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

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: Sarah L Schneider, Matthew S Clary, Daniel Steven Fink, Sean X Wang, Farshad N Chowdhury, Rena Yadlapati, Marie E Jetté, Mark S Courey
• Journal: The Laryngoscope (Laryngoscope) Vol. 129 Issue 5 Pg. 1169-1173 (05 2019) ISSN: 1531-4995 [Electronic] United States
• PMID: 30444264 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2019 The American Laryngological, Rhinological and Otological Society, Inc.

Topics

• Cohort Studies
• Dysphonia (rehabilitation)
• Female
• Humans
• Laryngopharyngeal Reflux (diagnosis)
• Male
• Middle Aged
• Retrospective Studies
• Symptom Assessment
• Voice Training