Cause Of Dysphonia Research Articles

Dysphonia in children

Abstract Dysphonia is a frequent symptom in paediatric patients and it has a prevalence between 6 - 24%. In young patients, dysphonia has a direct importance because it impairs their communicative behaviour, their psychological status and also their social life. The most diagnosed voice pathologies in children are vocal nodules followed by vocal cord cysts, infectious and inflammatory causes, sulcus vocalis, laryngeal membranes, iatrogenic vocal cord paralysis, neurological causes, psychogenic factors, traumatic or irritative factors or, less commonly, laryngeal neoplasms. A correct diagnosis of dysphonia in paediatric patients is important for learning, voice training and their psychological development. Children with dysphonia have to be assessed with adequate equipment. It is recommended to use tools that are appropriate to the tolerance and cooperation of the patients and allow to have a good visualization of the vocal folds. Suitable preventive methods, early diagnosis, appropriate treatment of voice disorders should be taken into consideration in these cases. In this article, some of the most frequent causes of dysphonia in paediatric patients and their treatment options in order to achieve a proper voice are reviewed.

A Study on Vocal Attack During Voice Therapy Exercises Using Photoglottography

ObjectiveThere are various exercises for voice therapy, but current evidence is insufficient to decide the most effective training technique for each type of dysphonia. This study focused on vocal attack as one of the causes of dysphonia. Hence, vocal attack during voice therapy exercises was investigated using photoglottogram (PGG). MethodsEighteen healthy adult subjects (10 males and 8 females) were included in this study. The first to fifth vocal waves during natural voice, hard and soft voice onset, and semi-occluded vocal tract exercises (SOVTE: humming, tubing, and lip trill) were assessed. We also calculated the 25% vocal fold open quotient (OQ) using a PGG and compared these parameters. ResultsThe 25% OQ did not show any sex-related differences. In the first wave, the 25% OQ for hard attack was significantly lower than that for soft attack, tongue out humming, and lip trill. In contrast, the 25% OQ value for soft attack was significantly higher than that for humming, 6 mm tube phonation, and lip trill. The 25% OQ values differed between SOVTE procedures; it was higher for the 13 mm tube phonation than for the 6 mm tube phonation. The 25% OQ at voice onset in the first to fifth waves differed depending on the SOVTE technique, indicating different voice onset patterns. ConclusionsThese results suggest that appropriate selection of SOVTE tailored for each patient may have benefit in further voice improvement. Future research should focus on conducting a similar study on patients with dysphonia.

Speaking without vocal folds using a machine-learning-assisted wearable sensing-actuation system

Voice disorders resulting from various pathological vocal fold conditions or postoperative recovery of laryngeal cancer surgeries, are common causes of dysphonia. Here, we present a self-powered wearable sensing-actuation system based on soft magnetoelasticity that enables assisted speaking without relying on the vocal folds. It holds a lightweighted mass of approximately 7.2 g, skin-alike modulus of 7.83 × 105 Pa, stability against skin perspiration, and a maximum stretchability of 164%. The wearable sensing component can effectively capture extrinsic laryngeal muscle movement and convert them into high-fidelity and analyzable electrical signals, which can be translated into speech signals with the assistance of machine learning algorithms with an accuracy of 94.68%. Then, with the wearable actuation component, the speech could be expressed as voice signals while circumventing vocal fold vibration. We expect this approach could facilitate the restoration of normal voice function and significantly enhance the quality of life for patients with dysfunctional vocal folds.

A Systematic Review of Speech-Language Pathology Interventions for Presbyphonia Using the Rehabilitation Treatment Specification System

