الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
RA is an autoimmune systemic disease with a wide clinical
presentation. The laryngeal manifestations are often masked by the
articular disability often experienced in the early and late stages of the
disease.
The emergence of subtle airway symptoms and or change in
voice quality in patients with RA should alert the primary caring
physician and specialists to the presence of laryngeal involvement.
Laryngeal involvement in patients with RA is common but
usually subclinical. Several studies have reported that up to fifty
percent of patients are having laryngeal involvement as the sole
manifestation of this disease.
Laryngeal symptoms during RA vary in their incidence from
31-75%, while histopathological changes in the larynx are presented
postmortem in 90% of cases.
The most frequent symptoms are the feeling of a foreign body
in the throat, dysphonia and voice weakness.
Despite the burden of a voice disorder and its apparent
contribution to reduced quality of life, few RA patients seek medical
advice and help.
To some extent, limited physician and patient education may be
an explanation for this low rate of help seeking behavior for voice
disorders.
It may be that the primacy of other RA symptoms diminishes
the attention given to voice function. Given the increased burden on
quality of life related to voice dysfunction in RA, combined with low