Zubiaur GFM, James P Thomas JP

Language: Spanish
References: 11
Page: 52-58
PDF size: 866.10 Kb.

ABSTRACT

Objectives: 1) To determine the percentage of patients seen in a private laryngology clinic with voice related disorders that are previously diagnosed with and treated for laryngopharyngeal reflux (LPR). 2) To determine how many of those patients are found to have disorders other than LPR as a cause for their voice disorder.
Material and method: A retrospective, chart-review analysis of new patients was conducted from January 2005 through December 2007 in a private laryngology clinic setting. Patients with a previous diagnosis of LPR as the cause of hoarseness, with or without anti-reflux treatment were included. Incomplete charts and patients with additional diagnoses besides LPR were excluded. Patient charts were analyzed in search of different variables including main complaint, previous medications and final diagnosis among others.
Results: 784 consecutive charts were reviewed. Inclusion criteria was met in 105 charts. 82% had no improvement or felt worse after previous anti-reflux treatment while 18% had significant or mild improvement, all patients, however, remained with some degree of hoarseness. Final diagnosis was diverse and was divided into structural and functional precipitators, none of the patients had laryngopharyngeal reflux as a final diagnosis and none of them referred worsening of their voice after respective treatment.
Conclusion: LPR has become an over diagnosed entity. With a thorough history, vocal capability testing and physical exam, an accurate diagnosis can be made in the vast majority of cases. LPR is seldom the cause of voice related disorders and should become a diagnosis of exclusion, not of assumption.

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