RESUMO
Laryngeal diseases are sources of increasing concerns. Continuous exposure to certain pathogens can lead not only to voice changes but also to life threatening stridor. One of these pathogens is laryngoscleroma which is endemic in some countries including Egypt. The diagnosis of laryngoscleroma may elude the clinicians for years with subsequent increase in the severity of the resultant morbidity. The aim of this work was to study some of the laryngoscopic, acoustic, and aerodynamic changes that occur in patients with laryngoscleroma in order to reach a better understanding of the phonatory changes that occur in such patients. 30 subjects were involved in this study. The subjects were divided into 2 groups. Group 1 [study/patient group] included 15 female patients suffering from laryngoscleroma and receiving medical treatment. The patients were selected from the Phoniatric Unit and ENT department, Faculty of Medicine, Cairo University. Their ages ranged from 26 to 35 with a mean of 27 +/- 3.16. Group 2 [control/normal group] included 15 age-matched female normal subjects. Their ages ranged from 25 to 34 with a mean of 26.4 +/- 2.5. Each subject under study was subjected to patient interview, history taking, Auditory Perceptual Assessment of voice using the modified GRBAS Scale. Visual inspection of the larynx was performed using fiberoptic Nasopharyngolaryngoscopy. Acoustic analysis of voice was performed and the values of Fundamental Frequency [F[0]], jitter%, Shimmer [ShdB], Amplitude Perturbation Quotient [APQ], and Pitch Perturbation Quotient [PPQ] were computed. Thereafter, aerodynamic measurements were obtained. These included Mean Flow Rate [MFR], Subglottic Pressure [Psub], Glottic Resistance [GR] and Glottal Efficiency [GE]. Mean values were calculated and the results of 2 groups were statistically compared and differences were tested for significance. In most of the patients under study, laryngoscleroma was more abundant in the subglottic region. Auditory perceptual Assessment revealed changes in voice quality and loudness. Statistically Highly significant differences [p<0.01] between the patient group and the control group were found in all acoustic parameters, with the patients having higher values in all the included acoustic measures. Highly Significant differences [p<0.01] were found between the patient and control groups with the patient group having higher values in Mean Flow Rate and the Subglottic pressure. On the other hand, higher values were obtained by the control group in Glottic Resistance and Glottal Efficiency. Infection with laryngoscleroma can lead to various voice changes that can be detected perceptually, acoustically, and aerodynamically. Considering aerodynamic measures and acoustic analysis as additional tools in assessing the phonatory changes that occur in patients having rhinolaryngoscleroma