The Value of Routine pH Monitoring in the Diagnosis and Treatment of Laryngopharyngeal Reflux

Friedman, Michael; Hamilton, Craig S.; Samuelson, Christian G.; Kelley, Kanwar; Taylor, Renwick; Darling, R. Clement; Taylor, David; Fisher, Michelle; Maley, Alexander

doi:10.1177/0194599812436952

Cited by 42 publications

(45 citation statements)

References 23 publications

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“…Thus, the diagnosis of LPR is mainly a diagnosis of exclusion. LPR diagnosis includes different modalities such as response to empirical therapeutic trials of proton pump inhibitors, reflux symptom index (RSI), reflux finding score (RFS), and pH monitoring [4]. …”

Section: Introductionmentioning

confidence: 99%

Voice Problems among Laryngopharyngeal Reflux Patients Diagnosed with Oropharyngeal pH Monitoring

Mesallam

Malki²,

Farahat³

et al. 2013

Folia Phoniatr Logop

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Background and Objectives: There is a lack of consensus regarding the clinical presentation and diagnosis of laryngopharyngeal reflux (LPR). The aim of this study was to explore voice-related abnormalities in a group of LPR patients, diagnosed with a 24-hour oropharyngeal pH monitoring. Patients and Methods: Eighty-two patients with voice-related problems participated in the study. Diagnosis of LPR was made using a 24-hour oropharyngeal pH monitoring. Patients were divided accordingly into positive and negative pH groups. Comparisons between the two groups were done, including results of clinical presentation, Voice Handicap Index-10 (VHI-10), reflux symptom index (RSI), reflux finding score (RFS), and acoustic measurements. The correlation was conducted between Ryan scores and other variables including VHI-10, RSI, and RFS. Results: Significant differences were found between the two groups for RSI and VHI-10. No significant differences were found between the two groups regarding clinical presentation, RFS or acoustic measures. Significant positive correlations were found between the Ryan composite measurements and both severity ratings (VHI-10, RSI). Conclusion: LPR clinical presentation appears to be non-specific in terms of symptoms and laryngeal findings. LPR appears to have an effect on the patients' self-perception of voice problems. Further studies are needed to clarify the effect of LPR on acoustic measurements.

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Section: Introductionmentioning

confidence: 99%

Voice Problems among Laryngopharyngeal Reflux Patients Diagnosed with Oropharyngeal pH Monitoring

Mesallam

Malki²,

Farahat³

et al. 2013

Folia Phoniatr Logop

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“…When data retrieved from Dx pH probe are transferred into a computerized system, any desired value can be determined as a baseline pH and relevant calculations can be performed. [3][4][5][6][17][18][19][20] In an investigation performed on 55 asymptomatic volunteers, Gloub et al [5] reported parallelism between data obtained by Dx pH and standard dualprobe monitorization technique. In another study conducted in Emory University (Atlanta, 2007) Dx pH probe was compared to gold standard dual-probe 24-hour and detected mean pH measurements at the end of a 24-hour monitorization period (excl.…”

Section: Discussionmentioning

confidence: 97%

“…In many studies performed reproducible RSI scores were used. [16][17][18]20] Even though RSI and RFS have been used as separate diagnostic criteria, in our study cases meeting the requirements of both criteria (LPR if RSI >13, and RFS >7 and healthy if RSI <13 and RFS <7) were included in the study. Besides RSI scores of both groups were compared and increases in the patient group were found to be statistically significant (p<0.05).…”

Section: Discussionmentioning

confidence: 99%

“…Applicability and preferability in the diagnosis of LPR has been emphasized. [18,20] Still limited number of studies have applied monitorization with Dx pH probe to substantiate RFS and RSI findings for the establishment of LPR diagnosis. In our study, when clinical and physical examination, laryngeal endoscopy, together with application of RSI and RFS measurement tools before diagnosis and treatment of LPR were realized, pH measurements with Dx pH pharyngeal probe yielded significant diagnostic information favouring LPR.…”

Section: Discussionmentioning

confidence: 99%

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A pilot study on diagnosing laryngopharyngeal reflux disease by pharyngeal pH probe monitoring

