title: Hoarseness misattributed to reflux: sources and patterns of error.
abstract: OBJECTIVE
  This study aimed to identify voice disorders commonly misidentified as reflux and sources of such misattribution.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Twenty-six patients carrying a diagnosis of reflux alone presenting for second-opinion evaluation were identified from among 381 new patients presenting with a chief complaint of hoarseness over an 8-month period. Patients specifically referred for further workup were excluded.
  
  
  RESULTS
  Average duration of reflux treatment was 10.6 +/- 9.0 weeks. In no case was reflux alone the cause of hoarseness. Eleven (42%) had phonotraumatic lesions, 9 (34%) had neurologic disorders, 5 (19%) had age-related changes, and I (4%) was infectious. Twenty-two (85%) abnormalities were diagnosed by dynamic laryngeal examination with improved optics, including stroboscopy. Only 4 (15%) represented disorders routinely diagnosed with flexible fiberoptic laryngoscopy.
  
  
  CONCLUSIONS
  Hoarse patients with no apparent cause for dysphonia other than reflux after flexible laryngoscopy, or who fail to improve with appropriate treatment, may benefit from further laryngeal investigation rather than continued empiric treatment or further reflux evaluation.
authors.forename: Lucian
authors.initials: L
authors.lastname: Sulica
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002921:Cicatrix / Q000175:diagnosis; D003560:Cysts / Q000175:diagnosis; D003951:Diagnostic Errors; D055154:Dysphonia / Q000175:diagnosis; D005260:Female; D006685:Hoarseness / Q000209:etiology*; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis*; D057045:Laryngopharyngeal Reflux / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000175:diagnosis; D012017:Referral and Consultation; D012189:Retrospective Studies; D014826:Vocal Cord Paralysis / Q000175:diagnosis; D055815:Young Adult