Dr. Abdel-Hakim Fouad Elwany :: Publications:

Background: There are several possible causes of vocal fold polyps in adults. The mechanical damage is the main cause for polyp formation. Laryngopharyngeal reflux and human papilloma virus are possible co-factors. Objective: The aim of this study was to find out the associated roles of laryngopharyngeal reflux and human papilloma virus in the development of adult vocal fold polyps. Patients and Methods: This cross-sectional observational study included 50 adult patients presented with vocal fold polyps. Patients were preoperatively assessed for the presence of laryngopharyngeal reflux using the validated nine-item reflux symptom index and eight-item reflux finding score. All patients were subjected to excision of the laryngeal polyp by microlaryngoscopic surgery. The excised samples were sent for human papilloma virus (HPV) detection by PCR. Results: Laryngopharyngeal reflux (LPR) was presented in 34 patients (68%). Reflux symptom index ranged from 6 to 25 (mean 13.06 ± 4.95). Reflux finding score ranged from 3 to 18 (mean 10.08 ± 4.32). Seventeen patients (34%) had positive HPV-6. Fifteen patients had positive HPV-6 out of 34 patients diagnosed with LPR (44.11%), compared to only two patients had positive HPV-6 among 16 patients without LPR (12.5%) (P = 0.027). There were significant relations between presence of HPV-6 and both reflux symptom index and reflux finding score; both were significantly higher among patients with positive HPV-6 (P = 0.028) and (P < 0.001) respectively. Conclusion: Both laryngopharyngeal reflux and human papilloma virus play important associated roles in the development of vocal fold polyps in adults.