Acoustic Analysis Findings in Objective Laryngopharyngeal Reflux Patients (original) (raw)
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Journal of Voice, 2003
Thirteen individuals with laryngopharyngeal reflux (LPR) were studied pre-and post-treatment. The effect of treatment on perceptual ratings of voice quality and frequency and intensity measures was examined. Relationships between perceptual and acoustic parameters were assessed descriptively. Results showed a small, but significant improvement in the perception of voice quality post-treatment. No significant differences were found between pre-and post-treatment means for any of the acoustic measures except harmonics-to-noise ratio (HNR). Descriptive analyses showed some association between perceptual ratings and acoustic measures. Discussion of results focuses on severity of LPR.
Acoustic Analysis of Voice and Electroglottography in Patients With Laryngopharyngeal Reflux
Journal of voice : official journal of the Voice Foundation, 2017
Laryngopharyngeal reflux (LPR) refers to the flow of gastric acid content into the laryngopharynx. It has been reported that 10% of the patients consulting an otolaryngologist present with this condition. Signs of LPR can be identified during flexible or rigid laryngoscopy. The Voice Handicap Index (VHI) is a reliable tool for detecting the impact of voice disorders, and acoustic assessment of voice including acoustic analysis of voice (AAV) and electroglottography (EGG) provide objective data of voice production and voice disorders. This study aimed to describe changes in AAV, EGG, and VHI in patients who present with LPR compared with a matched control group of healthy subjects. Seventeen patients with LPR were studied. A group of healthy subjects matched by age and gender without any history of voice disorder, LPR, or gastroesophageal reflux disease was assembled. Both groups of patients were studied by VHI, flexible laryngoscopy, AAV, and EGG. All patients with LPR demonstrated ...
Voice Problems among Laryngopharyngeal Reflux Patients Diagnosed with Oropharyngeal pH Monitoring
Folia Phoniatrica Et Logopaedica, 2013
two groups regarding clinical presentation, RFS or acoustic measures. Significant positive correlations were found between the Ryan composite measurements and both severity ratings (VHI-10, RSI). Conclusion: LPR clinical presentation appears to be non-specific in terms of symptoms and laryngeal findings. LPR appears to have an effect on the patients' self-perception of voice problems. Further studies are needed to clarify the effect of LPR on acoustic measurements.
Acoustic voice analysis in patients with laryngopharyngeal reflux
Journal of Physics: Conference Series, 2018
Exposure of laryngeal mucosa to gastric juice causes trauma either directly or through a secondary mechanism, which causes chronic cough. Laryngeal mucosal trauma can cause voice problems, which is a frequent complaint in patients with laryngopharyngeal reflux (LPR). Acoustic voice analysis using Multi-Dimensional Voice Program (MDVP) is a relatively convenient and objective method for the assessment of voice disorders. This study assessed the differences between the values of acoustic voice parameters in patients with LPR and those without LPR. A comparative cross-sectional study was conducted in the outpatient Clinic at the Cipto Mangunkusumo Hospital between May and November 2016 (LPR group, n = 40; non-LPR group, n = 20). Some acoustic voice parameters in the LPR group were higher than those in the non-LPR group. Male patients exhibited significantly higher jitter, Pitch Perturbation Quotient (PPQ), and Noise/Harmony noise (NHR) values, whereas female patients exhibited significantly higher shimmer and Amplitude Perturbation Quotient (APQ) values. Significant differences were observed with respect to jitter, PPQ, APQ, and NHR values between male patients in the mild-LPR group and those in the moderate-severe LPR group. * Mean and standard deviation values ** Median value and min-max value Table 1. Age and RFS values in the LPR and non-LPR groups. Variable LPR group (n = 40) Non-LPR group (n = 20) Age (years) Male 32.5 (28−60)** 30.5 (28−53)** Female 45.5 (29−60)** 36.5(25−56)** RFS value Male 12.5 (8−15)** 6.5 (3−7)** Female 12.31 ± 2.15* 4.5 ± 1.99*
Journal of Otolaryngology - Head & Neck Surgery
