Halitosis associated volatile sulphur compound levels in patients with laryngopharyngeal reflux

Avınçsal, Mehmet Özgür; Altundağ, Aytuğ; Ulusoy, Seçkin; Dinç, Mehmet Emre; Dalğıç, Abdullah; Topak, Murat

doi:10.1007/s00405-016-3961-1

Cited by 16 publications

(14 citation statements)

References 20 publications

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“…66,78,82 The RFS does not take into consideration many LPR findings, including vocal fold erythema, leukoplakia, posterior pharyngeal wall inflammation, anterior pillars inflammation, and coated tongue. 3,79,80,83 Some LPR signs are described in Figure 3 . Second, the RFS allows a subjective evaluation of some signs without clear definition of the rating, which can be a factor explaining the low interreliability among judges.…”

Section: Discussionmentioning

confidence: 99%

Evaluation and Management of Laryngopharyngeal Reflux Disease: State of the Art Review

Lechien¹,

Akst

Hamdan

et al. 2019

Otolaryngol.--head neck surg.

279

401

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Objective To review the current literature about the epidemiology, clinical presentation, diagnosis, and treatment of laryngopharyngeal reflux (LPR). Data Sources PubMed, Cochrane Library, and Scopus. Methods A comprehensive review of the literature on LPR epidemiology, clinical presentation, diagnosis, and treatment was conducted. Using the PRISMA statement, 3 authors selected relevant publications to provide a critical analysis of the literature. Conclusions The important heterogeneity across studies in LPR diagnosis continues to make it difficult to summarize a single body of thought. Controversies persist concerning epidemiology, clinical presentation, diagnosis, and treatment. No recent epidemiologic study exists regarding prevalence and incidence with the use of objective diagnostic tools. There is no survey that evaluates the prevalence of symptoms and signs on a large number of patients with confirmed LPR. Regarding diagnosis, an increasing number of authors used multichannel intraluminal impedance–pH monitoring, although there is no consensus regarding standardization of the diagnostic criteria. The efficiency of proton pump inhibitor (PPI) therapy remains poorly demonstrated and misevaluated by incomplete clinical tools that do not take into consideration many symptoms and extralaryngeal findings. Despite the recent advances in knowledge about nonacid LPR, treatment protocols based on PPIs do not seem to have evolved. Implications for Practice The development of multichannel intraluminal impedance–pH monitoring and pepsin and bile salt detection should be considered for the establishment of a multiparameter diagnostic approach. LPR treatment should evolve to a more personalized regimen, including diet, PPIs, alginate, and magaldrate according to individual patient characteristics. Multicenter international studies with a standardized protocol could improve scientific knowledge about LPR.

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Section: Discussionmentioning

confidence: 99%

Evaluation and Management of Laryngopharyngeal Reflux Disease: State of the Art Review

Lechien¹,

Akst

Hamdan

et al. 2019

Otolaryngol.--head neck surg.

279

401

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“…According to 98% of our patients, the RSS completely assessed their complaints that could have been associated with LPR. The RSS has the advantage of including some common symptoms associated with LPR, such as odynophagia, 24 throat pain, 25 tongue burning, 26 nausea, 1 and halitosis, 27 which had been ignored in previous PRO questionnaires. 1 As demonstrated in the present study, the inclusion of these symptoms makes sense in regard to their prevalence in LPR patients and their related impact on QoL.…”

