Correlation of body mass index with laryngopharyngeal reflux causing change in voice

Asitama Sarkar

Abstract

Correlation of body mass index with laryngopharyngeal reflux causing change in voice

Introduction: Voice provides us with the framework on which speech is constructed. Studies have recently shown that our bodystructure plays a key role in production of voice. The aim of this study is to evaluate the influence of body structure in patientswith dysphonia occurring due to laryngopharyngeal reflux. Laryngopharyngeal reflux causes chronic non-specific laryngitiswhich leads to pathological phonation. The condition has been clinically more commonly seen in patients who are over-weightand obese. Body mass index serves as the tool to measure body structure. This study aims to understand and identify, if any acorrelation between the two entities- body mass index and laryngopharyngeal reflux. This will help patients to make relevantlifestyle adjustments and avoid recurrence in patients presenting with dysphonia due to laryngopharyngeal reflux. It also willprovide the ENT practitioner a basis for early diagnosis and prevention.
Aims:
1. Study risk factors that cause laryngopharyngeal reflux.
2. Understand the structural and functional changes of vocal folds that are associated with laryngopharyngeal reflux.
3. Find correlation between BMI and voice change due to the chronic laryngitis.
Methodology:
Study Design: This is an analytical observational study done within our hospital premises. It is a case-control study design inwhich the study sample is selected from the patients that came to the OPD during a period of one year.
Hypothesis: The occurrence of raised/deranged body mass index is higher in patients with laryngo-pharyngeal reflux.
Sampling: Simple random sampling of cases and controls were done in this study. A total of 142 individuals participated. Thesample group sized 71 patients who were diagnosed with laryngo-pharyngeal reflux in the OPD. The control group consisted of 71 random persons with normal vocal fold anatomy with no signs of laryngo-pharyngeal reflux who live in and around the samegeographic area from where the cases are taken.
Exclusion criteria:
• All persons with mid-membranous vocal fold lesions were excluded from the study.
• Patients with history of smoking were also not taken into consideration owing to the fact that smoking will act as a majorconfounding factor in this study.
• We have also excluded individuals with co-morbidities- particularly diabetes and hypertension.
Diagnosis of laryngopharyngeal reflux shall be done by using 2 established questionnaires- Baylor Institute’s reflux symptomindex and Belafsky’s reflux finding
score.
Body mass index will be calculated using the standard formula, which is body weight divided by square of the body height andexpressed in kg/m2. Each participant will be categorized as per the WHO classification as underweight (<18.5), normal (18.5-24.9) overweight (25-29.9) and obese (>30). Only the persons above the normal BMI; that is overweight and obese categories areconsidered as part of the ‘deranged’ BMI group. Thereafter, the data collected will be evaluated and interpreted.
Results and Conclusion: Dysphonia has significant effect on quality of life. Chronic laryngitis is a common cause of abnormalphonation. Lifestyle modifications are a rational approach for its management. This study provides better understanding of thecausative factors by attempting to correlate body structure with laryngopharyngeal reflux causing voice change. This will helppatients to make relevant lifestyle adjustments and avoid recurrence as well as provide a basis for early diagnosis and prevention.