Symptoms, laryngeal findings, and 24-hour pH monitoring in patients with suspected gastroesophago-pharyngeal reflux

Objectives: To investigate the laryngeal signs and symptoms associated with gastroesophago-pharyngeal reflux (GEPR). Study Design: A prospective contr olled study. Methods: Nineteen healthy control subjects and 43 patients, 26 with posterior laryngitis (PL) and 17 with a normal larynx and suspected G EPR, were examined using videolaryngoscopy and 24-hour ambulatory dual-prob e pH monitoring. Results: Pharyngeal acid reflux occurred in IS (69%) patie nts with PL, in 9 (53%) patients with a normal larynx, and in 5 (26%) healt hy control subjects. Multiple-comparison procedure showed that pharyngeal r eflux was significantly more prevalent in patients with PL than in the heal thy control subjects (P < .05). The laryngoscopic findings in patients with pharyngeal reflux varied from normal mucosa to thickening or edema of the posterior wall of the glottis, which was the most frequent finding in the P l, group. Erythema. was uncommon; it was found only in patients with verifi ed pharyngeal reflux. There was no difference in symptom profile between th e patients with Pl, and patients with a normal larynx or patients with or w ithout pharyngeal reflux. Conclusions: Pharyngeal reflux. is significantly more prevalent in patients with posterior laryngitis than in healthy contro l subjects. Moreover, a certain degree of pharyngeal reflux appears to be a normal phenomenon. The most common laryngeal finding in patients with post erior laryngitis is thickening or edema of the posterior wall of the glotti s. GEPR does not yield specific laryngeal symptoms. Thus, it is unreliable to base the reflux diagnosis on symptoms alone.