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Dysphonia and Laryngopharyngeal Reflux

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Gastrointestinal Motility Disorders

Abstract

Since it was described, laryngopharyngeal reflux (LPR) has become linked with and blamed for a multitude of head and neck complaints ranging from globus pharyngeus, dysphagia, postnasal drip, vocal fatigue, excessive throat clearing, chronic cough, and hoarseness. In several ways, physicians have utilized LPR as an easy target to treat with proton pump inhibitor medical therapy without any further examination or evaluation. This chapter describes the literature surrounding dysphonia and LPR and tries to build a rational approach to diagnosis and management. However, laryngovideostroboscopy is absolutely necessary for those patients with dysphonia lasting for more than 4 weeks as there are a litany of other causes of hoarseness that can only be diagnosed with direct visualization.

“My doctor says my reflux is causing my hoarseness. What do you think?”

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References

  1. Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope. 1991;101(4 Pt 2 Suppl 53):1–78.

    Article  CAS  PubMed  Google Scholar 

  2. Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reflux symptom index (RSI). J Voice. 2002;16(2):274–7.

    Article  PubMed  Google Scholar 

  3. Belafsky PC, Postma GN, Koufman JA. The validity and reliability of the reflux finding score (RFS). Laryngoscope. 2001;111(8):1313–7.

    Article  CAS  PubMed  Google Scholar 

  4. Ruiz R, et al. Hoarseness and laryngopharyngeal reflux: a survey of primary care physician practice patterns. JAMA Otolaryngol Head Neck Surg. 2014;140(3):192–6.

    Article  PubMed  Google Scholar 

  5. Karkos PD, et al. Is laryngopharyngeal reflux related to functional dysphonia? Ann Otol Rhinol Laryngol. 2007;116(1):24–9.

    Article  PubMed  Google Scholar 

  6. Koufman JA, Amin MR, Panetti M. Prevalence of reflux in 113 consecutive patients with laryngeal and voice disorders. Otolaryngol Head Neck Surg. 2000;123(4):385–8.

    Article  CAS  PubMed  Google Scholar 

  7. Patel AK, et al. Symptom overlap between laryngopharyngeal reflux and glottic insufficiency in vocal fold atrophy patients. Ann Otol Rhinol Laryngol. 2014;123(4):265–70.

    Article  PubMed  Google Scholar 

  8. Qadeer MA, et al. Gastroesophageal reflux and laryngeal cancer: causation or association? A critical review. Am J Otolaryngol. 2006;27(2):119–28.

    Article  PubMed  Google Scholar 

  9. Ozturk O, et al. Hoarseness and laryngopharyngeal reflux: a cause and effect relationship or coincidence? Eur Arch Otorhinolaryngol. 2006;263(10):935–9.

    Article  PubMed  Google Scholar 

  10. Cohen SM, Garrett CG. Hoarseness: is it really laryngopharyngeal reflux? Laryngoscope. 2008;118(2):363–6.

    Article  PubMed  Google Scholar 

  11. Groome M, et al. Prevalence of laryngopharyngeal reflux in a population with gastroesophageal reflux. Laryngoscope. 2007;117(8):1424–8.

    Article  PubMed  Google Scholar 

  12. Tauber S, Gross M, Issing WJ. Association of laryngopharyngeal symptoms with gastroesophageal reflux disease. Laryngoscope. 2002;112(5):879–86.

    Article  PubMed  Google Scholar 

  13. Delahunty JE, Cherry J. Experimentally produced vocal cord granulomas. Laryngoscope. 1968;78(11):1941–7.

    Article  CAS  PubMed  Google Scholar 

  14. Johnston N, et al. Cell biology of laryngeal epithelial defenses in health and disease: further studies. Ann Otol Rhinol Laryngol. 2003;112(6):481–91.

    Article  PubMed  Google Scholar 

  15. Johnston N, et al. Receptor-mediated uptake of pepsin by laryngeal epithelial cells. Ann Otol Rhinol Laryngol. 2007;116(12):934–8.

    Article  PubMed  Google Scholar 

  16. Fritz MA, et al. The accuracy of the laryngopharyngeal reflux diagnosis: utility of the stroboscopic exam. Otolaryngol Head Neck Surg. 2016;155(4):629–34.

    Article  PubMed  Google Scholar 

  17. Casiano RR, Zaveri V, Lundy DS. Efficacy of videostroboscopy in the diagnosis of voice disorders. Otolaryngol Head Neck Surg. 1992;107(1):95–100.

