인후두 역류 질환 환자에서 선별 검사로서의 식도조영술의 유용성

Abstract

Background and Objectives：Laryngopharyngeal reflux (LPR)20~30% of ENT outpatients, and over a half of patients who complains of voice disorder and laryngeal symptoms are asociated with LPR. So we evaluate the usefulnes of the esophagography as an initial screning test for patients suspected of LPR. Subjects and Method：From 2000 to 2002, we performed esophagography with water-siphon (WS) test for 540 patients with typical symptoms and telescopic findings. The results of esophagography were compared with those of 113 patients confirmed with gastroesohageal reflux (GER)moderate and severe according to the degre of reflux. Results：In the WS test of LPR group, 48 patients were normal (8.9%), 166 mild (30.7%), 143 moderate (26.5%) and 183 severe degree of reflux (33.9%). We evaluated moderate and severe degree of reflux as having positive findings of the WS test because mild degree of reflux can be seen in physiologic conditions. In the LPR group, the positive ratio of WS test was 60.4%. In GER group, 12 patients were normal (10.6%), 30 mild (26.5%), 31 moderate (27.7%), 40 severe degree of reflux (35.4%) and 62.8% of positive WS test. In 174 patients without LPR or GER, 73 patients were normal (42.0%), 40 mild (23.0%), 17 moderate (9.8%) and 4 presented severe degree of reflux (25.2%). Fourty-two patients of the 540 LPR group (7.8%) showed esophageal lesions in esophagography. Conclusion：In literature, the sensitivity esophagography can demonstrate esophageal abnormalities that might otherwise be mised. So we confirmed the effectiveness of esophagography as a strong initial screening test for LPR.