The Derkay Scale as a Predictor of Voice Dysfunction in Recurrent Respiratory Papillomatosis: Correlations Between Acoustic and Patient-Reported Outcomes

TL;DR

This study shows that the Derkay scale is useful for predicting voice problems in patients with a vocal cord condition called RRP.

Contribution

The study demonstrates the Derkay scale's correlation with both acoustic and patient-reported voice outcomes in RRP.

Findings

Derkay scores strongly correlate with voice handicap index in women but less so in men.

HPV-6 patients had higher soft phonation index values than HPV-11 patients.

Derkay scores correlate with acoustic parameters like F0 and Jitter in men.

Abstract

Objectives: The aim of the study was to gauge the clinical usefulness of the Derkay scale in assessing the severity of voice dysfunction in patients with recurrent respiratory papillomatosis (RRP). Material and Methods: The study included 29 patients (8 women and 21 men) with a mean age of 40.2 years. To subjectively assess each patient’s voice, the Polish version of the Voice Handicap Index questionnaire was used. Acoustic parameters were calculated using the Multidimensional Voice Program, which included mean fundamental frequency (F0), frequency changes (% Jitter), amplitude changes (% Shimmer), noise-to-harmonic ratios (NHRs), and the soft phonation Index (SPI). The stage of RRP was assessed using the Derkay scale, together with the anatomical location of the lesion (from laryngeal endoscopy) and the impact RRP had on the general condition of the patient. Results: In women, Derkay clinical and total scores showed significant, positive, and strong correlations with almost all VHI-30 subscales (rho = 0.73–0.76). In men, the correlations were weaker (rho = 0.38–0.55) but were strong between the Derkay total score and F0 and total score and Jitter (rho = 0.63–0.65). Patients with human papilloma virus HPV-6 had significantly higher soft phonation index values (M = 11.97) compared to patients with HPV-11 (M = 6.91, U = 34.0; p = 0.019). Conclusions: The Derkay classification system correlates well with objective acoustic frequency measures and patient-reported voice outcomes. The system may be helpful in identifying patients at increased risk of voice dysfunction. It could be used to guide decisions about voice assessment and rehabilitation.

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