    Article  CAS  PubMed  Google Scholar 

  18. Woo P, et al. Diagnostic value of stroboscopic examination in hoarse patients. J Voice. 1991;5(3):231–8.

    Article  Google Scholar 

  19. Sulica L. Hoarseness misattributed to reflux: sources and patterns of error. Ann Otol Rhinol Laryngol. 2014;123(6):442–5.

    Article  PubMed  Google Scholar 

  20. Rafii B, et al. Incidence of underlying laryngeal pathology in patients initially diagnosed with laryngopharyngeal reflux. Laryngoscope. 2014;124(6):1420–4.

    Article  PubMed  Google Scholar 

  21. Thomas JP, Zubiaur FM. Over-diagnosis of laryngopharyngeal reflux as the cause of hoarseness. Eur Arch Otorhinolaryngol. 2013;270(3):995–9.

    Article  PubMed  Google Scholar 

  22. Hicks DM, et al. The prevalence of hypopharynx findings associated with gastroesophageal reflux in normal volunteers. J Voice. 2002;16(4):564–79.

    Article  PubMed  Google Scholar 

  23. Branski RC, Bhattacharyya N, Shapiro J. The reliability of the assessment of endoscopic laryngeal findings associated with laryngopharyngeal reflux disease. Laryngoscope. 2002;112(6):1019–24.

    Article  PubMed  Google Scholar 

  24. Katsinelos P, et al. Should inspection of the laryngopharyngeal area be part of routine upper gastrointestinal endoscopy? A prospective study. Dig Liver Dis. 2009;41(4):283–8.

    Article  CAS  PubMed  Google Scholar 

  25. Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach. Arch Intern Med. 2006;166(9):965–71.

    Article  PubMed  Google Scholar 

  26. Reichel O, et al. Double-blind, placebo-controlled trial with esomeprazole for symptoms and signs associated with laryngopharyngeal reflux. Otolaryngol Head Neck Surg. 2008;139(3):414–20.

    Article  PubMed  Google Scholar 

  27. Hill RK, et al. Pachydermia is not diagnostic of active laryngopharyngeal reflux disease. Laryngoscope. 2004;114(9):1557–61.

    Article  PubMed  Google Scholar 

  28. Lee JS, et al. Changes in the quality of life of patients with Laryngopharyngeal reflux after treatment. J Voice. 2014;28(4):487–91.

    Article  PubMed  Google Scholar 

  29. Abramowitz J, et al. Adverse event reporting for proton pump inhibitor therapy: an overview of systematic reviews. Otolaryngol Head Neck Surg. 2016;155(4):547–54.

    Article  PubMed  Google Scholar 

  30. McGlashan JA, et al. The value of a liquid alginate suspension (Gaviscon advance) in the management of laryngopharyngeal reflux. Eur Arch Otorhinolaryngol. 2009;266(2):243–51.

    Article  PubMed  Google Scholar 

  31. Weber B, et al. Efficacy of anti-reflux surgery on refractory Laryngopharyngeal reflux disease in professional voice users: a pilot study. J Voice. 2014;28(4):492–500.

    Article  PubMed  Google Scholar 

  32. Wolfsen HC, Richards WO. The Stretta procedure for the treatment of GERD: a registry of 558 patients. J Laparoendosc Adv Surg Tech A. 2002;12(6):395–402.

    Article  PubMed  Google Scholar 

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Conflict of interest: None.

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Authors and Affiliations

  1. Department of Otolaryngology—Head and Neck Surgery, Medical College of Georgia at Augusta University, 1120 15th Street, Suite BP 4109, Augusta, GA, 30912, USA

    Gregory Postma M.D. & Mark A. Fritz M.D.

Authors
  1. Gregory Postma M.D.
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  2. Mark A. Fritz M.D.
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Correspondence to Gregory Postma M.D. .

Editor information

Editors and Affiliations

  1. Institute of Gastroenterology, Sheba medical Center, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel

    Eytan Bardan

  2. Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    Reza Shaker

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Postma, G., Fritz, M.A. (2018). Dysphonia and Laryngopharyngeal Reflux. In: Bardan, E., Shaker, R. (eds) Gastrointestinal Motility Disorders . Springer, Cham. https://doi.org/10.1007/978-3-319-59352-4_16

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  • DOI: https://doi.org/10.1007/978-3-319-59352-4_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-59350-0

  • Online ISBN: 978-3-319-59352-4

  • eBook Packages: MedicineMedicine (R0)

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