Background: Laryngopharyngeal reflux is a prevalent, not well-understood disease affecting a high proportion of patients who seek laryngology consultation. The objective of this prospective case series is to explore the subjective and objective voice modifications in Laryngopharyngeal reflux (LPR), especially the usefulness of acoustic parameters as treatment outcomes, and to better understand the pathophysiological mechanisms underlying the development of voice disorder. Methods: Forty-one patients with a reflux finding score (RFS) > 7 and a reflux symptom index (RSI) > 13 were enrolled and treated with pantoprazole 20 mg twice daily for three months. RSI, RFS, Voice Handicap Index (VHI), and Grade, Roughness, Breathiness, Asthenia, Strain and Instability (GRBASI) were assessed at baseline and after three months post-therapy. Acoustic parameters were measured by selecting the most stable interval of the vowel /a/. A study of correlations between acoustic measurements and laryngoscopic signs was conducted in patients with roughness. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS). Results: Significant improvement in RSI, RFS, VHI, jitter, percent jitter, relative average perturbation (RAP), shimmer, percent shimmer, and amplitude perturbation quotient (APQ) was found at 3 months of treatment (p < .05). A correlation analysis revealed significant correlations between the grade of dysphonia, breathiness, asthenia, instability and jitter, percent jitter, RAP, shimmer, percent shimmer and APQ. In dividing our cohort into two groups of patients according to the presence of roughness, shimmer, percent shimmer and APQ significantly improved in patients with roughness, but no positive correlation was found between acoustic parameters and laryngoscopic signs. Conclusion: Acoustic parameters can help to better understand voice disorders in LPR and can be used as treatment outcomes in patients with roughness.
Clinical Otolaryngology, 2018
To assess the usefulness of voice quality measurements as a treatment outcome in patients with laryngopharyngeal reflux (LPR)-related symptoms. Design: Prospective uncontrolled multi-centre study. Material and methods: A total of 80 clinically diagnosed LPR patients with a reflux finding score (RFS)>7 and a reflux symptom index (RSI)>13 were treated with pantoprazole and diet recommendations during 3 or 6 months, according to their evolution. RSI; RFS; blinded Grade, Roughness, Breathiness, Asthenia, Strain and Instability (GRBASI) and aerodynamic and acoustic measurements were evaluated at baseline, 3 months (n = 80), and 6 months (n = 41) post-treatment. We conducted a correlation analysis between the adherence to the diet, and the evolution of both signs and symptoms and between videolaryngostroboscopic signs and acoustic measurements. Results: Reflux symptom index, RFS, perceptual voice quality evaluations (dysphonia, roughness, strain and instability), and aerodynamic and acoustic measurements (ie, percent jitter and percent shimmer) were significantly improved at 3 months post-treatment but not at 6 months. Percent jitter was the most useful outcome for evaluating the clinical evolution of patients throughout the treatment course. A significant relationship between globus sensation and posterior commissure hypertrophy was documented; both seemed to significantly improve from 3 to 6 months. The correlation analysis revealed correlations between adherence to diet recommendations and the improvement of symptoms and between posterior commissure granulation severity and acoustic measurement impairments. Conclusion: Voice quality improved in a manner similar to both signs and symptoms throughout a 6-month empirical treatment with better improvement the 3 first months. Voice quality assessments can be used as indicators of treatment effectiveness in patients with LPR-related symptoms. 1 | INTRODUCTION Laryngopharyngeal reflux (LPR) is the backflow of gastric contents into the laryngopharynx, where it comes in contact with the tissues Study from LPR project of Young Otolaryngologist International Federation of Otorhino-laryngology Societies-Research Committee. Harmegnies and Saussez equally contributed to this study and should be regarded as joint last authors.
The Journal of Laryngology & Otology, 2013
Objective:To assess the impact of anti-reflux treatment and speech therapy on subjective voice measurements of patients with laryngopharyngeal reflux.Methods:This paper reports a prospective study of patients seen in a voice clinic over a three-year period who were being treated for laryngopharyngeal reflux. Patients were assessed at presentation using the reflux symptom index and voice symptom scale, and were reassessed at three months and six months post-treatment. Treatment entailed twice daily proton pump inhibitor therapy and speech therapy.Results:The study comprised 74 patients. The reflux symptom index and voice symptom scale scores significantly improved following treatment at both three and six months. There was a correlation between improved reflux symptom index scores and improved voice symptom scale scores.Conclusion:Treatment of laryngopharyngeal reflux with twice daily proton pump inhibitors and speech therapy resulted in improved subjective voice measurements for pat...
