Amernik Katarzyna
Katedra i Klinika Otolaryngologii i Onkologii Laryngologicznej Pomorskiej Akademii Medycznej w Szczecinie, Szczecin.
Ann Acad Med Stetin. 2007;53(3):55-65.
The aim of this study was estimation of glottis morphology and perceptive-acoustic characteristics of voice and speech in patients suffering from rheumatoid arthritis (RA).
77 patients (51 women and 15 men), 19-77 years of age (average 56,7) with recognized RA. The disease duration was from 1 month to 29 (average 9,4) years. Laryngeal, phoniatric examination and phonetic-acoustic analysis of voice and speech (program IRIS). One patient with bilateral vocal folds immobilization had computer tomography of the larynx and electromiography of internal laryngeal muscles.
The most frequent complains were: foreign body sensation in the throat 51% (n = 39/76), hoarseness - 47% (n = 36/76), weakness of voice - 29% (n = 22/76). Redness of the mucosal tissue in the area of arytenoids was stated in 41% (32/77) patients and edema in 28% (21/77). Complains and morphological features of inflammation in the larynx were considerably more frequent in patients with active RA. 3 patients had impairment of vocal folds mobility, in 2 of them it was bilateral immobilization requiring emergency tracheotomy. Subjective voice analysis was made according to GRBAS scale. In 35% (26/75) patients there was G2 or G3 stated. The average time of phonation [a] was 7 seconds. Average basic voice frequency was for women 216 Hz and for men 118 Hz. There was statistically important correlation between increasing of some acoustic voice parameters and RA activity and intensity.
Patient's complains for foreign body sensation in the throat and hoarseness, especially when RA is active, can indicate on inflammatory process in the larynx. For these reason it seems to be reliable to stay in close contact for rheumatologist, laryngologist and phoniatrist in every day practice.
本研究旨在评估类风湿关节炎(RA)患者的声门形态以及嗓音和言语的感知声学特征。
77例患者(51名女性和15名男性),年龄在19至77岁之间(平均56.7岁),均确诊为RA。病程从1个月至29年(平均9.4年)。进行喉部、嗓音科检查以及嗓音和言语的语音声学分析(IRIS程序)。1例双侧声带固定患者进行了喉部计算机断层扫描和喉内肌电图检查。
最常见的主诉为:咽部异物感51%(n = 39/76)、声音嘶哑 - 47%(n = 36/76)、嗓音无力 - 29%(n = 22/76)。41%(32/77)的患者杓状软骨区域黏膜组织发红,28%(21/77)有水肿。活动性RA患者喉部炎症的主诉和形态学特征更为常见。3例患者存在声带活动障碍,其中2例为双侧固定,需要紧急气管切开术。根据GRBAS量表进行主观嗓音分析。35%(26/75)的患者存在G2或G3级。发[a]音的平均时长为7秒。女性平均基频为216 Hz,男性为118 Hz。一些嗓音声学参数的增加与RA的活动度和强度之间存在统计学上的显著相关性。
患者咽部异物感和声音嘶哑的主诉,尤其是在RA活动期时,可能提示喉部存在炎症过程。因此,在日常临床实践中,风湿科医生、耳鼻喉科医生和嗓音科医生保持密切联系似乎是可靠的。