Gastroesophageal reflux disease and otolaryngologic manifestations: use of videofluorography

Background. The aim of this study is to evaluate the appropriateness of videofluorography (VFG) in otolaryngologic patients with symptoms of suspected gastroesophageal reflux-related (GER) origin. Methods. 151 consecutive patients underwent esophageal VFG following a clinical ENT examination. These patients had pharyngo-laryngeal symptoms of uncertain etiology such as chronic cough, hoarseness, throat clearing, globus sensation and voice changes, Results. There were anatomical and/or functional disorders of the esophagus and gastroesophageal junction such as sliding hiatal hernia (HH), episodes of barium reflux, and decreased esophageal clearing occurring in the vast majority of patients: HH 81%, GER 75%. Given certain necessary lifestyle changes in the patient, prolonged acid suppression with higher doses of proton pump inhibitors (PPI) and prokinetics agents was the pharmacologic treatment of choice. In 3 months 86% of the controlled patients showed a significant improvement of otolaryngologic symptoms thereby proving the causal relationship between reflux and symptoms. Conclusions. In our opinion in all cases of chronic aspecific pharyngo-laryngitis VFG is the diagnostic test most favorably accepted by patients, and is even more useful in confirming the relationship between GERD and otolaryngologic symptoms if used in association with the so-called "PPI test".