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Hong I, Bae S, Lee HK, Bonilha HS. Prevalence of Dysphonia and Dysphagia Among Adults in the United States in 2012 and 2022. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-12. [PMID: 38713813 DOI: 10.1044/2024_ajslp-23-00407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Abstract
PURPOSE The purpose of this study was to compare the prevalence of dysphonia and dysphagia among adults in the United States between 2012 and 2022. METHOD A retrospective and cross-sectional design with national surveys was used. The 2012 and 2022 National Health Interview Surveys were utilized to estimate the number of adults reporting dysphonia and dysphagia in the past 12 months. Multivariate logistic regression models were used to examine associations between the survey year (2022 vs. 2012) and the prevalence rate of dysphonia and dysphagia while accounting for demographics and clinical characteristics. RESULTS The population-estimated mean age was 46.63 years in 2012, which increased to 48.12 years in 2022. In 2012, adults reporting dysphonia and dysphagia were 17.89 million (7.62%) and 9.44 million (4.02%), respectively. In 2022, these estimates increased to 29.92 million adults (11.71%) and 15.10 million adults (5.91%), respectively. Adults in 2022 had significantly higher odds for reporting dysphonia (odds ratio [OR] = 1.602, 95% confidence intervals [CIs] [1.486, 1.726], p < .0001) and dysphagia (OR = 1.461, 95% CI [1.328, 1.606], p < .0001) in the past 12 months compared to adults in 2012. CONCLUSIONS The population-estimates indicated that in 2022, dysphonia affected one in 8.5 adults and dysphagia affected one in 17 adults. The increase in prevalence of these disorders should serve as a call-to-action to improve access to care and research for voice and swallowing disorders.
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Affiliation(s)
- Ickpyo Hong
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Suyeong Bae
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju, Republic of Korea
| | - Ho Kyung Lee
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju, Republic of Korea
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Saghiri MA, Vakhnovetsky J, Amanabi M, Karamifar K, Farhadi M, Amini SB, Conte M. Exploring the impact of type II diabetes mellitus on voice quality. Eur Arch Otorhinolaryngol 2024; 281:2707-2716. [PMID: 38319369 DOI: 10.1007/s00405-024-08485-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/15/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE This cross-sectional study aimed to investigate the potential of voice analysis as a prescreening tool for type II diabetes mellitus (T2DM) by examining the differences in voice recordings between non-diabetic and T2DM participants. METHODS 60 participants diagnosed as non-diabetic (n = 30) or T2DM (n = 30) were recruited on the basis of specific inclusion and exclusion criteria in Iran between February 2020 and September 2023. Participants were matched according to their year of birth and then placed into six age categories. Using the WhatsApp application, participants recorded the translated versions of speech elicitation tasks. Seven acoustic features [fundamental frequency, jitter, shimmer, harmonic-to-noise ratio (HNR), cepstral peak prominence (CPP), voice onset time (VOT), and formant (F1-F2)] were extracted from each recording and analyzed using Praat software. Data was analyzed with Kolmogorov-Smirnov, two-way ANOVA, post hoc Tukey, binary logistic regression, and student t tests. RESULTS The comparison between groups showed significant differences in fundamental frequency, jitter, shimmer, CPP, and HNR (p < 0.05), while there were no significant differences in formant and VOT (p > 0.05). Binary logistic regression showed that shimmer was the most significant predictor of the disease group. There was also a significant difference between diabetes status and age, in the case of CPP. CONCLUSIONS Participants with type II diabetes exhibited significant vocal variations compared to non-diabetic controls.
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Affiliation(s)
- M A Saghiri
- Biomaterial and Prosthodontics Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Rutgers Biomedical and Health Sciences, MSB C639A, 185 South Orange Avenue, Newark, NJ, 07103, USA.
- Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
| | - Julia Vakhnovetsky
- Sector of Innovation in Dentistry, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
- Rutgers School of Dental Medicine, Newark, NJ, USA
- University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | | | - Kasra Karamifar
- Sector of Innovation in Medicine and Dentistry, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
| | - Maziar Farhadi
- Sector of Innovation in Medicine and Dentistry, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
| | - Saeid B Amini
- Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
| | - Michael Conte
- Office for Clinical Affairs, Rutgers School of Dental Medicine, Newark, NJ, USA
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Rocha MC, Nogueira BDFM, Nunes FB, de Medeiros AM. Self-perception of voice, hearing, and general health in screening for voice changes in older women. Codas 2024; 36:e20220063. [PMID: 38198297 PMCID: PMC10782509 DOI: 10.1590/2317-1782/20232022063pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/22/2022] [Indexed: 01/12/2024] Open
Abstract
PURPOSE To verify the association between sociodemographic factors, vocal behavior, morbidities, and self-perception of voice, hearing, and general health in older women with voice disorders. METHODS The sample had 95 older women aged 60 to 84 years (mean of 69,5). They were interviewed with a structured questionnaire on sociodemographic aspects, health, and vocal behavior. The Screening Protocol for Voice Disorders in Older Adults (RAVI) was used to identify the presence of voice disorders. RESULTS Participants who had finished high school and were retired predominated. The number of older women with voice disorders according to RAVI was 46.3%. Physical sensations such as dry throat, throat clearing, and itchy throat were the most common complaints. The group of older women with voice disorders had worse self-perception of voice quality, hearing, and general health and a higher frequency of upper airway infections than those without voice disorders (p ≤ 0.05). CONCLUSION The vocal self-assessment measured with RAVI was statistically associated with self-perception of voice quality, hearing, general health, sore throat, sinusitis, and respiratory allergies.
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Affiliation(s)
- Maria Clara Rocha
- Graduação em Fonoaudiologia, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Bárbara de Faria Morais Nogueira
- Programa de Pós-graduação em Ciências Fonoaudiológicas, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Flávio Barbosa Nunes
- Departamento de Otorrinolaringologia, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
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Merrill RM, Gibbons IS, Barker CJ. Upper Airway-Related Symptoms According to Mental Illness and Sleep Disorders among Workers Employed by a Large Non-Profit Organization in the Mountain West Region of the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7173. [PMID: 38131725 PMCID: PMC10743120 DOI: 10.3390/ijerph20247173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/01/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
The relationships between selected upper airway-related symptoms (speech disturbances, voice disorders, cough, and breathing abnormalities) and mental illness and sleep disorders have been previously demonstrated. However, these relationships have not been compared in a single study with consideration of potential confounding variables. The current research incorporates a descriptive study design of medical claims data for employees (~21,362 per year 2017-2021) with corporate insurance to evaluate the strength of these relationships, adjusting for demographic variables and other important confounders. The upper airway-related symptoms are each significantly and positively associated with several mental illnesses and sleep disorders, after adjusting for demographic and other potential confounders. The rate of any mental illness is 138% (95% CI 93-195%) higher for speech disturbances, 55% (95% CI 28-88%) higher for voice disorders, 28% (95% CI 22-34%) higher for cough, and 58% (95% CI 50-66%) higher for breathing abnormalities, after adjustment for the confounding variables. Confounding had significant effects on the rate ratios involving cough and breathing abnormalities. The rate of any sleep disorder is 78% (95% CI 34-136%) higher for speech disturbances, 52% (95% CI 21-89%) higher for voice disorders, 34% (95% CI 27-41%) higher for cough, and 172% (95% CI 161-184%) higher for breathing abnormalities, after adjustment for the confounding variables. Confounding had significant effects on each of the upper airway-related symptoms. Rates of mental illness and sleep disorders are positively associated with the number of claims filed for each of the upper airway-related symptoms. The comorbid nature of these conditions should guide clinicians in providing more effective treatment plans that ultimately yield the best outcome for patients.
