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Reflux laryngitis: a feasible indication for laparoscopic antireflux surgery?
Paulina Salminen1, Eeva Sala, Juha Koskenvuo
1Department of Surgery, Turku University Central Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland. paulina.salminen@tyks.fi
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|April 24, 2007
Summary
Laparoscopic Nissen fundoplication improved objective laryngeal findings in reflux laryngitis patients. While voice quality showed less improvement, most patients found the surgery satisfactory for supraesophageal symptoms.
Area of Science:
- Gastroenterology
- Otorhinolaryngology
- Surgical Innovation
Background:
- Gastro-esophageal reflux disease (GERD) management often includes laparoscopic fundoplication for moderate to severe cases.
- Supraesophageal symptoms of GERD present a challenge, with ongoing debate regarding surgical indications.
- Reflux laryngitis, a supraesophageal manifestation, requires evaluation for effective treatment strategies.
Purpose of the Study:
- To assess subjective symptom outcomes and objective laryngeal findings after laparoscopic Nissen fundoplication in patients with proven reflux laryngitis.
- To evaluate the efficacy of antireflux surgery in improving supraesophageal symptoms and laryngeal health.
- To determine patient satisfaction and willingness to undergo the procedure again.
Main Methods:
- A cohort of 40 patients with pH monitoring-proven reflux laryngitis underwent laparoscopic Nissen fundoplication between 1998 and 2002.
- Patients were followed by an otorhinolaryngology specialist, with subjective symptoms assessed via questionnaire at a median of 42 months post-surgery.
- Objective laryngeal findings were compared preoperatively and at 12 months postoperatively.
Main Results:
- Objective laryngeal status improved in 92.3% of patients by 12 months post-surgery.
- Voice quality improvement was reported by only 38.5% of patients.
- Postoperatively, 62.5% experienced mild or no cough/hoarseness, while 15% still had significant supraesophageal symptoms.
- Overall patient satisfaction was high, with 95% rating the results as excellent, good, or satisfactory.
Conclusions:
- Laparoscopic Nissen fundoplication is an effective treatment for reflux laryngitis, significantly improving objective laryngeal findings.
- While objective laryngeal improvements are common, subjective voice quality may not always recover fully.
- The procedure offers a valuable alternative treatment for GERD patients with supraesophageal symptoms and objective pharyngeal acid exposure.
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