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Published in: European Archives of Oto-Rhino-Laryngology 6/2018

01-06-2018 | Laryngology

Gender differences in the presentation of dysphonia related to laryngopharyngeal reflux disease: a case-control study

Authors: Jérôme R. Lechien, Kathy Huet, Mohamad Khalife, Anne-Françoise Fourneau, Camille Finck, Véronique Delvaux, Myriam Piccaluga, Bernard Harmegnies, Sven Saussez

Published in: European Archives of Oto-Rhino-Laryngology | Issue 6/2018

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Abstract

Objective

To investigate the voice quality impairments in patients with laryngopharyngeal reflux (LPR) according to the gender.

Design

Controlled multi-center study.

Materials and methods

80 LPR patients (40 males and 40 females) with reflux finding score (RFS) > 7 and reflux symptom index (RSI) > 13 were included and clinically compared according to gender. To be considered as LPR patients, subjects responded to an empiric therapeutic trial based on pantoprazole intake and diet recommendations for 3 months or had positive pH/Impedance metry. Voice Handicap Index (VHI); Short Form Healthy Survey 36 (SF36), blinded Grade, Roughness, Breathiness, Asthenia, Strain and Instability (GRBASI); aerodynamic and acoustic measurements were assessed in all patients and compared with 80 healthy controls (40 males and 40 females) according to gender.

Results

The most common reasons for the consultation were, respectively, globus sensation in males (22.5%) and dysphonia (27.5%) in female who complained more of breathing difficulties and choking episodes related to LPR than males (p = 0.024). From a quality of life standpoint, female had increased significant impact of LPR disease on vitality and mental health than male. Compared to healthy subjects, both LPR male and female patients had stronger values of G, R, B, S, I, VHI, percent jitter, percent shimmer, and soft palate index than controls. In addition, LPR female had stronger values of lowest fundamental frequency and all aerodynamic measurements than controls.

