BACKGROUND Laryngeal contact granuloma(LCG)is difficult to treat and frequently associated with high persistence and recurrence,despite the availability of both surgical and pharmacological treatment options.An approp...BACKGROUND Laryngeal contact granuloma(LCG)is difficult to treat and frequently associated with high persistence and recurrence,despite the availability of both surgical and pharmacological treatment options.An appropriate strategy is therefore needed to help patients with multiple recurrences of LCG to potentially avoid unnecessary surgery.CASE SUMMARY We describe the case of a 34-year-old male patient with recurrent LCG in which a good response was achieved through successful management of laryngopharyngeal reflux disease using a combination pharmacotherapeutic regimen consisting of anti-reflux therapy,pepsin secretion inhibition,bile acid neutralization,and lifestyle modifications.This patient underwent surgery to excise the granuloma,then relapsed,underwent a second surgery,which was followed by a second recurrence.The granuloma then disappeared after 9 mo of combined treatment with ilaprazole enteric-coated capsules(10 mg qd),mosapride tablets(5 mg tid)and compound digestive enzyme capsules(2 tablets).The drug regimen was discontinued after one year,and no recurrence of the lesion has been reported during the one-year follow-up period.CONCLUSION We report a combination of pharmacotherapeutics and lifestyle modifications for the management of laryngopharyngeal reflux disease to address recurring LCG.展开更多
Gastroesophageal reflux disease(GERD) has many protean manifestations.Some of the most vexing have to do with the airway.GERD affects the tracheobronchial tree directly,leading to aspiration pneumonia and asthma,or ex...Gastroesophageal reflux disease(GERD) has many protean manifestations.Some of the most vexing have to do with the airway.GERD affects the tracheobronchial tree directly,leading to aspiration pneumonia and asthma,or exacerbating existing pulmonary disease,such as asthma or chronic obstructive pulmonary disease.In addition to the respiratory manifestation of GERD,there are unique pharyngeal and laryngeal manifestations.These include voice hoarseness,throat-clearing,chronic cough,globus,and "post-nasal drip".Linking these symptoms to GERD is challenging and frequently the diagnosis is that of exclusion.Despite proton pump inhibitor therapy being the mainstay of treatment,with anti-reflux surgery being reserved for intractable cases,there is no definitive evidence of the superiority of either.展开更多
Objective(s): Laryngeal inflammations lead to voice disorders. Medical conditions such as chronic laryngitis, gastroesophageal reflux, laryngopharyngeal reflux, Reinke edema and/or vocal folds hemorrhage, result in di...Objective(s): Laryngeal inflammations lead to voice disorders. Medical conditions such as chronic laryngitis, gastroesophageal reflux, laryngopharyngeal reflux, Reinke edema and/or vocal folds hemorrhage, result in diverse symptoms including chronic cough, throat cleaning and dysphonia (e.g. hoarseness). In turn, the dysphonic symptoms can be evaluated via subjective and objective procedures. The objective procedures usually include self-perceived questionnaires like the Voice Handicap Index (VHI). Studies reported that VHI can distinguish objectively dysphonic and non-dysphonic populations using the cut-off points of Receiver Operating Characteristic Curves. The purpose of this study was to calculate the cut-off points for individuals exhibiting voice symptoms which had been developed from laryngeal inflammatory diseases in Greece. Methods: One hundred and twelve participants (90 non-dysphonic and 22 dysphonic) filled in the Hellenic Voice Handicap Index (VHI) and the Greek translated version of Voice Evaluation Template (VEF) were administrated. All subjects were evaluated by an Otolaryngologist and a Speech-Language Pathologist. Results: The group with voice disorders exhibited higher VHI scores (in total and in its 3 subdomains) compared to non-dysphonic subgroup. Statistical significant differences were found for all VHI’s total cut-off point of 19.50 (sensitivity: 0.882, 1-specificity: 0.011) and for its three subdomains [functional 6.50 (sensitivity = 0.636, and 1-specificity = 0.022);physical 9.50 (sensitivity = 0.636, and 1-specificity = 0.000);emotional 6.50 (sensitivity = 0.455, and 1-specificity = 0.133)]. Conclusion: The preliminary results showed that VHI could discriminate individuals having voice disorders from laryngeal inflammations. The Voice Handicap Index can be used as a primary health care tool and a self-monitoring procedure in acute and sub-acute phases of the laryngeal inflammation.展开更多
