title: Hoarseness and laryngopharyngeal reflux: a cause and effect relationship or coincidence?
abstract: The role of laryngopharyngeal reflux (LPR) on hoarseness is widely assumed and accepted. Few articles present objective information on the subject. One of the main problems in establishing a relationship is our lack of knowledge of what is normal. We compared patients with chronic hoarseness and healthy controls to establish three goals: (1) to demonstrate the presence of additional symptoms and signs of LPR in patients with hoarseness; (2) to find the prevalence of LPR by utilizing 24 h double-probe in patients with hoarseness and compare it with that of the control group; (3) to contribute data to establish prevalence of LPR in healthy population. Forty-three patients with hoarseness and 20 healthy volunteers were enrolled in the study. All the patients in the study group had hoarseness of more than 3 months duration. The subjects recieved videolaryngoscopic evaluation and 24 h double-probe pH monitoring, and the results were compared. In the study group, 27 patients (62.8%) out of 43 had LPR episodes, compared to 6 (30%) of 20 healthy volunteers. Mean number of LPR episodes recorded by the pharyngeal probe was 7.0 [standard deviation (SD): 8.8] in 24 h, and this was significantly higher than that of the healthy controls [0.9/24 h (SD: 1.9)] (P = 0.003). Mean number of LPR episodes of the study group in upright position was 5.8 (SD: 7,0) and in supine position was 1.2 (SD: 3.3). These numbers were also significantly higher from the controls (P = 0.005 and P = 0.014 respectively). The results of this study show that: (1) most common additional symptoms were heartburn and chronic throat clearing and most common finding is pachydermia; (2) LPR incidence in patients with chronic hoarseness is significantly higher than the LPR incidence in healthy controls; (3) LPR is present in healthy people. However, the severity of LPR seems to be the causative factor rather than its presence.
authors.affiliation: Department of Otolaryngology and Head Neck Surgery, Duzce Medical Faculty, Duzce University, P.K. 8, 81010, Duzce, Turkey. ozturko_70@yahoo.com
authors.forename: Ozcan
authors.initials: O
authors.lastname: Ozturk
authors.forename: Ferhan
authors.initials: F
authors.lastname: Oz
authors.forename: Baris
authors.initials: B
authors.lastname: Karakullukcu
authors.forename: Fatih
authors.initials: F
authors.lastname: Oghan
authors.forename: Ender
authors.initials: E
authors.lastname: Guclu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ada
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006685:Hoarseness / Q000209:etiology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007818:Laryngeal Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000209:etiology*; D018709:Statistics, Nonparametric