Management of Chronic Laryngeal Neuropathy in the United States versus Europe

Abstract

Objectives: Analyze differences in the evaluation of laryngeal neuropathy by laryngologists in the United States versus other countries. Methods: Members of the American Laryngology Society (ALA) and the European Laryngological Society (ELS) were surveyed. Questionnaires were emailed to 137 members of the ALA and 324 members of the ELS. As laryngology fellowships are less available outside the U.S., ELS members who devoted more than 50% of their practice to laryngology were identified as laryngologists for this study. Results: Of the ELS members surveyed, 72 (22.2%) responded, compared to 43 (24.5%) for ALA members. 56.9% of ELS respondents identified as devoting more than 50% of their practice to laryngology. Fellowship-level training in laryngology was completed by 74.1% of ELS respondents and 79.5% of ALA respondents. 11% of ELS respondents commented on completing fellowships in phoniatry or phonosurgery, or the absence of formal fellowships in their country. When comparing comfort with the diagnosis of laryngeal neuropathy, ELS laryngologists’ average comfort level was 4.33 on the Leikert scale versus 6.1 for ALA laryngologists ( P <.000002). When asked if they were concerned about over-diagnosing gastroesophageal reflux disease (GERD)-related laryngitis, 73% of ELS respondents vs. 40.9% of ALA respondents said yes ( P = 0.0109). Conclusions: Laryngologists in the United States vs. Europe vary significantly in their familiarity with laryngeal neuropathy. This could lead to differences in the workup of patients with laryngopharyngeal symptoms, possibly resulting in ineffective treatments. These differences are likely amenable to further education.