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J Voice. 2019 Feb 18. pii: S0892-1997(19)30005-0. doi: 10.1016/j.jvoice.2019.02.002. [Epub ahead of print]

Correlating Undiagnosed Hearing Impairment with Hyperfunctional Dysphonia.

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Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, New York; Faculty of Medicine, E.N.T Department, Fayoum University, Fayoum, Egypt. Electronic address:
Faculty of Medicine, E.N.T Department, Fayoum University, Fayoum, Egypt.



This study initially investigated the co-occurrence of hearing impairment that had not been previously diagnosed in a group of patients with hyperfunctional dysphonia. Subsequently, it explored whether any correlations exist between quantitative dysphonia severity assessment parameters and distinctive acoustic features of hearing impairment.


The age-stratified participants were 36 patients presenting with hyperfunctional dysphonia to the voice clinic. For each subject, the following measurements were collected: grade of dysphonia severity rating by the clinician, a Voice Handicap Index (VHI) Patient Questionnaire, and an acoustic analysis of a standardized voice sample. Subsequently, the participants were referred to the audiology clinic for pure tone audiometry testing.


The co-occurrence of hyperfunctional dysphonia and coincidentally discovered hearing impairment showed a percentage of 33% in the study subjects. There were no significant differences in the acoustic profiles of patients with and without hearing impairment. Mean frequency and jitter % were positively correlated in all investigated cohorts, except in subjects with simultaneous occurrence of hearing impairment and dysphonia. Mean intensity and shimmer % were not correlated in any of the groups investigated.


The physiological mechanism for regulating pitch perturbation is altered in individuals with hearing impairment compared to normal hearing subjects. Pitch and amplitude perturbation have different regulatory mechanisms.


Acoustic analysis; Amplitude; Dysphonia; Hearing impairment; Pitch regulation

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