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Belching is the act of expelling air from the stomach or esophagus into the pharynx. Although the process is regarded as physiological, excessive belching might be associated with a significant burden for affected patients in the sense of a belching disorder. Diagnosis of a belching disorder is often challenging, and its differentiation from other conditions such as rumination syndrome, singultus, or aerophagia can be difficult. Treatment of these disorders also represents a challenge for otorhinolaryngologists. Hence, the aim of this review is to provide an interdisciplinary overview of these clinical syndromes and provide practical guidance for their diagnosis and treatment., (© 2024. The Author(s).)

In this short communication, we discuss the recently described syndrome of retrograde cricopharyngeal dysfunction (R-CPD) with its first description in 2019 by the laryngologist Dr. Bastian. Diagnosis is generally based on typical clinical symptoms, e.g., the inability to belch, a bloated abdomen and retrosternal gurgling noises. We also describe high-resolution esophageal manometry as a new tool to further secure the diagnosis of R‑CPD, as well as therapeutic options such as botulinum toxin injections in the cricopharyngeal muscle or cricopharyngeal myotomy and the published data thereon., (© 2023. The Author(s).)

Standardized and validated patient surveys in the form of questionnaires are becoming increasingly important in otorhinolaryngology. Subjective symptoms and functional limitations but also health-related quality of life are assessed with so-called patient-reported outcome measures (PROMs). Besides patient history and objective findings, these questionnaires can be applied as another important source for ensuring the quality of patient-centered care. In German-speaking countries there are now several PROMs that specifically ask for the patient perspective on voice and swallowing disorders. For patients with voice disorders the following questionnaires based on the Voice Handicap Index (VHI), which are also used internationally, are mainly applied: VHI-30, VHI-12i, and VHI-9i. In the field of oropharyngeal dysphagia, the German versions of the Eating Assessment Tool-10 (EAT-10), des Sydney Swallow Questionnaire SSQ‑G, the Swallowing Quality of Life Questionnaire (SWAL-QoL), and the MD Anderson Dysphagia Inventory (MDADI) are currently mostly used., (© 2023. The Author(s).)

Laryngopharyngeal reflux (LPR) is characterized by backflow of gastric or gastroduodenal content and gases into the upper aerodigestive tract, which can damage the mucus membranes of the larynx and pharynx. It is associated with a variety of symptoms such as retrosternal burning and acid regurgitation, or other unspecific symptoms such as hoarseness, globus sensation, chronic cough, or mucus hypersecretion. Due to the lack of data and the heterogeneity of studies, diagnosis of LPR is problematic and challenging, as recently discussed. Moreover, the different therapeutic approaches are also discussed controversially in the face of the poor evidence base, and include pharmacologic and conservative dietary measures. Hence, in the following review, the available options for treatment of LPR are critically discussed and summarized for daily clinical use., (© 2023. The Author(s).)

In addition to clinical and instrumental methods as well as medical history, questionnaires are well-established tools in the diagnosis of laryngopharyngeal reflux (LPR). Recently, the reflux symptom score (RSS) as well as the short version of it, the RSS-12, which are self-administered patient-reported outcome questionnaires, have been published as an alternative to the well-established reflux symptom index (RSI). The RSS-12 assesses severity and frequency of LPR symptoms as well as the impact on quality of life and has been shown to have high reliability and validity. However, so far, only French, English, and Portuguese versions of the RSS-12 have been published. Hence, the aim of this study was to prepare a transcultural German translation of the RSS-12 (G-RSS-12) to provide a new clinical and scientific tool for the diagnosis of LPR in German-speaking regions., (© 2022. The Author(s).)

Background: Prolonged ulcerative laryngitis is a rare, benign inflammatory alteration of the larynx that persists for months. The laryngoscopic findings suggest a malignant process and can therefore be a challenge for the treating ear, nose and throat (ENT) physician., Objectives: Presentation of the current database to provide an overview of the etiology, progress and treatment for everyday clinical practice., Methods: Three case studies from the Department of Phoniatrics and Speech Pathology of the ENT Department, University Hospital Zurich, Switzerland, are presented. Analysis and discussion of the current literature base and of case reports in the English literature., Results: The etiology and predisposing factors for this disease are unclear. Previous respiratory infection with cough and dysphonia seems to be the most common cause. Biopsies should be avoided., Conclusions: The typical laryngoscopic findings show corresponding circumscribed lancet-shaped ulcerations in the middle third of the vocal fold. The course of the disease appears to be self-limiting and without permanent structural consequences. Therefore, good patient education and close laryngoscopic follow-up should be performed., (© 2021. The Author(s).)

Background: The Sydney Swallow Questionnaire (SSQ) is a self-report inventory assessing subjective symptoms of oropharyngeal dysphagia with strong content, construct, discriminant, and predictive validity and test-retest reliability in a range of patient populations., Objective: The main aim of this work was to assess the validity and reliability of the German version of the SSQ (SSQ-G)., Materials and Methods: In a cross-validation study, 48 adult German-speaking patients (12 women, 36 men) with neurogenic (n = 16), structural (n = 16), and functional (n = 16) oropharyngeal dysphagia were assessed with the SSQ‑G and the MD Anderson Dysphagia Inventory (MDADI). Cronbach's α was applied to assess the reliability. Criteria and construct validity were investigated using the Spearman correlation coefficient., Results: With Cronbach's α = 0.94, the internal consistency of the SSQ‑G was excellent. The SSQ‑G questions 1 and 17 showed a moderately significant and highly significant correlation coefficient of -0.43 and -0.45, respectively, with MDADI question 1 (p < 0.5, p < 0.001). Between questions 8, 11, and 12 of the SSQ‑G and questions 7, 13, and 10 of the MDADI, coefficients of -0.48 to -0.55 showed a moderate to strong highly significant correlation (p < 0.001). Thus, the reliability and criterion and construct validity were statistically confirmed., Conclusion: The German version of the SSQ (SSQ-G) allows a reliable and valid assessment of functional swallowing difficulties. In combination with questionnaires on symptom-specific quality of life, such as the MDADI, a more differentiated clinical analysis of swallowing problems is thus possible., (© 2021. The Author(s).)

Laryngopharyngeal reflux (LPR) is defined as backflow of gastral or gastroduodenal content into the upper aerodigestive tract and characterized by a variety of unspecific symptoms such as chronic cough, globus sensation, or mucus hypersecretion. Due to the lack of a gold standard and the heterogeneity of studies, the diagnosis of LPR is still problematic and challenging. However, in patients with characteristic symptoms and endoscopic findings, with an increased reflux symptom index, a pathologic reflux finding score (RFS), pathologic 24 h esophageal or oropharyngeal pH monitoring, and without any other underlying condition, the diagnosis of LPR is probable. In the following review, we critically discuss the abovementioned methods as well as more recent tools such as measurements of pepsin concentrations in the saliva for diagnosis of LPR., (© 2021. The Author(s).)

Significant and new impulses regarding the treatment concept for outpatient phonosurgery on unsedated patients are currently coming from various Anglo-American authors. These "office-based procedures" have been propagated as an alternative to many conventional surgical interventions under anesthesia. The main reason for this remarkable development is the use of new endoscopic techniques in combination with photoangiolytic laser (KTP and blue laser), which allow safe and efficient phonosurgical procedures. Patient acceptance is high since outpatient procedures are considered to have a lower surgical risk. Despite the widespread euphoria, there is a lack of studies evaluating the medical decision criteria and safety management of office-based laryngeal surgery., (© 2021. The Author(s).)

Background: In clinical routine, vocal fatigue is a common symptom in patients with dysphonia., Objective: The aim of this study was to conduct a transcultural translation of the Vocal Fatigue Index (VFI), a standardized subjective questionnaire. Furthermore, pretesting and prevalidation were performed in 20 subjects, with comparison to the Voice Handicap Index (VHI‑9i) and the Vocal Tract Discomfort Scale (VTD)., Materials and Methods: The translation, content review, and pretest of the German Vocal Fatigue Index (VFI-D) was divided into four sections: 1. transcultural translation, 2. expert voting on comprehensibility, 3. test of comprehensibility through cognitive interviews in 15 participants, 4. pretest of the VFI‑D with cross validation compared to VHI‑9i and VTD in 20 subjects. This process corresponds to current standards for transcultural translation and adaptation of questionnaires., Results: According to expert voting and cognitive testing, the VFI‑D is correct and comprehensible (intercoder reliability κ = 0.66). The factor analysis revealed three distinguishable parts: VFI‑D part 1 correlates strongly with VHI‑9i and VTD, VFI‑D part 2 with VTD only (rho ≈ 0.800 each), and VFI‑D part 3 correlates only weakly with VHI‑9i and VTD (rho ≈ 0.585). Thus, convergence and divergence validity are proven., Conclusion: The first German version of the VFI‑D might be a base for further research on symptoms, causes, and treatment options in vocal fatigue. Particularly patients in voice-intensive professions may benefit.