Association between Laryngopharyngeal Reflux and Vocal Fold Leukoplakia

Abstract

<b><i>Introduction:</i></b> Vocal fold leukoplakia (VFL) has a risk of malignant transformation, and the underlying mechanisms are currently unrecognized. Some clinical evidence has indicated that laryngopharyngeal reflux (LPR) probably plays a critical role. <b><i>Objective:</i></b> To explore the risk factors associated with the occurrence of VFL and to investigate the importance of LPR in VFL and its different pathological types using 24-h multichannel intraluminal impedance-pH monitoring. <b><i>Materials and Methods:</i></b> Eighty-one patients with VFL and 27 healthy volunteers were recruited. General information and LPR parameters were analyzed. <b><i>Results:</i></b> The monitoring showed that 35.8% (29/81) of patients had acidic LPR and that 43.2% (35/81) had weakly acidic LPR. Heavy drinking (odds ratio = 4.004, <i>p</i> = 0.037) and acidic LPR (odds ratio = 4.471, <i>p</i> = 0.029) were independent risk factors for the occurrence of VFL. Acidic LPR showed a strong correlation with the Reflux Finding Score (<i>p</i> &#x3c; 0.05) in patients suspected of having LPR based on the scale score. Meanwhile, weakly acidic LPR parameters increased with the severity of pathological degrees which were higher in high-grade dysplasia (<i>p</i> &#x3c; 0.05). <b><i>Conclusion:</i></b> Our study confirms the importance of LPR in VFL. Heavy drinking patients with VFL, particularly those with acidic LPR, should undergo intensive treatment. Meanwhile, weakly acidic LPR may play a critical role in the pathological changes in VFL.