BackgroundThe prevalence of voice disorders for people over the age of 65 is 4× higher than for the population at large. The most common cause of dysphonia in this group is presbyphonia, the preferred first-line treatment for which is voice therapy with a speech-language pathologist. This systematic review seeks to identify how voice therapy affects multidimensional voice outcomes in people with presbyphonia. MethodsA systematic search of CINAHL, Embase, Emcare, MEDLINE and Google Scholar was undertaken in March 2023. Comparative and non-comparative studies of voice therapy in participants over 50 years with presbyphonia were considered for inclusion. No limitations were placed on date or language of publication. Study quality and risk of bias were assessed with the Cochrane Risk of Bias 2 (RoB 2) tool and the Methodological Index for Non-Randomized Studies (MINORS). Subgroup analysis was used to compare studies based on participant sex, intervention duration, study design and intervention content. Interventions were specified using the Rehabilitation Treatment Specification System (RTSS) employing a consensus methodology among reviewers. Results were synthesized utilizing metanalysis when outcomes were adequately specified, and narrative analysis when they were not. Results23 studies were included with 1,050 subjects (mean age: 72.5 ± 8.6; 51% female). The most reported intervention was Vocal Function Exercises (VFEs). Per the RTSS, 14 interventions employed a predominantly Organ Functions approach and the 14 remaining interventions employed a Skills & Habits approach. Metanalysis confirmed post-therapy improvement in patient-related outcome measures (PROMs) of 0.93 standard mean difference (p<0.00001, 95% CI: 0.70-1.17); studies with predominantly males and with longer treatment periods were associated with larger improvements, while RCTs reported more modest improvements. Metanalysis also identified a mean post-therapy increase in maximum phonation time (MPT) of 5.37 seconds (p<0.00001, 95% CI: 3.52-7.22). Treatments with an Organ Functions focus resulted in greater gains in MPT than those with a Skills & Habits focus (7.52 s vs. 2.90 s). Finally, metanalysis identified reductions in acoustic perturbation measures (jitter: 0.62%, p<0.001, 95% CI: 0.26-0.97%; shimmer 1.05%, p<0.00001, 95% CI: 0.67-1.44%). Narrative synthesis further identified improvement in auditory-perceptual voice quality in all active treatment groups as well as improved glottal function in most studies which reported this. ConclusionsDespite the uncertainty around internal validity introduced by the inclusion of a wide range of study designs, there is convincing evidence that voice therapy for presbyphonia results in significant improvement in patient-reported, aerodynamic, acoustic, and expert-rated voice outcomes. Treatments with an Organ Functions focus may better address the underlying physiological deficits of presbyphonia, although future comparative studies with multidimensional voice assessment are warranted.

Surgical management of vocal cord nodules in children: Trends and outcomes

ObjectivesVocal cord nodules (VCNs) are the most common cause of dysphonia in school-aged children, with potential negative impacts on quality of life including diminished self-esteem and academic performance. The standard of care for VCNs is conservative management which ranges from voice hygiene to speech therapy with a focus on voice otherwise known as voice therapy, with surgical excision reserved for refractory cases. Thus, few studies have analyzed outcomes of surgical management of VCNs. The purpose of this study is to assess the prevalence and efficacy of surgical excision of VCNs when compared to speech therapy. MethodsChildren with VCNs seen at a single tertiary care institution between 2015 and 2020 were identified by ICD-9 code 478.5 and ICD-10 code J38.2. Demographics, objective voice assessment, intervention, and follow-up assessment data were reviewed. Frequencies, medians, and interquartile ranges were calculated. Time to resolution and improvement were assessed by Cox proportional hazards model. Univariate logistic regression was performed. A P value of <0.05 was considered statistically significant. ResultsThree hundred sixty-eight patients diagnosed with VCNs were identified. 169 patients received intervention for VCNs, with 159 (43.2 %) receiving speech therapy alone and 5 (1.4 %) receiving surgery alone. On bivariate analysis, there was no significant difference in demographic features between treatment groups, however speech therapy patients did have a longer follow-up time. 154 patients underwent objective voice assessment at the time of VCN diagnosis. Among these patients, 95 (61.7 %) received speech therapy and 59 (40.3 %) received no intervention. Speech therapy patients had significantly higher pVHI scores, however there was no significant difference in CAPE-V Overall Severity scores or computerized voice assessment analysis. On Cox proportional hazards analysis, surgical intervention was associated with faster resolution and faster improvement of dysphonic symptoms. On binary logistic regression, surgery was associated with a significantly greater proportion of patients reporting resolution of dysphonic symptoms, however there was no significant difference in proportion of patients reporting improvement of dysphonia. ConclusionFor most patients with VCNs, conservative measures such as voice hygiene and speech therapy remain first line, however certain patients may benefit from the rapid improvement and resolution of symptoms that surgical intervention may provide.

