Voice-Related Quality of Life in Patients with Benign Vocal Fold Lesions

Objectives: Efforts to assess the level of voice-related disability through application of written instruments are gaining wider acceptance in clinical practice. However, based on the questions posed, additional diagnostic information may be obtained. This study evaluated the potential extended utility of the Physical Functioning (PF) subscore of the Voice-Related Quality of Life (V-RQOL) measurement instrument. Specifically, we examined whether the PF subscore could distinguish between the presence or absence of vocal fold lesions in patients who presented with dysphonia secondary to hyperfunctional voice disorders. A normative control database was also used for comparative purposes. Design: Comparative analysis. Setting: Academic tertiary care centre. Methods: Forty adults with a hyperfunctional voice disorder. All had been seen for medical evaluation to confirm laryngeal status. Main Outcome Measures: V-RQOL total and domain scores. Results: Although variability in V-RQOL scores was observed, differential profiles emerged from comparisons of participants who presented with vocal fold pathology and those who did not. Significantly lower PF and total V-RQOL scores were observed for those with benign mass lesions of the vocal folds. Additionally, discriminant analysis of the data permitted the generation of a cutoff value for the PF subscore, which identified 80% of those with mass lesions. These data also permitted calculation of sensitivity, specificity, and positive predictive and negative predictive values. Conclusions: The findings suggest that the PF subscore may exhibit the capacity to distinguish dysphonic patients who present with a mass lesion of the vocal folds from those who do not within the context of a hyperfunctional voice disorder. Clinical implications and applications of the V-RQOL are discussed.