1. Prevalence of Voice Disorders Among the Attendants of Speech and Language Clinic at King Abdulaziz Medical City, Riyadh,Saudi Arabia Dr. Feras Alkholaiwi Otorhinolaryngology, Head and Neck Surgery Resident Demonstrator, Imam University

2.  Voice disorders are described as effortful or difficulties in phonation and deviant voice qualities are very often associated with physical discomfort and disability. Introduction:

3.  Heavy voice users, old age, female gender are twice likely to report vocal symptoms.  Alterations in laryngeal function and voice production and any degenerative changes in the structure and function of the vocal fold mucosa, musculature, and peripheral nerve supply could cause vocal complaints.  Smoking,Gastro-esophageal reflux, polyps and nodules, are some of the major factors that have a significant role in voice disorders. Smith E, Kirchner LH, Taylor M, Hoffman H, Lemke JH. Voice problems among teachers: differences by gender and teaching characteristics. J Voice 1998(b);12(3): 328-34

4.  The aim of the study is to magnitude the patient with voice disorders at King Abdulaziz Medical City (KAMC ), as well as their correlation between some pre- disposing factors.  To identify the rate of voice disorders among patients attended to speech and language pathology clinic at KAMC. Objectives of the Study:

5.  A retrospective, cross sectional study was carried out to estimate the prevalence of voice disorder among all patients who attended the speech and language clinic at King Abdulaziz Medical City during 2007-2013.  Data was extracted from medical charts from the Quadra-med medical system and reviewed for key variables such as (age, gender, occupation, smoking history and history of known related diseases).  SPSS program (V.20 USA) was used for the data.  P- value considered significant if < 0.05 Methodology:

6. Inclusion:  Both Gender  All ages  All records belong to patient attended to the speech and language at King Abdulaziz Medical City during the study period.  Patients underwent stroboscopy in the study period. Exclusion :  Records with incomplete main data, repeated files and out the study period,or without stroboscopy were execluded. Inclusion and Exclusion Criteria:

7. 1. 2508 patients 2. Chart review done. Inclusion and Exclusion criteria applied 3. 998 patients are included.

11. Laryngopharyngeal reflux 43.49% Vocal cord polyp 13.5% Vocal cord cyst 12.42 % Vocal cord paralysis 10.3% Vocal cord nodule 7.8% Others Commonest:

13.  Voice disorder is a complex phenomenon that is expressed in several ways and has different levels of severity.  In our study, we could observe : male gender, elderly age group and heavy voice users are at risk for voice disorder. Discussion:

14. Well, What about out side the hall?  Epidemiology of voice disorders in the elderly: preliminary findings. Roy N1, et all. Laryngoscope. 2007 Apr;117(4):628-33. - The lifetime prevalence of a voice disorder was 47%  Voice Problems in New Zealand Teachers: A National Survey. females (P=0.008) more likely to report voice problems, and more recovery time. J Voice. 2015 Sep;29(5):645.e1-645.e13. doi: 10.1016/j.jvoice.2014.11.004. Epub 2015 Jan 22.

15.  Voice Disorders: Etiology and Diagnosis. Martins RH1, do Amaral HA2, Tavares EL3, Martins MG4, Gonçalves TM3, Dias NH3. J Voice. 2015 Nov 4. pii: S0892-1997(15)00217-9. doi: 10.1016/j.jvoice.2015.09.017. -Smoking was reported by 13.6% patients -Nodules and cysts were predominant in children, functional dysphonia and reflux in adults, and presbyphonia and Reinke's edema in the elderly.

16.  Psychosocial assessment of voice problems among Saudi teachers.  Malki KH1, Mesallam TA., Malki KH1,  J Otolaryngol Head Neck Surg. 2012 Jun 1;41(3):189-99. - 33 %of teachers in Riyadh city reported having voice problems

17.  Multi-central institutions involvements in the region is highly advised.  To increase the awareness of voice disorder in the community for further measurements of prevention. Recommendation

18. Thank you,  King Abdullah Research Center  Dr. Sameer Bahkly  Dr. Mohammed Nasser  Dr. Rahaf Almadhri  Dr. Hind Alshehri  Dr. Samaher Alharthi  Mr. Ghassan Ahmed

19.  Smith E, Kirchner LH, Taylor M, Hoffman H, Lemke JH. Voice problems among teachers: differences by gender and teaching characteristics. J Voice 1998(b);12(3): 328-34  Voice Disorders: Etiology and Diagnosis. Martins RH1, do Amaral HA2, Tavares EL3, Martins MG4, Gonçalves TM3, Dias NH3. J Voice. 2015 Nov 4. pii: S0892-1997(15)00217-9. doi: 10.1016/j.jvoice.2015.09.017.  Voice Problems in New Zealand Teachers: A National Survey. J Voice. 2015 Sep;29(5):645.e1-645.e13. doi: 10.1016/j.jvoice.2014.11.004. Epub 2015 Jan 22.  Primov-Fever, A., et al., The Effect of Physical Effort on Voice Characteristics. Folia PhoniatrLogop, 2014. 65(6): p. 288-293.  Roy, N., et al., Epidemiology of voice disorders in the elderly: preliminary findings.Laryngoscope, 2007.117(4): p. 628-33.  Smith, E., et al., Frequency and effects of teachers' voice problems.J Voice, 1997.11(1): p. 81-7.  Awan, S.N., The effect of smoking on the dysphonia severity index in females. Folia PhoniatrLogop, 2011. 63(2): p. 65-71.  Makhadoom, N., et al., Prevalence of gastroesophageal reflux disease in patients with laryngeal and voice disorders.Saudi Med J, 2007.28(7): p. 1068-71.  Zhang, B., et al., [The difference of phonation patterns in vocal fold polyps and vocal nodules]. Lin Chung Er Bi Yan HouTou Jing WaiKeZaZhi, 2013. 27(18): p. 1014-5. 7. References: