Prevalence of Esophageal Dysmotility and Reflux in Muscle Tension Dysphonia Patients

ABSTRACT Objectives Laryngopharyngeal reflux (LPR) contributes to muscle tension dysphonia (MTD); however, symptoms overlap with esophageal dysmotility. Study aims were to determine the prevalence of esophageal disorders among MTD patients and correlate pathologies to patient‐reported outcome measures (PROMs). Methods Retrospective chart review of MTD patients diagnosed by laryngologists who underwent barium esophagram for suspected LPR. Demographics, Voice Handicap Index 10 (VHI‐10), Voice Related Quality of Life (V‐RQOL), and imaging were reviewed. The Kruskal–Wallis test was used to compare VHI‐10 and V‐RQOL across groups. The Wilcoxon rank‐sum test was applied to compare scores including their subitems, between dysmotility only and reflux only groups. Results A total of 128 patients with MTD underwent barium esophagram. The average age was 61 years; 70% were female. Esophageal findings included dysmotility only (31%), reflux only (24%), both (12%), and neither (33%). The reflux‐only group reported significantly worse voice‐related outcomes on PROMS compared to dysmotility only. Reflux‐only patients had higher total VHI‐10 ( p = 0.04) and were more likely to report difficulty being heard ( p = 0.01), understood in noisy environments ( p = 0.02), restricted socially ( p < 0.01), and left out of conversations ( p = 0.03). V‐RQOL items like speaking loudly ( p = 0.04), using phone ( p = 0.04), performing work duties ( p = 0.03), and feeling less outgoing ( p = 0.02) were also more negatively impacted in reflux‐only. Conclusion Esophageal dysmotility is prevalent in MTD patients and may mimic LPR. Patients with reflux may have more negative impacts on V‐RQOL. Although esophagrams can be used as a screening tool, further studies can help elucidate the connection between esophageal dysmotility and laryngeal function. Level of Evidence 3.