Is there a role for voice therapy in the treatment of laryngopharyngeal reflux? A pilot study.

Thomas L Carroll, Andrea Nacci, Fabrizio Minichilli, Salvatore Tolone, Luca Bastiani, Jerome R Lechien, Ludovico Docimo, Antonino Maniaci, Maria Rosaria Barillari, Giuseppe Costa, Giuseppina Mirra, Federica Giumello, Carlos M Chiesa Estomba

Journal: Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale 2024;44(1):27-35

PMID: 38420719

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Abstract

OBJECTIVE

The aim of this study was to compare the efficacy of voice therapy combined with standard anti-reflux therapy in reducing symptoms and signs of laryngopharyngeal reflux (LPR).

METHODS

A randomised clinical trial was conducted. Fifty-two patients with LPR diagnosed by 24 h multichannel intraluminal impedance-pH monitoring were randomly allocated in two groups: medical treatment (MT) and medical plus voice therapy (VT). Clinical symptoms and laryngeal signs were assessed at baseline and after 3 months of treatment with the Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Voice Handicap Index (VHI) and GRBAS scales.

RESULTS

Groups had similar scores at baseline. At 3-month follow-up, a significant decrease in RSI and RFS total scores were found in both groups although it appeared to be more robust in the VT group. G and R scores of the GRBAS scale significantly improved after treatment in both groups, with better results in the VT group. The VHI total score at 3 months improved more in the VT group (VHI delta 9.54) than in the MT group (VHI delta 5.38) (p < 0.001).

CONCLUSIONS

The addition of voice therapy to medications and diet appears to be more effective in improving treatment outcomes in subjects with LPR. Voice therapy warrants consideration in addition to medication and diet when treating patients with LPR.

Address: Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, "L. Vanvitelli" University, Naples, Italy.; Laryngology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).; ENT Audiology and Phoniatric Unit, University of Pisa, Pisa, Italy.; Clinical Physiology Institute, Consiglio Nazionale delle Ricerche Area della Ricerca di Pisa (CNR), Pisa, Italy.; Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, "L. Vanvitelli" University, Naples, Italy.; Laryngology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).; Department of Medical, Surgical and Advanced Technologies G.F. Ingrassia, ENT Section, University of Catania, Italy.; Division of General, Mininvasive and Bariatric Surgery, "L. Vanvitelli" University, Naples, Italy.; Laryngology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).; Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia-Biodonostia Health Research Institute, Donostia-San Sebastian, Spain.; Laryngology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).; Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France.; Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.; Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.

DOI: 10.14639/0392-100X-N2742

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MeSH Terms: Humans, Laryngopharyngeal Reflux, Pilot Projects, Proton Pump Inhibitors, Voice Quality, Voice