Factors predicting Voice Handicap Index

Objective: To assess factors that may be predictive of patient perception of dysphonia severity, as quantified by the Voice Handicap Index (VHI) score.

Methods: A prospective study is carried out in 81 voice samples from patients diagnosed with benign vocal fold lesions. Variables assessed for predictive value to VHI score are maximum fonation time, narrow band spectrogram, jitter, shimmer, HNR, NNE, F0 and the auditory perceptual evaluation of severity of dysphonia GRABS.

Results: HNR, F0 and B and S parameters of GRABS were predictors of total VHI score, functional and emotional subscales. No parameter was found to predict the physical subscale.

Conclusions: VHI score is correlated with the perceived breathy voice and its acoustic attributes, such as signal-to-noise ratio. In other studies, patient perception of dysphonia is independent of many factors commonly assessed during the evaluation of voice disorders. It is reasonable to assume that the severity of glottic gap caused by benign vocal folds lesions is related to a low signal-to-noise ratio and the breathy phonation as its perceptual correlate. The physical subscale appears to be an independent element in the assessment of the patient perception of dysphonia.