Multimodal Analysis of Dysphonia in Smokers: A Two Year Comprehensive Study

To study the specific effects of smoking on laryngeal mucosa and voice using video-stroboscopy, subjective and objective voice analysis. This cross-sectional and observational study was carried out in the Department of Otorhinolaryngology, M.G.M. Medical College & M.Y. Hospital, Indore on 103 subjects with dysphonia (49 smokers and 54 non-smokers), between October 2018 to October 2020. After detailed history and general examination, all the cases underwent video-stroboscopic analysis and voice analysis by simple parameters-Maximum Phonation Time (M.P.T.) & s/z score. The cases answered the Voice Related Quality Of Life questionnaire (V.R.Q.O.L.). The observations between smokers and non-smokers were compared. Statistically significant (P < 0.05) associations were observed between smoking and various vocal fold pathological characteristics. There was statistically significant association of smoking with overall possibility of benign vocal fold lesions (P = 0.0129). Significant association was noted of smoking with specific lesions like leukoplakia (P = 0.02), erythema (P = 0.0161) and Reinke's edema (P = 0.322). The mean M.P.T. was 9.5 s in smokers and 11 s in non-smokers. We observed statistically significant relationship between smoking and abnormal s/z ratio (P = 0.0165). This study shows the observable effects of smoking on vocal fold micro-anatomy and voice. Dysphonia was primary complaint in both groups, but all observations were worse in smokers, indicating harmful effects of smoking.