ESOPHAGOPHARYNGEAL DISTRIBUTION OF REFLUXED GASTRIC-ACID IN PATIENTS WITH REFLUX LARYNGITIS

Background & Aims: A variety of otolaryngological abnormalities have b een attributed to the contact of gastroesophageal refluxate with respe ctive structures of the aerodigestive tract, The aim of this study was to determine and compare the pharyngoesophageal distribution of gastr ic acid refluxate between patients with proven laryngitis attributed c linically to gastroesophageal reflux and three control groups. Methods : An ambulatory 24-hour simultaneous three-site pharyngoesophageal pH monitoring technique was used to measure reflux parameters in the phar ynx, proximal esophagus, and distal esophagus. Results: Between-group comparison showed no significant difference in the reflux parameters i n the distal esophagus between the studied groups. A significantly hig her percentage of distal reflux episodes reached the proximal esophagu s in the laryngitis group than in the control groups (P < 0.01), and t he number of pharyngeal reflux episodes and time of acid exposure were significantly higher in the laryngitis group than in the control grou ps (P < 0.001), Conclusions: Compared with normal controls and patient s with gastroesophageal reflux disease, pharyngeal reflux of gastric a cid is significantly more prevalent and the ratio of proximal to dista l esophageal acid reflux episodes is significantly increased in patien ts with posterior laryngitis, Simultaneous three-site ambulatory phary ngoesophageal pH monitoring may provide supporting evidence when the d iagnosis of reflux-induced aerodigestive tract lesions is considered.