Conclusion

As showed in many other laryngeal conditions, voice quality of female could be more impaired by LPR than male. Some anatomical, histological and functional factors can be suspected and need additional future researches.
Literature
1.
go back to reference Koufman JA, Aviv JE, Casiano RR, Shaw GY (2002) Laryngopharyngeal reflux: position statement of the committee on speech, voice, and swallowing disorders of the American Academy of Otolaryngology-Head and Neck Surgery. Otolaryngol Head Neck Surg 127(1):32–35CrossRefPubMed Koufman JA, Aviv JE, Casiano RR, Shaw GY (2002) Laryngopharyngeal reflux: position statement of the committee on speech, voice, and swallowing disorders of the American Academy of Otolaryngology-Head and Neck Surgery. Otolaryngol Head Neck Surg 127(1):32–35CrossRefPubMed
2.
go back to reference Sen P, Georgalas C, Bhattacharyya AK (2006) A systematic review of the role of proton pump inhibitors for symptoms of laryngopharyngeal reflux. Clin Otolaryngol 31(1):20–24 (discussion 24) CrossRefPubMed Sen P, Georgalas C, Bhattacharyya AK (2006) A systematic review of the role of proton pump inhibitors for symptoms of laryngopharyngeal reflux. Clin Otolaryngol 31(1):20–24 (discussion 24) CrossRefPubMed
3.
go back to reference Jin BJ, Lee YS, Jeong SW, Jeong JH, Lee SH, Tae K (2008) Change of acoustic parameters before and after treatment in laryngopharyngeal reflux patients. Laryngoscope 118(5):938–941CrossRefPubMed Jin BJ, Lee YS, Jeong SW, Jeong JH, Lee SH, Tae K (2008) Change of acoustic parameters before and after treatment in laryngopharyngeal reflux patients. Laryngoscope 118(5):938–941CrossRefPubMed
4.
go back to reference Lee YS, Choi SH, Son YI, Park YH, Kim SY, Nam SY (2011) Prospective, observational study using rabeprazole in 455 patients with laryngopharyngeal reflux disease. Eur Arch Otorhinolaryngol 268(6):863–869CrossRefPubMed Lee YS, Choi SH, Son YI, Park YH, Kim SY, Nam SY (2011) Prospective, observational study using rabeprazole in 455 patients with laryngopharyngeal reflux disease. Eur Arch Otorhinolaryngol 268(6):863–869CrossRefPubMed
5.
go back to reference Lechien JR, Finck C, Huet K, Khalife M, Fourneau AF, Delvaux V, Piccaluga M, Harmegnies B, Saussez S (2017) Impact of age on laryngopharyngeal reflux disease presentation: a multi-center prospective study. Eur Arch Otorhinolaryngol 274(10):3687–3696CrossRefPubMed Lechien JR, Finck C, Huet K, Khalife M, Fourneau AF, Delvaux V, Piccaluga M, Harmegnies B, Saussez S (2017) Impact of age on laryngopharyngeal reflux disease presentation: a multi-center prospective study. Eur Arch Otorhinolaryngol 274(10):3687–3696CrossRefPubMed
6.
go back to reference Koufman JA (1991) The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope 101(4 Pt 2 Suppl 53):1–78CrossRefPubMed Koufman JA (1991) The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope 101(4 Pt 2 Suppl 53):1–78CrossRefPubMed
7.
go back to reference Ross JA, Noordzji JP, Woo P (1998) Voice disorders in patients with suspected laryngo-pharyngeal reflux disease. J Voice 12(1):84–88CrossRefPubMed Ross JA, Noordzji JP, Woo P (1998) Voice disorders in patients with suspected laryngo-pharyngeal reflux disease. J Voice 12(1):84–88CrossRefPubMed
8.
go back to reference Pribuisiene R, Uloza V, Kupcinskas L, Jonaitis L (2006) Perceptual and acoustic characteristics of voice changes in reflux laryngitis patients. J Voice 20(1):128–136CrossRefPubMed Pribuisiene R, Uloza V, Kupcinskas L, Jonaitis L (2006) Perceptual and acoustic characteristics of voice changes in reflux laryngitis patients. J Voice 20(1):128–136CrossRefPubMed
9.
