evaluated the effectiveness of interventions for 1) treating functional/nonorganic dysphonia or 2) preventing voice disorders. We identified six randomized controlled trials about treatment and two about prevention. Two authors independently extracted data and assessed trial quality.
RESULTS
A combination of direct and indirect voice therapy, compared with no intervention, improves self-reported (standardized mean difference -1.07; 95% CI -1.94 to -0.19), observer-rated (weighted mean difference [WMD] -13.00; 95% CI -17.92 to -8.08), and instrumentally assessed vocal functioning (WMD -1.20; 95% CI -2.37 to -0.03) in adults with functional dysphonia. Effects are reported to remain for at least 14 weeks. Effects are similar in patients and in teachers and student teachers screened for voice problems. We found two studies that did not show voice training, compared with no intervention, to have a preventive effective in improving self-reported vocal functioning. Assessment of publication bias showed that the real effect sizes are probably smaller.
CONCLUSION
Comprehensive voice therapy is effective in improving vocal performance in adults with functional dysphonia. There is no evidence of effectiveness of voice training in preventing voice disorders.
Topics: Humans; Voice Disorders; Voice Training
PubMed: 18439458
DOI: 10.1016/j.otohns.2008.01.014 -
Journal of Voice : Official Journal of... Nov 2017The study aimed to review the prevalence of self-reported voice disorders in singers. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The study aimed to review the prevalence of self-reported voice disorders in singers.
STUDY DESIGN
The study is a systematic review and meta-analysis.
METHODS
A systematic review of five major scientific databases was conducted. An extensive search strategy was used considering the rules of each database. Original articles were included only if they had data related to self-perception of dysphonia in the past. Furthermore, heterogeneity and its relative significance were assessed.
RESULTS
There were 2371 articles identified; duplicates were deleted, screenings were conducted, and inclusion and exclusion criteria were applied. The final analysis was conducted on 11 studies. The most implemented instruments for the study were customized questionnaires. The findings about singing styles, voice use, and age were found to be different among subjects. The overall prevalence of self-reported dysphonia in singers was 46.09% (95% confidence interval: 38.16-54.12). The heterogeneity was considerable among the studied samples (I = 90.59%). Four groups were then established-students, teachers, classical, and nonclassical-and compared regarding overall prevalence (21.76% in students, and significantly higher and nondifferent in the other three groups, 55.15%, 40.53%, and 46.96%, respectively) and heterogeneity (low only for the students' studies).
CONCLUSION
Although with low homogeneity, singers present a high prevalence of self-perceived dysphonia over their careers. Singing students were the group with a lower prevalence. On the other hand, traditional and popular music singers, as well as singing teachers, revealed significantly higher prevalence of self-perceived dysphonia. Overall, singers are likely to report voice disorders, no matter their singing style or skills. This highlights the need of a preventive approach to address voice disorders in traditional and untrained singers.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Auditory Perception; Child; Child, Preschool; Female; Humans; Male; Middle Aged; Occupational Diseases; Occupational Health; Occupations; Prevalence; Risk Factors; Self Concept; Self Report; Singing; Voice Disorders; Young Adult
PubMed: 28342677
DOI: 10.1016/j.jvoice.2017.02.010 -
Journal of Neurosurgery. Spine Feb 2023The optimal surgical approach for patients with multilevel degenerative cervical myelopathy (DCM) remains unknown. This systematic review and meta-analysis sought to...
OBJECTIVE
The optimal surgical approach for patients with multilevel degenerative cervical myelopathy (DCM) remains unknown. This systematic review and meta-analysis sought to compare anterior cervical discectomy and fusion (ACDF) versus posterior decompression (PD) in patients with DCM spanning ≥ 2 levels without ossification of the posterior longitudinal ligament.
