Shaw G Y, Searl J P, Young J L, Miner P B
University of Kansas Medical Center, Kansas City 66160, USA.
J Voice. 1996 Dec;10(4):410-8. doi: 10.1016/s0892-1997(96)80033-6.
Laryngeal manifestation of gastroesophageal reflux is felt to be prevalent in our society. In general, diagnosis has been based primarily on symptoms. Historically, additional testing included laryngoscopy, barium swallow, manometry, and more recently, single- and double-probe pH monitoring. We evaluated 68 patients who were symptomatically suggestive of having reflux laryngitis. We administered surveys grading their symptoms. All patients underwent standardized videolaryngostroboscopic evaluation and computerized acoustic analysis. Patients then underwent a uniform therapy of dietary restrictions and omeprazole, a hydrogen ion inhibitor, for 12 weeks. Patients were then retested. This regimen demonstrated an 85% success of relieving symptoms. Utilizing the new laryngoscopic grading system, improvement was found to be statistically significant in improvement of all findings except granulomas. In patients with the pretherapy complaint of hoarseness, acoustic measures of jitter, shimmer, habitual frequency, and frequency range all showed significant improvement. The authors conclude that in patients with symptomatic reflux laryngitis, standardized videolaryngoscopy and, if hoarse, acoustic analysis are useful exam techniques to aide diagnosis and monitor therapy. Anti-reflux therapy with omeprazole is effective and improvement can be objectively demonstrated with the techniques described.
胃食管反流的喉部表现被认为在我们的社会中很普遍。一般来说，诊断主要基于症状。从历史上看，额外的检查包括喉镜检查、吞钡检查、测压检查，以及最近的单探头和双探头pH监测。我们评估了68例有反流性喉炎症状提示的患者。我们进行了症状分级调查。所有患者均接受了标准化的视频频闪喉镜评估和计算机声学分析。然后，患者接受了为期12周的饮食限制和质子泵抑制剂奥美拉唑的统一治疗。之后对患者进行了重新检测。该治疗方案显示缓解症状的成功率为85%。利用新的喉镜分级系统，发现除肉芽肿外，所有检查结果的改善在统计学上均有显著意义。在治疗前有声音嘶哑主诉的患者中，声学测量的抖动、闪烁、习惯频率和频率范围均显示出显著改善。作者得出结论，对于有症状的反流性喉炎患者，标准化的视频喉镜检查以及（如果患者声音嘶哑）声学分析是有助于诊断和监测治疗的有用检查技术。使用奥美拉唑进行抗反流治疗是有效的，并且可以用所描述的技术客观地证明病情有所改善。
