The Role of Allergy in Phonation

Spantideas, Nikolaos; Bougea, Anastasia; Drosou, Eirini; Assimakopoulos, D.

doi:10.1016/j.jvoice.2018.02.016

Cited by 12 publications

(18 citation statements)

References 55 publications

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“…The laryngeal pathology of individuals with AR or laryngitis has only been insufficiently investigated, possibly because laryngoscopy is not a routine procedure when diagnosing AR or laryngitis. AR causes nasal congestion, nasal obstruction, and mucus hypersecretion, and triggers rhinolaryngeal reflexes, resulting in altered voice resonance, hoarseness, laryngeal edema, and dysphagia [7]. In one cohort study [6], laryngoscopy identified vocal nodules, laryngitis, Reinke's edema, vocal polyps, and epiglottic cysts as the top five causes of voice complaints and laryngeal disease.…”

Section: Discussionmentioning

confidence: 99%

“…Voice problems affect up to 41 million older adults in the United States, and among younger adults, a prevalence of 6% has been noted [4,5]. Vocalization can be affected by several factors, including respiratory allergies and laryngeal disease [6,7]. In a large population-based study, the three most common laryngeal diseases, which were accompanied with voice complaints, were allergic laryngitis, vocal nodules, and vocal polyps in descending order [6].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, a study has identified a strong link of allergic laryngitis and vocal nodules with AR [6]. Allergies may inflame the mucus from the upper to lower airway and trigger hypersecretion of mucus, leading to cough, dysphonia, and laryngeal edema [7,10]. Understanding the relationship between AR and laryngeal pathologies can help to clarify its cause and determine how to effectively treat the disease.…”

Section: Introductionmentioning

confidence: 99%

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Allergic Rhinitis and Laryngeal Pathology: Real-World Evidence

et al. 2021

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Allergic rhinitis (AR) is correlated with diseases including allergic laryngitis, chronic obstructive pulmonary disease (COPD), asthma, and chronic rhinosinusitis (CRS). The unified airway model suggests that inflammation can spread in both lower and upper respiratory tracts. Moreover, some voice problems—laryngeal edema, dysphonia, and vocal nodules—have been associated with AR. We examined the association between AR and laryngeal pathology. We investigated 51,618 patients with AR between 1 January 1997 and 31 December 2013, along with 206,472 patients without AR matched based on age, gender, urbanization level, and socioeconomic status at a 1:4 ratio. We followed patients up to the end of 2013 or their death. The occurrence of laryngeal pathology was the primary outcome. Individuals with AR had a 2.43 times higher risk of laryngeal pathology than the comparison cohort group (adjusted HR: 2.43, 95% CI: 2.36–2.50, p < 0.001). Patients diagnosed as having AR exhibited higher comorbidity rates, including of asthma, COPD, CRS, gastroesophageal reflux disease, and nasal septum deviation, than those of the comparison cohort. Our results strongly indicate that AR is an independent risk factor for laryngeal pathology. Therefore, when treating AR and voice problems, physicians should be attuned to possible laryngeal pathology.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Allergic Rhinitis and Laryngeal Pathology: Real-World Evidence

et al. 2021

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“…2 Upper airway inflammation that results in both CRS and laryngeal dysfunction appears to be common, but has been less thoroughly described. 3…”

Section: Introductionmentioning

confidence: 99%

“…2 Upper airway inflammation that results in both CRS and laryngeal dysfunction appears to be common, but has been less thoroughly described. 3 The 22-Item Sino-nasal Outcome Test (SNOT-22) is a validated and widely used patient-reported quality of life (QOL) outcomes tool for patients with CRS. 4 The SNOT-22 has three questions that could relate to potential vocal manifestations of CRS.…”

