Posterior laryngitis: a study of persisting symptoms and health-related quality of life

Abstract

2013Link to publication Citation for published version (APA): Pendleton, H., Ahlner-Elmqvist, M., Jannert, M., & Ohlsson, B. (2013). Posterior laryngitis: a study of persisting symptoms and health-related quality of life. European Archives of Oto-Rhino-Laryngology, 270(1), 187-195. https://doi.org/10.1007/s00405-012-2116-2 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. The aim of the present study was to examine how patients with posterior laryngitis have been examined, treated and followed up, and to assess their present health-related quality of life (HRQOL). Methods. Patients treated for posterior laryngitis at consultation at the Ear-, Nose-and Throat (ENT) clinic during 2000-2008 were contacted by mail. The letter contained questionnaires addressing the current symptoms and medication, and the HRQOL 36-item short-form questionnaire (SF-36). Medical records were scrutinized. One hundred and twenty-two patients with verified signs and symptoms of posterior laryngitis were included.Results. Forty percent of the patients had been treated for acid-related symptoms prior to consultation. The most common symptoms at the time of consultation were the sensation of hoarseness (women 40%, men 37%), globus (women 35%, men 33%) and cough (women 33%, men 26%). The most frequent diagnosis was gastro oesophageal reflux disease (GORD). Ninety percent of the women and 92% of the men were treated with proton pump inhibitors (PPIs). At the time of study, 63% of the patients still had symptoms. The results of the SF-36 questionnaire showed significantly lower HRQOL for women. Conclusions. Patients with posterior laryngitis present varying symptoms, and are often not adequately treated or followed up. When PPI treatment fails, other aetiologies of their complaints, such as visceral hypersensivity, weakly gaseous acid reflux or non-acid reflux are not considered. Symptoms from posterior laryngitis have a negative impact on the HRQOL for women.

Antibodies against Gonadotropin-Releasing Hormone in Patients with Posterior Laryngitis

“…This raises the hypothesis that patients with different functional disorders, which often are associated and show an overrepresentation in women,14,15 may express GnRH antibodies as a common feature. We have recently shown how the majority of patients suffering from PL are women who are not improved by PPI treatment and express low health-related quality of life 16. This is in accordance with the hypothesis of a functional etiology of proximal gastrointestinal and extra-esophageal complaints 8,17…”

The factors associated with allergic rhinitis in the dysphonic professional voice users

“…Some authors think that the studies made until now did not confirm that LPR is so much present among dysphonic patients (26)(27)(28), and there is a significant overlap in the symptomatic presentation of patients with LPR and allergic laryngitis (15,28). The LPR and AR are difficult to be differentiated because they have similar signs and symptoms as reported.…”

Posterior laryngitis: a disease with different aetiologies affecting health-related quality of life: a prospective case–control study

“…Different functional disorders often overlap, and patients may suffer from more than one such disorder [37]. These patients have a poorer response to acid suppressive therapy [3,19], which also applies to acid-suppressing therapy to patients with PL [15]. In accordance with patients affected by functional oesophageal disease, patients diagnosed with PL might suffer from functional pharyngeal-laryngeal disease.…”

“…Consequently, an inappropriate use of proton pump inhibitors (PPIs) are prescribed even though the symptoms and the findings are not related to acid reflux [14]. It has recently been shown that patients with PL, despite treatment with sufficient doses of PPI over many years, still suffer from their initial symptoms and complaints, with impaired health-related quality of life (HRQOL) as a result [15]. …”

“…The reason to functional disturbances is unclear, but may depend on altered central processing of visceral afferent information [18], where patients with FGID are thought to have a heightened perception of normal visceral stimuli, called visceral hypersensitivity [19-21]. The same functional aetiology has also been suggested in the case of PL [13,15]. …”