Validity of Reflux Symptom Index in the Diagnosis of Laryngopharyngeal Reflux Disease

Introduction: Laryngopharyngeal reflux (LPR) is a disease, in which the diagnosis and treatment are controversial. The main objectives of this study were to assess the validity of the reflux symptom index (RSI) in patients exhibiting symptoms of LPR disease (LPRD) or gastroesophageal reflux disease (GERD). Materials and Methods: This study was a hospital-based, cross-sectional study. The study included all patients above the age of 12 years who presented to the ENT outpatient department with symptoms of LPRD or GERD. Patients who refused to give consent for the study, those who had undergone medical treatment past 6 weeks or surgical treatment for similar complaints, patients with malignancy of the hypopharynx and esophagus, patients with neurological causes of dysphonia and dysphagia, patients with a history of throat trauma or prior intubation, patients with allergies or chronic upper respiratory tract infections, and pregnant patients were excluded from the study. The variables examined in this study included age, sex, RSI, and reflux finding score. Results: The majority of patients (49.3%) with LPRD were in the age group of 31–50 years. Among the patients diagnosed with LPRD were females, only 15 patients (21.7%) diagnosed with LPRD had diabetes mellitus, only 7 patients (10.1%) had bronchial asthma, 4 patients (5.8%) diagnosed with LPRD had a history of thyroid disease, 8.7% had a history of smoking/tobacco usage addiction, and 18.8% of the patients experienced recurrent throat infection. The sensitivity was found to be 97.1%, specificity 66.7%, positive predictive value 84.8%, and negative predictive value 92.3%. The diagnostic accuracy of RSI was calculated to be 86.7%. It was found that only 46 of the 69 LPRD-positive patients (66.7%) showed symptoms suggestive of GERD. Conclusion: LPRD is predominantly a lifestyle-related disease. The fast-food lifestyle and the irregular and unhealthy spicy high acid dietary habits have led to a rapid increase in the prevalence of gastroesophageal reflux, and hence, the LPR in the general population, especially India.

Efficacy of the DoctorVox Voice Therapy Technique for the Management of Vocal Fold Nodules.

Vocal fold nodules (VFNs) are among the most common causes of dysphonia. Phono-laryngeal microsurgery, pharmacological treatments, and voice therapy (VT) have been used for treating VFNs. VT has been advocated as the primary treatment of choice. This study investigated the efficacy of the DoctorVox Voice therapy technique (DVT) for treating VFNs. A total of 38 patients with VFNs and 40 individuals without any voice problem (control group) were included. All patients received the DVT program. Otorhinolaryngology examination, videolaryngostroboscopy (VLS), and acoustic analysis (SPL, mean F0, jitter %, shimmer %, NHR) were performed at pretreatment, one and six months after the end of treatment. The voice handicap index-10 (VHI-10) and the GRB scales were used for perceptual voice evaluation. GRB and VLS scorings were done blindly. Compared with the pretreatment values, the first- and the sixth-month values after treatment demonstrated a significant decrease in VHI-10 (19.5 vs. 5.1), GRB (2.3 vs 0.68 for G value) and VLS scores, SPL (54.4 vs 66.1 dB), F0 (201 vs. 227 Hz), jitter % (1.46 vs 0.85), shimmer % (3.27 vs 2.51), NHR (1.15 vs. 0.46) values among patients. Most of the voice parameters in the sixth month after the DVT program did not differ significantly from those of the control group. The DVT was found to be an effective method in VFN treatment.

Multiple myeloma with laryngeal affectation: an uncommon cause of dysphonia

Plasma cell proliferation leads to the formation of a single tumour (plasmacytoma) or to systemic disease (myeloma). Plasma cell myeloma involving laryngeal cartilage is unusual and clinical manifestations are similar to those of laryngeal carcinoma. We report the case of a 70-year-old man with disphonia after a recent diagnosis of multiple myeloma. Radiological and immunohistochemical studies showed laryngeal involvement. The patient is currently under treatment with lenalidomide, dexamethasone, and bortezomib.

Options for treatment of a small glottic gap.

