Untersuchungen zur Stimmbelastbarkeit bei stimmgestörten Patienten. Evaluation eines neuen Testverfahrens.

In der vorliegenden klinischen prospektiven Studie wurde ein möglichst praxistauglich einzusetzender Stimmbelastungstest erprobt. Bei der Konzipierung wurde darauf geachtet, dass der Test mit möglichst geringem Zeitaufwand durchführbar ist, was auf die bislang entwickelten Belastungstests nicht zut...

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Bibliographic Details
Main Author: Gaipl, Christoph
Contributors: Berger, R. (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Language:German
Published: Philipps-Universität Marburg 2009
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In the present clinical prospective study a vocal loading test which focused on simplifying its practicability without influencing the significance of the result was tested. During the conception, one of the main goals was to minimize the time consumption of the test as this is not the case with the loading tests existing by now. This shall be reached by a shortening of the load duration on one side and a rise of the load intensity on the other side. 46 patients (34 women and 12 men) were examined as well as 16 probands (8 women and 8 men). During the vocal loading test the sound pressure level and the fundamental frequency as well as the percentaged deviation of the demanded minimum volume were measured in real time. To load the voices the test subjects were instructed to read the predefined text (“The Valiant Little Tailor”) loudly over a period of 10 minutes corresponding to the requirements. A loudness of 75 and 80 dB(A) respectively was supposed to be reached alternately minute-by-minute. After the vocal load a recovery phase followed. During this time, the patients should spare their voices through vocal rest for 30 minutes. The recording of certain complaint symptoms (burning, dryness, irritation of the throat, mucous congestion, difficulties in swallowing) was carried out for checking the subjective state by means of suitable questionnaires before and after the vocal loading test as well as after the vocal recovery phase. The sound analytical recording which was gathered with the help of the hoarseness diagram allowed an analysis of the voice quality. More exactly, this afforded an objective assessment of the roughness and the breathiness of the sound of the voice. The recording of the hoarseness diagram was also carried out triplicate simultaneously with the recording of the subjective complaint symptoms. It can be noticed that a stress of the voices was reached by the vocal loading test proved in this study. However, a meaningful statement concerning the effect of a permanent stress of the voice was not derivable. The 10 minutes lasting vocal loading seemed to be too short. A distinction between ill and healthy voices could not be met by use of this vocal loading test. In the course of the vocal load, an improvement of the objective sound analytical parameters irregularity and roaring was noticeable. However, a difference between patients and probands could not be proved by this parameter either. Due to the vocal loading test, reinforcements of parts of the subjective troubles (burning, dryness, difficulties in swallowing) were provoked. By means of the type of disorders in throat and mouth it seems to be possible to differentiate between healthy and ill voices. Anyhow, a delimitation between healthiness and illness should not be carried out just on this basis because of the fact, that these are subjective details. For the regeneration of a voice after a 10 minutes lasting load situation a recovery phase of half an hour is sufficient. Furthermore, it became clear that in the context of the work an objective improvement of the vocal sound does not have to be mandatorily accompanied by a fall in the subjective troubles. Summarizing, it can be noticed that using the vocal loading test proved in this work a reliable statement concerning the permanent capacity of the voice cannot be made. A reliable distinction between healthy and ill voices is also not possible.