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The importance of voice analysis in evaluating the effectiveness of reflux treatment

Year 2016, Volume: 26 Issue: 4, 207 - 212, 10.09.2016

Abstract

Objectives: This study aims to investigate the effects of reflux treatment in voice disorders in laryngopharyngeal reflux LPR patients using acoustic analyses and the relationship between scoring systems. Patients and Methods: A total of 84 LPR patients 18 males, 66 females; mean age 43.1±11.3 years; range 18 to 73 years were evaluated using reflux symptom index RSI , reflux findings score RFS , videolaryngostroboscopic examination, and acoustic analysis with Dr. Speech 4 before LPR treatment and at the first and third months after treatment. Results: Maximum phonation time, fundamental frequency F0 , jitter, and shimmer scores did not show any statistically significant alteration at the posttreatment period according to pretreatment scores p>0.05 . However, the alteration in Harmonics-to-Noise ratio and Signals-to-Noise ratio scores were statistically significant p=0.017 and p=0.003, respectively . Reflux symptom index results showed significant positive correlation with F0 at the pretreatment, and at posttreatment first and third month evaluations Spearman's rank correlation coefficient [rho]=0.246, p=0.024; rho=0.300, p=0.006; rho=0.305, p=0.005, respectively . Conclusion: The relationship between the parameters of acoustic analysis and RSI and RFS values seems to be controversial for diagnosis and follow-up of LPR patients, requiring further investigations.

References

  • Jailwala JA, Shaker R. Supra-oesophageal complications of reflux disease. Dig Liver Dis 2000;32:267-74.
  • Koufman JA, Amin MR, Panetti M. Prevalence of reflux in 113 consecutive patients with laryngeal and voice disorders. Otolaryngol Head Neck Surg 2000;123:385-8.
  • Toohill RJ, Kuhn JC. Role of refluxed acid in pathogenesis of laryngeal disorders. Am J Med 1997;103:100-6.
  • Olson NR. Laryngopharyngeal manifestations of gastroesophageal reflux disease. Otolaryngol Clin North Am 1991;24:1201-13.
  • Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope 1991;101:1-78.
  • Hill J, Stuart RC, Fung HK, Ng EK, Cheung FM, Chung CS, et al. Gastroesophageal reflux, motility disorders, and psychological profiles in the etiology of globus pharyngis. Laryngoscope 1997;107:1373-7.
  • Woo P, Noordzij P, Ross JA. Association of esophageal reflux and globus symptom: comparison of laryngoscopy and 24-hour pH manometry. Otolaryngol Head Neck Surg 1996;115:502-7.
  • Bain WM, Harrington JW, Thomas LE, Schaefer SD. Head and neck manifestations of gastroesophageal reflux. Laryngoscope 1983;93:175-9.
  • Price JC, Jansen CJ, Johns ME. Esophageal reflux and secondary malignant neoplasia at laryngoesophagectomy. Arch Otolaryngol Head Neck Surg 1990;116:163-4.
  • Ward PH, Hanson DG. Reflux as an etiological factor of carcinoma of the laryngopharynx. Laryngoscope 1988;98:1195-9.
  • Ulualp SO, Toohill RJ. Laryngopharyngeal reflux: state of the art diagnosis and treatment. Otolaryngol Clin North Am 2000;33:785-802.
  • Pribuisiene R, Uloza V, Kupcinskas L, Jonaitis L. Perceptual and acoustic characteristics of voice changes in reflux laryngitis patients. J Voice 2006;20:128-36.
  • Oguz H, Tarhan E, Korkmaz M, Yilmaz U, Safak MA, Demirci M, et al. Acoustic analysis findings in objective laryngopharyngeal reflux patients. J Voice 2007;21:203-10.
  • Ali Mel-S. Laryngopharyngeal reflux: diagnosis and treatment of a controversial disease. Curr Opin Allergy Clin Immunol 2008;8:28-33.
  • Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reflux symptom index (RSI). J Voice 2002;16:274-7.
  • Maslan J, Leng X, Rees C, Blalock D, Butler SG. Maximum phonation time in healthy older adults. J Voice 2011;25:709-13.
  • Kılıç MA, Evaluation of the patient with voice problem by objective and subjective methods, Curr Pract ORL 2010;6:257-26.
  • Ross JA, Noordzji JP, Woo P. Voice disorders in patients with suspected laryngo-pharyngeal reflux disease. J Voice 1998;12:84-8.
  • Akyildiz S, Ogut F, Varis A, Kirazli T, Bor S. Impact of laryngeal findings on acoustic parameters of patients with laryngopharyngeal reflux. ORL J Otorhinolaryngol Relat Spec 2012;74:215-9.
  • Hamdan AL, Sharara AI, Younes A, Fuleihan N. Effect of aggressive therapy on laryngeal symptoms and voice characteristics in patients with gastroesophageal reflux. Acta Otolaryngol 2001;121:868-72.
  • Selby JC, Gilbert HR, Lerman JW. Perceptual and acoustic evaluation of individuals with laryngopharyngeal reflux pre- and post-treatment. J Voice 2003;17:557-70.
  • Hanson DG, Jiang JJ, Chen J, Pauloski BR. Acoustic measurement of change in voice quality with treatment for chronic posterior laryngitis. Ann Otol Rhinol Laryngol 1997;106:279-85.
  • Shaw GY, Searl JP. Laryngeal manifestations of gastroesophageal reflux before and after treatment with omeprazole. South Med J 1997;90:1115-22.
  • Branski RC, Bhattacharyya N, Shapiro J. The reliability of the assessment of endoscopic laryngeal findings associated with laryngopharyngeal reflux disease. Laryngoscope 2002;112:1019-24.
  • Komatsu Y, Kelly LA, Zaidi AH, Rotoloni CL, Kosovec JE, Lloyd EJ, et al. Hypopharyngeal pepsin and Sep70 as diagnostic markers of laryngopharyngeal reflux: preliminary study. Surg Endosc 2015;29:1080-7.
  • Siupsinskiene N, Adamonis K. Diagnostic test with omeprazole in patients with posterior laryngitis. Medicina (Kaunas) 2003;39:47-55.
  • Belafsky PC, Postma GN, Koufman JA. The validity and reliability of the reflux finding score (RFS). Laryngoscope 2001;111:1313-7.
  • Jin bJ, Lee YS, Jeong SW, Jeong JH, Lee SH, Tae K. Change of acoustic parameters before and after treatment in laryngopharyngeal reflux patients. Laryngoscope 2008;118:938-41.
  • DelGaudio JM, Waring JP. Empiric esomeprazole in the treatment of laryngopharyngeal reflux. Laryngoscope 2003;113:598-601.
  • Hanson DG, Kamel PL, Kahrilas PJ. Outcomes of antireflux therapy for the treatment of chronic laryngitis. Ann Otol Rhinol Laryngol 1995;104:550-5.

