Javier Gavilán Bouzas

Validación de la versión en español del índice de incapacidad vocal (S-VHI) para el canto

UNLABELLED In the questionnaires that currently exist in Spanish to assess the impact on quality of life of voice pathology, there are no questions that refer specifically to the singing voice. We present the results of the validation of the Singing Voice Handicap Index (SVHI) in Spanish. MATERIALS AND METHODS The SVHI was translated into Spanish from the validated version in English. The questionnaire was completed by 29 dysphonic singers and 81 healthy singers. RESULTS There was good test-retest reliability (r=0.63, p=0.000). Regarding the item-total correlation, it was found that all samples had high correlations on individual items. Significant correlations were found between the severity of the score of the voice self-rated by the singer and the total scores of the SVHI (r=0.52, p=0.000). There were significant differences between the group of singers with dysphonia and the control group in the SVHI scores (ANOVA, F=10.9, p <0.002). CONCLUSIONS The Spanish version of the translated SVHI questionnaire is a validated tool with proper internal consistency and reliability. The average score of the SVHI singers in a healthy population is 20% of the maximum possible questionnaire score, well above the average score in a healthy population for the spoken voice with the 30-item specific VHI.

La voz cantada

Singing voice is a special subgroup within the field of voice. In addition to the differences in physiology between singing and speaking voice, singer patients are often regarded as a challenge for the otolaryngologist. The reason for this is probably that the field of voice has not received as much attention as others in our speciality. Moreover, in the case of singers, empathy is vital in the doctor-patient relationship, and, as in many other cases, it forms part of the therapeutic effect. In order to achieve this, the physician has to know what singers are and which are the main pathologies they suffer, how they are formed and how they are expressed. This review offers an overlook of the pathological-physiology of singing voice from a double point of view, scientific and artistic, which in the case of singing are inevitably linked.

CSF fistulae following surgery for cerebellopontine angle tumours and their relationship with the body mass index

Abstract Introduction The most frequent complication after vestibular schwannoma surgery is cerebrospinal fluid (CSF) fistula. Material and methods Retrospective study of 170 patients who had vestibular schwannoma (163) or other tumours in the cerebellopontine angle (CPA) (7). Resection was carried out using different approaches: retrosigmoid (66%), translabyrinthine (24%), middle cranial fossa (5%), and others (5%). We studied the day of onset, location and treatment of the CSF leaks, and the influence of demographic, radiological and clinical variables, including body mass index. Results Twenty-seven patients developed a CSF fistula (15.9%): fifteen were incisional (8.8%), 8 patients developed CSF rhinorrhea (4.7%), 1 CSF otorrhea (0.6%), and 3 a combination of the above (1.8%). We controlled 11 CSF fistulae with bed rest and compressive dressings (6.5%), 7 required lumbar drainage (4.1%), 2 lumbar drainage and wound closure with local anaesthesia (1.2%), and 7 patients required returning to the operating room under general anaesthesia (4.1%). There was not a significant relationship between the apparition of CSF and tumour size, type of approach, age, or body mass index (BMI). Conclusions Despite the great development and new surgical techniques, CSF fistulae are still a frequent complication after VS surgery. There might be other aetiological factors such as intracranial pressure. There was no significant relationship between CSF fistula and BMI. Adequate management and early conservative measures led to reduced reintervention rates of less than 5% in all patients.

Mucosal Disease of the Glottis

Dysphonia is the most frequent clinical symptom of laryngeal disorders. Vocal abuse and vocal misuse predispose one to acute or chronic dysphonia. Vocal abuse includes excessive talking, throat clearing, coughing, inhaling of irritants, smoking, screaming, and yelling. Vocal misuse is improper voice usage such as speaking too loudly, or at an abnormally high or low pitch. Frequent vocal abuse and misuse can damage the vocal folds and cause temporary or permanent changes in vocal function and voice quality.