Laryngeal Involvement in Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) is a chronic autoimmune illness that results in progressive joint and bone damage. Aim: To estimate the laryngeal involvement in cases with RA and its relation to the severity of the illness. Patients and methods: This case-control research was performed on 80 patients with rheumatoid arthritis and 40 participants free of RA as a control group. Patients were randomly selected from the rheumatology department and Otorhinolaryngology and phoniatrics clinics at AL-Zahraa University hospital from March 2023 to June 2024. Results: No significant difference was found in Voice Handicap Index (VHI) (mild: 55% in Group 1, 47.5% in Group 2, 60% in controls; moderate: 45%, 52.5%, 40%, respectively). However, a significant difference was observed in APA of voice (Dysphonia) (Grade 0: 40% in Group 1, 55% in Group 2, 62.5% in controls). Laryngeal findings (edema/hyperemia: 32.5%, 35%, 20%; vocal nodules: 22.5%, 27.5%, 12.5%) showed no significant differences. Acoustic analysis revealed significantly higher fundamental frequency (235.28±24.26 Hz in Group 1 vs. 202.78±22.52 in Group 2 vs. 181.23±23.33 in controls), lower jitter (0.30±0.03 vs. 0.36±0.03 vs. 0.45±0.05), lower shimmer (1.81±0.37 vs. 4.62±0.40 vs. 5.35±0.55), and higher harmonic-to-noise ratio (7.59±0.194 vs. 7.23±0.196 vs. 6.74±0.231) in Group 1. VHI and APA of voice correlated positively with F0 and HNR but negatively with jitter and shimmer. Conclusion: RA patients frequently experience laryngeal involvement and voice abnormalities, emphasising the necessity for comprehensive voice assessment and management, regardless of disease severity.