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Affiliation(s)
- Ray M. Merrill
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT 84602, USA; (I.S.G.); (C.J.B.)
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Hamdan AL, Abi Zeid Daou C, Hosri J, Abou Raji Feghali P, Jabbour C, Alam E, Mourad M. Effect of Diabetes Mellitus Type 2 on Voice: A Systematic Review and Meta-Analysis. Folia Phoniatr Logop 2023; 76:219-231. [PMID: 37757764 DOI: 10.1159/000534271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Diabetes mellitus type 2 is a growing health concern that affects several systems in the body, among which is the phonatory apparatus. Voice may be affected in view of the high prevalence of myopathy and neuropathy in diseased subjects. The authors aimed to answer the following question: does type 2 diabetes have an effect on voice? METHODS The systematic review included search terms such as "speech, voice, larynx, glucose, diabetes, and hyperglycemia." The search strategy yielded 221 articles, only five of which satisfied the inclusion criteria. Articles were considered for inclusion using the PRISMA method. Analysis included 321 patients with type 2 diabetes mellitus and 171 controls. All studies included were case-control studies except for one study which was an observational cohort. Six parameters were chosen as endpoints for the systematic review and meta-analysis: the presence/absence of voice complaints, fundamental frequency, jitter, shimmer, noise-to-harmonic ratio, and maximum phonation time. RESULTS There was no significant difference in the prevalence of voice complaints (i.e., hoarseness) between diabetic patients and control groups. There was also no significant difference in any of the acoustic and aerodynamic measures between patients with type 2 diabetes and controls. These findings can be ascribed to the high resilience of the laryngeal muscles to the adverse effect of systemic diseases. CONCLUSION There is no consensus in the literature that the prevalence of voice symptoms in diabetic patients is significantly higher than that reported in healthy subjects.
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Affiliation(s)
- Abdul-Latif Hamdan
- Department of Otolaryngology and Head and Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Christophe Abi Zeid Daou
- Department of Otolaryngology and Head and Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Jad Hosri
- Department of Otolaryngology and Head and Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Patrick Abou Raji Feghali
- Department of Otolaryngology and Head and Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Christopher Jabbour
- Department of Otolaryngology and Head and Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Elie Alam
- Department of Otolaryngology and Head and Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Marc Mourad
- Department of Otolaryngology and Head and Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
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Perry TT, Brungart DS, Myers JR, Cord LL, Solomon NP. Prevalence of Self-Reported Voice Concerns and Associated Risk Markers in a Nonclinical Sample of Military Service Members. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3364-3381. [PMID: 37532245 DOI: 10.1044/2023_jslhr-23-00150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
INTRODUCTION Difficult communication environments are common in military settings, and effective voice use can be critical to mission success. This study aimed to estimate the prevalence of self-reported voice disorders among U.S. military service members and to identify factors that contribute to their voice concerns. METHOD A nonclinical sample of 4,123 active-duty service members was recruited across Department of Defense hearing conservation clinics. During their required annual hearing evaluation, volunteers provided responses to voice-related questions including a slightly adapted version of the Voice Handicap Index-10 (VHI-10) as part of a larger survey about communication issues. Changepoint detection was applied to age and years of service to explore cohort effects in the reporting of voice concerns. Logistic regression analyses examined multiple available factors related to communication to identify factors associated with abnormal results on the VHI-10. RESULTS Among the respondents, 41% reported experiencing vocal hoarseness or fatigue at least several times per year, and 8.2% (n = 336) scored above the recommended abnormal cut-point value of 11 on the VHI-10. Factors independently associated with the greatest risk for self-reported voice concerns were sex (female), cadmium exposure, vocal demands (the need for a strong, clear voice), and auditory health measures (frequency of experiencing temporary threshold shifts; self-reported hearing difficulties). CONCLUSIONS Based on self-reported voice concerns and false negative rates reported in the literature, the prevalence of dysphonia in a large sample of active-duty service members is estimated to be 11.7%, which is higher than that in the general population. Certain predictors for voice concerns were expected based on previous literature, like female sex and voice use, but frequency of temporary threshold shifts and exposure to cadmium were surprising. The strong link between voice and auditory problems has particular implications regarding the need for effective communication in high-noise military and other occupational environments.
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Affiliation(s)
- Trevor T Perry
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
- Oak Ridge Institute for Science and Education, APHC Research Participation Program, TN
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
| | - Douglas S Brungart
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Jennifer Rae Myers
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Laura L Cord
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Nancy Pearl Solomon
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
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Hamdan AL, Ghanem A, Hosri J, Abou Raji Feghali P, Abi Zeid Daou C, Fadel C, Alam E. Prevalence of Laryngeal Muscle Tension in Patients With Obstructive Sleep Apnea. J Voice 2023:S0892-1997(23)00183-2. [PMID: 37433706 DOI: 10.1016/j.jvoice.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE/HYPOTHESIS To determine the prevalence of laryngeal muscle tension in patients with obstructive sleep apnea (OSA). STUDY DESIGN Retrospective case-control. METHODS A total of 75 patients were included in this study. These were divided into a study group with a history of OSA (n = 45), and a control group with no history of OSA matched according to age and gender (n = 30). The risk of OSA was assessed using the STOP-BANG questionnaire. Demographic data included age, gender, body mass index, smoking, history of snoring, history of use of continuous positive airway pressure, and history of reflux disease. Symptoms such as hoarseness, throat clearing/cough, and globus sensation were also noted. The video recordings of the flexible nasopharyngoscopy of both groups were analyzed for the presence or absence of four laryngeal muscle tension patterns (MTPs). RESULTS Twenty-five patients of the study group (55.6%) had signs of laryngeal muscle tension on laryngeal endoscopy compared to nine in the control patients (30%) (P = 0.029). The most common MTP observed in the study group was MTP III (n = 19), followed by MTP II (n = 17). Laryngeal muscle tension was more prevalent in patients of the intermediate and high-risk categories compared to those of the low-risk category (73.3% and 62.5% vs 28.6%, respectively) (P = 0.042). Patients with at least one MTP had more dysphonia and throat clearing than patients without any MTP. CONCLUSION Patients with a history of OSA have a higher prevalence of laryngeal muscle tension in comparison to subjects with no history of OSA. Moreover, patients at high risk of OSA have a higher prevalence of laryngeal muscle tension than those at low risk of OSA.
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Affiliation(s)
- Abdul-Latif Hamdan
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut Medical Center, Riad El Solh, Beirut, Lebanon
| | - Anthony Ghanem
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut Medical Center, Riad El Solh, Beirut, Lebanon
| | - Jad Hosri
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut Medical Center, Riad El Solh, Beirut, Lebanon
| | - Patrick Abou Raji Feghali
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut Medical Center, Riad El Solh, Beirut, Lebanon
| | - Christophe Abi Zeid Daou
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut Medical Center, Riad El Solh, Beirut, Lebanon
| | - Charbel Fadel
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut Medical Center, Riad El Solh, Beirut, Lebanon
| | - Elie Alam
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut Medical Center, Riad El Solh, Beirut, Lebanon.
