Despite the wealth of publications on the topic of gastroesophageal reflux and its variants, there are still many unsettled questions before one accepts the prevalent cult of "reflux disease". This study is summarizing the results of the critical analysis of the literature, 436 articles,during the last 30 years. The golden test to identify the patient group suffering from this rather common phenomenon is still lacking. The claimed extra-esophageal manifestations especially in the larynx are non-specific and may be caused by other factors well-known within the domain of vocology. The response to therapeutic intervention still lacks serious well-controlled studies to allow drawing reasonable conclusions. An outstanding feature of the publications is that most of them fall in the category of "review". It seems that there is a tendency to perpetuate the concept without objective criticism. Following the analysis, a recommendation for anew plan of original well-controlled multi-center studies is highlighted.

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Background: Phonasthenia is a voice disorder where the larynx looks essentially normal and dysphonia is not heard but felt by the patient. This study aims to use videokymography (VKG) to detect any abnormalities in the vibratory pattern in phonasthenia and to find out whether or not these abnormalities change after vocal loading. Methods: Thirty-seven phonasthenic patients and 31 normal subjects participated in a detailed protocol, including analysis of subjective complaints and videokymographic quasi-objective parameters (baseline) followed by loading their voices through prolonged loud reading for 45 min. A second evaluation (experimental) was done after loading. Results: Before vocal loading, patients had significantly more symptoms in all questionnaire questions and higher maximum width difference in VKG than controls. When pre- and postloading values were compared, both groups experienced more symptoms after loading (significant in most of the questions), while the pre- and post-VKG parameters did not show significant differences neither in patients nor controls. On comparing their percent change, the only statistically significant difference between the 2 groups was a greater change in the total score of the questionnaire in the control group. Conclusion: Patients had more vocal fatigue symptoms and more amplitude asymmetry between left and right vocal folds than normal subjects.

Background. Applying measures that prioritize staff safety, while protecting patient safety and care, represents a challenge during the current pandemic. Many documents of recommendations toward safe practice have been developed for this purpose. Objective. To assess adjustments that have been undertaken by phoniatricians and otolaryngologists in the delivery of health-care services during the pandemic in order to reduce staff exposure to COVID-19 and improve safety. Study design. Cross-sectional.Methods. An online self-administered survey was used during the first wave of the COVID-19 pandemic in June 2020 to collect data related to demographics of participants, their sources of information, administrative alterations, and changes they adopted when meeting patients for a consultation/procedure/surgery. Results. The eligible 154 responses were grouped into 4 groups based on country of residence. Alterations to service delivery amongst the different groups were compared. Conclusions. The majority of participants were following the suggested recommendations to service delivery adjustments, with some inconsistencies in practice across countries.

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