Araştırma Makalesi
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Determination of the Relationship Between Voice and Swallowing Characteristics in Individuals aged 65 and Over with Sarcopenia Risk

Yıl 2024, Cilt: 34 Sayı: 4, 97 - 104, 31.12.2024
https://doi.org/10.26650/Tr-ENT.2024.1546320

Öz

Objective: Sarcopenia, which increases with age, causes a decrease in muscle mass and strength, potentially leading to changes in the voice’s acoustic, perceptual, and aerodynamic parameters, as well as dysphagia. This study aimed to assess the voice and swallowing functions of individuals aged 65 years at risk of sarcopenia and to explore the relationship between these functions.

Method: Forty-nine participants who scored ≥4 on the Sarcopenia Risk Assessment Scale were included. Acoustic analysis was performed using the Multi-Dimensional Voice Programme (MDVP), and aerodynamic analysis included the maximum phonation time (MPT) and the s/z ratio. Swallowing was evaluated using the Swallowing Function Screening Test (EAT-10).

Results: Participants were categorised into dysphagic (n=29) and non-dysphagic (n=20) groups based on their EAT-10 scores. Significant differences were found in several acoustic parameters, including fundamental frequency (F0), Shimmer, vAm, and FTRI (p=0.011, p=0.043, p=0.037, p=0.001). A significant difference in the SPI parameter was observed only in female participants (p=0.028). MPT showed significant differences between the dysphagic and non-dysphagic groups in both men and women (p=0.001, p=0.003, p=0.037). Positive correlations were found between EAT-10 and the acoustic parameters SPI and FTRI (p=0.031, p=0.048), while a negative correlation was found between MPT and EAT-10 (p=0.001).

Conclusion: MPT was decreased in dysphagic individuals aged ≥65 years at risk of sarcopenia, and parameters related to decreased respiratory support and control, vocal cord closure, and airflow control during vocal cord adduction were negatively affected. These findings suggest that these parameters may be related to dysphagia risk factors in elderly individuals at risk of sarcopenia.

