Christina H Kang1, Nan Zhang2, David G Lott1. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Division of Laryngology, Mayo Clinic Arizona, Phoenix, Arizona, USA. 2. Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
Abstract
OBJECTIVE: To determine factors contributing to disease etiology and treatment efficacy. STUDY DESIGN: Original Report. SETTING: Tertiary academic center. METHODS: IRB approved prospective study of 20 patients with reported dysphagia who exhibited normal oropharyngeal and esophageal swallowing function as evidenced by videofluoroscopic swallow study, esophagogastroduodenoscopy, high-resolution esophageal manometry with stationary impedance, and Bravo pH probe off proton pump inhibitor. Patients underwent speech-language pathology intervention. RESULTS: Atypical laryngeal muscle tension was present in 100% of patients. Forty percent of patients had diagnosed positive gastroesophageal reflux disease. Sixty-five percent of patients showed signs of non-specific laryngeal inflammation and laryngeal hyperresponsiveness during strobolaryngoscopy. All patients reported a mean of 90% recovery by the completion of voice therapy directed toward unloading muscle tension. CONCLUSION: The study results suggest an association between laryngeal muscle tension and these patients' dysphagia symptoms regardless of associated conditions. Speech-language pathology intervention showed high treatment efficacy. LEVEL OF EVIDENCE: 2c- Outcomes research.
OBJECTIVE: To determine factors contributing to disease etiology and treatment efficacy. STUDY DESIGN: Original Report. SETTING: Tertiary academic center. METHODS: IRB approved prospective study of 20 patients with reported dysphagia who exhibited normal oropharyngeal and esophageal swallowing function as evidenced by videofluoroscopic swallow study, esophagogastroduodenoscopy, high-resolution esophageal manometry with stationary impedance, and Bravo pH probe off proton pump inhibitor. Patients underwent speech-language pathology intervention. RESULTS: Atypical laryngeal muscle tension was present in 100% of patients. Forty percent of patients had diagnosed positive gastroesophageal reflux disease. Sixty-five percent of patients showed signs of non-specific laryngeal inflammation and laryngeal hyperresponsiveness during strobolaryngoscopy. All patients reported a mean of 90% recovery by the completion of voice therapy directed toward unloading muscle tension. CONCLUSION: The study results suggest an association between laryngeal muscle tension and these patients' dysphagia symptoms regardless of associated conditions. Speech-language pathology intervention showed high treatment efficacy. LEVEL OF EVIDENCE: 2c- Outcomes research.
Authors: Carolyn K Novaleski; Richard L Doty; Alissa A Nolden; Paul M Wise; Joel D Mainland; Pamela H Dalton Journal: J Voice Date: 2021-01-14 Impact factor: 2.300