Estimated Subglottic Pressure Evaluation According to Vocal Pathology. Study on 418 Patients

Estimated subglottic pressure (ESGP) is part of the aerodynamic measurements included in the vocal profile. It is an indication of vocal effort and can guide the therapist in his clinical approach.
We aim to examine the clinical interest of the ESGP by observing its values according to voice pathology, age, gender and sound pressure level. We also examine the relationships between PSGE, DSI and VHI.
Method:The study includes 418 patients (M:118/W:300). Each patient’s file consists of VLS, acoustic, aerodynamic and perceptual measures. The ESGP was collected through the Phonatory Aerodynamic System Model 6600 (KayPentax). Patients produced 3 sequences of / ipipi / at low (IL), conversational (IC) and high (IH) intensity. Patients were grouped according to the ENT’s diagnosis.
Results: Patients without vocal lesions (MTD) had a significantly lower ESGP compared to patients with nodules, polyps, inflammation, edema (IL, IC), cysts (IC) or scar (IC). Patients with vocal fold atrophy had a lower ESGP than those suffering from nodules and polyps at conversational and high intensity, but were not differentiated at low intensity. Amongst patients without lesions (MTD), a positive correlation appeared between ESGP and intensity; which was not the case for patients with lesions. At high intensity, men had a significantly higher ESGP than women. At low intensity, we noted a positive correlation between the VHI scores and ESGP levels. At low and conversational intensity, we observed a negative correlation between DSI and ESGP scores.
Conclusion: This study highlights the importance of considering ESGP in the vocal profile. As expected, patients with vocal pathology produce high ESGP. However, the correlations between intensity and ESGP vary depending on the patient's pathology. In addition, ESPG values allow the clinician to distinguish MTD and healthy patients and thus could help the therapist in his clinical approach.