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Santos M, Azevedo S, Sousa F, Machado AS, Santos PC, Freitas SV, Almeida E Sousa C, da Silva ÁM. Presbylarynx: Is It a Sign of the Health Status of the Elderly? J Voice 2023; 37:304.e1-304.e7. [PMID: 33461883 DOI: 10.1016/j.jvoice.2020.12.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/14/2020] [Accepted: 12/21/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Only a full understanding of how different diseases affect the same or different anatomical/functional entities, may provide a clue on how comorbidity should be taken into consideration. The aim of this study was to evaluate the chronic medical illnesses of an elderly population, in order to analyze potential correlation of specific comorbidities with presbylarynx. METHODS This case-control, prospective, observational, and cross-sectional study was carried out on consecutive subjects observed by otorhinolaryngology, in a tertiary center, from January to September 2020. The inclusion criteria were ability to report an accurate medical history and ≥65 years of age. The exclusion criteria were neurologic diagnoses, autoimmune disease, history of thoracic or head and neck surgery, cancer, radiotherapy, thyroid pathology, vocal fold mass lesions, acute laryngitis, or vocal fold paralysis. Based on videostroboscopy of the larynx, the patients were subdivided into two main groups: presbylarynx versus no presbylarynx. Health status was assessed by evaluation of chronic medical illnesses (individual diagnoses of chronic conditions plus Charlson comorbidity index [CCI]), functional status (Katz index of independence in activities of daily living and functional Ambulation ambulation classification), and emotional status (Geriatric Depression Scale). RESULTS A total of 174 subjects (60 males; 114 females) were included (mean age = 73.99 years; range 65-95 years). Presbylarynx was identified in 71 patients (41%). A statistically significant difference was found concerning diabetes mellitus type 2 (T2DM); P< 0.001), asthma or chronic obstructive pulmonary disease (COPD; P< 0.001), and psychiatric disorder (P< 0.001). The mean score of CCI between "presbylarynx" and "no presbylarynx" groups was statistically different (P= 0.021). Results showed an association between some functional dependence (P< 0.001), and mild or severe depression (P< 0.001) and the presence of presbylarynx. CONCLUSIONS Presbylarynx may be considered a sign of the health status of the elderly. Based on CCI, It was found that patients with higher probability of 10-year mortality exhibit more endoscopic signs of presbylarynx. It was also found that patients with better scores in functionality scales exhibited less endoscopic findings compatible with presbylarynx. Among chronic medical illnesses, T2DM, asthma, or COPD may be considered risk factors for noticeable endoscopic signs of presbylarynx.
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Affiliation(s)
- Mariline Santos
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
| | - Sara Azevedo
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Francisco Sousa
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - André Sousa Machado
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Pedro Carvalho Santos
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Susana Vaz Freitas
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal; LIAAD - Laboratório de Inteligência Artificial e Apoio à Decisão, INESCTEC, Porto, Portugal
| | - Cecília Almeida E Sousa
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Álvaro Moreira da Silva
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
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Santos M, Freitas SV, Almeida E Sousa C, da Silva ÁM. Presbylarynx: validation of a classification based on morphological characteristics. Eur Arch Otorhinolaryngol 2023; 280:781-788. [PMID: 36030469 DOI: 10.1007/s00405-022-07618-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 08/15/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Validation of a classification to stratify presbylarynx into three types. METHODS Evaluate the reproducibility of this classification. 30 video recordings of rigid laryngostroboscopies were presented to 20 otorhinolaryngologists from five tertiary hospitals: 10 residents and 10 specialists. Specialists with different differentiations were included. RESULTS Among 1200 evaluations performed (30 video recordings × 20 raters, twice), average intra-rater agreement rate was 0.847 (p < 0.001). The average inter-rater reliability was 0.67 ± 0.179 on the first evaluation, and 0.691 ± 0.131 on the second evaluation. CONCLUSIONS This study presented the validation of a classification that allows stratifying laryngeal endoscopic signs in elderly patients with presbyphonia. We believe that this classification will enrich the diagnostic protocol of the aging voice and will improve the documentation of treatment outcomes.
