Læknablaðið : fylgirit - 01.06.2005, Blaðsíða 11

ABSTRACTS / XXIX CONGRESS OF THE NORDIC ASSOCIATION OF OTOLARYNGOLOGY
ABSTRACTS
Opening Ceremony
Abstract no.: 001
History of Scandinavian Ear, Nose and Throat praxis
Tomas Gejrot, Sweden
Abstract missing
S-l THE RETURN OF THE PICKLED ONION
Abstract no.: 002
Laryngopharyngeal reflux (LPR): a new paradigm of airway
disease
Jamie Koufman, MD, FACS, Director, Center for Voice and Swallowing
Disorders of Wake Forest University and Professor of Surgery
(Otolaryngology), Wake Forest University Health Sciences, Medical
Center Boulevard, Winston-Salem, NC 27157-1034, Tel (336) 716-3876 or
716-8877, jkoufman@wfubmc.edu; www.lhevoiceceiuer.com
LPR is ubiquitous. A prospective study of 113 patients with laryn-
geal disorders found that 50% had pH-documented LPR; and, in
a community-based cohort of 'asymptomatic normals' (N = 100,
mean age 60 years), 35% of the subjects reported one or more
LPR symptoms, and on examination, 64% had one or more LPR
findings. If one combines all of the clinical and normative data, it
would be easy to conclude that as many as one-third or more of
the American population over age 40 years has LPR.
What is the new paradigm of airway disease? In the coming
years, research will show that reflux dominates the internal envi-
ronment, and thus influences all airway diseases (but obviously,
not all airway diseases in all patients). Peptic injury is associated
with many important inflammatory and neoplastic conditions; see
the table below. Furthermore, research is beginning to show that
pepsin is an inflammatory catalyst for most aerodigestive cancers,
including cancers of the laryngopharynx, esophagus, and lung.
Based upon the available data, it is reasonable to postulate that
one can get cancer of the aerodigestive tract without tobacco, but
not without reflux.
References
Koufman JA. The Otolaryngologic manifestations of gastroesophageal reflux
disease (GERD): A clinical investigation of 225 patients using ambulatory 24-
hour pH monitoring and an experimental investigation of the role of acid and
pepsin in the development of laryngeal injury. Laryngoscope 1991; 101 (Suppl.
53): 1-78.
Koufman JA, Amin M, Panetti M. Prevalence of reflux in 113 consecutive
patients with laryngeal and voice disorders. Otolaryngol Head Neck Surg 2000;
123:385-8.
Reulbach TR. Belafsky PC, Blalock PD. Koufman JA, Postma GN. Occult
laryngeal pathology in a community-based cohort. Otolaryngol Head Neck Surg
2001; 124: 448-50.
Belafsky PC, Postma GN, Koufman KA. Laryngopharyngeal reflux symptoms
improve before changes in physical findings. Laryngoscope 2001; 111:979-81.
Tasker A, Dettmar PW, Panetti M. Koufman JA, Birchall JP, Pearson JP. Reflux
of gastric juice and glue ear in children. Lancet 2002; 359:493.
Koufman JA. Laryngopharyngeal reflux 2002: A new paradigm of airway dis-
ease. Ear. Nose Throat J 2002; (Supplement 2) 81:2-6.
Table I. Clinical Manifestations Reported to Be Related to LPR.
Laryngeal
Subglottic and tracheal stenosis
Carcinoma of the larynx
Endotracheal intubation injury
Contact ulcers and granulomas
Posterior glottic stenosis
Paroxysmal laryngospasm
Paradoxical vocal fold movement
Vocal nodules
Polypoid degeneration
Laryngomalacia
Recurrent respiratory papillomas
Pachydermia laryngis
Recurrent leukoplakia
Pharyngeal
Globus pharyngeus
Chronic sore throat
Dysphagia
Zenker's diverticulum
Pulmonary
Asthma
Bronchiectasis
Chronic cough
Aspiration pneumonia
Chronic obstructive pulmonary disease
Miscellaneous
Sudden infant death syndrome
Chronic rhinitis and Sinusitis
Otitis media in children
Obstructive sleep apnea
Dental erosions
Johnston N, Bulmer D, Gill GA, Panetti M, Ross PE, Pearson JP, et al. Cell
biology of laryngeal epithelial defenses in health and disease (Part II). Ann Otol
Rhinoí Laryngol 2003; 112:481-91.
Johnston N, Knight J, Dettmar P, Lively M, Koufman JA. Pepsin and carbonic
anhydrase isoenzyme III as diagnostic merkers for laryngopharyngeal reflux
disease. Laryngoscope 2004; 114:2129-34.
S-ll NOSE AND ITS SURROUNDING CHAMBERS
Abstract no.: 003
The concept of Minimal Invasive Sinus Surgery
Reuben Setliff, USA
This presentation will address the concepts of Minimally Invasive
Sinus Surgery as presented by its original proponent, Dr. Reuben
Setliff. Dr. Setliff enjoys some notoriety in the field of sinus
surgery, being the first to use powered instrumentation as well as
the author of the first article in the medical literature addressing
minimally invasive sinus surgery. He will address, by lecture and
video demonstrations, the problem of sinus disease in children
and adults, endoscopic surgical anatomy, a fail-safe approach to
visualization of the maxillary and frontal sinus entries into the
nasal cavity as well as the importance of mucosal preservation
in minimizing the burden of postoperative care for both patient
and surgeon. Included in the presentation will be the treatment
of long-term refractory chronic sinusitis and a modification of his
anatomical surgical model for sinus surgery which he has consis-
tently used in more than 5000 operative cases, thus far without
a major complication. Issues relating to minimizing the risks of
endoscopic sinus surgery will also be addressed.
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