High incidence of gastropharyngeal and gastroesophageal reflux after total laryngectomy

Smit, Conrad F.; Mathus-Vliegen, Lisbeth; Devriese, P. P.; Brandsen, Marc; Grolman, Wilko; Schouwenburg, Paul F.

doi:10.1002/(sici)1097-0347(199810)20:7<619::aid-hed7>3.0.co;2-1

Cited by 39 publications

(32 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar results were obtained by other authors who performed long-term pH monitoring in laryngectomised patients and detected supra-oesophageal reflux in 30% of the patients and oesophageal reflux in 40% [26,41]. Unlike the oesophageal mucosa, the tracheal mucosa does not possess protective mechanisms against gastric acid exposure and may therefore be substantially exposed to gastric acid in patients with periprosthetic leakage and pathological reflux.…”

Section: Discussionsupporting

confidence: 88%

The management of periprosthetic leakage in the presence of supra-oesophageal reflux after prosthetic voice rehabilitation

Lorenz¹,

Grieser²,

Ehrhart³

et al. 2010

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

The objective of the study was to investigate the influence of anti-reflux medications on the management of periprosthetic leakage in laryngectomised patients with prosthetic voice rehabilitation. Sixty patients underwent laryngectomy and prosthetic voice rehabilitation. In a prospective non-randomised study, we examined the patients clinically and assessed the presence of reflux disease using 24-h dual-probe pH monitoring before and 6 months after oral anti-reflux treatment with proton pump inhibitors (PPIs). The severity of reflux, the effectiveness of anti-reflux therapy, and the clinical success of treatment were evaluated. Reflux parameters before and after anti-reflux therapy as well as the severity and incidence of periprosthetic leakage before and after PPI therapy were the main outcome measures. The absolute number of reflux events was 162.2 (±144.3) before treatment and 63.1 (±87.9) after treatment with PPIs (p = 0.031). The reflex area index score decreased from 327.1 (±419.3) without PPIs to 123.8 (±249.7) with PPIs (p = 0.0228). The mean DeMeester score was 108.3 (±85.4) before treatment and 47.4 (±61.7) after 6 months of treatment (p = 0.0557). The relative risk of periprosthetic leakage decreased to 0.5 after anti-reflux treatment. In 19 patients, leakage problems were successfully managed by rigorous treatment with PPIs. No further surgical procedures were required in these cases. Rigorous anti-reflux treatment leads to an improvement in parameters that can be assessed objectively by 24-h dual-probe pH monitoring. In the majority of patients, the symptoms associated with periprosthetic leakage can be improved or cured.

show abstract

Section: Discussionsupporting

confidence: 88%

The management of periprosthetic leakage in the presence of supra-oesophageal reflux after prosthetic voice rehabilitation

Lorenz¹,

Grieser²,

Ehrhart³

et al. 2010

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…Most suffered from fundamental, if not terminal, flaws in study design: lack of controls; retrospective evaluation of insensitive or nonspecific diagnostic methods, unclear patient selection or extrapolation from noncomparable population control data [23]. One study, indicating reflux in the vast majority of laryngectomees, is of particular interest [24]. Of course, the lack of a pharyngoesophageal barrier and swallow mechanism makes the postoperative situation quite unlike that in the untreated disease.…”

Section: Pathogenesis Of Reflux-induced Laryngeal Damagementioning

confidence: 99%

What is the evidence that gastroesophageal reflux is involved in the etiology of laryngeal cancer?

Wilson

2005

Current Opinion in Otolaryngology & Head and Neck Surgery

View full text Add to dashboard Cite

show abstract

“…According to some authors, estimates as to acid reflux causing posterior laryngitis vary greatly, coming up to 80% of the cases 14,33 . This causal relationship has increased thanks to the technological development of devices capable of measuring the proximal and distal stomach acidity and that of the pharynx 13,21,[34][35][36][37][38][39][40] , we also have optic fibers which are broadly used in clinical practice, and they do facilitate viewing the larynx 19,20 . We still do not know, exactly, how many reflux episodes are necessary to produce inflammatory changes and larynx lesions.…”

Section: Introductionmentioning

confidence: 99%

Estudo comparativo do pH e do volume salivar em indivíduos com laringofaringite crônica por doença do refluxo gastroesofágica antes e após o tratamento

Eckley

Costa²

2006

Rev. Bras. Otorrinolaringol.

View full text Add to dashboard Cite

INTRODUÇÃO: A Doença do Refluxo Gastroesofágico (DRGE) é a doença digestiva mais prevalente da atualidade e, recentemente, tem sido implicada em uma gama de alterações do seguimento laringofaríngeo (RLF). No entanto, pouco se sabe dos mecanismos fisiopatológicos destas manifestações supraesofágicas da DRGE. Os achados clínicos contraditórios e recentes pesquisas sugerem haver deficiências na capacidade de defesa deste seguimento. Uma das principais responsáveis pela homeostase da mucosa oral e do trato digestivo é a saliva com seu conteúdo orgânico e inorgânico. Tanto alterações do pH quanto do volume salivar já foram correlacionados com os sintomas e sinais sugestivos da DRGE e RLF. Estudo recente de nossa autoria demonstra diminuição estatisticamente significante do pH salivar de indivíduos com RLF quando comparado a controles sem a doença. Outro estudo constatou correlação entre a redução do volume X pH da saliva em indivíduos com DRGE, estando esta redução diretamente relacionada aos níveis de pH esofágico constatados durante pH-metria esofágica de 24 horas. OBJETIVOS: Avaliar como se comportam o pH e volume da saliva em um mesmo indivíduo com DRGE e RLF antes e após o tratamento clínico. MATERIAL E MÉTODO: Vinte e três pacientes com RLF tiveram o pH e volume da saliva total testados antes e após receberem tratamento com droga bloqueadora de bomba de prótons durante 12 semanas. RESULTADOS: Houve uma diferença estatisticamente significante (p<0,001) entre o pH da saliva antes e após o tratamento, estando este maior após o controle clínico da doença. O volume de saliva no paciente tratado foi significativamente maior do que no paciente pré-tratamento (p=0.009). DISCUSSÃO: Os achados sugerem que o pH salivar é influenciado pela presença de refluxo gastroduodenal à região laringofaríngea. Caso estudos futuros com populações maiores realmente comprovem esta correlação, poderemos cogitar a possibilidade de usar a mensuração do pH salivar, que é feita de forma rápida e não invasiva, como um meio de diagnosticar e avaliar o comportamento e controle do Refluxo Laringofaríngeo.

show abstract

High incidence of gastropharyngeal and gastroesophageal reflux after total laryngectomy

Cited by 39 publications

References 17 publications

The management of periprosthetic leakage in the presence of supra-oesophageal reflux after prosthetic voice rehabilitation

The management of periprosthetic leakage in the presence of supra-oesophageal reflux after prosthetic voice rehabilitation

What is the evidence that gastroesophageal reflux is involved in the etiology of laryngeal cancer?

Estudo comparativo do pH e do volume salivar em indivíduos com laringofaringite crônica por doença do refluxo gastroesofágica antes e após o tratamento

Contact Info

Product

Resources

About