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Laryngopharyngealer Reflux und kehlkopfassoziierte Beschwerden

Laryngopharyngeal reflux and larynx-related symptoms

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Zusammenfassung

Hintergrund

Ein weites Spektrum an Beschwerden wie chronische Heiserkeit, Globus- und Verschleimungsgefühl hängt möglicherweise mit einem laryngopharyngealen Reflux (LPR) zusammen.

Methode und Ergebnisse

Eine selektive Literaturrecherche in der Datenbank PubMed unter Berücksichtung von deutsch- und englischsprachigen Originalia und Übersichtsarbeiten erbrachte 2541 Arbeiten. Trotz dieser Vielzahl von Publikationen gibt es zu den Aspekten des LPR viele offene Fragen.

Diskussion

Es ist davon auszugehen, dass auf die Larynxschleimhaut gelangtes Refluat diese schädigen kann. Da die Beschwerden, die im Zusammenhang mit LPR diskutiert werden, auch auf andere Ursachen zurückzuführen sein können, ist eine gründliche Anamneseerhebung vor einer obligaten Laryngoskopie erforderlich. Andere diagnostische Verfahren, z. B. die probatorische Gabe von Protonenpumpeninhibitoren (PPI) oder Langzeit-pH-Metrie, sollten selektiv eingesetzt werden. Je nach Beschwerden bietet sich als Therapie eine (probatorische) Atem- oder Stimmtherapie und/oder eine (probatorische) PPI-Therapie an. Es sollte auch immer erwogen werden, ob eine Änderung der Lebensführung einschließlich diätetischer Maßnahmen sinnvoll sein kann.

Abstract

Background

Chronic hoarseness, globus sensation or mucous obstruction are among a wide range of symptoms possibly related to laryngopharyngeal reflux (LPR).

Method and results

A selective literature research was carried out using PubMed, in which original articles and reviews in German and English were included. Altogether, 2541 articles were found. Despite the large number of publications, there are still open questions regarding aspects of LPR.

Discussion

It can be assumed that refluxate reaching the larynx can damage it. Due to the fact that the symptoms possibly related to LPR can, however, be linked to other causes, a careful consideration of the patient’s medical history is of the utmost importance, followed by mandatory laryngoscopy. Diagnostic procedures, such as the trial administration of proton pump inhibitors (PPI) or long-term pH measurement should be used selectively. Depending on the individual symptoms, breathing or voice therapy and/or PPI therapy might be useful. Lifestyle changes including dietary measures should also be contemplated.

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Notes

  1. Veränderungen/Symptome/Erkrankungen wie chronische Sinusitis, chronische Mittelohrentzündungen und Asthma werden hier nicht behandelt.

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  1. Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

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Ptok, M., Ptok, A. Laryngopharyngealer Reflux und kehlkopfassoziierte Beschwerden. HNO 60, 200–205 (2012). https://doi.org/10.1007/s00106-011-2441-6

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