Relationship Between Self-Reported Vocal, Auditory and Extra-Auditory Symptoms and Complaints and Vocal Quality in Brazilian Teachers

Objective: The recent studies described vocal symptoms and vocal quality in teachers. However, the studies did not take account of the relationship between vocal and auditory and extra-auditory symptoms and its role in vocal production. These findings are necessary, once we know the direct role of auditory-processing skills on vocal production and deviation. Thus, our objective is to verify possible comparisons and correlations between self-reported vocal and auditory symptoms and complaints to vocal quality in Brazilian teachers

Methods: The present research is a cross-sectional study, bringing a secondary, documental and retrospective data analysis of a private Speech-Therapy Clinic. This study was approved by the Ethics Committee of a Public Brazilian University. The data were collected by an online application between May to July/2022. All participants had to record their voices and answer two questionnaires. The recordings were (1) a sustained vowel /a/ and (2) counting numbers from 1-10 on comfortable pitch and loudness. The questionnaires were the Voice Handicap Index-10 (VHI-10) and the Auditory Symptoms Questionnaire (ASQ), both validated to Brazilian Portuguese. The voices were classified according to GRBAS scale by a consensual evaluation by two speech-therapists. All data was compared and correlated to the Vocal Quality evaluation.

Results: On average, participants have high vocal handicap and auditory symptoms scores. There are more participants with high Voice Handicap than without vocal complaints (p= 0,49). The participants with vocal deviation have more self-reported vocal complaints than the ones without vocal deviation (p= 0,14). The Breathiness (B) and Strain (S) deviations are related to higher self-perceived Voice Handicap (p= 0,006; p= 0,45). The Total Score of the VHI-10 had a moderate positive correlation to G (Coef.; 0,383; p= 0,003), B (Coef.: 0,339; p= 0,010) and S (Coef.: 0,463; p< 0,001) from GRBAS Scale. The G from GRBAS had a stronger positive correlation to R (Coef.: 0,587; p< 0,001), B (Coef.: 0,831; p< 0,001) and S (Coef.: 0,471; p< 0,001). There were no differences between groups nor correlation between questionnaires or vocal quality to the ASQ.

Conclusions: Teachers are voice professional with high self-reported vocal handicap and auditory and extra-auditory symptoms. The vocal complaints are correlated to vocal quality, specially with breathness and strain, the two symptoms that are more present in vocal deviations regardless of the degree of dysphonia. Even though the participants have high auditory symptoms and complaints, it was not correlated to vocal quality and vocal handicap.