Identifying Concomitant Health Conditions in Individuals With Chronic Voice Problems

  • Charles Lenell
    Affiliations
    Department of Communicative Sciences and Disorders, New York University, New York

    Department of Otolaryngology – Head and Neck Surgery, New York University, School of Medicine, New York
    Search for articles by this author
  • Qianhui Shao
    Affiliations
    Department of Otolaryngology – Head and Neck Surgery, New York University, School of Medicine, New York
    Search for articles by this author
  • Aaron M. Johnson
    Correspondence
    Address correspondence and reprint requests to Aaron M. Johnson, NYU Voice Center, Department of Otolaryngology – Head and Neck Surgery, New York University, School of Medicine, 345 East 37th Street, Suite 306, New York, NY 10016.
    Affiliations
    Department of Otolaryngology – Head and Neck Surgery, New York University, School of Medicine, New York
    Search for articles by this author
Published:January 28, 2020DOI:https://doi.org/10.1016/j.jvoice.2020.01.007

      Summary

      Objective

      Current clinical practice guidelines recommend a laryngoscopic referral for patients who present with hoarseness for longer than 28 days and earlier for patients with certain high-risk factors. The goal of this study was to identify additional possible concomitant health conditions in individuals with chronic (>28 days) hoarseness to improve early detection of chronic voice problems.

      Methods

      Using data from the 2012 National Health Interview Survey, four health conditions were selected: Swallowing problems, respiratory problems, hormonal-cycle problems, and physical activity limitations. Multivariable logistic regressions controlling for age, gender, race, and smoking status, were used to calculate the odds ratios for the association of each of these four health conditions to chronic versus acute voice problems.

      Results

      Of the 2,746 respondents who reported a voice disorder within the last year, 736 reported a voice problem lasting longer than 4 weeks in duration. After controlling for covariates, individuals reporting swallowing problems and physical activity limitations were more likely to report a chronic voice problem versus an acute voice problem, odds ratios with 95% confidence intervals of 1.983 (1.619, 2.430) and 1.716 (1.355, 2.173), respectively. No significant associations were found for respiratory or hormonal-cycle problems.

      Conclusion

      Individuals who present with both a voice problem and a swallowing problem or physical activity limitation may be at increased risk for developing a chronic voice problem. Therefore, these two health conditions should be included as high-risk factors when determining the escalation of care for a patient presenting with acute dysphonia.

      Key Words

      To read this article in full you will need to make a payment
      Subscribe to Journal of Voice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Bhattacharyya N
        The prevalence of voice problems among adults in the United States.
        Laryngoscope. 2014; 124: 2359-2362
        • Cohen SM
        Self-reported impact of dysphonia in a primary care population: an epidemiological study.
        Laryngoscope. 2010; 120: 2022-2032
        • Mackie J
        Nursing education in the U.S.A. and Canada.
        Aust Nurses J. 1972; 2: 30-32
        • Roy N
        • Kim J
        • Courey M
        • et al.
        Voice disorders in the elderly: a national database study.
        Laryngoscope. 2016; 126: 421-428
        • Roy N
        • Merrill RM
        • Thibeault S
        • et al.
        Prevalence of voice disorders in teachers and the general population.
        J Speech Lang Hear Res. 2004; 47: 281-293
        • Martins RH
        • do Amaral HA
        • Tavares EL
        • et al.
        Voice disorders: etiology and diagnosis.
        J Voice. 2016; 30 (761 e761-761 e769)
        • National Center for Health Statistics (2012)
        Data File Documentation NHIS, 2014 (machine readable data file and documentation).
        Centers for Disease Control and Prevention. National Center for Health. National Center for Health Statistics, Hyattsville, Maryland2014
        • Morris MA
        • Meier SK
        • Griffin JM
        • et al.
        Prevalence and etiologies of adult communication disabilities in the United States: results from the 2012 National Health Interview Survey.
        Disabil Health J. 2016; 9: 140-144
        • Bertelsen C
        • Zhou S
        • Hapner ER
        • et al.
        Sociodemographic characteristics and treatment response among aging adults with voice disorders in the United States.
        JAMA Otolaryngol Head Neck Surg. 2018; 144: 719-726
        • Marmor S
        • Horvath KJ
        • Lim KO
        • et al.
        Voice problems and depression among adults in the United States.
        Laryngoscope. 2016; 126: 1859-1864
        • Hur K
        • Zhou S
        • Bertelsen C
        • et al.
        Health disparities among adults with voice problems in the United States.
        Laryngoscope. 2018; 128: 915-920
        • Daniels SK
        Neurological disorders affecting oral, pharyngeal swallowing.
        GI Motility Online. 2006; https://doi.org/10.1038/gimo34
        • Smith M
        • Ramig L
        Neurological disorders and the voice.
        National Center for Voice and Speech: Status and Progress Report. 1994; 7: 207-227
        • Amir O
        • Biron-Shental T
        The impact of hormonal fluctuations on female vocal folds.
        Curr Opin Otolaryngol Head Neck Surg. 2004; 12: 180-184
        • Celik O
        • Celik A
        • Atespare A
        • et al.
        Voice and speech changes in various phases of menstrual cycle.
        J Voice. 2013; 27: 622-626
        • Chae SW
        • Choi G
        • Kang HJ
        • et al.
        Clinical analysis of voice change as a parameter of premenstrual syndrome.
        J Voice. 2001; 15: 278-283
        • Raj A
        • Gupta B
        • Chowdhury A
        • et al.
        A study of voice changes in various phases of menstrual cycle and in postmenopausal women.
        J Voice. 2010; 24: 363-368
        • Abitbol J
        • Abitbol P
        • Abitbol B
        Sex hormones and the female voice.
        J Voice. 1999; 13: 424-446
        • Saeed AM
        • Riad NM
        • Osman NM
        • et al.
        Study of voice disorders in patients with bronchial asthma and chronic obstructive pulmonary disease.
        Egypt J Bronchol. 2018; 12: 20
        • Woo P
        • Casper J
        • Colton R
        • et al.
        Dysphonia in the aging: physiology versus disease.
        Laryngoscope. 1992; 102: 139-144
        • Stachler RJ
        • Francis DO
        • Schwartz SR
        • et al.
        Clinical practice guideline: hoarseness (dysphonia) (update).
        Otolaryngol Head Neck Surg. 2018; 158: S1-S42
        • Thibeault SL
        • Merrill RM
        • Roy N
        • et al.
        Occupational risk factors associated with voice disorders among teachers.
        Ann Epidemiol. 2004; 14: 786-792
        • Chodzko-Zajko WJ
        • Ringel RL
        Physiological aspects of aging.
        J Voice. 1987; 1: 18-26
        • Golub JS
        • Chen PH
        • Otto KJ
        • et al.
        Prevalence of perceived dysphonia in a geriatric population.
        J Am Geriatr Soc. 2006; 54: 1736-1739
        • Linville SE
        Source characteristics of aged voice assessed from long-term average spectra.
        J Voice. 2002; 16: 472-479