Kaynakça

  • 1. Elmas Ö. Evaluation of functional status in sarcopenic elderly individuals [Master's thesis]. Hacettepe University; 2018. google scholar
  • 2. Brocklehurst JC, Fillit H, Rockwood K, Woodhouse K, editors. Brocklehurst’s textbook of geriatric medicine and gerontology. 7th ed. Elsevier; 2010. google scholar
  • 3. Saka B, Kaya O, Ozturk GB, Erten N, Karan MA. Prevalence of malnutrition and its relationship with sarcopenia among nursing home residents. J Int Med 2012;19(1):39-46. google scholar
  • 4. Cruz-Jentoft AJ, Baeyens JP, Bauer J, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis. Age Ageing 2010;39(4):412-23. google scholar
  • 5. Vandewoude MF, Alish CJ, Sauer AC, Hegazi RA. Malnutrition-sarcopenia syndrome: is this the future of nutrition screening and assessment for older adults? J Aging Res 2012;7:651570. google scholar
  • 6. Sakai K, Sakuma K. Sarcopenic Dysphagia as a New Concept. In: Frailty and Sarcopenia - Onset, Development and Clinical Challenges. InTech; 2017. http://dx.doi.org/10.5772/ intechopen.68791 google scholar
  • 7. Chang SF, Lin PL. Systematic literature review and meta-analysis of the association of sarcopenia with mortality. Worldviews Evid Based Nurs 2016;13(2):153-62. google scholar
  • 8. Reiter R, Hoffmann TK, Pickhard A, Brosch S. Hoarseness: Causes and treatments. Dtsch Arztebl Int 2015;112(19):329-37. google scholar
  • 9. Bağçeci İ. Acoustic, aerodynamic and perceptual evaluation of sound characteristics of Turkish-speaking geriatric population [Master’s thesis]. Istanbul: Medipol University Institute of Health Sciences 2020. google scholar
  • 10. Tsai MJ, Wang CT, Fu S, Lin FC. Effect of intensive water resistance phonation therapy for people with presbyphonia: A pilot study. Int J Speech Lang Pathol 2024;26(5):728-36. google scholar
  • 11. Kendall K. Presbyphonia: A review. Curr Opin Otolaryngol Head Neck Surg 2007;15(3):137-40. google scholar
  • 12. Bruzzi C, Salsi D, Minghetti D, Torretta S, Guastella C, Filauro M, et al. Presbyphonia. Acta Bio Med Atenei Parmensis. 2017;88(1):6-10. google scholar
  • 13. Gama AC, Alves CF, Cerceau JD, Teixeira LC. Correlation between acoustic-perceptual data and voice-related quality of life in elderly women. Pro Fono 2009;21(2):125-30. google scholar
  • 14. Kost KM, Sataloff RT. Voice disorders in the elderly. Clin Geriatr Med 2018;34(2):191-203. google scholar
  • 15. Mallick AS, Garas G, McGlashan J. Presbylaryngis: A state-of-the-art review. Curr Opin Otolaryngol Head Neck Surg 2019;27(3):168-77. google scholar
  • 16. Kosztyta-Hojna B, Zdrojkowski M, Duchnowska E. Presbyphonia as an individual process of voice change. J Voice 2023;37(2):303. e1-14. google scholar
  • 17. Peres ADC, Pessim ABB, Rodrigues SA, Martins RHG. Effect of aging on the vocal muscle. J Voice 2024;38(5):1002-7. google scholar
  • 18. Kılıç MA. Evaluation of patients with voice problems using objective and subjective methods. Curr Pract Otolaryngol 2010;6(2):257-65. google scholar
  • 19. Robbins J, Hamilton JW, Lof GL, Kempster GB. Oropharyngeal swallowing in normal adults of different ages. Gastroenterology 1992;103(3):823-9. google scholar
  • 20. Ney DM, Weiss JM, Kind AJH, Robbins J. Senescent swallowing: Impact, strategies, and interventions. Nutr Clin Pract 2009;24(3):395-413. google scholar
  • 21. Demir Aİ, Köksal, M, Yılmaz, A. Turkish adaptation, validity, and reliability of the Dysphagia Risk Assessment Scale in individuals 65 years and older. J Speech Lang Swallow Res 2023;6(3):288-308. google scholar
  • 22. Fukada J, Kamakura Y, Kitaike T, Nojiri M. Development of a dysphagia risk assessment scale for elderly living at home. J Jpn Soc Nurs Res 2002;25:87-99. google scholar
  • 23. Song J, Wan Q, Wang Y, Liu Z, Song W, Yin S. Establishment of a multi-parameter evaluation model for risk of aspiration in dysphagia: A pilot study. Dysphagia 2023;38(1):406-14. google scholar
  • 24. Festic E, Soto JS, Pitre LA, Bajracharya GR, Shillcutt SK, DeMerle KM, et al. Novel bedside phonetic evaluation to identify dysphagia and aspiration risk. Chest 2016;149(3):649-59. google scholar
  • 25. Sun Y, Zhao W, Kang X, Zhang X, Zhang Q, Cheng L, et al. Speech acoustic parameters for predicting presbyphagia: A preliminary study in the elderly Shanghainese population. J Voice. 2024 Jan 16. https://doi.org/10.1016/j.jvoice.2024.01.001. google scholar
