Context:
Patients presenting with benign mucosal disturbances such as nodules and polyps frequently describe themselves as innately talkative. Others, with conditions such as bowing or "voice fatigue syndrome" often describe themselves as taciturn.
Objective:
To determine the degree of correlation between self-rating scales of talkativeness and loudness and various types of voice disorders.
Design:
Prospective cohort and case control studies using Likert Scale ratings and their ability to predict laryngeal disease.
Setting:
One clinic of a university laryngology/voice practice in Chicago, Illinois.
Subjects:
974 total patients consisting of two subgroups. The cohort study includes 430 consecutive patients presenting to the senior author with voice complaints from December 1995 through December 1998. The case control study adds 544 consecutive patients referred to the same examiner from January 1988 through December 1998 for vocal fold examination prior to thyroid, parathyroid, and carotid surgery.
Main Outcome Measures:
Patient responses on 7 point Likert self-rating scales of talkativeness and loudness were compared with laryngeal disease.
Results:
More than 70% of patients subsequently found to have mucosal lesions clearly associated with vibratory trauma will rate themselves as highly talkative. Conversely, those with bowing tend to describe themselves as relatively untalkative.
Conclusions:
Use of a simple self-rating scale of vocal loudness and talkativeness during history taking can separate patients into categories of vocal overdoers and vocal underdoers. This process can reliably orient the examiner to the types of voice disorders likely to be diagnosed subsequently during vocal capability testing and laryngeal examination. The high degree of talkativeness and loudness seen in vocal overdoers correlates well with mucosal disorders such as nodules, polyps, capillary ectasia, epidermoid inclusion cysts and hemorrhage. The low degree of talkativeness and loudness seen in vocal underdoers correlates well with disorders such as bowing and voice fatigue syndrome.
Key words:
larynx, vocal nodules, vocal polyps, vocal fold bowing, hoarseness, behavior, vocal trauma, vocal abuse, personality
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