laryngeal findings and acoustic changes in light cigar smoker
TRANSCRIPT
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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A R Y N G E A F I N D I N
A N D A C O U S T I C
C H A N G E S I N I G H
C I G A R S M O K E R S
H A M D A N , A B D U L - L A T I F , M D , F A C S ; A L - B A R A Z I , R A N D A ,M D ; A S H K A R , J I H A D , M D ; H U S S E I N I , S A M I , M D ; D O W L I . E A R
N O S E & T H R O A T J O U R N A L ; J U N 2 0 1 5 ; 9 4 , ; ! R O " U E S TN U R S I N # $ A L L I E D H E A L T H S O U R C E ! # . 2 % 1
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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BACKGROUND
• Cigar consumption is rapidly increasing in United States. It rose
from 1993 to 1996. 1 Cigar usage increased dramatically in men
34 years of age. !
• In !"13# a randomi$ed surey of 6".""" adults &1 years of age
smo'ed cigars and !% smo'ed t(em daily. 3
• In a study by S(apiro et al# loo'ing at t(e association bet)een csmo'ing and deat( from tobacco related cancers. *(ere )as an
ris' of deat( from cancer of t(e lung# oral caity# p(aryn+# laryn
esop(agus. 4
,amdan# -bdullatif# /0# -CS2-lara$i# anda# /02-s('ar# i(ad# /02,usseini# Sami# /020o)li. Ear, NosThroat Journal; un !"152 94# 62 ro7uest 8ursing -llied ,ealt( Source pg. !31
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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BACKGROUND
• 0espite t(e reports relating cigar smo'ing to prealence of canc
cardioascular disease# no study (as loo'ed at t(e laryngeal end
c(anges and acoustic c(aracteristic of cigar smo'ers
• *(e purpose of t(e study is to loo' at t(e laryngeal :ndings and
c(anges in lig(t cigar smo'ers in comparison to control.
,amdan# -bdullatif# /0# -CS2-lara$i# anda# /02-s('ar# i(ad# /02,usseini# Sami# /020o)li. Ear, NosThroat Journal; un !"152 94# 62 ro7uest 8ursing -llied ,ealt( Source pg. !31
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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METHODS
• - total of !! male cigar smo'ers )ere recruited for t(is study. 0
data includes age# se+# fre;uency of cigar smo'ing per )ee'# nu
years smo'ing# (istory of allergy# and (istory of re<u+.
• - total of 19 male controls also included. -nd all sub=ects )ere m
t(e age of 1.
,amdan# -bdullatif# /0# -CS2-lara$i# anda# /02-s('ar# i(ad# /02,usseini# Sami# /020o)li. Ear, NosThroat Journal; un !"152 94# 62 ro7uest 8ursing -llied ,ealt( Source pg. !31
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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METHODS
S/&/3/& +/63
• re;uencies# means# and standard deiaton >S0? )ere used to d
study sample.
• *(e study assessed diBerences in t(e laryngeal :ndings and aco
analysis parameters bet)een t(e t)o groups.
• 8onparametric tests# t(e Mann-Whitney U test and t(e Chi-Squa
)ere used for continuous and categorical ariables.
• - p value "."5 )as considered signi:cant
,amdan# -bdullatif# /0# -CS2-lara$i# anda# /02-s('ar# i(ad# /02,usseini# Sami# /020o)li. Ear, NosThroat Journal; un !"152 94# 62 ro7uest 8ursing -llied ,ealt( Source pg. !31
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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RESULTS
• 0emograp(ic data
• Daryngeal :ndings
,amdan# -bdullatif# /0# -CS2-lara$i# anda# /02-s('ar# i(ad# /02,usseini# Sami# /020o)li. Ear, NosThroat Journal; un !"152 94# 62 ro7uest 8ursing -llied ,ealt( Source pg. !31
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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RESULTS
• -coustic analysis
:ndings -bbreiati
• E A -erage
fre;uency
• - A elati
perturbation
• 8, A 8oiset
• F*I A Foice tu
• /* A /a+im
,amdan# -bdullatif# /0# -CS2-lara$i# anda# /02-s('ar# i(ad# /02,usseini# Sami# /020o)li. Ear, NosThroat Journal; un !"152 94# 62 ro7uest 8ursing -llied ,ealt( Source pg. !31
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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DISCUSSION
• Cigarette smo'ing is 'no)n to aBect oice. In study e+amining t(
smo'ing and drin'ing on (istologic c(anges in laryngeal tissue# m
t(e supraglottic region )as found to be increased )it( aging# alco
consumption# and tobacco usage. >1"?
• In a study by 0osmeci et al# (ig(est ris's )ere obsered in t(e su
region of t(e laryn+ among smo'ers. >11?• unc'rentano et al s(o)ed t(at pipe or cigar smo'ing )as asso
lo)er e+posure to product of tobacco metabolism t(an cigarette s
to and absence of cytoc(rome 45"1- induction# )(ic( is beliee
ma=or pat()ay to actiating carcinogen from tobacco smo'e. >13
,amdan# -bdullatif# /0# -CS2-lara$i# anda# /02-s('ar# i(ad# /02,usseini# Sami# /020o)li. Ear, NosThroat Journal; un !"152 94# 62 ro7uest 8ursing -llied ,ealt( Source pg. !31
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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DISCUSSION
• *(e result of t(e study are not accordance )it( t(e literature# as
no signi:cant c(ange# at least endoscopically# in t(e ocal fold m
no signi:cant diBerence in t(e prealence of any of t(e laryngea
comparison )it( controls.
