Médecine communautaire et éducation à la santé

Abstrait

Laryngopharyngeal reflux - a randomized controlled trial of voice changes after treatment in Scandinavian adults.

Mette Pedersen MD.

A randomized prospective controlled study was made in order to find out if voice related acoustical measures show usable predictive pathologies in patients with laryngo-pharyngeal reflux (LPR), based on high speed films with 4000 pictures of the larynx per second. The main results of this study were that lifestyle changes (according to the standard literature) did optimize the voice in patients with LPR. The used acoustical program was an advanced MDVP (multi-dimensional voice program) by Laryngograph Ltd. which routinely adjusts to well-defined sustained tones measures as well as reading of a standard text and electroglottography. Three treatment groups for LPR with each 78, 70 and 89 patients respectively were treated with standard advice of lifestyle changes, combined with proton pump inhibitors, and a third group with lifestyle changes, proton pump inhibitors and alginate. The mean age was 42, 42 and 41 years, all three groups with a standard deviation of 15 years. There was no difference of treatments effect between the groups; they were therefore added to each other. A comparison between the first and second consultation after two weeks did show shimmer change from 9.35% to 7.76% after two weeks to 7.96% follow up after three months, comparing the first to the third measurement. In reading of a standard text the frequency and intensity variations were also reduced from 10.73% and 16.23% at the first consultation to 9.43% and 15.26% at the second consultation and after three months the frequency variation was 9.51% and 15.77%. So it can be concluded that especially reading of a standard text is changed after treatment of LPR. No change was found of electroglottography. The acoustical findings were not related to the oedema of the arytenoid region based on high speed films with 4000 pictures per second. The acoustical measures should be refined in the future with online measures on high speed films.