go back to reference Oguz H, Tarhan E, Korkmaz M et al (2007) Acoustic analysis findings in objective laryngopharyngeal reflux patients. J Voice 21(2):203–210CrossRefPubMed Oguz H, Tarhan E, Korkmaz M et al (2007) Acoustic analysis findings in objective laryngopharyngeal reflux patients. J Voice 21(2):203–210CrossRefPubMed
10.
go back to reference Akyildiz S, Ogut F, Varis A, Kirazli T, Bor S (2012) Impact of laryngeal findings on acoustic parameters of patients with laryngopharyngeal reflux. ORL J Otorhinolaryngol Relat Spec 74(4):215–219CrossRef Akyildiz S, Ogut F, Varis A, Kirazli T, Bor S (2012) Impact of laryngeal findings on acoustic parameters of patients with laryngopharyngeal reflux. ORL J Otorhinolaryngol Relat Spec 74(4):215–219CrossRef
11.
go back to reference Kumar R, Bhat JS (2008) Aerodynamic analysis of voice in persons with laryngopharyngeal reflux. Online J Health Allied Scs 7(4):5 Kumar R, Bhat JS (2008) Aerodynamic analysis of voice in persons with laryngopharyngeal reflux. Online J Health Allied Scs 7(4):5
12.
go back to reference Naunheim MR, Carroll TL (2017) Benign vocal fold lesions: update on nomenclature, cause, diagnosis, and treatment. Curr Opin Otolaryngol Head Neck Surg 25(6):453–458CrossRefPubMed Naunheim MR, Carroll TL (2017) Benign vocal fold lesions: update on nomenclature, cause, diagnosis, and treatment. Curr Opin Otolaryngol Head Neck Surg 25(6):453–458CrossRefPubMed
13.
go back to reference Kantas I, Balatsouras DG, Kamargianis N, Katotomichelakis M, Riga M, Danielidis V (2009) The influence of laryngopharyngeal reflux in the healing of laryngeal trauma. Eur Arch Otorhinolaryngol 266(2):253–259CrossRefPubMed Kantas I, Balatsouras DG, Kamargianis N, Katotomichelakis M, Riga M, Danielidis V (2009) The influence of laryngopharyngeal reflux in the healing of laryngeal trauma. Eur Arch Otorhinolaryngol 266(2):253–259CrossRefPubMed
14.
go back to reference Martins RH, do Amaral HA, Tavares EL, Martins MG, Gonçalves TM, Dias NH (2016) Voice Disorders Etiol Diagn. J Voice 30(6):761.e1–761.e9CrossRef Martins RH, do Amaral HA, Tavares EL, Martins MG, Gonçalves TM, Dias NH (2016) Voice Disorders Etiol Diagn. J Voice 30(6):761.e1–761.e9CrossRef
15.
go back to reference Herrington-Hall BL, Lee L, Stemple JC, Niemi KR, McHone MM (1988) Description of laryngeal pathologies by age, sex, and occupation in a treatment-seeking sample. J Speech Hear Disord 53(1):57–64CrossRefPubMed Herrington-Hall BL, Lee L, Stemple JC, Niemi KR, McHone MM (1988) Description of laryngeal pathologies by age, sex, and occupation in a treatment-seeking sample. J Speech Hear Disord 53(1):57–64CrossRefPubMed
16.
go back to reference Van Houtte E, Van Lierde K, Claeys S (2011) Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge. J Voice 25(2):202–207CrossRefPubMed Van Houtte E, Van Lierde K, Claeys S (2011) Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge. J Voice 25(2):202–207CrossRefPubMed
17.
go back to reference Zhukhovitskaya A, Battaglia D, Khosla SM, Murry T, Sulica L (2015) Gender and age in benign vocal fold lesions. Laryngoscope 125(1):191–196CrossRefPubMed Zhukhovitskaya A, Battaglia D, Khosla SM, Murry T, Sulica L (2015) Gender and age in benign vocal fold lesions. Laryngoscope 125(1):191–196CrossRefPubMed
18.
go back to reference Belafsky PC, Postma GN, Koufman JA (2001) The validity and reliability of the reflux finding score (RFS). Laryngoscope 111(8):1313–1317CrossRefPubMed Belafsky PC, Postma GN, Koufman JA (2001) The validity and reliability of the reflux finding score (RFS). Laryngoscope 111(8):1313–1317CrossRefPubMed
19.
go back to reference Belafsky PC, Postma GN, Koufman JA (2002) Validity and reliability of the reflux symptom index (RSI). J Voice 16(2):274–277CrossRefPubMed Belafsky PC, Postma GN, Koufman JA (2002) Validity and reliability of the reflux symptom index (RSI). J Voice 16(2):274–277CrossRefPubMed
