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

Abstract

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.

Defining the Performance of Clinician's Ability to Screen for Laryngeal Mass From Voice

“…Some argue VFMA should be included in the definition of urgent dysphonia 1,3 . Similarly, roughness is one of the strongest perceptual correlates with laryngopharyngeal reflux, a common differential diagnosis in the outpatient setting 49 . As 35% to 71% of dysphonia in the primary care setting is caused by acute laryngitis, 6 creating an algorithm that can help distinguish inflammatory pathologies, using either acoustic or risk‐based tools, may be beneficial.…”

Development of a New Self-Assessment Tool for Laryngopharyngeal Reflux Screening in Singers (SVHI-12-LPR)

“…LPR determines a worsening of voice quality, with a subsequent negative impact on the quality of life of a singer [31, 32]. Since its introduction in 2002 by Belafsky et al [23], RSI has become the most used self-assessment questionnaire for the evaluation of LPR risk.…”

“…Voice quality alterations (especially grade of overall severity of dysphonia and roughness) and variations in acoustical parameters of voice (SD of f0, noise-to-harmonic ratio, percent jitter, pitch perturbation quotient, percent shimmer, smoothed amplitude perturbation quotient, peak-to-peak amplitude variation) have been associated to LPR [31, 33]. As recently reported by Lechien [33] and Mozzanica [34], in self-assessment questionnaires of voice, such as the Voice Handicap Index (VHI), the Vocal Tract Discomfort Scale (VTDS), and the Voice Symptom Scale (VoiSS), results altered when LPR is present.…”