Hoarseness: Is It Really Laryngopharyngeal Reflux?
Hoarseness: Is It Really Laryngopharyngeal Reflux?
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DOI：
10.1097/mlg.0b013e318158f72d
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发表时间：
2008-02-01
期刊：
影响因子：
2.6
通讯作者：
Garrett, C. Gaelyn
中科院分区：
文献类型：
--
作者：
Cohen, Seth M.;Garrett, C. Gaelyn
目的/假设：这项研究将验证质子泵抑制剂(PPI)在转诊为声音嘶哑的患者中普遍使用的假设，并将评估最终诊断和与患者嗓音结果相关的因素。研究设计：对三级护理嗓音诊所的患者进行回顾性回顾。方法：确定在过去两个月内正在或曾经服用PPI并转诊至三级护理嗓音诊所的声音嘶哑患者。结果：299例患者中，264例符合纳入标准，包括PPI给药剂量和时间、胃食道反流(GER)患者报告、是否存在肌肉紧张性发音障碍(MTD)、患者人口学特征、诊断、症状的慢性化、干预措施、随访和结果。年龄18~89岁，平均47.2岁，男性26.7%，女性73.3%。在被转介为嗓音问题的患者中，148名(56.1%)以前曾尝试过PPI或目前正在接受PPI治疗；44名(29.7%)因持续的声音嘶哑而停止服用PPI；104名(70.3%)尽管继续接受PPI治疗，但仍有持续性的声音嘶哑和相关的喉咙不适。在因持续发声而停止服用PPI的患者中，79.5%的患者没有胃灼热或反流的传统GER症状。转诊后最常见的治疗是发声治疗，总的发声治疗有效率为62.7%。结论：PPI在转诊患者中普遍使用，原因是持续性声音嘶哑。患者是否患有GER或MTD可能会影响患者对PPI治疗的嗓音结果。
Objective/Hypothesis: This study will test the hypothesis that proton pump inhibitor (PPI) use is prevalent among patients referred for hoarseness and will assess the ultimate diagnosis and factors associated with patients' voice outcomes.Study Design: Retrospective review of patients in a tertiary care voice clinic.Methods: Patients with a primary diagnosis of hoarseness, who were taking or had taken PPIs in the previous 2 months and referred to a tertiary care voice clinic, were identified. The dosage and length of PPI administration, patient report of gastroesophageal reflux (GER), presence of findings suggesting muscle tension dysphonia (MTD), patient demographics, diagnosis, chronicity of symptoms, interventions, follow-up, and outcome were determined.Results: Of 299 patients, 264 met the inclusion criteria. The mean age was 47.2 years, with a range of 18 to 89 years, with 26.7% male and 73.3% female. Among patients referred for voice problems, 148 (56.1%) had previously tried PPIs or were currently on PPI treatment; 44 (29.7%) stopped taking their PPI because of continued hoarseness, and 104 (70.3%) had persistent hoarseness and associated throat complaints despite continued PPI treatment. Among patients who quit taking their PPI because of continued voice complaints, 79.5% did not have traditional GER symptoms of heartburn or regurgitation. The most common treatment after referral was voice therapy, with an overall voice therapy response rate of 62.7%.Conclusions: PPI use is prevalent among patients referred because of persistent hoarseness. Whether patients have GER or MTD may influence patients' voice outcomes in response to PPI treatment.