Glottic insufficiency, or glottic gap as it is commonly called, is a common cause of dysphonia, producing symptoms of soft voice, decreased projection, and vocal fatigue. The etiology of glottic gap can occur from issues related to muscle atrophy, neurologic impairment, structural abnormalities, and trauma related causes. Treatment of glottic gap can include surgical and behavioral therapies or a combination of the two. When surgery is chosen, closure of the glottic gap is the primary goal. Options for surgical management include injection medialization, thyroplasty, and other methods of medializing the vocal folds. This manuscript reviews the current literature regarding the options for treatment of glottic gap. This manuscript discusses options for treatment of glottic gap, including the indications for temporary and permanent treatment modalities; the differences between the available materials for injection medialization laryngoplasty and how they affect the vibratory function of the vocal folds and vocal outcome; and the evidence that supports an algorithm for treatment of glottic gap. 3a-Systematic review of case-control studies.

Комплексное лечение хронической патологии гортани при болезни Шегрена

Issues of voice quality and health, as the main means of communication, are becoming increasingly relevant. One of the causes of dysphonia is Sjögren’s disease. Progressive dryness of the mucous membrane of the upper respiratory tract, autoimmune disorders lead to the development of chronic pathology of the vocal apparatus. Treatment methods traditionally used for chronic pathology of the larynx do not achieve high and lasting improvement in voice quality in patients with Sjögren’s disease. The purpose of this study was to evaluate the effectiveness of the developed method of complex treatment of chronic laryngeal pathology in Sjögren’s disease. 46 patients with voice disorders associated with Sjögren’s disease were examined and treated. The patients were divided into two groups. Group I (20 patients) received treatment traditionally used for chronic laryngitis. In group II (26 patients), complex treatment was supplemented by three-stage aerosol therapy of the mucous membrane of the upper respiratory tract with saline solution sounded by low-intensity ultrasound, intranasal application of a drug containing hyaluronic acid, and light therapy to the larynx area. Based on an assessment of the dynamics of patient complaints, data from videolaryngostroboscopy, acoustic analysis of the voice, and the results of a questionnaire using a visual analogue scale for the severity of dryness of the mucous membrane of the upper respiratory tract, a comparative analysis of the results of therapy demonstrated a more striking and lasting improvement in the clinical and functional state of the larynx in patients of group II. Thus, the developed method of complex treatment of chronic pathology of the larynx in Sjögren’s disease, including three-stage aerosol therapy of the mucous membrane of the upper respiratory tract with saline solution sounded by low-intensity ultrasound, light therapy to the larynx area, and a topical preparation containing hyaluronic acid, allows achieving a pronounced positive effect with an aftereffect for 5 months.

Analysis of the Effect of Intralesional Steroid Injection on the Voice During Laryngeal Microsurgery

Background and Objectives Vocal fold (VF) scar is known to be the most common cause of dysphonia after laryngeal microsurgery (LMS). Steroids reduce postoperative scar formation by inhibiting inflammation and collagen deposition. However, the clinical evidence of whether steroids are helpful in reducing VF scar formation after LMS is still lacking. The purpose of this study is to determine whether intralesional VF steroid injection after LMS helps to reduce postoperative scar formation and voice quality.Materials and Method This study was conducted on 80 patients who underwent LMS for VF polyp, Reinke’s edema, and leukoplakia. Among them, 40 patients who underwent VF steroid injection after LMS were set as the injection group, and patients who had similar sex, age, and lesion size and who underwent LMS alone were set as the control group. In each group, stroboscopy, multi-dimensional voice program, Aerophone II, and voice handicap index (VHI) were performed before and 1 month after surgery, and the results were statistically analyzed.Results There were no statistically significant differences in the distribution of sex, age, symptom duration, occupation and smoking status between each group. Both groups consisted of VF polyp (n=21), Reinke’s edema (n=11), and leukoplakia (n=9). On stroboscopy, the lesion disappeared after surgery, and the amplitude and mucosal wave were symmetrical on both sides of the VFs in all patients. Acoustic parameters and VHI significantly improved after surgery in all patients. However, there was no significant difference between the injection and control group in most of the results.Conclusion There was no significant difference in the results of stroboscopy, acoustic, aerodynamic, and subjective evaluation before and after surgery in the injection group and the control group.