  • 26. Gross RD, Atwood CW, Grayhack JP, Shaiman S, Drake ME. Lung volume effects on pharyngeal swallowing physiology. J Appl Physiol 2003;95(6):2211-7. google scholar
  • 27. Morton R, Minford J, Ellis R, Pinnington L. Aspiration with dysphagia: The interaction between oropharyngeal and respiratory impairments. Dysphagia 2002;17(3):192-6. google scholar
  • 28. Malmstrom TK, Morley JE. SARC-F: A simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc 2013;14(8):531-2. google scholar
  • 29. Demir N, Serel Arslan S, İnal Ö, Karaduman AA. Reliability and validity of the Turkish Eating Assessment Tool (T-EAT-10). Dysphagia 2016;31(5):644-9. google scholar
  • 30. Ma EPM, Yiu EML. Handbook of Voice Assessments. San Diego: Plural Publishing; 2011. google scholar
  • 31. Mukaka MM. A guide to the appropriate use of correlation coefficients in medical research. Malawi Med J 2021;24(3):69-71. google scholar
  • 32. Çolak B, Çiftçi S. Yaşlılarda Sarkopenik Obezite ve Güncel Beslenme Önerileri. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi 2021;3(3):208-21. google scholar
  • 33. Yoshikawa M, Yoshida M, Nagasaki T, Tanimoto K, Tsuga K, Akagawa Y, et al. Aspects of swallowing in healthy dentate individuals older than 80 years. J Gerontol A Biol Sci Med Sci 2005;60(4):506-9. google scholar
  • 34. Jones SW, Hill RJ, Krasney PA, O’Conor RJ, Peirce N, Greenhaff PL. Sarcopenia: Mechanisms and management of muscle loss in the elderly. J Clin Med 2019;8(7):1036. google scholar
  • 35. Rajappa AT, Soriano KR, Ziemer C, et al. Reduced maximum pitch elevation predicts silent aspiration of small liquid volumes in stroke patients. Front Neurol 2017;8:436. google scholar
  • 36. Bengisu S, Topbaş S, Koçak İ. Relationship between muscle tension dysphonia type 1 and soft phonation index and the effectiveness of voice therapy. Turk J Ear Nose Throat 2008;18(3):131-8. google scholar
  • 37. Hacıoğlu NH, Bengisu S. Voice problems in elderly and presbyphonia: Evaluating effectiveness of therapy. Int J Speech Lang Pathol 2022;25(4):153-60. google scholar
  • 38. Bengisu S, Topbaş S, Koçak İ. Kas gerilimi disfonisi tip 1 hastalığı ile yumuşak fonasyon indeksi arasındaki ilişki ve ses terapisinin etkinliği. Tr-ENT. 2008;18(3):131-8. google scholar
  • 39. Titze IR. Principles of voice production. Iowa City: National Center for Voice and Speech, 2000. google scholar
  • 40. Ryu JS, Park SR, Choi KH. Prediction of laryngeal aspiration using voice analysis. Am J Phys Med Rehabil 2004;83(10):753-7. google scholar
  • 41. Sapmaz Atalar M, Genç G, Işık EE, Cangı ME, Pehlivan B, Bulut S. Can voice parameters provide cutoff values for predicting dysphagia in individuals with multiple sclerosis? Dysphagia. 2024 Jun 13. doi: 10.1007/s00455-024-10720-3. google scholar
  • 42. Song YJ, Lee HN, Yoo YJ, Choi KH, Jung SH, Lee JH. Predicting aspiration using the functions of voice production and quality of voice in dysphagic patients. J Korean Dysphagia Soc 2022;12(1):50-8. google scholar
  • 43. Titze I, Wong D, Story B, Long R. Considerations in voice transformation with physiologic scaling principles. Speech Commun 1997;22(2-3):113-23. google scholar
  • 44. Martin-Harris B. Clinical implications of respiratory-swallowing interactions. Curr Opin Otolaryngol Head Neck Surg 2008;16(3):194-9. google scholar
  • 45. Hao N, Sasa A, Kulvanich S, Nakajima Y, Mori N, Onizuka M, et al. Coordination of respiration, swallowing, and chewing in healthy young adults. Front Physiol 2021;12:696071. google scholar
  • 46. Song J, Wan Q, Wang Y, Wu J, Fang X, Liu Z, et al. Establishment of a multi-parameter evaluation model for risk of aspiration in dysphagia: A pilot study. Dysphagia 2023;38(1):406-14. google scholar
  • 47. Ko EJ, Chae M, Cho SR. Relationship between swallowing function and maximum phonation duration in patients with Parkinsonism. Ann Rehabil Med 2018;42(3):425-32. google scholar
  • 48. Yamaguchi S, Ishida M, Hidaka H, Yoshida M, Shinogami M, Hiraoka A. Relationship between swallowing function and respiration/ phonation. Auris Nasus Larynx. 2018;45(3):533-5. google scholar
Yıl 2024, Cilt: 34 Sayı: 4, 97 - 104, 31.12.2024
https://doi.org/10.26650/Tr-ENT.2024.1546320

