الفهرس 
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Abstract
Laryngopharyngeal reflux disease (LPRD) is becoming commonly diagnosed condition among pharyngeal and voice disorders and the diagnosis depend on full history and clinical examination followed by laryngeal endoscopy. Large percentage (87.5%) of GERD patients had laryngeal disorders. The main complaint was throat clearing and postnasal drip i.e. 100% each, while ventricular obliteration, erythema or hyperemia, vocal fold edema, diffuse laryngeal edema, and posterior commissure hypertrophy were the most obvious signs i.e. 100% each. There is a significant direct proportional relationship between severity of GERD and both, the RSI and RFS. PPI greatly improve the laryngeal disorders among GERD patients with high response rate (77.6%).By implantation of reflux symptoms index and reflux finding score in daily use, this decrease time consumption and expensive examinations for patients and help us in early diagnosis of LPRD and decrease serious complications as laryngeal granuloma, subglottic stenosis and laryngeal cancer. Longer follow up period is needed to evaluate the prolonged role of PPI in controlling laryngeal disorders. PPI adverse effects needed to be evaluated as we did not address this issue in our study. Larger prospective randomized studies are needed to confirm our results. The present study is a prospective clinical trial study aimed to evaluate the prevalence of laryngeal reflux in GERD cases, and to evaluate the effect of GERD treatment on these laryngeal disorders in adult confirmed GERD patients in one year and 8 months study from the start of February 2020 up to the end of October 2021. The study included 80 patients. The mean age of the studied participants was 37.56 ± 9.51 years and ranged from 18 up to 60 years, 38 (47.5%) were males and 42 (52.5%) were females.
Among 80 confirmed GERD cases, 70 (87.5%) were suffered from LPR. Based on RFS; ventricular obliteration, erythema or hyperemia, vocal fold edema, diffuse laryngeal edema, and posterior commissure hypertrophy were the most obvious signs i.e. 100% each. Subglottic edema in 61.2%, granuloma or granulation in 44.8%, and thick endolaryngeal mucus in 73.1%. Based on RSI; clearing throat, and post nasal drip were the most obvious signs i.e. 100% each. Coughing after eat or lying down in 98.5%, sensation of something sticking in throat in 97.0%, and heartburn, chest pain, indigestion or stomach acid coming up in 83.6%.By using RSI and RFS to assess the role of proton pump inhibitors (PPI) e,g omeprazole 40mg once daily 1hour before breakfast without any laryngeal treatment and follow up after 3 months, significant improvement in both symptoms and signs after 3 months of PPI therapy was clearly observed. But the resistance rate among our studied participants was reported to be 22.4%. Larger prospective studies are needed to confirm the role of PPI in controlling the laryngeal disorders associated with GERD disease, evaluate its long term side effects. There is a vital need for the implantation of RSI and RFS in daily use to decrease time consumption and expensive examinations for patients, and to help in early diagnosis of LPR with subsequent decrease in serious complications as laryngeal granuloma, subglottic stenosis and laryngeal cancer