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Affiliation(s)
- Mariline Santos
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Professor Abel Salazar, 4100-099, Porto, Portugal.
| | - Susana Vaz Freitas
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Professor Abel Salazar, 4100-099, Porto, Portugal.,Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal
| | - Cecília Almeida E Sousa
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Professor Abel Salazar, 4100-099, Porto, Portugal
| | - Álvaro Moreira da Silva
- Serviço de Cuidados Intensivos do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
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Alves CS, Santos M, Castro A, Lino J, Freitas SV, Almeida e Sousa C, da Silva ÁM. Geriatric otorhinolaryngology: reasons for outpatient referrals from generalists to ENT specialists. Eur Arch Otorhinolaryngol 2023; 280:461-467. [PMID: 36094563 PMCID: PMC9466320 DOI: 10.1007/s00405-022-07641-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 11/25/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE To determine the main symptoms leading to referral of geriatric patients from primary care to otorhinolaryngology. METHODS Retrospective, observational study performed on patients aged 65 and older, referred from Primary Care to the Otorhinolaryngology and Head and Neck Surgery department of a tertiary centre during 2019 and 2020. Symptoms leading to otorhinolaryngological referral were categorized as "Oto-neurological symptoms", "Nasal symptoms", "Pharyngolaryngeal symptoms", "Other Head and Neck symptoms" and "Other Reasons". Data regarding age, gender and whether patients maintain follow-up or have been discharged was also collected. RESULTS The study population included a total of 1304 patients (697 female; 607 male). Oto-neurological symptoms were found to be the most prevalent symptoms, with 65% of patients reporting oto-neurological symptoms as at least one of the reasons for referral. Hearing loss was the most commonly reported symptom, with an association found between this symptom and age (p < 0.001). Results also showed an association between the female gender and vertigo/dizziness (p < 0.001) and tinnitus (p = 0.007). An association between the male gender and nasal symptoms was also found (p = 0.018), particularly nasal obstruction (p = 0.003) and epistaxis (p = 0.028). No statistically significant associations were found among the pharyngolaryngeal group. CONCLUSIONS This retrospective observational study allowed for a better understanding of the type of otorhinolaryngological symptoms affecting elderly patients and driving otorhinolaryngology evaluation, cementing hearing loss as one of the major complaints among older adults and allowing for a better preparation by otorhinolaryngologists for the changing needs of this subset of the population.
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Affiliation(s)
- Clara Serdoura Alves
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Professor Abel Salazar, 4100-099 Porto, Portugal
| | - Mariline Santos
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Professor Abel Salazar, 4100-099 Porto, Portugal
| | - Afonso Castro
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Professor Abel Salazar, 4100-099 Porto, Portugal
| | - João Lino
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Professor Abel Salazar, 4100-099 Porto, Portugal
| | - Susana Vaz Freitas
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Professor Abel Salazar, 4100-099 Porto, Portugal ,Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal ,LIAAD, Laboratório de Inteligência Artificial e Apoio à Decisão, INESCTEC, Porto, Portugal
| | - Cecília Almeida e Sousa
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Professor Abel Salazar, 4100-099 Porto, Portugal
| | - Álvaro Moreira da Silva
- Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Professor Abel Salazar, 4100-099 Porto, Portugal
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Santos M, Freitas SV, Sousa CAE, da Silva ÁM. Stratifying Presbylarynx: Characterization of its Three Types. J Voice 2022:S0892-1997(22)00289-2. [PMID: 36266223 DOI: 10.1016/j.jvoice.2022.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 03/07/2023]
Abstract
OBJECTIVES To describe the clinical characteristics of each type of glottal configuration proposed in a classification that allows stratifying presbylarynx into three types: Type 0: there is no significant morphological alteration in glottal configuration. Type 1: two or more of the following endoscopic signs are present: atrophic vocal folds, vocal fold bowing, prominence of vocal processes, supraglottal hyperactivity, decreased amplitude (vocal fold edge stiffness without evidence of vocal post-traumatic scar), and tremor of laryngeal structures. Type 2: elderly patients with type 1 plus glottal insufficiency. METHODS Prospective, observational, and cross-sectional study. Data regarding age, gender, type of glottal configuration, self-assessment regarding vocal complaints, as well as acoustic and audio-perceptive examination were collected. RESULTS The study population included 306 subjects (180 females), and the mean age was 73.85. Type 0 was the most frequent (61%). A statistically significant association was found between type 0 and female subjects, as well as type 2 and male subjects. The mean age of the patients with type 0 was statistically lower than the mean age of the patients with type 1 or type 2. The mean score of self-assessment questionnaires of patients with type 2 was statistically higher than the mean score registered for patients with type 0 and type 1. The mean score of Jitter, Shimmer, and HNR in type 2 were statistically higher than in type 0 or type 1 (P < 0.05). The mean score of Maximum Phonation Time in type 2 was statistically lower than in type 0 or 1 (P < 0.001). Based on vocal complaints, 115 subjects (38%) had presbyphonia (46 males; 69 females), and the mean age was 75.97 years (SD = 6.98; range 65 - 97). Among subjects without presbyphonia (n = 191), type 0 was the most frequent (84%), followed by type 1 (15%) and type 2 (1%). Among subjects with presbyphonia (n = 115), type 1 was the most frequent (58%), followed by type 0 (23%) and type 2 (19%). CONCLUSIONS This study presented the clinical characterization of a classification that allows stratifying endoscopic laryngeal signs in elderly patients with presbyphonia. We believe this classification will enrich the diagnostic protocol of the aging voice and will improve the documentation of treatment outcomes.
