Pharmacologic management of voice disorders by general medicine providers and otolaryngologists

Abstract

2b. Laryngoscope, 128:682-689, 2018.

Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics

“…UVFP may result from iatrogenic or traumatic causes and from neoplastic or systemic inflammatory diseases (See KQ3). Traditional support for the use of systemic steroids might be due to training in otolaryngology [ 65 ]. The efficacy of systemic steroids for Bell’s palsy (idiopathic facial palsy) and sudden hearing loss is well documented, as systemic steroids can reduce or completely alleviate the symptoms of patients with these conditions [ 66 , 67 ].…”

“…Theoretically, systemic steroids may counteract inflammation of the innervating vagus nerve and facilitate recovery to neuropraxia, thereby allowing vocal fold mucosal movement to recover to its normal state. Oral steroids are prescribed for VFP by general practitioners (2.4%) and laryngologists (5%) in the United States [ 65 ]. At the 2017 KSLPL fall meeting, a survey was conducted regarding systemic steroid use for UVFP, and three of 29 laryngologists (10.1%) supported the use of systemic steroids (oral or parenteral) for UVFP (unpublished data).…”

Associations between Community‐Acquired Pneumonia and Proton Pump Inhibitors in the Laryngeal/Voice‐Disordered Population

“…4,6 For patients with laryngeal/ voice disorders who saw GMPs, received associated PPI treatment, and subsequently had otolaryngology evaluation, otolaryngologists more frequently diagnosed laryngeal structural abnormalities, neuromuscular impairment, and multiple laryngeal diagnoses. 7 Likewise, prior investigations focused on otolaryngology care found a high rate of diagnosis change among patients with laryngeal/voice disorders initially treated with PPIs, suggesting that such treatment may not have been needed. [27][28][29] The association between PPI use and CAP occurrence, combined with the possible misuse of PPIs, should caution GMPs and otolaryngology providers when considering PPI treatment.…”

“…3 Yet, for patients with laryngeal/voice disorders, the practice patterns of GMPs and otolaryngologists suggest uncertainty surrounding the indications for PPI use, with the subsequent potential for inappropriate use. [4][5][6][7][8] Thus, the frequent use of PPIs in the treatment of voice disorders has important public health implications for patients and society.…”

Care and Management of Voice Change in Thyroid Surgery: Korean Society of Laryngology, Phoniatrics and Logopedics Clinical Practice Guideline

“…For patients with VFP that occurred after thyroid surgery, voice therapy by qualified SLPs specialized in the field of voice not only helps the patient adjust to their "new" voice but also improves voice quality to waive the need for injection laryngoplasty (IL) or surgical treatment if the symptoms are mild [68]. In particular, for VFP occurring after thyroid surgery, early voice therapy not only improves subjective voice disorders but also improves acoustic and auditory-perceptual voice quality and increases the possibility of A c c e p t e d A r t i c l e loss has been reported to decrease the symptom duration and improve prognosis [82][83][84]. Although their effects have not yet been proven, corticosteroids are being used empirically for enhancement of voice quality after thyroid surgery [82].…”