Ex juvantibus approach for chronic posterior laryngitis: results of short-term pantoprazole therapy

The aim of this study was to investigate whether patients with chronic post erior laryngitis and symptoms of gastro-pharyngeal reflux benefit from a si x-week therapy with pantoprozole. Twenty-nine out-patients with voice disor ders (case history of at least two months) and simultaneous symptoms of gas tropharyngeal reflux were recruited for this study. At the entry to the stu dy a symptom questionnaire and a video-laryngo/stroboscopy were completed. The symptom questionnaire and the video-laryngo/stroboscopy were repeated a fter the six weeks of therapy with pantoprazole 40 mg once a day and again six weeks and three months after this follow-up, during which time the pati ent was without therapy. Hoarseness, globus pharyngeus, sore throat, heartburn, and coughing were th e symptoms which showed a significant (p<0.05) recovery at the follow-ups ( mean of hoarseness index: 7.28 to 0.92; mean of globus pharyngeus index: 3. 14 to 0.58; mean of heartburn index: 2.86 to 0.5; mean of cough index: 1.72 to 0.25; mean of throat soreness index: 1.72 to 0.15). Laryngoscopy scores of the posterior laryngeal region, the glottic and the supraglottic region showed statistically significant improvement (p<0.05) after the treatment with pantoprazole. The therapeutic effect exceeded the drug administration until the last follow-up (after three months). The medication was tolerated without side-effects in all patients. A primary (ex juvantibus) therapy with proton pump inhibitors seems to be a therapeutic option for patients with long-lasting chronic inflammation of the larynx not responding to common therapy. In this case a six-week course of treatment has been shown to be sufficient.