• Seeral reasons t(at t(e result do not agree )it( t(ose preious
small sample si$e# relatiely s(ort duration of smo'ing# and mosimportantly# t(e sub=ectsG lig(t smo'ing
,amdan# -bdullatif# /0# -CS2-lara$i# anda# /02-s('ar# i(ad# /02,usseini# Sami# /020o)li. Ear, NosThroat Journal; un !"152 94# 62 ro7uest 8ursing -llied ,ealt( Source pg. !31
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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DISCUSSION
• -ccordance to acoustic analysis# studies inestigating t(e ocal
smo'ers (ae demonstrating a lo)ering of pitc(. Huimares et al
decrease in pitc( across all speec( tas'# alt(oug( t(e diBerence
signi:cant. >!1?
• 0amborenea *a=ada et al also reported a lo)er fundamental fre;
o)el @a@ along )it( an increase in cycletocycle ariation in fre>=itter?. >!!?
• is'irs'ao$nica et al# s(o)ed a result same as before2 )it( lo
fundamental fre;uency and increase in =itter. >!3?
,amdan# -bdullatif# /0# -CS2-lara$i# anda# /02-s('ar# i(ad# /02,usseini# Sami# /020o)li. Ear, NosThroat Journal; un !"152 94# 62 ro7uest 8ursing -llied ,ealt( Source pg. !31
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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DISCUSSION
• In t(e related study# cigarsmo'ing group also (ad a signi:cantly
fundamental fre;uency and (abitual pitc( compared to t(e cont
• ,ypot(etically# t(ese :ndings can be attributed to t)o factors. E
an increase in mass )it( resultant decrease in pitc(2 t(e increas
can be in t(e form of lesion# edema of t(e ocal fold# or e+cessi
• *(e study :nd (ig( prealence mucus in cigar smo'ers and limiin ocal fold2 1 patient )it( edema and 1 )it( cyst.
,amdan# -bdullatif# /0# -CS2-lara$i# anda# /02-s('ar# i(ad# /02,usseini# Sami# /020o)li. Ear, NosThroat Journal; un !"152 94# 62 ro7uest 8ursing -llied ,ealt( Source pg. !31
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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DISCUSSION
• -not(er factor is t(e possible decrease or alteration in breat(ing
eidence by a reduction t(e ma+imum p(onation time# een t(o
signi:cant.
• *(e study is t(e :rst to loo' at laryngeal :ndings and acoustic c
sub=ect )(o smo'e cigars 8eert(eless# it carries some limitatio
t(e lac' of perceptual ealuation of t(e oice ;uality in sub=ectssmo'e# and anot(er is t(e limited number of sub=ects.
,amdan# -bdullatif# /0# -CS2-lara$i# anda# /02-s('ar# i(ad# /02,usseini# Sami# /020o)li. Ear, NosThroat Journal; un !"152 94# 62 ro7uest 8ursing -llied ,ealt( Source pg. !31
8/19/2019 Laryngeal Findings and Acoustic Changes in Light Cigar Smoker
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CONCLUSION
• *(e results are in accordance )it( t(e (ypot(esis t(at cigar smo
oice. Cigar smo'ers are more li'ely to (ae a lo) fundamental
and (abitual pitc( t(an controls sub=ect.
• *(ese :ndings could represent early symptoms and signs of oc
c(anges not seen in laryngeal ideotroboscopy.
• 0ramatic rise in cigar consumption brings )it( it need to promopreention programs and to incorporate cigar smo'ing into toba
cessation programs.
,amdan# -bdullatif# /0# -CS2-lara$i# anda# /02-s('ar# i(ad# /02,usseini# Sami# /020o)li. Ear, NosThroat Journal; un !"152 94# 62 ro7uest 8ursing -llied ,ealt( Source pg. !31
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REFERENCE
1. Centers for 0isease Control and reention >C0C?. Cigar smo'teenagers —United States, Massachusetts, and New York, 1996. MMWR M
Wkly Re 199!"#6$%&'(#))*#&.
%. Ny+an -, aylor M, /iener -. rends in ci0ar s+okin0 and ercetions o
a+on0 Massachusetts adult. ob 2ontrol %&&%"11$sul %'(ii%3*4.
). 0aku 5, in0 /, 7usten 28, et al. obacco roduct use a+on0 adults—U
%&1%*%&1). MMWR Morb Mortal Wkly Re %&1#"6)$%3'(3#%*!.
#. Shairo , acobs :, hun M. 2i0ar s+okin0 in +en and risk o death ro+
related cancers. Natl 2ancer 5nst %&&&"9%$#'()))*!.