الفهرس 
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Abstract
Study of Voice Disorders in Patients With Bronchial Asthma and chronic Obstructive Pulmonary Disease(COPD)
*Adel M. Saeed **Nermine M. Riad, ,***Nehad M. Osman, ****Ahmed Nabil Khattab, *****Shymaa E. Mohamed
*Professor of Chest Diseases, **Assistant Professor of Chest Diseases, ***Assistant Professor of Chest Diseases ****Lecturer of phoniatrics ****M.B., B.CH
Faculty of Medicine, Ain Shams University, Chest Diseases Department
Abstract
Background: Voice problems in COPD and bronchial asthma patients have been neglected. These respiratory conditions are known to cause adverse effects on voice which might further affect the quality of life of an individual.
The Aim: The study was designed to study the voice disorders in patients with COPD and bronchial asthma and its relation to disease severity and medication.
Methodology: Sixty patients were recruited; thirty stable bronchial asthma patients and thirty stable COPD patients. All subjects underwent spirometry and study of voice parameters; using Auditory perceptual assessment (modified GRBAS score), video-laryngo-stroboscopy system, voice recording and acoustic analysis.
Results: Impaired voice quality and mild to moderate grade of dysphonia were detected in COPD group in (30%) by auditory perceptual assessment ; structural changes in the vocal folds (diffuse congestion, unhealthy mucosa, viscid secretions and edema) in 36.6%. In bronchial asthma group, impaired voice quality and mild to moderate grade of dysphonia were detected in 16.7%, structural changes in 20% of them, while acoustic analysis showed highly significant increase in jitter and shimmer and decreased harmonic to noise ratio in 100% of patients of both groups. These changes were more with metered dose inhaler users than dry-powder inhalers; In bronchial asthma group, Fluticasone Propionate (FP) users had a significantly decreased H/N than Beclomethasone dipropionate and budesonide; also the least pitch and highest shimmer and jitter in these patients. A significant statistical correlation was found between Ipratropium inhalation usage and increased shimmer in COPD group. There was a highly significant correlation between spirometric severity and both grade of dysphonia and character of voice in bronchial asthma patients.
Conclusion: All COPD and bronchial asthma patients had dysphonia, either due to organic or functional causes. Voice changes were directly correlated with degree of severity and Fluticasone Propionate inhalation use in bronchial asthma patients; and with Ipratropium Bromide inhalation in COPD group.
Keywords: Voice changes, COPD, bronchial asthma.