Oropharyngeale pH-Metrie

Jungheim, M.; Ptok, M.

doi:10.1007/s00106-011-2329-5

HNO

2011

DOI: 10.1007/s00106-011-2329-5

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Oropharyngeale pH-Metrie

M. Jungheim

M. Ptok

Abstract: Überblick und Darstellung einer neuen pH-MetriemethodeÜbersichten Patienten, die einen Hals-Nasen-Ohrenarzt oder Phoniater aufsuchen, klagen häufig über Heiserkeit, Räus-perzwang und Verschleimungsgefühl im Larynxbereich oder über Schluckbeschwerden. Nach Ausschluss anderer organischer Ursachen sollte der behandelnde Arzt auch an eine extraösophageale Refluxerkrankung denken.

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Cited by 5 publications

(1 citation statement)

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“…GER often occurs at night and has classic reflux symptoms such as heartburn, acid regurgitation and retrosternal pain.In contrast, LPR occurs mostly during daytime and causes non-specific symptoms such as hoarseness, globus sensation, chronic throat clearing and increased mucus. 3 Nevertheless, GER and LPR can occur simultaneously and cause similar symptoms. 4 A correlation between various clinical pictures and GER has already been established.…”

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confidence: 99%

A novel scoring system for evaluating laryngopharyngeal reflux

Horvath

Hagmann

Burri

et al. 2021

Clinical Otolaryngology

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Risk factors for the development of reflux disease include increased gastric acid production, prolonged gastric emptying, restricted oesophageal clearance, reduced saliva secretion, increased intraabdominal pressure and sphincter insufficiency. Above all, acid, pepsin, bile salts and other gastroduodenal proteins cause mucosal irritation. Particularly, the combination of acid and pepsin tends to lead to mucosal damage, whereas the laryngopharyngeal mucosa is much more sensitive than the oesophageal mucosa due to a lack of defence mechanisms. 1,2 Gastro-oesophageal reflux (GER) and laryngopharyngeal reflux (LPR) are two different clinical entities, and a fundamental distinction needs to be made. GER often occurs at night and has classic reflux symptoms such as heartburn, acid regurgitation and retrosternal pain.In contrast, LPR occurs mostly during daytime and causes non-specific symptoms such as hoarseness, globus sensation, chronic throat clearing and increased mucus. 3 Nevertheless, GER and LPR can occur simultaneously and cause similar symptoms. 4 A correlation between various clinical pictures and GER has already been established. 5 These include reflux oesophagitis, oesophageal strictures, Barrett oesophagus and Barrett carcinoma. However, data for LPR are less clear.Various medical conditions seen on a daily basis such as chronic laryngopharyngitis, chronic sinusitis, bronchial asthma, pulmonary fibrosis and recurrent otitis media are associated with LPR. 6 Today, oesophago-gastro-duodenoscopy and impedance pH monitoring are the gold standard to assess GER. 5 In contrast, LPR is often diagnosed by clinical signs and symptoms and/or a trial of proton pump inhibitor (PPI) therapy. A few validated methods already exist to detect and quantify LPR, namely the reflux symptom index (RSI), the reflux finding score (RFS) and oropharyngeal pH monitoring (PHM). The latter was first described in 2009 and has been validated by various research groups. [7][8][9] Meanwhile, its reliability and reproducibility was proven to be high for extraoesophageal reflux assessment. [10][11][12]

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mentioning

confidence: 99%

A novel scoring system for evaluating laryngopharyngeal reflux

Horvath

Hagmann

Burri

et al. 2021

Clinical Otolaryngology

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Laryngopharyngealer Reflux und kehlkopfassoziierte Beschwerden

Ptok

2012

HNO

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It can be assumed that refluxate reaching the larynx can damage it. Due to the fact that the symptoms possibly related to LPR can, however, be linked to other causes, a careful consideration of the patient's medical history is of the utmost importance, followed by mandatory laryngoscopy. Diagnostic procedures, such as the trial administration of proton pump inhibitors (PPI) or long-term pH measurement should be used selectively. Depending on the individual symptoms, breathing or voice therapy and/or PPI therapy might be useful. Lifestyle changes including dietary measures should also be contemplated.

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Beziehung zwischen Funktionsendoskopie und Impedanz-pH-Metrie

Michel

Stroh

Fritsche

et al. 2017

HNO

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Classic gastroenterological diagnostic tools are proving increasingly insufficient for analyzing the complex causal relationship between extra-esophageal symptoms and presumed pathological reflux activity. Some new methodological approaches, such as functional endoscopy (videopanendoscopy, VPE), are considered to be helpful. However, there are currently no data objectively verifying the usefulness of this method. In a pilot study, a good correlation between the reflux symptom index (RSI) and endoscopic findings was shown. Impedance-pH measurement is considered to be the "gold standard" in esophageal reflux disease diagnostics. Therefore, the relationship between endoscopic findings and the results of impedance-pH monitoring are now studied in patients with extra-esophageal reflux symptoms. The investigation demonstrates that the pathological findings of VPE correlate well with impedance-pH measurements in terms of the parameters "number of reflux episodes", "fraction time", and "DeMeester score".

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Oropharyngeale pH-Metrie

Cited by 5 publications

References 42 publications

A novel scoring system for evaluating laryngopharyngeal reflux

A novel scoring system for evaluating laryngopharyngeal reflux

Laryngopharyngealer Reflux und kehlkopfassoziierte Beschwerden

Beziehung zwischen Funktionsendoskopie und Impedanz-pH-Metrie

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