The quality of life is associated with different impaired laryngeal functions. For this purpose, we used standardized and validated quality of life questionnaires.

The EULAR Sjogren’s Syndrome Patient Reported Index (ESSPRI) was completed by the patients and it contains three items to be given an activity level score between 0 and 10: pain, fatigue and dryness, the final ESSPRI score is the mean of all three scores and therefore also between 0 and 10 [20].

The QLQ H&N35 incorporates nine multi-item scales: five functional scales (physical, role, cognitive, emotional, and social); three symptom scales (fatigue, pain, and nausea and vomiting); and a global health and quality-of-life scale. Several single-item symptom measures are also included [21].

The German version of the ADI consists of 20 questions from the global, emotional, functional and physical domain. Each question can be scored 1–5 points. A value of less than 55 is considered “highly noticeable”, 55–70 “rather noticeable” and greater than 70 “not noticeable” [22].

The validated German version of the VHI measures voice-related impairment of the quality of life in the functional, physical and emotional dimension.

[23]. VHI values of 0–11 are classified as grade 0 suffering (almost certainly not noticeable), while values of 12–28 reflect grade 1 suffering (more likely unnoticeable than conspicuous); values of 29–56 reflect grade 2 suffering (more probably noticeable than not), and values of 57–120 suggest a classification of certainly noticeable and are graded as grade 3 suffering [24].

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