Department of Otorhinolaryngology, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania.
Medicina (Kaunas). 2009;45(12):978-87.
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.
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.
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.
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.
分析诊断为反流相关性发声障碍的患者与具有健康嗓音的对照组之间的发声能力，选择最具信息量的鉴别定量参数，并评估治疗后的嗓音变化。
对 60 名经反流相关非典型和典型症状、视频喉镜检查、上消化道内镜检查和经验性奥美拉唑治疗 3 个月阳性反应诊断为喉咽反流（LPR）的女性门诊发声障碍患者和 76 名具有健康嗓音的女性进行嗓音范围分析（VRP）的 6 个参数和语音范围分析（SRP）的 5 个参数的检测和分析。
在奥美拉唑治疗前，所有 6 个 VRP 参数和 5 个 SRP 参数中的 3 个参数在 LPR 患者与对照组之间均存在显著差异（P<0.05）。逻辑回归分析显示，VRP 最大-最小强度范围是区分反流相关性发声障碍和健康嗓音最具信息量的参数（总体预测准确性为 86.8%）。使用受试者工作特征曲线确定了显著参数的阈值值。奥美拉唑治疗显著改善了嗓音质量，大多数 VRP 参数的平均评分显示出最大变化。
与具有健康嗓音的受试者相比，LPR 女性患者的发声能力，特别是通过嗓音范围分析评估，受到限制。通过嗓音范围分析进行定量嗓音评估可能为筛查发声障碍提供更客观的方面，并可作为此类患者治疗效果评估的标准。
