Voice Quality Changes After Laryngopharyngeal Reflux Disease Treatment: A Systematic Review.

OBJECTIVE

To review the current literature dedicated to the voice quality changes throughout laryngopharyngeal reflux disease (LPRD) treatment.

METHODS

Two independent investigators conducted a literature search for studies investigating the voice quality changes after treatment in LPRD patients through PubMED, Scopus, BioMed Central, Biological Abstracts, and Cochrane Library databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements.

RESULTS

Twenty-seven studies (1470 patients, 48.0% females) were included. Most LPRD diagnoses were based on symptoms and findings, with only three studies using 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH testing. Treatment regimens primarily involved proton pump inhibitors, with adjunctive therapies in 10 studies and diet/lifestyle modifications in 15 studies. Post treatment voice quality reported improvements in subjective parameters, such as the Voice Handicap Index and grade of dysphonia, roughness, breathiness, asthenia, strain, instability, regardless of study design. Acoustic parameters (percent jitter, percent shimmer, and harmonic-to-noise ratio) consistently improved throughout treatment, while aerodynamic measurements yielded controversial results. Quality assessment revealed methodological limitations, with only three studies combining objective LPRD diagnosis with multidimensional voice quality assessment.

CONCLUSION

Voice quality is an interesting biomarker of therapeutic changes in LPRD patients with perceived or self-reported dysphonia. Future studies are needed to correlate the voice quality impairment with microscopic vocal fold changes.