ENT, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy.
Department of Diagnostic, Clinical and Public Health, Audiology Unit, University of Modena and Reggio Emilia, Modena, Italy.
Folia Phoniatr Logop. 2023;75(5):284-294. doi: 10.1159/000529800. Epub 2023 Feb 23.
The present study aimed to develop a new tool for the evaluation of singers with self-reported symptoms suggestive of laryngopharyngeal reflux (LPR) (the SVHI-12-LPR), by correlating RSI with SVHI in a population sample of 163 subjects (both professional and amateur singers), evaluated also by videolaryngostroboscopy. This study was a cross-sectional, double-observational study.
RSI and SVHI were administered to 159 singers (amateurs, singing students, and professional singers). All subjects underwent videolaryngostroboscopy to objectively identify four subgroups: normal subjects (41.5%), subjects with organic lesions occupying the glottic space (17.6%), subjects with functional dysphonia (18.2%), and subjects presenting solely signs suggestive of LPR (22.6%). Using the validated RSI threshold, 33.9% of participants presented an RSI total score >13, suggestive of LPR.
Subjects with a suspected diagnosis of LPR at videolaryngostroboscopy presented a mean RSI significantly higher than other subgroups (p < 0.001). Moreover, the SVHI-36 score did not statistically differ between pathological subgroups. A significant positive relationship was observed between RSI and SVHI total score (Spearman's rank correlation coefficient [ρ] = 0.474, p < 0.001). 12 SVHI items (items 1, 2, 4, 5, 6, 7, 12, 20, 24, 25, 26, 30) showed a significant association with RSI pathology classification. Statistical analysis demonstrated for the 12 selected items (SVHI-12-LPR) acceptable specificity (0.691) and sensibility (0.833) for the suspected diagnosis of LPR with a cut-off of 15.
From the SVHI-36, 12 items were extracted that correlated with the specific impact that LPR has on the singer's voice (SVHI-12-LPR), as evaluated by RSI and videolaryngostroboscopy. Such questionnaire represents a new tool that could be applied to singers with symptoms suggestive of LPR to select which patients would benefit from a further phoniatric and videolaryngostroboscopic evaluation.
本研究旨在开发一种新的工具，用于评估自我报告有喉咽反流（LPR）症状的歌手（SVHI-12-LPR），通过在 163 名受试者（包括专业和业余歌手）的人群样本中，将 RSI 与 SVHI 相关联进行评估，这些受试者还接受了频闪喉镜检查。这是一项横断面、双观察研究。
对 159 名歌手（业余歌手、歌唱学生和专业歌手）进行 RSI 和 SVHI 评估。所有受试者均接受频闪喉镜检查，以客观地识别出四个亚组：正常受试者（41.5%）、占据声门空间的器质性病变受试者（17.6%）、功能性发声障碍受试者（18.2%）和仅表现出 LPR 体征的受试者（22.6%）。使用经过验证的 RSI 阈值，33.9%的参与者的 RSI 总分>13，提示存在 LPR。
在频闪喉镜下疑似诊断为 LPR 的受试者的 RSI 均值明显高于其他亚组（p < 0.001）。此外，病理性亚组之间的 SVHI-36 评分无统计学差异。RSI 与 SVHI 总分之间存在显著的正相关关系（Spearman 秩相关系数 [ρ] = 0.474，p < 0.001）。12 项 SVHI 条目（条目 1、2、4、5、6、7、12、20、24、25、26、30）与 RSI 病理分类显著相关。统计分析表明，对于 12 项选定条目（SVHI-12-LPR），对于疑似 LPR 的诊断具有可接受的特异性（0.691）和敏感性（0.833），其截断值为 15。
从 SVHI-36 中提取了 12 项与 RSI 和频闪喉镜评估的 LPR 对歌手嗓音的特定影响相关的条目（SVHI-12-LPR）。该问卷是一种新的工具，可用于评估有 LPR 症状的歌手，以选择哪些患者将受益于进一步的嗓音科和频闪喉镜评估。
