Impact of laryngopharyngeal reflux on subjective and objective voice assessments: a prospective study.
BACKGROUND
Laryngopharyngeal reflux is a prevalent, not well-understood disease affecting a high proportion of patients who seek laryngology consultation. The objective of this prospective case series is to explore the subjective and objective voice modifications in Laryngopharyngeal reflux (LPR), especially the usefulness of acoustic parameters as treatment outcomes, and to better understand the pathophysiological mechanisms underlying the development of voice disorder.


METHODS
Forty-one patients with a reflux finding score (RFS) > 7 and a reflux symptom index (RSI) > 13 were enrolled and treated with pantoprazole 20 mg twice daily for three months. RSI, RFS, Voice Handicap Index (VHI), and Grade, Roughness, Breathiness, Asthenia, Strain and Instability (GRBASI) were assessed at baseline and after three months post-therapy. Acoustic parameters were measured by selecting the most stable interval of the vowel /a/. A study of correlations between acoustic measurements and laryngoscopic signs was conducted in patients with roughness. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS).


RESULTS
Significant improvement in RSI, RFS, VHI, jitter, percent jitter, relative average perturbation (RAP), shimmer, percent shimmer, and amplitude perturbation quotient (APQ) was found at 3 months of treatment (p < .05). A correlation analysis revealed significant correlations between the grade of dysphonia, breathiness, asthenia, instability and jitter, percent jitter, RAP, shimmer, percent shimmer and APQ. In dividing our cohort into two groups of patients according to the presence of roughness, shimmer, percent shimmer and APQ significantly improved in patients with roughness, but no positive correlation was found between acoustic parameters and laryngoscopic signs.


CONCLUSIONS
Acoustic parameters can help to better understand voice disorders in LPR and can be used as treatment outcomes in patients with roughness.
Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Avenue du Champ de mars, 6, B7000, Mons, Belgium. jerome.lechien@umons.ac.be.|Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons, Belgium. jerome.lechien@umons.ac.be.|Department of Otorhinolaryngology and Head and Neck Surgery, RHMS Baudour, EpiCURA Hospital, Baudour, Belgium. jerome.lechien@umons.ac.be.
Jérôme R
JR
Lechien
Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons, Belgium.
Kathy
K
Huet
Department of Otorhinolaryngology and Head and Neck Surgery, RHMS Baudour, EpiCURA Hospital, Baudour, Belgium.
Mohamad
M
Khalife
Department of Otorhinolaryngology and Head and Neck Surgery, RHMS Baudour, EpiCURA Hospital, Baudour, Belgium.
Anne-Françoise
AF
Fourneau
Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons, Belgium.
Véronique
V
Delvaux
Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons, Belgium.
Myriam
M
Piccaluga
Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons, Belgium.
Bernard
B
Harmegnies
Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Avenue du Champ de mars, 6, B7000, Mons, Belgium.|Department of Otorhinolaryngology and Head and Neck Surgery, RHMS Baudour, EpiCURA Hospital, Baudour, Belgium.
Sven
S
Saussez
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D000077402:Pantoprazole; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014832:Voice Disorders / Q000209:etiology* / Q000503:physiopathology; D014833:Voice Quality
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D000077402:Pantoprazole
Laryngopharyngeal reflux; Reflux laryngitis; Subjective and objective assessment; Voice