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Suppakitjanusant P, Kasemkosin N, Sivapiromrat AK, Weinsein S, Ongphiphadhanakul B, Hunt WR, Sueblinvong V, Tangpricha V. Predicting glycemic control status and high blood glucose levels through voice characteristic analysis in patients with cystic fibrosis-related diabetes (CFRD). Sci Rep 2023; 13:8617. [PMID: 37244957 DOI: 10.1038/s41598-023-35416-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/17/2023] [Indexed: 05/29/2023] Open
Abstract
Cystic fibrosis-related diabetes (CFRD) is associated with reduced life expectancy in adults with cystic fibrosis (CF). Voice analysis may be a convenient method for diagnosing and monitoring CFRD. This study aims to determine the relationship between voice characteristics and markers of glucose and glycemic control and to identify if voice analysis can predict high blood glucose levels and glycemic control in adults with CFRD. We conducted a prospective cross-sectional study in adults with CF from March to December 2021. We recorded 3-second voice samples of a sustained /a/ vowel and analyzed voice characteristic using the Computerized Speech Lab with the Multi-Dimensional Voice Program. In female participants with CFRD, the noise-to-harmonic ratio was significantly lower in those with HbA1c ≥ 7. Furthermore, fundamental frequency variation was significantly lower in both male and female participants with CFRD who had a glucose level of 200 mg/dL or higher at the time of collection. This finding was also associated with a high level of point-of-care glucose. The human voice has potential as a non-invasive tool for measuring glucose levels and glycemic control status in CFRD patients in the future.
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Affiliation(s)
- Pichatorn Suppakitjanusant
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Samut Prakan, Thailand.
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, USA.
| | - Nittaya Kasemkosin
- Department of Communication Science and Disorders, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Samuel Weinsein
- Emory College of Arts and Sciences, Emory University, Atlanta, USA
| | - Boonsong Ongphiphadhanakul
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - William R Hunt
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, USA
| | - Viranuj Sueblinvong
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, USA
| | - Vin Tangpricha
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, USA
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The effect of type 1 diabetes mellitus on voice in pediatric patients. Eur Arch Otorhinolaryngol 2023; 280:269-275. [PMID: 35829805 DOI: 10.1007/s00405-022-07543-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/04/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE The aim of this prospective case-control study was to determine the effect on the voice of type 1 diabetes mellitus (T1DM) in paediatric patients. MATERIALS AND METHODS The study included patients aged 6-18 years followed up for at least 1 year because of T1DM, and a control group of age and gender-matched healthy volunteers. Following an Ear, Nose, and Throat (ENT) examination, all subjects underwent flexible endoscopic laryngeal examination. Fasting venous blood samples were taken in the morning for the examination of fasting blood glucose (FBG), HgbA1C, and kidney, liver, and thyroid function tests. Data were recorded from the patient files of age, gender, comorbidities, and the development of diabetes-related complications. Voice recordings were taken and the Voice Handicap Index (VHI)-10 form was completed. The patients and control group were compared in respect of the parameters of fundamental frequency, jitter, shimmer, and acoustic voice quality index (AVQI). RESULTS Evaluation was made of 64 children and adolescents as 32 in the patient group (Group 1) and 32 healthy control subjects (Group 2). Group 1 comprised 17 females and 15 males with a mean age of 12.75 ± 3.23 years. Group 2 comprised 17 females and 15 males with a mean age of 12.75 ± 3.33 years. In Group 1, mean disease duration was 5.21 ± 3.17 years (range, 1-13 years), the FBG value was mean 216.6 ± 122.3 mg/dl, mean HgbA1c was 10.7 ± 2.8, as ≤ 7 in 4 patients, 7-9 in 4, and > 9 in 24. Maximum phonation time (MPT) was determined as 10.66 ± 3.6 secs in Group 1 and 12.11 ± 4.43 in Group 2. VHI was determined as 2.33 ± 3 in Group 1 and 2.31 ± 2.77 in Group 2. No statistically significant difference was determined between the groups was determined in respect of acoustic analysis, perturbation parameters, AVQI and body mass index. CONCLUSIONS This study is the first to have investigated the effects of T1DM on the voice in paediatric patients. The study results showed that the AVQI value was higher in the patient group but not to a statistically significant level. Therefore, there is a need for further studies with larger samples. The current study can be of guidance for further studies in this field.
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Leite DRA, de Moraes RM, Lopes LW. Different Performances of Machine Learning Models to Classify Dysphonic and Non-Dysphonic Voices. J Voice 2022:S0892-1997(22)00353-8. [PMID: 36513560 DOI: 10.1016/j.jvoice.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To analyze the performance of 10 different machine learning (ML) classifiers for discrimination between dysphonic and non-dysphonic voices, using a variance threshold as a method for the selection and reduction of acoustic measurements used in the classifier. METHOD We analyzed 435 samples of individuals (337 female and 98 male), with a mean age of 41.07 ± 13.73 years, of which 384 were dysphonic and 51 were non-dysphonic. From the sustained /ε/ vowel sample, 34 acoustic measurements were extracted, including traditional perturbation and noise measurements, cepstral/spectral measurements, and measurements based on nonlinear models. The variance method was used to select the best set of acoustic measurements. We tested the performance of the best-selected set with 10 ML classifiers using precision, sensitivity, specificity, accuracy, and F1-Score measurements. The kappa coefficient was used to verify the reproducibility between the two datasets (training and testing). RESULTS The naive Bayes (NB) and stochastic gradient descent classifier (SGDC) models performed best in terms of accuracy, AUC, sensitivity, and specificity for a reduced dataset of 15 acoustic measures compared to the full dataset of 34 acoustic measures. SGDC and NB obtained the best performance results, with an accuracy of 0.91 and 0.76, respectively. These two classifiers presented moderate agreement, with a Kappa of 0.57 (SGDC) and 0.45 (NB). CONCLUSION Among the tested models, the NB and SGDC models performed better in discriminating between dysphonic and non-dysphonic voices from a set of 15 acoustic measures.
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Affiliation(s)
- Danilo Rangel Arruda Leite
- Department of Statistics, Graduate Program in Health Decision Models, Universidade Federal da Paraíba - UFPB, João Pessoa, Paraíba, Brasil; Brazilian Hospital Services Company- Ebserh, Universidade Federal da Paraíba - UFPB, João Pessoa, Paraíba, Brasil
| | - Ronei Marcos de Moraes
- Department of Statistics, Graduate Program in Health Decision Models, Universidade Federal da Paraíba - UFPB, João Pessoa, Paraíba, Brasil; Department of Statistics, Universidade Federal da Paraíba - UFPB, João Pessoa, Paraíba, Brasil
| | - Leonardo Wanderley Lopes
- Department of Statistics, Graduate Program in Health Decision Models, Universidade Federal da Paraíba - UFPB, João Pessoa, Paraíba, Brasil; Department of Speech-Language and Hearing Sciences, Graduate Program in Linguistics, Universidade Federal da Paraíba - UFPB, João Pessoa, Paraíba, Brasil.