20.
go back to reference Lechien JR, Huet K, Finck C, Khalife M, Fourneau AF, Delvaux V, Piccaluga M, Harmegnies B, Saussez S (2017) Validity and reliability of a French version of reflux symptom index. J Voice 31(4):512.e1–512.e7CrossRef Lechien JR, Huet K, Finck C, Khalife M, Fourneau AF, Delvaux V, Piccaluga M, Harmegnies B, Saussez S (2017) Validity and reliability of a French version of reflux symptom index. J Voice 31(4):512.e1–512.e7CrossRef
21.
go back to reference Lechien JR, Harmegnies B, Saussez S (2018) Reply to the letter “Laryngopharyngeal reflux disease in the elderly”. Eur Arch Otorhinolaryngol 275(1):317–318CrossRefPubMed Lechien JR, Harmegnies B, Saussez S (2018) Reply to the letter “Laryngopharyngeal reflux disease in the elderly”. Eur Arch Otorhinolaryngol 275(1):317–318CrossRefPubMed
22.
go back to reference Lin CC, Wang YY, Wang KL, Lien HC, Liang MT, Yen TT, Wang JP, Liu SA, Wang CC (2009) Association of heartburn and laryngopharyngeal symptoms with endoscopic reflux esophagitis, smoking, and drinking. Otolaryngol Head Neck Surg v141(2):264–271CrossRef Lin CC, Wang YY, Wang KL, Lien HC, Liang MT, Yen TT, Wang JP, Liu SA, Wang CC (2009) Association of heartburn and laryngopharyngeal symptoms with endoscopic reflux esophagitis, smoking, and drinking. Otolaryngol Head Neck Surg v141(2):264–271CrossRef
23.
go back to reference Chen L, Lai Y, Dong L, Kang S, Chen X (2017) Polysaccharides from Citrus grandis L. Osbeck suppress inflammation and relieve chronic pharyngitis. Microb Pathog 113:365–371CrossRefPubMed Chen L, Lai Y, Dong L, Kang S, Chen X (2017) Polysaccharides from Citrus grandis L. Osbeck suppress inflammation and relieve chronic pharyngitis. Microb Pathog 113:365–371CrossRefPubMed
24.
25.
go back to reference Gupta N, Green RW, Megwalu UC (2016) Evaluation of a laryngopharyngeal reflux management protocol. Am J Otolaryngol 37(3):245–250CrossRefPubMed Gupta N, Green RW, Megwalu UC (2016) Evaluation of a laryngopharyngeal reflux management protocol. Am J Otolaryngol 37(3):245–250CrossRefPubMed
26.
go back to reference Berg M, Fuchs M, Wirkner K, Loeffler M, Engel C, Berger T (2017) The speaking voice in the general population: normative data and associations to sociodemographic and lifestyle factors. J Voice 31(2):257.e13–257.e24CrossRef Berg M, Fuchs M, Wirkner K, Loeffler M, Engel C, Berger T (2017) The speaking voice in the general population: normative data and associations to sociodemographic and lifestyle factors. J Voice 31(2):257.e13–257.e24CrossRef
27.
go back to reference Xue SA, Fucci D (2000) Effects of race and sex on acoustic features of voice analysis. Percept Mot Skills 91(3 Pt 1):951–958CrossRefPubMed Xue SA, Fucci D (2000) Effects of race and sex on acoustic features of voice analysis. Percept Mot Skills 91(3 Pt 1):951–958CrossRefPubMed
28.
go back to reference Gorham-Rowan MM, Laures-Gore J (2006) Acoustic-perceptual correlates of voice quality in elderly men and women. J Commun Disord 39(3):171–184CrossRefPubMed Gorham-Rowan MM, Laures-Gore J (2006) Acoustic-perceptual correlates of voice quality in elderly men and women. J Commun Disord 39(3):171–184CrossRefPubMed
29.
go back to reference Woisard V, Bodin S, Puech M (2004) The Voice Handicap Index: impact of the translation in French on the validation. Rev Laryngol Otol Rhinol (Bord) 125(5):307–312 Woisard V, Bodin S, Puech M (2004) The Voice Handicap Index: impact of the translation in French on the validation. Rev Laryngol Otol Rhinol (Bord) 125(5):307–312
30.
