Chronic laryngitis is a multifactorial disease with a large differential diagnosis for the patient who presents with hoarseness. Fortunately, the diagnosis of inflamed larynx has improved in recent years.
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September 2010Robert Sataloff, MD, professor and chair of otolaryngology-head and neck surgery at Drexel University College of Medicine in Philadelphia, said progress has included a growing understanding of the anatomy and physiology of the larynx; improved visualization with strobovideolaryngoscopy, videokymography and high-speed video; an improved understanding of laryngopharyngeal reflux (LPR); and the recognition of the role played by certain medications, such as steroid inhalers used for the long-term treatment of asthma.
Seth Dailey, MD, associate professor of otolaryngology-head and neck surgery at the University of Wisconsin in Madison, said gastric reflux multichannel intraluminal impedance testing, coupled with esophageal pH monitoring, has “allowed us to understand when there are reflux events up into the esophagus and whether they are liquid or non-liquid, acid or non-acid.” He added that “we can begin to understand if there is a strong, intermediate or weak correlation between those events and the patient’s symptoms,” which may aid decision for more aggressive therapy such as a Nissen fundoplication.