[Hoarseness: biomechanisms and quantitative laryngoscopy]

[Voice diagnostics in phonosurgical interventions]

Stimmdiagnostische Untersuchungen vor und nach phonochirurgischen Eingriffen dienen zum einen der detaillierten Planung der chirurgischen Vorgehensweise und zum anderen der Nachvollziehbarkeit des postoperativen Ergebnisses. Die Stimmdiagnostik verfolgt dabei eine vielschichtige Vorgehensweise und umfasst Aspekte aus perzeptiver Stimmklangbeurteilung, Laryngostroboskopie, Stimmakustik, Aerodynamik und der Selbsteinschätzung durch die Patient*innen. Die Auswahl stimmdiagnostischer Methoden sollte sich dabei immer am aktuellen Wissensstand orientieren und das einrichtungsinterne Vorgehen prägen.

Systematic evaluation of laryngeal impairment in Sjögren's syndrome

INTRODUCTION

Sjögren's syndrome (SjS) causes malfunction of the salivary and lacrimal glands. Consequently, patients suffer from xerostomia and keratoconjunctivitis sicca. This can further affect the voice and swallowing function resulting in an impaired quality of life. Aim of this study is the systematic evaluation of the impact on voice and swallowing-related quality of life in patients with SjS.

MATERIAL AND METHODS

SjS patients were classified according to the American-European Consensus Group (AECG) criteria; antibodies to Ro (SS-A) or La (SS-B) antigens were detected, ESSPRI was completed. We used the following quality of life questionnaires: EORTC QLQ H&N 35, Anderson Dysphagia Inventory (ADI) and Voice Handicap Index (VHI). Patients additionally received a detailed phoniatric examination (auditory perception, videostroboscopy, acoustic analysis, Dysphonia Severity Index (DSI), aerodynamics measurements).

RESULTS

Almost all the 54 patients (96.3%) had a limited quality of life due to their swallowing problems and 48% due to their voice problems. Both values correlated significantly with the degree of xerostomia. In the phoniatric examination, 77.8% had an increased DSI and two-thirds had abnormalities in videostroboscopy.

CONCLUSIONS

A reasonable impairment of quality of life in patients with SjS due to the limitations in voice and swallowing function was observed. As SjS does not limitate life expectancy, preservation of quality of life is important. Detection of voice and swallowing problems as potential reasons for quality of life impairment should be detected and, if diagnosed, treated accordingly.

Objective analysis of voice changes in a hemodialysis session and its correlation with ultrafiltration

INTRODUCTION

The aim of the study is to analyze the voice changes occurring during a hemodialysis session objectively and to investigate the statistical correlation between voice changes and ultrafiltration, blood pressure, dry weight and the other variables of the patients.

MATERIALS AND METHODS

A total of 169 patients were included in the study. Electronic voice recordings of the patients were performed with the aim of making objective voice analysis before and after dialysis. Fundamental frequency measurements occurring at the level of the larynx (Fo) and harmonic-to-noise ratio (HNR) were measured from these voice recordings.

RESULTS

When the voice recordings obtained from 169 hemodialysis patients before and after dialysis were investigated, it was observed that a significant increase occurred in the Fo (from 164.52±43.36 Hz to 193.19±47.08 Hz, p<0.01). When the change in HNR was investigated, a significant reduction was determined in the post-dialysis measurements (4.6±3.23 dB) compared to the pre-dialysis measurements (16.10±4.06 dB, p<0.01). Mean 2.49±0.83 L of ultrafiltration was performed and a significant reduction was observed in post-session body weights of the patients (p<0.01). There was a highly statistical significance between the measurements of post-dialysis Fo and post-dialysis body weights. A highly significant correlation was determined between the amount of ultrafiltration performed and a significant increase observed in Fo before and after dialysis. Also a significant correlation was determined between the reduction in the mean post-session blood pressures and the reduction in the HNRs.

CONCLUSION

Objective voice analysis is suggesting that it can be a simple and applicable method that can be used to determine the dry weight.