James A. Koufman MD

During the past decade, techniques of diagnostic ambulatory 24-hour double-probe pH monitoring and laryngeal photography were both refined. As a consequence, patients with suspected laryngopharyngeal reflux disease could be more objectively evaluated. It now appears that reflux is often unassociated with "typical posterior laryngitis" (red arytenoids and piled-up interarytenoid mucosa), and that laryngeal edema, and not erythema, appears to be the most common finding. In addition granulomas, intracordal cysts, sulcus vocalic, fibroepithelial polyps, webs, Reinke's edema, leukoplakia, carcinoma, and subglottic stenosis are also commonly found in patients with laryngopharyngeal reflux disease. Presented are 50 laryngeal photographs of patients with pH-confirmed laryngopharyngeal reflux disease, as well as a discussion of the spectrum of the laryngeal findings and a system for grading Reinke's edema.