202 | Chapter 8 Voice Handicap Index -10 Nine (60%) patients had a VHI-10 score of 11 or higher when using their regular VP (a score above 11 is considered as limiting in daily life). This number increased to 12 (80%) when using the PVHP. The median VHI-10 score of the regular VPs was 14 (range 4-32 in comparison to 21 (3-35 for the PVHP. When comparing differences within subjects, eight (53%) patients scored higher with the PVHP than with their regular VP, one (7%) had comparable scores for both VPs, and six (40%) scored better with their regular VP (see figure 4A). AVQI score As shown in figure 4B, all participants have a higher score (meaning a deviant voice) than the cutoff point (2.95, red line). The median AVQI score of the PVHP was 8.4 (range 7.05-10) and 8.2 (range 6.93-10) for the regular VP. Voice Quality and Effort to speak (rated by SLPs) Fourteen voice recordings could be analyzed since one of the participants was not able to speak at the first meeting (participant 9). The inter-rater reliability (ICC) of the subjective voice assessments was ‘almost perfect’ for the effort to speak (0.933, 95% IC 0.856-0.969) and ‘substantial’ to ‘almost perfect’ for the voice quality (0.863, 95% CI 0.707-0.937). The mean effort to speak and voice quality scores were worse for the PVHP in comparison to the regular VP. The voice quality rating decreased from 5.1 (regular VP) to 4.4 (PVHP) and the effort to speak rating decreased from 3.7 (regular VP) to 3.0 (PVHP). Six (43%) patients had better voice quality with the PVHP compared to with their regular VP, and eight (57%) were rated with better voice quality with their regular VP. Seven (50%) needed less effort to speak with the PVHP, and seven (50%) less with their regular VP. See figure 4C and 4D for individual scores. The maximum phonation time (MPT) with their regular VP was median 4.60 seconds (range 1.90-27.74), and with the PVHP median 5.37 seconds (range 0.98-22.79). The loudness with their regular VP was median 4.65 dB (range 2.8-11.0) and for the PVHP median 5.1 dB (range 1.6-10.8). Long-term follow-up Device lifetime To determine device lifetime, data of all fifteen participants was analyzed (see table 2). Ten subjects (67%) had their PVHP replaced because of leakage (transprosthetic n=6, periprosthetic n=4). Three participants (20%) had the PVHP replaced because of reaching the one year follow-up without device failure/leakage. Noteworthy is that two subjects (13%) brushed the PVHP out of their stoma without need for medical
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