Wierzbicka Małgorzata, Brzuzgo Katarzyna, Pazdrowski Jakub, Wierzbicki Tomasz, Kruk-Zagajewska Aleksandra, Szyfter Witold
Klinika Otolaryngologii AM im. K. Marcinkowskiego w Poznaniu.
Otolaryngol Pol. 2003;57(2):191-8.
Symptoms from the ears, throat, nose and larynx--the laryngeal mask's manifestations of gastroesophageal reflux disease (GERD) are important clinical problem of significant occurrence.
(1) Determination of GERD's frequency of occurrence, especially within the group of patients with the pathology of the posterior laryngeal commissure. (2) Evaluation of the effective algorithms for detecting and management of patients demonstrating symptoms of laryngeal mask, which develop on the ground of gastroesophageal reflux disease. The investigation included 9 patients who were hospitalized in the Department of Otolaryngology of Karol Marcinkowski University of Medical Sciences in Poznań. Every patient was carefully interviewed by means of 3 questionnaires: the first one being Karlsson's general questionnaire, the second one--author's questionnaire designed in the Department of Otolaryngology of Medical Academy in Poznań which emphasises laryngeal symptoms; and the third one being the inquiry including serious past diseases, regularly taken medications, and stimulants. The objective condition of the hypopharynx and larynx was estimated on the basis of indirect laryngoscopy, followed by manometric examination of the oesophagus and 24-hour pH-metry carried out in Motility Laboratory of Surgical Department. 8 patients (88.9%) out of 9 were diagnosed as having GERD on the ground of the questionnaires as well as on the base of the results from the 24-hour pH-metry, and among 7 patients (87.5%) out of the 8 motility disfunction of the oesophagus was detected. Within the group of 8 patients with diagnosed GERD on the ground of additional tests 3 patients (37.5%) were diagnosed as having posterior laryngitis, 2 patients (25%) were diagnosed as having chronic laryngitis and the last 1 (12.5%) suffering from dysphagia. Among 3 patients (37.5%) with tumors of the larynx of rare location within the posterior laryngeal commissure coexistence of gastroesophageal reflux disease (GERD) was proved. The remaining 1 patient (11.1%) with the larynx cancer had no confirmation of GERD. The connection between chronic laryngitis and gastroesophageal reflux disease and/or motility disfunction of the oesophagus described in the literature was confirmed within the group of examined patients. Awareness of GERD and diagnostics carried out in that direction is needed in the group of patients with typical symptoms of the laryngeal mask. Significant frequency of coexistence of gastroesophageal reflux disease and pathology of the posterior laryngeal commissure requires effective algorithms for management of these patients.
耳、鼻、喉及喉部的症状——喉罩型胃食管反流病（GERD）的表现是一个重要且常见的临床问题。
（1）确定GERD的发生率，尤其是在后联合病变患者群体中的发生率。（2）评估检测和管理因胃食管反流病出现喉罩症状患者的有效算法。该研究纳入了在波兹南卡罗尔·马尔钦科夫斯基医科大学耳鼻喉科住院的9名患者。通过3份问卷对每位患者进行仔细询问：第一份是卡尔森通用问卷，第二份是波兹南医科大学耳鼻喉科设计的强调喉部症状的作者问卷，第三份是关于严重既往疾病、定期服用药物和刺激因素的询问。下咽和喉部的客观状况通过间接喉镜检查进行评估，随后在外科动力实验室对食管进行测压检查并进行24小时pH监测。9名患者中有8名（88.9%）根据问卷以及24小时pH监测结果被诊断为GERD，8名患者中有7名（87.5%）检测到食管动力功能障碍。在通过额外检查诊断为GERD的8名患者中，3名（37.5%）被诊断为后喉炎，2名（25%）被诊断为慢性喉炎，最后1名（12.5%）患有吞咽困难。在3名后联合部位罕见喉肿瘤患者中（37.5%），证实存在胃食管反流病（GERD）。其余1名喉癌患者未证实存在GERD。在所检查的患者群体中，证实了文献中所述的慢性喉炎与胃食管反流病和/或食管动力功能障碍之间的关联。有典型喉罩症状的患者群体需要了解GERD并进行相关诊断。胃食管反流病与后联合病变并存的高发生率需要有效的患者管理算法。
