Systematic evaluation of laryngeal impairment in Sjögren’s syndrome

Abstract

Introduction Sjögren’s syndrome (SjS) causes malfunction of the salivary and lacrimal glands. Consequently, patients suffer from xerostomia and keratoconjunctivitis sicca. This can further affect the voice and swallowing function resulting in an impaired quality of life. Aim of this study is the systematic evaluation of the impact on voice and swallowing-related quality of life in patients with SjS. Material and methods SjS patients were classified according to the American–European Consensus Group (AECG) criteria; antibodies to Ro (SS-A) or La (SS-B) antigens were detected, ESSPRI was completed. We used the following quality of life questionnaires: EORTC QLQ H&N 35, Anderson Dysphagia Inventory (ADI) and Voice Handicap Index (VHI). Patients additionally received a detailed phoniatric examination (auditory perception, videostroboscopy, acoustic analysis, Dysphonia Severity Index (DSI), aerodynamics measurements). Results Almost all the 54 patients (96.3%) had a limited quality of life due to their swallowing problems and 48% due to their voice problems. Both values correlated significantly with the degree of xerostomia. In the phoniatric examination, 77.8% had an increased DSI and two-thirds had abnormalities in videostroboscopy. Conclusions A reasonable impairment of quality of life in patients with SjS due to the limitations in voice and swallowing function was observed. As SjS does not limitate life expectancy, preservation of quality of life is important. Detection of voice and swallowing problems as potential reasons for quality of life impairment should be detected and, if diagnosed, treated accordingly.

Inhalative Treatment of Laryngitis Sicca in Patients with Sjögren’s Syndrome—A Pilot Study

“…Particularly in recent years, several publications have described voice and swallowing disorders in patients with Sjögren's syndrome [8]. Swallowing disorders are caused by dryness, which impairs the oral and pharyngeal transport of food.…”

“…The reduced production of saliva can result in numerous other complaints in the area of the upper respiratory and digestive tract, such as periodontal disease, loss of teeth and oral candidiasis [3][4][5][6][7]. In addition, recent reports have shown consistently, that the hyposalivation in patients with Sjögren's syndrome also leads to a laryngeal impairment, resulting in dysphonia and dysphagia [8,9].…”

Perspective Chapter: Pulmonary System and Sjogren’s Syndrome

“…Many patients may lose their teeth and have a significant decrease in their quality of life. This later is in part attributable to the dysphagia and dysphonia, both related with xerostomia [125]. Hoarseness presents in a frequency between 26% and 33% [125,126].…”

“…This later is in part attributable to the dysphagia and dysphonia, both related with xerostomia [125]. Hoarseness presents in a frequency between 26% and 33% [125,126]. The laryngeal mucus and vocal folds will harden causing morphological revealing distinctive vessels and/or edema on the exam.…”

Sex Differences in Otolaryngology: Focus on the Emerging Role of Estrogens in Inflammatory and Pro-Resolving Responses

“…Although SS is a well-known systemic disease that differs from most ENT diseases, which are localized, its geographical distribution is notable because most patients affected by SS also exhibit otorhinolaryngological manifestations [1,10,12]. For instance, patients with SS also show bilateral parotid enlargement, recurrent sinusitis, hearing loss, nasal crust formation, and dysphonia [12][13][14][209][210][211][212][213][214][215]. The incidence rate of SS is estimated to be 6.9 per 100,000 people annually, with an average age of 56 years.…”