Voice deviation, dysphonia risk screening and quality of life in individuals with various laryngeal diagnoses

OBJECTIVES: To characterize the voice quality of individuals with dysphonia and to investigate possible correlations between the degree of voice deviation (D) and scores on the Dysphonia Risk Screening Protocol-General (DRSP), the Voice-Related Quality of Life (V-RQOL) measure and the Voice Handicap Index, short version (VHI-10). METHODS: The sample included 200 individuals with dysphonia. Following laryngoscopy, the participants completed the DRSP, the V-RQOL measure, and the VHI-10; subsequently, voice samples were recorded for auditory-perceptual and acoustic analyses. The correlation between the score for each questionnaire and the overall degree of vocal deviation was analyzed, as was the correlation among the scores for the three questionnaires. RESULTS: Most of the participants (62%) were female, and the mean age of the sample was 49 years. The most common laryngeal diagnosis was organic dysphonia (79.5%). The mean D was 59.54, and the predominance of roughness had a mean of 54.74. All the participants exhibited at least one abnormal acoustic aspect. The mean questionnaire scores were DRSP, 44.7; V-RQOL, 57.1; and VHI-10, 16. An inverse correlation was found between the V-RQOL score and D; however, a positive correlation was found between both the VHI-10 and DRSP scores and D. CONCLUSION: A predominance of adult women, organic dysphonia, moderate voice deviation, high dysphonia risk, and low to moderate quality of life impact characterized our sample. There were correlations between the scores of each of the three questionnaires and the degree of voice deviation. It should be noted that the DRSP monitored the degree of dysphonia severity, which reinforces its applicability for patients with different laryngeal diagnoses.

Sindrome de laringe irritable / Irritable larynx syndrome

Dentro de las funciones laríngeas, la refleja es la más desarrollada y por ello conlleva a un sofisticado mecanismo de regulación sensitivo-motora que aún no conocemos del todo bien. Este fino mecanismo de regulación puede verse modificado por una alteración del control neuronal, provocando un estado de hipersensibilidad de respuesta a nivel laríngeo ante una gran variedad de estímulos. Las diversas formas de manifestación de esta hiperreactividad se agrupan en lo descrito como “Síndrome de Laringe Irritable”, entidad que da respuesta a gran cantidad de pacientes de curso crónico, persistente y que no presentan una causa clara o demostrable que explique su sintomatología. El manejo de estos pacientes debe ser multidisciplinario, no existiendo aún un tratamiento específico para ello, por lo cual se nos presenta no sólo como un desafío diagnóstico sino también de manejo terapéutico.

The reflected functions in the larynx is the most developed and so carries a sophisticated mechanism for regulating sensory-motor still does not know all that well. This fine regulation mechanism may be to modify by an alteration of neural control, causing a hypersensitivity response to laryngeal level in a variety of stimuli. The various manifestations of this hiperreacividad are grouped into what is described as Irritable Larynx Syndrome, an entity that responds to many patients during chronic, persistent and with no clear cause or a demonstrable to explain their symptoms. The management of these patients should be multidisciplinary not yet exist a specific treatment for this reason that we are presented not only as a diagnostic challenge but also of therapeutic.

Reflujo faringolaríngeo: revisión bibliográfica: [revisión] / Pharyngolaryngeal reflux: a literature review: [revision]

El reflujo faringolaríngeo (RFL) es un síndrome que se asocia a una constelación de síntomas. Entre ellos los más frecuentemente descritos son la disfonía, la fatiga vocal, el globus faríngeo, la tos crónica y la carraspera. Se realizó una búsqueda exhaustiva en bases de datos internacionales y nacionales en relación a RFL. Se utilizaron palabras clave como globus, carraspera, laringitis, disfonía y reflujo gastroesofágico. Se obtuvieron alrededor de 35 referencias en relación al tema estudiado, siendo la mayoría publicadas con posterioridad al año 2000. En relación a su etiología, se cree que el flujo retrógrado de contenido gástrico hacia la faringe sería el hecho más importante para su génesis, pero recientemente se ha demostrado que si bien este hecho patológico es fundamental en la producción de los síntomas, existen factores adicionales, capaces de perpetuarlo, permitiendo considerar al RFL como una entidad diferente del reflujo gastroesofágico (RGE).

