Department of Otorhinolaryngology, Key Laboratory for Hearing Medicine of the Health Ministry of China, Eye and ENT Hospital of Fudan University, 83 Fen Yang Road, 200031 Shanghai, People's Republic of China.
Eur Arch Otorhinolaryngol. 2012 Aug;269(8):1939-44. doi: 10.1007/s00405-012-1968-9. Epub 2012 Mar 2.
The role of lower esophageal sphincter (LES) in laryngopharyngeal reflux is controversial. In this study, we used an animal model to investigate the association between LES dysfunction and reflux laryngitis. Twelve healthy New Zealand albino rabbits (2.5-3.5 kg) were utilized in this study. The animals were divided into two groups. Eight rabbits underwent total cardiomyectomy to induce reflux, and the remaining four rabbits underwent a control sham operation. A laryngoscopy and a 24-hour intra-esophageal pH-metry were performed prior to surgery and again 2 and 8 weeks postsurgery. After the final laryngoscopy, all animals were sacrificed to obtain histological results. Total cardiomyectomy significantly increased the reflux index, the duration of the longest reflux episode and the total number of episodes that occurred in 24 h postsurgery. No significant difference was observed in the reflux finding score (RFS) between preoperative and 2-week postoperative rabbits (P = 0.11). But there was a statistically significant change in the RFS before and 8 weeks after the induction of reflux from 4.6 ± 0.9 to 8.3 ± 3.6 (P = 0.02). Submucous gland hyperplasia and inflammation were significantly increased in the reflux group compared to the control group. The results of this study suggest that chronic lower esophageal sphincter dysfunction is associated with reflux laryngitis in rabbits.
食管下括约肌(LES)在喉咽反流中的作用存在争议。本研究采用动物模型探讨了 LES 功能障碍与反流性喉炎之间的关系。本研究共纳入 12 只健康新西兰白兔(2.5-3.5kg),随机分为两组。8 只兔子接受全心肌切除术以诱导反流,另外 4 只兔子接受对照假手术。术前及术后 2 周和 8 周分别进行喉镜检查和 24 小时食管内 pH 监测。最后一次喉镜检查后,所有动物均被处死以获取组织学结果。全心肌切除术显著增加了反流指数、最长反流时间和 24 小时内反流次数。术前和术后 2 周时,反流发现评分(RFS)无显著差异(P=0.11)。但在诱导反流前和 8 周后,RFS 从 4.6±0.9 显著增加至 8.3±3.6(P=0.02)。与对照组相比,反流组的黏膜下腺增生和炎症明显增加。本研究结果表明,慢性食管下括约肌功能障碍与兔反流性喉炎有关。