Abstract: The purpose of this current study is to investigate the role of gastroesophageal reflux disease
(GERD) as a risk factor for Minimal Associated Pathological Lesions (MAPLs) of the vocal folds with
associated symptoms and laryngeal findings, and to assess the prevalence of GERD in these patients.
This study included one hundred and fourteen patients with MAPLs and associated symptoms who
have met the inclusion criteria. The patients were 72 (63%) males and 42 (37%) females with age
ranged from 19 to 72 years. All the patients were assessed according to a protocol including auditory
perceptual analysis (APA), E.N.T examination, vocal fold augmentation and documentation via video
stroboscopic system, acoustic analysis of patient's voice, and finally esophagogastroduodenoscopy
(EGD) and lower esophageal biopsies were taken for histopathological evaluation. Results revealed
that the MAPLs of the vocal folds and associated laryngeal findings were significantly higher in
GERD compared with non-GERD patients (P<0.05) except for vocal folds polyps, vocal folds nodules
and chronic laryngitis (P>0.05). In conclusion, the prevalence of GERD in patients with MAPLs is
high, and GERD may manifest atypically as ENT symptoms without symptoms of heartburn and
regurgitation.