title: Allergic laryngitis as a cause of dysphonia: a preliminary report.
abstract: OBJECTIVE
  To investigate the relationship between air-borne allergen exposure and Voice Handicap Index scores in patients seeking medical treatment for rhinitis.
  
  
  METHODS
  As we had previously identified a higher-than-expected incidence of allergy in patients presenting to a voice clinic, we undertook a prospective audit of patients without specific voice-related complaints presenting to a rhinology clinic to see if these patients might have unrecognized vocal dysfunction. To this end 70 consecutive patients with no pre-reported voice-related symptoms presenting to a teaching hospital rhinology clinic underwent skin prick testing to common air-borne allergens and completed the Voice Handicap Index (VHI) questionnaire. Discriminant performances in the Voice Handicap Index and its individual domains and questions were determined using analysis of variance. An allergy-specific subset of the VHI was constructed and tested using receiver operating characteristic (ROC) statistics.
  
  
  RESULTS
  There were 30 males and 40 females. Mean age was 36 ± 12 years. Dust mite (83%), house dust mite (55%), and grass pollen (40%) were the commonest allergens, and 23 patients did not react to common allergens. Mean VHI score was 23.7 ± 20.1 in patients with ≥ 4 allergens, 10.8 ± 21.3 in patients with fewer than 4 allergies, and 7.8 ± 8.5 in non-allergics (P = 0.044; analysis of variance). Nine VHI questions best discriminated between allergic and non-allergic patients (P < 0.05), and the combined VHI-9 score had a ROC area under the curve of 0.85.
  
  
  CONCLUSIONS
  Patients with more air-borne allergies have a higher incidence of undiagnosed vocal dysfunction, as determined by the raised Voice Handicap Index score, than those with fewer or no such allergies. As noted, earlier work has shown that, conversely, patients with vocal dysfunction have a high incidence of undiagnosed allergy.
authors: The Royal National Throat Nose and Ear Hospital, London, UK.
authors: Premjit S
authors: PS
authors: Randhawa
authors: Sar
authors: S
authors: Nouraei
authors: Shaji
authors: S
authors: Mansuri
authors: John S
authors: JS
authors: Rubin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D016002:Discriminant Analysis; D055154:Dysphonia / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000175:diagnosis; D019570:Inhalation Exposure; D007428:Intradermal Tests; D007827:Laryngitis / Q000150:complications* / Q000175:diagnosis; D008131:London; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000485:Allergens