METHODS
MEDLINE and PubMed were searched from inception to February 22, 2022. The primary outcomes were Neck Disability Index (NDI), SF-36 Physical Component Summary (PCS), modified Japanese Orthopaedic Association (mJOA) scale, visual analog scale (VAS), and EQ-5D scores. Secondary outcomes were operative bleeding, operative duration, hospital length of stay (LOS), postoperative morbidity (including hematoma, surgical site infection [SSI], CSF leakage, dysphagia, dysphonia, C5 palsy, and fusion failure), mortality, readmission, reoperation, and Cobb angle.
RESULTS
Nineteen studies comprising 8340 patients were included, of whom 4118 (49.4%) and 4222 (50.6%) underwent ACDF and PD, respectively. The mean number of involved spinal levels was comparable between the groups (3.1 vs 3.5, p = 0.15). The mean differences (MDs) of the primary outcomes were the mean of each index in the ACDF group minus that of the PD group. At the 1-year follow-up, the MDs of the NDI (-1.67 [95% CI -3.51 to 0.18], p = 0.08), SF-36 PCS (2.48 [95% CI -0.59 to 5.55], p = 0.11), and VAS (-0.32 [95% CI -0.97 to 0.34], p = 0.35) scores were similar between the groups. While the MDs of the mJOA (0.71 [95% CI 0.27 to 1.16], p = 0.002) and EQ-5D (0.04 [95% CI 0.01 to 0.08], p = 0.02) scores were greater in the ACDF group, the differences were not clinically significant given the minimal clinically important differences (MCIDs) of 2 and 0.05 points, respectively. In the ACDF group, the MDs for operative bleeding (-102.77 ml [95% CI -169.23 to -36.30 ml], p = 0.002) and LOS (-1.42 days [95% CI -2.01 to -0.82 days], p < 0.00001) were lower, the dysphagia OR (11.10 [95% CI 5.43-22.67], p < 0.0001) was higher, and the ORs for SSI (0.43 [95% CI 0.24-0.78], p = 0.006) and C5 palsy (0.32 [95% CI 0.15-0.70], p = 0.004) were lower. The other outcomes were similar between the groups. Overall evidence according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach was moderate.
CONCLUSIONS
ACDF and PD are similar regarding functional outcomes. ACDF is beneficial in terms of less bleeding, shorter LOS, and lower odds of SSI and C5 palsy, while the procedure carries higher odds of dysphagia. The authors recommend individualized treatment decision-making.
PubMed: 36840737
DOI: 10.3171/2023.1.SPINE221244 -
Frontiers in Surgery 2023Fibrin sealants have recently been thoroughly studied in several surgical specialties; however, results are conflicting. We aimed to examine the safety and efficacy of... (Review)
Review
Fibrin sealants have recently been thoroughly studied in several surgical specialties; however, results are conflicting. We aimed to examine the safety and efficacy of fibrin sealant patients having thyroidectomies. A thorough, systematic literature search was carried out using the terms thyroidectomy and fibrin sealant using PubMed, Cochrane Library, and Clinicaltrials.gov on December 25, 2022. The primary outcome of interest in this review was the amount of drainage, whereas hospitalization, the length of drain retention, and temporary dysphonia were secondary outcomes. Our meta-analysis ( = 249) showed that application of fibrin sealant is associated with lesser total drainage [SMD -2.76 (-4.83, -0.69); = 0.009; I2 97%], but not with retention time of drainage [SMD -2.35 (-4.71, 0.01); = 0.05; I2 98%], hospitalization time [SMD -1.65 (-3.70, 0.41); = 0.12; I2 97%], and transient dysphonia [RR 1.01 (0.27, 3.82); = 0.99; I2 0%]. The systematic review found that the use of fibrin sealant in thyroid surgery is positive in total volume drainage but not with the retention time of drainage, hospitalization time, and transient dysphonia. It is notable to remember that this interpretation is complicated by uneven, occasionally subpar technique and trial reporting, according to this systematic review's findings.
PubMed: 37409068
DOI: 10.3389/fsurg.2023.1149882 -
Disability and Rehabilitation Jul 2020Oropharyngeal dysphagia and laryngeal dysfunction are known to impact on health outcomes of patients with critical illness. The incidence in patients after heart and/or...
