Laryngopharyngeal Reflux and Proton Pump Inhibitors.

Laryngopharyngeal reflux (LPR) refers to the backflow of stomach contents into the throat that is into the hypopharynx.LPR is different from classical GERD. Although PPIs appear to be effective, higher doses for a longer duration are necessary as compared with esophageal GERD disease. In this study we focused on clinical characteristics and role of proton pump inhibitors in Laryngopharyngeal Reflux. Material and Methods: The prospective observational study was done in LPR patients in the Department of ENT and HNS of SKIMS Medical College and Government Medical College Srinagar for a period of 2 years from 2010 to 2012 .Sixty cases were enrolled in the study. LPR was diagnosed on the basis of RFS and RSI. Role of PPI was assessed by the changes of RSI and RFS with Proton pump inhibitors. Results: Total number of patients included in the study were 60, 42 (70%) cases were females, 18 (30%) were males. Frequent clearing of throat was the most common symptom. Mean RSI of all patients was 25.25 before treatment. Significant change in RSI occurred after first 10 weeks of therapy and no further significant change occurred in the next 10 weeks. Most common laryngeal finding was erythema/hyperaemia; Mean RFS of the patients was 13 before treatment with proton pump inhibitors. There was slight response after 10 weeks of therapy in physical findings and significant response after 20 weeks. Conclusion: LPR is a common condition presenting in ENT settings, the symptoms and signs may be complex. PPI are treatment of choice and should be continued for about 5 months because clinical symptoms take about two month to resolve while signs take about 5 months to resolve.

Epidermoid Cysts of the Vocal Cords: An Undiagnosed Clinical Entity

The present study was carried out on 20 patients at SIKMS Medical College from January 2000 to March 2001. All the patients presented with hoarseness of voice. Laryngeal examination revealed smooth well-defined swelling involving left vocal cord in 12 cases, right vocal cord in 6 cases and bilateral involvement was noticed in 2 cases. Dysphonia being the main symptom, only one patient complained of some difficulty in breathing. Seventy-five percent of the patients were females. The lesion was generally located in the middle third of the vocal cord,just beneath its free border. The diagnosis was established by direct laryngoscope excision and histopathological examination of the lesion.