Laparoscopic Nissen fundoplication effectively relieves symptoms in patients with laryngopharyngeal reflux.
BACKGROUND
The utility of laparoscopic Nissen fundoplication in the treatment of laryngopharyngeal reflux symptoms remains controversial. We hypothesized that a carefully selected population with these symptoms would benefit from antireflux surgery.


METHODS
Sixty-one consecutive patients have undergone antireflux surgery for laryngopharyngeal reflux at a single institution. Preoperative evaluation including upper endoscopy, laryngoscopy, and 24-h ambulatory pharyngeal pH probe monitoring confirmed the diagnosis. Patients completed two validated symptom assessment instruments preoperatively and at multiple time points postoperatively.


RESULTS
Patients were followed for up to 3 years with a mean follow-up of 15.2 months. A significant improvement in reflux symptom index score (preoperative= 1.5+/-7.4 vs 3 years=12.4+/-10.9, p<0.01), laryngopharyngeal reflux health-related quality of life overall score (preoperative=55.0+/-26.0 vs 3 years=11.3+/-13.9, p<0.01), and symptom domain scores (voice, cough, throat clearing, and swallowing) occurred within 1 month of surgery and remained improved over the course of the study.


CONCLUSIONS
Laparoscopic Nissen fundoplication is effective in relieving the symptoms of laryngopharyngeal reflux in a carefully selected patient population. Benefits are seen within 1 month of surgery and persist for at least 3 years.
Catania
Robert A
RA
Division of General Surgery, University of Maryland Medical Center, 22 South Greene Street, Room S4B14, Baltimore, MD 21201-1595, USA.
Kavic
Stephen M
SM
Roth
J Scott
JS
Lee
Tommy H
TH
Meyer
Tanya
T
Fantry
George T
GT
Castellanos
Paul F
PF
Park
Adrian
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D018662:Fundoplication / Q000379:methods; D006801:Humans; D007013:Hypopharynx; D010535:Laparoscopy; D007818:Laryngeal Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010608:Pharyngeal Diseases / Q000601:surgery*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D011788:Quality of Life; D016896:Treatment Outcome
D054328:Proton Pump Inhibitors