Utility of Audiometry in the Evaluation of Patients Presenting with Dysphonia

Justin Ross, William L. Valentino, Alyssa Calder, David Bigly, Sammy Othman, Brian McKinnon, Robert T. Sataloff

Research output: Contribution to journalArticle

Abstract

Objectives: Hearing loss has been implicated in dysphonia secondary to voice misuse, although the data supporting this claim are scant. Determining the prevalence of hearing loss in patients with dysphonia and correlating it with self-perception of vocal handicap may help clarify the value of audiometry in evaluation of patients with dysphonia. Methods: This is a retrospective chart review of all new voice patients (n = 405) presenting with dysphonia to the primary investigator between 2015 and 2018. Each new patient routinely undergoes audiometric and voice objective analyses. Main outcomes measured include prevalence, severity of hearing loss, and voice handicap index-10 (VHI-10). Results: Of the 405 subjects reviewed, mean age was 49.0 years (SD = 17.4). 60.7% of subjects were female and 39.3% male. Patients with hearing loss defined as >25 dB in worse ear with pure tone average (PTA) thresholds at 0.5, 1, 2, and 3 kHz (PTA-S) accounted for 18% of the total cohort. The prevalence of previously undiagnosed hearing loss in this cohort was 13.1% (53 of 405 subjects). Of these subjects, 62.3% (33 subjects) reported no perception of hearing loss while 37.7% (20 subjects) suspected they had some hearing loss, yet never sought evaluation. Only increased PTA-S, speech discrimination, Reflux Symptom Index, and female gender demonstrated a significant relationship with VHI-10 when analyzed with multivariate linear regression analysis. Conclusions: The prevalence of hearing loss in patients presenting with dysphonia in this cohort is similar to normative population data. This study has also demonstrated that the majority of these patients did not perceive any hearing loss. The reasons behind this may be a result of or associated with the patients’ dysphonia. Furthermore, clinicians should consider performing audiometric evaluation in patients with abnormal VHI-10 scores in the appropriate clinical context.

Original languageEnglish (US)
JournalAnnals of Otology, Rhinology and Laryngology
DOIs
StateAccepted/In press - Jan 1 2019
Externally publishedYes

Fingerprint

Dysphonia
Audiometry
Hearing Loss
Speech Perception
Self Concept
Ear
Linear Models
Regression Analysis
Research Personnel

Keywords

  • dysphonia
  • hearing loss
  • hoarseness
  • laryngology
  • VHI-10
  • voice

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Utility of Audiometry in the Evaluation of Patients Presenting with Dysphonia. / Ross, Justin; Valentino, William L.; Calder, Alyssa; Bigly, David; Othman, Sammy; McKinnon, Brian; Sataloff, Robert T.

In: Annals of Otology, Rhinology and Laryngology, 01.01.2019.

Research output: Contribution to journalArticle

Ross, Justin ; Valentino, William L. ; Calder, Alyssa ; Bigly, David ; Othman, Sammy ; McKinnon, Brian ; Sataloff, Robert T. / Utility of Audiometry in the Evaluation of Patients Presenting with Dysphonia. In: Annals of Otology, Rhinology and Laryngology. 2019.
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abstract = "Objectives: Hearing loss has been implicated in dysphonia secondary to voice misuse, although the data supporting this claim are scant. Determining the prevalence of hearing loss in patients with dysphonia and correlating it with self-perception of vocal handicap may help clarify the value of audiometry in evaluation of patients with dysphonia. Methods: This is a retrospective chart review of all new voice patients (n = 405) presenting with dysphonia to the primary investigator between 2015 and 2018. Each new patient routinely undergoes audiometric and voice objective analyses. Main outcomes measured include prevalence, severity of hearing loss, and voice handicap index-10 (VHI-10). Results: Of the 405 subjects reviewed, mean age was 49.0 years (SD = 17.4). 60.7{\%} of subjects were female and 39.3{\%} male. Patients with hearing loss defined as >25 dB in worse ear with pure tone average (PTA) thresholds at 0.5, 1, 2, and 3 kHz (PTA-S) accounted for 18{\%} of the total cohort. The prevalence of previously undiagnosed hearing loss in this cohort was 13.1{\%} (53 of 405 subjects). Of these subjects, 62.3{\%} (33 subjects) reported no perception of hearing loss while 37.7{\%} (20 subjects) suspected they had some hearing loss, yet never sought evaluation. Only increased PTA-S, speech discrimination, Reflux Symptom Index, and female gender demonstrated a significant relationship with VHI-10 when analyzed with multivariate linear regression analysis. Conclusions: The prevalence of hearing loss in patients presenting with dysphonia in this cohort is similar to normative population data. This study has also demonstrated that the majority of these patients did not perceive any hearing loss. The reasons behind this may be a result of or associated with the patients’ dysphonia. Furthermore, clinicians should consider performing audiometric evaluation in patients with abnormal VHI-10 scores in the appropriate clinical context.",
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AU - Valentino, William L.

AU - Calder, Alyssa

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AU - McKinnon, Brian

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