Journal of voice : official journal of the Voice Foundation
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Comparative Study
Readability of patient-reported outcome questionnaires for use with persons with dysphonia.
The purpose of this study was to examine the readability of several published patient-reported outcome (PRO) questionnaires for persons with dysphonia, and to compare the readability results with existing data about average reading levels for English-speaking adults living in the United States. ⋯ In the demand for standardization of voice-related quality of life assessment tools, developers should consider readability as another testable construct because poor readability may affect validity, reliability and sensitivity. The voice clinician should consider the average reading level needed to understand a particular PRO questionnaire when administering it to a patient or their proxy. Developers of PRO questionnaires should consider reading level of respondents and include information about this when reporting psychometric data.
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To discuss four techniques used to overcome the problem of difficult exposure during operative microlaryngoscopy (microdirect laryngoscopy [MDL]). The protocol uses four techniques in escalating fashion. These techniques are: high-frequency jet ventilation (high-frequency positive pressure ventilation [HFPPV]), using a narrow-bore diagnostic laryngoscope (Holinger) with suspension, using the 30° and 70° telescopes with angled instruments, and using a flexible laryngoscope through a laryngeal mask anesthesia (LMA) device. ⋯ Difficult exposure during MDL is unusual but not rare. It is often unanticipated. A proposal for graded use of the four techniques preserves some advantages of MDL. With each escalation, there is a degradation of the advantages afforded by traditional MDL. These include minor increase in movement with HFPPV, loss of binocular visualization with diagnostic laryngoscopes, loss of bimanual instrument manipulation with the telescopes, and loss of stability with flexible laryngoscopy. Having an understanding of each technique and the need for escalation will allow the surgeon to perform rescue laryngoscopy and complete the surgery.