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Affiliation(s)
- Mariline Santos
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Porto, Portugal.
| | - Susana Vaz Freitas
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Porto, Portugal; Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Porto, Portugal
| | - Cecília Almeida E Sousa
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Porto, Portugal
| | - Álvaro Moreira da Silva
- Serviço de Cuidados Intensivos do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Porto, Portugal
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The Regenerative Effects of c-Met Agonistic Antibodies in Vocal Fold Atrophy. Int J Mol Sci 2022; 23:ijms23147818. [PMID: 35887165 PMCID: PMC9318927 DOI: 10.3390/ijms23147818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/07/2022] [Accepted: 07/13/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Atrophy of the vocal folds and the accompanying glottic insufficiency affect the quality of life. Although growth factors have been used to treat muscle atrophy, their effectiveness is limited by their short half-life. Methods: In total, 15 rabbits and 24 rats were used for the study. The right recurrent laryngeal nerves of all animals were transected. One month following nerve transection, PBS (PBS group), rHGF (HGF group), or a c-Met agonistic antibody (c-Met group) was injected into the paralyzed vocal folds. The larynges of the rabbits were harvested from each group for histologic examination and subjected to PCR analysis. Results: Cross-sectional areas (CSAs) of thyroarytenoid muscles were evaluated. The c-Met group had increased CSAs compared to the PBS and HGF groups, but there were no significant differences compared to normal controls. The expression levels of myogenesis-related genes were evaluated three weeks after the injection. The expression levels of myosin heavy chain IIa were significantly increased in the PBS group, while the expression levels of MyoD were increased in the c-Met group. Conclusions: The c-Met agonistic antibody showed promise for promoting muscle regeneration in a vocal fold palsy model.
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Santos M, Sousa CA, Freitas SV, Almeida E Sousa C, da Silva ÁM. Presbylarynx: How Easy Is It To Recognize The Aging Signs? A Prospective Study With Inter- And Intra-Rater Reliability In Laryngoscopic Evaluation. J Voice 2022:S0892-1997(22)00109-6. [PMID: 35641383 DOI: 10.1016/j.jvoice.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE To determine if recognition of presbylarynx is easy and straightforward. METHOD First, a systematic review regarding the structural features of the geriatric larynx through laryngostroboscopy was performed, and its results were presented to the raters in an educational session. Then, video recordings of rigid laryngostroboscopies were randomly selected and presented to a panel of otorhinolaryngologists. Intra- and inter-rater reliability were determined. RESULTS Based on the main findings of the systematic review, raters were invited to consider the diagnosis of presbylarynx when one or more of the following endoscopic signs were present: atrophic vocal folds (VF), VF bowing, prominence of vocal processes, or spindle-shaped glottal gap. Twenty otorhinolaryngologists from five tertiary hospitals participated in this study (residents and specialists). Among 300 evaluations performed (15 video recordings x 20 raters), the intra-rater agreement was 93.0%. The Cohen´s Kappa for intra-rater reliability was higher than 0.600 for all the raters except for two residents. Cohen´s Kappa was higher among specialists (0.893) than among residents (0.826). The highest Cohen´s Kappa was registered for evaluations performed by specialists with differentiation in laryngology (0.933). Presbylarynx was identified mostly in laryngostroboscopic recordings of subjects older than 65 years. CONCLUSION we consider the answer to "Presbylarynx: How easy is it to recognize the aging signs" to be "After education on signs of presbylarynx, it is easy." This answer is supported by the high rate of intra- and inter-rater agreement, in a blinded and randomized presentation of laryngostroboscopic recordings, and by the fact that the diagnosis of presbylarynx was mostly attributed to videos regarding subjects aged 65 years and older. It proves that is not difficult to recognize aging signs in the larynx. Thus, in the future, more education regarding presbylarynx and further studies to improve criteria for its diagnosis may improve the management of the aging voice.
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Affiliation(s)
- Mariline Santos
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.