Reflü tedavisinin etkililiğinin değerlendirilmesinde ses analizinin önemi

Year 2016, Volume: 26 Issue: 4, 207 - 212, 10.09.2016

Abstract

Amaç: Bu çalışmada akustik analizler kullanılarak larengofarengeal reflü LPR hastalarındaki ses bozukluklarında reflü tedavisinin etkileri ve skorlama sistemleri arasındaki ilişki araştırıldı.Hastalar ve Yöntemler: Toplam 84 LPR hastası 18 erkek, 66 kadın; ort. yaş 43.1±11.3 yıl; dağılım 18-73 yıl reflü semptom indeksi RSİ , reflü bulgu skoru RBS , videolaringostroboskopik inceleme ve Dr. Speech 4 ile akustik analiz kullanılarak LPR tedavisi öncesinde ve tedavi sonrası birinci ve üçüncü ayda değerlendirildi.Bulgular: Maksimum fonasyon zamanı, temel frekans F0 , jitter ve shimmer skorları tedavi öncesi skorlara göre tedavi sonrası dönemde istatistiksel olarak anlamlı değişiklik göstermedi p>0.05 . Fakat harmonik gürültü oranı ve sinyal gürültü oranı skorlarındaki değişiklik istatistiksel olarak anlamlı idi sırasıyla p=0.017 ve p=0.003 . Reflü semptom indeksi bulguları tedavi öncesi ve tedavi sonrası birinci ve üçüncü ay değerlendirmelerinde F0 ile anlamlı pozitif ilişki gösterdi sırasıyla Spearman’ın sıralama korelasyon katsayısı [rho]=0.246, p=0.024; rho=0.300, p=0.006; rho=0.305, p=0.005 .Sonuç: Akustik analiz parametreleri ve RSİ ve RBS değerleri arasındaki ilişki LPR hastalarının tanısı ve takibi için tartışmalı gözükmekte ve ileri araştırmalar gerektirmektedir

