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Incidence of Posterior Laryngeal Erythema and Edema in Patients Undergoing Upper GI Endoscopy (EGD)

MOHAMMAD FARIVAR and JAMES KOLTON, DEPT of MEDICINE and DEPT of PATHOLOGY, NORWOOD HOSPITAL, NORWOOD, MA

Posterior vocal cord erythema and intra-arytenoid erythema and edema (mild reflux laryngitis [RL]) is common in patients Undergoing EGD. In 176 consecutive EGD patients, the larynx was carefully observed (LEGD) for the presence of RL. In addition, in all patients, 4 endoscopic biopsies were taken 2-4 cm from the gastroesophageal junction to look for microscopic evidence of chronic esophagitis. Of the 176 patients, 70 were male (average age 54), 106 were female (average age 49). 32 smoked tobacco, 18 consumed ethanol and 5 had atopic allergic disorders.

Results: 136 (77%) patients had some degree of RL. Among them only 15 (11%) had ENT symptoms (chronic hoarseness, sore throat, cervical pain with swallowing, lump in the throat, or persistent dry cough). In 18 total patients with mainly ENT symptoms, EGD was positive (grade I-III erosive esophagitis) in 3 (17%) and RL was found in 15 (83%). Among these 18 patients, one used tobacco, one consumed ethanol and non had allergies.

Conclusions: 1) The majority of patients with endoscopic evidence of RL are asymptomatic; 2) Endoscopic yield of erosive esophagitis is low in patients with ENT symptoms of RL; 3) Esophageal biopsies show chronic esophagitis in most patients with RL.

 

 

 

 

 

         This is an educational site created by M. Farivar, M.D. The information provided is the author's opinion based on years of clinical experience and research.  You are advised to consult your own physician about the applicability of this information to your particular needs.  Also, keep in mind that symptom response to therapy does not preclude the presence of more serious conditions. 

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