Extraesophageal reflux: the role in laryngeal disease

Extraesophageal reflux (EER) has assumed a prominent role in the differential diagnosis of many laryngeal and other extraesophageal disorders. A knowledge of the scope of the problem and the particular complexities involved the diagnosis of EER facilitates sound clinical judgment. A presumptive diagnosis of EER is based on a combination of historical information and laryngeal findings. The presumptive diagnosis can be confirmed with ambulatory pH monitoring using a hypopharyngeal probe or an empiric trial of proton pump inhibitors. Recent evidence supports the use of proton pump inhibitor therapy for a period of 3 to 6 months. The surgical treatment of EER is evolving and may be considered in selected patients.