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September 1993

Gastroesophageal Reflux and Laryngeal Disease

Author Affiliations

From the Departments of Surgery (Dr Deveney) and Otolaryngology (Dr Cohen) and the Division of Gastroenterology (Dr Benner), Oregon Health Sciences University, and the Surgical Service, Veterans Affairs Medical Center (Drs Deveney and Cohen), Portland.

Arch Surg. 1993;128(9):1021-1027. doi:10.1001/archsurg.1993.01420210085011

Objective:  We wanted to determine if surgical correction of gastroesophageal reflux disease (GERD) would affect inflammatory laryngeal lesions in a select group of patients with known GERD and chronic inflammatory laryngeal lesions.

Design:  Patients with persistent inflammatory lesions in the larynx were referred for workup of GERD when these lesions were not associated with smoking or drinking or when cessation of smoking 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 one patient had typical symptoms of esophagitis and incompetent lower esophageal sphincter. Thus, 13 patients with chronic laryngeal inflammation persistent after cessation of smoking had concomitant GERD. These patients were all treated with Nissen fundoplication for GERD.

Setting:  Patients with chronic laryngitis were referred to an otolaryngologist at a tertiary medical center.

Patients:  Patients were consecutively selected as they presented with chronic persistent laryngeal lesions and were found to have GERD.

Interventions:  Surgical correction of GERD with Nissen fundoplication.

Main Outcome Measures:  Status of the larynx was assessed at 3-month intervals with fiberoptic laryngoscopy and symptoms (ie, hoarseness, sore throat) were evaluated.

Results:  Laryngeal inflammatory lesions and voice changes (hoarseness and sore throat) promptly resolved in eight (73%) of 11 patients. To date, these improvements have continued after a mean follow-up of 11 months.

Conclusions:  Correction of GERD in a selected subset of patients with laryngeal inflammatory lesions ameliorates these lesions.(Arch Surg. 1993;128:1021-1027)