ENT Audiology Phoniatric Unit, University of Pisa, Pisa, Italy; Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France.
CNR Institute of Clinical Physiology, Epidemiology Section, Pisa, Italy.
J Voice. 2022 Mar;36(2):288.e25-288.e34. doi: 10.1016/j.jvoice.2020.05.005. Epub 2020 Jun 15.
To correlate, RSI with SVHI, in a group of singing students, by means of a specific anamnestic questionnaire which analyzes the physical, social, emotional, and economic impacts of voice problems on their lives. This study is a cross-sectional single-center observational study.
Forty-two modern singing students (26F/16M; average age: 24.9 ± 5.7; range: 16-46 years old) were recruited. A self-assessment of the singing-voice (SVHI) and of reflux symptom (RSI) was performed.
Using the validated RSI threshold, 31% of participants were classified as RSI greater than 13 as an indication of suspected LPR. Classifying the SVHI score as proposed in the recent literature (cutoff of 20.35) our sample was a voice disorders prevalence of 71.4%. There was no significant positive or negative relationship between RSI and SVHI total score (rho = 0.238, P = 0.13). Instead, by considering the relationship between the individual items of the two questionnaires, it is highlighted that the item 1 of SVHI was significantly correlated with most of the RSI items (P = 0.0001-0.006). In the same vein, the item 5 of SVHI was correlated to hoarseness and coughing (P = 0.005-0.006). The item 20 of SVHI was significantly correlated with hoarseness, excess mucus in the throat or postnasal drip and with the pharyngeal Globus sensation (P = 0.001-0.005). By aggregating the SVHI item response as a positive response (2-4) versus a negative response (0 or 1) between "RSI pathology classification," a significant association was observed for SVHI item 1 (P < 0.021), item 5 (P < 0.006), item 20 (P < 0.042), item 24 (P < 0.044) item 25 (P < 0.047). These associations were confirmed by univariate binary logistic. Multivariate binary logistic regression confirms that SVHI Item 1, Item 5 were more associated with RSI positive. Based on results, we propose a questionnaire that combines the most relevant SVHI items correlated to LPRD (SVHI-10-LPRD questionnaire). Cronbach's alpha coefficient for the 10 items selected was 0.87; item-total correlation coefficients for each item were in the range of 0.461 to 0.670.
This pilot study shows that, in case of significant RSI for LPR, it is possible to observe a significant association with some symptoms described in SVHI. These results underline that the association of the RSI and SVHI questionnaires administered to singers and singing students, can represent a simple screening to reveal possible alterations of the singing voice correlate to LPR. Moreover, we propose a Singing Voice Handicap Index correlated to LPR (SVHI-10-LPRD). It will be necessary to increase the sample of subjects in the study to confirm these preliminary data.
通过专门的病史问卷，将 RSI 与 SVHI 相关联，对一组歌唱学生进行分析，该问卷分析了嗓音问题对他们生活的身体、社会、情感和经济影响。本研究为一项横断面单中心观察性研究。
招募了 42 名现代歌唱学生（26F/16M；平均年龄 24.9±5.7 岁；年龄范围 16-46 岁）。进行了嗓音自我评估（SVHI）和反流症状（RSI）评估。
使用经过验证的 RSI 阈值，31%的参与者被归类为 RSI 大于 13，表明疑似 LPR。根据最近文献中提出的 SVHI 评分（20.35 的截止值），我们的样本中嗓音障碍的患病率为 71.4%。RSI 总评分与 SVHI 总评分之间没有显著的正相关或负相关（rho=0.238，P=0.13）。相反，通过考虑两个问卷中各个项目之间的关系，突出显示 SVHI 的第 1 项与 RSI 的大多数项目显著相关（P=0.0001-0.006）。同样，SVHI 的第 5 项与声音嘶哑和咳嗽（P=0.005-0.006）相关。SVHI 的第 20 项与声音嘶哑、喉咙中过多的黏液或后鼻滴注以及咽部 Glob 感觉显著相关（P=0.001-0.005）。通过将 SVHI 项目反应汇总为“RSI 病理分类”中的阳性反应（2-4）与阴性反应（0 或 1）之间，观察到与 SVHI 项目 1（P<0.021）、项目 5（P<0.006）、项目 20（P<0.042）、项目 24（P<0.044）和项目 25（P<0.047）之间存在显著关联。这些关联通过单变量二项逻辑回归得到证实。多变量二项逻辑回归证实，SVHI 项目 1 和项目 5 与 RSI 阳性更相关。基于结果，我们提出了一个结合了与 LPRD 最相关的 SVHI 项目的问卷（SVHI-10-LPRD 问卷）。选择的 10 个项目的 Cronbach's alpha 系数为 0.87；每个项目的项目-总分相关系数在 0.461 到 0.670 之间。
这项初步研究表明，在 RSI 对 LPR 显著的情况下，可能会观察到与 SVHI 中描述的某些症状存在显著关联。这些结果强调，对歌手和歌唱学生进行 RSI 和 SVHI 问卷联合评估，可能是一种简单的筛查方法，可以揭示与 LPR 相关的可能的歌唱声音改变。此外，我们提出了与 LPR 相关的歌唱嗓音障碍指数（SVHI-10-LPRD）。有必要增加研究对象的样本量来确认这些初步数据。
