Laryngopharyngeal Reflux
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Laryngopharyngeal Reflux (LPR) and Gastroesophageal Reflux (GERD)
Laryngopharyngeal Reflux (LPR) and Gastroesophageal Reflux (GERD) Laryngopharyngeal reflux (LPR) is an inflammatory condition defined as the backflow of gastric contents into the laryngopharynx, where it comes in contact with the tissues of the upper aerodigestive tract. LPR is characterized by chronic inflammation of the laryngopharynx and, more broadly, the tissues of the upper aerodigestive tract. The mechanism of LPR requires bypassing both the upper and lower esophageal sphincters to achieve extraesophageal reflux of gastric contents. This is in contrast to gastroesophageal reflux disease (GERD), which involves backflow of gastric contents into the esophagus bypassing only the lower esophageal sphincter. J.A. Koufman, J.E. Aviv, R.R. Casiano, et al. Laryngopharyngeal reflux: position statement of the committee on speech, voice, and swallowing disorders of the American Academy of Otolaryngology- Head and Neck Surgery Otolaryngol Head Neck Surg, 127 (2002), pp. 32-35. J.R. Lechien, C. Finck, P. Costa de Araujo, et al. Voice outcomes of laryngopharyngeal reflux treatment: a systematic review of 1483 patients. Eur Arch Otorhinolaryngol, 274 (2016), pp. 1-23. Anatomy and Physiology Over time, liquid or aerosolized gastric contents, including acid, bile, and pepsin inflame the tissue of the laryngopharynx, leading to symptoms including cough, throat clearing, mucus sensation, globus sensation, and hoarseness as well as laryngeal findings such as postcricoid edema, arytenoid mucosal erythema, pachydermia, and pseudosulcus. Ford CN. Evaluation and management of laryngopharyngeal reflux. JAMA 2005;294:1534–1540. Noordzij P, Khidr A, Evans B, et al. Omeprazole in treatment of reflux laryngitis. Laryngoscope 2001;111:2147–2151. Although gastroesophageal reflux GERD similarly involves the reflux of gastric contents, LPR, also referred to as extraesophageal or atypical reflux is a distinct diagnosis, is often present without the esophagitis, frank regurgitation or heartburn associated with GERD, and only 20% of LPR patients have frank GERD symptoms. -
Larynx Anatomy
LARYNX ANATOMY Elena Rizzo Riera R1 ORL HUSE INTRODUCTION v Odd and median organ v Infrahyoid region v Phonation, swallowing and breathing v Triangular pyramid v Postero- superior base àpharynx and hyoid bone v Bottom point àupper orifice of the trachea INTRODUCTION C4-C6 Tongue – trachea In women it is somewhat higher than in men. Male Female Length 44mm 36mm Transverse diameter 43mm 41mm Anteroposterior diameter 36mm 26mm SKELETAL STRUCTURE Framework: 11 cartilages linked by joints and fibroelastic structures 3 odd-and median cartilages: the thyroid, cricoid and epiglottis cartilages. 4 pair cartilages: corniculate cartilages of Santorini, the cuneiform cartilages of Wrisberg, the posterior sesamoid cartilages and arytenoid cartilages. Intrinsic and extrinsic muscles THYROID CARTILAGE Shield shaped cartilage Right and left vertical laminaà laryngeal prominence (Adam’s apple) M:90º F: 120º Children: intrathyroid cartilage THYROID CARTILAGE Outer surface à oblique line Inner surface Superior border à superior thyroid notch Inferior border à inferior thyroid notch Superior horns à lateral thyrohyoid ligaments Inferior horns à cricothyroid articulation THYROID CARTILAGE The oblique line gives attachement to the following muscles: ¡ Thyrohyoid muscle ¡ Sternothyroid muscle ¡ Inferior constrictor muscle Ligaments attached to the thyroid cartilage ¡ Thyroepiglottic lig ¡ Vestibular lig ¡ Vocal lig CRICOID CARTILAGE Complete signet ring Anterior arch and posterior lamina Ridge and depressions Cricothyroid articulation -
Reflux Advice Sheet
Avoid tight clothing around your waist: It is best to take Gaviscon Advance as the Bending from the knees when lifting very last thing you take before going to and moving may also help. bed. It can also be of benefit after meals and before strenuous exercise. You should Some people find it helpful to keep a food not take it at the same time as taking your diary to identify any particular foods or PPI or other anti-acid medication, as it can eating habits which make their symptoms make them less effective. worse. For advice on any medications you have Are there any medicines I can been prescribed or purchased over the take to help? counter speak to your GP or pharmacist. Your consultant or GP may have prescribed a medicine known as a PPI or Proton Pump Inhibitor. Examples include Lanzoprazole and Omeprazole. These prevent the secretion of acid into the stomach. For the most effective treatment of LPR these should be taken half an hour before meals. For the medication to be effective, you should take it for a continuous period of time once or twice a day, as prescribed. If The Trust provides free symptoms do not improve go to your GP to monthly health talks on a Reflux Advice review the type and amount of medication. variety of medical conditions It may take a couple of attempts to find and treatments. For more information visit the combination that works best for you. www.uhb.nhs.uk/health-talks.htm or Sheet call 0121 371 4323. -
