Laryngeal Manifestations of Systemic Diseases

Review by L Flood
Middlesborough, UK

A glance at Plural Publishing’s catalogue shows how much this company has released that is aimed at audiologists and speech and language pathologists, but which can be less relevant to a non-specialist otolaryngologist. The title suggested that this would be an exception and so it proved, although the result still concentrates very much on one aspect of laryngeal func- tion, the voice. Of 15 chapters, 9 have ‘voice’ in the title, but there is also coverage of disorders of the airway and its selective sphincter role.

I confess to a momentary blank moment reading the book’s title, as something I had never really considered. Salvation came with recall of the survival mode in any examination, when lost for an answer. Just start reciting ‘congenital, traumatic, infective, neoplastic, degenerative etc.’ and all becomes obvious. Sure enough, that is just the style here, but I will admit I had not thought of ageing, or sleep disorders and fatigue, as systemic disorders, each meriting their own chapter dealing with effects on voice. The psychological aspects of voice disorder, however common, I might have missed, and the impact of disorders on the auditory system certainly so. Fortunately then, my days of examination candidature are decades in the past.

The book opens with the customary basic sciences, republished from earlier work by Prof Sataloff. Systemic disorders really kick off with ‘Genetics of the Voice’ and do show how much our understanding has increased over the last two decades. I will certainly now be watching out for ‘Floating Harbor syndrome’. Chapter 4 ‘Common Medical Diagnoses and Treatments’ introduces, in outline, the systemic disorders that influence voice, but with much more detailed coverage in subsequent chapters. ‘Sleep, Body Fatigue’ sounded a very imaginative chapter title, but proved very short, at effectively two pages of text. The ‘Neurology’ chapter considered disorders of local motor nerve function, as well as the more obvious central abnormalities, such as Parkinson’s disease, multiple sclerosis or amyotrophic lateral sclerosis, with these last being particularly well covered.

A personal favourite, however, was the chapter on ‘Laryngeal Manifestations of Gastrointestinal Disorders’. Laryngopharyngeal reflux we all blame for many a symptom, whether globus, voice change, throat clearing or chronic cough. This remarkable and recommended chapter ranges from consideration of sudden infant death syndrome to the increasingly recognised perils of those proton pump inhibitors. By far the longest chapter (nearly 100 pages), this is supported by no fewer than 593 references!

A chapter on autoimmune diseases cites the usual suspects, including rheumatoid arthritis, systemic lupus erythematosus or the granulomatosis of he-who-must-not-be-named (but is here), and does consider effects other than voice, I will concede. The less obvious diseases, such as relapsing polychondritis, systemic sclerosis or amyloidosis, are also here, however. ‘Endocrine Disorders’ tends to concentrate on sex hormones and their fluctuations through life, but thyroid and pituitary abnormalities are not overlooked. The book closes with ‘Medications and the Voice’, whether in causing or solving problems. A highlight is the lengthy coverage of ‘alternative’ and various over-the-counter preparations, and the evidence for efficacy (or lack thereof, of course).

Endoscopic illustrations of the larynx are sparse and vary in quality, but the text itself is thorough; it is ‘different’ and of obvious relevance to the general otolaryngologist and trainee. The coverage of reflux disorders, alone, recommends this book to our readers.

Amazon Link: Laryngeal Manifestations of Systemic Diseases
By purchasing books via this link you will help to fund the JLO