title: Double probe pH-monitoring findings in patients with benign lesions of the true vocal folds: comparison with typical GERD and the effect of smoking.
abstract: We conducted a pH-monitoring study to determine the prevalence of pathologic gastroesophageal reflux (GER+) and laryngopharyngeal reflux (LPR+) in patients with resected benign true vocal fold lesions (TVFLs) and positive reflux finding score (RFS). We compared our findings with those of patients with typical GER disease (GERD) symptoms and normal laryngoscopy. In the group of patients with TVFLs, we compared the pH-monitoring findings of smokers with those of non-smokers. Seventy-two [females 32, mean (SD) age 49.3 (13.1) years] patients with resected TVFLs (polyps: 32, nodules: 20, Reinke's edema: 12, granulomas: 4, leukoplakia: 4) and 24 [females 14, mean (SD) age 42.2 (13.4) years] patients with typical GERD symptoms, who served as controls for the hypopharyngeal measurements, underwent 24-h double probe, hypopharyngeal and distal esophageal, ambulatory pH monitoring. Thirty-eight (52.8%) patients with TVFLs had GER+ and 52 (72.2%) had LPR+. More laryngopharyngeal reflux episodes (LPREs) were detected in patients with TVFLs compared to those with GERD (P < 0.001). With respect to the specific TVFLs, 12 (37.5%) patients with polyps had GER+ and 24 (75%) had LPR+, 6 (30%) patients with nodules had GER+ and 12 (60%) had LPR+, 6 (50%) patients with Reinke's edema had GER+ and 8 (66.7%) had LPR+ and all the patients with granuloma or leucoplakia had both GER+ and LPR+. Twenty (55.6%) of the 36 smokers and 32 (88.9%) of the 36 non-smokers with TVFLs had LPR+ (P = 0.003), while GER+ was recorded in 16 (44.4%) smokers and 22 (61.1%) non-smokers (P = 0.238). Smokers had significantly less LPREs (P < 0.001). In conclusion, 24-h double probe pH monitoring may detect GER+ and/or LPR+ in a substantial proportion of patients with resected TVFLs and positive RFS. Our study suggests that LPR+ is more prevalent in patients with TVFLs compared with typical GERD patients and that non-smokers with TVFLs are more likely to have LPR+ than smokers with TVFLs.
authors: Department of Endoscopy and Motility Unit, Central Hospital, Ethnikis Aminis 41, Thessaloniki, Greece. beltsis@yahoo.com.
authors: Athanasios
authors: A
authors: Beltsis
authors: Department of Endoscopy and Motility Unit, Central Hospital, Ethnikis Aminis 41, Thessaloniki, Greece.
authors: Panagiotis
authors: P
authors: Katsinelos
authors: Second Department of Internal Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
authors: Jannis
authors: J
authors: Kountouras
authors: ENT Department, Central Hospital, Thessaloniki, Greece.
authors: Nikolaos
authors: N
authors: Kamarianis
authors: Second Department of Internal Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
authors: Christos
authors: C
authors: Zavos
authors: ENT Department, Central Hospital, Thessaloniki, Greece.
authors: Agathoklis
authors: A
authors: Pournaras
authors: Department of Endoscopy and Motility Unit, Central Hospital, Ethnikis Aminis 41, Thessaloniki, Greece.
authors: Dimitrios
authors: D
authors: Kapetanos
authors: Department of Endoscopy and Motility Unit, Central Hospital, Ethnikis Aminis 41, Thessaloniki, Greece.
authors: Kostas
authors: K
authors: Fasoulas
authors: Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
authors: Chrysanthos
authors: C
authors: Zamboulis
authors: Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
authors: Nikolaos
authors: N
authors: Eugenidis
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004867:Equipment Design; D050782:Esophageal pH Monitoring / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D008297:Male; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*; D014827:Vocal Cords