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González AD, de Almeida Lopes ACB, de Andrade SM, Gabani FL, da Silva Santos MC, Rodrigues R, Mesas AE. Schoolteachers with voice handicap are twice as likely to report depressive symptoms. Eur Arch Otorhinolaryngol 2022; 279:4043-4051. [PMID: 35441894 PMCID: PMC9249687 DOI: 10.1007/s00405-022-07376-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022]
Abstract
This study aimed to examine the association between voice disorder and depressive symptoms in schoolteachers. A cross-sectional survey was conducted with elementary and secondary schoolteachers. Voice disorders and depressive symptoms were assessed with the Voice Handicap Index-10 and the Beck Depression Inventory-II, respectively. Logistic and linear regressions models were adjusted for confounding variables. In the 389 schoolteachers studied, the prevalence of voice handicap and depressive symptoms was 18.8 and 38.8%, respectively. Voice handicap was associated with depressive symptoms on all models tested. The logistic regression showed an odds ratio of 2.21 (95% confidence interval: 1.19, 4.08; p value < 0.05), while in the linear regression each point increase on the voice disorder scale increased the Beck Depression Inventory-II score by 0.39 points (95% confidence interval: 0.26, 0.54; p value < 0.05). This study showed that teachers of public schools with voice handicap are twice as likely to report depressive symptoms.
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Affiliation(s)
- Alberto Durán González
- Postgraduate Program in Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, n° 60, Londrina, 86038-350, Brazil
| | - Ana Carolina Bertin de Almeida Lopes
- Postgraduate Program in Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, n° 60, Londrina, 86038-350, Brazil
| | - Selma Maffei de Andrade
- Postgraduate Program in Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, n° 60, Londrina, 86038-350, Brazil
| | - Flávia Lopes Gabani
- Department of Nursing, Health Sciences Center, State University of Londrina, Londrina, Brazil
| | - Mayara Cristina da Silva Santos
- Postgraduate Program in Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, n° 60, Londrina, 86038-350, Brazil
| | - Renne Rodrigues
- Postgraduate Program in Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, n° 60, Londrina, 86038-350, Brazil
| | - Arthur Eumann Mesas
- Postgraduate Program in Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, n° 60, Londrina, 86038-350, Brazil. .,Universidad de Castilla-La Mancha, Health and Social Research Centre, Cuenca, Spain.
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12
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Stogowska E, Kamiński KA, Ziółko B, Kowalska I. Voice changes in reproductive disorders, thyroid disorders and diabetes: a review. Endocr Connect 2022; 11:EC-21-0505.R1. [PMID: 35148272 PMCID: PMC8942322 DOI: 10.1530/ec-21-0505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/11/2022] [Indexed: 11/12/2022]
Abstract
The subject of vocal changes accompanying pathological conditions, although still not well explored, seems to be promising. The discovery of laryngeal receptors for sex hormones and thyroid hormones can strongly support the hypothesis of changes in voice due to various endocrinopathies. On the other hand, the impairment of the proper function of the vocal apparatus can also be caused in the process of the microvasculature complications of diabetes mellitus. This review was a comprehensive summary of the accessible literature concerning the influence of selected endocrinopathies on subjective and objective voice parameters. We analysed a total number of 16 English-language research papers from the PubMed database, released between 2008 and 2021, describing vocal changes in reproductive disorders such as polycystic ovary syndrome and congenital adrenal hyperplasia, thyroid disorders in shape of hypo- or hyperthyroidism and type 2 diabetes mellitus. The vast majority of the analysed articles proved some changes in voice in all mentioned conditions, although the detailed affected vocal parameters frequently differed between research. We assume that the main cause of the observed conflicting results might stem from non-homogeneous methodology designs of the analysed studies.
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Affiliation(s)
- Ewa Stogowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, Bialystok, Poland
| | - Karol Adam Kamiński
- Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | | | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, Bialystok, Poland
- Correspondence should be addressed to I Kowalska:
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13
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King RE, Novaleski CK, Rousseau B. Voice Handicap Index Changes After Microflap Surgery for Benign Vocal Fold Lesions Are Not Associated With Recommended Absolute Voice Rest Duration. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:912-922. [PMID: 35179998 PMCID: PMC9150674 DOI: 10.1044/2021_ajslp-21-00115] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/27/2021] [Accepted: 11/14/2021] [Indexed: 06/01/2023]
Abstract
PURPOSE Voice rest is frequently prescribed after phonosurgery, but optimal type and duration for voice outcomes have not been demonstrated. Studies to date have been characterized by heterogeneity in surgical procedures and laryngeal diagnoses. We sought to analyze the effect of recommended absolute voice rest duration on outcomes of microflap surgery for benign vocal fold lesions. A secondary purpose was to identify patient factors associated with postoperative voice outcomes. METHOD Forty-three patients were included in this retrospective review of patients aged 18 years and above who underwent direct microlaryngoscopy with microflap for vocal fold polyp or cyst over a 5-year period at a multidisciplinary voice center. Duration of recommended postoperative absolute voice rest was classified as less than 7 days, 7 days, and more than 7 days. Demographic and vocal hygiene data and voice treatment history were collected. Outcome measures consisted of one pre- and two postoperative Voice Handicap Index (VHI) scores. Effects of recommended voice rest on outcomes were analyzed using mixed models for repeated measures. Effects of patient factors on outcomes were analyzed as exploratory measures. Stroboscopy ratings were analyzed descriptively. RESULTS Thirteen patients were recommended 7 days of absolute voice rest, 15 were recommended less than 7 days, and 15 were recommended more than 7 days. Postoperatively, VHI scores significantly improved for all patients. Voice rest as a continuous variable was associated with the Functional subscale score in the short term, but there was no effect on VHI total score and no longer term effect of voice rest on any outcome. Age, sex, and preoperative voice therapy were associated with at least one VHI subscale score on at least one time point. CONCLUSION VHI outcomes of microflap surgery for polyps and cysts do not differ by duration of recommended absolute postoperative voice rest. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19178459.