Section: Discussionmentioning

confidence: 99%

Validity and reliability of the reflux symptom score

Lechien¹,

Bobin²,

et al. 2019

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Objectives/Hypothesis To develop and validate the Reflux Symptom Score (RSS), a self‐administered patient‐reported outcome questionnaire for patients with laryngopharyngeal reflux (LPR). Study Design Prospective controlled study. Methods A total of 113 patients with LPR were enrolled and treated with diet and 3 months of pantoprazole, alginate, and/or magaldrate depending on the LPR characteristics (acid, nonacid, or mixed). Eighty asymptomatic individuals completed the study. Patients and controls completed the RSS twice within a 7‐day period to assess test‐retest reliability. Internal consistency was measured using Cronbach's α for the RSS items in patients and controls. Validity was assessed by comparing the baseline RSS with the Reflux Symptom Index (RSI) and Voice Handicap Index (VHI). Seventy‐seven patients completed the RSS at baseline and after 6 and 12 weeks of treatment to assess responsiveness to change. The RSS cutoff for determining the presence and absence of LPR was examined by receiver operating characteristic analysis. Results Test‐retest reliability (rs = 0.921) and internal consistency reliability (α = 0.969) were high. RSS exhibited high external validity indicated by a significant correlation with the RSI (rs = 0.831). Internal validity was excellent based on the higher RSS in patients compared with controls (P = .001). RSS, RSI, and VHI scores significantly improved from pre‐ to posttreatment, indicating a high responsiveness to change. RSS >13 can be considered suggestive of LPR‐related symptoms. RSS was not influenced by the occurrence of gastroesophageal reflux disease, LPR subtypes, or patient characteristics. Conclusions RSS is a self‐administered patient‐reported outcome questionnaire that demonstrates high reliability and excellent criterion‐based validity. RSS can be used in diagnosing and monitoring LPR disease. Level of Evidence 3b Laryngoscope, 130:E98–E107, 2020

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“…Using an industrial procedure to measure odor intensity (Lang, Farber, Beck, & Yerman, ), they found that VRSs are indeed produced in the oral cavity in halitosis, and they identified mainly VSCs, in particular methyl mercaptan (CH 3 SH) and hydrogen sulfide (H 2 S) (Tonzetich & Richter, ). Since then, dozens of scientific reports using state‐of‐the‐art technologies (chromatography, spectrometry, and different chemical gas sensors) have confirmed the presence of measurable exhaled VSCs and their potential as non‐invasive biomarkers for the diagnosis and monitoring of halitosis (Avincsal et al., ; Coli & Tonzetich, ; Koshimune et al., ; Rosenberg, Kulkarni, Bosy, & McCulloch, ; Van den Velde, Quirynen, van Hee, & van Steenberghe, a; Waler, ; Yaegaki & Sanada, b).…”

Section: Volatile Sulfuric Compounds: From Bad Smell To Potential Biomentioning

confidence: 99%

“…Indeed, studies have shown increased levels of volatile sulfuric compounds (VSCs), which have been measured in the oral cavity and exhaled breath of patients with halitosis. Linked to bacterial activity and produced by local microbial‐enzymatic breakdown of amino acids and other mechanisms, exhaled VSCs have been proposed as biomarkers for diagnosis and monitoring of halitosis (Avincsal et al., ; Aydin, Bollen, & Ozen, ; Kapoor et al., ; Laleman, Dadamio, De Geest, Dekeyser, & Quirynen, ).…”

Section: Introductionmentioning

confidence: 99%

Detection of halitosis in breath: Between the past, present, and future

2017

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To develop a new generation of diagnostics for halitosis, replacing the subjective organoleptic assessment, a series of exhaled breath analyzers has been developed and assessed. All three devices rely on the assessment of exhaled volatile sulfuric compounds (VSCs), which are mainly generated in and emitted from the oral cavity, contributing to the malodor. Portable, on-site and easy to use, these devices have potential for non-invasive diagnosis of halitosis. However, global assessment of exhaled VSCs alone has two main drawbacks: (i) the absence of VSCs does not rule out halitosis; (ii) non-sulfuric volatile compounds that could be biomarkers of systemic diseases, found in up to 15% of halitosis cases, are neglected. In this article, we review and discuss progress to date in the field of oral/exhaled volatile compounds as potential noninvasive diagnostics for halitosis. We will briefly describe the generation of these compounds both from local (oral) and distal (extra-oral) sources. In addition, we debate the different analytical approaches in use and discuss the potential value of bio-inspired artificially intelligent olfaction in diagnosing and classifying oral and systemic diseases by analyzing exhaled breath.

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Halitosis associated volatile sulphur compound levels in patients with laryngopharyngeal reflux

Cited by 16 publications

References 20 publications

Evaluation and Management of Laryngopharyngeal Reflux Disease: State of the Art Review

Evaluation and Management of Laryngopharyngeal Reflux Disease: State of the Art Review

Validity and reliability of the reflux symptom score

Detection of halitosis in breath: Between the past, present, and future

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