How the Larynx (Voice Box) Works
How the Larynx (Voice Box) Works Charles R. Larson, PhD If you love opera, or if you admire the voices of pop singers such as Celine Dion or Barbra Streisand, you may have wondered how it is these marvelous singers are able to create such beautiful music with this instrument we call the human voice. You may also know of someone who has a bad voice or has had to have their voice box, or larynx, removed because of illness or injury. The larynx is a critical organ of human speech and singing, and it serves important biological functions as well. Let's have a look at the larynx to understand its functions, what it looks like and how it works. It is thought that the same factors that favored the evolution of air‐breathing animals on earth led to the evolution of the larynx. Lungs are comprised of very delicate tissues that must be maintained within strict biological limits, that is, temperature, humidity and freedom from foreign particles. Thus, along with the first air‐breathing animals, there appeared a primitive sort of larynx, whose one and only function was protection of the lung. This function remains the most important of those the larynx has assumed in subsequent evolutionary developments. Now, of course we recognize that the larynx is critical for human speech and singing. But we also should realize that the larynx is important for swallowing, coughing, vomiting and eliminating contents of the abdomen. If you have ever felt your 'Adam's Apple', then you know where the larynx is. -
Gastroesophageal and Laryngopharyngeal Reflux Associated with Laryngeal Malignancy: a Systematic Review and Meta-Analysis
Accepted Manuscript Gastroesophageal and Laryngopharyngeal Reflux Associated with Laryngeal Malignancy: A Systematic Review and Meta-Analysis Sean M. Parsel, DO, Eric L. Wu, MD, Charles A. Riley, MD, Edward D. McCoul, MD, MPH PII: S1542-3565(18)31150-9 DOI: https://doi.org/10.1016/j.cgh.2018.10.028 Reference: YJCGH 56150 To appear in: Clinical Gastroenterology and Hepatology Accepted Date: 8 October 2018 Please cite this article as: Parsel SM, Wu EL, Riley CA, McCoul ED, Gastroesophageal and Laryngopharyngeal Reflux Associated with Laryngeal Malignancy: A Systematic Review and Meta-Analysis, Clinical Gastroenterology and Hepatology (2018), doi: https://doi.org/10.1016/ j.cgh.2018.10.028. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. ACCEPTED MANUSCRIPT Title : Gastroesophageal and Laryngopharyngeal Reflux Associated with Laryngeal Malignancy: A Systematic Review and Meta-Analysis Sean M. Parsel, DO 1, Eric L. Wu, MD 1, Charles A. Riley, MD 2, and Edward D. McCoul, MD, MPH 1, 3, 4 1 Tulane University School of Medicine, Department of Otolaryngology—Head and Neck Surgery, New Orleans, LA 2 Weill Cornell Medical Center, Department of Otolaryngology—Head and Neck Surgery, New York, NY 3 Ochsner Clinic Foundation, Department of Otorhinolaryngology, New Orleans, LA 4 University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA Short title: Reflux and Laryngeal Malignancy Grant support: none Correspondence Edward D. -
Laryngopharyngeal Reflux
International Journal of Otolaryngology Laryngopharyngeal Reflux Guest Editors: Wolfgang Issing, Petros D. Karkos, Oliver Reichel, and Marcus Hess Laryngopharyngeal Reflux International Journal of Otolaryngology Laryngopharyngeal Reflux Guest Editors: Wolfgang Issing, Petros D. Karkos, Oliver Reichel, and Marcus Hess Copyright © 2012 Hindawi Publishing Corporation. All rights reserved. This is a special issue published in “International Journal of Otolaryngology.” All articles are open access articles distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Board Rolf-Dieter Battmer, Germany Ludger Klimek, Germany Leonard P. Rybak, USA Robert Cowan, Australia Luiz Paulo Kowalski, Brazil Shakeel Riaz Saeed, UK P. H. Dejonckere, The Netherlands Roland Laszig, Germany Michael D. Seidman, USA Joseph E. Dohar, USA Charles Monroe Myer, USA Mario A. Svirsky, USA Paul J. Donald, USA Jan I. Olofsson, Norway Ted Tew fik, Canada R. L. Doty, USA Robert H. Ossoff,USA Paul H. Van de Heyning, Belgium David W. Eisele, USA JeffreyP.Pearson,UK Blake S. Wilson, USA Alfio Ferlito, Italy Peter S. Roland, USA B. J. Yates, USA Contents Laryngopharyngeal Reflux, Petros D. Karkos, Wolfgang Issing, Oliver Reichel, and Marcus Hess Volume 2012, Article ID 926806, 2 pages Chronic Cough, Reflux, Postnasal Drip Syndrome, and the Otolaryngologist,DeborahC.Sylvester, Petros D. Karkos, Casey Vaughan, James Johnston, Raghav C. Dwivedi, Helen Atkinson, and Shah Kortequee Volume 2012, Article ID 564852, 5 pages Impact of Laparoscopic Fundoplication for the Treatment of Laryngopharyngeal Reflux: Review of the Literature, Guilherme da Silva Mazzini and Richard Ricachenevsky Gurski Volume 2012, Article ID 291472, 4 pages Eosinophilic Esophagitis for the Otolaryngologist, Petros D. -
