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Histological findings in the posterior wall of larynx in patients with GERD

Introduction: The mechanisms of the otolaryngologic manifestations of GERD are most likely the result of intermittent nocturnal gastroesophageal-pharyngeal reflux and contact or upper airway structures with refluxate. The contact of the gastric juice with the pharynx and larynx, result in edema and inflammation, even with minimal acid exposition. Although, histological findings in the posterior wall of the larynx in patients with GERD, may be a important diagnostic tool in these patients. The aim of this study is to describe the results of the biopsies of the posteiror wall of the larynx in patients with GERD. Study design: Prospective no randomized. Material and method: We performed biopsies in the laryngeal posterior wall in seven patients complaints of cronical pharyngeal symptoms with gastroesophageal reflux disease (GERD). All the patients were investigated with digestive endoscopy and all had erosive esophagitis. Laryngoscopy were performed looking for lesions sugestive of GERD. Two groups were created: group I - normal laryngoscopy; and group II - laryngoscopy with posterior laryngitis. Results: The results showed that 42.85% of the patients presented with scamous epithelim in the laryngeal posterior wall, 42.85% presented areas of scamous metaplasia among the respiratory epithelium and 28.57% of the patients presented with respiratory epithelium. 71.4% of the patients presented with histologic alterations of the GERD that are found in the mucosal esophagus. Conclusions: The results ot this study suggest that the GERD can be related to the epithelium changes in the laryngeal posterior wall and inflamatory histologic alterations in this region.

histology; reflux; larynx; biopsy


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