2018 Section 6 - Laryngology, Voice Disorders, and Bronchoesophalogy

Chandrasekhar SS, Randolph GW, Seidman MD, et al. Clinical practice guideline: improving voice outcomes after thyroid surgery. Otolaryngol Head Neck Surg . 2013; 148(6 Suppl):S1-S37. EBM level N/A....................................................................118-154 Summary : This AAO evidence-based review on voice change after thyroid surgery advocates for evaluation of patients with dysphonia both before and after thyroid surgery, among other recommendations.

Lee JC, Breen D, Scott A, et al. Quantitative study of voice dysfunction after thyroidectomy. Surgery . 2016; 160(6):1576-1581. EBM level 4..........................155-160

Summary : Voice quality deteriorates with thyroid surgery despite a functionally intact recurrent laryngeal nerve. While likely multifactorial, the degree of deterioration is related to the extent of the operation and may also be related to the degree of recurrent laryngeal nerve swelling. Spontaneous resolution is expected in the majority of patients. Sinclair CF, Bumpous JM, Haugen BR, et al. Laryngeal examination in thyroid and parathyroid surgery: an American Head and Neck Society consensus statement: AHNS Consensus Statement. Head Neck . 2016; 38(6):811-819. EBM level 3a..............161-169 Summary : This American Head and Neck Society (AHNS) consensus statement discusses the techniques of laryngeal examination for patients undergoing thyroidectomy and parathyroidectomy. It is intended to help guide all clinicians who diagnose or manage adult patients with thyroid disease for whom surgery is indicated, contemplated, or has been performed. This consensus statement concludes that flexible transnasal laryngoscopy is the optimal laryngeal examination technique, with other techniques, including laryngeal ultrasound and stroboscopy, being useful in selected scenarios. Tedla M, Chakrabarti S, Suchankova M, Weickert MO. Voice outcomes after thyroidectomy without superior and recurrent laryngeal nerve injury: VoiSS questionnaire and GRBAS tool assessment. Eur Arch Otorhinolaryngol . 2016; 273(12):4543-4547. EBM level 4............................................................................170-174 Summary : This study looks at GRBAS and VoiSS scores following thyroidectomy in patients without recurrent or superior laryngeal nerve injury and concludes that change in voice is prevalent. Age, TSH level, and reflux are risk factors for voice change. Attwood SE, Ell C, Galmiche JP, et al. Long-term safety of proton pump inhibitor therapy assessed under controlled, randomised clinical trial conditions: data from the SOPRAN and LOTUS studies. Aliment Pharmacol Ther . 2015; 41(11):1162-1174. EBM level 1..............................................................................................................175-187 Summary : This paper reports findings from two large randomized studies of GERD treatment. The study design is unique in that patients were prospectively randomized to anti-reflux surgery vs. proton pump inhibitor therapy. Over a period of 5 to 12 years, the incidence of serious adverse events did not differ between groups. Some metabolic differences were detected. These studies provide some of the best evidence available on long-term risks of GERD treatment. Though study bias is minimized, the studies were funded by a pharmaceutical company that produces omeprazole and esomeprazole.

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Bronchoesophagology A. Treatment of laryngopharyngeal reflux