The role of anti-reflux therapy in preparing patients for phonosurgical intervention

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Abstract

BACKGROUND: Among patients who consult ear–nose-throat specialists for dysphonia, 50% were found to have pharyngolaryngeal reflux, often combined with benign neoplasms of the vocal folds, which require phonosurgical intervention. No comparative data in the literature indicate the rationality of the prescription of anti-reflux therapy as part of preoperative preparation.

AIM: This study aimed to evaluate the effect of preoperative antireflux therapy on the functional results of phonosurgical interventions performed using a 445-nm semiconductor laser.

MATERIAL AND METHODS: In total, 59 surgical interventions for dysphonia caused by vocal fold lesions were performed in patients with concomitant objective signs of pharyngolaryngeal reflux. In each case, the intervention was performed using a 445-nm semiconductor laser under direct microlaryngoscopy and general anesthesia with high-frequency ventilation. Group 1 (n = 27) was prescribed a course of anti-reflux therapy 1 month before the planned intervention, and group 2 (n = 32) did not receive this therapy at the preoperative stage. Both groups received the prescribed therapy in the postoperative period. Comparative analysis was carried out according to the results of objective and subjective assessments of the voice function quality (acoustic voice analysis; VHI-10rus questionnaire).

RESULTS: No significant differences in the objective and subjective changes in voice quality were found between the two groups.

CONCLUSIONS: Preventive prescription of anti-reflux therapy before the planned phonosurgical intervention does not guarantee the more successful restoration of vocal function. All patients with signs of pharyngolaryngeal reflux should be prescribed anti-reflux therapy in the postoperative period.

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About the authors

Marina A. Ryabova

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: marinaryabova@mail.ru
ORCID iD: 0000-0002-6714-9454

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Michail Yu. Ulupov

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: mike.ulupov@gmail.com
ORCID iD: 0000-0002-8460-9889

MD, Dr. Sci. (Medicine), Assistant Professor

Russian Federation, Saint Petersburg

Valeriya A. Stepanova

Academician I.P. Pavlov First St. Petersburg State Medical University

Author for correspondence.
Email: vallery1508@gmail.com
ORCID iD: 0000-0003-4187-5295

Postgraduate student

Russian Federation, Saint Petersburg

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Supplementary files

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2. Fig. 1. Jitter (%) after surgical treatment: (a) patients who received antireflux therapy before surgical treatment and (b) patients who did not receive therapy

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3. Fig. 2. Shimmer (%) after surgical treatment: (a) patients who received antireflux therapy before surgical treatment and (b) patients who did not receive therapy

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4. Fig. 3. HNR (dB) after surgical treatment: (a) patients who received antireflux therapy before surgical treatment and (b) patients who did not receive therapy

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5. Fig. 4. VHI-10rus (scores) after surgical treatment: (a) patients who received antireflux therapy before surgical treatment and (b) patients who did not receive therapy

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