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

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.