Laryngeal and vocal evaluation in untreated growth hormone deficient adults

Abstract

OBJECTIVE To evaluate the consequences of lifetime, severe and untreated isolated growth hormone deficiency (IGHD) on vocal and laryngeal function. STUDY DESIGN Cross-sectional. SUBJECTS AND METHODS A total of 23 IGHD adult subjects and 22 controls were administered a questionnaire about vocal complaints and harmful voice habits, and underwent video-laryngostroboscopic examination, voice evaluation by perceptual-auditory analysis with GRBAS scale including grade of dysphonia, roughness, breathiness, asthenia and strain items, objective voice evaluation by maximum phonation time (MPT), and acoustic analysis. RESULTS There was no difference in vocal complaints between IGHD subjects and controls. Vocal abuse and smoking were more frequent in IGHD subjects. IGHD subjects presented higher values for roughness, breathiness, and strain. Laryngopharyngeal reflux (LPR) signs and laryngeal constriction were more frequent in IGHD individuals. MPT was similar in the two groups. Fundamental frequency was higher in IGHD females and males. Harmonic to noise ratio was higher in IGHD in both genders and shimmer was lower in IGHD females. CONCLUSIONS IGHD subjects have higher prevalence of signs of LPR and laryngeal constriction, with high pitch in both genders, which suggests a prominent role of IGHD on these parameters.

MECHANISMS IN ENDOCRINOLOGY: The multiple facets of GHRH/GH/IGF-I axis: lessons from lifetime, untreated, isolated GH deficiency due to a GHRH receptor gene mutation

“…3) (61). These cephalometric features may help the diagnosis of IGHD, and -together with the underdevelopment of the larynx -lead to a typically highpitched voice with high fundamental frequency in both genders (62,63). Formal voice analysis showed higher values of most formant frequencies, suggesting smaller oral and pharyngeal cavities.…”

“…The voice changes result in a reduction of the effect of gender on the structure of the formants, maintaining a pre-pubertal acoustic prediction (64). Therefore, GH plays a relevant role in the development of voice quality, mostly increasing vocal cords thickness (62,63,64).…”

“…These features have been published in 42 different publications (2,19,22,25,27,29,30,31,32,33,36,37,38,40,41,44,45,46,47,48,49,50,51,52,53,54,56,57,61,62,63,64,66,67,68,74,75,76,77,78,79,80). We have used this experiment of nature to discover 'usual laws of nature' as suggested by William Harvey, and to understand some aspects of more common conditions such as short stature, insulin resistance, diabetes, atherosclerosis, osteoporosis, cancer and ultimately longevity.…”

Voice Quality in Short Stature With and Without GH Deficiency

“…7 In the present study, voice quality was assessed by a Brazilian Portuguese version of the Voice-Related Qualityof-Life (V-RQOL) score. [12][13][14][15] The total score results from the sum of 10 items, six from physical and four from socialemotional scores.…”

“…Harmonic-to-noise ratio is higher in both genders, and shimmer is lower in IGHD females. 7 f 0 is inversely correlated to stature, 8 which is heavily influenced by GH. Our hypothesis is that IGHD can influence the voice in a manner not uniquely caused by SS but specifically caused by the lack of GH.…”