Objectives To evaluate the different characteristics of oropharyngeal pH changes in patients with different laryngeal diseases. Methods A retrospective analysis was performed. The clinical data of 262 patients were summarized. The patients were divided into 4 groups. Group 1 included 123 patients with suspected laryngopharyngeal reflux disease (LPRD). Group 2 included 45 patients with vocal cord polyps. Group 3 included 40 patients with vocal cord leukoplakia. Group 4 included 54 patients with laryngeal carcinoma. Their reflux symptom indexes (RSIs), reflux finding scores (RFSs), and Dx-pH monitoring results were compared. Results In total, 235 patients had abnormal RSI/RFS, 90 patients had abnormal Ryan scores. The rate of abnormal RSI/RFS of Group 1 was significantly higher than that of Group 4 (P = .001). Significant differences of the rates of abnormal Ryan scores existed between Groups 2 and 4 (P = .021) and Groups 3 and 4 (P = .027). There were obvious differences in upright Ryan scores between Groups 1 and 2 (P = .013), Groups 1 and 3 (P = .002), Groups 2 and 4 (P = .046), and Groups 3 and 4 (P = .009). There were significant differences in time percentage of oropharyngeal pH of upright 5.5∼6.5 and supine 5.0∼6.5 between Groups 1 and 3 as well as Groups 1 and 4 (upright: Groups 1 and 3: P = .017; Groups 1 and 4: P = .019. Supine: Groups 1 and 3: P = .018; Groups 1 and 4: P = .023). Conclusions There were different oropharyngeal pH characteristics in patients with different laryngeal diseases, which indicated laryngopharyngeal reflux may play different roles in different diseases through various patterns. Patients with vocal cord polyps, vocal cord leukoplakia, and laryngeal carcinoma had more and different patterns of oropharyngeal pH change than patients with LPRD. Patients with vocal cord polyps and vocal cord leukoplakia had more severe acid oropharyngeal pH change episodes than patients with laryngeal carcinoma.
Objectives: To evaluate the characteristics of laryngopharyngeal reflux (LPR) in patients with different hypertrophic laryngeal diseases and to explore the relationship between LPR and these diseases. Methods: A retrospective analysis was performed. The clinical data of 154 patients were collected. According to their diagnoses, patients were divided into 3 groups. Group 1 included 49 patients with vocal cord polyps. Group 2 contained 52 patients with vocal cord leukoplakia. Group 3 included 53 patients with laryngeal carcinoma. The reflux symptom indexes (RSIs), reflux finding scores (RFSs), and Ryan scores of all patients were evaluated and compared. Results: Patients with vocal cord polyps were the youngest of the 3 groups, and those with laryngeal carcinoma were the oldest. A male preponderance emerged in each group. In total, 128 patients (83.12%) had positive RSI/RFS values and 60 (60/146, 41.1%) patients had positive Ryan scores. The positive RSI/RFS rates of both groups 1 and 2 (89.80% and 92.16%, respectively) were significantly higher than that of group 3 (69.81%). Moreover, the positive Ryan score rates in both groups 1 and 2 (39.58% and 53.85%, respectively) were significantly higher than that of group 3 (28.26%). Conclusions: Laryngopharyngeal reflux occurs in many patients with vocal cord polyps, vocal cord leukoplakia, and vocal cord carcinoma, indicating that LPR may be important in the pathogenesis of these diseases. Laryngopharyngeal reflux occurs more common in patients with vocal cord polyps and leukoplakia and less common in those with laryngeal carcinoma, suggesting the role of LPR on these diseases may be different.
ObjectiveThis study analyzed the differences in the cerebral blood flow (CBF) between unilateral Sudden Sensorineural Hearing Loss (SSNHL) patients and healthy controls (HCs). We also investigated CBF differences in auditory-related areas in patients with left- and right-sided SSNHL (lSSNHL and rSSNHL) and HCs. We further explore the correlation between unilateral SSNHL characteristics and changes in the CBF.Methods36 patients with unilateral SSNHL (15 males and 21 females, 40.39 ± 13.42 years) and 36 HCs (15 males and 21 females, 40.39 ± 14.11 years) were recruited. CBF images were collected and analyzed using arterial spin labeling (ASL). CereFlow software was used for the post-processing of the ASL data to obtain the CBF value of 246 subregions within brainnetome atlas (BNA). The Two-sample t-test was used to compare CBF differences between SSNHL patients and HCs. One-way ANOVA or Kruskal-Wallis test was used to compare the CBF difference of auditory-related areas among the three groups (lSSNHL, rSSNHL, and HCs). Then, the correlation between CBF changes and specific clinical characteristics were calculated.ResultsThe SSNHL patients exhibited decreased CBF in the bilateral middle frontal gyrus (MFG, MFG_7_1 and MFG_7_3), the contralateral precentral gyrus (PrG, PrG_6_3) and the bilateral superior parietal lobule (SPL, bilateral SPL_5_1, SPL_5_2, and ipsilateral SPL_5_4), p < 0.0002. Compared with HCs, unilateral SSNHL patients exhibited increased rCBF in the bilateral orbital gyrus (OrG, OrG_6_5), the bilateral inferior temporal gyrus (ITG, contralateral ITG_7_1 and bilateral ITG_7_7), p < 0.0002. lSSNHL showed abnormal CBF in left BA21 caudal (p = 0.02) and left BA37 dorsolateral (p = 0.047). We found that the CBF in ipsilateral MFG_7_1 of SSNHL patients was positively correlated with tinnitus Visual Analog Scale (VAS) score (r = 0.485, p = 0.008).ConclusionOur preliminary study explored CBF pattern changes in unilateral SSNHL patients in auditory-related areas and non-auditory areas, suggesting that there may exist reduced attention and some sensory compensation in patients with SSNHL. These findings could advance our understanding of the potential pathophysiology of unilateral SSNHL.
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