Abstract
Posterior laryngitis is a common cause of chronic cough, hoarseness, voice fatigue and throat pain. The aim of the present study was to examine how patients with posterior laryngitis have been examined, treated and followed up, and to assess their present health-related quality of life (HRQOL). Patients treated for posterior laryngitis at consultation at the ear-, nose- and throat clinic during 2000–2008 were contacted by mail. The letter contained questionnaires addressing the current symptoms and medication, and the HRQOL 36-item short-form questionnaire (SF-36). Medical records were scrutinized. One hundred and twenty-two patients with verified signs and symptoms of posterior laryngitis were included. Forty percent of the patients had been treated for acid-related symptoms prior to consultation. The most common symptoms at the time of consultation were the sensation of hoarseness (women 40 %, men 37 %), globus (women 35 %, men 33 %) and cough (women 33 %, men 26 %). The most frequent diagnosis was gastro-oesophageal reflux disease. Ninety percent of the women and 92 % of the men were treated with proton pump inhibitors (PPIs). At the time of study, 63 % of the patients still had symptoms. The results of the SF-36 questionnaire showed significantly lower HRQOL for women. Patients with posterior laryngitis present varying symptoms, and are often not adequately treated or followed up. When PPI treatment fails, other aetiologies of their complaints, such as visceral hypersensitivity, weakly gaseous acid reflux or non-acid reflux are not considered. Symptoms from posterior laryngitis have a negative impact on the HRQOL for women.
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Koufman JA, Amin MR, Panetti M (2000) Prevalence of reflux in 113 consecutive patients with laryngeal and voice disorders. Otolaryngol Head Neck Surg 123(4):385–388. doi:10.1067/mhn.2000.109935
Hopkins C, Yousaf U, Pedersen M (2006) Acid reflux treatment for hoarseness. Cochrane Database Syst Rev (1):CD005054
Barry DW, Vaezi MF (2010) Laryngopharyngeal reflux: more questions than answers. Cleve Clin J Med 77(5):327–334. doi:10.3949/ccjm.77a.09121
Kotby MN, Hassan O, El-Makhzangy AM, Farahat M, Milad P (2010) Gastroesophageal reflux/laryngopharyngeal reflux disease: a critical analysis of the literature. Eur Arch Otorhinolaryngol 267(2):171–179. doi:10.1007/s00405-009-1176-4
Belafsky PC, Postma GN, Koufman JA (2001) Laryngopharyngeal reflux symptoms improve before changes in physical findings. Laryngoscope 111(6):979–981. doi:10.1097/00005537-200106000-00009
Jones R, Coyne K, Wiklund I (2007) The gastro-oesophageal reflux disease impact scale: a patient management tool for primary care. Aliment Pharmacol Ther 25(12):1451–1459. doi:10.1111/j.1365-2036.2007.03343.x
Winstead W, Barnett SN (1998) Impact of endoscopic sinus surgery on global health perception: an outcomes study. Otolaryngol Head Neck Surg 119(5):486–491
Nordin K, Pahlman L, Larsson K, Sundberg-Hjelm M, Loof L (2002) Health-related quality of life and psychological distress in a population-based sample of Swedish patients with inflammatory bowel disease. Scand J Gastroenterol 37(4):450–457
Sullivan M, Karlsson J, Taft C (2002) SF-36: Swedish manual and interpretation guide, 2nd edn.Sahlgrenska University Hospital, Gothenburg
Korkmaz M, Tarhan E, Unal H, Selcuk H, Yilmaz U, Ozluoglu L (2007) Esophageal mucosal sensitivity: possible links with clinical presentations in patients with erosive esophagitis and laryngopharyngeal reflux. Dig Dis Sci 52(2):451–456. doi:10.1007/s10620-006-9514-5
Tibblin G, Bengtsson C, Furunes B, Lapidus L (1990) Symptoms by age and sex. The population studies of men and women in Gothenburg, Sweden. Scand J Prim Health Care 8(1):9–17
Simren M, Abrahamsson H, Svedlund J, Bjornsson ES (2001) Quality of life in patients with irritable bowel syndrome seen in referral centers versus primary care: the impact of gender and predominant bowel pattern. Scand J Gastroenterol 36(5):545–552
Dimenas E, Carlsson G, Glise H, Israelsson B, Wiklund I (1996) Relevance of norm values as part of the documentation of quality of life instruments for use in upper gastrointestinal disease. Scand J Gastroenterol Suppl 221:8–13