Oropharyngeal dysphagia and laryngeal dysfunction are known to impact on health outcomes of patients with critical illness. The incidence in patients after heart and/or lung transplantation is unknown. This paper investigates the frequency, characteristics and risk factors for these complications following such transplantation. Eight databases were systematically searched. Inclusion criteria were (a) adults who underwent heart and/or lung transplantation as their primary surgery, (b) new onset of oropharyngeal dysphagia and/or laryngeal dysfunction and dysphonia identified in the acute hospital phase (c) original studies (d) in English. Two thousand six hundred and sixteen articles were identified. Five met the inclusion criteria. Studies were few and heterogeneous in design and sample size, therefore meta-analysis was not performed. All included studies were of relatively low quality. However, rates of oropharyngeal dysphagia up to 70.5% were reported, with 25% of these patients presenting with vocal cord palsy. Limited conclusions can be drawn from the available evidence regarding the frequency, characteristics and risk factors for the development of oropharyngeal dysphagia and/or laryngeal dysfunction after heart and/or lung transplantation due to limited evidence and low quality of the included studies. This highlights the need for high quality studies in this population.Implications for rehabilitationOropharyngeal dysphagia and dysphonia are known to impact on mortality and quality of lifeThere is a paucity of literature describing these complications after lung and/or heart transplantation, however the data available indicates high rates of swallowing and voice disorders in this immunosuppressed populationEarly identification and management of oropharyngeal dysphagia and dysphonia is vital to aid rehabilitation and improve mortality and quality of life in patients following lung and/or heart transplantation.
Topics: Adult; Deglutition; Deglutition Disorders; Heart Transplantation; Humans; Lung; Quality of Life
PubMed: 30694075
DOI: 10.1080/09638288.2018.1552326 -
Journal of Voice : Official Journal of... Aug 2022To analyze the prevalence of work-related voice disorders (WRVD) among the voice professionals. (Review)
Review
OBJECTIVE
To analyze the prevalence of work-related voice disorders (WRVD) among the voice professionals.
METHODS
The study protocol was registered in PROSPERO (CRD42021250121). The search was performed in the Embase, Lilacs, Medline, SCOPUS, and Web of Sciences databases. There were no limitations to the year of publication and the search included observational studies which reported data on the prevalence of dysphonia in voice professionals measured through vocal complaints, vocal self-assessment, the auditory-perceptual judgment of the voice, and laryngoscopy examinations. The critical appraisal instrument for studies reporting prevalence data was used to analyze the risk of bias of the studies. Data analysis was performed using Jamovi and R software with a significance level of 5%.
RESULTS
The initial search identified 561 articles, 73 of which were finally included and analyzed. The total number of participants was 63,126. Dysphonia was diagnosed in 45,996 participants based on a vocal complaint, 12,843 using vocal self-assessment, 1,254 using the auditory-perceptual judgment, and 1,683 using laryngoscopies. The prevalence of total dysphonia was 44.0 (95% CI 38.47; 49.69). The prevalence of vocal complaints was 43.9% (95% CI 37.37; 50.52), 42.5% (95% CI 28.57; 57.08) for self-assessment, 53.0% (95% CI 29.87; 77.19) for auditory-perceptual judgment, and 36.9% (95% CI 18.62; 57.08) for laryngoscopic examination. In the auditory-perceptual judgment, voice professionals in class 3 (moderate quality, high demand) had a higher prevalence of dysphonia than those in class 4 (moderate quality, moderate demand) (P = 0.04). In the auditory-perceptual judgment (P = 0.04), there was a higher prevalence of dysphonia in teachers than among other voice professionals non-teachers, and in the laryngeal evaluation, no differences were found between professionals (P = 0.8).
CONCLUSION
There was a high prevalence of dysphonia in voice professionals, especially in the detection by auditory-perceptual judgment. High vocal demand and being a teacher influenced the increase in the prevalence of WRVD.