Pediatric Voice Handicap Index (pVHI): A Tool for Evaluating the Reliability and Validity of Voice Therapy in Children With Benign Vocal Fold Nodules

benign vocal fold lesions (BVFLs) represent the most common etiology of voice disorders in paediatric population, cause of dysphonia by preventing full vocal fold closure and modifying vibratory characteristics. Of those pathologies, vocal fold nodules represent almost 63% of the cases in children between 0-14 years. Management may include a combination of phonosurgery, voice therapy and pharmacological treatment, but almost 95% of otolaryngologists recommend voice therapy as primary treatment. The Pediatric Voice Handicap Index (pVHI) is nowadays widely used and accepted in the evaluation and monitoring of paediatric patients with dysphonia. The aim of our study was to demonstrate the reliability and validity of PVHI in the evaluation of the effects of voice therapy as treatment of vocal fold nodules in the paediatric population. in this retrospective chart review twenty-seven (27) dysphonic patients with bilateral vocal fold nodules were treated with behavioral voice therapy approaches, and the PVHI surveys was administered to each patient parent's before and after therapy. The age of the patients ranged from 4 to 14 years (mean age 8.7 y-o); 17 (63%) were male and 10 (37%) females. according to our results, behavioral voice therapy effectively improved pVHI scores from pre- to post-treatment in paediatric patients with bilateral vocal fold nodules.

Correlation Between a Diagnosis of Anxiety or Depression and Initial VHI-10 Scores in Benign Dysphonia.

Anxiety and depression have demonstrated a positive correlation with vocal handicap among patients with benign causes of dysphonia. Our objective is to explore differences in initial Vocal Handicap Index-10 (VHI-10) scores between patients with a mental health history of anxiety or depression and those without. Retrospective cohort study. Demographic data, diagnoses, and initial VHI-10 scores were collected for patients presenting with dysphonia to 2 tertiary laryngology clinics. A Kruskal-Wallis test and subsequent Mann-Whitney U test for pairwise comparisons were used to compare distribution of VHI-10 scores among patients with anxiety, depression, anxiety and depression, and no such conditions. Bonferroni correction was used to control for multiple comparisons. Robust regression was used for multivariable analysis. A total of 620 cases of benign dysphonia were analyzed. Forty-two percent of the patient cohort had a preexisting diagnosis of anxiety (n = 121, 20%), depression (n = 64, 10%), or anxiety and depression (n = 74, 12%). VHI-10 scores were higher in patients with depression than in those without anxiety or depression (median difference, 4 [95% CI, 1-8]; P = .005) but did not differ significantly among the other groups. The effects of depression and anxiety status on initial VHI-10 scores among the causes of benign dysphonia varied. Patients with a history of depression who presented with dysphonia had worse vocal handicap than those without anxiety/depression history. Future studies may clarify how optimization of anxiety and depression can affect patient-reported vocal handicap.

Влияние пандемии COVID-19 на заболеваемость гортани

Among the symptoms of COVID-19, scientists pay the most attention to damage to the lower respiratory tract, neurological and cardiovascular systems, gastrointestinal tract, psychoemotional disorders and anosmia. Less common are articles about the state of auditory and vestibular as well as voice disorders. Inflammatory changes of the larynx, trauma due to intubation and severe coughing, neuropathy of the recurrent laryngeal nerve, consequences of the pathology of the bronchopulmonary system, psychogenic factors are indicated as the cause of dysphonia. The purpose of our study is to determine the structure of laryngeal morbidity in voice professionals during the COVID-19 pandemic. The analysis of case histories of 2,438 patients of voice professions who applied to the phoniatric department of the Saint Petersburg Institute of Ear, Throat, Nose, and Speech was performed. The diagnosis, a history of COVID-19, dysphonia directly during COVID-19 were considered. The number of patients compared to the period before the COVID-19 decreased by 39,8% due to anti-epidemic measures. The leading causes were functional dysphonia (29,3%), acute and chronic laryngitis (27,8%). Tumor-like disease are in third place (19,1%). Paresis of the larynx (8,5%) was diagnosed less frequently compared to the period before the pandemic, which is associated with a reduction in the number of elective operations on the organs of the head and neck. The frequency of laryngeal neoplasms (4,1%) has remained at the same level, almost half of them are malignant. Congenital malformations of the larynx were found in 2,9% of patients. Vascular pathology of the vocal folds was detected in 1.1%, scar stenosis, in 0,5%, rare diseases of the larynx, in 0,6% of patients. Appeals on the other occasions accounted for 6,1% of cases. 43,7% of patient have had COVID-19. The direct connection of dysphonia with COVID-19 was revealed in 18,0% of them. The most common cause of impaired vocal function against the background of coronavirus infection were functional dysphonia (39,1%) and inflammatory diseases of the larynx (34,9%). Tumor-like disease became the next most common (17,2%). Vascular pathology of the vocal folds was found less frequently (5,2%). Unilateral vocal fold paresis was detected in 3,1% of patients. One patient suffered from chondroperichondritis with granuloma formation in the area of the arytenoid cartilage of the larynx (0,5%). In relation to the total number of examined patients, COVID-19 as the cause of dysphonia was 7,9% of cases.