References

  • Jailwala JA, Shaker R. Supra-oesophageal complications of reflux disease. Dig Liver Dis 2000;32:267-74.
  • Koufman JA, Amin MR, Panetti M. Prevalence of reflux in 113 consecutive patients with laryngeal and voice disorders. Otolaryngol Head Neck Surg 2000;123:385-8.
  • Toohill RJ, Kuhn JC. Role of refluxed acid in pathogenesis of laryngeal disorders. Am J Med 1997;103:100-6.
  • Olson NR. Laryngopharyngeal manifestations of gastroesophageal reflux disease. Otolaryngol Clin North Am 1991;24:1201-13.
  • Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope 1991;101:1-78.
  • Hill J, Stuart RC, Fung HK, Ng EK, Cheung FM, Chung CS, et al. Gastroesophageal reflux, motility disorders, and psychological profiles in the etiology of globus pharyngis. Laryngoscope 1997;107:1373-7.
  • Woo P, Noordzij P, Ross JA. Association of esophageal reflux and globus symptom: comparison of laryngoscopy and 24-hour pH manometry. Otolaryngol Head Neck Surg 1996;115:502-7.
  • Bain WM, Harrington JW, Thomas LE, Schaefer SD. Head and neck manifestations of gastroesophageal reflux. Laryngoscope 1983;93:175-9.
  • Price JC, Jansen CJ, Johns ME. Esophageal reflux and secondary malignant neoplasia at laryngoesophagectomy. Arch Otolaryngol Head Neck Surg 1990;116:163-4.
  • Ward PH, Hanson DG. Reflux as an etiological factor of carcinoma of the laryngopharynx. Laryngoscope 1988;98:1195-9.
  • Ulualp SO, Toohill RJ. Laryngopharyngeal reflux: state of the art diagnosis and treatment. Otolaryngol Clin North Am 2000;33:785-802.
  • Pribuisiene R, Uloza V, Kupcinskas L, Jonaitis L. Perceptual and acoustic characteristics of voice changes in reflux laryngitis patients. J Voice 2006;20:128-36.
  • Oguz H, Tarhan E, Korkmaz M, Yilmaz U, Safak MA, Demirci M, et al. Acoustic analysis findings in objective laryngopharyngeal reflux patients. J Voice 2007;21:203-10.
  • Ali Mel-S. Laryngopharyngeal reflux: diagnosis and treatment of a controversial disease. Curr Opin Allergy Clin Immunol 2008;8:28-33.
  • Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reflux symptom index (RSI). J Voice 2002;16:274-7.
  • Maslan J, Leng X, Rees C, Blalock D, Butler SG. Maximum phonation time in healthy older adults. J Voice 2011;25:709-13.
  • Kılıç MA, Evaluation of the patient with voice problem by objective and subjective methods, Curr Pract ORL 2010;6:257-26.
  • Ross JA, Noordzji JP, Woo P. Voice disorders in patients with suspected laryngo-pharyngeal reflux disease. J Voice 1998;12:84-8.
  • Akyildiz S, Ogut F, Varis A, Kirazli T, Bor S. Impact of laryngeal findings on acoustic parameters of patients with laryngopharyngeal reflux. ORL J Otorhinolaryngol Relat Spec 2012;74:215-9.
  • Hamdan AL, Sharara AI, Younes A, Fuleihan N. Effect of aggressive therapy on laryngeal symptoms and voice characteristics in patients with gastroesophageal reflux. Acta Otolaryngol 2001;121:868-72.
  • Selby JC, Gilbert HR, Lerman JW. Perceptual and acoustic evaluation of individuals with laryngopharyngeal reflux pre- and post-treatment. J Voice 2003;17:557-70.
  • Hanson DG, Jiang JJ, Chen J, Pauloski BR. Acoustic measurement of change in voice quality with treatment for chronic posterior laryngitis. Ann Otol Rhinol Laryngol 1997;106:279-85.
  • Shaw GY, Searl JP. Laryngeal manifestations of gastroesophageal reflux before and after treatment with omeprazole. South Med J 1997;90:1115-22.
  • Branski RC, Bhattacharyya N, Shapiro J. The reliability of the assessment of endoscopic laryngeal findings associated with laryngopharyngeal reflux disease. Laryngoscope 2002;112:1019-24.
  • Komatsu Y, Kelly LA, Zaidi AH, Rotoloni CL, Kosovec JE, Lloyd EJ, et al. Hypopharyngeal pepsin and Sep70 as diagnostic markers of laryngopharyngeal reflux: preliminary study. Surg Endosc 2015;29:1080-7.
  • Siupsinskiene N, Adamonis K. Diagnostic test with omeprazole in patients with posterior laryngitis. Medicina (Kaunas) 2003;39:47-55.
  • Belafsky PC, Postma GN, Koufman JA. The validity and reliability of the reflux finding score (RFS). Laryngoscope 2001;111:1313-7.
  • Jin bJ, Lee YS, Jeong SW, Jeong JH, Lee SH, Tae K. Change of acoustic parameters before and after treatment in laryngopharyngeal reflux patients. Laryngoscope 2008;118:938-41.
  • DelGaudio JM, Waring JP. Empiric esomeprazole in the treatment of laryngopharyngeal reflux. Laryngoscope 2003;113:598-601.
  • Hanson DG, Kamel PL, Kahrilas PJ. Outcomes of antireflux therapy for the treatment of chronic laryngitis. Ann Otol Rhinol Laryngol 1995;104:550-5.
There are 30 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Ayşegül Batıoğlu Karaaltın This is me

