ROLE OF REFLUXED GRID IN PATHOGENESIS OF LARYNGEAL DISORDERS

The neuroanatomic proximity of the larynx to the hypopharynx and proxi mal esophagus make it particularly vulnerable to diseases that occur i n those 2 areas. This is particularly true of gastroesophageal reflux disease (GERD), There is increasing awareness of this relationship, an d dysphonias from gastroesophageal reflux (GER) are far more common th an previously realized. The symptoms and findings of reflux laryngitis , vocal nodules, Reinke's edema, contact ulcer and granuloma, laryngea l stenosis, and paroxysmal laryngospasm are presented, and diagnostic protocols for each disorder are suggested. The treatment varies with t he severity of each problem. Conservative lifestyles and dietary contr ol are helpful, but long-term medical therapy with HPI Hr, and prokine tic drugs are usually needed. Surgical therapy may be indicated for su ch life-threatening problems as laryngeal stenosis and paroxysmal lary ngospasm. The need for physician and patient awareness, research, and improved and less expensive therapy are discussed. (C) 1997 by Excerpt a Medica, Inc.