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Wise et al.

Page 456

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Study Year LOE Study design Study groups Clinical endpoint Conclusion Laryngeal findings in AR and LPR

Thick endolaryngeal mucus was a predictor of allergy. No association between allergic

sensitization and presence of LPR. No significant difference in laryngeal appearance between allergy-positive and LPR-positive individuals.

Three times as many patients had allergies compared with LPR, no statistical significance.

The degree of allergen load correlates with the severity of vocal symptoms, as per an increase in score on the VHI.

Symptom prevalence Individuals with allergies had more severe vocal symptoms than non-allergic controls. Patients who had undergone AIT >2 years had fewer symptoms. Association between AR, LPR, laryngeal findings Could not determine causative relationship between allergy and vocal symptoms. Mean eosinophilic profile in the glottic, subglottic, and tracheal epithelium and submucosa

Iron soot and HDM resulted in eosinophilia in glottic, subglottic, and tracheal epithelium and submucosa.

Histopathologic findings Twice as much eosinophilia in supraglottis in animals exposed to HDM vs saline.

Prevalence of AR and LPR

Allergy and vocal

dysfunction association

Randhawa et al. 1999 2010 4 Cross sectional Patients presenting to rhinology clinic, no prior voice-related symptoms Simberg et al. 2002 2007 4 Cross sectional 1 Allergy patients in AIT program; 2 Nonallergic controls

1 Saline (allergen control) + filtered air (pollution control); 2 HDM + filtered air;

3 Saline + combustion particulates;

4 HDM + combustion particulates

Eren et al. 2005 2014 4 Case series Patients referred from allergy clinic with SPT testing

Randhawa et al. 2003 2010 4 Case series Patients with primary voice disorder or globus sensation

Jackson-Menaldi et al. 2012 1997 4 Prospective cohort Subjects referred to voice center with a voice problem Belafsky et al. 2006 2015 5 Bench research Guinea pigs exposed to:

Mouadeb et al. 2007 2009 5 Bench research Guinea pigs exposed to intranasal HDM for 9 weeks

AIT = allergen immunotherapy; AR = allergic rhinitis; GERD = gastroesophageal reflux; HDM = house dust mite; LOE = level of evidence; LPR = laryngopharyngeal reflux; NAR = non-allergic rhinitis; QOL = quality of life; RCT = randomized controlled trial; SPT = skin-prick test; VHI = Voice Handicap Index.

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.