Voice Quality Measurement as an Indicator of Efficiency of Treatment in Laryngopharyngeal Reflux Disease
Main Article Content
Abstract
Introduction
Laryngopharyngeal reflux disease can alter the structural and functional integrity of the vocal fold. Objectives of the study was to determine the effect of Laryngopharyngeal Reflux Disease (LPRD) on selected Acoustic, Aerodynamic and perceptual parameters of voice and to establish its effectiveness in therapeutic outcome.
Materials and Methods
The number of patients enrolled for this prospective observational study was 65, all with Reflux symptom index (RSI) more than 13. Quality of life was evaluated using voice handicap index (VHI). Perceptual evaluation of voice done by Grade Roughness Breathiness Asthenia Strain score (GRBAS) followed by acoustic and aerodynamic analysis. Patients were started on a once daily proton pump inhibitor therapy for 3 months along with vocal hygiene measures and RSI, VHI and voice analysis repeated after the treatment.
Results
There was significant improvement in the RSI score after treatment. Percent jitter and shimmer showed significant improvement in males post treatment (p value:<0.05). Harmonic to noise ratio improved 3 months post treatment in both sexes. Improvement noted in Maximum phonation time and GRBAS score except asthenia and strain post treatment.
Conclusion
Measurement of voice quality can be used as an effective tool to monitor the efficiency of treatment of LPRD.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Lechien JR, Akst LM, Hamdan AL, Schindler A, et al. Evaluation and management of laryngopharyngeal reflux disease: state of the art review. Otolaryngology–Head and Neck Surgery 2019; 160(5):762-82
Datta R, Datta K, Venkatesh MD. Laryngopharyngeal reflux: Larynx on fire. Medical Journal Armed Forces India 2010; 66(3):245-8
Hopkins C, Yousaf U, Pedersen M. Acid reflux treatment for hoarseness. Cochrane Database Syst Rev. 2006; (1):CD005054. Published 2006 Jan 25
Koufman JA, Amin MR, Panetti M. Prevalence of reflux in 113 consecutive patients with laryngeal and voice disorders. Otolaryngology- Head and Neck Surgery 2000; 123(4):385-8
Joshi AA, Chiplunkar BG, Bradoo RA. Assessment of treatment response in patients with laryngopharyngeal reflux. Indian J Otolaryngol Head Neck Surg. 2017; 69(1):77-80
Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reflux symptom index (RSI). Journal of Voice 2002; 16(2):274-7
Rosen CA, Lee AS, Osborne J, Zullo T, Murry T. Development and validation of the voice handicap index‐10. Laryngoscope 2004; 114(9):1549-56
De Bodt MS, Wuyts FL, Van de Heyning PH, Croux C. Test-retest study of the GRBAS scale: influence of experience and professional background on perceptual rating of voice quality. Journal of Voice 1997; 11(1):74-80
Watson MG, Ah-See K. Reflux disease. In: Watkinnson JC, Clarke RW, eds. Scott Brown’s Otolaryngology and Head and Neck Surgery: CRC press; 2018. p. 1136-42
Lechien JR, Finck C, Khalife M, Huet K, et al. Change of signs, symptoms and voice quality evaluations throughout a 3‐to 6‐month empirical treatment for laryngopharyngeal reflux disease. Clinical Otolaryngology 2018; 43(5):1273-82
Lee JS, Lee YC, Kim SW, Kwon KH, Eun YG. Changes in the quality of life of patients with laryngopharyngeal reflux after treatment. Journal of Voice 2014; 28(4):487-91
Sereg-Bahar M, Jansa R, Hocevar-Boltezar I. Voice disorders and gastroesophageal reflux. Logopedics Phoniatrics Vocology 2005; 30(3-4):120-4
Siupsinskiene N, Adamonis K, Toohill RJ. Quality of life in laryngopharyngeal reflux patients. Laryngoscope 2007; 117(3):480-4
Lechien JR, Finck C, de Araujo PC, Huet K, et al. Voice outcomes of laryngopharyngeal reflux treatment: a systematic review of 1483 patients. European Archives of Oto-Rhino-Laryngology 2017; 274(1):1-23
Vashani K, Murugesh M, Hattiangadi G, Gore G, et al. Effectiveness of voice therapy in reflux-related voice disorders. Diseases of the Esophagus 2010; 23(1):27-32
Park JO, Shim MR, Hwang YS, Cho KJ, et al. Combination of voice therapy and antireflux therapy rapidly recovers voice-related symptoms in laryngopharyngeal reflux patients. Otolaryngology-Head and Neck Surgery 2012 Jan;146(1):92-7
Lechien JR, Huet K, Finck C, Khalife M, et al. Clinical and acoustical voice quality evolutions throughout empirical treatment for laryngopharyngeal reflux disease according to gender: a preliminary study. Folia Phoniatrica et Logopaedica 2020; 72(4):257-66
Zhukhovitskaya A, Battaglia D, Khosla SM, Murry T, Sulica L. Gender and age in benign vocal fold lesions. Laryngoscope 2015; 125(1):191-6
Lechien JR, Saussez S, Harmegnies B, Finck C, Burns JA. Laryngopharyngeal reflux and voice disorders: a multifactorial model of etiology and pathophysiology. Journal of Voice 2017; 31(6):733-52
Roy N, Tanner K, Gray SD, Blomgren M, Fisher KV. An evaluation of the effects of three laryngeal lubricants on phonation threshold pressure (PTP). Journal of Voice 2003; 17(3):331-42
Van Houtte E, Van Lierde K, Claeys S. Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge. Journal of Voice 2011; 25(2):202-7
Cesari U, Galli J, Ricciardiello F, Cavaliere M, Galli V. Dysphonia and laryngopharyngeal reflux. Acta Otorhinolaryngologica Italica 2004; 24:13-9
Kumar R, Bhat JS. Aerodynamic analysis of voice in persons with laryngopharyngeal reflux. Online J Health Allied Scs. 2008; 7(4):5.