Diagnostic Considerations

These include the following:

Deglutitive dysfunction
Primary disorder of esophageal musculature or neural supply
Degenerative disorders
Myasthenia gravis
Peripheral disorder due to diabetes
Vagal injury
Esophageal, pharyngeal, thyroid, or laryngeal neoplasm

Differential Diagnoses

Workup

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US Food and Drug Administration. FDA Requests Removal of All Ranitidine Products (Zantac) from the Market. FDA. Available at https://www.fda.gov/news-events/press-announcements/fda-requests-removal-all-ranitidine-products-zantac-market. Apr 1, 2020; Accessed: May 7, 2020.

Media Gallery

The RSI documents the presence and degree of nine laryngopharyngeal reflux (LPR) symptoms both before and after treatment; maximum score: 45.
The reflux finding score (RFS) documents the presence and degree of eight laryngopharyngeal reflux (LPR) findings during fiberoptic laryngoscopy; maximum score: 26.

of 2

Table 2. shows key features of the 7 studies that evaluated efficacy of antireflux medical treatment. These studies were published from 1991-1997 and reported on 346 adult patients with otherwise unexplained posterior laryngitis suspected to be caused by GERD who received antireflux medical treatment in an uncontrolled nonblinded clinical trial. Outcomes Reported by Trials of Antireflux Medical Treatment of Reflux Laryngitis

Table 2. shows key features of the 7 studies that evaluated efficacy of antireflux medical treatment. These studies were published from 1991-1997 and reported on 346 adult patients with otherwise unexplained posterior laryngitis suspected to be caused by GERD who received antireflux medical treatment in an uncontrolled nonblinded clinical trial. Outcomes Reported by Trials of Antireflux Medical Treatment of Reflux Laryngitis

Author	n	Pharmacologic Intervention	Treatment Duration wk	Symptom Improvement		Laryngoscopic Improvement	Follow-up wk	Repeat Treatment
Author	n	Pharmacologic Intervention	Treatment Duration wk	Laryngeal	Esophageal	Laryngoscopic Improvement	Follow-up wk	Repeat Treatment
Koufman	33	Ranitidine 300-600 mg/d or Famotidine 80 mg/d	24	85%	…	85%	44	50%
Kamel	16	Omeprazole 40 mg/d	6-24	79%	96%	56%	6	Majority
Hanson	182	Step-wise treatment Famotidine 20 mg/d, Omeprazole 20-40 mg/d	6-12	96%	…	96%	>6-12	79%
Shaw	68	Omeprazole 20 mg bid	12	Significantly improved	40%	Significantly improved	None	…
Wo	21	Omeprazole 40 mg/d	8	40%	48%	50%	8	38%
Metz	10	Omeprazole 20 mg bid	4	60%	100%	…	…	…
Hanson	16	Omeprazole 20 mg/d	6-9	Significantly improved acoustic parameters	…	…	…	…

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Author

Pamela A Mudd, MD, MBA Attending Physician in Pediatric Otolaryngology, Children's National Medical Center

Pamela A Mudd, MD, MBA is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Bardia Amirlak, MD Assistant Professor of Plastic Surgery, Director of Residency Cosmetic Clinic, Director of Plastic Surgery Global Health Program, University of Texas Southwestern Medical Center at Dallas; Chief of Hand and Peripheral Nerve Surgery, Dallas Veterans Affairs Medical Center

Bardia Amirlak, MD is a member of the following medical societies: American College of Surgeons, American Society of Plastic Surgeons, American Society of Reconstructive Transplantation, Kleinert Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Robert M Kellman, MD Professor and Chair, Department of Otolaryngology and Communication Sciences, State University of New York Upstate Medical University

Robert M Kellman, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Head and Neck Society, American Rhinologic Society, Triological Society, American Neurotology Society, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, Medical Society of the State of New York

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan; Ryte; Neosoma; MI10<br/>Received income in an amount equal to or greater than $250 from: Neosoma; Cyberionix (CYBX)<br/>Received ownership interest from Cerescan for consulting for: Neosoma, MI10.

Additional Contributors

Clark A Rosen, MD Director, University of Pittsburgh Voice Center; Professor, Department of Otolaryngology and Communication Science and Disorders, University of Pittsburgh School of Medicine

Clark A Rosen, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, Pennsylvania Medical Society

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Merz North America Inc<br/>Received consulting fee from Merz North America Inc for consulting; Received consulting fee from Merz North America Inc for speaking and teaching.

Reza Shaker, MD

Reza Shaker, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Federation for Medical Research, American Gastroenterological Association, American Neurogastroenterology and Motility Society, American Physiological Society, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Ramin Soraya, MD Chair, Department of Science, West Coast University, Dallas

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Ann L Edmunds, MD, PharmD, to the development and writing of this article.

Sections Reflux Laryngitis
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Reflux Laryngitis Differential Diagnoses

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