Mjönes Anna-Britta, Borch Kurt, Tibbling Lita, Ledin Torbjörn, Hultcrantz Elisabeth
Department of Otorhinolaryngology, University Hospital, Linköping, Sweden.
Eur Arch Otorhinolaryngol. 2007 Dec;264(12):1437-9. doi: 10.1007/s00405-007-0396-8. Epub 2007 Jul 21.
The purpose of this study was to elucidate whether misdirected swallowing is an extra-laryngeal cause of hoarseness and investigate whether the prevalence of misdirected swallowing and hoarseness in patients with hiatal hernias differ from those with and without pathological gastroesophageal reflux (GER). One hundred and ninety eight patients with hiatal hernias diagnosed via esophageal manometry and pH-reflux test and 262 subjects in the general population who did not have a hiatal hernia at endoscopy, filled in a questionnaire about symptoms on hoarseness, misdirected swallowing, and heartburn. Hoarseness (35%), misdirected swallowing to the larynx (MSL; 35%), misdirected swallowing to the nose (MSN; 22%) and heartburn (85%) were significantly more common in patients with hiatal hernia than in controls (13, 5, 1, and 6%, respectively, P<0.001). MSL and MSN in the patient group were significantly interrelated (P<0.0001). Hoarseness and MSL were not significantly associated (P<0.076). Hoarseness and MSL were as common in the hernia group with normal GER, as in the group with pathological GER. There is a predisposition for hoarseness and MSL in patients with hiatal hernias, but the cause-and-effect relationship is unclear. Hoarseness does not seem to be caused by pathological GER.
本研究的目的是阐明误咽是否为声音嘶哑的喉外病因，并调查食管裂孔疝患者中误咽和声音嘶哑的患病率与有无病理性胃食管反流（GER）的患者相比是否存在差异。198例经食管测压和pH反流试验诊断为食管裂孔疝的患者以及262例在内镜检查中无食管裂孔疝的普通人群填写了一份关于声音嘶哑、误咽和烧心症状的问卷。食管裂孔疝患者中声音嘶哑（35%）、误咽入喉（MSL；35%）、误咽入鼻（MSN；22%）和烧心（85%）的发生率显著高于对照组（分别为13%、5%、1%和6%，P<0.001）。患者组中的MSL和MSN显著相关（P<0.0001）。声音嘶哑与MSL无显著相关性（P<0.076）。在GER正常的疝组中，声音嘶哑和MSL的发生率与病理性GER组相同。食管裂孔疝患者易出现声音嘶哑和MSL，但因果关系尚不清楚。声音嘶哑似乎不是由病理性GER引起的。
