Laryngopharyngeal Reflux With Sore Throat: An Ultrastructural Study of Oropharyngeal Epithelium

Objectives: We performed an electron microscopic ultrastructural study of oropharyngeal epithelium in patients with laryngopharyngeal reflux (LPR) and sore throat to evaluate whether dilatation of intercellular spaces could be traced at this level. Methods: The study included 20 patients with LPR and sore throat and 5 control subjects. The patients were subjected to upper gastrointestinal tract endoscopy and flexible pharyngolaryngoscopy. Oropharyngeal biopsy specimens were taken from the patients and controls for ultrastructural Study by transmission electron microscopy. Results: The entire group of patients with LPR showed dilatation of intercellular spaces essentially at the squamous basal and suprabasal levels in their oropharyngeal biopsy specimens, whereas none of the control subjects showed such a morphological marker. Conclusions: Dilatation of intercellular spaces as a morphological marker can be traced in patients with LPR and sore throat at the level of the oropharynx. This contributes to a better understanding of the pathophysiology of LPR. If this finding is confirmed in a large series, it will represent a cost-effective, relatively noninvasive method for diagnosis of LPR.