Efficacy of Speech-Language Pathology Interventions for Globus Pharyngeus: A Scoping Review.

OBJECTIVE: This scoping review aims to provide an overview of the literature investigating the efficacy of speech-language pathology (SLP) interventions in the treatment of globus pharyngeus (GP), identify gaps in knowledge, and guide future research. STUDY DESIGN: Scoping review. METHODS: Search terms were selected for five databases (PubMed, Embase, Web of Science, CINAHL, and Google Scholar). Inclusion criteria were broad and focused on any SLP intervention used to treat GP. Title and abstract and then full-text screening were performed. RESULTS: Of 420 unique abstracts identified, five studies met inclusion criteria. SLP interventions included explanation, education on normal swallow, laryngopharyngeal tension reduction exercises, "voice" exercises, neck/shoulder exercises, general relaxation, postural advice, diaphragmatic breathing, manual therapy, swallowing exercises, laryngeal hygiene, throat clearing suppression, stress management, and reassurance. All included studies reported statistically significant improvement in GP following SLP intervention based on the various outcome measures reported. CONCLUSIONS: This scoping review yields very little high-quality evidence supporting the efficacy of SLP interventions in the treatment of GP. Further prospective studies with systematic investigations and the use of validated outcome measures are needed to study the efficacy of SLP interventions as either adjuvant or stand-alone treatment for GP.

Evaluating Geographic Access to Interdisciplinary Laryngology and Speech-Language Pathology Clinic Models in the Southeast Region of the United States.

OBJECTIVE: An interdisciplinary model of care for the evaluation and treatment of voice, swallowing, and upper airway disorders with laryngologists and specialized speech-language pathologists is known to increase revenue, attendance to visits, patient adherence, and most importantly, improve patient outcomes. Individuals who live outside of areas with high population density often have reduced geographic access to this specialized care. The primary aim of this study is to identify the percentage of the population that has an "extended drive time" to access an interdisciplinary clinic in the Southeast region of the United States. STUDY DESIGN: NA. METHODS: Interdisciplinary laryngology and speech-language pathology clinics were identified via publicly accessible information including an internet search and state department of public health databases. Included clinics had at least one full-time fellowship-trained laryngologist and at least one full-time speech-language pathologist on staff. Descriptive statistics and visual representation of the results were achieved with the use of Smappen, a location intelligence online platform, to identify the percent of the population with a drive time greater than 1 hour. RESULTS: 47.24% of the Southeast population of the United States must drive over 1 hour to access an interdisciplinary clinic. Visual representations of these data are included and generated by Smappen. CONCLUSIONS: While close geographic proximity does not ensure access to care, it can increase the likelihood that healthcare services will be used. This study identified the population in the Southeast region of the United States with extended drive time to interdisciplinary voice and swallowing centers due to their geographic distance from these centers. The results from this study support the need for increased geographic access to specialty care clinics, specifically voice, swallowing, and upper airway care, and provide insight into potential sites for interdisciplinary centers based on population density in areas that are underserved.