Öz

Kaynakça

  • 1. Elmas Ö. Evaluation of functional status in sarcopenic elderly individuals [Master's thesis]. Hacettepe University; 2018. google scholar
  • 2. Brocklehurst JC, Fillit H, Rockwood K, Woodhouse K, editors. Brocklehurst’s textbook of geriatric medicine and gerontology. 7th ed. Elsevier; 2010. google scholar
  • 3. Saka B, Kaya O, Ozturk GB, Erten N, Karan MA. Prevalence of malnutrition and its relationship with sarcopenia among nursing home residents. J Int Med 2012;19(1):39-46. google scholar
  • 4. Cruz-Jentoft AJ, Baeyens JP, Bauer J, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis. Age Ageing 2010;39(4):412-23. google scholar
  • 5. Vandewoude MF, Alish CJ, Sauer AC, Hegazi RA. Malnutrition-sarcopenia syndrome: is this the future of nutrition screening and assessment for older adults? J Aging Res 2012;7:651570. google scholar
  • 6. Sakai K, Sakuma K. Sarcopenic Dysphagia as a New Concept. In: Frailty and Sarcopenia - Onset, Development and Clinical Challenges. InTech; 2017. http://dx.doi.org/10.5772/ intechopen.68791 google scholar
  • 7. Chang SF, Lin PL. Systematic literature review and meta-analysis of the association of sarcopenia with mortality. Worldviews Evid Based Nurs 2016;13(2):153-62. google scholar
  • 8. Reiter R, Hoffmann TK, Pickhard A, Brosch S. Hoarseness: Causes and treatments. Dtsch Arztebl Int 2015;112(19):329-37. google scholar
  • 9. Bağçeci İ. Acoustic, aerodynamic and perceptual evaluation of sound characteristics of Turkish-speaking geriatric population [Master’s thesis]. Istanbul: Medipol University Institute of Health Sciences 2020. google scholar
  • 10. Tsai MJ, Wang CT, Fu S, Lin FC. Effect of intensive water resistance phonation therapy for people with presbyphonia: A pilot study. Int J Speech Lang Pathol 2024;26(5):728-36. google scholar
  • 11. Kendall K. Presbyphonia: A review. Curr Opin Otolaryngol Head Neck Surg 2007;15(3):137-40. google scholar
  • 12. Bruzzi C, Salsi D, Minghetti D, Torretta S, Guastella C, Filauro M, et al. Presbyphonia. Acta Bio Med Atenei Parmensis. 2017;88(1):6-10. google scholar
  • 13. Gama AC, Alves CF, Cerceau JD, Teixeira LC. Correlation between acoustic-perceptual data and voice-related quality of life in elderly women. Pro Fono 2009;21(2):125-30. google scholar
  • 14. Kost KM, Sataloff RT. Voice disorders in the elderly. Clin Geriatr Med 2018;34(2):191-203. google scholar
  • 15. Mallick AS, Garas G, McGlashan J. Presbylaryngis: A state-of-the-art review. Curr Opin Otolaryngol Head Neck Surg 2019;27(3):168-77. google scholar
  • 16. Kosztyta-Hojna B, Zdrojkowski M, Duchnowska E. Presbyphonia as an individual process of voice change. J Voice 2023;37(2):303. e1-14. google scholar
  • 17. Peres ADC, Pessim ABB, Rodrigues SA, Martins RHG. Effect of aging on the vocal muscle. J Voice 2024;38(5):1002-7. google scholar
  • 18. Kılıç MA. Evaluation of patients with voice problems using objective and subjective methods. Curr Pract Otolaryngol 2010;6(2):257-65. google scholar
  • 19. Robbins J, Hamilton JW, Lof GL, Kempster GB. Oropharyngeal swallowing in normal adults of different ages. Gastroenterology 1992;103(3):823-9. google scholar
  • 20. Ney DM, Weiss JM, Kind AJH, Robbins J. Senescent swallowing: Impact, strategies, and interventions. Nutr Clin Pract 2009;24(3):395-413. google scholar
  • 21. Demir Aİ, Köksal, M, Yılmaz, A. Turkish adaptation, validity, and reliability of the Dysphagia Risk Assessment Scale in individuals 65 years and older. J Speech Lang Swallow Res 2023;6(3):288-308. google scholar
  • 22. Fukada J, Kamakura Y, Kitaike T, Nojiri M. Development of a dysphagia risk assessment scale for elderly living at home. J Jpn Soc Nurs Res 2002;25:87-99. google scholar
  • 23. Song J, Wan Q, Wang Y, Liu Z, Song W, Yin S. Establishment of a multi-parameter evaluation model for risk of aspiration in dysphagia: A pilot study. Dysphagia 2023;38(1):406-14. google scholar
  • 24. Festic E, Soto JS, Pitre LA, Bajracharya GR, Shillcutt SK, DeMerle KM, et al. Novel bedside phonetic evaluation to identify dysphagia and aspiration risk. Chest 2016;149(3):649-59. google scholar
  • 25. Sun Y, Zhao W, Kang X, Zhang X, Zhang Q, Cheng L, et al. Speech acoustic parameters for predicting presbyphagia: A preliminary study in the elderly Shanghainese population. J Voice. 2024 Jan 16. https://doi.org/10.1016/j.jvoice.2024.01.001. google scholar
