Investigation of Etiological Risk Factors, Mucosal Inflammation by Site and Laryngeal Hyperfunction in Dysphonic Patients Diagnosed with Chronic Laryngitis

Abstract

The present study investigated the associations among etiological risk factors, the presence of laryngeal mucosal inflammation by site, laryngeal hyperfunction, and the severity of hoarseness in chronic laryngitis. Of 45 dysphonic cases who were referred to the voice clinic at JCHO Osaka Hospital and diagnosed with chronic laryngitis, 55 %, 27 %, 11 %, and 7 % showed hoarseness of G0, G1R1, G2R2, and G3R3, respectively, at the initial consultation. As etiological risk factors, 24 % and 18% had experienced vocal abuse in their profession and inhaled corticosteroid therapy, respectively, but none had any smoking habit. With regard to gastroesophageal reflux disease, 11 % and 9 % had typical reflux symptoms and esophageal mucositis under upper gastrointestinal endoscopy, respectively, and 62 %, 78 %, and 24% showed mucosal inflammation of the vocal folds, posterior laryngeal structures, and subglottic region under laryngoscopy, respectively. In addition, vocal hyperfunction was observed in 24 %. After addressing each of the identified etiological factors, of the 18 cases showing objective hoarseness more severe than G 1 R 1 , 16 achieved vocal improvement to G0. In conclusion, the present results suggest that a substantial proportion of chronic laryngitis cases are associated with gastroesophageal reflux and have vocal impairment caused by organic changes in the vocal fold membrane rather than vocal hyperfunction.