Mustafa ŞAHİN, Emel ÇADALLI TATAR, Filiz CANPOLAT, Gökçe AKSOY YILDIRIM, Mehmet Hakan KORKMAZ

Sistemik isotretinoin kullanımının ses üzerindeki etkisi

Amaç: Bu çalışmada kronik bir inflamatuvar hastalık olan akne vulgarisin tedavisinde sistemik Isotretionoin Iso kullanımının ses üzerindeki etkisi araştırıldı.Hastalar ve Yöntemler: Mart 2014 - Mayıs 2016 tarihleri arasında, akne vulgaris nedeniyle sistemik Iso kullanımı endikasyonu olan toplam 62 gönüllü hasta 40 kadın, 22 erkek; ort. yaş 22.4±5.5 yıl; dağılım 18-36 yıl çalışmaya dahil edildi. Tedavi öncesinde, tedavinin üçüncü ve altıncı aylarında ve tedavinin bitiminden altı ay sonra kulak burun boğaz muayenesi, videolaringostroboskopi VLS , akustik ses analizi ses basınç seviyesi [SPL], ortalama F0, ilk üç formant, jitter%, shimmer% ve ses harmoni oranı [NHR] yapıldı, maksimum fonasyon zamanı MPT ve s/z oranı ölçüldü. Algısal ses değerlendirilmesinde Ses Handikap İndeksi-10 VHI-10 ve GRBAS kullanıldı.Bulgular: Maksimum fonasyon zamanı, F0, ilk üç formant, SPL, GRBAS tedavi sırasında artış gösterdi , shimmer% değerlerinde ve VLS parametrelerinde istatistiksel olarak anlamlı bir değişiklik saptanmadı. Ses Handikap İndeksi-10, s/z oranı, jitter% ve NHR’nin tedavi sırasında anlamlı olarak arttığı görüldü.Sonuç: Standart klinik dozda altı aylık düzenli sistemik Iso tedavisinin ses kalitesi üzerinde hafif bir olumsuz etki gösterdiği ve bu etkinin tedavi sonlandırıldığında başlangıçtaki duruma döndüğü saptandı. Hastaların, özellikle de ses sanatçılarının, tedavi öncesinde bu olası yan etki açısından bilgilendirilmeleri önerilir

Anahtar Kelimeler:

Disfoni, isotretinoin, ses.

Effect of systemic isotretinoin treatment on voice

Objectives: This study aims to investigate the effects of oral systemic Isotretinoin Iso treatment of acne vulgaris, as a chronic inflammatory disease, on voice. Patients and Methods: Between March 2014 and May 2016, a total of 62 volunteer patients 40 females, 22 males; mean age 22.4±5.5 years; range 18 to 36 years with systemic Iso therapy indication due to acne vulgaris were included in the study. Ear nose and throat examination, videolaryngostroboscopy VLS and acoustic voice analysis sound pressure level [SPL], mean F0, first three formants, jitter%, shimmer% and noise to harmonic ratio [NHR] were performed, maximum phonation time MPT and s/z ratio were measured at pretreatment, third and sixth months of treatment and sixth month after the treatment was stopped. The Voice Handicap Index VHI-10 and the GRBAS scales were performed for perceptual voice evaluation. Results: There was no statistically significant difference in MPT, F0, the first three formants, SPL, GRBAS increased during the treatment , shimmer% ratings and VLS parameters during the Iso treatment. Voice Handicap Index-10, s/z ratio, jitter% and NHR were observed to have increased significantly during the treatment. Conclusion: Six-month regular systemic Iso treatment at standard clinical doses has mild negative effects on voice quality and this impact returns to baseline after the treatment is stopped. It is recommended that patients, especially vocal artists, to be informed prior to treatment about this possible side effect.

Keywords:

Dysphonia, isotretinoin, voice,

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