Impact of Laryngeal Findings on Acoustic Parameters of Patients with Laryngopharyngeal Reflux

Akyıldız, Serdar; Öğüt, Fatih; Varis, Ahmet; Kirazlı, Tayfun; Bor, Serhat

doi:10.1159/000340046

Cited by 18 publications

(18 citation statements)

References 26 publications

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“…Compared with other laryngeal diseases, granuloma was detected more frequently in the LPR group [20]. A recent study revealed that reflux was an independent factor affecting the resolution of granuloma [15].…”

Section: Discussionmentioning

confidence: 83%

Conservative Treatment versus Surgery for Laryngeal Contact Granuloma: A Prospective Study

Chen

Yang

et al. 2018

ORL

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Aims: To confirm the efficacy of conservative treatment for laryngeal contact granuloma and identify factors influencing treatment outcome. Methods: In this prospective study, patients with laryngeal contact granuloma were divided into a group receiving conservative treatment and a group undergoing surgery. Efficacy was assessed by analyzing the complete response after a 48-week follow-up. The association of treatment outcome with clinical factors was then evaluated. Results: In total, 61 patients, 43 in the group receiving conservative treatment and 18 in the group undergoing surgery, were analyzed, and the complete response rate was 72.1% and 38.9%, respectively. Both univariate analysis and multivariate analysis revealed that treatment modality (p₁ = 0.015, p₂ = 0.043), voice abuse (p₁ = 0.010, p₂ = 0.010), and the size of the granuloma (p₁ = 0.031, p₂ = 0.020) were significantly associated with the complete response of laryngeal contact granuloma. Kaplan-Meier curves showed that alcohol consumption (p = 0.031), voice abuse (p < 0.001), and granuloma size (p = 0.025) were significantly related to the complete response of conservative treatment. Conclusions: This prospective study strengthens the argument for conservative treatment (instead of surgery) as the first choice for laryngeal contact granuloma. The results also suggest that voice abuse, alcohol consumption, and the size of the granuloma may predict treatment outcome.

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Section: Discussionmentioning

confidence: 83%

Conservative Treatment versus Surgery for Laryngeal Contact Granuloma: A Prospective Study

Chen

Yang

et al. 2018

ORL

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“…Indeed, among the 4 studies that compared acoustic measurements between LPR and healthy participants, all reported different results. Percentage shimmer and percentage jitter were respectively identified as significantly different between LPR and healthy participants in three 10,11,13 and two 11,12 studies. The majority of these studies did not find substantial differences in the values of F0 and NHR between patients with LPR and healthy controls, which corroborates our findings.…”

Section: Discussionmentioning

confidence: 91%

“…7 Thus, some 20 prospective trials were conducted to assess the voice quality changes throughout treatment, 8,9 and only 5 case-control studies assessed voice quality impairments in patients with LPR compared to healthy participants. [10][11][12][13][14] Among the case-control studies, no study assessed voice quality with multidimensional approach including, at least, subjective, perceptual, aerodynamic, and acoustic evaluations. Moreover, the trials that measured objective voice quality reported mixed results, [10][11][12][13] which are probably due to methodological measurement discrepancies between studies.…”

Section: Introductionmentioning

confidence: 99%

Perceptual, Aerodynamic, and Acoustic Characteristics of Voice Changes in Patients with Laryngopharyngeal Reflux Disease

Lechien

Khalifé

Huet

et al. 2019

Ear, Nose & Throat Journal

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Laryngopharyngeal reflux (LPR) is an inflammatory condition suspected to be associated with dysphonia. In this study, we investigated multidimensional perceptual, aerodynamic, and acoustic voice changes in patients with clinically diagnosed LPR compared to healthy participants. We prospectively included 80 outpatients with Reflux Finding Score (RFS) >7 and Reflux Symptom Index (RSI) >13 from September 2013 to April 2016 and we compared clinical and voice quality assessments of these patients with 80 healthy participants. Statistically significant differences were found between groups with regard to Voice Handicap Index, perceptual voice quality (grades of dysphonia, roughness, strain, breathiness, asthenia, and instability), phonatory quotient, percentage jitter, percentage shimmer, peak-to-peak amplitude variation, standard deviation of fundamental frequency, and noise to harmonic ratio. Granulation score of RFS was found to affect the highest number of acoustic parameters. We did not identify significant correlation between vocal fold edema and objective voice quality measurements. This study supports that patients with LPR have significant deterioration of both subjective and objective voice quality compared to healthy participants.

