Intervention Review

Acid reflux treatment for hoarseness

  1. Claire Hopkins1,*,
  2. Umbreen Yousaf2,
  3. Mette Pedersen3

Editorial Group: Cochrane Ear, Nose and Throat Disorders Group

Published Online: 25 JAN 2006

Assessed as up-to-date: 15 NOV 2005

DOI: 10.1002/14651858.CD005054.pub2

How to Cite

Hopkins C, Yousaf U, Pedersen M. Acid reflux treatment for hoarseness. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD005054. DOI: 10.1002/14651858.CD005054.pub2.

Author Information

  1. 1

    Princess Royal Hospital, Farnborough, Department of ENT, Orpington, Kent, UK

  2. 2

    Broenshoej, Denmark

  3. 3

    The Medical Center, ENT, Copenhagen, Denmark

*Claire Hopkins, Department of ENT, Princess Royal Hospital, Farnborough, Carmay, Chelsfield Lane, Orpington, Kent, BR6 7RR, UK. clairehopkins@yahoo.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 25 JAN 2006

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要

Background

Acid reflux is a common problem, and is thought to occur in 4% to 10% of patients presenting to ENT clinics. A recent study of reflux and voice disorders suggests that up to 55% of patients with hoarseness (dysphonia) have laryngopharyngeal reflux. Anti-reflux therapy is often used empirically in treating patients with hoarseness, where no other cause has been identified by examination.

Objectives

The aim of the review was to assess the effectiveness of anti-reflux therapy for patients with hoarseness, in the absence of other identifiable causes, whether or not a definitive diagnosis of laryngopharyngeal and gastro-oesophageal reflux has been made. This was assessed by evaluation of prospective randomised controlled studies that were identified by a systematic review of the literature. Both medical and surgical treatments were evaluated.

Search methods

The Cochrane ENT Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library Issue 3, 2005), MEDLINE (1966 to 2005), EMBASE (1974 to 2005) and conference proceedings were searched with prespecified terms. The date of the last search was September 2005.

Selection criteria

Randomised controlled trials recruiting patients with hoarseness in the absence of other identifiable causes, such as malignancy, cord palsy or nodules, whether or not a definitive diagnosis of laryngopharyngeal and gastro-oesophageal reflux has been made.

Data collection and analysis

Three reviewers examined the search results and identified studies before deciding which would be included in the review.

Main results

302 potential studies were identified by the search strategy. No trials were identified which met our inclusion criteria. Six randomised controlled trials were identified in which some, but not all patients presented with hoarseness, and were treated with proton pump inhibition. As we could not determine with certainty whether all these patients had hoarseness among the other laryngeal symptoms, these were excluded. However, these studies suggest a significant placebo response, which is comparable to the benefit derived from anti-reflux therapy in some studies. As no trials met our criteria, we are unable to reach any firm conclusions regarding the effectiveness of anti-reflux treatment for hoarseness.

Authors' conclusions

There is a need for high quality randomised controlled trials to evaluate the effectiveness of anti-reflux therapy for patients with hoarseness which may be due to laryngopharyngeal and gastro-oesophageal reflux.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要

There is not enough evidence that anti-reflux therapies are effective in treating hoarseness

Hoarseness is a common disorder. A recent study suggested that up to 55% of patients with hoarseness have acid reflux (where stomach acid flows back up into the oesophagus), which affects their throat and voice box. Anti-reflux therapy includes drugs, lifestyle changes and sometimes surgery. These treatments are often used for patients with hoarseness, where no other cause has been found by examination. This review found no randomised controlled trials of patients with hoarseness treated by anti-reflux therapy. Some studies were found, however, where patients had hoarseness among other symptoms of acid reflux. These studies suggested a significant response of such symptoms to placebo therapy. More good quality studies are needed to test the effectiveness of anti-reflux therapies in patients with hoarseness.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要

以胃酸逆流療法治療聲音嘶啞

研究背景

胃酸逆流是一常見問題,大約占4%∼10%耳鼻咽喉科門診病人有胃酸逆流。一項近期對於胃酸逆流及聲音失常的研究顯示,高達55%聲音嘶啞(發音異常)的病患具有喉咽部逆流的情況。在檢查並沒有發現其他原因之下,抗逆流療法常經驗性地治療聲音嘶啞的病患。

研究目的

本回顧的目標在評估無論是否確診為咽喉或是胃食道逆流,在沒有其他可辨識病因的情況下,抗逆流療法對於嘶啞病患的療效。本文是用系統性文獻回顧的方式,找出用前瞻性對照試驗進行評估的研究,並以此進行評估。無論內科及外科處置皆進行評估。

检索方法

以預先設定好的詞彙搜尋Cochrane ENT Group Specialised Register、Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library Issue 3, 2005年)、MEDLINE (1966年∼2005年)、EMBASE (1974年∼2005年) 以及研討會手冊。最後搜尋日期為2005年9月。

纳入标准

無論是否確診為咽喉或是胃食道逆流,有關聲音嘶啞且缺乏其他可辨識原因(像是惡性腫瘤、聲帶麻痺或結節)的患者的隨機對照試驗。

数据收集与分析

三位回顧者檢查搜尋結果來決定哪個研究應被納入。

主要结果

利用搜尋策略找到了302個可能相關的研究。沒有試驗被認定符合納入標準。6項隨機對照的試驗被鑑別出來,其中僅有部分而非全部的病患具有聲音沙啞現象且以正離子幫浦抑制劑治療。由於我們不能由其他喉部症狀來確定是否所有病患具有聲音嘶啞現象,因此這些研究被排除。然而,在某些研究出現一個明顯的安慰劑反應,顯示安慰劑與抗逆流療法效益相當。由於沒有試驗符合納入標準,因此無法針對抗逆流療法治療聲音嘶啞的療效作出確切的結論。

作者结论

針對可能是因為咽喉或胃食道逆流引起聲音嘶啞的病患,需要以高品質的隨機對照試驗評估抗逆流療法的功效。

 

概要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要

以胃酸逆流療法治療聲音嘶啞

沒有足夠證據證明抗逆流的療法治療聲音嘶啞的功效。聲音嘶啞是一種常見的病症。一個近期的研究指出高達55%的聲音嘶啞病患具有胃酸逆流(該處胃酸往回流動進入食道),並影響到喉嚨及喉部。抗逆流療法包含藥物、改變生活方式,而有時候會以外科方法處置。無論是否檢驗出其他可能造成逆流的病因,這些處置常被用來治療聲音嘶啞的患者。本回顧沒有找到以抗逆流療法治療聲音嘶啞患者的隨機對照試驗。我們有找到一些研究,不過聲音嘶啞僅是其他胃酸逆流症狀之一。而這些研究指出這些症狀對於安慰劑治療有明顯的反應。 需要更多好品質的研究評估抗逆流療法對於聲音嘶啞患者的療效。

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