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Affiliation(s)
- Renee E. King
- Department of Surgery, University of Wisconsin–Madison
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN
| | - Carolyn K. Novaleski
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Bernard Rousseau
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
- Department of Communication Sciences and Disorders, University of Pittsburgh, PA
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14
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White SW, Bock JM, Blumin JH, Friedland DR, Adams JA, Tong L, Osinski K, Luo J. Analysis of socioeconomic factors in laryngology clinic utilization for treatment of dysphonia. Laryngoscope Investig Otolaryngol 2022; 7:202-209. [PMID: 35155799 PMCID: PMC8823153 DOI: 10.1002/lio2.715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/08/2021] [Accepted: 11/16/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To evaluate the association between patient socioeconomic and demographic factors and tertiary care utilization for dysphonia in a localized metropolitan area of the American Midwest. METHODS Multivariate regression analysis was used to correlate patient demographics and population level data (e.g., age, gender, race, insurance, median income, education level) with tertiary laryngology utilization for dysphonia care at our institution between 2000 and 2019. Initial analyses characterized tertiary laryngology utilization rates for all regional ZIP codes and correlated these data with census information for household income and education. Dysphonia patient demographics were compared among populations cared for in our entire academic Otolaryngology department, our health system, and the regional population. RESULTS Among 1,365,021 patients in our health system, there were 7066 tertiary laryngology visits with a diagnosis of dysphonia. Dysphonia patients as compared to the overall health system were older (62.0 vs. 50.8 years), more likely to be female (63.7 vs. 50.2%) and more likely to have insurance (98.4 vs. 87.5%, all p < .001). Patient and population-level factors including insurance status, education, and black race showed positive correlation with laryngology utilization while median income did not. CONCLUSIONS AND RELEVANCE Insurance status, education level, and race correlated with utilization of tertiary laryngology services for the evaluation of dysphonia in our community, while median income did not. Black patients utilized tertiary laryngology care at higher rates compared to departmental and regional population utilization data. These results underscore important demographic and disease-specific factors that may affect utilization of subspecialty care in Otolaryngology. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Shane W. White
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jonathan M. Bock
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Joel H. Blumin
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - David R. Friedland
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jazzmyne A. Adams
- Department of Otolaryngology and Communication SciencesMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Ling Tong
- Department of Health Informatics and AdministrationUniversity of Wisconsin – MilwaukeeMilwaukeeWisconsinUSA
| | - Kristen Osinski
- Clinical and Translational Science InstituteMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jake Luo
- Department of Health Informatics and AdministrationUniversity of Wisconsin – MilwaukeeMilwaukeeWisconsinUSA
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15
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Payten CL, Nguyen DD, Novakovic D, O'Neill J, Chacon AM, Weir KA, Madill CJ. Telehealth voice assessment by speech language pathologists during a global pandemic using principles of a primary contact model: an observational cohort study protocol. BMJ Open 2022; 12:e052518. [PMID: 35039289 PMCID: PMC8764716 DOI: 10.1136/bmjopen-2021-052518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION SARS-CoV-2, a highly contagious severe acute respiratory syndrome, has spread to most countries in the world and resulted in a change to practice patterns for the assessment and diagnosis of people with voice disorders. Many services are transitioning to telehealth models to maintain physical distancing measures and conserve personal protective equipment used by healthcare workers during laryngoscopy examinations. The speech-language pathology primary contact (SLPPC) assessment for patients referred to ear, nose and throat (ENT) services in Australia has been shown to reduce waiting times for assessment while streamlining access to ENT assessment and allied health practitioner treatment pathways. METHODS AND ANALYSIS A prospective observational cohort study will see patients in a newly developed telehealth model which uses the principles from a usual care SLPPC assessment protocol. Participants will be offered an initial telehealth assessment (speech-language pathology primary contact telehealth (SLPPC-T)) prior to being prioritised for a face-to-face laryngoscopy assessment to complete the diagnostic process. The telehealth assessment will collect sociodemographic information, personal and family medical history, key symptoms, onset and variability of symptoms, red-flag signs or symptoms for laryngeal malignancy, and clinical voice assessment data for auditory-perceptual and acoustic analysis. The study outcomes include (1) association of signs, symptoms and specific voice measures collected during SLPPC-T with voice disorder classification provided after laryngoscopy; (2) degree of concordance between voice disorder classification after SLPPC-T and after laryngoscopy; (3) health service and patient-related costs and health outcomes of the SLPPC-T; (4) patient and stakeholder views and beliefs about the SLPPC-T process. ETHICS AND DISSEMINATION Ethical approval has been granted prior to commencement of the study enrolment by the Gold Coast Hospital and Health Service Human Research Ethics Committee (reference number HREC/2020/QGC/62832). Results will be shared through the publication of articles in peer-reviewed medical journals and presentation at national and international scientific meetings. TRIAL REGISTRATION NUMBER ACTRN12621000427875.
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Affiliation(s)
- Christopher L Payten
- Department of Speech Pathology, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Duy Duong Nguyen
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Novakovic
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - John O'Neill
- Department of Ear, Nose and Throat, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Antonia M Chacon
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kelly A Weir
- School of Allied Health Sciences, Griffith University Faculty of Health, Gold Coast, Queensland, Australia
- Department of Research and Education, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Catherine J Madill
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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16
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Pierce JL, Tanner K, Merrill RM, Shnowske L, Roy N. Acoustic Variability in the Healthy Female Voice Within and Across Days: How Much and Why? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3015-3031. [PMID: 34269598 DOI: 10.1044/2021_jslhr-21-00018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose The aims of this study were (1) to quantify variability in voice production (as measured acoustically) within and across consecutive days in vocally healthy female speakers, (2) to identify which acoustic measures are sensitive to this variability, and (3) to identify participant characteristics related to such voice variability. Method Participants included 45 young women with normal voices who were stratified by age, specifically 18-23, 24-29, and 30-35 years. Following an initial acoustic and auditory-perceptual voice assessment, participants performed standardized field voice recordings 3 times daily across a 7-day period. Acoustic analyses involved 32 cepstral-, spectral-, and time-based measures of connected speech and sustained vowels. Relationships among acoustic data and select demographic, health, and lifestyle (i.e., participant-based) factors were also examined. Results Significant time-of-day effects were observed for acoustic analyses within speakers (p < .05), with voices generally being worse in the morning. No significant differences were observed across consecutive days. Variations in voice production were associated with several participant factors, including improved voice with increased voice use; self-perceived poor voice function, minimal or no alcohol consumption, and extroverted personality; and worse voice with regular or current menstruation, depression, and anxiety. Conclusions This acoustic study provides essential information regarding the nature and extent to which healthy voices vary throughout the day and week. Participant-based factors that were associated with improved voice over time included increased voice use, self-perceived poor voice function, minimal or no alcohol consumption, and extroverted personality. Factors associated with worse voice production over time included regular or current menstruation, and depression and anxiety.
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Affiliation(s)
- Jenny L Pierce
- Department of Surgery, The University of Utah, Salt Lake City
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City
| | - Kristine Tanner
- Department of Communication Disorders, Brigham Young University, Provo, UT
| | - Ray M Merrill
- Department of Public Health, Brigham Young University, Provo, UT
| | - Lauren Shnowske
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City
- Department of Communication Sciences and Disorders, University of Kentucky, Lexington
| | - Nelson Roy
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City
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17
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Anand S, Bottalico P, Gray C. Vocal Fatigue in Prospective Vocal Professionals. J Voice 2021; 35:247-258. [DOI: 10.1016/j.jvoice.2019.08.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 11/30/2022]
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18
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Wang YT, Chang GH, Yang YH, Liu CY, Tsai YT, Hsu CM, Lee YC, Lee LA, Yang PR, Tsai MS, Li HY. Allergic Rhinitis and Laryngeal Pathology: Real-World Evidence. Healthcare (Basel) 2021; 9:healthcare9010036. [PMID: 33401606 PMCID: PMC7824592 DOI: 10.3390/healthcare9010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 11/16/2022] Open
Abstract
Allergic rhinitis (AR) is correlated with diseases including allergic laryngitis, chronic obstructive pulmonary disease (COPD), asthma, and chronic rhinosinusitis (CRS). The unified airway model suggests that inflammation can spread in both lower and upper respiratory tracts. Moreover, some voice problems-laryngeal edema, dysphonia, and vocal nodules-have been associated with AR. We examined the association between AR and laryngeal pathology. We investigated 51,618 patients with AR between 1 January 1997 and 31 December 2013, along with 206,472 patients without AR matched based on age, gender, urbanization level, and socioeconomic status at a 1:4 ratio. We followed patients up to the end of 2013 or their death. The occurrence of laryngeal pathology was the primary outcome. Individuals with AR had a 2.43 times higher risk of laryngeal pathology than the comparison cohort group (adjusted HR: 2.43, 95% CI: 2.36-2.50, p < 0.001). Patients diagnosed as having AR exhibited higher comorbidity rates, including of asthma, COPD, CRS, gastroesophageal reflux disease, and nasal septum deviation, than those of the comparison cohort. Our results strongly indicate that AR is an independent risk factor for laryngeal pathology. Therefore, when treating AR and voice problems, physicians should be attuned to possible laryngeal pathology.
