Summary
Introduction
Obesity modifies vocal characteristics, causing abnormal fat deposition in the abdominal
region and upper airways. For some authors the voice of the obese is not different
from nonobese and the vocal symptoms are scarce; for others dysphonia in obese is
reported by 70% of them and the voice becomes hoarse, breathy, and unstable.
Objective
To characterize the voice of patients with morbid obesity.
Methods
Two groups were included: Obese (n-27), aged between 26 and 59 years, selected for
bariatric surgery; Control (n-27), matched in age, with ideal weight for height.
Parameters
Vocal self—assessment (Vocal Disadvantage Index—IDV and Quality of Life and Voice—QVV);
Perceptual-auditory vocal evaluation (GRBASI scale), maximum phonation time; Acoustic
vocal analysis and Videolaryngoscopic exams.
Results
In obese, the most frequent symptoms were gastroesophageal and hoarseness. The vocal
self-evaluation did not record any relevant complaints in both groups. In obese, the
perceptual-auditory voice evaluations indicated significant changes in R (roughness),
B (breathiness), I (instability), and S (tension) parameters. Acoustic vocal analysis
recorded changes in the noise-harmonic ratio (NHR) and soft phonation index (SPI)
parameters. The videolaryngoscopy examinations showed, in control and obese groups,
respectively: normal: 92.5% and 55.5%; posterior pachydermia: 11.1% and 33.3%; mid-posterior bowing: 0% and 7.4%; edema/congestion: 0% and 7.40%.
Conclusion
The voice of the obese becomes discreetly hoarse, breathless, and unstable. The most
frequent videolaryngoscopic findings in obese patients are hyperemia and edema of
vocal folds and posterior pachydermia, related to acid laryngitis, secondary to gastroesophageal
reflux.
Key Words
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REFERENCES
- The definition and prevalence of obesity and metabolic syndrome.AAdv Exp Med Biol. 2017; 960: 1-17https://doi.org/10.1007/978-3-319-48382-5_1
- Voice feature characteristic in morbid obese population.Obes Surg. 2011; 21: 340-344https://doi.org/10.1007/s11695-009-9959-7
- Do body mass index and fat volume influence vocal quality, phonatory range, and aerodynamics in females?.Codas. 2013; 25: 310-318
- Acoustic, perceptual and aerodynamic voice evaluation in an obese population.J Laryngol Otol. 2013; 127: 987-990https://doi.org/10.1017/S0022215113001916
- Validation in Brazil of self-assessment protocols for dysphonia impact.Pro Fono. 2009; 21: 326-332
- Upper airway size is related to obesity and body fat distribution in women.Eur Arch Otorhinolaryngol. 2009; 266: 559-563
- Respiratory muscle strength, sound pressure level, and vocal acoustic parameters and waist circumference of children with different nutritional status.JVoice. 2016; 30: 30-35https://doi.org/10.1016/j.jvoice.2015.02.006
- Neck circumference and vocal parameters in women before and after bariatric surgery.Obes Surg. 2016; 26: 576-580
- Influence of neck circumference on respiratory endurance and muscle strength in morbidly obese.Obes Surg. 2011; 21: 1250-1256
- Sites and sizes of fat deposits around the pharynx in obese patients with obstructive sleep apnoea and weight matched controls.Eur Respir J. 1989; 2: 613-622
- Relationships between MRI fat distributions and sleep apnea and obesity hypoventilation syndrome in very obese patients.Sleep Breath. 2018; 22: 673-681https://doi.org/10.1007/s11325-017-1599-x
- Gastroesophageal reflux disease and morbid obesity: evaluation and treatment.Updates Surg. 2018; 70: 331-337https://doi.org/10.1007/s13304-018-0579-4
- Gastroesophageal reflux disease in obese patients.J Laparoendosc Adv Surg Tech. 2018; 28: 949-952https://doi.org/10.1089/lap.2018.0395
Vaezi MF.Laryngeal manifestations of gastroesophageal reflux disease. Curr Gastroenterol Rep. 2008;10:271-7. Review.
- Laryngeal and voice disorders in patients with gastroesophageal symptoms. Correlation with pH-monitoring.Acta Cir Bras. 2012; 27: 821-828
- Vocal complaint, auditory-perceptual assessment of voice and vocal self-assessment in women with morbid obesity.Arq Bras Cir Dig. 2015; 28: 23-25https://doi.org/10.1590/S0102-6720201500S100008
- Do obesity and weight loss affect vocal function?.Semin Speech Lang. 2011 Feb; 32: 31-42https://doi.org/10.1055/s-0031-1271973
- Body mass index and acoustic voice parameters: is there a relationship?.Braz J Otorhinolaryngol. 2018; 84: 410-415https://doi.org/10.1016/j.bjorl.2017.04.003
Article info
Publication history
Published online: October 21, 2019
Accepted:
September 19,
2019
Footnotes
Financial support: FAPESP (2018/10493-8); CNPq.
Identification
Copyright
© 2019 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
