Voice Component Relationships with High Reflux Symptom Index Scores in Muscle Tension Dysphonia

Abstract

Objective To analyze the Reflux Symptom Index (RSI) and the Voice‐Related Quality of Life (V‐RQOL) scores based on the perceptual and analytical parameters in primary MTD patients with no reflux. Study Design Cross‐sectional study. Methods One hundred and eighteen participants, that is, sixty patients with normal voices and fifty‐eight patients with primary MTD were recruited in this study. The diagnosis of primary MTD was made by perceptual voice analysis, neck palpation, video‐laryngoscopic examination, and exclusion of other etiologies. Acoustic analysis and the GRBAS (Grade, Roughness, Breathiness, Asthenia, and Strain) scale were evaluated for all participants. The V‐RQOL and RSI questionnaires were then given to all participants. Results This study included 118 participants of 29 males (48.3%) and 31 females (51.7%) in the normal group. MTD group also included 27 males (46.6%) and 31 (53.4%) female patients. Mean (SD) RSI and V‐RQOL scores were 12.35 (3.84) and 11.09 (2.20) for the normal group, and 22.87 (6.97) and 22.89 (7.94) for the MTD group (P = .000). In the MTD group, V‐RQOL had a positive correlation with jitter for /i/ and /u/, Noise to Harmonic Ratio (NHR) for /i/, /a/, and /u/, and Grade, Roughness, and Strain of GRBAS scale (P < .05). In addition, RSI had a positive correlation with Strain in the MTD group (P < .05). Conclusion MTD patients in the absence of laryngopharyngeal reflux findings may have high RSI scores. Hence, patients with high RSI scores and disproportionate acoustic and perceptual analysis would require a thorough evaluation of MTD. Level of Evidence 4 Laryngoscope, 131:E1573–E1579, 2021

Active Ingredients of Voice Therapy for Muscle Tension Voice Disorders: A Retrospective Data Audit

“…Intraclass correlation coefficients (ICC) [54] were used to determine the level of agreement between the first and second (repeated) ratings (intra-rater reliability) and across listeners (inter-rater reliability). ICC was calculated using a two-way mixed model, consistency type, and single measure analysis [ICC (3,1)]. To assess the level of correlation, ICC < 0.5 indicates poor correlation, 0.5-0.75 indicates moderate correlation, 0.75-0.9 indicates good correlation, and >0.9 indicates excellent correlation [55].…”

“…It can occur as a primary condition without organic changes to the vocal folds or as a secondary, compensatory condition to underlying organic or neurological laryngeal pathology. The aetiology of MTVD can be multifactorial and includes phonotrauma, excessive vocal load, glottic incompetence (vocal fold paresis and atrophy), psychological stress, and cooccurring medical conditions such as upper respiratory tract infection, laryngopharyngeal reflux, and sinusitis with post-nasal drip [2,3]. Within the voice-disordered population, functional dysphonia has documented prevalence rates of between 20.5 to 41%, while the prevalence of phonotraumatic lesions (e.g., vocal nodules and polyps) is 12-15% [4,5].…”