  • 26. Gross RD, Atwood CW, Grayhack JP, Shaiman S, Drake ME. Lung volume effects on pharyngeal swallowing physiology. J Appl Physiol 2003;95(6):2211-7. google scholar
  • 27. Morton R, Minford J, Ellis R, Pinnington L. Aspiration with dysphagia: The interaction between oropharyngeal and respiratory impairments. Dysphagia 2002;17(3):192-6. google scholar
  • 28. Malmstrom TK, Morley JE. SARC-F: A simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc 2013;14(8):531-2. google scholar
  • 29. Demir N, Serel Arslan S, İnal Ö, Karaduman AA. Reliability and validity of the Turkish Eating Assessment Tool (T-EAT-10). Dysphagia 2016;31(5):644-9. google scholar
  • 30. Ma EPM, Yiu EML. Handbook of Voice Assessments. San Diego: Plural Publishing; 2011. google scholar
  • 31. Mukaka MM. A guide to the appropriate use of correlation coefficients in medical research. Malawi Med J 2021;24(3):69-71. google scholar
  • 32. Çolak B, Çiftçi S. Yaşlılarda Sarkopenik Obezite ve Güncel Beslenme Önerileri. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi 2021;3(3):208-21. google scholar
  • 33. Yoshikawa M, Yoshida M, Nagasaki T, Tanimoto K, Tsuga K, Akagawa Y, et al. Aspects of swallowing in healthy dentate individuals older than 80 years. J Gerontol A Biol Sci Med Sci 2005;60(4):506-9. google scholar
  • 34. Jones SW, Hill RJ, Krasney PA, O’Conor RJ, Peirce N, Greenhaff PL. Sarcopenia: Mechanisms and management of muscle loss in the elderly. J Clin Med 2019;8(7):1036. google scholar
  • 35. Rajappa AT, Soriano KR, Ziemer C, et al. Reduced maximum pitch elevation predicts silent aspiration of small liquid volumes in stroke patients. Front Neurol 2017;8:436. google scholar
  • 36. Bengisu S, Topbaş S, Koçak İ. Relationship between muscle tension dysphonia type 1 and soft phonation index and the effectiveness of voice therapy. Turk J Ear Nose Throat 2008;18(3):131-8. google scholar
  • 37. Hacıoğlu NH, Bengisu S. Voice problems in elderly and presbyphonia: Evaluating effectiveness of therapy. Int J Speech Lang Pathol 2022;25(4):153-60. google scholar
  • 38. Bengisu S, Topbaş S, Koçak İ. Kas gerilimi disfonisi tip 1 hastalığı ile yumuşak fonasyon indeksi arasındaki ilişki ve ses terapisinin etkinliği. Tr-ENT. 2008;18(3):131-8. google scholar
  • 39. Titze IR. Principles of voice production. Iowa City: National Center for Voice and Speech, 2000. google scholar
  • 40. Ryu JS, Park SR, Choi KH. Prediction of laryngeal aspiration using voice analysis. Am J Phys Med Rehabil 2004;83(10):753-7. google scholar
  • 41. Sapmaz Atalar M, Genç G, Işık EE, Cangı ME, Pehlivan B, Bulut S. Can voice parameters provide cutoff values for predicting dysphagia in individuals with multiple sclerosis? Dysphagia. 2024 Jun 13. doi: 10.1007/s00455-024-10720-3. google scholar
  • 42. Song YJ, Lee HN, Yoo YJ, Choi KH, Jung SH, Lee JH. Predicting aspiration using the functions of voice production and quality of voice in dysphagic patients. J Korean Dysphagia Soc 2022;12(1):50-8. google scholar
  • 43. Titze I, Wong D, Story B, Long R. Considerations in voice transformation with physiologic scaling principles. Speech Commun 1997;22(2-3):113-23. google scholar
  • 44. Martin-Harris B. Clinical implications of respiratory-swallowing interactions. Curr Opin Otolaryngol Head Neck Surg 2008;16(3):194-9. google scholar
  • 45. Hao N, Sasa A, Kulvanich S, Nakajima Y, Mori N, Onizuka M, et al. Coordination of respiration, swallowing, and chewing in healthy young adults. Front Physiol 2021;12:696071. google scholar
  • 46. Song J, Wan Q, Wang Y, Wu J, Fang X, Liu Z, et al. Establishment of a multi-parameter evaluation model for risk of aspiration in dysphagia: A pilot study. Dysphagia 2023;38(1):406-14. google scholar
  • 47. Ko EJ, Chae M, Cho SR. Relationship between swallowing function and maximum phonation duration in patients with Parkinsonism. Ann Rehabil Med 2018;42(3):425-32. google scholar
  • 48. Yamaguchi S, Ishida M, Hidaka H, Yoshida M, Shinogami M, Hiraoka A. Relationship between swallowing function and respiration/ phonation. Auris Nasus Larynx. 2018;45(3):533-5. google scholar
Toplam 48 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kulak Burun Boğaz
Bölüm Araştırma Makaleleri
Yazarlar

