Finally, we consider that, although GERD may be responsible for some episodes of chronic laryngitis, GERD is not the disease that is most frequently associated with chronic laryngitis. For those patients who do not respond adequately to PPI treatment and for whom pH impedance analysis does not succeed in establishing an association, we must rule out other diseases before insisting on a diagnosis of GERD as the cause of the symptoms of chronic laryngitis. 1. Vakil N, van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophageal reflux disease. Am J Gastroenterol 2006; 101: 1900-1920. 2. Moore JM, Vaezi MF. Extraesophageal manifestations of gastroesophageal reflux disease: real or imagined? Current Opinion in Gastroenterology 2010; 26: 389-394. 3. Vaezi MF. Laryngeal Manifestations of Gastroesophageal Reflux Disease. Current Gastroenterology Reports 2008; 10: 271-277. 4. Hicks DM, Ours TM, Abelson TI et al. The prevalence of hypopharynx findings associated with gastroesophageal reflux in normal volunteers. J voice 2002; 16: 554-579. 5. Vaezi MF. The role of pH monitoring in extraesophageal gastroesophageal reflux disease. Aliment Pharmacol Ther 2006; 23Suppl 1: 40-49. 6. Joniau S, Bradshaw A, Esterman A, et al. Reflux laryngitis: a systematic review. Otolaryngol Head Neck Surg 2007; 136: 686-692. 7. Malhotra A, Freston JW, Aziz K. Use of pH  Impedance Testing to Evaluate Patients with Suspect Extraesophageal Manifestations of Gastroesophageal Reflux Disease. J Clin Gastroenterol 2008; 42: 271-278. 8. Belafsky PC, Postma GN, Koufman JA. Laryngopharyngeal reflux symptoms improve before changes in physical findings. Laryngoscope 2001; 111 6: 979-981. 9. Vaezi MF. Gastroesophageal reflux-related chronic laryngitis: con. Arch Otolaryngol Head Neck Surg 2010; 1369: 914-915. 10. Qadeer MA, Phillips CO, Lopez AR, Steward DL, Noordzij JP, Wo JM, Suurna M, Havas T, Howden CW, Vaezi MF. Proton pump inhibitor therapy for suspected GERD-related chronic laryngitis: a meta-analysis of randomized controlled trials. Am J Gastroenterol 2006; 10111: 2646-2654. 11. Vaezi MF, Richter JE, Stasney CR, Spiegel JR, Iannuzzi RA, Crawley JA, Hwang C, Sostek MB, Shaker R. Treatment of chronic posterior laryngitis with esomeprazole. Laryngoscope. 2006; 1162: 254-260. 12. Park W, Hicks DM, Khandwala F, Richter JE, Abelson TI, Milstein C, Vaezi MF. Laryngopharyngeal reflux: prospective cohort study evaluating optimal dose of proton-pump inhibitor therapy and pretherapy predictors of response. Laryngoscope 2005; 1157: 1230-1238.
Finalmente, consideramos que aunque la ERGE pudiera ser la responsable de algunos episodios de laringitis crónica, no es la enfermedad que está asociada con mayor frecuencia, y en aquellos pacientes en los que no se observa una respuesta adecuada al tratamiento con IBP y en quienes la pHmetría con impedancia es negativa para lograr establecer dicha asociación, estamos obligados a descartar otras patologías antes de insistir en la ERGE como asociada o causante de los síntomas de laringitis crónica.