Effect of systemic isotretinoin treatment on voice

Abstract

Objectives: This study aims to investigate the effects of oral systemic Isotretinoin (Iso) treatment of acne vulgaris, as a chronic inflammatory disease, on voice. Patients and Methods:Between March 2014 and May 2016, a total of 62 volunteer patients (40 females, 22 males; mean age 22.4±5.5 years; range 18 to 36 years) with systemic Iso therapy indication due to acne vulgaris were included in the study. Ear nose and throat examination, videolaryngostroboscopy (VLS) and acoustic voice analysis (sound pressure level [SPL], mean F0, first three formants, jitter%, shimmer% and noise to harmonic ratio [NHR]) were performed, maximum phonation time (MPT) and s/z ratio were measured at pretreatment, third and sixth months of treatment and sixth month after the treatment was stopped. The Voice Handicap Index (VHI-10) and the GRBAS scales were performed for perceptual voice evaluation. Results:There was no statistically significant difference in MPT, F0, the first three formants, SPL, GRBAS (increased during the treatment), shimmer% ratings and VLS parameters during the Iso treatment. Voice Handicap Index-10, s/z ratio, jitter% and NHR were observed to have increased significantly during the treatment. Conclusion:Six-month regular systemic Iso treatment at standard clinical doses has mild negative effects on voice quality and this impact returns to baseline after the treatment is stopped. It is recommended that patients, especially vocal artists, to be informed prior to treatment about this possible side effect. Bulgular: Maksimum fonasyon zamanı, F0, ilk üç formant, SPL, GRBAS (tedavi sırasında artış gösterdi), shimmer% değerlerinde ve VLS parametrelerinde istatistiksel olarak anlamlı bir değişiklik saptanmadı. Ses Handikap İndeksi-10, s/z oranı, jitter% ve NHR'nin tedavi sırasında anlamlı olarak arttığı görüldü.Sonuç: Standart klinik dozda altı aylık düzenli sistemik Iso tedavisinin ses kalitesi üzerinde hafif bir olumsuz etki gösterdiği ve bu etkinin tedavi sonlandırıldığında başlangıçtaki duruma döndüğü saptandı. Hastaların, özellikle de ses sanatçılarının, tedavi öncesinde bu olası yan etki açısından bilgilendirilmeleri önerilir.Anahtar Sözcükler: Disfoni; isotretinoin; ses.