GASTROESOPHAGEAL REFLUX AND LARYNGEAL DISEASE

Objective: We wanted to determine if surgical correction of gastroesop hageal reflux disease (GERD) would affect inflammatory laryngeal lesio ns in a select group of patients with known GERD and chronic inflammat ory laryngeal lesions. Design: Patients with persistent inflammatory l esions in the larynx were referred for workup of GERD when these lesio ns were not associated with smoking or drinking or when cessation of s moking 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 o ne patient had typical symptoms of esophagitis and incompetent lower e sophageal sphincter. Thus, 13 patients with chronic laryngeal inflamma tion persistent after cessation of smoking had concomitant GERD. These patients were all treated with Nissen fundoplication for GERD. Settin gs: Patients with chronic laryngitis were referred to an otolaryngolog ist at a tertiary medical center. Patients: Patients were consecutivel y selected as they presented with chronic persistent laryngeal lesions and were found to have GERD. Interventions: Surgical correction of GE RD with Nissen fundoplication. Main Outcome Measures: Status of the la rynx was assessed at 3-month intervals with fiberoptic laryngoscopy an d symptoms (ie, hoarseness, sore throat) were evaluated. Results: Lary ngeal inflammatory lesions and voice changes (hoarseness and sore thro at) promptly resolved in eight (73%) of 11 patients. To date, these im provements have continued after a mean follow-up of 11 months. Conclus ions: Correction of GERD in a selected subset of patients with larynge al inflammatory lesions ameliorates these lesions.