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Impact of Anti-IL-5 Therapy (Mepolizumab) on Objective Acoustic Voice Parameters in Type 2 Chronic Rhinosinusitis
İlhami Yıldırım1, Ayşe Karaoğullarından1, Sanem Okşan Erkan1
1ENT Specialist in Adana City Training and Research Hospital ENT Department, Yüreğir, Adana, Turkey.
Objective:
Biological therapies targeting type 2 inflammation have become an important treatment option for chronic rhinosinusitis with nasal polyps (CRSwNP). While their effects on polyp size and symptom severity are well documented, their potential impact on voice quality remains unknown. This study aimed to evaluate the effect of anti-interleukin-5 therapy (mepolizumab) on objective acoustic voice parameters in patients with type 2 CRSwNP.
Methods:
Eighteen adult patients with type 2 CRSwNP who had previously undergone endoscopic sinus surgery and were scheduled to receive mepolizumab were included. A control group consisted of 18 patients not receiving biological therapy. Voice recordings were obtained 3 months after surgery (baseline) and 6 months after initiation of therapy. Sustained vowel /a/ phonations were analyzed using Praat software. Fundamental frequency (F0), jitter, shimmer, noise-to-harmonics ratio (NHR), and harmonics-to-noise ratio (HNR) were evaluated. Within- and between-group comparisons were performed using appropriate parametric and nonparametric tests, and effect sizes were calculated.
Results:
No significant baseline differences were observed between groups in any acoustic parameters. After 6 months, the mepolizumab group demonstrated significant reductions in jitter, shimmer, and NHR, and a significant increase in HNR compared with the control group with large to very large effect sizes. The most pronounced improvement was observed in NHR. Significant time*group interactions were detected for jitter, shimmer, NHR, and HNR (P < 0.001), indicating treatment-specific effects. Although F0 values changed significantly over time in both groups, no significant interaction effect was observed.
Conclusion:
Mepolizumab has resulted in significant improvement in objective acoustic voice parameters in patients with type 2 chronic rhinosinusitis and nasal polyps. The greatest post-treatment change was observed in the NHR parameter.