Voice therapy associated with a decrease in the reflux symptoms index in patients with voice complaints.

Autor: Schneider SL; Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California., Clary MS; Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado., Fink DS; Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado., Wang SX; Sutter Health, Fremont, California., Chowdhury FN; Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado., Yadlapati R; Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, Colorado., Jetté ME; Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado., Courey MS; Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, U.S.A.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2019 May; Vol. 129 (5), pp. 1169-1173. Date of Electronic Publication: 2018 Nov 16.
DOI: 10.1002/lary.27583
Abstrakt: Objectives/hypothesis: Patients with muscle tension dysphonia often demonstrate an elevation in Reflux Symptom Index (RSI) and 10-item Voice Handicap Index (VHI-10) scores, and may be erroneously diagnosed with laryngopharyngeal reflux disease. In this study we assessed the effects of voice therapy on RSI and VHI-10 scores in patients with voice complaints not responsive to antireflux medications.
Study Design: Retrospective cohort study.
Methods: A study of patients was conducted at a single tertiary-care center over 1 year (January 2012-January 2013). Patients were included if they had dysphonia not responsive to proton pump inhibition, did not have neurologic or neoplastic disease, and participated in at least three voice-therapy sessions in the absence of antireflux therapy. Primary analysis assessed change in RSI scores between the initial and follow-up visits with a laryngologist.
Results: A total of 18 patients were included (mean age = 49.9 ± 14.5 years, 89% female, 83% with a primary complaint of dysphonia). From initial to follow-up visit, the median RSI score (18.5 [interquartile range {IQR}, 9.5-22.8] vs. 10.5 [IQR, 4.5-14]; P = .02) and median VHI-10 score (25.5 [IQR, 11.3-30.0] vs. 13.5 [IQR, 9.5-20.8]; P = .03) significantly decreased. A significant inverse correlation was found between the number of voice therapy sessions/month and change in RSI score (r = -0.4; P = .05).
Conclusions: In this study of patients with muscle tension dysphonia or vocal hyperfunction not responsive to antireflux therapy, RSI and VHI-10 scores improved following voice therapy. Results suggest that self-reported symptoms typically attributed to laryngopharyngeal reflux disease may actually be secondary to inefficient voice use patterns or anxiety about dysphonia that are responsive to voice therapy.
Level of Evidence: 4 Laryngoscope, 129:1169-1173, 2019.
(© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
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