Parameters of the assessment of voice quality and clinical manifestation of rheumatoid arthritis

Abstract

Purpose: The aim of the study was to investigate the voice quality parameters in 72 rheumatoid arthritis (RA) patients and their relationships with the clinical manifestations and disease activity. The control group consisted of 30 healthy subjects.

Material and methods: All RA patients were evaluated by extensive clinical, laboratory and radiographic studies. The phoniatric assessment included the analysis of vocal folds vibrations by digital stroboscopy (DS) of the larynx using HRES ENDOCAM 5562 system, digital kymography (DKG) and High-Speed Digital Imaging (HSDI) technique. The acoustic voice analysis was conducted using DiagnoScope Specialist program.

Results: Voice quality disorders were registered in 32 (44.44%) RA patients and observed more frequently in patients with moderate and severe activity (DAS28≥3.2) than in mild RA. In digital stroboscopy, confirmed by digital kymography, the hypofunctional dysphonia was observed especially in patients with DAS28≥3.2. Outcomes of the subjective assessment of voice quality were in accordance with the objective parameters and acoustic voice examination.

Conclusions: In RA patients the most frequent voice quality disorders with hypofunctional dysphonia were registered. The relationships between voice quality disorders, clinical activity and radiographic progression of RA patients were observed. Digital stroboscopy, digital kymography, High-Speed Digital Imaging and acoustic voice analysis used in the complex diagnosis of RA confirmed the presence of pathological changes in the larynx. There is a need of cooperation between rheumatologists and phoniatricians in the diagnosis and treatment of dysphonia in RA patients.

Keywords: Digital kymography (DKG); Digital stroboscopy (DS); High-Speed Digital Imaging (HSDI); Rheumatoid arthritis (RA); Voice quality disorders.