[Glottis morphology and perceptive-acoustic characteristics of voice and speech in patients with rheumatoid arthritis].

INTRODUCTION: The aim of this study was estimation of glottis morphology and perceptive-acoustic characteristics of voice and speech in patients suffering from rheumatoid arthritis (RA).

MATERIAL AND METHODS: 77 patients (51 women and 15 men), 19-77 years of age (average 56,7) with recognized RA. The disease duration was from 1 month to 29 (average 9,4) years. Laryngeal, phoniatric examination and phonetic-acoustic analysis of voice and speech (program IRIS). One patient with bilateral vocal folds immobilization had computer tomography of the larynx and electromiography of internal laryngeal muscles.

RESULTS: The most frequent complains were: foreign body sensation in the throat 51% (n = 39/76), hoarseness - 47% (n = 36/76), weakness of voice - 29% (n = 22/76). Redness of the mucosal tissue in the area of arytenoids was stated in 41% (32/77) patients and edema in 28% (21/77). Complains and morphological features of inflammation in the larynx were considerably more frequent in patients with active RA. 3 patients had impairment of vocal folds mobility, in 2 of them it was bilateral immobilization requiring emergency tracheotomy. Subjective voice analysis was made according to GRBAS scale. In 35% (26/75) patients there was G2 or G3 stated. The average time of phonation [a] was 7 seconds. Average basic voice frequency was for women 216 Hz and for men 118 Hz. There was statistically important correlation between increasing of some acoustic voice parameters and RA activity and intensity.

CONCLUSIONS: Patient's complains for foreign body sensation in the throat and hoarseness, especially when RA is active, can indicate on inflammatory process in the larynx. For these reason it seems to be reliable to stay in close contact for rheumatologist, laryngologist and phoniatrist in every day practice.