2003, Number 2
Chronic laryngitis due to voice abuse in voice professionals is associated to non-apparent gastroesophagic reflux.
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ABSTRACTIntroduction: Gastroesophageal reflux can generate otolaryngological alterations such as chronic laryngitis. The management for these patients is with antireflux medication. Voice abuse can also be responsible for laryngeal lesions and the choice treatment is phoniatric therapy. At the Otorhinolaryngology department of the Hospital “Valentín Gómez Farías” ISSSTE Zapopan, Jalisco, Mexico. We observed that patients with voice abuse who do not respond with phoniatric therapy, improve with antireflux therapy. The aim of this study was to evaluate antireflux treatment in patients with clinical manifestations of chronic laryngitis and dysphonia caused by voice abuse without clinical or endoscopic manifestations of gastroesophageal reflux. Patients and methods: We studied 30 professional voice patients with chronic laryngitis and dysphonia caused by voice abuse without clinic or endoscopic manifestations of reflux. Patients were divided in two study groups: Group 1 were treated with phoniatric therapy and modifications in their diet and hygienic habits; Group 2 received, besides voice therapy, pharmacological treatment with ranitidine and cisapride at conventional doses. Clinical evolution was evaluated at the beginning of the study and 4 and 8 weeks after. In both groups we determined the presence of dysphonia (mild, moderate, severe), laryngitis (mild, moderate, severe), pharyngodynia, foreign body sensation, and cough during treatment. Results: At the beginning of the study, 100% of the patients in Group 1 had dysphonia (46.7% moderate, 53.3% severe); 100% laryngitis (33.3% moderate, 66.6 % severe); 80% pharyngodynia; 53.3% foreign body sensation and 40% cough. In Group 2, 100% of the patients had dysphonia (40% moderate, 60% severe); 100% laryngitis (33.3% moderate, 66.6% severe); 66.6% pharyngodynia; 66.6% foreign body sensation; 26.6% cough. At the end of the study, 100% of the patients in Group I had dysphonia (40% moderate, 60% severe); 100% laryngitis (26.6% moderate, 73.3% severe); 80% pharyngodynia; 60% foreign body sensation and 33.3% cough. In Group 2, 100% of the patients had dysphonia (26.6% mild, 46.6% moderate, 26.6% severe); 100% laryngitis (33.3% mild, 53.3% moderate, 13.3% severe); 40% pharyngodynia; 46.6% foreign body sensation and 13.3% cough . Discussion and conclusion: Results of this study show that professional voice patients with chronic laryngitis, dysphonia and pharyngodynia who do not respond with conventional phoniatric therapy, improve with ranitidine and cisapride. Taken together, present results suggest that chronic laryngitis could be associated to non-apparent gastroesophageal reflux in patients with voice abuse.
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