{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:52:53Z","timestamp":1787752373283,"version":"build-2784847793"},"reference-count":15,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T00:00:00Z","timestamp":1542326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Patients with muscle tension dysphonia often demonstrate an elevation in Reflux Symptom Index (RSI) and 10\u2010item Voice Handicap Index (VHI\u201010) scores, and may be erroneously diagnosed with laryngopharyngeal reflux disease. In this study we assessed the effects of voice therapy on RSI and VHI\u201010 scores in patients with voice complaints not responsive to antireflux medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A study of patients was conducted at a single tertiary\u2010care center over 1 year (January 2012\u2013January 2013). Patients were included if they had dysphonia not responsive to proton pump inhibition, did not have neurologic or neoplastic disease, and participated in at least three voice\u2010therapy sessions in the absence of antireflux therapy. Primary analysis assessed change in RSI scores between the initial and follow\u2010up visits with a laryngologist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 18 patients were included (mean age\u2009=\u200949.9\u2009\u00b1\u200914.5 years, 89% female, 83% with a primary complaint of dysphonia). From initial to follow\u2010up visit, the median RSI score (18.5 [interquartile range {IQR}, 9.5\u201322.8] vs. 10.5 [IQR, 4.5\u201314]; <jats:italic>P<\/jats:italic>\u2009=\u2009.02) and median VHI\u201010 score (25.5 [IQR, 11.3\u201330.0] vs. 13.5 [IQR, 9.5\u201320.8]; <jats:italic>P<\/jats:italic>\u2009=\u2009.03) significantly decreased. A significant inverse correlation was found between the number of voice therapy sessions\/month and change in RSI score (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.4; <jats:italic>P<\/jats:italic>\u2009=\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study of patients with muscle tension dysphonia or vocal hyperfunction not responsive to antireflux therapy, RSI and VHI\u201010 scores improved following voice therapy. Results suggest that self\u2010reported symptoms typically attributed to laryngopharyngeal reflux disease may actually be secondary to inefficient voice use patterns or anxiety about dysphonia that are responsive to voice therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 129:1169\u20131173, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27583","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T14:54:10Z","timestamp":1542380050000},"page":"1169-1173","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Voice therapy associated with a decrease in the reflux symptoms index in patients with voice complaints"],"prefix":"10.1002","volume":"129","author":[{"given":"Sarah L.","family":"Schneider","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California  San Francisco, San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew S.","family":"Clary","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Colorado School of Medicine  Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Steven","family":"Fink","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Colorado School of Medicine  Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean X.","family":"Wang","sequence":"additional","affiliation":[{"name":"Sutter Health  Fremont California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farshad N.","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Colorado School of Medicine  Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rena","family":"Yadlapati","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of Colorado School of Medicine  Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie E.","family":"Jett\u00e9","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Colorado School of Medicine  Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S.","family":"Courey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Mount Sinai Health System  New York New York 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