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Affiliation(s)
- Yun-Ting Wang
- Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (Y.-T.W.); (G.-H.C.); (Y.-T.T.); (C.-M.H.)
| | - Geng-He Chang
- Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (Y.-T.W.); (G.-H.C.); (Y.-T.T.); (C.-M.H.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
| | - Yao-Hsu Yang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Chia-Yen Liu
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
| | - Yao-Te Tsai
- Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (Y.-T.W.); (G.-H.C.); (Y.-T.T.); (C.-M.H.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
| | - Cheng-Ming Hsu
- Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (Y.-T.W.); (G.-H.C.); (Y.-T.T.); (C.-M.H.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
| | - Yi-Chan Lee
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Department of Otolaryngology—Head and Neck Surgery, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - Li-Ang Lee
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Department of Otolaryngology—Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Pei-Rung Yang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology—Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (Y.-T.W.); (G.-H.C.); (Y.-T.T.); (C.-M.H.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
- Correspondence: (M.-S.T.); (H.-Y.L.); Tel.: +886-5-3621-000 (ext. 2076) (M.-S.T.); Fax: +886-5-3623-002 (M.-S.T.)
| | - Hsueh-Yu Li
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Y.-H.Y.); (Y.-C.L.); (L.-A.L.); (P.-R.Y.)
- Department of Otolaryngology—Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
- Correspondence: (M.-S.T.); (H.-Y.L.); Tel.: +886-5-3621-000 (ext. 2076) (M.-S.T.); Fax: +886-5-3623-002 (M.-S.T.)
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19
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Bailey TW, Dos Santos AP, do Nascimento NC, Xie S, Thimmapuram J, Sivasankar MP, Cox A. RNA sequencing identifies transcriptional changes in the rabbit larynx in response to low humidity challenge. BMC Genomics 2020; 21:888. [PMID: 33308144 PMCID: PMC7733274 DOI: 10.1186/s12864-020-07301-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/04/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Voice disorders are a worldwide problem impacting human health, particularly for occupational voice users. Avoidance of surface dehydration is commonly prescribed as a protective factor against the development of dysphonia. The available literature inconclusively supports this practice and a biological mechanism for how surface dehydration of the laryngeal tissue affects voice has not been described. In this study, we used an in vivo male New Zealand white rabbit model to elucidate biological changes based on gene expression within the vocal folds from surface dehydration. Surface dehydration was induced by exposure to low humidity air (18.6% + 4.3%) for 8 h. Exposure to moderate humidity (43.0% + 4.3%) served as the control condition. Ilumina-based RNA sequencing was performed and used for transcriptome analysis with validation by RT-qPCR. RESULTS There were 103 statistically significant differentially expressed genes identified through Cuffdiff with 61 genes meeting significance by both false discovery rate and fold change. Functional annotation enrichment and predicted protein interaction mapping showed enrichment of various loci, including cellular stress and inflammatory response, ciliary function, and keratinocyte development. Eight genes were selected for RT-qPCR validation. Matrix metalloproteinase 12 (MMP12) and macrophage cationic peptide 1 (MCP1) were significantly upregulated and an epithelial chloride channel protein (ECCP) was significantly downregulated after surface dehydration by RNA-Seq and RT-qPCR. Suprabasin (SPBN) and zinc activated cationic channel (ZACN) were marginally, but non-significantly down- and upregulated as evidenced by RT-qPCR, respectively. CONCLUSIONS The data together support the notion that surface dehydration induces physiological changes in the vocal folds and justifies targeted analysis to further explore the underlying biology of compensatory fluid/ion flux and inflammatory mediators in response to airway surface dehydration.
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Affiliation(s)
- Taylor W Bailey
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, 47907, USA.,Department of Public Health, Purdue University, West Lafayette, IN, 47907, USA
| | | | | | - Shaojun Xie
- Bioinformatics Core, Purdue University, West Lafayette, Indiana, 47907, USA
| | - Jyothi Thimmapuram
- Bioinformatics Core, Purdue University, West Lafayette, Indiana, 47907, USA
| | - M Preeti Sivasankar
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, 47907, USA
| | - Abigail Cox
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, 47907, USA.
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20
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Kridgen S, Hillman RE, Stadelman-Cohen T, Zeitels S, Burns JA, Hron T, Krusemark C, Muise J, Van Stan JH. Patient-Reported Factors Associated with the Onset of Hyperfunctional Voice Disorders. Ann Otol Rhinol Laryngol 2020; 130:389-394. [PMID: 32909443 DOI: 10.1177/0003489420956379] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Prevention, diagnosis, and treatment of hyperfunctional voice disorders would be improved by better understanding their etiological contributing factors. Therefore, this study estimated the prevalence of etiological factors using self-reported data about disorder onset from a large cohort of patients with Phonotraumatic Vocal Hyperfunction (PVH) and Non-Phonotraumatic Vocal Hyperfunction (NPVH). METHODS Retrospective chart review extracted the self-reported rate (gradual, sudden) and events associated (voice use, anxiety/stress, upper respiratory infection [URI]) with disorder onset from 1,577 patients with PVH and 979 patients with NPVH. RESULTS Both patient groups reported a gradual onset more than a sudden onset. Voice use was the most frequently reported event for PVH and the NPVH group self-reported all three events at equal frequency. The largest PVH subgroups were associated with voice use while the NPVH subgroups were associated with only voice use, only URI, or only anxiety/stress. CONCLUSION The results support the general clinical view that PVH is most strongly related to the gradual accumulated effects of phonotrauma, while NPVH has a more heterogeneous etiology. The identified PVH and NPVH subgroups may have clinical relevance and future work could investigate differences in treatment and outcomes among these subgroups.
