title: [Gastro-esophageal reflux and laryngeal phlogistic disorders: clinical evaluation and multi-electrode pH monitoring].
abstract: Gastro-esophageal reflux (GER) is a complex pathology characterized by many clinical symptoms: gastroenterological (typical symptoms) and odontostomatological, pneumological and, more frequently, otorhinolaryngological (atypical symptoms). For this last manifestations no cause-effect relationship has yet been proven. Using a validated questionnaire about the typical reflux symptoms and the use of substances of abuse (tobacco and alcohol) and with the application of instrumental means such as electronic videolaryngoscopy and multi-electrode 24 hours esophageal pH monitoring, the Authors have studied 34 selected patients (16 female, 18 male) suffering from chronic clinical laryngeal symptoms and presenting a peculiar pharyngeal-laryngeal objectivity. Both these manifestations could be ascribed to atypical GER symptoms. Analysis of the data showed that 67.6% of the subjects presented pathological reflux, with a significant prevalence of inflammatory lesions in the posterior portion of the larynx (in 47.8% laryngitis and retrocricoid edema). The validated questionnaire on typical reflux symptoms showed that 69.5% did not complain of the typical gastro-esophageal symptoms thus indicating that pharyngeal-esophageal reflux can be totally asymptomatic. While confirming the strong association between inflammatory pathologies and GER, not enough cases have been studied to identify a direct cause-effect relationship and this is complicated by the presence of other concomitant risk factors such as cigarette smoking or alcohol consumption. Therefore the Authors underline the importance of an in-depth, multi-discipline approach in the evaluation of pharyngeal-laryngeal phlogoses. This approach must make use of all available modern diagnostic techniques (Electronic videolaryngoscopy, multi-electrode pH monitoring) in order to obtain as much information as possible to throw light on the pathogenic mechanism responsible for the damage and find more effective forms of anti-reflux therapy.
authors.affiliation: Istituto di Otorinolaringoiatria, Università Cattolica Sacro Cuore, Roma. iclot@rm.unicatt
authors.forename: J
authors.initials: J
authors.lastname: Galli
authors.forename: S
authors.initials: S
authors.lastname: Agostino
authors.forename: L
authors.initials: L
authors.lastname: Calò
authors.forename: B
authors.initials: B
authors.lastname: Sergi
authors.forename: G
authors.initials: G
authors.lastname: Cammarota
authors.forename: R
authors.initials: R
authors.lastname: Cianci
mesh_terms: D000293:Adolescent; D000328:Adult; D004567:Electrodes, Implanted; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires