Despite the wealth of publications on the topic of gastroesophageal reflux and its variants, there are still many unsettled questions before one accepts the prevalent cult of "reflux disease". This study is summarizing the results of the critical analysis of the literature, 436 articles,during the last 30 years. The golden test to identify the patient group suffering from this rather common phenomenon is still lacking. The claimed extra-esophageal manifestations especially in the larynx are non-specific and may be caused by other factors well-known within the domain of vocology. The response to therapeutic intervention still lacks serious well-controlled studies to allow drawing reasonable conclusions. An outstanding feature of the publications is that most of them fall in the category of "review". It seems that there is a tendency to perpetuate the concept without objective criticism. Following the analysis, a recommendation for anew plan of original well-controlled multi-center studies is highlighted.

Background: Phonasthenia is a voice disorder where the larynx looks essentially normal and dysphonia is not heard but felt by the patient. This study aims to use videokymography (VKG) to detect any abnormalities in the vibratory pattern in phonasthenia and to find out whether or not these abnormalities change after vocal loading. Methods: Thirty-seven phonasthenic patients and 31 normal subjects participated in a detailed protocol, including analysis of subjective complaints and videokymographic quasi-objective parameters (baseline) followed by loading their voices through prolonged loud reading for 45 min. A second evaluation (experimental) was done after loading. Results: Before vocal loading, patients had significantly more symptoms in all questionnaire questions and higher maximum width difference in VKG than controls. When pre- and postloading values were compared, both groups experienced more symptoms after loading (significant in most of the questions), while the pre- and post-VKG parameters did not show significant differences neither in patients nor controls. On comparing their percent change, the only statistically significant difference between the 2 groups was a greater change in the total score of the questionnaire in the control group. Conclusion: Patients had more vocal fatigue symptoms and more amplitude asymmetry between left and right vocal folds than normal subjects.

Background. Applying measures that prioritize staff safety, while protecting patient safety and care, represents a challenge during the current pandemic. Many documents of recommendations toward safe practice have been developed for this purpose. Objective. To assess adjustments that have been undertaken by phoniatricians and otolaryngologists in the delivery of health-care services during the pandemic in order to reduce staff exposure to COVID-19 and improve safety. Study design. Cross-sectional.Methods. An online self-administered survey was used during the first wave of the COVID-19 pandemic in June 2020 to collect data related to demographics of participants, their sources of information, administrative alterations, and changes they adopted when meeting patients for a consultation/procedure/surgery. Results. The eligible 154 responses were grouped into 4 groups based on country of residence. Alterations to service delivery amongst the different groups were compared. Conclusions. The majority of participants were following the suggested recommendations to service delivery adjustments, with some inconsistencies in practice across countries.

Background Caring for our patients while taking care of our own safety as well as theirs is a major concern during the current pandemic. Therefore, many societies developed guidance documents to educate clinicians about the required precautions. This study aims to assess personal protective equipment (PPE) usage, hand hygiene practice and infection control training among phoniatricians and otolaryngologists during the pandemic. An online survey was administered during the first wave of the COVID-19 pandemic in June 2020. Data collected included PPE availability, infection control training, adopted infection control precautions, hand hygiene practice, and use of different PPE elements as well as adherence to its use during potential aerosol generating procedures. Results Based on their country of residences, eligible 154 participants were grouped into 4 groups and their responses were compared. Conclusion Following the suggested recommendations, while adequate for some precautions, was still not satisfactory. Certain defects that are specific to particular groups had also been identified.

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Background Research findings on the reading outcomes of cochlear implants are inconsistent. Controversy was observed in the reading performance of implanted children, both in relation to hearing aid users and normally hearing children. This cross-sectional study aims to evaluate the phonological awareness and reading skills of school-aged, severe-to-profound, prelingually deafened children using cochlear implants and to identify any associations between these skills and age of implantation, language development, and the chosen side of implantation. Patients who met the selection criteria were assessed using standardized phonological awareness and reading tests, and their scores were compared to normative data. Results Patients’ average scores were significantly behind age-matched normative data. Phonological awareness was strongly correlated to reading skills, and both were positively correlated to language abilities. Age at implantation was not correlated to phonological skills yet it was positively correlated to reading scores for patients over 9 years old. Conclusion Many cochlear implanted children are still struggling with reading. Phonological development should be considered in the rehabilitation of this group of patients as it was found to be closely associated with reading proficiency.

Purpose COVID-19 is known to present with a wide range of clinical symptoms. COVID-19-related dysphagia has been frequently investigated in patients who were critically ill and mechanically ventilated, but not in those with less severe presentations. This study aims to identify the frequency, characteristics, and severity of self-perceived oropharyngeal dysphagia in non-intubated COVID-19 patients. Methods In this cross-sectional study, data were collected from patients using a self-administered questionnaire that included the Eating Assessment Tool (EAT-10). Results The study included 359 participants with a median age of 34 (range: 18–65) years. Self-perceived dysphagia (EAT-10 total score > 2) was identified in 64.62%, and their median EAT-10 total score was 13 (range 3–40). The most prevalent symptoms were painful swallowing, affected pleasure of eating, stressful swallowing, and coughing while eating. Age, gender, and hospitalization were not statistically significantly associated with the presence of dysphagia, while re-infection, duration, and severity of COVID-19 diagnosis were. The EAT-10 total score was higher in moderate and severe COVID-19 cases as compared to mild cases, and showed a statistically significant inverse correlation with the duration of COVID-19 (r = − 0.267). Conclusion Self-perceived dysphagia was prevalent in non-intubated COVID-19 patients. Its severity was related to that of COVID-19 and its duration.