RESUMO
Sjögren syndrome was chosen as a clinical model to study acinar salivary deficiencies in the development of laryngopharyngeal reflux (LPR). The objective of this prospective cohort study was to compare salivary epidermal growth factor (EGF) concentrations of patients with Sjögren syndrome with and without LPR and gastroesophageal reflux disease (GERD) with normal controls. LPR was diagnosed with positive scores on the Reflux Symptom Index and Reflux and Reflux Finding Score, corroborated by esophagogastroduodenoscopy and/or 24-hour pH-metry. Salivary EGF concentrations of both unstimulated and mechanically stimulated saliva were established using enzyme-linked immunosorbent assay, and the significance level was set at 95%. Twenty-one patients and 19 controls were studied. All patients had LPR and 60% also had GERD. The mean salivary EGF concentration of unstimulated and stimulated saliva in the control group was 1,751.37 pg/ml and 544.76 pg/ml, respectively. Unstimulated and stimulated salivary EGF concentrations in the study group were 2,534.65 pg/ml and 920.69 pg/ml, respectively. These differences were not statistically significant. Body mass index, presence of erosive esophagitis, or severity of hyposalivation did not significantly influence salivary EGF concentrations. LPR and GERD are highly prevalent in patients with Sjögren syndrome. Unlike previous studies in which significant EGF deficiencies were found in patients with reflux laryngitis and GERD, patients with Sjögren syndrome seem to have reflux caused by a decrease in clearance capacity and not in specific salivary components.
Assuntos
Fator de Crescimento Epidérmico , Refluxo Gastroesofágico/metabolismo , Saliva , Glândulas Salivares , Síndrome de Sjogren , Células Acinares/metabolismo , Adulto , Brasil , Estudos de Coortes , Endoscopia do Sistema Digestório/métodos , Ensaio de Imunoadsorção Enzimática/métodos , Fator de Crescimento Epidérmico/análise , Fator de Crescimento Epidérmico/metabolismo , Monitoramento do pH Esofágico/métodos , Feminino , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/etiologia , Humanos , Refluxo Laringofaríngeo/diagnóstico , Refluxo Laringofaríngeo/metabolismo , Refluxo Laringofaríngeo/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Saliva/química , Saliva/metabolismo , Glândulas Salivares/metabolismo , Glândulas Salivares/patologia , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/metabolismo , Síndrome de Sjogren/fisiopatologia , Estatística como Assunto , Avaliação de Sintomas/métodosRESUMO
UNLABELLED: Although suspension laryngoscopy is routinely used in laryngeal surgery, there are only few studies on the complications of this procedure. AIM: to evaluate the complications outside the larynx following suspension laryngoscopy and analyze their relation with surgery duration. MATERIALS AND METHODS: Thirty-seven procedures were prospectively analyzed for intervention-related complications. The study included patient preoperative and postoperative assessment, focusing on dental, mucosal and nerve status (hypoglossal and lingual nerves). RESULTS: Most procedures (27/37) were associated to some kind of complication, and mucosal injuries were the most common; temporary nerve lesions were observed in five cases and dental injuries in one case. Statistic significance was found between surgery duration and mucosal injury (lesions smaller than 1 centimeter), showing that longer procedure pose higher risks for these complications. CONCLUSION: These findings suggest that suspension laryngoscopy is frequently associated with complications outside the larynx. Although these injuries represent a low risk of significant morbidity, they can be avoided if more accurate techniques are used.