Relationship between history, laryngoscopy and esophagogastroduodenoscopy for diagnosis of laryngopharyngeal reflux in patients with typical GERD

Vardar, Rukiye; Varis, Ahmet; Bayrakçi, Berna; Akyıldız, Serdar; Kirazlı, Tayfun; Bor, Serhat

doi:10.1007/s00405-011-1748-y

Cited by 32 publications

(28 citation statements)

References 20 publications

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“…These results stand in contrast to the study by Jin et al, which showed a significant positive correlation between Jitt and RSI [20]. Other previous studies did not report a correlation between signs and symptoms in LPR patients [42]. However, we found significant correlations between the grade of dysphonia, breathiness, asthenia, instability and the values of Jitt, RAP, Shim, and APQ.…”

Section: Discussioncontrasting

confidence: 99%

Impact of laryngopharyngeal reflux on subjective and objective voice assessments: A prospective study

Lechien

Huet

Khalifé

et al. 2016

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundLaryngopharyngeal reflux is a prevalent, not well-understood disease affecting a high proportion of patients who seek laryngology consultation. The objective of this prospective case series is to explore the subjective and objective voice modifications in Laryngopharyngeal reflux (LPR), especially the usefulness of acoustic parameters as treatment outcomes, and to better understand the pathophysiological mechanisms underlying the development of voice disorder.MethodsForty-one patients with a reflux finding score (RFS) > 7 and a reflux symptom index (RSI) > 13 were enrolled and treated with pantoprazole 20 mg twice daily for three months. RSI, RFS, Voice Handicap Index (VHI), and Grade, Roughness, Breathiness, Asthenia, Strain and Instability (GRBASI) were assessed at baseline and after three months post-therapy. Acoustic parameters were measured by selecting the most stable interval of the vowel /a/. A study of correlations between acoustic measurements and laryngoscopic signs was conducted in patients with roughness. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS).ResultsSignificant improvement in RSI, RFS, VHI, jitter, percent jitter, relative average perturbation (RAP), shimmer, percent shimmer, and amplitude perturbation quotient (APQ) was found at 3 months of treatment (p < .05). A correlation analysis revealed significant correlations between the grade of dysphonia, breathiness, asthenia, instability and jitter, percent jitter, RAP, shimmer, percent shimmer and APQ. In dividing our cohort into two groups of patients according to the presence of roughness, shimmer, percent shimmer and APQ significantly improved in patients with roughness, but no positive correlation was found between acoustic parameters and laryngoscopic signs.ConclusionAcoustic parameters can help to better understand voice disorders in LPR and can be used as treatment outcomes in patients with roughness.

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Section: Discussioncontrasting

confidence: 99%

Impact of laryngopharyngeal reflux on subjective and objective voice assessments: A prospective study

Lechien

Huet

Khalifé

et al. 2016

Journal of Otolaryngology - Head & Neck Surgery

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“…GERD affects approximately 20% to 40% of the U.S. population, and a significant proportion of these patients (up to 70%) also have LPR . The pathophysiology of GERD and LPR is multifactorial, including esophageal sphincter dysfunction, exposure time of reflux, and tissue sensitivity.…”

Section: Introductionmentioning

confidence: 99%

Relationship between reflux and laryngeal cancer

et al. 2013

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Gastroesophageal reflux disease (GERD), or its variation known as laryngopharyngeal reflux (LPR), has been recognized as a potential cause of several laryngeal disorders. Patients with laryngeal cancer have lifestyle risk factors, especially tobacco and alcohol consumption, that play an etiological role in the development of their cancer but also places them at risk for reflux. The question then arises whether there is merely an association or a causal relationship between laryngeal cancer and reflux. However, despite a number of studies, a causal relationship with laryngeal cancer is uncertain. In this article, we address the current literature in a critical manner to evaluate the relationship between reflux and laryngeal cancer. From the review of the literature, we conclude that there is insufficient evidence to support a causal role of reflux in laryngeal cancer, mainly because of the confounding effect of tobacco and alcohol consumption and the inaccuracies in the diagnosis of reflux.

