2018 Section 6 - Laryngology, Voice Disorders, and Bronchoesophalogy

Mehlum CS, Rosenberg T, Groentved AM, et al. Can videostroboscopy predict early glottic cancer? A systematic review and meta-analysis. Laryngoscope . 2016; 126(9):2079‐2084. EBM level N/A.............................................................................21-26 Summary : This meta‐analysis (5 studies, 307 patients) was completed to estimate the diagnostic accuracy of stroboscopy in differentiating early glottic cancer from noninvasive lesions. The sensitivities of stroboscopy within the single studies ranged from 86% to 100%, and specificities ranged from 7% to 93%. The meta‐analysis showed that the sensitivity of the combined results was 0.96 (95% confidence interval [CI]: 0.89-0.98), and the specificity was 0.65 (95% CI: 0.21-0.93). The authors conclude that stroboscopy is able to identify almost all patients with cancer, but only approximately two-thirds of patients with noninvasive lesions are correctly identified as not having cancer. Zeitels SM, Burns JA. Oncologic efficacy of angiolytic KTP laser treatment of early glottic cancer. Ann Otol Rhinol Laryngol . 2014; 123(12):840-846. EBM level 4...........................................................................................................................27-33 Summary : This is a follow up to the original case series published by the authors with additional patients (N = 117) and longer follow‐up (minimum 3 years), allowing further analysis of oncologic efficacy of this technique. Disease control for T1 and T2 lesions was 96% (79/82) and 80% (28/35), respectively. There were 10 recurrences, all treated with radiotherapy. Larynx preservation and survival were achieved in 99% of patients (81/82) with T1 disease and 89% of patients (31/35) with T2 disease. B. Clinical practice guideline for dysphonia Stachler RJ, Francis DO, Schwartz SR, et al. Clinical practice guideline: hoarseness (dysphonia) (update). Otolaryngol Head and Neck Surg . 2018; 158(Suppl 1):S1-S42. EBM level N/A.............................................................................................................34-75 Summary : This AAO evidence-based review of management of dysphonia, focused on both otolaryngologists and primary care physicians, concludes that we should not be treating dysphonia with antibiotics, corticosteroids, proton pump inhibitors, etc, nor ordering imaging studies for the evaluation of dysphonia until vocal fold examination has been done to support the use of any of these approaches. C. Laryngeal hypersensitivity Chamberlain Mitchell SA, Garrod R, Clark L, et al. Physiotherapy, and speech and language therapy intervention for patients with refractory chronic cough: a multicentre randomised control trial. Thorax . 2017; 72(2):129-136. EBM level 1b....................76-83 Summary : In this randomized control trial, patients with refractory chronic cough were randomized to a cough-specific speech and language pathology treatment group or a control (general health and wellness counseling sessions) group. Leicester Cough Questionnaire (LCQ) scores improved and cough frequency decreased significantly in the intervention group as compared to control group.