The Efficacy of N-Acetyl Cysteine in Reflux Laryngitis

Abstract

Objective: Laryngopharyngeal reflux is a common disorder in otolaryngology patients. Some studies have shown that more than 50% of patients with hoarseness have evidence of laryngopharyngeal reflux. Because of mucosal dryness and mucus thickening in reflux laryngitis, we conducted a prospective study to evaluate the effects of N-acetyl cysteine.

Method: Between 2009 and 2011, patients with a reflux symptom score of more than 10 were selected and underwent endoscopic examination. Patients were randomly allocated into 3 groups and received either omeprazole, N-acetyl cysteine, or both of them. Patients were followed for 3 months, and examination was repeated after 1 and 3 months.

Results: Ninety patients entered the study (30 patients in each group). Forty-five of them were male, and 45 were females. Before treatment the reflux symptom scores were 18 ± 6, 16.3 ± 5, and 19.1 ± 3 for omeprazole, N-acetyl cysteine, and both drugs, respectively. These figures changed to 10.8 ± 4.6, 15.9 ± 5.3, and 7.6 ± 4.3 and showed a significant difference (P value <.001) in favor of omeprazole plus N-acetyl cysteine. After 3 months of treatment, the endoscopic findings score improved in 3 groups, but this change was significant in group 3 (omeprazole plus N-acetyl cysteine).

Conclusion: Our study showed that combination of omeperazole and N-acetylcysteine had a better influence on patients’ symptoms and endoscopic findings in reflux laryngitis comparing to the other 2 groups. All patients completed the treatment course very well without any major side effects.