Zenker Diverticulum: Does Size Correlate with Preoperative Symptoms?

Introduction Zenker diverticulum (ZD) usually affects adults after the 7 th decade of life. Treatment for ZD is indicated for all symptomatic patients, but some patients prefer to defer surgical treatment until symptoms get worse and decrease their quality of life. Objective To evaluate the association of the preoperative symptoms in ZD patients with the size of the ZD. Methods A retrospective study design. Electronic medical records were used to identify patients diagnosed with ZD and treated over 11 years. Data collection included the chief complaints and symptoms, medical history, and findings on radiologic swallow evaluations of the patients. The diverticulum size was stratified into 3 groups: small (< 1 cm), moderate (1–3 cm), and large (> 3 cm). Results A total of 165 patients were enrolled and stratified by diverticulum size (48 small, 67 medium, and 50 large). Dysphagia, cough, and regurgitation were the most prevalent symptoms. Dysphonia was more frequent among patients with a small pouch. Logistic regression analysis showed that dysphagia and choking were associated with large and medium diverticulum size ( p < 0.05 ) . Additionally, dysphonia was significantly associated with the presence of a small-sized ZD ( p < 0.04). Conclusion Upper gastrointestinal symptoms such as dysphagia and choking may be associated with a ZD > 1 cm and should always be evaluated. Additionally, the presence of dysphonia was found to be correlated with a ZD < 1 cm, suggesting that a prompt and appropriate fluoroscopic evaluation must be considered in those patients in whom no other clear cause of dysphonia is evident.

Assessment of Dysphonia in Children with Pompe Disease Using Auditory-Perceptual and Acoustic/Physiologic Methods.

Bulbar and respiratory weakness occur commonly in children with Pompe disease and frequently lead to dysarthria. However, changes in vocal quality associated with this motor speech disorder are poorly described. The goal of this study was to characterize the vocal function of children with Pompe disease using auditory-perceptual and physiologic/acoustic methods. High-quality voice recordings were collected from 21 children with Pompe disease. The Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale was used to assess voice quality and ratings were compared to physiologic/acoustic measurements collected during sustained phonation tasks, reading of a standard passage, and repetition of a short phrase at maximal volume. Based on ratings of grade, dysphonia was present in 90% of participants and was most commonly rated as mild or moderate in severity. Duration of sustained phonation tasks was reduced and shimmer was increased in comparison to published reference values for children without dysphonia. Specific measures of loudness were found to have statistically significant relationships with perceptual ratings of grade, breathiness, asthenia, and strain. Our data suggest that dysphonia is common in children with Pompe disease and primarily reflects impairments in respiratory and laryngeal function; however, the primary cause of dysphonia remains unclear. Future studies should seek to quantify the relative contribution of deficits in individual speech subsystems on voice quality and motor speech performance more broadly.