| | - Clara Alves Sousa
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Susana Vaz Freitas
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; Faculdade de Ciências da Saúde, Universidade Fernando Pessoa
| | - Cecília Almeida E Sousa
- Serviço de Otorrinolaringologia do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Álvaro Moreira da Silva
- Serviço de Cuidados Intensivos do Centro Hospitalar Universitário do Porto e Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto
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Bertinazzi M, Gheit T, Polesel J, McKay-Chopin S, Cutrone C, Sari M, Sbaraglia M, Tos APD, Nicolai P, Tommasino M, Boscolo-Rizzo P. Clinical implications of alpha, beta, and gamma HPV infection in juvenile onset recurrent respiratory papillomatosis. Eur Arch Otorhinolaryngol 2022; 279:285-292. [PMID: 34453571 PMCID: PMC8738360 DOI: 10.1007/s00405-021-07040-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of our study was to evaluate the prevalence of different HPV genera-alpha, beta and gamma-in Juvenile onset Recurrent Respiratory Papillomatosis (JoRRP) and examine the association of type and genus-specific viral features with the clinical outcome of disease. METHODS This retrospective observational study included consecutive patients with JoRRP who were treated in a referral centre between October 2000 and October 2020. All patients underwent cold excision and laser vaporisation of papillomatous lesions. Samples were analysed for the presence of 120 viral genotypes (22 alpha-HPV, 46 beta-HPV, 52 gamma-HPV) using a highly sensitive multiplex genotyping assay. RESULTS Twenty patients with JoRRP, aged 0.3-11 years, were included, with a median follow-up of 13.5 years. All samples were HPV DNA positive: 20 (100%) for alpha-HPV DNA; 7 (35%) for beta-HPV DNA; 0 for gamma-HPV DNA. Three groups were defined according to the number of infections: seven cases (35%) with HPV mono-infection; ten cases (50%) with HPV double-infection; three cases (15%) with ≥ 3 HPV infections. At diagnosis, patients with ≥ 3 HPV infections reported higher median Derkay's score than those with mono-infection (21 vs 14, P = 0.018). Number of HPV infections was also associated with clinical outcomes, with an average of 0.5 surgical procedures/year in patients with mono-infection, 1.2 for double-infection, 2.6 for ≥ 3 infections (P = 0.006). CONCLUSION Despite the small sample size, these preliminary data support an association between the number of different alpha and beta HPV co-infections and the clinical severity of the disease.
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Affiliation(s)
- Martina Bertinazzi
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
| | - Tarik Gheit
- International Agency for Research On Cancer, Lyon, France
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro Di Riferimento Oncologico Di Aviano (CRO) IRCCS, Aviano, Italy
| | | | - Cesare Cutrone
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
| | - Marianna Sari
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
| | - Marta Sbaraglia
- Department of Medicine, Section of Pathology, University of Padova, Padova, Italy
| | - Angelo Paolo Dei Tos
- Department of Medicine, Section of Pathology, University of Padova, Padova, Italy
| | - Piero Nicolai
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
| | | | - Paolo Boscolo-Rizzo
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy.
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy.
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Presbylarynx: is diabetes mellitus a risk factor for vocal atrophy? A prospective case control study. The Journal of Laryngology & Otology 2021; 136:871-874. [PMID: 34819185 DOI: 10.1017/s0022215121003637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Rodrigues Dias D, Santos M, Sousa F, Azevedo S, Sousa E Castro S, Freitas S, Almeida E Sousa C, Moreira da Silva Á. How do presbylarynx and presbycusis affect the Voice Handicap Index and the emotional status of the elderly? A prospective case-control study. J Laryngol Otol 2021; 135:1-6. [PMID: 34579801 DOI: 10.1017/s0022215121002528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the influence of presbylarynx and presbycusis on Voice Handicap Index and emotional status. METHODS A case-control, prospective, observational, cross-sectional study was conducted of patients aged 65 years or older referred to an otorhinolaryngology department from January to September 2020. Presbycusis was assessed by pure tone and vocal audiometry. Each subject underwent fibre-optic videolaryngoscopy with stroboscopy, and presbylarynx was considered when two or more of the following endoscopic findings were identified: vocal fold bowing, prominence of vocal processes in abduction, and a spindle-shaped glottal gap. Each subject completed two questionnaires: Voice Handicap Index and Geriatric Depression Scale (short-form). RESULTS The studied population included 174 White European subjects, with a mean age of 73.99 years, of whom 22.8 per cent presented both presbylarynx and presbycusis. Multivariate linear regression revealed that only presence and severity of presbylarynx had an influence on Voice Handicap Index-30 scores. However, both spindle-shaped glottal gap and presbycusis influenced Geriatric Depression Scale scores. CONCLUSION Presbylarynx has a strong association with the impact of voice on quality of life. Presbylarynx and presbycusis seem to have a cumulative effect on emotional status.
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Affiliation(s)
- D Rodrigues Dias
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - M Santos
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - F Sousa
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - S Azevedo
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - S Sousa E Castro
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - S Freitas
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal
| | - C Almeida E Sousa
- Department of Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
| | - Á Moreira da Silva
- Department of Intensive Care Unit, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto, Porto, Portugal
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Presbylarynx: stratifying endoscopic signs for future researches. Eur Arch Otorhinolaryngol 2021; 278:2157-2158. [PMID: 33686485 DOI: 10.1007/s00405-021-06735-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 10/22/2022]
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