Muscle Tension Dysphonia: A Sequeale of Chemoradiotherapy in Patients of Head and Neck Cancer

Vanita Sarin; B C Sarin; Arpita Chatterjee; Ateev Juneja

doi:10.1007/s12070-023-03577-9

Muscle Tension Dysphonia: A Sequeale of Chemoradiotherapy in Patients of Head and Neck Cancer

Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):1405-1413. doi: 10.1007/s12070-023-03577-9. Epub 2023 Feb 21.

Authors

Vanita Sarin¹, B C Sarin², Arpita Chatterjee¹, Ateev Juneja³

Affiliations

¹ Department of Otorhinolaryngology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India.
² Department of TB and Respiratory Diseases, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India.
³ Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India.

PMID: 37636687
PMCID: PMC10447776 (available on 2024-09-01)
DOI: 10.1007/s12070-023-03577-9

Abstract

It's very important to demarcate that voice is the production of sound by the larynx while speech is articulation of the produced sound by tongue movements, soft palate and the lips. Mucositis, dysphagia, change in speech and voice are the common sequelae of Radiotherapy (RT) alone or in combination with chemotherapy (CRT) which is commonly used in the treatment of head and neck cancer (HNC). The aim of this study was to investigate the patient-reported voice impairment among non laryngeal head and neck cancer survivors who were treated with curative RT/CRT with or without surgery. This tertiary institutional assessor blinded study consists of a study cohort of 128 patients who after of completion of treatment for HNC reported to the laryngology clinic for voice complaints and throat discomfort. The assessment included laryngeal endoscopic and stroboscopic imaging, acoustics assessment and VHI (Vocal handicap index). This study cohort consisted of 89.8% males and 11.2% females. There was hyperadduction and strain of ventricular bands in almost all the cases. There was hyperactivity and compression of both true and false cords in 80.5% of the cases. DSI impairment level showed significant association with gender, VHI, GRBAS score and RT/CRT and it did not show significant association with smoking and surgery, while VHI showed significant association with DSI and RT/CRT and it did not show significant association with gender, smoking and surgery. Muscle tension is a very common effect of RT/RCT and dysphonia can be easily associated with it. Future research needs to focus on specific voice treatment regimens in HNC treated with RT/CRT to improve the quality of life of these patients.

Keywords: Acoustics assessment; Chemoradiotherapy; DSI; GRBAS score; Laryngeal endoscopic imaging; Radiotherapy; Vocal handicap index.

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