Alterations in Voice, Speech and Swallowing in Patients With Sjögren's Syndrome

Abstract

Objective

To identify and describe voice, speech and swallowing abnormalities in patients with Sjögren's syndrome (SS).

Materials and methods

This was a prospective cross-sectional descriptive observational study. Patients with SS were interviewed and physically explored. Nasolaryngeal endoscopy, video laryngeal stroboscopy, fiberoptic endoscopic evaluation of swallowing and computerized voice spectrographic analysis (PRAAT^® software) of voice and speech were also performed.

Results

We included 31 patients (96.7% women). Average time of evolution was 5 years; mean age was 48.4 years. Of these SS cases, 87% were secondary and 13% primary. Symptomatology: 70.9% dysphagia, 41.9% dysphonia, 35.4% dysglossia, 3.2% dysarthria. We found abnormalities principally in: one or more cranial nerves (V, VII, IX, X, XII) (67.7%), nasopharyngolaryngeal mucosa (77.4%), mucosal wave of vocal cords (90%), swallowing mechanism (90.3%), spectrogram of the vowels /e/ (58.06%) and /i/ (51.61%), and rhythm of the trisyllable “pataka” (35.48%).

Conclusions

Patients with SS have voice, speech and swallowing abnormalities, not only associated to xerosis but perhaps also to neurological abnormalities, probably secondary to the syndrome.

Resumen

Objetivo

Identificar y describir alteraciones de voz, habla y deglución en pacientes con síndrome de Sjögren (SS).

Material y métodos

Estudio prospectivo, descriptivo, transversal, observacional. Pacientes con SS fueron interrogados y explorados físicamente, realizamos además nasofibrolaringoendoscopia, videolaringoestroboscopia, evaluación fibroendoscópica de la deglución y análisis espectrográfico computarizado de voz y habla (software PRAAT^®).

Resultados

Incluimos 31 pacientes (96,7% mujeres), tiempo de evolución promedio 5 años 8 meses, edad promedio 48,4 años. El SS en 87% secundario, en 13% primario. Sintomatología: 70,9% disfagia, 41,9% disfonía, 35,4% disglosias, 3,2% disartria. Encontramos principalmente alteraciones en: uno o más pares craneales (V, VII, IX, X, XII) (67,7%), mucosa nasofaringolaríngea (77,4%), ondulación de la mucosa alterada en cuerdas vocales (90%), mecanismo de la deglución (90,3%), espectrograma de vocales /e/ (58,06%), /i/ (51,61%) y ritmo del trisílabo «pataka» (35,48%).

Conclusiones

El SS presenta alteraciones en voz, habla y deglución, quizá no sólo asociadas a xerosis, sino también a trastornos neurológicos probablemente secundarios al síndrome.