Summary
Introduction
Measuring the impact of chronic cough on voice quality can be difficult and challenging
in daily practice. Evidence about its potential effects on diagnostic tools used in
voice evaluation is lacking. We hypothesized that the presence of chronic cough plays
a role in patients' perception of dysphonia severity, leading to a mismatch between
the subjective, objective, and perceptual evaluations.
Methods
A retrospective chart review involving patients with a diagnosis of dysphonia and
a complete speech voice evaluation was performed. A total of 311 patients were stratified
into two different groups according to the presence of chronic cough. A total of 151
patients were assigned to the dysphonia and chronic cough group, while 160 patients
were assigned to the dysphonia only group. During the initial evaluation, patients
completed the Voice Handicap Index (VHI)-30, Glottal Function Index (GFI), and Reflux
Symptoms Index (RSI). Voice evaluation also included aerodynamic/acoustic measures
and the application of the GRBAS scale by a speech-language specialist. A paired t test and a linear regression analysis were used to compare subjective, perceptual,
and aerodynamic/acoustic measures in both groups.
Results
The mean VHI-30 and GFI were elevated in both groups but significantly lower among
patients with dysphonia and chronic cough when compared to patients with dysphonia
only (P= 0.01). Additionally, a significantly higher RSI was found among patients with dysphonia
and chronic cough (P< 0.01). No difference in aerodynamic/acoustic measures was found between groups (P> 0.05). Our linear regression model demonstrated a significant effect of the presence
of chronic cough on the VHI-30, RSI, and GFI questionnaires (P< 0.05). Our model also found that the VHI-30 is a significant predictor for the (G),
(B), (A), and (S) components of the GRBAS scale (P< 0.05).
Conclusion
The presence of chronic cough has a significant impact on the different patient-reported
outcome measures, including VHI-30, RSI, and GFI. The use of VHI-30 as a predictor
for the GRBAS scale reinforces the importance of subjective and perceptual assessment
among patients with voice disorders and establishes a new area for exploration.
Key Words
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Article info
Publication history
Published online: January 08, 2021
Accepted:
December 15,
2020
Footnotes
Funding: None.
Conflicts of interest: None.
Identification
Copyright
© 2020 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
