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Extraesophageal Reflux (Part 2) ORL Manifestation and Therapy


Authors: Karol Zeleník 1;  Pavel Komínek 1;  I. Stárek 2;  E. Machytka 3
Authors‘ workplace: Otorinolaryngologická klinika FN Ostrava ;  přednosta doc. MUDr. P. Komínek, PhD., MBA Otorinolaryngologická klinika LF UP a FN, Olomouc 1;  přednosta prof. MUDr. I. Stárek, CSc. Interní klinika FN Ostrava 2;  přednosta doc. MUDr. A. Martínek, CSc. 3
Published in: Otorinolaryngol Foniatr, 57, 2008, No. 3, pp. 151-158.
Category: Comprehensive Reports

Overview

Extraesophageal reflux (EER) has been implicated in the pathogenesis of several otolaryngological disorders, including posterior laryngitis, vocald fold nodules, paroxysmal laryngospasm, Reinke’s edema, vocal folds ulcers and granuloma, globus pharyngeus, subglotic and laryngotracheal stenosis, chronic rhinosinusitis, chronic ear complaints, snoring and laryngopharyngeal carcinoma. These patients, due to different pathophysiology, usually do not suffer from the typical symptoms of gastroesophageal reflux disease, such as heartburn, regurgitation or esophagitis. Gastroesophageal reflux disease and EER are two independent clinical entities and can be present simultaneously as well as fully independently from each other. We should consider EER in all patients with reccurent or chronic inflammation, which do not respond to standard treatment. Diagnosis is usually done by 24hour pH–metry with proximal sensor placed above the level of upper esophageal sphincter. Best treatment outcomes are achieved with twice daily proton pump inhibitors therapy.

Key words:
gastroesophageal reflux, extraesophageal reflux, otolaryngologic manifestation, reflux symptom index, reflux finding score.


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