Abstract
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.
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