Abstract
Objectives: To find potential laryngopharyngeal reflux (LPR) from patients with chronic laryngitis, we exerted on correlating the subjectively fiberoptic laryngoscopic findings with objective 24-hour pH monitoring data to see if posterior laryngitis could be pathognomonic to LPR.
Methods: Thirty consecutive patients with chronic laryngitis presenting to the Department of Otolaryngology (Chang-Gung Memorial Hospital, Taiwan) between June 2000 and February 2001 were prospectively enrolled in this study. All the patients underwent fiberoptic laryngoscopic examination and ambulatory 24-hour pH monitoring with dual-probe catheter. The mainstay of the fiberoptic laryngoscopic examination is to identify the presence of posterior laryngitis. The definition of posterior laryngitis included erythema and edema of arytenoids, hypertrophic mucosa of interarytenoid area, or pachydermia laryngis. Concerning 24-hour pH monitoring, the proximal probe of the catheter was placed at hypopharynx as possible so that the distal probe could be placed 5 cm above the lower esophageal sphincter by selecting catheters with different sensor distances.
Results: The age range of the patients was 25 to 73 years (mean, 45 years), and the male/female ratio was 1:1. According to fiberoptic laryngoscopic examination, posterior laryngitis was present in 12 patients (40%) and 5 of them (42%) were noticed to have LPR by 24-hour pH monitoring. On the contrary, 12 (67%) of the remaining 18 patients without laryngoscopic evidence of posterior laryngitis were found to have LPR by 24-hour pH monitoring. The relationship between the presence of posterior laryngitis and LPR had no statistical significance (P < 0.05).
Conclusion: In this study, posterior laryngitis was not a reliable sign for the diagnosis of LPR. The subjective laryngeal manifestation and objective 24-hour pH monitoring could be distinct and integral part in the presenting of LPR. More precise findings in the fiberoptic laryngoscopy should be traced for the screen examination to diagnose the LPR.