The VHI in Patients with Chronic Lung Disease
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Abstract Introduction: The pulmonary ventilation system plays an important role in phonation, as it generates the lung pressure, a basic condition for vocal fold vibration. Thus it could be expected that patients with chronic impairment of respiratory function experience voice problems in daily life. The aim of this study is to examine if patients with chronic lung disease and reduced lung function experience lower ‘voice related quality of life’- measured by VHI- than the normal population. Patients with asthma and patients with COPD (Chronic Obstructive Lung Disease) are compared, as these are by far the most frequent chronic lung diseases, and are considered among the world’s most common health problems. Method: The voice related quality of life was measured using the Voice Handicap Index, a questionnaire of 30 statements. This questionnaire was filled in by 44 outpatients diagnosed with asthma and 30 outpatients diagnosed with COPD. All patients further underwent a complete spirometric investigation. Each patient also filled in the MRC scale (Medical Research Council) : a scale for subjectively assessing the severity of dyspnoea. Results: Globally the VHI-scores of patients with chronic lung disease (11,0) are slightly but significantly higher than those of the normal healthy population (6,0), but about 75% of chronic lung patients score within the normal range ( a score of 32,8 corresponds to the 95th percentile of the normal population). There is no significant difference between the median VHI score of asthma (9) and COPD (14) patients. Also no significant difference for gender is found .There is further no statistically significant correlation between the degree of impairment of the respiratory function – as measured with the spirometric parameters - and the VHI-score. However, the relation between MRC- and VHI scores is statistically significant. Conclusion: Chronic lung patients without specific voice complaints report a slightly but significantly decreased voice-related quality of life when compared to the normal healthy population. There is no significant difference in the voice related quality of life between the asthma and COPD group. There is no correlation between objective respiratory function and VHI score. Patients with a severe subjective score on the MRC-scale (high level of breathlessness) also report a quite serious impairment in their voice related quality of life.