Laryngeal Findings and Acoustic Changes in Light Cigar Smoker

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



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



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.




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.






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




RESULTS

• 0emograp(ic data

• Daryngeal :ndings




RESULTS

• -coustic analysis

:ndings -bbreiati

• E A -erage

fre;uency

• - A elati

perturbation

• 8, A 8oiset

• F*I A Foice tu

• /* A /a+im




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




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




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?




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.




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.




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.




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%$#'()))*!.

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Laryngeal Findings and Acoustic Changes in Light Cigar Smoker