The prevalence of dysphonia and dysphagia in patients affected by immunomediated diseases and the role of psychometric tests

• Published in: Clinical rheumatology Vol. 38; no. 1; pp. 77 - 84
• Main Authors: Galli, J., Marchese, M. R., De Canio, C., Di Salvo, M., Olivieri, I., Santandrea, L., Paludetti, G.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.01.2019; Springer Nature B.V
• Subjects: Adult; Cross-Sectional Studies; Deglutition Disorders - diagnosis; Deglutition Disorders - epidemiology; Dysphagia; Dysphonia - diagnosis; Dysphonia - epidemiology; Female; Food; Humans; Immune system; Italy - epidemiology; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Pharynx; Prevalence; Psychometrics; Quality of Life; Rheumatic Diseases - complications; Rheumatic Diseases - physiopathology; Rheumatology; Self-assessment; Severity of Illness Index; Statistical analysis; Surveys and Questionnaires; Swallowing; Italy; Globus pharyngeus; Dysphonia; Dysphagia; Immunomediated diseases
• ISSN: 0770-3198; 1434-9949
• DOI: 10.1007/s10067-018-4129-8

This cross-sectional investigation examined the prevalence and severity of dysphonia, globus pharyngeus, and dysphagia in patients affected by immunomediated (IM) diseases. Seventy subjects were administered the Voice Handicap Index (VHI) (scale 0–4), Glasgow-Edinburgh Throat Scale (GETS) (scale from 0 to 7) for globus pharyngeus assessment, and modified Swallowing Outcomes After Revised Laryngectomy (SOAL) (scale 0, 1, 2) to test swallowing symptoms. VHI: the mean percentage of answers with a score greater than 1 (corresponding to a frequency of situation’s occurrence “sometimes,” “almost always,” or “always”) was 25.7, 26.7, and 44.1% for functional, emotional, and physical groups of sub-items respectively. GETS: the mean percentage of answers with a score ≥ 3 was 60.85%, significantly higher if compared with that of answers with a score < 3 (40.14%). The mean percentages of answers with a score 0–2, 3–4, and 5–7 were 40.1, 16.7, and 43.7% respectively. SOAL: a mean of 57.9% of answers gained a symptomatic score (1 [“a little”] or 2 [“a lot”]) and 41.9%, the score 0. The difference was statistically significant ( p  < 0.05). The first two most recurrent items with a score 2 (“a lot”) were “Do you have a problem swallowing dry food?” (46%) and “Do you have a problem swallowing solid food?” (36%). The study represents the first to describe the globus pharyngeus symptoms in IM population. Moreover, it allows to confirm the recurrence of dysphonia and dysphagia in this type of patients. Particularly, it has been demonstrated that the alteration of swallowing function is related to solid and dry food. The self-assessment questionnaires proved as a useful tool to early detection of dysfunctions in order to avoid further deterioration of quality of life and to prevent serious life-threatening complications.