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Voice therapy associated with a decrease in the reflux symptoms index in patients with voice complaints.
Laryngoscope. 2019 05; 129(5):1169-1173.L

Abstract

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.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California.Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado.Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado.Sutter Health, Fremont, California.Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado.Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, Colorado.Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado.Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, U.S.A.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30444264

Citation

Schneider, Sarah L., et al. "Voice Therapy Associated With a Decrease in the Reflux Symptoms Index in Patients With Voice Complaints." The Laryngoscope, vol. 129, no. 5, 2019, pp. 1169-1173.
Schneider SL, Clary MS, Fink DS, et al. Voice therapy associated with a decrease in the reflux symptoms index in patients with voice complaints. Laryngoscope. 2019;129(5):1169-1173.
Schneider, S. L., Clary, M. S., Fink, D. S., Wang, S. X., Chowdhury, F. N., Yadlapati, R., Jetté, M. E., & Courey, M. S. (2019). Voice therapy associated with a decrease in the reflux symptoms index in patients with voice complaints. The Laryngoscope, 129(5), 1169-1173. https://doi.org/10.1002/lary.27583
Schneider SL, et al. Voice Therapy Associated With a Decrease in the Reflux Symptoms Index in Patients With Voice Complaints. Laryngoscope. 2019;129(5):1169-1173. PubMed PMID: 30444264.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Voice therapy associated with a decrease in the reflux symptoms index in patients with voice complaints. AU - Schneider,Sarah L, AU - Clary,Matthew S, AU - Fink,Daniel Steven, AU - Wang,Sean X, AU - Chowdhury,Farshad N, AU - Yadlapati,Rena, AU - Jetté,Marie E, AU - Courey,Mark S, Y1 - 2018/11/16/ PY - 2018/06/04/received PY - 2018/08/19/revised PY - 2018/08/28/accepted PY - 2018/11/18/pubmed PY - 2019/5/23/medline PY - 2018/11/17/entrez KW - Muscle tension dysphonia KW - laryngopharyngeal reflux KW - reflux symptom index SP - 1169 EP - 1173 JF - The Laryngoscope JO - Laryngoscope VL - 129 IS - 5 N2 - 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. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/30444264/Voice_therapy_associated_with_a_decrease_in_the_reflux_symptoms_index_in_patients_with_voice_complaints_ L2 - https://doi.org/10.1002/lary.27583 DB - PRIME DP - Unbound Medicine ER -