Laryngeal manifestations of gastroesophageal reflux before and after treatment with omeprazole.
BACKGROUND
Laryngeal manifestations of gastroesophageal reflux disease are thought to be prevalent in our society. In general, diagnosis has been primarily based on symptoms. Historically, additional testing has included laryngoscopy, barium swallow, manometry, and single and double probe pH monitoring.


METHODS
We assessed 96 patients who had symptoms suggestive of reflux laryngitis. We administered surveys grading their symptoms. All patients had standardized videolaryngostroboscopic evaluation and computerized acoustic analysis. Patients then received a uniform regimen of dietary restrictions and omeprazole (a proton pump inhibitor) for 12 weeks, after which they were retested.


RESULTS
Using the new laryngoscopic grading system, we found that this regimen produced statistically significant improvement in all symptoms except granulomas. In patients with the pretherapy complaint of hoarseness, acoustic measurements of jitter, shimmer, habitual frequency, and frequency range all showed significant improvement.


CONCLUSIONS
We conclude that in patients with symptomatic reflux laryngitis, standardized videolaryngoscopy and, if the patient is hoarse, acoustic analysis are useful techniques to aid diagnosis and monitor therapy. Antireflux therapy with omeprazole is effective, and improvement can be objectively shown with the techniques described.
Shaw
G Y
GY
Department of Otolaryngology, University of Kansas Medical Center, Kansas City 66160, USA.
Searl
J P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001466:Barium Sulfate; D003287:Contrast Media; D003679:Deglutition; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005069:Evaluation Studies as Topic; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000178:diet therapy / Q000188:drug therapy; D006685:Hoarseness / Q000628:therapy; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007827:Laryngitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D007828:Laryngoscopy; D008027:Light; D008297:Male; D008365:Manometry; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009853:Omeprazole / Q000627:therapeutic use*; D015995:Prevalence; D054328:Proton Pump Inhibitors; D012815:Signal Processing, Computer-Assisted; D013018:Sound Spectrography; D014741:Video Recording; D014832:Voice Disorders / Q000628:therapy
D000897:Anti-Ulcer Agents; D003287:Contrast Media; D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors; D001466:Barium Sulfate; D009853:Omeprazole