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Affiliation(s)
- Samantha Kridgen
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.,MGH Institute of Health Professions, Boston, MA, USA
| | - Robert E Hillman
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.,MGH Institute of Health Professions, Boston, MA, USA.,Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Tara Stadelman-Cohen
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.,MGH Institute of Health Professions, Boston, MA, USA
| | - Steven Zeitels
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.,Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - James A Burns
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.,Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Tiffiny Hron
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.,Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Carol Krusemark
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.,MGH Institute of Health Professions, Boston, MA, USA
| | - Jason Muise
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.,MGH Institute of Health Professions, Boston, MA, USA
| | - Jarrad H Van Stan
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, MA, USA.,MGH Institute of Health Professions, Boston, MA, USA.,Department of Surgery, Harvard Medical School, Boston, MA, USA
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21
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Spellman J, Coulter M, Roth C, Johnson C. Prevalence, Characteristics and Impact of Dysphonia in US Marine Corps Drill Instructors. J Voice 2020; 34:694-701. [DOI: 10.1016/j.jvoice.2019.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/27/2019] [Accepted: 02/27/2019] [Indexed: 12/29/2022]
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22
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Occupational voice is a work in progress: active risk management, habilitation and rehabilitation. Curr Opin Otolaryngol Head Neck Surg 2020; 27:439-447. [PMID: 31651425 PMCID: PMC6867679 DOI: 10.1097/moo.0000000000000584] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The current article reviews recent literature examining occupational voice use and occupational voice disorders (January 2018–July 2019).
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Roy N, Merrill RM, Pierce J, Sundar KM. Evidence of Possible Irritable Larynx Syndrome in Obstructive Sleep Apnea: An Epidemiologic Approach. J Voice 2020; 35:932.e29-932.e38. [PMID: 32171641 DOI: 10.1016/j.jvoice.2020.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/12/2019] [Accepted: 02/06/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE "Irritable larynx syndrome" (ILS) often refers to a constellation of laryngeal-based symptoms including chronic cough (CC), diurnal dyspnea, and dysphonia. In patients with OSA, we examined: (1) the frequency, severity, comorbidity, risks and triggers of each problem, (2) whether these symptoms were compatible with stereotypic ILS and (3) the role of CPAP in their expression. STUDY DESIGN Cross-sectional, descriptive epidemiology study. SETTING Sleep-Wake Center at University of Utah Health Care, Salt Lake City, UT. SUBJECTS AND METHODS Ninety-four individuals with OSA (53 men, 41 women; mean age 54.7 ± 12.8 yrs.) underwent an extensive telephone interview that addressed study objectives. RESULTS Long-term CC, daytime breathing and voice problems were common, especially among women despite less severe OSA. Women, more than men, reported all three chronic conditions alone or in combination: CC (44% vs 11.3%), diurnal dyspnea (41.5% vs 13.2%) and voice disorders (41.5% vs 13.2%). Symptoms were not associated with age, BMI or Apnea Hypopnea Index after adjusting for sex. Although evidence supporting stereotypic ILS symptomatology was inconsistent, those participants with a voice disorder were 3.3 (95% CI = 1.8-6.0) times more likely to report CC and 2.4 (95% CI = 1.3-4.4) times more likely to experience diurnal dyspnea. Esophageal reflux, post-nasal drip, and frequent sinus infections were significantly associated with all three conditions. Triggers that provoked or made symptoms worse varied by condition and sex. Nightly, humidified CPAP use was associated with fewer symptoms overall and improved quality of life. CONCLUSIONS Symptoms suggestive of possible ILS are common in OSA, especially among women, and lessened by nightly CPAP use.
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Affiliation(s)
- Nelson Roy
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, Utah.
| | - Ray M Merrill
- Department of Public Health, Brigham Young University, Provo, Utah
| | - Jenny Pierce
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, Utah
| | - Krishna M Sundar
- Division of Pulmonary, Critical Care and Sleep Medicine, The University of Utah, Salt Lake City, Utah
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Vojtech JM, Segina RK, Buckley DP, Kolin KR, Tardif MC, Noordzij JP, Stepp CE. Refining algorithmic estimation of relative fundamental frequency: Accounting for sample characteristics and fundamental frequency estimation method. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:3184. [PMID: 31795681 PMCID: PMC6847943 DOI: 10.1121/1.5131025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 05/26/2023]
Abstract
Relative fundamental frequency (RFF) is a promising acoustic measure for evaluating voice disorders. Yet, the accuracy of the current RFF algorithm varies across a broad range of vocal signals. The authors investigated how fundamental frequency (fo) estimation and sample characteristics impact the relationship between manual and semi-automated RFF estimates. Acoustic recordings were collected from 227 individuals with and 256 individuals without voice disorders. Common fo estimation techniques were compared to the autocorrelation method currently implemented in the RFF algorithm. Pitch strength-based categories were constructed using a training set (1158 samples), and algorithm thresholds were tuned to each category. RFF was then computed on an independent test set (291 samples) using category-specific thresholds and compared against manual RFF via mean bias error (MBE) and root-mean-square error (RMSE). Auditory-SWIPE' for fo estimation led to the greatest correspondence with manual RFF and was implemented in concert with category-specific thresholds. Refining fo estimation and accounting for sample characteristics led to increased correspondence with manual RFF [MBE = 0.01 semitones (ST), RMSE = 0.28 ST] compared to the unmodified algorithm (MBE = 0.90 ST, RMSE = 0.34 ST), reducing the MBE and RMSE of semi-automated RFF estimates by 88.4% and 17.3%, respectively.
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Affiliation(s)
- Jennifer M Vojtech
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts 02215, USA
| | - Roxanne K Segina
- Department of Speech, Language, and Hearing Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - Daniel P Buckley
- Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, 72 East Concord Street, Boston, Massachusetts 02118, USA
| | - Katharine R Kolin
- Department of Speech, Language, and Hearing Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - Monique C Tardif
- Department of Speech, Language, and Hearing Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - J Pieter Noordzij
- Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, 72 East Concord Street, Boston, Massachusetts 02118, USA
| | - Cara E Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215, USA
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25
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Ravi R, Gunjawate DR. Effect of diabetes mellitus on voice: a systematic review. PRACTICAL DIABETES 2019. [DOI: 10.1002/pdi.2240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Rohit Ravi
- Department of Audiology and Speech Language PathologyKasturba Medical College, Mangalore, Manipal Academy of Higher Education Manipal Karnataka India
| | - Dhanshree R Gunjawate
- Department of Audiology and Speech Language PathologyKasturba Medical College, Mangalore, Manipal Academy of Higher Education Manipal Karnataka India
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Bertelsen C, Zhou S, Hapner ER, Johns MM. Sociodemographic Characteristics and Treatment Response Among Aging Adults With Voice Disorders in the United States. JAMA Otolaryngol Head Neck Surg 2019; 144:719-726. [PMID: 30003217 DOI: 10.1001/jamaoto.2018.0980] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Importance Aging adults face unique barriers to care and have unique health care needs with a high prevalence of chronic conditions. A high proportion of individuals in this group have voice disorders, in part due to age-related changes in laryngeal anatomy and physiologic features. These disorders contribute significantly to health care costs and remain poorly understood. Objective To describe sociodemographic characteristics and response to treatment among aging adults with voice disorders. Design, Setting, and Participants A cross-sectional study using the 2012 National Health Interview Survey was used to evaluate adults who reported voice disorders in the past 12 months. Self-reported demographics and data regarding health care visits for voice disorders were analyzed. Statistical analysis was conducted from March 1, 2017, to February 1, 2018. Main Outcomes and Measures Self-reported voice disorders, whether or not treatment was sought, which types of professionals were seen for treatment, and whether or not the voice disorder improved after treatment. Results Among 41.7 million adults in the United States 65 years or older, 4.20 million (10.1%; 2 683 199 women and 1 514 909 men; mean [SE] age, 74.5 [0.3] years) reported having voice disorders. Of those with voice disorders, 10.0% (95% CI, 8.3%-11.7%) sought treatment. Of individuals seeking treatment, 22.1% (95% CI, 7.9%-36.3%) saw an otolaryngologist and 24.3% (95% CI, 10.6%-38.0%) saw a speech language pathologist. By controlling for race/ethnicity, income, sex, and geography, it was found that men were less likely than women to report voice disorders (36.1% [95% CI, 31.7%-40.5%] vs 63.9% [95% CI, 59.5%-68.3%]; odds ratio, 0.70; 95% CI, 0.57-0.86). Race/ethnicity, income, and geography were not significantly associated with the likelihood that an individual 65 years or older reported voice disorders. A greater percentage of elderly adults seeking treatment than not seeking treatment reported improvement in symptoms (32.4%; 95% CI, 17.9%-47.0% vs 15.6%; 95% CI, 10.4%-20.8%). Among adults treated for a voice disorder, a lower proportion of adults 65 years or older reported improvement in symptoms with treatment compared with adults younger than 65 years (32.4%; 95% CI, 17.9%-47.0% vs 56.0%; 95% CI, 42.5%-69.6%). Conclusions and Relevance A small percentage of older adults with voice disorders seek treatment; even fewer are treated by an otolaryngologist or a speech language pathologist. A greater percentage of those who undergo treatment experienced symptomatic improvement compared with those who did not undergo treatment. These trends highlight the need for greater access to and awareness of services available to older adults with voice disorders.
