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Gastroesophageal reflux disease (GERD) has several well-recognized complications, one of which relates to laryngeal injury. Laryngopharyngeal reflux (LPR) has a spectrum of clinical signs (vocal cord ulcers, polyps or granulomas, subglottic stenosis) and symptoms (hoarseness, cough, voice changes), all of which are attributed to exposure of the larynx to gastric refluxate. Acid is the major agent of injury, but the roles of pepsin and bile acid have not been studied extensively.
Investigators in Korea conducted two sequential experiments using anesthetized rabbits with posterior subglottic wounds. In the first experiment, to simulate reflux exposure, the wounded areas were suffused with acid (pH, 2.0), nonacid (pH, 6.0), or saline. Porcine p…