Section: Introductionmentioning

confidence: 99%

Voice-Related Quality of Life in Patients with Chronic Rhinosinusitis

Walgama

Borrelli

et al. 2020

Ann Otol Rhinol Laryngol

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Objective: Chronic rhinosinusitis (CRS) has long been associated with vocal dysfunction. However, studies quantifying the presence of voice dysfunction in CRS patients or the effects of functional endoscopic sinus surgery (FESS) are sparse. The goal of this study was to determine the voice-related quality of life in patients undergoing FESS for CRS using the validated Voice Related Quality of Life Survey (VRQL). We correlated the preoperative VRQL scores to the Sino-Nasal Outcome Test (SNOT-22) scores, and we determined the effect of FESS on postoperative VRQL scores. Methods: Consecutive patients undergoing FESS were preoperatively administered both the VRQL and the SNOT-22 surveys. Spearman (ρ) and Pearson ( r) correlation coefficients were calculated. The VRQL was mailed to patients postoperatively between 3 and 6 months. The paired t-test was used to compare pre- and post-FESS scores. Results: A total of 102 patients were enrolled, and 81 patients completed the two surveys. A total of 51 (62.9%) patients had raw VRQL score ≥ 10, signifying presence of significant vocal symptoms. The mean ± standard deviation (SD) raw VRQL score of the entire study population was 12.4 ± 4.6, and the mean SNOT-22 score was 37.8 ± 19.2. The Spearman correlation coefficient between VRQL and the total SNOT-22 score was 0.34 ( P =.002), and the Pearson correlation coefficient was 0.36 ( P = .001). Both correlations were similar, demonstrating that increasing severity of CRS symptoms correlates with decreasing voice-related quality of life (QOL). Seventy patients completed the postoperative survey for an 86% retention rate. Thirty-six of these patients had abnormal preoperative VRQL scores, and these patients improved significantly after FESS. The mean preoperative versus postoperative raw scores were 15.2 ± 5.6 versus 12.5 ± 4.1, respectively ( P = .003). Conclusion: This study demonstrates the increasing presence of vocal complaints with increasing severity of CRS. It also demonstrates that VRQL scores improve after FESS in those patients with preoperative vocal complaints. Level of Evidence: IV

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Association of Sinonasal Factors With Chronic Laryngitis in Korean Adults

Lee

Kang

Lee

et al. 2019

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Allergic laryngitis is underdiagnosed owing to overlapping clinical manifestations that arise from other causes of laryngitis. Sinonasal conditions associated with chronic laryngitis, including allergic laryngitis, have not been reported using population-based epidemiologic data. OBJECTIVE To estimate the association of the prevalence of chronic laryngitis with various sinonasal symptoms and endoscopic findings, and to identify which of the sinonasal factors are particularly associated with allergic cause of chronic laryngitis. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional, population-based study of 11 283 participants 18 years and older who had undergone laryngoscopic and nasal endoscopic examination used data from 2010 through 2012 in the fifth edition of the Korea National Health and Nutrition Examination Survey, a nationwide survey of South Korea. Participants were extracted by stratified, multistage, clustered sampling to comprise a nationally representative sample. Data were analyzed in September 2017. EXPOSURES Sociodemographic characteristics, smoking status, alcohol use, questionnaires for voice change and sinonasal symptoms, and nasal endoscopic examinations before and after shrinkage of the nasal mucosa. MAIN OUTCOMES AND MEASURES Chronic laryngitis diagnosed by laryngoscopic examination, and allergic cause of laryngitis determined by specific serum immunoglobulin E tests. RESULTS Of the 11 283 participants included in the study, the mean (SD) age was 50.1 (16.6) years, and 6365 (56.4%) were women. In total, 343 participants (3.0%) were diagnosed with chronic laryngitis through results of laryngoscopic examination. Chronic laryngitis was associated with a higher rate of rhinitis symptoms (odds ratio [OR], 1.54; 95% CI, 1.21-1.96), anterior/posterior nasal drip (OR, 2.03; 95% CI, 1.38-2.98), nasal congestion (OR, 1.49; 95% CI, 0.99-2.25), endoscopic findings of pale mucosa (OR, 1.74; 95% CI, 1.33-2.28), mucous or puslike discharge (OR, 1.53; 95% CI, 1.08-2.18), and puslike discharge in the middle meatus (OR, 1.85; 95% CI, 1.19-2.88), especially in female participants and participants older than 50 years. Subgroup analysis revealed that all participants with allergic laryngitis showed sensitization to Dermatophagoides farinae, and the allergic laryngitis group (n = 9) had a higher presence of rhinitis symptoms (n = 5; 56%) than did the nonallergic laryngitis group (n = 1 of 12; 8%) among participants younger than 50 years (risk difference, 47%; 95% CI, 4%-78%). CONCLUSIONS AND RELEVANCE The association of various sinonasal factors with chronic laryngitis were prominent in female participants, as well as those 50 years and older. Nevertheless, the presence of rhinitis symptoms in patients with chronic laryngitis was associated with allergic cause of laryngitis solely in participants younger than 50 years. In young adults, presence of rhinitis symptoms might aid in considering allergic laryngitis.

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The Role of Allergy in Phonation

Cited by 12 publications

References 55 publications

Allergic Rhinitis and Laryngeal Pathology: Real-World Evidence

Allergic Rhinitis and Laryngeal Pathology: Real-World Evidence

Voice-Related Quality of Life in Patients with Chronic Rhinosinusitis

Association of Sinonasal Factors With Chronic Laryngitis in Korean Adults

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