go back to reference Perneger TV, Leplège A, Etter JF, Rougemont A (1995) Validation of a French-language version of the MOS 36-Item Short Form Health Survey (SF-36) in young healthy adults. J Clin Epidemiol 48(8):1051–1060CrossRefPubMed Perneger TV, Leplège A, Etter JF, Rougemont A (1995) Validation of a French-language version of the MOS 36-Item Short Form Health Survey (SF-36) in young healthy adults. J Clin Epidemiol 48(8):1051–1060CrossRefPubMed
31.
go back to reference Braun L (2005) Spirometry, measurement, and race in the nineteenth century. J Hist Med Allied Sci 60(2):135–169CrossRefPubMed Braun L (2005) Spirometry, measurement, and race in the nineteenth century. J Hist Med Allied Sci 60(2):135–169CrossRefPubMed
32.
go back to reference Lechien JR, Delvaux V, Huet K et al (2017) phonetic approaches of laryngopharyngeal reflux disease: a prospective study. J Voice 31(1):119.e11–119.e20CrossRef Lechien JR, Delvaux V, Huet K et al (2017) phonetic approaches of laryngopharyngeal reflux disease: a prospective study. J Voice 31(1):119.e11–119.e20CrossRef
33.
go back to reference Lechien JR, Saussez S, Harmegnies B, Finck C, Burns JA (2017) Laryngopharyngeal reflux and voice disorders: a multifactorial model of etiology and pathophysiology. J Voice 31(6):733–752CrossRef Lechien JR, Saussez S, Harmegnies B, Finck C, Burns JA (2017) Laryngopharyngeal reflux and voice disorders: a multifactorial model of etiology and pathophysiology. J Voice 31(6):733–752CrossRef
34.
go back to reference Butler JE, Hammond TH, Gray SD (2001) Gender-related differences of hyaluronic acid distribution in the human vocal fold. Laryngoscope 111(5):907–911CrossRefPubMed Butler JE, Hammond TH, Gray SD (2001) Gender-related differences of hyaluronic acid distribution in the human vocal fold. Laryngoscope 111(5):907–911CrossRefPubMed
35.
go back to reference Lechien JR, Finck C, Costa de Araujo P et al (2017) Voice outcomes of laryngopharyngeal reflux treatment: a systematic review of 1483 patients. Eur Arch Otorhinolaryngol 274(1):1–23CrossRefPubMed Lechien JR, Finck C, Costa de Araujo P et al (2017) Voice outcomes of laryngopharyngeal reflux treatment: a systematic review of 1483 patients. Eur Arch Otorhinolaryngol 274(1):1–23CrossRefPubMed
36.
go back to reference Roy N, Tanner K, Gray SD, Blomgren M, Fisher KV (2003) An evaluation of the effects of three laryngeal lubricants on phonation threshold pressure (PTP). J Voice 17(3):331–342CrossRefPubMed Roy N, Tanner K, Gray SD, Blomgren M, Fisher KV (2003) An evaluation of the effects of three laryngeal lubricants on phonation threshold pressure (PTP). J Voice 17(3):331–342CrossRefPubMed
37.
go back to reference Yamauchi A, Yokonishi H, Imagawa H et al (2014) Age- and gender-related difference of vocal fold vibration and glottal configuration in normal speakers: analysis with glottal area waveform. J Voice 28(5):525–531CrossRefPubMed Yamauchi A, Yokonishi H, Imagawa H et al (2014) Age- and gender-related difference of vocal fold vibration and glottal configuration in normal speakers: analysis with glottal area waveform. J Voice 28(5):525–531CrossRefPubMed
38.
go back to reference Dejonckere PH, Kob M (2009) Pathogenesis of vocal fold nodules: new insights from a modelling approach. Folia Phoniatr Logop 61(3):171–179CrossRefPubMed Dejonckere PH, Kob M (2009) Pathogenesis of vocal fold nodules: new insights from a modelling approach. Folia Phoniatr Logop 61(3):171–179CrossRefPubMed
39.
go back to reference Patel AK, Mildenhall NR, Kim W, Carroll TL (2014) Symptom overlap between laryngopharyngeal reflux and glottic insufficiency in vocal fold atrophy patients. Ann Otol Rhinol Laryngol 123(4):265–270CrossRefPubMed Patel AK, Mildenhall NR, Kim W, Carroll TL (2014) Symptom overlap between laryngopharyngeal reflux and glottic insufficiency in vocal fold atrophy patients. Ann Otol Rhinol Laryngol 123(4):265–270CrossRefPubMed
