Gastro-esophageal reflux as an

Several forms of laryngeal dysfunction and pathology can beattributed to the effects of chronic gastric reflux through direct acidirritation, from a reflex alteration in voluntary muscle tone or referredsensation. It is widely accepted that contact ulcers and granulomata overthe arytenoid are associated with gastric reflux, but there have not beenwell-documented cases of laryngeal carcinoma that are reflux - related .Jacobe et al., 1991 Showed that reflux may be forceful enough to traversethe upper esophageal sphincter aided by a paradoxical relaxation of thissphincter particularly during sleep. This relaxation occurs independently ofswallowing, therefore, because the larynx is not elevated, the refluxate mayspill into the larynx.The two most accepted risk factors for the development of laryngealcancer are tobacco and alcohol use. Interestingly enough, both are alsomajor risk factors for the development of GERD. Tobacco decreases loweresophageal sphincter tone, delays gastric emptying, and stimulates gastricacid secretion. Alcohol also decreases lower esophageal sphincter tone,delays gastric emptying, and also impairs esophageal motility.