Herediter anjioödem hasta grubunda sesin objektif ve subjektif değerlendirilmesi
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Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Herediter anjioödem hastalığının kronik dönemde ses üzerine etkilerinin
incelenmesi amaçlanmıştır.
Yöntem: Çalışmaya Necmettin Erbakan Üniversitesi(NEÜ) Meram Tıp Fakültesi
Erişkin İmmünoloji ve Alerji Hastalıkları polikliniğinde herediter anjioödem hastalığı ile
takipli 31 hasta ve ek hastalığı olmayan benzer yaş ve cinsiyet dağılımında 25 sağlıklı birey
kontrol grubu olarak çalışmaya dahil edildi. Sigara içenler, gastroözefageal reflü hastalığı
olanlar, ses hastalığı olanlar , laringeal cerrahi öyküsü olan ve oral kavite, orofarenks,
nazofarenks veya larenkste sesi etkileyebilecek patolojisi olan hastalar çalışma dışı bırakıldı.
Değerlendirmeye alınan tüm hastalara ve kontrol grubuna ses handikap endeksi anketi, sesle
ilgili yaşam kalite ölçeği ve reflü semptom endeksi anketleri yapıldı. Video endoskopi
kayıtlarının tamamı 5.8 mm çapında, 19 cm uzunluğunda ve 70º açılı rijit Hopkins çubuk
teleskop (Karl Storz, Tuttlingen, Almanya) ile yapıldı ve endoskopik kamera sistemi (Karl
Storz TELE PACK Endovizyon Sistemi) ile kaydedildi. İşlem sırasında hastalar travmaya
maruz bırakılmadı. Ses kaydı ve akustik analizler, çevresel gürültüden arındırılmış izole bir
odada gerçekleştirildi. Kayıtlar, bir Audio-Technica model AT2005 dinamik mikrofon
(Audio-Technica Productions, Western Hemisphere) kullanılarak sabit bir ağızdan
mikrofona 15 cm mesafede elde edildi. Hastalardan 7 saniye boyunca ‘a’ sesli harfini
telaffuz etmeleri istendi. Tüm akustik ölçümler Praat bilgisayar yazılımı kullanılarak yapıldı.
Tüm hastaların akustik ses analizlerinde temel frekans (F0), formant frekans (F1, F2, F3 ve
F4), frekans pertürbasyonu (jitter), genlik pertürbasyonu (shimmer) ve Gürültü-Harmonik
Oranı (NHR) parametreleri değerlendirildi.
Bulgular: Hasta grubunun %61,30’u (n=19), kontrol grubunun %60,00’ı (n=15)
kadındı. Hastaların yaş ortalaması 41,19±12,82 yıl, kontrol grubunun ise 40,08±8,99 yıldı.
Hasta grubunun vücut kitle indeksi (BMI) 28,43±6,41 kg/m2 iken kontrol grubunun
28,95±2,62 kg/m2 olarak belirlendi. Hasta ve kontrol grubu arasında cinsiyet, yaş ve BMI
dağılımları istatistiksel olarak benzer tespit edildi. Hastaların %67,70’i (n=21) Tip 1,
%32,30’u (n=10) Tip 2 herediter anjoödem grubundaydı. Nefes darlığı, yutma güçlüğü, ses
kısıklığı, boğazda dolgunluk hissi gibi larenks semptomları hastaların %61,30’unda (n=19)
olduğu kaydedildi. Hastaların larenks atak sayısı ortalaması 6,68±11,94 olarak tespit edildi.
v
Hasta VHI, Hasta VQI ve hasta reflü değerleri hasta grubunda kontrol grubuna göre
istatistiksel olarak anlamlı düzeyde yüksek bulundu (p değerleri sırasıyla; p=0,007; p=0,001;
p<0,001). Diğer akustik parametrelerin hasta ve kontrol grupları arasında dağılımı benzerdi
(p>0,05). Hasta reflü değeri atak sayısı 5 ve üzerinde olan grupta istatistiksel olarak daha
yüksek tespit edildi. (p=0,018).
Sonuç: Çalışmamızda herediter anjioödem hastalığında reflünün daha sık izlendiği ancak
herediter anjioödem hastalığının kronik dönemde ses objektif parametreleri üzerine kalıcı
etkisinin olmadığı gösterilmiştir. Atak sayısı arttıkça reflü şikayetlerinin arttığı gözlenmiştir.