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“…Increased jitter and shimmer may reflect degenerative changes in laryngeal tissue but shimmer seems to be a more sensitive parameter than jitter in LPR patients. [13,18,19,20] The HNR changes in LPR patients were shown as well. Some authors found statistically significant changes for HNR values [18,19,21] but others did not find any differences.…”

Section: Discussionmentioning

confidence: 95%

“…[13,18,19,20] The HNR changes in LPR patients were shown as well. Some authors found statistically significant changes for HNR values [18,19,21] but others did not find any differences. [18] On the other hand, it is still controversial whether voice parameters improve with medical treatment or not.…”

Section: Discussionmentioning

confidence: 95%

The importance of voice analysis in evaluating the effectiveness of reflux treatment

Batıoğlu-Karaaltın

Develioğlu²,

Tarhan³

et al. 2016

Kulak Burun Bogaz Ihtis Derg

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Objectives: This study aims to investigate the effects of reflux treatment in voice disorders in laryngopharyngeal reflux (LPR) patients using acoustic analyses and the relationship between scoring systems. Patients and Methods:A total of 84 LPR patients (18 males, 66 females; mean age 43.1±11.3 years; range 18 to 73 years) were evaluated using reflux symptom index (RSI), reflux findings score (RFS), videolaryngostroboscopic examination, and acoustic analysis with Dr. Speech 4 before LPR treatment and at the first and third months after treatment.Results: Maximum phonation time, fundamental frequency (F0), jitter, and shimmer scores did not show any statistically significant alteration at the posttreatment period according to pretreatment scores (p>0.05). However, the alteration in Harmonics-to-Noise ratio and Signals-to-Noise ratio scores were statistically significant (p=0.017 and p=0.003, respectively). Reflux symptom index results showed significant positive correlation with F0 at the pretreatment, and at posttreatment first and third month evaluations (Spearman's rank correlation coefficient [rho]=0.246, p=0.024; rho=0.300, p=0.006; rho=0.305, p=0.005, respectively). Conclusion:The relationship between the parameters of acoustic analysis and RSI and RFS values seems to be controversial for diagnosis and follow-up of LPR patients, requiring further investigations.Keywords: Laryngopharyngeal reflux; reflux scoring system; voice analysis. ÖZAmaç: Bu çalışmada akustik analizler kullanılarak larengofarengeal reflü (LPR) hastalarındaki ses bozukluklarında reflü tedavisinin etkileri ve skorlama sistemleri arasındaki ilişki araştırıldı. Hastalar ve Yöntemler:Toplam 84 LPR hastası (18 erkek, 66 kadın; ort. yaş 43.1±11.3 yıl; dağılım 18-73 yıl) reflü semptom indeksi (RSİ), reflü bulgu skoru (RBS), videolaringostroboskopik inceleme ve Dr. Speech 4 ile akustik analiz kullanılarak LPR tedavisi öncesinde ve tedavi sonrası birinci ve üçüncü ayda değerlendirildi. Bulgular: Maksimum fonasyon zamanı, temel frekans (F0), jitter ve shimmer skorları tedavi öncesi skorlara göre tedavi sonrası dönemde istatistiksel olarak anlamlı değişiklik göstermedi (p>0.05). Fakat harmonik gürültü oranı ve sinyal gürültü oranı skorlarındaki değişiklik istatistiksel olarak anlamlı idi (sırasıyla p=0.017 ve p=0.003). Reflü semptom indeksi bulguları tedavi öncesi ve tedavi sonrası birinci ve üçüncü ay değerlendirmelerinde F0 ile anlamlı pozitif ilişki gösterdi (sırasıyla Spearman'ın sıralama korelasyon katsayısı [rho]=0.246, p=0.024; rho=0.300, p=0.006; rho=0.305, p=0.005).Sonuç: Akustik analiz parametreleri ve RSİ ve RBS değerleri arasındaki ilişki LPR hastalarının tanısı ve takibi için tartışmalı gözükmekte ve ileri araştırmalar gerektirmektedir.Anahtar Sözcükler: Larengofarengeal reflü; reflü skorlama sistemi; ses analizi.

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Impact of Laryngeal Findings on Acoustic Parameters of Patients with Laryngopharyngeal Reflux

Cited by 18 publications

References 26 publications

Conservative Treatment versus Surgery for Laryngeal Contact Granuloma: A Prospective Study

Conservative Treatment versus Surgery for Laryngeal Contact Granuloma: A Prospective Study

Perceptual, Aerodynamic, and Acoustic Characteristics of Voice Changes in Patients with Laryngopharyngeal Reflux Disease

The importance of voice analysis in evaluating the effectiveness of reflux treatment

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