Dysphonia and Delayed Food Allergy: A Provocation/ Neutralization Study with Strobovideolaryngoscopy

Abstract

In most cases the cause of intermittent dysphonia remains undiagnosed. This descriptive study explores the relationship between this problem and delayed food allergy. Double-blind intradermal provocation/neutralization skin tests to food antigens were used to do 12 tests in 10 subjects with food allergies. Strobovideolaryngoscopy was used to document changes in the vocal folds and in the quality of the voice. Double-blind measurements of signs and symptoms, digital audio recordings of the voice for perceptual and acoustic analysis, and aerodynamic laryngeal airflow and resistance measurements were done. The cause of dysphonia appeared to be associated with an increase in thick mucus production and irregular and asymmetric glottic edge edema of the vocal folds. Elimination of the positive specific foods resulted in cessation of dysphonia in all the test subjects. Statistical analysis was not done because of the lack of parametric data for paired analysis, lack of sufficient data points for resampling statistics, and the small sample size.

The reliability and sensitivity to change of acoustic measures of voice quality

“…Furthermore, there are many sources of potential variability within the process of acoustic analysis. Previous studies have examined the intra‐ and inter‐system reliability of a number of computerized acoustic analysis programmes and found them to be only moderately reliable 18–20 . This reliability would appear to be best in near‐to‐normal (type I) voice signals but decrease further as the voices become more severely dysphonic (less periodic).…”

“…One useful means of informing the choice would be robust evidence of a parameter's reliability and sensitivity to change as applied to a typical voice pathology clinical population. However, this information is surprisingly sparse and incomplete 18–20 . This study aimed to evaluate the discriminatory power, reliability, and effect size of the sensitivity to change of three commonly used acoustic parameters as measured by the Multi‐Dimensional Voice Programme (MDVP); jitter, shimmer and noise‐to‐harmonic ratio (NHR).…”

Hoarseness as a Sign of Possible Nonspecific Mucosal Hyperreactivity in Vocal Tract

“…1,2 (1,4) As can be seen from Fig 1 the Grade of Voice Disorder was judged higher in patients than in controls, already at base recordings. In controls, this parameter was rated equally low through all challenge procedures.…”

“…We presume that controls had no particular expectations on voice alteration after nasal application of any substance. Patients, on the other hand, as being more predisposed to voice problems, could have been more focused on their voices, being their locus minoris resistentiae (4,6). Moreover, due to ethical demands, the patients had to be informed of all possible effects of the sniffed substance, including hoarseness.…”

Nahrungsmittelallergien: Bedeutung, Schnittstellen und Perspektiven der HNO-Heilkunde

“…Hinweise auf eine verz ö gerte oder chronische laryngeale Manifestation von Nahrungsmittelallergien fi nden sich nur vereinzelt in der Literatur [25] . So beschrieb einzig Dixon sowohl die stroboskopischen Befunde unter Provokationstestung bei 10 Nahrungsmittelallergikern mit Dysphonie, als auch die erfolgreiche Anwendung der individuellen Eliminationsdi ä t zur Therapie der Dysphonie [26] . Aufgrund der aktuell vorliegenden Publikationen l ä sst sich die Bedeutung der Nahrungsmittelallergie f ü r die Dysphonie nicht verl ä sslich bewerten.…”