Validation of the self-assessment questionnaire for patients with unilateral vocal cord paralysis (PVU-HI-10) in Spanish.

Abstract

Introduction and objective: Unilateral vocal cord paralysis (UVCP) is a condition that directly affects laryngeal functions. While most cases have an organic cause, idiopathic cases have also been described. Patients with UVCP often experience symptoms that impact not only their vocal abilities but also their nutritional and social well-being. Our primary objective is to validate a self-assessment questionnaire for patients with UVCP and unilateral vocal immobility, incorporating questions that cover all possible symptoms of this condition, adapted to the Spanish spoken in Spain.

Methodology: This is a prospective observational study using the PVU-HI-10 questionnaire, which assesses the functional, physical, and emotional impact of UVCP-related symptoms. For validation, we statistically evaluated test-retest reliability, item-total correlation, internal consistency, concurrent validity, and discriminative validity, with sensitivity and specificity analysis. A total of 62 subjects participated: 33 patients (case group) and 29 healthy individuals (control group). All participants completed the PVU-HI-10 questionnaire twice, with a three-week interval between assessments and no treatment administered between them. The maximum phonation time (MPT) was used as the objective reference measure.

Results: The test-retest reliability was high, with an intraclass correlation coefficient (ICC) of 0.95. Internal consistency, measured using McDonald's omega coefficient, was 0.91 for the case group and 0.94 for the control group. The correlation between MPT and questionnaire scores was strong and inversely related (-0.61 and -0.67, respectively). Discriminative validity was demonstrated using the ROC curve, with a cutoff point of 12.1, yielding a sensitivity of 82% and a specificity of 93.1%.

Conclusions: In the management of unilateral vocal immobility, it is essential to consider the degree of disability caused by the symptoms. The PVU-HI-10 is a condition-specific questionnaire that has shown high reliability and validity. It is a brief, simple test that provides a numerical result, allowing for the quantification and comparison of treatment outcomes. This makes it a useful tool in the evaluation protocol for patients with unilateral vocal paralysis in Spanish-speaking populations.