J Korean Soc Laryngol Phoniatr Logoped.  2022 Apr;33(1):31-36. 10.22469/jkslp.2022.33.1.31.

Effect of Proton Pump Inhibitors, Mucolytics and Steroids on Voice Outcomes After Laryngomicrosurgery

• Choi YS
• Kim JW

• KMID: 2529631
• DOI: http://doi.org/10.22469/jkslp.2022.33.1.31

Abstract

Background and Objectives
Proton pump inhibitors (PPIs), mucolytics, and steroids were commonly recommended after phonomicrosurgery to prevent worsening of vocal fold (VF) scar formation and subglottal swelling. However, there is no consensus about whether laryngeal reflux and thick discharge are associated with the voice outcomes following phonomicrosurgery in benign VF lesions. The purpose of this study is to examine voice outcomes of use of PPIs, mucolytics,and steroids after phonomicrosurgery. Materials and Method This randomized controlled study is performed with patients undergoing laryngomicroscopic surgery for VF polyp and cyst. Participants were randomly assigned to 1) no medication, 2) PPIs, 3) PPIs+mucolytics, and 4) PPIs+mucolytics+steroids for 2 months postoperatively. Grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, stroboscopic examination, aerodynamic assessment, acoustic analysis, and Voice Handicap Index-10 (VHI-10) were performed pre- and post-operatively at 2 months. Parameters were compared among four groups.
Results
Among 85 patients, a total of 50 patients were included. The VHI-10, perceptual and acoustic parameters improved in all groups after surgery. However, there was no significant difference in those parameters among all groups.
Conclusion
PPIs, mucolytics, and steroids did not significantly influence voice outcomes after phonomicrosurgery in patients with benign VF lesions.

Keyword

Proton pump inhibitors; Expectorants; Steroids; Microsurgery; Voice; 성자펌프억제제; 점액용해제; 스테로이드; 미세수술; 음성