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GERD: Stroboscopy and Voice Analysis

Objective: 1) Identify the laryngopharyngeal features of GERD and its impact on voice. 2) Assess the response to antireflux therapy. Method: Prospective study of 30 patients with GERD and laryngopharyngeal symptoms in Tertiary Referral University Hospital over 2 years. All subjects underwent videolaryngoscopy, stroboscopy, upper GI endoscopy and biopsy, esophageal pH monitoring, and treatment. Pre- and posttreatment questionnaires on lifestyle and symptoms were used. Results: Difficulty in swallowing and throat clearing were the most common symptoms. H pylori infection was found in 43% of patients. Videolaryngoscopy: edema and congestion of arytenoids. Stroboscopy: posterior laryngitis (83%). Voice analysis by GRBAS scale showed subtle changes in grade, pitch, and range. Comparison of 24-hour pH monitoring pre- and postantireflux therapy showed significant improvement in the posttreatment group (pThe lifestyle profile showed increased stress, improper food habits, and lack of sleep. Smoking and alcohol intake were minimal in this group of patients. Lifestyle modification, proper dietary habits, vocal hygiene, treatment of H pylori infection, and antireflux medication cured 90% of patients. Conclusion: Analysis showed laryngopharyngeal symptoms and signs to be associated with GERD, which adversely affects vocal function. A new management protocol has been developed to treat patients with laryngopharyngeal symptoms with GERD. Emphasis on identification of GERD in patients with laryngopharyngeal symptoms needs to be recognized by otorhinolaryngolgists.