Usefulness of assessment of voice capabilities in female patients with reflux-related dysphonia

Nora Šiupšinskienė, Kęstutis Adamonis¹, Robert J. Toohill²

Department of Otorhinolaryngology, ¹Department of Gastroenterology, Kaunas University of Medicine, Lithuania, ²Department of Otolaryngology and Communications Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

Key words: laryngopharyngeal reflux; quantitative voice assessment; voice range profile; speech range profile.

Summary. Objectives. To analyze vocal capabilities in patients diagnosed with reflux related dysphonia versus controls with healthy voice with selection of the most informative discriminating quantitative parameters and to assess voice changes following treatment.

Material and methods. Six parameters of voice range profile (VRP) and five parameters of speech range profile were taken and analyzed from 60 dysphonic outpatient females with laryngopharyngeal reflux (LPR) diagnosed by reflux-related atypical and typical symptoms, videolaryngoscopic findings, upper gastrointestinal endoscopy, and positive response to empiric 3-month omeprazole treatment. Seventy-six females with healthy voice served as controls.

Results. All six parameters of voice range profile and three of 5 parameters of speech range profile showed significant differences comparing LPR patients with controls before omeprazole treatment (P<0.05). Logistic regression analysis revealed VRP maximum-minimum intensity range to be the most informative parameter for discrimination between reflux-related dysphonic and healthy voices (overall prediction accuracy, 86.8%). A threshold value of significant parameter was stated using the receiver operating characteristic curve. Treatment with omeprazole significantly improved voice quality showing the greatest changes in the mean scores of majority of voice range profile parameters.

Conclusions. Vocal capabilities, especially evaluated by voice range profile, are restricted in LPR female patients in comparison to subjects with healthy voice. Quantitative voice assessment with voice range profile may add more objective aspect for screening dysphonia and could be used as a criterion of evaluation of treatment efficacy in such patients.

Correspondence to N. Šiupšinskienė, Department of Otorhinolaryngology, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: norai_s@yahoo.com

Received 29 June 2009, accepted 7 December 2009