Pharyngolaryngeal reflux and gastroesophageal reflux disease at children with chronic diseases of larynx

Aim of investigation. To study interrelation of a gastroesophageal and laryngopharyngeal reflux (LPR) with chronic larynx diseases.

Stuff and methods. 47 children in the age of 6 to 16 years with acquired scar stenosis of larynx (11), vocal folds nodules (17) and relapsing respiratory papillomatosis (19) were investigated. The reflux disease was diagnosed by original procedure of рН-monitoring at which electrodes were positioned in a laryngopharynx, middle and lower thirds of esophagus. Results. At typical low frequency of clinical symptoms various variants of reflux disease were determined at 42 (89,3%) children: gastroesophageal reflux disease (GERD) in combination to laryngopharyngeal reflux (LPR) – at 26 (55,3%), isolated LPR – at 15 (31,9%), isolated GERD – at 1 (2,1%). In patients with isolated LPR pH-metry data in laryngopharynx proved lower severity of acidic refluxes in comparison to combined GERD and LPR. At scar stenosis of larynx and vocal folds nodules refluxes episodes with рН <4,0, including ones longer then 5 min in esophagus, occurred more frequently in comparison to relapsing respiratory papillomatosis (р><0,05 – р><0,05). The similar trend of pH-metry figures was in laryngopharynx, but with absence of significant differences (р>0,05 – р>0,05).

Conclusion. Various variants of reflux disease are characteristic attributes of chronic larynx diseases. In the case of isolated LPR protective alkalizing mechanism of the esophagus often succeeds. For chronic larynx diseases it is reasonable to include 24-hour рН-monitoring to investigation plan of children with esophagus and laryngopharynx electrodes placement. Potential involvement of LPR in pathogenesis of chronic diseases of larynx requires further studies.

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