文摘BACKGROUND Laryngeal contact granuloma(LCG)is difficult to treat and frequently associated with high persistence and recurrence,despite the availability of both surgical and pharmacological treatment options.An appropriate strategy is therefore needed to help patients with multiple recurrences of LCG to potentially avoid unnecessary surgery.CASE SUMMARY We describe the case of a 34-year-old male patient with recurrent LCG in which a good response was achieved through successful management of laryngopharyngeal reflux disease using a combination pharmacotherapeutic regimen consisting of anti-reflux therapy,pepsin secretion inhibition,bile acid neutralization,and lifestyle modifications.This patient underwent surgery to excise the granuloma,then relapsed,underwent a second surgery,which was followed by a second recurrence.The granuloma then disappeared after 9 mo of combined treatment with ilaprazole enteric-coated capsules(10 mg qd),mosapride tablets(5 mg tid)and compound digestive enzyme capsules(2 tablets).The drug regimen was discontinued after one year,and no recurrence of the lesion has been reported during the one-year follow-up period.CONCLUSION We report a combination of pharmacotherapeutics and lifestyle modifications for the management of laryngopharyngeal reflux disease to address recurring LCG.
文摘Gastroesophageal reflux disease(GERD) has many protean manifestations.Some of the most vexing have to do with the airway.GERD affects the tracheobronchial tree directly,leading to aspiration pneumonia and asthma,or exacerbating existing pulmonary disease,such as asthma or chronic obstructive pulmonary disease.In addition to the respiratory manifestation of GERD,there are unique pharyngeal and laryngeal manifestations.These include voice hoarseness,throat-clearing,chronic cough,globus,and "post-nasal drip".Linking these symptoms to GERD is challenging and frequently the diagnosis is that of exclusion.Despite proton pump inhibitor therapy being the mainstay of treatment,with anti-reflux surgery being reserved for intractable cases,there is no definitive evidence of the superiority of either.
文摘Objective(s): Laryngeal inflammations lead to voice disorders. Medical conditions such as chronic laryngitis, gastroesophageal reflux, laryngopharyngeal reflux, Reinke edema and/or vocal folds hemorrhage, result in diverse symptoms including chronic cough, throat cleaning and dysphonia (e.g. hoarseness). In turn, the dysphonic symptoms can be evaluated via subjective and objective procedures. The objective procedures usually include self-perceived questionnaires like the Voice Handicap Index (VHI). Studies reported that VHI can distinguish objectively dysphonic and non-dysphonic populations using the cut-off points of Receiver Operating Characteristic Curves. The purpose of this study was to calculate the cut-off points for individuals exhibiting voice symptoms which had been developed from laryngeal inflammatory diseases in Greece. Methods: One hundred and twelve participants (90 non-dysphonic and 22 dysphonic) filled in the Hellenic Voice Handicap Index (VHI) and the Greek translated version of Voice Evaluation Template (VEF) were administrated. All subjects were evaluated by an Otolaryngologist and a Speech-Language Pathologist. Results: The group with voice disorders exhibited higher VHI scores (in total and in its 3 subdomains) compared to non-dysphonic subgroup. Statistical significant differences were found for all VHI’s total cut-off point of 19.50 (sensitivity: 0.882, 1-specificity: 0.011) and for its three subdomains [functional 6.50 (sensitivity = 0.636, and 1-specificity = 0.022);physical 9.50 (sensitivity = 0.636, and 1-specificity = 0.000);emotional 6.50 (sensitivity = 0.455, and 1-specificity = 0.133)]. Conclusion: The preliminary results showed that VHI could discriminate individuals having voice disorders from laryngeal inflammations. The Voice Handicap Index can be used as a primary health care tool and a self-monitoring procedure in acute and sub-acute phases of the laryngeal inflammation.