Serkan Bengisu 0000-0002-6580-1189

Aynur İkra Demir 0009-0004-2811-017X

Yayımlanma Tarihi 31 Aralık 2024
Gönderilme Tarihi 11 Eylül 2024
Kabul Tarihi 26 Eylül 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 34 Sayı: 4

Kaynak Göster

APA Bengisu, S., & Demir, A. İ. (2024). Determination of the Relationship Between Voice and Swallowing Characteristics in Individuals aged 65 and Over with Sarcopenia Risk. The Turkish Journal of Ear Nose and Throat, 34(4), 97-104. https://doi.org/10.26650/Tr-ENT.2024.1546320
AMA Bengisu S, Demir Aİ. Determination of the Relationship Between Voice and Swallowing Characteristics in Individuals aged 65 and Over with Sarcopenia Risk. Tr-ENT. Aralık 2024;34(4):97-104. doi:10.26650/Tr-ENT.2024.1546320
Chicago Bengisu, Serkan, ve Aynur İkra Demir. “Determination of the Relationship Between Voice and Swallowing Characteristics in Individuals Aged 65 and Over With Sarcopenia Risk”. The Turkish Journal of Ear Nose and Throat 34, sy. 4 (Aralık 2024): 97-104. https://doi.org/10.26650/Tr-ENT.2024.1546320.
EndNote Bengisu S, Demir Aİ (01 Aralık 2024) Determination of the Relationship Between Voice and Swallowing Characteristics in Individuals aged 65 and Over with Sarcopenia Risk. The Turkish Journal of Ear Nose and Throat 34 4 97–104.
IEEE S. Bengisu ve A. İ. Demir, “Determination of the Relationship Between Voice and Swallowing Characteristics in Individuals aged 65 and Over with Sarcopenia Risk”, Tr-ENT, c. 34, sy. 4, ss. 97–104, 2024, doi: 10.26650/Tr-ENT.2024.1546320.
ISNAD Bengisu, Serkan - Demir, Aynur İkra. “Determination of the Relationship Between Voice and Swallowing Characteristics in Individuals Aged 65 and Over With Sarcopenia Risk”. The Turkish Journal of Ear Nose and Throat 34/4 (Aralık 2024), 97-104. https://doi.org/10.26650/Tr-ENT.2024.1546320.
JAMA Bengisu S, Demir Aİ. Determination of the Relationship Between Voice and Swallowing Characteristics in Individuals aged 65 and Over with Sarcopenia Risk. Tr-ENT. 2024;34:97–104.
MLA Bengisu, Serkan ve Aynur İkra Demir. “Determination of the Relationship Between Voice and Swallowing Characteristics in Individuals Aged 65 and Over With Sarcopenia Risk”. The Turkish Journal of Ear Nose and Throat, c. 34, sy. 4, 2024, ss. 97-104, doi:10.26650/Tr-ENT.2024.1546320.
Vancouver Bengisu S, Demir Aİ. Determination of the Relationship Between Voice and Swallowing Characteristics in Individuals aged 65 and Over with Sarcopenia Risk. Tr-ENT. 2024;34(4):97-104.