Acoustic Voice Analysis for the Diagnosis of Laryngopharyngeal Reflux: A Preliminary Study

Background and Objectives Twenty-four-hour multichannel intraluminal impedance-pH (24-h MII-pH) monitoring is considered the gold standard for diagnosing laryngopharyngeal reflux (LPR), but limited accessibility and patient discomfort hinder clinical application. This study evaluated the correlation between reflux characteristics identified through 24-h MII-pH monitoring and acoustic voice parameters in patients with suspected LPR.Materials and Method Fourteen patients with suspected LPR were prospectively enrolled and underwent both 24-h MII-pH monitoring and voice analysis using the Multidimensional Voice Program (MDVP). Spearman correlation, Mann–Whitney U test, and receiver operating characteristic curve analysis were used to assess the association and predictive value of MDVP parameters for reflux.Results Reflux was identified in 11 of 14 patients: 6 had acid reflux and 5 had nonacid reflux. For statistical analysis, patients were grouped as reflux vs. non-reflux (11 vs. 3), and acid reflux vs. acid reflux-negative (6 vs. 8), with the latter including both nonacid reflux and non-reflux patients. Shimmer, noise-to-harmonic ratio (NHR), and voice turbulence index (VTI) were associated with overall reflux, while shimmer, amplitude perturbation quotient, and VTI were associated with acid reflux. NHR tended to be higher in the overall reflux group (p=0.072, area under the curve AUC=0.864), and shimmer was significantly elevated in the acid reflux group (p=0.02, AUC=0.875).Conclusion Amplitude-related measures and noise components were associated with reflux presence, suggesting that acoustic voice analysis may support LPR diagnosis. Further studies with larger cohorts are needed to validate its clinical utility.