PAROXYSMAL LARYNGOSPASM SECONDARY TO GASTROESOPHAGEAL REFLUX

Over a 2-year period (1992 to 1994), 12 consecutive adult patients wit h paroxysmal laryngospasm were prospectively studied. All had had othe r symptoms of gastroesophageal reflux (GER); however, only 4 (33%) exp erienced symptoms of heartburn. Each patient underwent fiberoptic lary ngeal examination, barium swallow/esophagography, and ambulatory, 24-h our, double-probe pH monitoring (pH-metry). Eleven (92%) of the 12 pat ients had evidence of GER on examination, and 10 (83%) had abnormal pH -metry, including 3 who demonstrated pharyngeal reflux while having no rmal total acid exposure times in the esophageal probe. All the patien ts responded to antireflux treatment, using dietary and lifestyle modi fications and omeprazole, with complete cessation of the laryngospasti c episodes. This study documents the role of GER in the etiology of pa roxysmal laryngospasm, it highlights the advantages of double-probe pH -metry in diagnosing this extraesophageal manifestation of GER, and it demonstrates that antireflux therapy with omeprazole is effective in controlling GER-induced laryngospasm.