Investigation of Therapeutic Effects of Combination of Proton Pump Inhibitor Administration and Voice Therapy on Muscle Tension Dysphonia with Laryngopharyngeal Reflux Disease (LPRD) -Related Organic Findings

The present study investigated the associations among etiological risk factors, the presence of laryngeal mucosal inflammation by site, laryngeal hyperfunction, and the severity of hoarseness in chronic laryngitis. Of 45 dysphonic cases who were referred to the voice clinic at JCHO Osaka Hospital and diagnosed with chronic laryngitis, 55 %, 27 %, 11 %, and 7 % showed hoarseness of G0, G1R1, G2R2, and G3R3, respectively, at the initial consultation. As etiological risk factors, 24 % and 18% had experienced vocal abuse in their profession and inhaled corticosteroid therapy, respectively, but none had any smoking habit. With regard to gastroesophageal reflux disease, 11 % and 9 % had typical reflux symptoms and esophageal mucositis under upper gastrointestinal endoscopy, respectively, and 62 %, 78 %, and 24% showed mucosal inflammation of the vocal folds, posterior laryngeal structures, and subglottic region under laryngoscopy, respectively. In addition, vocal hyperfunction was observed in 24 %. After addressing each of the identified etiological factors, of the 18 cases showing objective hoarseness more severe than G 1 R 1 , 16 achieved vocal improvement to G0. In conclusion, the present results suggest that a substantial proportion of chronic laryngitis cases are associated with gastroesophageal reflux and have vocal impairment caused by organic changes in the vocal fold membrane rather than vocal hyperfunction.

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Voice Disorders Associated with LPRD-related Chronic Cough

Suzuki,

Seki,

Hanazawa

et al. 2023

LARYNX JAPAN

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Objective : To investigate the causes of voice disorders associated with laryngopharyngeal reflux disease (LPRD)related chronic cough. Methods : We performed a psychoacoustic evaluation, laryngoscopy (to detect the presence of obvious organic lesions, organic lesions associated with LPRD [subglottic edema and vocal fold edema], and determine the muscle tension dysphonia [MTD] score) for chronic cough patients with LPRD diagnosed by hypopharyngeal multichannel intraluminal impedance. Results : Among a total of 24 patients, 11 ( 46 %) patients had voice disorder. However, 7 of the 11 patients (64%) had no abnormalities in a psychoacoustic evaluation. Obvious vocal fold lesions were found in 2 of the 11 patients in the voice disorder group (18%). The score of subglottic edema and vocal fold edema, and the total MTD score (false vocal fold compression [FVF-C] and anterior-to-posterior compression [AP-C]) did not differ to a significant extent (p=0.52); however, the AP-C score of the voice disorder group was significantly higher than that of the normal group (p=0.04). Conclusions : The main component of the voice disorder was MTD, especially in AP-C. MTD should be taken into consideration and the possibility of LPRD should be considered in patients with voice disorders when there is a discrepancy between the chief complaint and laryngeal findings.

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Investigation of Therapeutic Effects of Combination of Proton Pump Inhibitor Administration and Voice Therapy on Muscle Tension Dysphonia with Laryngopharyngeal Reflux Disease (LPRD) -Related Organic Findings

Cited by 3 publications

References 12 publications

Therapeutic Effects of Combination of Proton Pump Inhibitor Administration and Vocal Training in Laryngopharyngeal Reflux Disease (LPRD) Patients with Both of Vocal Cord Inflammation and Muscle Tension Dysphonia

Therapeutic Effects of Combination of Proton Pump Inhibitor Administration and Vocal Training in Laryngopharyngeal Reflux Disease (LPRD) Patients with Both of Vocal Cord Inflammation and Muscle Tension Dysphonia

Investigation of Etiological Risk Factors, Mucosal Inflammation by Site and Laryngeal Hyperfunction in Dysphonic Patients Diagnosed with Chronic Laryngitis

Voice Disorders Associated with LPRD-related Chronic Cough

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