This group consists of all patients presenting seeking treatment for laryngeal complaints from December 1995 through December 1998. 430 charts with laryngeal complaints were reviewed. Data extracted included the self rating score for talkativeness and for loudness, age, sex, chief complaint and diagnosis.

All patients were asked to rate themselves prior to laryngeal examination, via intake questionaire and confirmatory interview on two parameters: talkativeness and loudness. Each uses a seven point scale. To score talkativeness, 1 represents a quiet untalkative person, 4 represents an averagely talkative person and 7 represents an extremely talkative person. Next, 1 represents marked soft spokenness, 4 averagely loud spoken and 7 very loud spoken.

During face to face history taking, they are asked to confirm their response. Questions that help the clinician confirm an accurate response include: "Is this number you chose, your life-long innate degree of talkativeness? Remember, this is not the amount of talking required of you by work or lifestyle." "If I asked your friends and family, would they agree with the answer here? Since your family is with you, may I ask them if they agree with your answer?" "This number should represent your degree of talkativeness in a comfortable social setting." These additional promptings help the patient better understand the intent of the question and they are allowed to change their initial answer. Occasionally, though surprisingly infrequently, it will appear to the examiner that the patient is not quite in touch with their inner drive to speak. In this practice, the actual rating is not changed, though the actual amount of talkativeness perceived by the physician is still considered in making a diagnosis. Some patients circle two adjacent numbers and cannot peg themselves to one particular number. For example, if they choose both a 6 and a 7, saying they are somewhere in the middle of these numbers, the answer is coded as 6.5. For purposes of this study the Likert scale was treated as a continuous variable.

Pre neck surgery: case control study

Patients (with no voice complaint) undergoing a pre-neck surgery laryngeal evaluation from January 1988 through December 1998 were asked to self rate their talkativeness and loudness prior to laryngeal examination. This included all evaluations performed during the senior authors residence at Loyola Medical School from January 1988 through December 1998. Patients were being screened for laryngeal problems prior to thyroid, parathyroid or carotid surgeries. 544 charts were reviewed. Data extracted included the self rating score for talkativeness and for loudness, age, sex, chief complaint and diagnosis. The identical approach to obtaining data for the cohort study was utilized.

All patients in both groups were then subgrouped (catergorized) by type of laryngeal disease (see table1) as determined by using the three part examination described by Bastian4.