40.
go back to reference Lechien JR, Huet K, Khalife M, Fourneau AF, Delvaux V, Piccaluga M, Harmegnies B, Saussez S (2016) Impact of laryngopharyngeal reflux on subjective and objective voice assessments: a prospective study. J Otolaryngol Head Neck Surg 45(1):59CrossRefPubMedPubMedCentral Lechien JR, Huet K, Khalife M, Fourneau AF, Delvaux V, Piccaluga M, Harmegnies B, Saussez S (2016) Impact of laryngopharyngeal reflux on subjective and objective voice assessments: a prospective study. J Otolaryngol Head Neck Surg 45(1):59CrossRefPubMedPubMedCentral
41.
go back to reference Beaver ME, Stasney CR, Weitzel E, Stewart MG, Dono- van DT, Parke RB Jr, Rodriguez M (2003) Diagnosis of laryngopharyngeal reflux disease with digital imaging. Otolaryngol Head Neck Surg 128:103–108CrossRefPubMed Beaver ME, Stasney CR, Weitzel E, Stewart MG, Dono- van DT, Parke RB Jr, Rodriguez M (2003) Diagnosis of laryngopharyngeal reflux disease with digital imaging. Otolaryngol Head Neck Surg 128:103–108CrossRefPubMed
42.
go back to reference Wiener GJ, Koufman JA, Wu WC, Cooper JB, Richter JE, Castell DO (1989) Chronic hoarseness secondary to gastroesophageal reflux disease: documentation with 24-H ambulatory pH monitoring. Am J Gastroenterol 84:1503–1508PubMed Wiener GJ, Koufman JA, Wu WC, Cooper JB, Richter JE, Castell DO (1989) Chronic hoarseness secondary to gastroesophageal reflux disease: documentation with 24-H ambulatory pH monitoring. Am J Gastroenterol 84:1503–1508PubMed
43.
go back to reference Shaw GY, Searl JP, Young JL, Miner PB (1996) Subjective, laryngoscopic, and acoustic measurements of laryngeal reflux before and after treatment with omeprazole. J Voice 10:410–418CrossRefPubMed Shaw GY, Searl JP, Young JL, Miner PB (1996) Subjective, laryngoscopic, and acoustic measurements of laryngeal reflux before and after treatment with omeprazole. J Voice 10:410–418CrossRefPubMed
44.
go back to reference Noordzij JP, Khidr A, Desper E, Meek RB, Reibel JF, Levine PA (2002) Correlation of pH probe-measured laryngopharyngeal reflux with symptoms and signs of reflux laryngitis. Laryngoscope 112(12):2192–2195CrossRefPubMed Noordzij JP, Khidr A, Desper E, Meek RB, Reibel JF, Levine PA (2002) Correlation of pH probe-measured laryngopharyngeal reflux with symptoms and signs of reflux laryngitis. Laryngoscope 112(12):2192–2195CrossRefPubMed
45.
go back to reference Sataloff RT, Hawkshaw MJ, Gupta R (2010) Laryngopharyngeal reflux and voice disorders: an overview on disease mechanisms, treatments, and research advances. Discov Med 10(52):213–224PubMed Sataloff RT, Hawkshaw MJ, Gupta R (2010) Laryngopharyngeal reflux and voice disorders: an overview on disease mechanisms, treatments, and research advances. Discov Med 10(52):213–224PubMed
46.
go back to reference Wan Y, Yan Y, Ma F et al (2014) LPR: how different diagnostic tools shape the outcomes of treatment. J Voice 28(3):362–368CrossRefPubMed Wan Y, Yan Y, Ma F et al (2014) LPR: how different diagnostic tools shape the outcomes of treatment. J Voice 28(3):362–368CrossRefPubMed
Metadata
Title
Gender differences in the presentation of dysphonia related to laryngopharyngeal reflux disease: a case-control study
Authors
Jérôme R. Lechien
Kathy Huet
Mohamad Khalife
Anne-Françoise Fourneau
Camille Finck
Véronique Delvaux
Myriam Piccaluga
Bernard Harmegnies
Sven Saussez
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 6/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-4951-2

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