Skip to main content
AAO-HNSF 2023 Annual Meeting & OTO Experience Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Comprehensive Otolaryngology

Getting Smarter About LPR: The Hoarseness Edition

Sunday, October 1, 2023
1:00 PM - 2:00 PM East Coast USA Time
Location: 101CD

    Lead Presenter(s)

  • Lee M. Akst, MD

    Director, Johns Hopkins Voice Center
    Johns Hopkins University
    Lutherville, MD, United States

    • Co-Presenter(s)

  • Thomas L. Carroll, MD

    Director, Brigham and Women's Voice Program and Section Chief, Laryngology
    Brigham and Women's Hospital Div of OTO
    Boston, MA, United States

Disclosure(s):
Lee M. Akst, MD: No relevant relationships to disclose.
Thomas L. Carroll, MD: No relevant relationships to disclose.
PROGRAM DESCRIPTION: This course emphasizes critical, evidence-based review of current practice regarding laryngopharyngeal reflux with focus on improving patient care related to dysphonia - helping to answer the question, "If it's not LPR making my patient hoarse, then what is it?". Based on enthusiastic feedback from prior meetings, case-based discussion will focus on clinical management and will introduce various topics concerning the epidemiology, pharmacologic management, role of empiric treatment, and testing strategies for LPR. It will also offer insights into differential diagnosis for dysphonia beyond LPR, focusing on subtle pathologies that are often missed.

Relative to LPR, current paradigms often yield uncertain diagnosis, while prolonged treatment and/or extensive testing are time-consuming and costly, have side effects, and yield equivocal benefit in many cases. Through focus on strengths/weaknesses of various diagnostic strategies and with knowledge of current practice patterns, this panel hopes to identify "best practices" for evaluation of presumed laryngopharyngeal reflux and offer suggestions for patient management of non-reflux causes of hoarseness. This presentation aims to recall Otolaryngologists to a broader patient-based perspective and refocus attention on better evaluation for complaints possibly related to laryngopharyngeal reflux.

OUTCOME OBJECTIVE 1: Discuss current Otolaryngology practice patterns for patients with hoarseness and presumed reflux disease.

OUTCOME OBJECTIVE 2: Explore tests for patients with hoarseness and presumed reflux, emphasizing importance of stroboscopy for accurate diagnosis.

OUTCOME OBJECTIVE 3: Review evidence-based approaches to reflux treatment, and strategies for next steps in care if antacids don't address patient complaints.

BACKGROUND STATEMENT: Despite Academy guidelines on dysphonia, empiric PPI are widely used and LPR is overemphasized. Without stroboscopy, many laryngologic diagnoses go unrecognized. Evidence-based discussion of the intersection of LPR and dysphonia is necessary for improved patient care.