PubMed: 36057482
DOI: 10.1016/j.jvoice.2022.07.030 -
PloS One 2019Despite evidence of physical (illness) and mental (stress) health problems, there appears to be a lack of studies or concern regarding occupational safety and health...
BACKGROUND
Despite evidence of physical (illness) and mental (stress) health problems, there appears to be a lack of studies or concern regarding occupational safety and health among educators in Malaysia.
OBJECTIVE
To review the prevalence of illness, stress, and corresponding risk factors among educators in Malaysia.
METHOD
Scopus, ProQuest, PubMed, ScienceDirect, CAB, and other computerized databases were searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies published between January 2013 and April 2019 on the prevalence and associated risk factors of illness and stress among educators (S1 Checklist). The keywords used included educator, teacher, lecturer, academic staff, teaching profession, university staff, academician, faculty, illness, injury, disease, pain, WMSD, dysphonia, hoarseness, stress, mental health, strain, health problem, disorder, and/or Malaysia. Selected studies were evaluated by quality assessment.
RESULTS
Twenty-two articles fulfilled the eligibility criteria. The prevalence of illness and stress was determined for low back pain (33.3-72.9%); upper back pain (33.33-56.4%); neck/shoulder pain (40.4-80.1%); upper arm discomfort (91.3%); forearm pain (89.6%); wrist pain (16.7-93.2%); hip pain (13.2-40.9%); thigh discomfort (91.8%); lower leg discomfort (90.5%); knee pain (23.7-88.0%); ankle/feet pain (19.3-87.7%); elbow pain (3.5-13.0%); voice disorder (10.4-13.0%) and stress (5.5-25.9%). Sex, education level, teaching experience, quality of life, anxiety, depression, coping styles, and others were reported as associated risk factors across the studies.
CONCLUSIONS
There appears to be a cause for concern regarding musculoskeletal disorders, voice disorder, and stress reported among educators in Malaysia. While most risk factors matched those reported in studies elsewhere, others such as school characteristics (school level, government or private school, and location [rural/urban]) have not been investigated.
Topics: Female; Humans; Malaysia; Male; Musculoskeletal Diseases; Pain; Prevalence; Quality of Life; Risk Factors; School Teachers; Stress, Psychological; Voice Disorders
PubMed: 31136594
DOI: 10.1371/journal.pone.0217430 -
Otolaryngology--head and Neck Surgery :... Feb 2017Objective The effect of botulinum toxin among patients with adductor spasmodic dysphonia (AdSD) is temporary. To optimize long-term treatment outcome, other therapy... (Review)
Review
Objective The effect of botulinum toxin among patients with adductor spasmodic dysphonia (AdSD) is temporary. To optimize long-term treatment outcome, other therapy options should be evaluated. Alternative treatment options for AdSD comprise several surgical treatments, such as thyroarytenoid myotomy, thyroplasty, selective laryngeal adductor denervation-reinnervation, laryngeal nerve crush, and recurrent laryngeal nerve resection. Here, we present the first systematic review comparing the effect of botulinum toxin with surgical treatment among patients diagnosed with AdSD. Data Sources MEDLINE (PubMed), EMBASE, and the Cochrane Library. Methods Articles were reviewed by 2 independent authors, and data were compiled in tables for analysis of the objective outcome (voice expert evaluation after voice recording), the subjective outcome (patient self-assessment scores), and voice-related quality of life (Voice Health Index scores). Results No clinical trials comparing both treatment modalities were identified. Single-armed studies evaluated either the effect of botulinum toxin or surgical treatment. Thirteen studies reported outcomes after botulinum toxin treatment (n = 419), and 9 studies reported outcomes after surgical treatment (n = 585 patients). A positive effect of bilateral botulinum toxin injections was found for the objective voice outcome, subjective voice outcome, and quality of life. The duration of the beneficial effect ranged from 15 to 18 weeks. Surgical treatment had an overall positive effect on objective voice improvement, subjective voice improvement, and quality of live. Conclusion No preference for one treatment could be demonstrated. Prospective clinical trials comparing treatment modalities are recommended to delineate the optimal outcomes by direct comparison.
