Cervical Spine Disability in Correlation with Subjective Voice Handicap in Patients With Voice Disorders: A Retrospective Analysis

Publication date: Available online 12 December 2018

Source: Journal of Voice

Author(s): Anke Langenfeld, Jörg E. Bohlender, Jaap Swanenburg, Meike Brockmann-Bauser

Abstract

Objective

Neck muscle dysfunction has been considered as risk factor or consequence of voice disorders. This study investigates the correlation between neck and voice-related subjective symptoms in patients with voice disorders.

Study Design

Retrospective case-control study.

Methods

100 adult patients (59 female and 41 male) over 18 years with a mean age of 50.01 years (SD 16, range 24–87), of which 68 were under 60 years, were included. 50 patients had organic voice pathologies and 50 functional dysphonia. Outcome measures were the Voice Handicap Index 9 international (VHI-9i) and the Neck Disability Index (NDI-G). Spearman rank order coefficient was applied to determine the correlation between overall and single item VHI and NDI results. Subanalyses were done for functional vs. organic disorder, gender and age ± 60 years.

Results

Mean overall VHI-9i (13.93, SD = 7.81, range = 0–31) and mean NDI-G (6.07, SD = 7.71, range = 0–43) showed a significant mild correlation (r_s = 0.220, P = 0.02). Split into subgroups the relation was stronger in patients with organic pathologies (r_s = 0.297, P = 0.03), but not significant in functional disorders (r = 0.148, P = 0.30). There was a moderate relation in men (r_s = 0.317, P = 0.04). Single item correlation was highest between VHI-9i item P4 (physiological) and NDI-G item reading (cognitive functioning) (r_s = 0.480, P = 0.002).

Conclusion

Specifically patients with organic voice disorders showed increased voice symptoms with the presence of neck dysfunction. This indicates a risk for a functional imbalance of the muscles surrounding the larynx, which in extreme cases may hinder functional voice rehabilitation even after phonosurgery. Therefore, neck dysfunction should be considered in voice diagnostics.

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