Management of symptoms for patients within this subgroup of the GERD spectrum is difficult. Once these patients are identified, behavioural and dietary changes are advised. Dietary modifications may include limiting the intake of chocolate, caffeine, acidic food and liquids, gaseous beverages and foods high in fat. Behavioral changes may include weight loss, cessation of smoking, limiting alcohol consumption and avoiding the ingestion of food shortly before bed. Lifestyle changes in children diagnosed with<unk>  include dietary modifications to avoid foods that will aggravate<unk>  (e.g., chocolate or acidic and spicy food), altering positioning (e.g., sleeping on your side), modifying the textures of foods (e.g., thickening feeds to heighten awareness of the passing bolus), and eliminating the intake of food before bed. Proton pump inhibitors (PPIs) are the leading pharmaceutical intervention chosen for the relief and reduction of<unk>  and are typically recommended for ongoing use twice a day for a period of 3–6 months. PPIs have been shown to be ineffective in very young children and are of uncertain efficacy in older children, for whom their use has been discouraged. While PPIs may provide limited clinical benefits in some adults, there is insufficient evidence to support routine use. Many studies show that PPIs are not more effective than placebos in treating<unk> . When medical management fails, Nissen fundoplication can be offered. However, patients should be advised that surgery may not result in complete elimination of<unk>  symptoms and even with immediate success, recurrence of symptoms later on is still possible. One way to assess treatment outcomes for<unk>  is through the use of voice quality measures. Both subjective and objective measures of voice quality can be used to assess treatment outcomes. Subjective measures include scales such as the Grade, Roughness, Breathiness, Asthenia, Strain Scale (GRBAS); the<unk>  Symptom Index; the Voice Handicap Index (VHI); and a voice symptom scale. Objective measures often rely on acoustic parameters such as jitter, shimmer, signal-to-noise ratio, and fundamental frequency, among others. Aerodynamic measures such as vital capacity and maximum phonation time (MPT) have also been used as an objective measure. However, there is not yet a consensus on how best to use the measures or which measures are best to assess treatment outcomes for<unk> .
Laryngopharyngeal reflux
Subglottic stenosis
Laryngomalacia
Velopharyngeal insufficiency
Laryngotracheal stenosis
Post-nasal drip
Exercise-induced laryngeal obstruction
Nasal septum deviation