Pharyngeal pH monitoring in patients with posterior laryngitis

OBJECTIVE: To evaluate the diagnostic value of 3-site 24-hour ambulatory pH monitoring in patients with posterior laryngitis (PL) and the prevalence o f esophageal abnormalities in this patient group. METHODS: Twenty patients with PL and 17 healthy volunteers were studied as controls. Control subjects had transnasal esophagogastroduodenoscopy (T-EGD ) and ambulatory pH monitoring. Patients underwent T-EGD, ambulatory pH mon itoring, and barium esophagram RESULTS: T-EGD documented no abnormality in controls. Esophagitis was prese nt in 2 PL patients, and hiatal hernia in 3. Ambulatory pH monitoring showe d that 15 PL patients and 2 controls exhibited pharyngeal acid reflux, Bari um esophagram documented gastroesophageal reflux in 5 PL patients. However, none of these barium reflux events reached the pharynx. All PL patients wi th barium esophagram evidence of gastroesophageal reflux also showed pharyn geal acid reflux by pH monitoring. CONCLUSION: Pharyngeal acid reflux is more prevalent in patients with PL th an in healthy controls. Patients with PL infrequently have esophageal seque lae of reflux disease. Ambulatory 24-hour simultaneous 3-site pharyngoesoph ageal pH monitoring detects gastroesophagopharyngeal acid reflux events in most patients with PL.