Pharyngolaryngeal reflux (RFL) is a syndrome associated to a variety of symptoms. Among them, the most frequently described are dysphonia, vocal fatigue, pharyngeal globus, chronic coughing and throat clearing. An exhaustive search of international and national databases was performed. Globus, throat clearing, laryngitis and gastroesophageal reflux were used as keywords. Some 35 search-related references were retrieved, of which most were published from 2000 to date. Respect to the etiology of pharyngolaryngeal reflux, the current view is that gastric contain reflux to the pharynx is the most important factor, but recently it has been demonstrated that, although this pathological trait is pivotal for symptoms appearance, there are additional factors that could perpetuate the symptoms in time, which contribute to consider RFL as a different entity from gastroesophageal reflux (RGE).

Perfil dos profissionais da voz com queixas vocais atendidos em um centro terciário de saúde / Profile of voice professionals seen in a tertiary health center

As laringopatias relacionadas ao trabalho acarretam conseqüências para os profissionais da voz. OBJETIVO: Analisar o perfil destes profissionais atendidos em um hospital terciário. FORMA DE ESTUDO: Estudo de coorte histórica longitudinal. MATERIAL E MÉTODOS: Análise retrospectiva de prontuários. Os diagnósticos foram fornecidos através de videoestrobolaringoscopia. RESULTADOS: Foram atendidos 163 pacientes (119 do sexo feminino, 44 do sexo masculino), idade média de 36,5 anos. Em relação aos grupos profissionais, encontramos profissionais da voz falada (vendedores, professores, telemarketing, recepcionistas, atores e profissionais de saúde) e da voz cantada. Os diagnósticos foram: alteração estrutural mínima (33 por cento), nódulos (22 por cento), edema de Reinke (10 por cento) e pólipos (6 por cento). Foi observada correlação com tabagismo (p=0,002), sexo (p=0,004) e idade (p<0,001), com tendência para associação do tabagismo com edema de Reinke e leucoplasia; sexo feminino com AEM, nódulos e edema de Reinke; pacientes acima de 40 anos com edema de Reinke, e dos mais jovens com nódulos, cordite e AEM. O tempo de queixa foi superior a 6 meses em 74 por cento dos casos. CONCLUSÃO: Este perfil inclui profissionais da voz falada e cantada. Houve predomínio das AEMs, seguida por nódulos, edema de Reinke e pólipos.

Work-related laryngopathy may have negative consequences for voice professionals. AIM: To analyze the profile of voice professionals seen in a tertiary level hospital. STUDY DESIGN: a longitudinal historical cohort. METHODS: A retrospective analysis of patient files. Diagnosis was reached using videostroboscopy. RESULTS: 163 patients (119 females and 44 males) were seen. The mean age was 36.5 years. Professionals included spoken voice users (salesman, teachers, telemarketers, receptionists, health professionals) and singers. The most frequent diagnoses were: minor structural changes (33 percent), nodules (22 percent), ReinkeÆs edema (10 percent), and polyps (6 percent). A correlation was observed between smoking, age and gender; there was an association between smoking and ReinkeÆs edema, leucoplasia and tabagism, females and ReinkeÆs edema, nodules and minor structural changes, and also between patients aged over 40 years and ReinkeÆs edema, and patients under 40 with nodules, laryngitis, and minor structural changes. Symptoms lasted more than 6 months in 74 percent of patients. CONCLUSION: The profile of voice professionals seen in a tertiary hospital included spoken voice patients and singers. In our study minor structural changes predominated, followed by nodules, Reinke edema and polyps.