Volume 134, Issue 2 pp. 773-778
Original Report

Laryngological Complaint Prevalence in Hypermobile Ehlers-Danlos or Hypermobility Spectrum Disorders

Stacey M. Menton MM, MA, CCC-SLP

Corresponding Author

Stacey M. Menton MM, MA, CCC-SLP

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida, U.S.A.

Send correspondence to Stacey M. Menton, Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224. Email: [email protected]

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DeLisa Fairweather PhD

DeLisa Fairweather PhD

Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, U.S.A.

Department of General Internal Medicine, Mayo Clinic, Jacksonville, Florida, U.S.A.

Center for Clinical and Translational Sciences, Mayo Clinic, Jacksonville, Florida, U.S.A.

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Katelyn A. Bruno PhD

Katelyn A. Bruno PhD

Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, U.S.A.

Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, Florida, U.S.A.

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Chandler C. Thompson DMA, MS, CCC-SLP

Chandler C. Thompson DMA, MS, CCC-SLP

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida, U.S.A.

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Estephania Candelo MD, MSc

Estephania Candelo MD, MSc

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida, U.S.A.

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Ashley A. Darakjian BS

Ashley A. Darakjian BS

Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, U.S.A.

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Jessica M. Gehin MS, BSN, RN

Jessica M. Gehin MS, BSN, RN

Department of General Internal Medicine, Mayo Clinic, Jacksonville, Florida, U.S.A.

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Angita Jain MBBS

Angita Jain MBBS

Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, U.S.A.

Center for Clinical and Translational Sciences, Mayo Clinic, Jacksonville, Florida, U.S.A.

Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, U.S.A.

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Archana Kotha MD

Archana Kotha MD

Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, U.S.A.

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Emily R. Whelan BS

Emily R. Whelan BS

Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, U.S.A.

Center for Clinical and Translational Sciences, Mayo Clinic, Jacksonville, Florida, U.S.A.

Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, Florida, U.S.A.

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Zhuo Li MS

Zhuo Li MS

Department of Quantitative Health Science, Mayo Clinic, Jacksonville, Florida, U.S.A.

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Dacre R.T. Knight MD

Dacre R.T. Knight MD

Department of General Internal Medicine, Mayo Clinic, Jacksonville, Florida, U.S.A.

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Amy L. Rutt DO, FACS

Amy L. Rutt DO, FACS

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida, U.S.A.

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First published: 19 August 2023
Editor's Note: This Manuscript was accepted for publication on July 21, 2023.

Stacey M. Menton, DeLisa Fairweather and Katelyn A. Bruno co-first authors.

Dacre R. T. Knight and Amy L. Rutt co-senior authors.

This work was supported by National Institutes of Health (NIH) R21 AI163302 to KAB, and NIH R01 HL164520, R21 AI145356, R21 AI152318, and R21 AI154927 to DF, American Heart Association 20TPA35490415 to DF, the Mayo Clinic RACER Award to DRTK, EDS Society Micro grant to DRTK and DF, Mayo Clinic's Division of General Internal Medicine to DRTK, KAB, and DF, and the Ralph E. Pounds and Kathy Olesker Pounds Fund in Research Related to Chronic Pain to DF.

The authors have no other funding, financial relationships, or conflicts of interest to disclose.

This work was presented as a poster at The Combined Otolaryngology Spring Meetings, Boston, MA, United States of America, May 3–7, 2023.

Abstract

Objective

The aim was to study laryngological complaints in patients with hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorders (HSD).

Methods

A total of 363 patients met inclusion for the study by completing questions related to voice, upper airway, and swallowing between July 7, 2020 and July 13, 2022. Demographic data, voice-related questions, and hypermobility diagnosis were analyzed retrospectively. From those, 289 patients were diagnosed with hEDS or HSD with 74 that did not meet the diagnostic criteria for either diagnosis serving as controls.

Results

There were no statistically significant differences between patients with hEDS and HSD regarding Voice Handicap Index (VHI-10) scores, voice, upper airway, or swallow complaints. However, more hEDS/HSD patients answered positively to the laryngeal dysfunction question versus controls (p = 0.031). 22.5% of hEDS/HSD patients (n = 65) reported hoarseness, of which 52.3% reported hoarseness >2 days/month. 33.9% (n = 98) with hEDS/HSD reported symptoms of dysphagia, and 27.0% (n = 78) reported laryngeal dysfunction symptoms. Controls demonstrated 20.3% prevalence of hoarseness, of which 46.7% reported hoarseness >2 days/month. 24.3% of controls had dysphagia and 14.9% laryngeal dysfunction symptoms. Of the 363 patients, VHI-10 scores >11 were more likely in patients reporting >2 days of hoarseness/month (p = 0.001) versus those with <2 days of hoarseness/month. There was an increased prevalence of voice, upper airway, and dysphagia symptoms in hEDS/HSD patients compared with previously reported prevalence data in the general population.

Conclusion

A significant proportion of patients diagnosed with hypermobility due to hEDS or HSD were found to have voice, upper airway, and dysphagia symptoms. These rates are higher than those previously reported in the general population.

Level of Evidence

3 Laryngoscope, 134:773–778, 2024

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