Dysphonia and Laryngopharyngeal Reflux

Since it was described, laryngopharyngeal reflux (LPR) has become linked with and blamed for a multitude of head and neck complaints ranging from globus pharyngeus, dysphagia, postnasal drip, vocal fatigue, excessive throat clearing, chronic cough, and hoarseness. In several ways, physicians have utilized LPR as an easy target to treat with proton pump inhibitor medical therapy without any further examination or evaluation. This chapter describes the literature surrounding dysphonia and LPR and tries to build a rational approach to diagnosis and management. However, laryngovideostroboscopy is absolutely necessary for those patients with dysphonia lasting for more than 4 weeks as there are a litany of other causes of hoarseness that can only be diagnosed with direct visualization.