Gastroesophageal reflux and laryngeal disease.

OBJECTIVE

We wanted to determine if surgical correction of gastroesophageal reflux disease (GERD) would affect inflammatory laryngeal lesions in a select group of patients with known GERD and chronic inflammatory laryngeal lesions.

DESIGN

Patients with persistent inflammatory lesions in the larynx were referred for workup of GERD when these lesions were not associated with smoking or drinking or when cessation of smoking failed to ameliorate these lesions during a minimum period of 6 months. Twenty-four-hour pH monitoring was used to confirm GERD in 10 patients, while two patients had GERD confirmed radiologically, and one patient had typical symptoms of esophagitis and incompetent lower esophageal sphincter. Thus, 13 patients with chronic laryngeal inflammation persistent after cessation of smoking had concomitant GERD. These patients were all treated with Nissen fundoplication for GERD.

SETTING

Patients with chronic laryngitis were referred to an otolaryngologist at a tertiary medical center.

PATIENTS

Patients were consecutively selected as they presented with chronic persistent laryngeal lesions and were found to have GERD.

INTERVENTIONS

Surgical correction of GERD with Nissen fundoplication.

MAIN OUTCOME MEASURES

Status of the larynx was assessed at 3-month intervals with fiberoptic laryngoscopy and symptoms (ie, hoarseness, sore throat) were evaluated.

RESULTS

Laryngeal inflammatory lesions and voice changes (hoarseness and sore throat) promptly resolved in eight (73%) of 11 patients. To date, these improvements have continued after a mean follow-up of 11 months.

CONCLUSIONS

Correction of GERD in a selected subset of patients with laryngeal inflammatory lesions ameliorates these lesions.