Síntomas laríngeos y laringitis posterior: ¿siempre es secundario a reflujo gastroesofágico?

Abstract

Background: Gastroesophageal reflux (GER) is syndicated as a cause of posterior laryngitis. However the evidence for the association is weak. Aim: To determine if the presence of posterior laryngitis is associated with GER. Material and Methods: Cross sectional study of 43 patients (19 males) with endoscopically confirmed posterior laryngitis derived for the study of GER. All patients underwent a clinical examination, upper gastrointestinal endoscopy, esophageal manometry and 24 hour pH monitoring. Results: Forty eight percent of patients had GER. Among 28 patients with dysphonia, 10 (36%) had heartburn and 11 (39%) had regurgitation. A hypotensive lower esophageal sphincter was associated with dysphagia in 100% of patients, regurgitation in 81%, cough in 100% and hoarseness in 87% of patients. Upper digestive endoscopy revealed the presence of esophagitis in 6 patients (14%) and was normal in the rest. Dysphonia had the best association with GER with a positive predictive value of 64%. Conclusions: Most patients with laryngeal symptoms and posterior laryngitis do not have GER.