Research Article
Year 2022,
Volume: 11 Issue: 1, 45 - 51, 29.04.2022
Abstract
Amaç: Bu çalışmanın amacı, miyasteni gravis (MG) hastalarının akustik analizlerinin bazı parametrelerinde sabah ve akşam yapılan ölçümler arasındaki değişiklikleri incelemektir.
Gereç ve Yöntemler: Osserman ve Gengkins sınıflandırmasına göre bir nöroloji uzmanı tarafından Faz-2A (Hafif Genelleştirilmiş MG) tanısı almış 24 MG hastası dahil edildi. İşitsel-Bilişsel ses muayeneleri GRBASI ölçeği kullanılarak gerçekleştirilmiş ve Fo, Shimmer, Jitter, NHR (Noise to harmonic ratio), MPT (Maximum Phonation Time) ve s / z oranları hesaplanmıştır.
Bulgular: Hastaların sabah ve akşam ses ölçümleri GRBASI ölçeğine göre karşılaştırıldığında, B, A ve S değerleri arasında anlamlı fark bulunurken, G, R ve I değerleri arasında istatistiksel olarak anlamlı bir fark bulunmadı. Sabah ve akşam yapılan vakaların Fo, Shimmer, NHR, s / zRatio ve VHI (ses handikap indeksi) ölçümleri arasında istatistiksel olarak anlamlı farklılıklar bulundu. Ancak, Jitter ölçümleri arasında hiçbir fark bulunamadı. Erkeklerin Fo ve MPT ölçümlerinin sabah ve akşam değerleri arasında istatistiksel olarak anlamlı fark bulundu. Yine kadınların Fo ve MPT ölçümlerinin sabah ve akşam değerleri arasında istatistiksel olarak anlamlı fark bulundu.
Sonuç: Myasthenia Gravis hastaları için gün içinde kas gücünün azalması ve gırtlak kaslarındaki yorgunluk beklenen bir süreçtir ve bu çalışmada objektif olarak sunulmuştur. Böylelikle MG hastalarının sabah ve akşam akustik analizlerinin değerlendirilmesiyle olası iletişim problemlerinin ses terapileri ile önlenebileceği düşünülmektedir.
Keywords
References
- 1. Osserman KE, Genkins G. Studies in myasthenia gravis: review of twenty year experience in over 1200 patient. Mt Sinai J Med 1971; 38: 497-537.
- 2. Berrih-Aknin S, Frenkian-Cuvelier M, Eymard B. Diagnostic and clinical classification of autoimmune myasthenia gravis. J Autoimmun. 2014 Feb-Mar; 48-49: 143-148.
- 3. Conti-Fine BM, Milani M, Kaminski HJ. Myasthenia gravis: past, present, and future. J Clin Invest. 2006 Nov 1; 116 (11) : 2843–2854.
- 4. Xu W, Han D, Hou L, Hu R, Wang L. Clinical and Electrophysiological Characteristics of Larynx in Myasthenia Gravis. Ann Otol Rhinol Laryngol. 2009 Sep; 118(9): 656-661.
- 5. Carpenter RC, Mc Donald TJ, Howard EM. The otolaryngologic presentation of myasthenia gravis. Laryngoscope 1979; 89: 922–928.
- 6. Grob D, Arsura EL, Brunner NG, et al. The course of myasthenia gravis and therapies a Vecting outcome. Ann N Y AcadSci 1987; 505: 472–499.
- 7. Liu WB, Xia Q, Men LN, Wu ZK, Huang RX. Dysphonia as a primary manifestation in myasthenia gravis (MG): A retrospective review of 7 cases among 1520 MG patients. J Neurol Sci. 2007 Sep 15; 260(1-2): 16-22.
- 8. Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jacobson G, Benninger MS, Newman CW. The Voice Handicap Index (VHI): Development and Validation. American Journal of Speech-Language Pathology; 6(3): 66-70.
- 9. Kiliç MA, Okur E, Yildirim I, Oğüt F, Denizoğlu I, Kizilay A, Oğuz H, KandoğanT, Doğan M, Akdoğan O, Bekiroğlu N, Oztarakçi H. Ses Handikap Endeksi (Voice Handicap Index) Türkçe versiyonunun güvenilirliği ve geçerliliği Kulak Burun Bogaz Ihtis Derg. 2008; 18:139–147.
- 10. Praat: doing phonetics by computer. http://www.fon.hum.uva.nl/praat/
- 11. Drachman DB. Myasthenia gravis. N Engl J Med 1994; 330: 1791-1810.
- 12. Pego-Fernandes P, de Campos JRM, et al. Thymectomy by Partial Sternotomy for the Treatment of Myasthenia Gravis. Ann Thorac Surg 2002; 74: 204-208.
- 13. Grob D, Arsura EL, Brunner NG, Namba T. The course of myasthenia gravis and the-rapies affecting outcome. Ann NY Acad Sci 1987; 505: 472-499.
- 14. Shields TW, Cicero JL, Ponn RB, Rusch VW. General Thoracic Surgery, sixth edition. Lippincott Williams & Wilkins, Philadelphia. 2005; 2347-2356, 2617-2675.
- 15. Heller A, Tanner K, Roy N, Nissen SL, Merrill RM, Miller KL, Houtz DR, Ellerston J, Kendall K. Voice, speech, and laryngeal features of primary Sjögren's syndrome. Ann Otol Rhinol Laryngol. 2014 Nov; 123(11): 778-785.
