Isshaki et al developed a classification of 17 scales to describe a hoarse voice. A simplified version of 4 factors proved simpler to use for the clinical assessment of patients.
(1) rough, rumbling or rattling quality (R)
(2) breathy quality (B)
(3) asthenic (A, indicating weakness or lack of strength)
(4) degree of hoarseness (D)
Scoring the quality for each parameter
total score =
= SUM(points for all 4 parameters)
• minimum score: 0
• maximum score: 12
• The higher the score the more severe the hoarseness.
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