Open AccessManagement of Dysphonia among General Otolarygologists
Author(s) -
Cohen Seth,
Courey Mark,
Pitman Michael,
Noordzij Pieter
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811415823a195
Subject(s) - medicine , voice therapy , laryngoscopy , etiology , throat , referral , muscle tension , voice training , stroboscope , audiology , pediatrics , physical therapy , surgery , intubation , family medicine , engineering , electrical engineering
Objective Investigate common treatment approaches of general otolaryngologists for adult patients with dysphonia, particularly for patients without obvious laryngeal anatomic abnormalities. Method One thousand randomly chosen AAOHNS general otolaryngologists were mailed a survey. The response rate was 27.8%. Mean years in practice were 19.5 years. Results The most common treatments for adult dysphonic patients were anti‐reflux treatment, voice therapy, and allergy treatment. For patients with mobile vocal folds without lesions on laryngoscopy, 52% refer to speech‐language pathologists, 57.9% obtain stroboscopy, and 58.6% start proton pump inhibitors (PPI). Muscle tension dysphonia, vocal fold nodules, and dysphonia of uncertain etiology were the most common reasons for voice therapy referral. Response to once daily PPI, laryngeal signs, and throat symptoms were the most common determinants for LPR. When patients failed initial treatment, 46.9% obtain stroboscopy, 37.4% refer for voice therapy, and 33.3% extend or increase duration of PPI treatment. Conclusion Varied treatment approaches to adult dysphonic patients were identified. How practice patterns vary from best practice guidelines, impact patient outcome, and influence health care costs needs examination.