Study Guide Medical Terminology by Thea Liza Batan About the Author
Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails proficiencyincommunicatingwithhealthcareprofessionalssuchasphysicians,nurses, or dentists. -
Medical Term for Throat
Medical Term For Throat Quintin splined aerially. Tobias griddles unfashionably. Unfuelled and ordinate Thorvald undervalues her spurges disroots or sneck acrobatically. Contact Us WebsiteEmail Terms any Use Medical Advice Disclaimer Privacy. The medical term for this disguise is called formication and it been quite common. How Much sun an Uvulectomy in office Cost on Me MDsave. The medical term for eardrum is tympanic membrane The direct ear is. Your throat includes your esophagus windpipe trachea voice box larynx tonsils and epiglottis. Burning mouth syndrome is the medical term for a sequence-lastingand sometimes very severeburning sensation in throat tongue lips gums palate or source over the. Globus sensation can sometimes called globus pharyngeus pharyngeus refers to the sock in medical terms It used to be called globus. Other medical afflictions associated with the pharynx include tonsillitis cancer. Neil Van Leeuwen Layton ENT Doctor Tanner Clinic. When we offer a throat medical conditions that this inflammation and cutlery, alcohol consumption for air that? Medical Terminology Anatomy and Physiology. Empiric treatment of the lining of the larynx and ask and throat cancer that can cause nasal cavity cancer risk of the term throat muscles. MEDICAL TERMINOLOGY. Throat then Head wrap neck cancers Cancer Research UK. Long term monitoring this exercise include regular examinations and. Long-term a frequent exposure to smoke damage cause persistent pharyngitis. Pharynx Greek throat cone-shaped passageway leading from another oral and. WHAT people EXPECT ON anything LONG-TERM BASIS AFTER A LARYNGECTOMY. Sensation and in one of causes to write the term for throat medical knowledge. The throat pharynx and larynx is white ring-like muscular tube that acts as the passageway for special food and prohibit It is located behind my nose close mouth and connects the form oral tongue and silk to the breathing passages trachea windpipe and lungs and the esophagus eating tube. -
Laryngopharyngeal Reflux Is Associated with Nasal Septal Deviation
Eur J Rhinol Allergy 2020; 3(1): 1-3 Original Article Laryngopharyngeal Reflux is Associated with Nasal Septal Deviation Eugene Wong , Nathaniel Deboever , Niranjan Sritharan , Narinder Singh Department of Otolaryngology Head and Neck Surgery, University of Sydney Westmead Hospital, Sydney, Australia Abstract Objective: Laryngopharyngeal reflux (LPR) is defined as a retrograde flow of gastric contents into the larynx and hy- popharynx. However, a possible pathophysiological contribution from nasal resistance has been proposed, according to which increased nasal resistance associated with septal deviation may cause increased respiratory effort, resulting in a more negative intrathoracic pressure, which may, in turn, overcome the upper esophageal sphincter and lead to the retrograde passage of gastric contents. The aim of this study was to investigate whether septal deviation of adequate severity necessitating septoplasty is associated with an increased use of proton pump inhibitors (PPIs) in comparison with the general population. Material and Methods: This retrospective single-center cohort study investigated the usage of PPIs in patients undergoing septoplasty. Hospital databases were searched to identify patients aged 18-85 years who underwent sep- toplasty from January 2012 to December 2016. Electronic medical records were reviewed to collect details pertaining to demographic variables, usage of PPIs, smoking and drinking status, and other comorbidities. A control group of subjects who underwent an unrelated procedure (arthroscopy) was also sampled. Results: The data of 200 patients (29% females, mean age 40.8±14.8 years) who underwent septoplasties were com- pared with those of 200 control subjects (39.5% females, mean age 45.3±15.0 years) who underwent arthroscopies. -
Pediatric Gastroesophageal Reflux Clinical Practice
