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喉后遗症对副球孢子菌病中与嗓音和吞咽相关结局的影响。

Impact of laryngeal sequelae on voice- and swallowing-related outcomes in paracoccidioidomycosis.

作者信息

Pissurno Neisa Santos Carvalho Alves, Esteves Lucas da Motta, Benedito Juliana Marques, Giglio Vanessa Ponsano, de Carvalho Lídia Raquel, Mendes Rinaldo Poncio, Paniago Anamaria Mello Miranda

机构信息

Medical School, Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.

Maria Aparecida Pedrossian University Hospital, Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.

出版信息

J Venom Anim Toxins Incl Trop Dis. 2020 Aug 17;26:e20200008. doi: 10.1590/1678-9199-JVATITD-2020-0008.

Abstract

BACKGROUND

The present study was carried out aiming to evaluate the impact of laryngeal sequelae on the quality of life of treated paracoccidioidomycosis (PCM) patients.

METHODS

This cross-sectional study was conducted at the Otorhinolaryngology Outpatient Clinic of the University Hospital, Federal University of Mato Grosso do Sul, Brazil. Thirty-two PCM patients considered clinically and immunologically cured were included: 16 with laryngeal involvement during the active phase of the disease (laryngeal PCM group) and 16 without laryngeal involvement (control group). They were submitted to structured interview, otorhinolaryngology examination, videolaryngoscopy, videoendoscopic swallowing study, completed two questionnaires for voice self-assessment - Voice-related Quality of Life (V-RQOL) and Voice Handicap Index (VHI) - and were asked to score their voices on a scale from zero to 10 (self-assessment of vocal quality).

RESULTS

Dysphonia was present in 50% of the cases. Patients with laryngeal PCM presented worse voice-related quality of life scores on the V-RQOL and poorer vocal quality self-assessment than the control group. No significant differences in the VHI were found between the groups. None of the participants developed dysphagic sequelae, although some minor changes were observed on videoendoscopic examination.

CONCLUSION

There were no dysphagia complaints and only a few mild changes were found on the fiberoptic endoscopic evaluation of swallowing, suggesting that this evaluation should be performed only in specific cases. Patients with laryngeal involvement presented worse V-RQOL and self-assessment voice quality. This study contributes to the current knowledge of the functional assessment of the larynx affected by PCM and the impact of dysphonia on quality of life.

摘要

背景

本研究旨在评估喉部后遗症对已治愈的副球孢子菌病(PCM)患者生活质量的影响。

方法

本横断面研究在巴西南马托格罗索联邦大学医院的耳鼻喉科门诊进行。纳入32例临床和免疫方面已治愈的PCM患者:16例在疾病活动期有喉部受累(喉部PCM组),16例无喉部受累(对照组)。他们接受了结构化访谈、耳鼻喉科检查、电子喉镜检查、视频内镜吞咽研究,完成了两份声音自我评估问卷——声音相关生活质量(V-RQOL)和嗓音障碍指数(VHI),并被要求对自己的声音从0到10进行评分(嗓音质量自我评估)。

结果

50%的病例存在发音障碍。喉部PCM患者在V-RQOL上的声音相关生活质量得分比对照组差,嗓音质量自我评估也更差。两组在VHI上未发现显著差异。尽管在视频内镜检查中观察到一些轻微变化,但没有参与者出现吞咽后遗症。

结论

未发现吞咽困难主诉,在纤维内镜吞咽评估中仅发现少数轻度变化,提示仅在特定情况下应进行此项评估。喉部受累的患者V-RQOL和声音质量自我评估较差。本研究有助于增进对受PCM影响的喉部功能评估以及发音障碍对生活质量影响的现有认识。

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