Correlation Between Voice Handicap Index-10 Score and Auditory Perceptual Evaluation in Lebanese and Iraqi Patients: Impact of Cultural Disparity

Abdul-Latif Hamdan, Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.Follow
Zeina Maria Semaan, Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Omar Aboul Hosn, Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Jonathan Abou Chaar, Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Maher Kasti, Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Batoul Jaber, Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.

Article Type

Original Study

Abstract

Background: Voice disorders are prevalent, impacting nearly 25% of adults, with even higher rates among who rely on their voices professionally. Contributing factors include smoking, poor vocal hygiene, and environmental conditions. These factors can disrupt laryngeal biomechanics, leading to functional and structural voice disorders, which can cause communication issues and diminished productivity. Evaluation methods encompass subjective evaluations, such as self-reported quality of life scales, alongside objective auditory perceptual evaluations. This study aims to establish a correlation between self-reported vocal handicap and perceptual voice evaluation, while also investigating the influence of cultural factors on auditory perceptual evaluation, specifically comparing Lebanese and Iraqi patients due to their distinct vocal characteristics and cultural influences on phonation. Aim: The aim of this study is to evaluate the variances in voice ratings of patients with similar voice disorders but hailing from different cultural backgrounds: Iraqis vs. Lebanese. Methods: The methodology involved reviewing the medical records of Iraqi patients presenting with hoarseness at the voice clinic. Collected demographic information included age, gender, smoking history, history of reflux disease, and clinical dysphonia diagnosis. The clinical diagnosis of dysphonia was stratified into structural, neurologic, and functional types. The VHI-10 questionnaire and GRB (grade, roughness, breathiness) rating scale served as the outcome measures. Results: The study included 28 Iraqi patients with voice disorders (Group A) and 28 Lebanese patients matched by age, gender, and clinical diagnosis (Group B). A statistically significant difference was observed in the mean grade of breathiness between the Iraqi and Lebanese groups (0.44 ± 0.62 and 1.07 ± 0.95, respectively; p = 0.006). Within the Iraqi subgroup, a significant moderate positive correlation was found between the VHI-10 score and the overall roughness rating (r = 0.445; p = 0.018). Conversely, in the Lebanese subgroup, a significant strong positive correlation was identified between the VHI-10 score and the overall dysphonia grade (r = 0.709; p < 0.001). A notable moderate positive correlation was observed between the VHI-10 score and the overall breathiness rate (r = 0.593; p < 0.001). Conclusions: These findings indicate that cultural factors impact the perceptual evaluation of patients with similar voice disorders but hailing from different cultural backgrounds. Specifically, Lebanese evaluators assigned a more severe rating of breathiness to Lebanese patients in comparison to Iraqi patients.

Keywords

VHI-10, GRB, Perceptual evaluation, Cultural background, Iraqi, Lebanese

Recommended Citation

Hamdan, Abdul-Latif; Semaan, Zeina Maria; Hosn, Omar Aboul; Chaar, Jonathan Abou; Kasti, Maher; and Jaber, Batoul (2026) "Correlation Between Voice Handicap Index-10 Score and Auditory Perceptual Evaluation in Lebanese and Iraqi Patients: Impact of Cultural Disparity," Iraqi National Journal of Medicine: Vol. 8 : Iss. 2 , Article 4.
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