Ayşegül BATIOĞLU KARAALTIN, Ömer Necati DEVELİOĞLU, Özge TARHAN, Mehmet KÜLEKÇİ

Reflü tedavisinin etkililiğinin değerlendirilmesinde ses analizinin önemi

Amaç: Bu çalışmada akustik analizler kullanılarak larengofarengeal reflü LPR hastalarındaki ses bozukluklarında reflü tedavisinin etkileri ve skorlama sistemleri arasındaki ilişki araştırıldı.Hastalar ve Yöntemler: Toplam 84 LPR hastası 18 erkek, 66 kadın; ort. yaş 43.1±11.3 yıl; dağılım 18-73 yıl reflü semptom indeksi RSİ , reflü bulgu skoru RBS , videolaringostroboskopik inceleme ve Dr. Speech 4 ile akustik analiz kullanılarak LPR tedavisi öncesinde ve tedavi sonrası birinci ve üçüncü ayda değerlendirildi.Bulgular: Maksimum fonasyon zamanı, temel frekans F0 , jitter ve shimmer skorları tedavi öncesi skorlara göre tedavi sonrası dönemde istatistiksel olarak anlamlı değişiklik göstermedi p>0.05 . Fakat harmonik gürültü oranı ve sinyal gürültü oranı skorlarındaki değişiklik istatistiksel olarak anlamlı idi sırasıyla p=0.017 ve p=0.003 . Reflü semptom indeksi bulguları tedavi öncesi ve tedavi sonrası birinci ve üçüncü ay değerlendirmelerinde F0 ile anlamlı pozitif ilişki gösterdi sırasıyla Spearman’ın sıralama korelasyon katsayısı [rho]=0.246, p=0.024; rho=0.300, p=0.006; rho=0.305, p=0.005 .Sonuç: Akustik analiz parametreleri ve RSİ ve RBS değerleri arasındaki ilişki LPR hastalarının tanısı ve takibi için tartışmalı gözükmekte ve ileri araştırmalar gerektirmektedir

Anahtar Kelimeler:

Larengofarengeal reflü, reflü skorlama sistemi, ses analizi

The importance of voice analysis in evaluating the effectiveness of reflux treatment

Objectives: This study aims to investigate the effects of reflux treatment in voice disorders in laryngopharyngeal reflux LPR patients using acoustic analyses and the relationship between scoring systems. Patients and Methods: A total of 84 LPR patients 18 males, 66 females; mean age 43.1±11.3 years; range 18 to 73 years were evaluated using reflux symptom index RSI , reflux findings score RFS , videolaryngostroboscopic examination, and acoustic analysis with Dr. Speech 4 before LPR treatment and at the first and third months after treatment. Results: Maximum phonation time, fundamental frequency F0 , jitter, and shimmer scores did not show any statistically significant alteration at the posttreatment period according to pretreatment scores p>0.05 . However, the alteration in Harmonics-to-Noise ratio and Signals-to-Noise ratio scores were statistically significant p=0.017 and p=0.003, respectively . Reflux symptom index results showed significant positive correlation with F0 at the pretreatment, and at posttreatment first and third month evaluations Spearman's rank correlation coefficient [rho]=0.246, p=0.024; rho=0.300, p=0.006; rho=0.305, p=0.005, respectively . Conclusion: The relationship between the parameters of acoustic analysis and RSI and RFS values seems to be controversial for diagnosis and follow-up of LPR patients, requiring further investigations.

Keywords:

Laryngopharyngeal reflux, reflux scoring system, voice analysis,

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