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Andrew Hetland, '10

Reflux and Post-intubation Dysphonia

Background: Laryngopharyngeal reflux (LPR) has been linked to dysphonia. It is also widely known that intubation is a risk factor for dysphonia and LPR may be a risk factor. However, the significance of LPR in promoting or predisposing a patient to postintubation dysphonia is not clear.

Objective: The purpose of this study is to determine the relationship of LPR to post-intubation dysphonia.

Study Design: Prospective observational study

Setting: Tertiary care center

Study Participants: Participants will be enrolled in the study from the operative schedule and via the Intensive Care Unit (ICU). Patients with a history of previously identified laryngeal lesions, airway trauma, laryngeal surgery, tracheal surgery, scarring due to granulomatous disease, or who are undergoing neck or airway surgery will be excluded. The rationale for including presurgical and ICU patients is to allow examination of duration of intubation. Inclusion of ICU patients will allow a range of duration data.

Methods: Pre-operative subjects will complete the validated questionnaire instruments and an additional survey to record symptoms, relevant surgery data, risk factors, and demographics prior to surgery. Risk factors will include occupation, sinus disease, reason for intubation, endotracheal tube size, and duration of intubation. The Reflux Symptom Index (RSI) and Voice Handicap Index (VHI) will be used. Surveys will also be completed at one week and one month post surgery. ICU patients will be asked to complete the surveys one week following extubation and to consider preintubation perceptions retrospectively. Participants a RSI score of greater than 13 will be stratified to a "reflux group" while the remaining participants will comprise the "nonreflux group" for analysis purposes. Degree of change in the VHI pre vs. post intubation, and across time points will be compared in the two groups, and for presurgical vs. ICU patients. The VHI will be repeated at 1 month to evaluate disease progression or resolution. Participants who were noted to have significant dysphonia at 1 month will undergo endoscopic evaluation with videostroboscopy to characterize abnormalities.

Significance: This study aims to further describe the significance of LPR in patients requiring intubation. If LPR is found to be a significant risk factor for post-intubation dysphonia, then prophylactic medical management for reflux may be advocated.

 


 

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Otolaryngology Surgery University of Wisconsin Department of Surgery
First published: 07/15/02 Last updated: 11/24/09 webmaster@surgery.wisc.edu
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