- 16. Karlsen T, Heimdal JH, Grieg AR, Aarstad HJ. The Norwegian Voice Handicap Index (VHI-N) patient scores are dependent on voice-related disease group. Eur Arch Otor-hinolaryngol. 2015 Oct; 272(10): 2897-2905.
Year 2022,
Volume: 11 Issue: 1, 45 - 51, 29.04.2022
Abstract
Objective: This study aims to examine the changes between the measurements done in the morning and evening in some acoustic analyses of patients having myasthenia gravis (MG).
Materials and Methods: Twenty-four MG patients diagnosed with Phase-2A (Mildly Generalized MG) according to the classification of Osserman and Genkins by a neurology specialist were involved. Videolaryngostroboscopic examinations and acoustic analyses of these patients were performed in the Ear, Nose, and Throat (ENT) clinic. Perceptual voice assessments were performed using the GRBASI scale, Fo, Shimmer, Jitter, NHR (Noise to harmonic ratio), MPT (Maximum Phonation Time), and s/z rates were calculated.
Results: When the morning and evening vocal measurements of patients were compared according to the GRBASI scale, a significant difference was found between B and A and S values, while no statistically significant difference was found between G, R, and I value. Statistically significant differences were found between cases’ Fo, Shimmer, NHR, s/z Ratio, and VHI (voice handicap index) measurements made in the morning and the evening. But no difference was found between the Jitter measurements. A statistically significant difference was found between the morning and evening values of men’s Fo and MPT measurements. Again, a statistically significant difference was found between the morning and evening values of women’s Fo and MPT measurements.
Conclusion: For Myasthenia Gravis patients, the decrease in muscle power within the day and the tiredness in larynx muscles are an expected process, and it is objectively presented in this study. In addition, further studies are needed to show that possible communication problems can be prevented with sound therapies by evaluating the morning and evening acoustic analyses of MG patients.
Keywords
References
- 1. Osserman KE, Genkins G. Studies in myasthenia gravis: review of twenty year experience in over 1200 patient. Mt Sinai J Med 1971; 38: 497-537.
- 2. Berrih-Aknin S, Frenkian-Cuvelier M, Eymard B. Diagnostic and clinical classification of autoimmune myasthenia gravis. J Autoimmun. 2014 Feb-Mar; 48-49: 143-148.
- 3. Conti-Fine BM, Milani M, Kaminski HJ. Myasthenia gravis: past, present, and future. J Clin Invest. 2006 Nov 1; 116 (11) : 2843–2854.
- 4. Xu W, Han D, Hou L, Hu R, Wang L. Clinical and Electrophysiological Characteristics of Larynx in Myasthenia Gravis. Ann Otol Rhinol Laryngol. 2009 Sep; 118(9): 656-661.
- 5. Carpenter RC, Mc Donald TJ, Howard EM. The otolaryngologic presentation of myasthenia gravis. Laryngoscope 1979; 89: 922–928.
- 6. Grob D, Arsura EL, Brunner NG, et al. The course of myasthenia gravis and therapies a Vecting outcome. Ann N Y AcadSci 1987; 505: 472–499.
- 7. Liu WB, Xia Q, Men LN, Wu ZK, Huang RX. Dysphonia as a primary manifestation in myasthenia gravis (MG): A retrospective review of 7 cases among 1520 MG patients. J Neurol Sci. 2007 Sep 15; 260(1-2): 16-22.
- 8. Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jacobson G, Benninger MS, Newman CW. The Voice Handicap Index (VHI): Development and Validation. American Journal of Speech-Language Pathology; 6(3): 66-70.
- 9. Kiliç MA, Okur E, Yildirim I, Oğüt F, Denizoğlu I, Kizilay A, Oğuz H, KandoğanT, Doğan M, Akdoğan O, Bekiroğlu N, Oztarakçi H. Ses Handikap Endeksi (Voice Handicap Index) Türkçe versiyonunun güvenilirliği ve geçerliliği Kulak Burun Bogaz Ihtis Derg. 2008; 18:139–147.
- 10. Praat: doing phonetics by computer. http://www.fon.hum.uva.nl/praat/
- 11. Drachman DB. Myasthenia gravis. N Engl J Med 1994; 330: 1791-1810.
- 12. Pego-Fernandes P, de Campos JRM, et al. Thymectomy by Partial Sternotomy for the Treatment of Myasthenia Gravis. Ann Thorac Surg 2002; 74: 204-208.
- 13. Grob D, Arsura EL, Brunner NG, Namba T. The course of myasthenia gravis and the-rapies affecting outcome. Ann NY Acad Sci 1987; 505: 472-499.
- 14. Shields TW, Cicero JL, Ponn RB, Rusch VW. General Thoracic Surgery, sixth edition. Lippincott Williams & Wilkins, Philadelphia. 2005; 2347-2356, 2617-2675.
- 15. Heller A, Tanner K, Roy N, Nissen SL, Merrill RM, Miller KL, Houtz DR, Ellerston J, Kendall K. Voice, speech, and laryngeal features of primary Sjögren's syndrome. Ann Otol Rhinol Laryngol. 2014 Nov; 123(11): 778-785.
- 16. Karlsen T, Heimdal JH, Grieg AR, Aarstad HJ. The Norwegian Voice Handicap Index (VHI-N) patient scores are dependent on voice-related disease group. Eur Arch Otor-hinolaryngol. 2015 Oct; 272(10): 2897-2905.
There are 16 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Articles |
| Authors | |
| Early Pub Date | April 26, 2022 |
| Publication Date | April 29, 2022 |
| Submission Date | May 31, 2021 |
| Published in Issue | Year 2022 Volume: 11 Issue: 1 |
