THE CLINICALLY PREDICTIVE FACTORS FOR THE AERODYNAMICS OF VOCAL FOLD ATROPHY IN ELDERLY
- Wei-Kang Tung, Hsiang-Chen Hsu and Shiao-Wen Tung
- Vol 12 Num 3 January 2020
- Hits: 53
THE CLINICALLY PREDICTIVE FACTORS FOR THE
AERODYNAMICS OF VOCAL FOLD ATROPHY IN ELDERLY
Department of Otorhinolaryngology, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan, 80457
PhD Student, Industrial Management Department, I-Shou University
Kaohsiung, Taiwan, 84001
Industrial Management Department, I-Shou University
Kaohsiung, Taiwan, 84001
Kaohsiung Municipal Kaohsiung Girls' Senior High School,
Kaohsiung, Taiwan, 80148
Background: Hoarseness due to vocal fold atrophy (VFA) embraced a substantial part of vocal clinic's patients. Frailty seemed common in the elderly with vocal fold atrophy. We aimed to find out: 1. The Maximum phonation time (MPT) in VFA and in normal vocal folds (NVF); the incidence rate of frailty in NVF and VFA. 2. The association of Clinical Frailty Scale (CFS), Study of Osteoporotic Fracture Criteria for Frailty (SOF), Charlson Comorbidity index( CCI) and MPT in all patients. 3. The predictive factors for MPT in NVF and VFA. 4. The sports-days per week (SDW) in NVF and VFA.
METHOD: This was a retrospective medical chart review with 212 patients 65 years or older enrolled. 112 patients in this study were all diagnosed as VFA. 100 patients were with NVF. All the patients were recorded with MPT, AGE, CCI, CFS, SOF, SDW. Pearson correlation was used to find the correlation of AGE, GENDER, SOF, CFS, CCI, SDW and MPT in all patients. Stepwise regression and Area Under the ROC Curve ( AUC) were used to find out the predictive factors for MPT in NVF and VFA..
Results: Comparing with patients with NVF, the MPT was shorter in patients with VFA. The incidence rate of frailty was higher in patients with VFA than those with NVF. In elderly patients of both genders with VFA, MPT was moderately to highly negatively correlated with CFS, SOF, and CCI. In elderly patients of both genders with NVF, MPT was modestly to moderately negatively correlated with CFS ,SOF and CCI. In all elderly patients with VFA, SOF, SDW, AGE, and CFS were the predictive factors for MPT. In patients with NVF, the predictive factors for MPT were SOF, SDW, and CFS. The SDW of VFA was less than that of NVF.
Conclusions: The MPT of VFA was shorter than that of NVF. The MPT was a valid and excellent indicator of physical condition for the patients with VFA. The predictive factors for the MPT were SOF, SDW, AGE, and CFS in patients with vocal fold atrophy. It could be found that more amount of exercise, although which exerted muscles unrelated to the intrinsic laryngeal muscles, would be correlated with longer MPT and lower incidence rate of frailty in normal vocal folds groups. Besides, less amount of exercise would be correlated with shorter MPT and higher incidence rate of frailty in vocal fold atrophy groups.
Keywords: Clinical Frailty Scale, Maximum Phonation Time, Vocal Fold Atrophy, Study of Osteoporotic Fracture Criteria for Frailty, Charlson Comorbidity Index