Association of Stress and Laryngopharyngeal Reflux with Vocal Fold Polyps

Abstract

Aim: Stress and laryngopharyngeal reflux can cause many laryngeal pathologies. In this study, we aimed to investigate the role of stress and laryngopharyngeal reflux (LPR) in the development of vocal fold polyps. Methods: Forty-five patients who were scheduled for surgery because of vocal fold polyps between October 2021 and May 2022 were included in the study. A control group was formed from 45 patients who applied to the otolaryngology outpatient clinic with the complaint of hoarseness lasting more than 3 weeks and had no vocal cord lesion in their 70-degree rigid endoscopic examination. Participants were asked to complete the reflux symptom index and depression anxiety stress scale (DASS) questionnaires. Reflux finding score (RFS) and grade, roughness, pallor, asthenia, strain, instability (GRBASI) voice analyses were conducted by two otolaryngologists familiar with both scales. Results: There was no significant difference between the speech characteristics of the patient groups. Reflux symptom index, RFS, and GRBASI scores were significantly higher in the group with vocal fold polyps (p=0.000, p=0.000, and p=0.009, respectively). Stress scores for DASS were significantly higher in the control group (p=0.025). There was no significant difference between the two groups in terms of depression and anxiety scores. Conclusion: Laryngopharyngeal reflux is more prevalent in patients with vocal fold polyps. This may be related to mucosal or submucosal damage from LPR. We also observed that increased stress can cause hoarseness without vocal fold lesions.

Keywords

• voice
• vocal cords
• laryngopharyngeal reflux
• anxiety