Ömer Necati Develioğlu This is me

Özge Tarhan This is me

Mehmet Külekçi This is me

Publication Date September 10, 2016
Published in Issue Year 2016 Volume: 26 Issue: 4

Cite

APA Batıoğlu Karaaltın, A., Develioğlu, Ö. N., Tarhan, Ö., Külekçi, M. (2016). Reflü tedavisinin etkililiğinin değerlendirilmesinde ses analizinin önemi. The Turkish Journal of Ear Nose and Throat, 26(4), 207-212.
AMA Batıoğlu Karaaltın A, Develioğlu ÖN, Tarhan Ö, Külekçi M. Reflü tedavisinin etkililiğinin değerlendirilmesinde ses analizinin önemi. Tr-ENT. September 2016;26(4):207-212.
Chicago Batıoğlu Karaaltın, Ayşegül, Ömer Necati Develioğlu, Özge Tarhan, and Mehmet Külekçi. “Reflü Tedavisinin etkililiğinin değerlendirilmesinde Ses Analizinin önemi”. The Turkish Journal of Ear Nose and Throat 26, no. 4 (September 2016): 207-12.
EndNote Batıoğlu Karaaltın A, Develioğlu ÖN, Tarhan Ö, Külekçi M (September 1, 2016) Reflü tedavisinin etkililiğinin değerlendirilmesinde ses analizinin önemi. The Turkish Journal of Ear Nose and Throat 26 4 207–212.
IEEE A. Batıoğlu Karaaltın, Ö. N. Develioğlu, Ö. Tarhan, and M. Külekçi, “Reflü tedavisinin etkililiğinin değerlendirilmesinde ses analizinin önemi”, Tr-ENT, vol. 26, no. 4, pp. 207–212, 2016.
ISNAD Batıoğlu Karaaltın, Ayşegül et al. “Reflü Tedavisinin etkililiğinin değerlendirilmesinde Ses Analizinin önemi”. The Turkish Journal of Ear Nose and Throat 26/4 (September 2016), 207-212.
JAMA Batıoğlu Karaaltın A, Develioğlu ÖN, Tarhan Ö, Külekçi M. Reflü tedavisinin etkililiğinin değerlendirilmesinde ses analizinin önemi. Tr-ENT. 2016;26:207–212.
MLA Batıoğlu Karaaltın, Ayşegül et al. “Reflü Tedavisinin etkililiğinin değerlendirilmesinde Ses Analizinin önemi”. The Turkish Journal of Ear Nose and Throat, vol. 26, no. 4, 2016, pp. 207-12.
Vancouver Batıoğlu Karaaltın A, Develioğlu ÖN, Tarhan Ö, Külekçi M. Reflü tedavisinin etkililiğinin değerlendirilmesinde ses analizinin önemi. Tr-ENT. 2016;26(4):207-12.