Determination Of The DSI Scores Normal Range And Application Of The Dysphonia Severity Index (DSI) In Evaluating Voice Of Vocal Polyps Patients

Voice medicine has just being developed as an emerging discipline in China.There are many measurements in the voice evaluation, which are composed ofsubjective assessment and objective assessment. Dysphonia severity index (DSI), asdysphonia multi-parametric assessment, commonly is used in Europe, butstill rarely reported in China. This study include two procedures: investigating normalrange of DSI in Chinese population, evaluating vocal quality with DSI in vocal cordpolyp patients.First Procedure:Objective DSI has been commonly studied as a multiparametric assessmentof dysphonia in Europe. There are still some confusing that European DSI normalrange scores apply to Asia, because of different race, language, culture and geograghy?For DSI application in China, We investigated the DSI scores normal range in theChinese population. Methods Thirty four volunteers (14males,20females) who hadnormal voice, no voice disease history and no smoking habit were recruited in thisstudy (age range of18–50). We measured their maximum phonation time (MPT),highest phonational frequency, lowest intensity, and jitter measurements withDiVAS2.30(XION, Germany). We calculated the90%medical reference range of theDSI scores as our normal range with SPSS13.0. We also tested the gender differenceof the MPT, F0-high, I-low, jitter and DSI with independent variance analysis.Results The normal range of DSI scores is-1.24to5.84, mean is2.3±2.16. Bothare lower than the European study. Except the Highest frequencyvalue(F0-High), the other parameters have no difference between male and femalegroups. Conclusion The southern Chinese DSI scores are different from Europeanpopulation which have been tested by DiVAS system(XION,Germany). Gender hasno effective on the DSI.Second ProcedureObjective To investigate the applicability of the Dysphonia Severity Index (DSI) inevaluating voice of vocal polyps patients pre-or post-operation, we using the dysphonia severity index (DSI) to evaluate voice in normal voice, pre-orpost-operation polyps patients voice. Methods Thirty three vocal polyps patients didthe microflap surgery to remove vocal polyps. Thirty four normal voice volunteerswere evaluated as normal control group. The patients and control groups voice weretested with the voice handicap index(VHI) for subjective assessment， with theGRBAS system for perceptual assessment, with fiber electronic laryngoscopy videofor vocal visual, with maximum phonation time (MPT) for phonetic aerodynamicevaluation. They also are tested with computer voice analysis for objective evaluation,including shimmer, jitter and DSI using DiVAS2.30system(XION, Germany). TheDSI scores differences among the normal control, pre-and post-operation groupswere analysis with One-way ANOVA variance statistics by SPSS13.0. The correlation of DSI scores with VHI scores, GRBAS, MPT, jitter andshimmer also were analysis. Results In this study, the DSI score are significantdifference between vocal polyps patients and normal control group(P<0.01). Thepatients DSI improved significantly after surgery from-3.92±4.97to1.3±1.68（P<0.01). There are no significant difference between the post-operation andcontrol groups. The DSI and VHI scores have a strong correlation byPearson correlation analysis(p <0.01). There are also strong correlation between theDSI and the GRBAS, MPT, jitter and shimmer value. Conclusions DSI is aneffective and high accuracy multi-parameter system for evaluation of vocal cordpolyp patients as independent assessment of dysphonia. DSI also can be used inevaluation of the effects of the vocal cord polyp surgery.