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“…Additionally, the prevalence of GERD is 68% in patients with hiatal hernia[24,25]. Recent studies have shown that LPR is found in 70% of patients with GERD, 53% patients with GERD and LPR have hiatal hernia, and approximately 50% of patients with GERD and hernia have common symptoms of LPR[4,26]. In our study, we found that 67.7%-74.2% of patients with LPR and type I hiatal hernia had typical GERD symptoms, similar to a pervious study[26].…”

Section: Discussionmentioning

confidence: 99%

“…The reflux finding score, which is based on laryngoscopic findings, also has poor reliability in detecting LPR[8,9]. Recent evidence has suggested no relationship between clinical findings of LPR, laryngoscopy, and the reflux finding score[26]. Monitoring of pH can directly detect increased esophageal or laryngopharyngeal acid exposure by a pH probe, and is thus regarded as the best evidence for diagnosis of LPR.…”

Section: Discussionmentioning

confidence: 99%

Nissen fundoplicationvsproton pump inhibitors for laryngopharyngeal reflux based on pH-monitoring and symptom-scale

Zhang¹,

Hu²,

Chen³

et al. 2017

WJG

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AIMTo compare the outcomes between laparoscopic Nissen fundoplication (LNF) and proton pump inhibitors (PPIs) therapy in patients with laryngopharyngeal reflux (LPR) and type I hiatal hernia diagnosed by oropharyngeal pH-monitoring and symptom-scale assessment.METHODSFrom February 2014 to January 2015, 70 patients who were diagnosed with LPR and type I hiatal hernia and referred for symptomatic assessment, oropharyngeal pH-monitoring, manometry, and gastrointestinal endoscopy were enrolled in this study. All of the patients met the inclusion criteria. All of the patients underwent LNF or PPIs administration, and completed a 2-year follow-up. Patients’ baseline characteristics and primary outcome measures, including comprehensive and single symptoms of LPR, PPIs independence, and satisfaction, and postoperative complications were assessed. The outcomes of LNF and PPIs therapy were analyzed and compared.RESULTSThere were 31 patients in the LNF group and 39 patients in the PPI group. Fifty-three patients (25 in the LNF group and 28 in the PPI group) completed reviews and follow-up. Oropharyngeal pH-monitoring parameters were all abnormal with high acid exposure, a large amount of reflux, and a high Ryan score, associated reflux symptom index (RSI) score. There was a significant improvement in the RSI and LPR symptom scores after the 2-year follow-up in both groups (P < 0.05), as well as typical symptoms of gastroesophageal reflux disease. Improvement in the RSI (P < 0.005) and symptom scores of cough (P = 0.032), mucus (P = 0.011), and throat clearing (P = 0.022) was significantly superior in the LNF group to that in the PPI group. After LNF and PPIs therapy, 13 and 53 patients achieved independence from PPIs therapy (LNF: 44.0% vs PPI: 7.14%, P < 0.001) during follow-up, respectively. Patients in the LNF group were more satisfied with their quality of life than those in the PPI group (LNF: 62.49 ± 28.68 vs PPI: 44.36 ± 32.77, P = 0.004). Body mass index was significantly lower in the LNF group than in the PPI group (LNF: 22.2 ± 3.1 kg/m2 vs PPI: 25.1 ± 2.9 kg/m2, P = 0.001).CONCLUSIONDiagnosis of LPR should be assessed with oropharyngeal pH-monitoring, manometry, and the symptom-scale. LNF achieves better improvement than PPIs for LPR with type I hiatal hernia.

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Relationship between history, laryngoscopy and esophagogastroduodenoscopy for diagnosis of laryngopharyngeal reflux in patients with typical GERD

Cited by 32 publications

References 20 publications

Impact of laryngopharyngeal reflux on subjective and objective voice assessments: A prospective study

Impact of laryngopharyngeal reflux on subjective and objective voice assessments: A prospective study

Relationship between reflux and laryngeal cancer

Nissen fundoplicationvsproton pump inhibitors for laryngopharyngeal reflux based on pH-monitoring and symptom-scale

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