The Prevalence of Gastroesophageal Reflux in Patients with Paradoxical Vocal Fold Motion

作者：John Boger, Joyce Gurevich-Uvena, Eric Frizzel, William E. Norris, Corinne Maydonovitch, Joseph L. Perry, Jeffrey Laczek, Roy Wong · 发表于：The American Journal of Gastroenterology · 年份：2008 · DOI：10.14309/00000434-200809001-00064 · 被引用次数：4 · 研究领域：Voice and Speech Disorders、Respiratory and Cough-Related Research、Gastroesophageal reflux and treatments

Purpose: Paradoxical vocal fold motion (PVFM) is an inappropriate adduction of the true vocal folds, which causes airway obstruction and inspiratory stridor. PVFM may lead to wheezing and is often mistaken for asthma, and patients are treated with glucocorticoids and beta-agonists inappropriately. There is a body of evidence stating that irritation of the vocal folds may cause or exacerbate PVFM. One-third of PVFM patients have been shown to report GERD symptoms, but studies to evaluate PVFM patients with pH monitoring have all been small (<10 subjects). We studied patients with PVFM to determine the prevalence of GERD in this population as diagnosed by esophagogastroduodenoscopy (EGD) or 48-hour esophageal acid monitoring. Methods: Patients diagnosed with PVFM by flattened inspiratory loop on pulmonary function testing underwent EGD with BRAVO capsule placement at 6 cm proximal to SCJ. All patients abstained from acid suppression agents (PPI's, H2RA's) for 7 days prior to the EGD. 48 hours of pH monitoring was performed with the BRAVO capsule. Patients were considered to have a diagnosis of GERD if they had any evidence of erosive esophagitis on EGD or if they had a positive Johnston-Demeester (JD) score (>22) during the second 24-hour period of pH monitoring by BRAVO capsule. Results: 32 patients (20 females, mean age 42 + 16 yrs) with PVFM completed the study. 31% (10/32) of subjects had a positive JD score, 50% of which had significant combined upright and supine reflux. ...