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Pharyngeal pH monitoring in patients with posterior laryngitis
S O Ulualp1, R J Toohill, R Hoffmann
1Department of Medicine (Division of Gastroenterology and Hepatology), Medical College of Wisconsin, Milwaukee, USA.
Objective:
To evaluate the diagnostic value of 3-site 24-hour ambulatory pH monitoring in patients with posterior laryngitis (PL) and the prevalence of 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 monitoring, and barium esophagram.
Results:
T-EGD documented no abnormality in controls. Esophagitis was present in 2 PL patients, and hiatal hernia in 3. Ambulatory pH monitoring showed that 15 PL patients and 2 controls exhibited pharyngeal acid reflux. Barium esophagram documented gastroesophageal reflux in 5 PL patients. However, none of these barium reflux events reached the pharynx. All PL patients with barium esophagram evidence of gastroesophageal reflux also showed pharyngeal acid reflux by pH monitoring.
Conclusion:
Pharyngeal acid reflux is more prevalent in patients with PL than in healthy controls. Patients with PL infrequently have esophageal sequelae of reflux disease. Ambulatory 24-hour simultaneous 3-site pharyngoesophageal pH monitoring detects gastroesophagopharyngeal acid reflux events in most patients with PL.