Determinant of Voice Handicap Index Degree as Dysphonia Patients’ Quality of Life Indicator

Background: Dysphonia will interfere with communication which will have an impact on social life such as depression, disrupt activities, work and can affect the quality of life. Dysphonia risk factors such as age, sex, duration of illness and etiology will affect the course of it. The purpose of this study was to identify risk factors for with the degree of Voice Handicap Index (VHI) as an indicator of dysphonia patients.Methods: Analytical descriptive study with cross-sectional design in dysphonia patients, the sample was determined as many as 62 who met the inclusion criteria. Quality of life was assessed by the VHI questionnaire. VHI degrees are classified into mild and moderate-severe. Data analysis using chi-square test and multivariate logistic regression. Results:Thirty-two (51.6%) subjects were women. Mean age was 47.26 +12.2. The most common causes of dysphonia (85.5%) were due to organic disorders and laryngopharyngeal reflux (LPR) is the most common cause (37.1%) of all organic dysphonia disorders. Analysis of risk factors for age, gender, etiology of dysphonia and duration of illness with VHI degree were p = 0.282, p =0.76, p= 0.067, p= 0.001, respectively. Duration of illness ≥2 weeks has a 38.3x risk to severity VHI compared to &lt;2 weeks. Conclusion: The duration of illness is a determinan related to of the degree of VHI that quality of life indicator in dysphonia patients.&#x0D; Key Words: Risk factors, Dysphonia, Voice Handicap Index

Antifibrotic effects of eupatilin on TGF-β1-treated human vocal fold fibroblasts.

Vocal fold scarring is a major cause of dysphonia. Vocal fold fibroblasts (VFFs) and the TGF-β signaling pathway play important roles in scar formation. Eupatilin, a chromone derivative of the Artemisia species, is a traditional folk remedy for wound healing. However, until recently, few studies investigated the therapeutic effects of eupatilin. We investigated the antifibrogenic effects of eupatilin on TGF-β1-treated human vocal fold fibroblasts (hVFFs). The optimal concentration of eupatilin was determined by a cell viability assay. Western blotting was used to measure the expression of alpha-smooth muscle actin during myofibroblast differentiation, fibronectin (FN), collagen type I (Col I), and collagen type III (Col III) extracellular matrix proteins, and Smad2, Smad3, and p38 in the fibrotic pathway. Measurements were made before and after eupatilin treatment. Eupatilin at 100 nM was shown to be safe for use in hVFFs. TGF-β1 induced hVFFs to proliferate and differentiate into myofibroblasts and increased Col III and FN synthesis in a time- and dose-dependent manner. Eupatilin suppressed TGF-β1-induced hVFF proliferation and differentiation into myofibroblasts through the Smad and p38 signaling pathways. Furthermore, eupatilin inhibited TGF-β1-induced FN, Col I, and Col III synthesis in hVFFs. Our in vitro findings show that eupatilin effectively suppressed TGF-β1-induced fibrotic changes in hVFFs via the Smad and p38 signaling pathways. Thus, eupatilin may be considered a novel therapeutic agent for the treatment of vocal fold fibrosis.

Unusual cause of dysphonia: an aortic aneurysm of syphilitic origin

Unusual cause of dysphonia: an aortic aneurysm of syphilitic origin

Дисфония — современное состояние проблемы и методы лечения

Dysphonia is a voice disorder manifesting with hoarseness, nasality, weak voice, and vocal fatigue. Being a common complaint, dysphonia is a common cause of medical referral and disability due to absence from work. Voice disorders affect individuals of any age. Meanwhile, voice disorders are more commonly reported in patients over 65 years (29.1%) and children. Moreover, 23.4% of children may have dysphonia at a certain point — this disorder is more common in boys than in girls. There are numerous causes of dysphonia, e.g., head snd neck tumors, neurological, gastrointestinal, or lung diseases, psychological disorders, injuries, iatrogenic injuries, infections, etc. Meanwhile, acute laryngitis, a symptom of acute respiratory infections, is one of the leading causes of dysphonia. The most common causative agents of acute laryngitis are parainfluenza and influenza viruses, adenoviruses, on occasion, respiratory syncytial virus, and viral-bacterial associations. Dysphonia treatment should be complex and include systemic and topical corticosteroids, antihistamines, mucoactive medications, systemic and topical antibiotics, and combined medications (e.g., Homeovox). Clinical trials have demonstrated their efficacy in adults and children. KEYWORDS: acute laryngitis, dysphonia, hoarseness, treatment. FOR CITATION: Nikolaeva S.V., Turovskiy A.B., Khlypovka Yu.N. Dysphonia: state-of-the-art and treatment tools. Russian Medical Inquiry. 2021;5(11):749–754 (in Russ.). DOI: 10.32364/2587-6821-2021-5-11-749-754.