SOCIETY PAPER Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition ÃRachel Rosen, yYvan Vandenplas, zMaartje Singendonk, §Michael Cabana, jjCarlo DiLorenzo, ôFrederic Gottrand, #Sandeep Gupta, ÃÃMiranda Langendam, yyAnnamaria Staiano, zzNikhil Thapar, §§Neelesh Tipnis, and zMerit Tabbers ABSTRACT This document serves as an update of the North American Society for Pediatric INTRODUCTION Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European n 2009, the joint committee of the North American Society for Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Pediatric Gastroenterology, Hepatology, and Nutrition (NASP- 2009 clinical guidelines for the diagnosis and management of gastroesophageal GHAN)I and the European Society for Pediatric Gastroenterology, refluxdisease(GERD)ininfantsandchildrenandisintendedtobeappliedin Hepatology, and Nutrition (ESPGHAN) published a medical posi- daily practice and as a basis for clinical trials. Eight clinical questions addressing tion paper on gastroesophageal reflux (GER) and GER disease diagnostic, therapeutic and prognostic topics were formulated. A systematic (GERD) in infants and children (search until 2008), using the 2001 literature search was performed from October 1, 2008 (if the question was NASPGHAN guidelines as an outline (1). Recommendations were addressed -
Diet and Lifestyle Changes for Reducing Reflux And
HERE PLACE PLACE STAMP STAMP Diet and lifestyle changes for reducing reflux and LPR LPRD • Cut out caffeine and alcohol, especially Laryngopharyngeal Reflux Disease in the late evening and before bedtime as Chronic cough these allow reflux to occur more easily. Frequent throat clearing •Avoid carbonated drinks or acidic foods like juice, especially before bedtime. Excessive mucous in the throat •Eliminate fatty, fried, or spicy foods Intermittent hoarseness especially at the last meal of the day. Post nasal drip sensation •Stop eating at least 3 hours before Sensation of lump in throat going to bed or laying down. •Evaluate if you might have sleep apnea. Symptoms include loud snoring, Northwestern Medicine non-restful sleep, daytime fatigue. Department of Otolaryngology •Elevate the head of your bed by 4-6 Head and Neck Surgery 675 N. St. Clair Street, inches. Galter, Suite 15-200 •Lose weight if you are overweight. Chicago, IL, 60611 Tel: 312-695-8182 •If you smoke tobacco, quit! Smoking Fax: 312-695-7851 www.ent.nm.org worsens reflux and makes your larynx more sensitive to damage. What is LPR? How do I know if I have LPR? How is LPR treated? Laryngopharyngeal reflux (LPR), also called laryngopharyngeal reflux disease (LPRD), If you experience symptoms such as throat There are two main ways to treat LPR: extraesophogeal reflux, reflux laryngitis, and clearing, chronic hoarseness, difficulty medications and changes to your behavior. posterior laryngitis, is a common diagnosis swallowing, a feeling of a lump in the throat In very rare cases, surgery may be hypothesized to be caused by the backflow of stomach contents into the throat and back of your or a cough, for several weeks you might have recommended to help prevent acid reflux. -
Resident Manual of Trauma to the Face, Head, and Neck
Resident Manual of Trauma to the Face, Head, and Neck First Edition ©2012 All materials in this eBook are copyrighted by the American Academy of Otolaryngology—Head and Neck Surgery Foundation, 1650 Diagonal Road, Alexandria, VA 22314-2857, and are strictly prohibited to be used for any purpose without prior express written authorizations from the American Academy of Otolaryngology— Head and Neck Surgery Foundation. All rights reserved. For more information, visit our website at www.entnet.org. eBook Format: First Edition 2012. ISBN: 978-0-615-64912-2 Preface The surgical care of trauma to the face, head, and neck that is an integral part of the modern practice of otolaryngology–head and neck surgery has its origins in the early formation of the specialty over 100 years ago. Initially a combined specialty of eye, ear, nose, and throat (EENT), these early practitioners began to understand the inter-rela- tions between neurological, osseous, and vascular pathology due to traumatic injuries. It also was very helpful to be able to treat eye as well as facial and neck trauma at that time. Over the past century technological advances have revolutionized the diagnosis and treatment of trauma to the face, head, and neck—angio- graphy, operating microscope, sophisticated bone drills, endoscopy, safer anesthesia, engineered instrumentation, and reconstructive materials, to name a few. As a resident physician in this specialty, you are aided in the care of trauma patients by these advances, for which we owe a great deal to our colleagues who have preceded us. Additionally, it has only been in the last 30–40 years that the separation of ophthal- mology and otolaryngology has become complete, although there remains a strong tradition of clinical collegiality.