Sataloff RT, Hawkshaw MJ, Gupta R (2010) Laryngopharyngeal reflux and voice disorders: an overview on disease mechanisms, treatments, and research advances. Discov Med 10(52):213–224
Khan AM, Hashmi SR, Elahi F, Tariq M, Ingrams DR (2006) Laryngopharyngeal reflux: a literature review. Surgeon 4(4):221–225
Vaezi MF, Richter JE, Stasney CR, Spiegel JR, Iannuzzi RA, Crawley JA, Hwang C, Sostek MB, Shaker R (2006) Treatment of chronic posterior laryngitis with esomeprazole. Laryngoscope 116(2):254–260. doi:10.1097/01.mlg.0000192173.00498.ba
Pearson JP, Parikh S, Orlando RC, Johnston N, Allen J, Tinling SP, Belafsky P, Arevalo LF, Sharma N, Castell DO, Fox M, Harding SM, Morice AH, Watson MG, Shields MD, Bateman N, McCallion WA, van Wijk MP, Wenzl TG, Karkos PD, Belafsky PC (2011) Review article: reflux and its consequences—the laryngeal, pulmonary and oesophageal manifestations. In: Conference held in conjunction with the 9th international symposium on human pepsin (ISHP) Kingston-upon-Hull, UK, 21–23 April 2010. Aliment Pharmacol Ther 33(Suppl 1):1–71. doi:10.1111/j.1365-2036.2011.04581.x
Kahrilas PJ, Hughes N, Howden CW (2011) Response of unexplained chest pain to proton pump inhibitor treatment in patients with and without objective evidence of gastro-oesophageal reflux disease. Gut 60(11):1473–1478. doi:10.1136/gut.2011.241307
Tamhankar AP, Peters JH, Portale G, Hsieh CC, Hagen JA, Bremner CG, DeMeester TR (2004) Omeprazole does not reduce gastroesophageal reflux: new insights using multichannel intraluminal impedance technology. J Gastrointest Surg 8(7):890–897. doi:10.1016/j.gassur.2004.08.001 discussion 897–898
Tack J (2005) Review article: role of pepsin and bile in gastro-oesophageal reflux disease. Aliment Pharmacol Ther 22(Suppl 1):48–54. doi:10.1111/j.1365-2036.2005.02609.x
Ohlsson B, Sjoberg K, Alm R, Fredrikson GN (2011) Patients with irritable bowel syndrome and dysmotility express antibodies against gonadotropin-releasing hormone in serum. Neurogastroenterol Motil 23(11):1000–1006. doi:10.1111/j.1365-2982.2011.01744.x
Pendleton H, Ekman R, Olsson R, Ekberg O, Ohlsson B (2009) Motilin concentrations in relation to gastro intestinal dysmotility in diabetes mellitus. Eur J Intern Med 20(6):654–659. doi:10.1016/j.ejim.2009.05.015
Koufman JA, Belafsky PC, Bach KK, Daniel E, Postma GN (2002) Prevalence of esophagitis in patients with pH-documented laryngopharyngeal reflux. Laryngoscope 112(9):1606–1609
Toros SZ, Toros AB, Yuksel OD, Ozel L, Akkaynak C, Naiboglu B (2009) Association of laryngopharyngeal manifestations and gastroesophageal reflux. Eur Arch Otorhinolaryngol 266(3):403–409. doi:10.1007/s00405-008-0761-2
Becher A, Dent J (2011) Systematic review: ageing and gastro-oesophageal reflux disease symptoms, oesophageal function and reflux oesophagitis. Aliment Pharmacol Ther 33(4):442–454. doi:10.1111/j.1365-2036.2010.04542.x
Siupsinskiene N, Adamonis K, Toohill RJ (2007) Quality of life in laryngopharyngeal reflux patients. Laryngoscope 117(3):480–484. doi:10.1097/MLG.0b013e31802d83cf
Carrau RL, Khidr A, Crawley JA, Hillson EM, Davis JK, Pashos CL (2004) The impact of laryngopharyngeal reflux on patient-reported quality of life. Laryngoscope 114(4):670–674
Powitzky ES, Khaitan L, Garrett CG, Richards WO, Courey M (2003) Symptoms, quality of life, videolaryngoscopy, and twenty-four-hour triple-probe pH monitoring in patients with typical and extraesophageal reflux. Ann Otol Rhinol Laryngol 112(10):859–865
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This study was performed with grants from the Swedish ACTA Foundation and Skane County Council’s Research and Development Foundation.
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The authors declare that they have no conflict of interest.
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Pendleton, H., Ahlner-Elmqvist, M., Jannert, M. et al. Posterior laryngitis: a study of persisting symptoms and health-related quality of life. Eur Arch Otorhinolaryngol 270, 187–195 (2013). https://doi.org/10.1007/s00405-012-2116-2
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DOI: https://doi.org/10.1007/s00405-012-2116-2