Objective: It was aimed to examine the effects of hereditary angioedema on the voice in the chronic period. Method: 31 patients with hereditary angioedema followed in the Adult Immunology and Allergy Diseases outpatient clinic of Necmettin Erbakan University (NEU) Meram Medical Faculty and 25 healthy individuals with similar age and gender distribution without any additional disease were included in the study as the control group. Smokers, patients with gastroesophageal reflux disease, voice disease, history of laryngeal surgery and pathology that may affect the voice in the oral cavity, oropharynx, nasopharynx or larynx were excluded from the study. Voice handicap index questionnaire, voice-related quality of life scale and reflux symptom index questionnaires were administered to all patients and the control group. All video endoscopy recordings were made with a 5.8 mm diameter, 19 cm long and 70º angled rigid Hopkins rod telescope (Karl Storz, Tuttlingen, Germany) and were recorded with an endoscopic camera system (Karl Storz TELE PACK Endovision System). The patients were not exposed to trauma during the procedure. Sound recording and acoustic analyzes were performed in an isolated room free from environmental noise. Recordings were obtained using an Audio-Technica model AT2005 dynamic microphone (Audio- Technica Productions, Western Hemisphere) at a fixed mouth-to-mouth distance of 15 cm. The patients were asked to pronounce the vowel 'a' for 7 seconds. All acoustic measurements were made using Praat computer software. Fundamental frequency (F0), formant frequency (F1, F2, F3 and F4), frequency perturbation (jitter), amplitude perturbation (shimmer) and Noise-Harmonic Ratio (NHR) parameters were evaluated in acoustic sound analysis of all patients. Results: 61.30% (n=19) of the patient group and 60.00% (n=15) of the control group were women. The mean age of the patients was 41.19±12.82 years, and the control group was 40.08±8.99 years. While the body mass index (BMI) of the patient group was 28.43±6.41 kg/m2, it was 28.95±2.62 kg/m2 in the control group. Gender, age and BMI distributions were found to be statistically similar between the patient and control groups. 67.70% (n=21) vii of the patients were in the Type 1 and 32.30% (n=10) Type 2 hereditary angioedema group. It was noted that laryngeal symptoms such as shortness of breath, difficulty in swallowing, hoarseness, and a feeling of fullness in the throat were observed in 61.30% (n=19) of the patients. The mean number of laryngeal attacks of the patients was determined as 6.68±11.94. Patient VHI, Patient VQI and patient reflux values were statistically significantly higher in the patient group than in the control group (p values, respectively; p=0.007; p=0.001; p<0.001). The distribution of other acoustic parameters between the patient and control groups was similar (p>0.05). . The patient's reflux value was found to be statistically higher in the group with 5 or more attacks. (p=0.018). Conclusion: In our study, it was shown that reflux is observed more frequently in hereditary angioedema, but in the chronic period, hereditary angioedema does not have a permanent effect on objective vocal parameters. It was observed that reflux complaints increased as the number of attacks increased.
Objective: It was aimed to examine the effects of hereditary angioedema on the voice in the chronic period. Method: 31 patients with hereditary angioedema followed in the Adult Immunology and Allergy Diseases outpatient clinic of Necmettin Erbakan University (NEU) Meram Medical Faculty and 25 healthy individuals with similar age and gender distribution without any additional disease were included in the study as the control group. Smokers, patients with gastroesophageal reflux disease, voice disease, history of laryngeal surgery and pathology that may affect the voice in the oral cavity, oropharynx, nasopharynx or larynx were excluded from the study. Voice handicap index questionnaire, voice-related quality of life scale and reflux symptom index questionnaires were administered to all patients and the control group. All video endoscopy recordings were made with a 5.8 mm diameter, 19 cm long and 70º angled rigid Hopkins rod telescope (Karl Storz, Tuttlingen, Germany) and were recorded with an endoscopic camera system (Karl Storz TELE PACK Endovision System). The patients were not exposed to trauma during the procedure. Sound recording and acoustic analyzes were performed in an isolated room free from environmental noise. Recordings were obtained using an Audio-Technica model AT2005 dynamic microphone (Audio- Technica Productions, Western Hemisphere) at a fixed mouth-to-mouth distance of 15 cm. The patients were asked to pronounce the vowel 'a' for 7 seconds. All acoustic measurements were made using Praat computer software. Fundamental frequency (F0), formant frequency (F1, F2, F3 and F4), frequency perturbation (jitter), amplitude perturbation (shimmer) and Noise-Harmonic Ratio (NHR) parameters were evaluated in acoustic sound analysis of all patients. Results: 61.30% (n=19) of the patient group and 60.00% (n=15) of the control group were women. The mean age of the patients was 41.19±12.82 years, and the control group was 40.08±8.99 years. While the body mass index (BMI) of the patient group was 28.43±6.41 kg/m2, it was 28.95±2.62 kg/m2 in the control group. Gender, age and BMI distributions were found to be statistically similar between the patient and control groups. 67.70% (n=21) vii of the patients were in the Type 1 and 32.30% (n=10) Type 2 hereditary angioedema group. It was noted that laryngeal symptoms such as shortness of breath, difficulty in swallowing, hoarseness, and a feeling of fullness in the throat were observed in 61.30% (n=19) of the patients. The mean number of laryngeal attacks of the patients was determined as 6.68±11.94. Patient VHI, Patient VQI and patient reflux values were statistically significantly higher in the patient group than in the control group (p values, respectively; p=0.007; p=0.001; p<0.001). The distribution of other acoustic parameters between the patient and control groups was similar (p>0.05). . The patient's reflux value was found to be statistically higher in the group with 5 or more attacks. (p=0.018). Conclusion: In our study, it was shown that reflux is observed more frequently in hereditary angioedema, but in the chronic period, hereditary angioedema does not have a permanent effect on objective vocal parameters. It was observed that reflux complaints increased as the number of attacks increased.
Açıklama
Anahtar Kelimeler
Herediter anjioödem, Akustik ses analizi, Jitter, Shimmer, Hereditary Angioedema, Acoustic voice analysis, Jitter, Shimmer
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Oğul, M. (2023). Herediter anjioödem hasta grubunda sesin objektif ve subjektif değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü İç Hastalıkları Anabilim Dalı, Konya.
