Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-26T08:38:11.909Z Has data issue: false hasContentIssue false
  • English
  • Français

Patterns of laryngopharyngeal and gastroesophageal reflux

Published online by Cambridge University Press:  22 May 2009

K Sato ,
H Umeno ,
S Chitose  and
T Nakashima
K Sato*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
H Umeno
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
S Chitose
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
T Nakashima
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
*
Address for correspondence: Dr Kiminori Sato, Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. Fax: 81 942 37 1200 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

Double-probe, 24-hour pH monitoring remains the ‘gold standard’ for the diagnosis of laryngopharyngeal reflux disease, even though there is no consensus on how to interpret the data collected.

Methods:

Tetra-probe, 24-hour pH monitoring was performed in 56 patients with suspected laryngopharyngeal reflux, in order to investigate patterns of laryngopharyngeal and gastroesophageal reflux.

Results:

The number of reflux episodes and the total and percentage time periods spent with pH < 4.0 were correlated with the distance of the probe from the lower oesophageal sphincter. The number of reflux episodes and the total and percentage time periods with pH < 4.0 were greater when patients were upright (i.e. during the daytime). There were few laryngopharyngeal reflux events recorded for pH levels of <4.0; however, there were a significant number of laryngopharyngeal reflux events recorded for pH levels of <5.0, a level capable of causing laryngopharyngeal reflux disease. When a pH level of <5.0 was used, the number, total time and percentage time of laryngopharyngeal reflux episodes was greater during the supine period (i.e. during sleeping) in a quarter of the cases, compared with results when a pH of <4.0 was used.

Conclusions:

It is valid to use a pH level of 5.0 as indicative of laryngopharyngeal reflux in the hypopharynx.

Keywords

Laryngopharyngeal Reflux DiseasepH MonitoringTetra-probe
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Supplement S31 , May 2009 , pp. 42 - 47
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the 85th Annual Meeting of the American Broncho-Esophagological Association, May 13–14 2005, Boca Raton, Florida, USA.

References

1Koufman, JA. Laryngopharyngeal reflux 2002: a new paradigm of airway disease. ENT J 2002;81(suppl 2):2–6Google ScholarPubMed
2Koufman, JA, Aviv, JE, Casiano, RR, Shaw, GY. Laryngopharyngeal reflux: position statement of the Committee on Speech, Voice, and Swallowing Disorders of the American Academy of Otolaryngology-Head and Neck Surgery. Otolaryngol Head Neck Surg 2002;127:32–5CrossRefGoogle Scholar
3Postma, GN. Ambulatory pH monitoring methodology. Ann Otol Rhinol Laryngol 2000;109(suppl 184):10–4CrossRefGoogle Scholar
4Postma, GN, Belafsky, PC, Aviv, JE, Koufman, JA. Laryngopharyngeal reflux testing. ENT J 2002;81(suppl 2):14–18Google ScholarPubMed
5Sato, K: Tetra-probe 24-hour monitoring for laryngopharyngeal reflux diseases. J Jpn Bronchoesophagol Soc 2004;55:9–15CrossRefGoogle Scholar
6Feussner, H, Petri, A, Walker, S, Bollschweiner, E, Siewert, JR. The modified AFP score: an attempt to make the results of anti-reflux surgery comparable. Br J Surg 1991;78:942–6CrossRefGoogle ScholarPubMed
7Smit, CF, Tan, J, Devriese, PP, Mathus-Vliegen, LMH, Brandsen, M, Schouwenburg, PF. Ambulatory pH measurements at the upper esophageal sphincter. Laryngoscope 1998;108:299–302CrossRefGoogle ScholarPubMed
8Koufman, JA. The otolaryngologic manifestation of gastroesophageal reflux disease. Laryngoscope 1991;10(suppl 53):1–78CrossRefGoogle Scholar
9Axford, SE, Sharp, N, Ross, PE, Pearson, JP, Dettmar, PW, Panetti, M et al. Cell biology of laryngeal epithelial defences in health and disease. Preliminary studies. Ann Otol Rhinol Laryngol 2001;110:1099–108CrossRefGoogle ScholarPubMed
10Dobhan, R, Castell, DO. Normal and abnormal proximal esophageal acid exposure. Results of ambulatory dual-probe pH monitoring. Am J Gastroenterol 1993;88:25–9Google ScholarPubMed