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A 59-year-old man (with a 40-year-long history of smoking) and a 53-year-old woman were referred because of reflux symptoms, such as heartburn and regurgitation, associated with dysphonia, chronic throat clearing and globus pharyngeus. The man had undergone Billroth II gastrectomy 29 years previously, while the woman had a history of cholecystectomy 32 years previously. Their symptoms prompted us to perform a preliminary evaluation of the larynx in both patients during a magnifying upper gastrointestinal endoscopy (using a Fuji EG-485ZH video endoscope). After local surface anesthesia with 0.4 % benoxinate hydrochloride, and before introduction of the scope into the esophagus, careful inspection of the larynx with the video endoscope revealed vocal cord leukoplakia and signs of chronic laryngitis in both patients (Figure 1 and 2). Furthermore, in both patients, upper gastrointestinal endoscopy revealed signs of esophagitis, hiatus hernia, and a large amount of bile in the stomach. Subsequently, the ear, nose, and throat (ENT) specialist confirmed our preliminary laryngeal findings. After vocal cord decortications, histological examination revealed moderat e epithelial dysplasia on the vocal cords in both patients. They were therefore treated with prokinetic and acid-suppressive drugs, and a ENT follow-up program was

Preliminary Laryngeal Examination During Magnifying Upper Gastrointestinal Video Endoscopy in Two Patients with Reflux Symptoms