Primary Sjögren's Syndrome (SS) is an autoimmune disease that causes dehydration of the eyes, mouth, and throat. Individuals with Primary SS are at risk for voice problems associated with vocal fold dehydration. Topical hydration treatments show promise in reducing the negative effects of vocal fold dehydration on voice production. However, no studies have examined the preventive effects of topical hydration treatments on voice production in individuals at risk for vocal fold dehydration. The purpose of this study was to quantify the effects of a topical vocal fold hydration treatment on voice production in individuals with Primary SS using the Cepstral Spectral Index of Dysphonia (CSID). Eight participants with Primary SS completed an eight-week study involving twice-daily audio recordings of sustained vowels and the Rainbow Passage. Participants received 9 mL of nebulized isotonic saline (0.9% Na+Cl-) immediately following morning and evening voice recordings during weeks 3, 4, 7, and 8 using an ABAB within-subjects experimental design. Baseline CSID values were in the mild range. Although CSID values decreased (improved) during the treatment phases of the study, no statistically significant changes were observed from baseline to treatment. Statistically significant correlations were observed among CSID values and patient-based ratings of vocal effort and dryness, which did improve with treatment (p < .05). These results indicate that topical saline treatments may prevent and treat some voice problems associated with vocal fold dehydration in at-risk populations.



College and Department

David O. McKay School of Education; Communication Disorders



Date Submitted


Document Type





Sjögren's Syndrome, CSID, laryngeal hydration, vocal effort, nebulized saline