Laryngopharyngeal reflux in laryngeal cancer

Gastropharyngeal or laryngopharyngeal reflux is considered as a factor in various diseases of the larynx and pharynx. The most important consequence of the reflux into the larynx is laryngeal cancer.

In this prospective study the incidence of gastropharyngeal and laryngopharyngeal reflux in 22 patients with untreated laryngeal cancer was investigated with 24-hour, double probe pH measurements. A group of 25 patients with heartburn and dyspepsia complaints in whom esophagogastroscopy revealed no pathology and for whom 24-hour pH measurement was indicated served as a control group.

Two of the 22 patients never smoked and two others had quit smoking 16 and 25 years previously. All four of these patients revealed gastropharyngeal reflux. In total, 14 of the laryngeal cancer patients (63.6%) revealed gastropharyngeal reflux. The rate of gastroesophageal reflux was close among the two groups (50% in the cancer group vs 32% in the control group, p>0.05), but the laryngopharyngeal reflux rate was much higher in the cancer group (63.6% of the cancer patients vs 20% in the control group, p: 0.003). Among the reflux-positive patients and the controls, gastroesophageal reflux rate was higher in the supine position in cancer patients (12.10% vs 6.25, p: 0.02). In the upright position, control cases revealed higher rates of gastroesophageal reflux than the cancer patients. Laryngopharyngeal reflux rates were slightly higher in laryngeal cancer patients than the controls in both upright (9.29% vs 7.67%, p: 0.6) and supine positions (4.83% vs 3.50%, p: 0.6).

Laryngeal cancer patients and patients with heartburn complaints all have a high rate of gastroesophageal reflux. But cancer patients reveal a higher rate of laryngopharyngeal reflux than the symptomatic patients with normal laryngeal findings.