Prevalence and Severity of Dysphonia in Patients with Cystic Fibrosis

Abstract

Objective To assess the prevalence and severity of dysphonia in patients with cystic fibrosis sinusitis. We hypothesized that patients with CF sinusitis, compared with 2 control groups, would have higher self-reported prevalence of dysphonia and greater severity of dysphonia, according to patient-reported outcome measures as well as auditory-perceptual evaluation by expert listeners. Study Design Cross-sectional comparative pilot study. Setting Academic tertiary care clinic. Study Participants and Methods Analysis included 37 study participants: 17 patients with CF sinusitis, 10 healthy individuals, and 10 patients with non-CF sinusitis. All participants completed the 10-item Voice Handicap Index (VHI-10) questionnaire and provided voice samples. On all samples, 6 blinded speech-language pathologists independently performed auditory-perceptual evaluation, using Consensus Auditory-Perceptual Evaluation of Voice. To assess severity of sinonasal symptoms, we used the 20-item Sinonasal Outcome Test (SNOT-20). Standard parametric and nonparametric statistical analysis was performed. Results The differences between the 3 groups in prevalence of abnormal VHI-10 scores were not statistically significant. SNOT-20 scores were similar in the 2 sinusitis patient groups. VHI-10 scores were highest in patients with CF sinusitis, intermediate in patients with non-CF sinusitis, and lowest in healthy individuals (P = .005). Auditory-perceptual evaluation demonstrated greater overall severity of dysphonia in patients with CF sinusitis compared with the 2 control groups (P = .0005). Conclusions Cystic fibrosis sinusitis appeared to be associated with worse vocal function as measured by patient self-report as well as auditory-perceptual evaluation of voice compared with patients with non-CF sinusitis and healthy controls. Further investigation in this area is warranted.

Cystic Fibrosis: The Sense of Smell

“…Such data agree with those previously described by Willis et al. 20 that found a mean value of 33.9 ± 16.8 points in 17 patients with CF and CRS and a value of 39.1 ± 19.9 points in 10 patients with CRS, not due to CF. Thus, despite the presence of CRS, patients with CF had a low value of SNOT-22 as compared to other groups of patients with CRS, 16 and these data confirm that CF patients do not feel the severity of sinus alterations because of the early onset of CRS in childhood and because sinus symptoms are masked by the severity of other medical issues.…”

Importance to question sinonasal symptoms and to perform rhinoscopy and rhinomanometry in cystic fibrosis patients

“…Evaluation of subjective symptoms in our CF‐population of 124 patients revealed a mean total SNOT‐20 score of 15.2 ± 12.1 pts. Willis et al found that SNOT scores from non‐CF patients with sinusitis (39.1 ± 19.9 pts) were higher than those reported by CF patients (33.9 ± 16.8 pts), whereas scores in his healthy controls resulted to be significantly lower (5.2 ± 5.4 pts) . Accordingly, prevalences of chronic rhinosinusitis in CF patients accord for 11–72% of patients assessed in recent studies .…”

A comparison of symptoms and quality of life before and after nasal septoplasty and radiofrequency therapy of the inferior turbinate

“…The Sino-Nasal Outcome Test-20 (SNOT-20) questionnaire was used to assess HQOL more specifically related to the sino-nasal outcome. It has been validated in patients with chronic rhinosinusitis [ 31 , 32 ], and used to assess sino-nasal outcome in relation to other diseases such as asthma [ 33 ], cystic fibrosis [ 34 ], skull base tumors [ 35 ] and in healthy individuals [ 33 ].…”