Pharyngo-UES contractile reflex in patients with posterior laryngitis.
BACKGROUND
Earlier studies have shown that stimulation of the human pharynx by injection of minute amounts of water stimulates the pharyngo-UES contractile reflex. It has been suggested that this reflex may be activated during pharyngeal reflux of gastric and/or esophageal content, thus increasing the UES pressure and possibly preventing further entry of the refluxate into the pharynx. However, the integrity of this reflex in patients with posterior laryngitis has not been studied.


OBJECTIVE
Evaluate the pharyngo-UES contractile reflex in a group of patients with objective findings of posterior laryngitis.


METHODS
Fourteen consecutive patients with posterior laryngitis (mean age, 48+/-6 y) and 13 healthy volunteers (mean age, 53+/-6 y) were studied by concurrent pharyngeal water stimulation and UES manometry.


RESULTS
The threshold volume required to evoke the pharyngo-UES contractile reflex in the laryngitis group (0.4+/-0.05 mL) was significantly higher than that of the control (0.2+/-0.04 mL) (P < .05). Following stimulation of the pharyngo-UES contractile reflex, the maximum postinjection pressure in patients (75+/-6 mm Hg) was similar to that of the controls (78+/-6 mm Hg). The percent increase in UES pressure following stimulation of the reflex in the laryngitis group (99%+/-15%) was significantly higher than that of controls (55%+/-11%) (P < .05).


CONCLUSIONS
Compared with normal controls, a significantly larger volume of liquid is required to trigger this reflex in patients with posterior laryngitis. When triggered, the maximum UES pressure induced by the pharyngo-UES contractile reflex is similar between the two groups. These findings suggest an altered afferent sensory limb of this reflex in patients with posterior laryngitis.
Ulualp
S O
SO
Medical College of Wisconsin Dysphagia Institute, Department of Medicine, The Medical College of Wisconsin, Milwaukee, USA.
Toohill
R J
RJ
Kern
M
M
Shaker
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004943:Esophagogastric Junction / Q000294:innervation*; D005260:Female; D006801:Humans; D007827:Laryngitis / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008365:Manometry / Q000379:methods; D009119:Muscle Contraction / Q000502:physiology*; D010614:Pharynx / Q000294:innervation*; D012018:Reflex / Q000502:physiology*; D013997:Time Factors