Department of Otolaryngology, Elsan Hospital, Paris, France.
Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, University Paris Saclay, Paris, France.
Eur Arch Otorhinolaryngol. 2022 Jul;279(7):3543-3549. doi: 10.1007/s00405-022-07283-0. Epub 2022 Feb 25.
The objective is to study the usefulness of acoustic measurements as therapeutic outcomes for patients with dysphonia related to laryngopharyngeal reflux (LPR).
From September 2019 to April 2021, 120 patients with LPR at the hypopharyngeal-esophageal multichannel intraluminal impedance pH-monitoring (HEMII-pH) were prospectively recruited from three University Hospitals. They were divided in two groups regarding the presence of dysphonia. The treatment consisted of a combination of diet, proton-pump inhibitors, magaldrate and alginate for 3-6 months. The following clinical and acoustic evaluations were studied regarding groups at baseline, 3- and 6-month posttreatment: reflux symptom score (RSS), reflux sign assessment (RSA), percent jitter, percent shimmer and noise-to-harmonic ratio (NHR).
A total of 109 patients completed the evaluations, accounting for 49 dysphonic and 60 non-dysphonic individuals. HEMII-pH, gastrointestinal endoscopy, baseline clinical and acoustic features were comparable between groups. RSS and RSA significantly improved from pre- to 3-month posttreatment in both groups. Jitter, Shimmer and NHR significantly improved from pre- to 3-month posttreatment in dysphonic patients, without additional 3- to 6-month posttreatment changes. Acoustic parameters did not change throughout treatment in patients without dysphonia.
Acoustic measurements may be an interesting indicator of treatment in LPR patients who reported dysphonia. In this group of individuals, the evolution of acoustic parameters was consistent with the evolution of symptoms and findings.
研究声学测量在与喉咽反流(LPR)相关的发声障碍患者的治疗结果中的有用性。
从 2019 年 9 月至 2021 年 4 月,在三个大学医院通过下咽部食管多通道腔内阻抗 pH 监测(HEMII-pH)前瞻性招募了 120 例 LPR 患者。他们根据是否存在发声障碍分为两组。治疗包括饮食、质子泵抑制剂、镁铝碳酸盐和藻酸盐联合治疗 3-6 个月。在基线、治疗后 3 个月和 6 个月时,研究了以下临床和声学评估:反流症状评分(RSS)、反流征象评估(RSA)、微扰百分比、振幅微扰比和噪声与谐噪比(NHR)。
共有 109 例患者完成了评估,其中 49 例为发声障碍患者,60 例为非发声障碍患者。HEMII-pH、胃肠内窥镜、基线临床和声学特征在两组之间具有可比性。RSS 和 RSA 在两组中均从治疗前到治疗后 3 个月显著改善。在发声障碍患者中,从治疗前到治疗后 3 个月,微扰、振幅微扰比和噪声与谐噪比显著改善,而在治疗后 3 至 6 个月没有进一步改善。在无发声障碍的患者中,整个治疗过程中声学参数没有变化。
对于报告有发声障碍的 LPR 患者,声学测量可能是一种有趣的治疗指标。在这群患者中,声学参数的演变与症状和发现的演变一致。