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Affiliation(s)
- Caitlin Bertelsen
- University of Southern California Voice Center, Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles
| | - Sheng Zhou
- University of Southern California Voice Center, Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles
| | - Edie R Hapner
- University of Southern California Voice Center, Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles
| | - Michael M Johns
- University of Southern California Voice Center, Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles
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Lai YT, Wang YH, Yen YC, Yu TY, Chao PZ, Lee FP, Dailey S. The Epidemiology of Benign Voice Disorders in Taiwan: A Nationwide Population-Based Study. Ann Otol Rhinol Laryngol 2019; 128:406-412. [PMID: 30734582 DOI: 10.1177/0003489419826136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Because there are few population-based studies regarding the epidemiology of benign voice diseases, the present study used a nationwide population-based claims database (the National Health Insurance Research Database) to investigate the epidemiology of benign voice diseases among the general adult population in Taiwan. METHODS Study participants were retrieved for those patients who were 20 to 90 years old with a diagnosis of benign voice diseases that were defined by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes from 2006 to 2014. Patient visits were grouped into infectious (ICD-9-CM: 012.3, 032.3, 034.0, 090.5, 095.8,101, 464.0, 464.20, 464.21, 465.x, 476.0, 476.1) and noninfectious (ICD-9-CM: 306.1, 478.3x, 478.4, 478.5, 748.3, 784.4x) dysphonia groups. RESULTS Benign voice disorders have a prevalence of approximately 3.6% in Taiwan as of 2014. The year-to-year prevalence decreased gradually in the query period. Infectious dysphonia diagnoses were higher than noninfectious ones. Dysphonia caused by noninfectious diagnoses was most prevalent in the 60 to 79 years age group. Dysphonia caused by infectious diagnoses was highest in 20 to 39 years group. Noninfectious dysphonia diagnoses were more common in women. CONCLUSION The prevalence of voice disorders among the adult population in Taiwan was 3.6% in 2014. Voice disorders are more common in women and occur primarily in the 20 to 39 years age group. Infectious dysphonia is more common than noninfectious dysphonia. The results may be underestimated due to limitation of the database. This is the first population-based epidemiology study of adult voice disorders.
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Affiliation(s)
- Ying-Ta Lai
- 1 Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yuan-Hung Wang
- 2 Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,3 Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chun Yen
- 4 Research Center of Biostatistics, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Yun Yu
- 4 Research Center of Biostatistics, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Pin-Zhir Chao
- 1 Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,3 Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Fei-Peng Lee
- 1 Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,3 Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,5 Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Seth Dailey
- 6 Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Roy N, Merrill RM, Pierce J, Sundar KM. Voice Disorders in Obstructive Sleep Apnea: Prevalence, Risk Factors, and the Role of CPAP. Ann Otol Rhinol Laryngol 2018; 128:249-262. [PMID: 30577715 DOI: 10.1177/0003489418819541] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) is characterized by frequent interruptions in breathing related to upper airway collapse during sleep and may adversely affect phonatory function. This study aimed to: (1) establish the prevalence, risks, and quality of life burden of voice disorders in OSA and (2) explore the relation between voice disorders and positive airway pressure (PAP) therapy. STUDY DESIGN Cross-sectional, descriptive epidemiology study. METHODS Analyses were based on 94 individuals with OSA (53 men, 41 women; mean age = 54.7 ± 12.8 years) who completed a telephone interview. RESULTS Twenty-eight percent of participants reported having a current voice disorder. Of those with a current voice disorder, 83% had experienced symptoms for at least a year, and 58% had symptoms for at least 4 years. The prevalence of a current voice disorder was greater in women than men (44% vs 15%, P = .0020) but did not vary significantly across different age groups, body mass index (BMI), apnea/hypopnea index (AHI) severity, or medical history. After adjusting for sex, consistent use of PAP therapy (with humidification) was associated with (1) lower occurrence of voice disorders in women (Mantel-Haenszel [MH] χ2P = .0195), (2) reduced snoring severity accompanied by fewer voice disorders in men (MH χ2P = .0101), and (3) fewer reports of acid reflux as a possible trigger for voice problems (MH χ2P = .0226). Patients with OSA who also had a current voice disorder experienced lower overall quality of life compared to those without. CONCLUSIONS Chronic, longstanding voice disorders are common in women with OSA and produce significant adverse effects on quality of life. Nightly PAP use (with humidification) was associated with fewer voice symptoms and reduced severity of snoring and acid reflux as possible contributors. Further research is necessary to better understand the origin of these voice disorders in OSA and their potential response to treatment.
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Affiliation(s)
- Nelson Roy
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, UT, USA
| | - Ray M Merrill
- Department of Public Health, Brigham Young University, Provo, UT, USA
| | - Jenny Pierce
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, UT, USA
| | - Krishna M Sundar
- Division of Pulmonary, Critical Care and Sleep Medicine, The University of Utah, Salt Lake City, UT, USA
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Hur K, Zhou S, Bertelsen C, Johns MM. Health disparities among adults with voice problems in the United States. Laryngoscope 2017; 128:915-920. [DOI: 10.1002/lary.26947] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 08/23/2017] [Accepted: 09/05/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Kevin Hur
- USC Voice Center, Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine; University of Southern California; Los Angeles California U.S.A
| | - Sheng Zhou
- USC Voice Center, Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine; University of Southern California; Los Angeles California U.S.A
| | - Caitlin Bertelsen
- USC Voice Center, Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine; University of Southern California; Los Angeles California U.S.A
| | - Michael M. Johns
- USC Voice Center, Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine; University of Southern California; Los Angeles California U.S.A
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