OBJECTIVE: To determine in true vocal fold (TVF) atrophy patients if symptoms of throat clearing and mucus sensation, attributed to laryngopharyngeal reflux (LPR), are due to glottic insufficiency. Is the TVF atrophy population being prescribed proton pump inhibitors unnecessarily? METHODS: A retrospective review of patients with TVF atrophy but no other underlying laryngeal pathology seen at a tertiary voice center from July 2009 to May 2012 was conducted. Patient demographics, symptoms, LPR diagnosis, interventions, and pre-intervention and post-intervention Voice Handicap Index-10 (VHI) and Reflux Symptom Index (RSI) scores were recorded. RESULTS: Twenty-six patients met inclusion criteria, and 85% were treated for LPR. Throat clearing and mucus sensation (85%), dysphonia (54%), and globus sensation (46%) were recorded. Interventions included LPR medical management (65%), vocal fold augmentation (23%), and voice therapy (12%). Reflux Symptom Index scores improved in all groups. Voice Handicap Index-10 and RSI scores normalized in patients treated with augmentation. Globus was never present in patients who received augmentation. CONCLUSION: Throat clearing and mucus sensation may be due to underlying glottic insufficiency and changes of the aging larynx rather than LPR. High VHI and RSI scores normalized with TVF augmentation. Further work is needed to evaluate symptom presentation and risk versus benefit of treatment options, especially if it avoids unnecessary proton pump inhibitor trials.
OBJECTIVE: To determine in true vocal fold (TVF) atrophypatients if symptoms of throat clearing and mucus sensation, attributed to laryngopharyngeal reflux (LPR), are due to glottic insufficiency. Is the TVF atrophy population being prescribed proton pump inhibitors unnecessarily? METHODS: A retrospective review of patients with TVF atrophy but no other underlying laryngeal pathology seen at a tertiary voice center from July 2009 to May 2012 was conducted. Patient demographics, symptoms, LPR diagnosis, interventions, and pre-intervention and post-intervention Voice Handicap Index-10 (VHI) and Reflux Symptom Index (RSI) scores were recorded. RESULTS: Twenty-six patients met inclusion criteria, and 85% were treated for LPR. Throat clearing and mucus sensation (85%), dysphonia (54%), and globus sensation (46%) were recorded. Interventions included LPR medical management (65%), vocal fold augmentation (23%), and voice therapy (12%). Reflux Symptom Index scores improved in all groups. Voice Handicap Index-10 and RSI scores normalized in patients treated with augmentation. Globus was never present in patients who received augmentation. CONCLUSION: Throat clearing and mucus sensation may be due to underlying glottic insufficiency and changes of the aging larynx rather than LPR. High VHI and RSI scores normalized with TVF augmentation. Further work is needed to evaluate symptom presentation and risk versus benefit of treatment options, especially if it avoids unnecessary proton pump inhibitor trials.
Authors: Peter C Belafsky; Gregory N Postma; Todd R Reulbach; Bradford W Holland; James A Koufman Journal: Otolaryngol Head Neck Surg Date: 2002-11 Impact factor: 3.497
Authors: David O Francis; Dhyanesh A Patel; Rohit Sharda; Kristen Hovis; Nila Sathe; David F Penson; Irene D Feurer; Melissa L McPheeters; Michael F Vaezi Journal: Otolaryngol Head Neck Surg Date: 2016-08-23 Impact factor: 3.497
Authors: Rena Yadlapati; Alexander M Kaizer; Daniel R Sikavi; Madeline Greytak; Jennifer X Cai; Thomas L Carroll; Samir Gupta; Sachin Wani; Paul Menard-Katcher; Tsung-Chin Wu; Philip Weissbrod; Andrew M Vahabzadeh-Hagh; John E Pandolfino; Walter W Chan Journal: Clin Gastroenterol Hepatol Date: 2021-05-20 Impact factor: 11.382