The utility of office-based biopsy for laryngopharyngeal lesions: comparison with surgical evaluation.

Objectives/hypothesis: Advances in flexible endoscopy with working-channel biopsy forceps have led to excellent visualization of laryngopharyngeal lesions with capability for in-office awake biopsy. Potential benefits include prompt diagnosis without risk of general anesthesia, preoperative counseling, and avoiding an anesthetic should the lesion return benign. We evaluate the accuracy of these biopsies in order to determine their role and diagnostic value.

Laryngeal sensory deficits in patients with chronic cough and paradoxical vocal fold movement disorder.

Objectives/hypothesis: Although the diagnostic accuracy of paradoxical vocal fold movement disorder and chronic cough has improved, the underlying pathophysiology remains relatively unknown. We hypothesize that one potential etiological factor in these patients is an aberrant laryngeal sensory response and sought to determine if respiratory retraining in addition to antireflux therapy alters this aberrant response.

Study Design: Retrospective, outcomes.

A prospective, randomized trial of nerve monitoring of the external branch of the superior laryngeal nerve during thyroidectomy under local/regional anesthesia and IV sedation.

Background: The aim of this study was to assess the impact of the neuromonitoring of the external branch of the superior laryngeal nerve (EBSLN) on the voice quality after mini-incision thyroidectomy under local/regional anesthesia and intravenous sedation.

Methods: Patients undergoing mini-incision thyroidectomy under local anesthesia were prospectively randomized for either nerve monitoring of the EBSLN (group 1) or no nerve monitoring (group 2). Voice and swallowing assessment were obtained by using the Voice Handicap Index-10 (VHI-10) and the Reflux Symptom Index questionnaires (RSI) before surgery and at 3 weeks and 3 months after surgery.

Paradoxical vocal fold motion: a sensory-motor laryngeal disorder.

Objectives: The purpose of this study is to determine the laryngeal sensitivity (LS) thresholds and the ratings of laryngopharyngeal reflux symptoms in patients with paradoxical vocal fold motion (PVFM).

Methods: This is a chart review following Institutional Review Board approval of 75 patients from January 2006 to June 2007. The patients were diagnosed with PVFM following case history, transnasal flexible laryngoscopy and spirometric testing.

Respiratory retraining therapy and management of laryngopharyngeal reflux in the treatment of patients with cough and paradoxical vocal fold movement disorder.

Objectives: We describe the outcome of patients with cough and paradoxical vocal fold movement disorder (PVFMD) treated with respiratory retraining therapy and management of laryngopharyngeal reflux (LPR).

Methods: Twenty patients with the complaint of cough were given a diagnosis of PVFMD and treated with proton pump inhibitors for a minimum of 6 months followed by 3 to 5 sessions of respiratory retraining therapy. Pulmonary function testing (PFT) and subjective rating of cough and reflux (reflux symptom index; RSI) were performed.

Flexible endoscopic evaluation of swallowing with sensory testing: patient characteristics and analysis of safety in 1,340 consecutive examinations.

Flexible endoscopic evaluation of swallowing with sensory testing (FEESST) is a comprehensive endoscopic assessment of the sensory and motor components of a swallow. Previous studies addressing patient safety issues with respect to FEESST included relatively small numbers of patients and paid almost no attention to patient characteristics. The purpose of this study was to determine the incidence of FEESST-related complications in the outpatient and inpatient settings and to analyze patient diagnoses that led to the performance of FEESST.

Respiratory retraining of refractory cough and laryngopharyngeal reflux in patients with paradoxical vocal fold movement disorder.

Objectives/hypothesis: The objective was to describe a case series of patients with refractory cough and paradoxical vocal fold movement disorder treated with respiratory retraining therapy.

Study Design: Retrospective review of a case series in a tertiary medical care center.

Methods: Five patients with laryngopharyngeal reflux were identified with refractory cough and paradoxical fold movement disorder on transnasal fiberoptic laryngoscopy by a greater than 50% reduction in airway during inspiration.

The relationship between ratings of voice quality and quality of life measures.

In the past several years, a number of scales have been developed that elicit a patient's self-assessment of the severity of his or her voice problem. The Voice Related Quality of Life Measure (V-RQOL) assesses a patient's perception of the impact of the voice problem on quality of life. Although this tool assesses the patient's perception of the voice disorder, it may not reflect the severity of dysphonia as perceived by a clinician.

Hypopharyngeal perforation near-miss during transesophageal echocardiography.

Objectives/hypothesis: The traditional blind passage of a transesophageal echocardiography probe transorally through the hypopharynx is considered safe. Yet, severe hypopharyngeal complications during transesophageal echocardiography at several institutions led the authors to investigate whether traditional probe passage results in a greater incidence of hypopharyngeal injuries when compared with probe passage under direct visualization.

Study Design: Randomized, prospective clinical study.

Laryngopharyngeal reflux testing.

Reflux testing is still evolving as new technology. New criteria for determination of clinical and subclinical laryngopharyngeal reflux are surfacing. The technique and interpretation of pH monitoring, the current gold standard, are still somewhat controversial.

Laryngeal adductor reflex and pharyngeal squeeze as predictors of laryngeal penetration and aspiration.

Objectives: The contribution of laryngopharyngeal (LP) sensory deficits to the outcome of swallowing and the relationship between sensory and motor deficits in the laryngopharynx is unclear. The study purpose is to determine if patients with LP sensory and motor deficits are at increased risk for laryngeal penetration and aspiration during swallowing, and to determine the relationship between pharyngeal motor weakness and LP sensory deficits.

Materials And Methods: Endoscopic evaluation of swallowing with sensory testing was performed on 122 dysphagic patients who were prospectively divided into two groups.