THE EFFECT OF LARYNGOPHARYNGEAL REFLUX ON ACOUSTIC
Laryngopharyngeal reflux (LPR) is a very common disorder and it's objective effects over voice are controversial. In this study, to find out objective measures, the effects of LPR on acoustic parameters in functional dysphonia (FD) patients was investigated. 129 patients, aged between 14 and 88 years of which 71 were females and 58 were males. 81 patients had functional dysphonia (mean age 46), and 48 patients (mean age 51) had functional dysphonia as well as LPR. All data were obtained at the time of the initial examination. The laryngeal changes related with LPR were evaluated according to the Reflux Finding Score. Furthermore, acoustic analysis [Jitter, shimmer, Disphonia Severity Index (DSH), Noise to Harmonics ratio (NHR) and (F0)], auditive analysis [Roughness, breathiness, and hoarseness], voice range profile and voice intensity were selected as parameters for investigation in this study. Firstly, results show that the impact of LPR is significantly lower for male patients than for female patients. Secondly, maxdB was significantly higher for LPR patients. It decreases significantly with age for non-LPR patients and this decrease with age is even stronger for LPR patients. The percentage of jitter and schimmer increased significantly with age. Furthermore, DSH is significantly lower for males than it is for females. For all other dependent variables, age, LPR, and gender did not play a significantly role. Thus, for FD patients with LPR condition, we highly recommend that LPR treatment should be part of the treatment plan.
Voice Quality as Therapeutic Outcome in Laryngopharyngeal Reflux Disease: A Prospective Cohort Study
Journal of Voice, 2018
Purpose. To study the usefulness of voice quality as therapeutic outcome in laryngopharyngeal reflux disease. Material and methods. A total of 80 patients with reflux finding score (RFS) > 7 and reflux symptom index (RSI) > 13 were treated with pantoprazole, diet, and lifestyle recommendations for 3 months. The therapeutic effectiveness was assessed with RSI; RFS; Voice Handicap Index; blinded Grade, Roughness, Breathiness, Asthenia, Strain, and Instability (GRBASI); aerodynamic and a panel of acoustic measurements before and after treatment. A correlation analysis between symptoms, videolaryngostroboscopic signs, and acoustic measurements was conducted. Results. Compared to baseline, means of RSI, RFS, Voice Handicap Index, perceptual dysphonia, and roughness significantly decreased. Significant improvements of phonatory quotient, percent jitter, percent shimmer, Relative Average Perturbation, Pitch Perturbation Quotient, Phonatory F0 Range, Amplitude Perturbation Quotient, smooth Amplitude Perturbation Quotient, and Peak-to-Peak Amplitude Variation were found at the end of treatment. Studies of correlation did not identify relevant correlation between videolaryngostroboscopic signs, especially vocal folds edema, and objective voice quality evaluations. Conclusion. Voice quality assessments can help to better understand voice disorders and can be used as indicators of the treatment effectiveness in patients with laryngopharyngeal reflux-related symptoms.
Ear, Nose & Throat Journal
Laryngopharyngeal reflux (LPR) is an inflammatory condition suspected to be associated with dysphonia. In this study, we investigated multidimensional perceptual, aerodynamic, and acoustic voice changes in patients with clinically diagnosed LPR compared to healthy participants. We prospectively included 80 outpatients with Reflux Finding Score (RFS) >7 and Reflux Symptom Index (RSI) >13 from September 2013 to April 2016 and we compared clinical and voice quality assessments of these patients with 80 healthy participants. Statistically significant differences were found between groups with regard to Voice Handicap Index, perceptual voice quality (grades of dysphonia, roughness, strain, breathiness, asthenia, and instability), phonatory quotient, percentage jitter, percentage shimmer, peak-to-peak amplitude variation, standard deviation of fundamental frequency, and noise to harmonic ratio. Granulation score of RFS was found to affect the highest number of acoustic parameters. W...