Topics: Botulinum Toxins, Type A; Dysphonia; Humans; Injections, Intramuscular; Laryngeal Muscles; Laryngismus; Neuromuscular Agents; Quality of Life; Voice Quality
PubMed: 27803079
DOI: 10.1177/0194599816675320 -
Journal of Communication Disorders 2013To provide a quantitative assessment of the occurrence of voice disorders among teachers and to identify associated work-related and individual factors in the teaching... (Review)
Review
PURPOSE
To provide a quantitative assessment of the occurrence of voice disorders among teachers and to identify associated work-related and individual factors in the teaching profession.
METHOD
A systematic review was conducted using three computerized databases on the occurrence of voice disorders among teachers and their associations with work-related and individual factors. Some of the keywords used were: "teacher", "voice disorder", "voice problem", and "dysphonia". Information regarding the occurrence of voice disorders and associations between work-related and individual factors and voice disorders were extracted from each paper. Occurrence and associations were expressed in prevalence and odds ratios, respectively.
RESULTS
In total, 23 publications met the criteria for inclusion. All publications were cross-sectional studies. Prevalence estimates varied widely, reflecting disparity in definitions of "voice problem". Teachers had a significantly increased occurrence of voice disorders compared to other occupations. Several work-related and individual factors were consistently associated with voice disorders, most notably high levels of noise in classrooms, being a physical education instructor, and habitual use of a loud speaking voice.
CONCLUSION
This review shows that teachers report voice disorders more often than non-teachers. Various work-related and individual factors are associated with reported voice disorders. Longitudinal studies are urgently required to get more insight into the development of voice disorders, their work-related determinants, and the consequences of these voice disorders for functioning and work performance among teachers.
LEARNING OUTCOMES
Describe the occurrence of voice disorders among teachers. Identify some work-related factors of voice disorders among teachers. Interpret the quality of the publications to describe or analyze the relationship between working conditions and voice disorders among teachers.
Topics: Faculty; Humans; Noise; Occupational Diseases; Physical Education and Training; Prevalence; Voice Disorders
PubMed: 23415241
DOI: 10.1016/j.jcomdis.2013.01.001 -
American Journal of Speech-language... Nov 2023This study aims to investigate the prevalence of presbyphonia among older adults who report voice complaints. (Meta-Analysis)
Meta-Analysis
PURPOSE
This study aims to investigate the prevalence of presbyphonia among older adults who report voice complaints.
METHOD
We conducted a systematic search of five medical databases to identify studies that reported on presbyphonia as the cause of voice disorders in older adults. The pooled prevalence was calculated using random-effects models and presented as percentages with 95% confidence intervals (CI). The degree of heterogeneity among studies was assessed using statistics. Subgroup analyses were performed to identify the sources of heterogeneity.
RESULTS
Out of 764 abstracts from five libraries, 11 studies were included in this systematic review. The pooled prevalence of presbyphonia among older adults with voice disorders is 17.78% (95% CI [12.69, 23.51]). We conducted a subgroup analysis on studies that used laryngeal visualization to confirm the diagnosis for all patients and found that the prevalence of presbyphonia was lower in studies with unrestrictive inclusion criteria (12.84%, 95% CI [8.38, 18.08]) compared to studies with restricted inclusion criteria (22.59%, 95% CI [14.49, 31.88]).
CONCLUSIONS
This study suggests that voice disorders in older adults have multiple causes, not predominantly presbyphonia. Overestimation of presbyphonia prevalence occurs if certain diagnoses are excluded at recruitment. This study emphasizes the importance of recognizing the diverse underlying etiologies of dysphonia in older adults; therefore, comprehensive examination and accurate diagnosis are crucial.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.24263029.
Topics: Humans; Aged; Dysphonia; Prevalence; Larynx; Voice Quality; Voice
PubMed: 37816221
DOI: 10.1044/2023_AJSLP-23-00143