Chronic Pharyngitis is Associated with Severe Acidic Laryngopharyngeal Reflux in Patients with Reinke's Edema

Abstract

Objectives:

We evaluated the association between pathological acidic laryngopharyngeal reflux (LPR) events and chronic pharyngitis in patients with Reinke's edema.

Methods:

We performed a prospective controlled study in 20 consecutive patients with Reinke's edema without pathological acidic LPR events (group A) and 40 consecutive patients with Reinke's edema with both clinical symptoms and 24-hour pH-metry suggesting acidic LPR (group B). The severity of acidic LPR was assessed by use of the Reflux Finding Score (RFS), the Reflux Symptom Index (RSI), and dual antimony probe 24-hour pH-metry. The patients were evaluated for the presence of chronic pharyngitis by clinical examination and biopsy specimens taken from the posterior pharyngeal wall. The χ² test was used to compare the groups for the presence of pharyngitis. In group B, the RSI, the RFS, and the total duration and number of acidic LPR events on 24-hour pH-metry were compared between patients with and without concomitant pharyngitis by use of the Mann-Whitney test.

Results:

Five patients of group A and 20 patients of group B had chronic pharyngitis. Therefore, more patients with Reinke's edema and clinical signs of LPR tended to have chronic pharyngitis than did those with Reinke's edema and no clinical signs of LPR, but the difference was not statistically significant (p = 0.064; odds ratio, 3.0; 95% confidence interval, 0.9 to 9.8). Among group B patients, those with pharyngitis had significantly more acidic LPR events (p < 0.001) and a greater exposure time to gastric fluid (p = 0.008) than did those without pharyngitis. Their RFS and RSI did not differ significantly (p = 0.692 and p = 0.914, respectively).

Conclusions:

Only in the subgroup of patients with Reinke's edema and LPR was there a statistically significant correlation between the pH probe results and the incidence of clinical pharyngitis. Awareness should increase among physicians about addressing chronic pharyngitis in therapy for acidic LPR and/or Reinke's edema.

Keywords

acid larynx pharyngitis pharynx reflux Reinke's edema

Get full access to this article

View all access options for this article.

References

Koufman

Aviv

Casiano

Shaw

. Laryngopharyngeal reflux: Position statement of the Committee on Speech, Voice, and Swallowing Disorders of the American Academy of Otolaryngology-Head and Neck Surgery. Otolaryngol Head Neck Surg 2002;127:32–5.

Belafsky

Postma

Koufman

. The validity and reliability of the reflux finding score (RFS). Laryngoscope 2001;111:1313–7.

Belafsky

Postma

Koufman

. Validity and reliability of the reflux symptom index (RSI). J Voice 2002;16:274–7.

Yazici

Sayin

Kayhan

Biskin

. Laryngopharyngeal reflux might play a role on chronic nonspecific pharyngitis. Eur Arch Otorhinolaryngol 2010;267:571–4.

Amin

Maged

KH Abdel

Naser

Aly

. Laryngopharyngeal reflux with sore throat: An ultrastructural study of oropharyngeal epithelium. Ann Otol Rhinol Laryngol 2009;118:362–7.

Johnston

Wells

Samuels

Blumin

. Pepsin in nonacidic refluxate can damage hypopharyngeal epithelial cells. Ann Otol Rhinol Laryngol 2009;118:677–85.

Wada

Sasaki

Kataoka

. Gastroesophageal and laryngopharyngeal reflux symptoms correlate with histopathologic inflammation of the upper and lower esophagus. J Clin Gastroenterol 2009;43:249–52.