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J Korean Soc Laryngol Phoniatr Logop > Volume 28(1); 2017 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2017;28(1): 43-47.
doi: https://doi.org/10.22469/jkslp.2017.28.1.43
인후두 역류질환으로 오인된 식도 이완불능증 1예
노승호, 이용우, 박진수, 이상혁
성균관대학교 의과대학 강북삼성병원 이비인후과학교실
A Case of Esophageal Achalasia Misconceived as Laryngopharyngeal Reflux Disease
Seung Ho Noh, Yong Woo Lee, Jin Su Park, Sang Hyuk Lee
Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence  Sang Hyuk Lee ,Tel: (02) 2001-2269, Fax: (02) 2001-2273, Email: entlsh@hanmail.net
Received: 5 January 2017; Revised: February 2, 2017   Accepted: 12 March 2017.  Published online: 30 June 2017.
ABSTRACT
Laryngopharyngeal reflux disease (LPRD) is common in laryngologic practice. In Korea, up to 1 out of every 5 patients who visit otorhinolaryngology clinic is supposed to have LPRD with symptoms and physical findings. Major symptoms of LPRD include hoarseness, cough, reflux symptom and mild dysphagia. Even though LPRD is common, its diagnosis may be difficult, because its symptoms are nonspecific and the laryngeal findings are not always associated with symptom severity. In Recent study, 66.4% of Patient who has LPRD also associated with esophageal motility disorders. Esophageal achalasia is a disease of unknown etiology characterized by an absence of peristalsis in the body of esophagus and nonrelaxing hypertension of the lower esophageal sphincter. Common cause is loss of ganglion cells in Auerbachs plexus. The classic triad of symptoms in achalasia includes dysphagia, regurgitation and weight loss. LPRD and esophageal achalasia have similar symptoms but have different treatment of choice. The Differentiation diagnosis of theses disease is important and should be established by history, radiologic examination and endoscopic examination. We recently assessed a 59-year-old female patient who complained of an epigastric pain, dysphagia and chronic cough. LPRD was initially diagnosed on Laryngoscopic examination and Reflux Symptom Index, but patient was not relieved of any symptoms after treatment of Proton Pump Inhibitor for 3 months. After high resolution manometry, esophageal achalasia was finally diagnosed. We report this case regarding the diagnosis and treatment with review of literatures because we have to think about esophageal motility disorders as a differential diagnosis in laryngology.
KEY WORDS: Esophageal achalasiaLaryngopharyngeal reflux diseaseHigh resolution manometryEsophagus Diagnosis
중심 단어: 식도 이완불능증인후두 역류질환고해상도 식 도 내압검사식도진단
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