Effect in symptoms of acid suppression therapy on postoperative recurrence of vocal leukoplakia / 医学研究生学报

ABSTRACT

[Abstract ] Objective Clinically, the necessity of acid suppression treatment in vocal leukoplakia is still controversial .This paper aims to investigate the roles of LPR in the pathogenesis and pathological process of vocal leukoplakia , and to clear the signifi-cance of acid suppression in the treatment of this disease through observing the influence of laryngopharyngeal reflux ( LPR) on the symptoms of postoperative vocal leukoplakia . Methods We collected 97 cases underwent vocal leukoplakia surgery from June 2013 to December 2015 in the Department of Otorhinolarygology Head and Neck Surgery , Nanjing General Hospital of Nanjing Military Re-gion.According to the results of ambulatory 24-hour double probe ( simultaneous esophageal and pharyngeal ) pH monitoring ( pH-me-try), the patients with vocal leukoplakia were divided into LPR group (n=26, laryngopharyngeal reflux) and non-LPR group(n=71, non-laryngopharyngeal reflux).Meanwhile, the patients in LPR group were then randomly divided into acid-suppressing group(n=13, oral esomeprazole ) and non-acid-suppressing ( n=13, oral placebo ) . All patients received evaluation and compared by electrolaryngendo-scope, voice handicap index-10 ( VHI-10), reflux symptom index ( RSI) and reflux finding score ( RFS) before operation and 8 weeks after operation, and observe the effect of laryngopharyngeal reflux and acid suppression on the symptoms of postoperative vocal leukoplakia . Results RSI and RFS after operation were significantly lower than before operation in LPR group[(13.6±5.8) vs (18.2±6.2), (9.2±2.4) vs (10.6±2.8), P<0.05].The difference of RSI and RFS between before and after operation in LPR group was higher than the non-LPR group[(5.8±1.4) vs (2.3±0.8), (1.2±0.6) vs (0.5±0.2), P<0.05].The difference of RSI and RFS between before and after operation in acid-suppressing group was higher than the non-acid-suppressing group[(6.6±1.2) vs (0.8±0.6), (2.6±0.6) vs (0.5±0.3), P<0.05].VHI-10 after operation was significantly lower than before operation in acid-suppressing group[(12.6±3.6) vs (15.2±4.2), P<0.05] Conclusion Standard PPI administration to patients suffering from vocal leukoplakia accompanied with LPR can alleviate the symptoms of LPR and improve hoarseness .