Torun¹

2013

J Med Updates

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Gastroesophageal reflux (GER) is a spontaneous and effortless regurgitation of gastric contents into esophagus. However laryngopharyngeal reflux (LPR) is an atypical form of GER in which gastric contents severely regurgitate up to upper esophageal sphincter without retching or vomiting. Retrosternal burning sensation and regurgitation are Özet Amaç: Çal›flmam›zda larengofarengeal reflü (LFR) hastal›¤› olan ve sa¤l›kl› iki grup de¤erlendirilerek, Dx pH probunun LPR tan›s›nda sonuçlar›n› karfl›laflt›rmay› amaçlad›k.Yöntem: Di¤er hastal›klar ekarte edildikten sonra hem reflü semptom indeksi (RS‹) hem de reflü bulgu skoru (RBS) ile tipik skorlara sahip 57 LFR olgusu ile larengofarengeal yak›nmas› ve fizik muayene bulgular› olmayan 20 sa¤l›kl› gönüllü çal›flmaya al›nd›. Tüm olgulara RS‹ ve RBS formlar› dolduruldu. RS‹ <13 ve RBS <7 olanlar sa¤l›kl› grubu olufltururken RS‹ >13 ve RBS >7 olanlar LFR grubunu oluflturdu. ‹ki gruba Dx pH probu tak›larak veriler elde edildi. ‹statistiksel de¤erlendirmede Fisher'in kesin olas›l›k testi, Shapiro-Wilk testi, T testi ve Mann-Whitney testi kullan›ld›. p<0.05 istatistiksel olarak anlaml› kabul edildi. Bulgular: ‹ki grup aras›nda yafl, cinsiyet ve vücut kitle indeksi bak›-m›ndan istatistiksel fark saptanmad›. Sa¤l›kl› gönüllülerde ortalama pH de¤eri 6.97 saptan›rken hasta grupta 6.27 olarak hesapland› (p<0.05). pH olaylar›, pH <5.5 ve pH <5.0 de¤erleri için ayr› ayr› hesapland›; asit maruziyet süreleri de de¤erlendirilerek iki grup aras›n-da karfl›laflt›r›ld›¤›nda istatistiksel olarak anlaml› fark saptand› (p<0.05). Ayr›ca iki grubun pH olaylar› dik ve s›rtüstü pozisyonlarda ayr› ayr› hesaplanarak hem kendi içlerinde hem de gruplar aras›nda karfl›laflt›rma yap›ld›. Kendi içlerindeki k›yaslamalarda istatistiksel olarak anlaml› fark saptanamad› (p>0.05), ancak iki grup aras›nda bu k›yaslamada istatistiksel olarak anlaml› fark saptand› (p<0.05).Sonuç: Dx pH probu verileri RS‹ ve RBS de¤erleri ile k›yasland›¤›n-da tutarl› ve do¤ru sonuçlar elde edilmifltir. Larengofarengeal reflü tan›s›nda s›k kullan›lan di¤er yöntemlere alternatif olabilece¤i görül-müfltür.Anahtar sözcükler: Larengofarengeal reflü, reflü semptom indeksi, reflü bulgu skoru, farengeal pH probu. AbstractObjective: We aimed to evaluate (laryngopharyngeal reflux) LPR disease group and group with healthy volunteers and compare results obtained using Dx pH probe in the diagnosis of LPR disease.Methods: Fifty-seven LPR patients with typical scores of reflux symptom index (RSI) and reflux finding scoring (RFS) system and 20 healthy volunteers without laryngopharyngeal symptoms and physical examination findings were included in the study after excluding other concomitant diseases. All patients were requested to complete RSI and RFS forms. Healthy volunteers, with RSI <13 and RFS <7 constituted the control group and LPR group consisted of patients with RSI >13 and RFS >7. Dx pH probes were applied to each group. Fisher's exact test, Shapiro-Wilk test, T test and Mann-Whitney test were used for statistical analysis. A p value <...

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“…RSI questionnaire contains 9 symptoms, which are rated by the patient according to the severity of those ailments. Total score above the defined threshold indicates a high probability of the LPR diagnose, but does not guarantee it [13].…”

Section: Diagnostic Methodsmentioning

confidence: 99%

Laryngopharyngeal Reflux and Asthma

DembiÅski¹,

Aleks²,

Banaszkiewicz³

et al. 2013

J Allergy Ther

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The gastroesophageal reflux presence in asthma has been the subject of many studies indicating their frequent coexisting. The essence of this correlation is not entirely clear and several hypotheses can be found in literature. Recently defined laryngopharyngeal reflux and studies on its impact on the course of asthma seem to bring us closer to understanding this issue. In the last years we gained access to the new diagnostic methods allowing direct registration of laryngopharyngeal reflux. This paper summarizes laryngopharyngeal reflux diagnostic possibilities including the most advanced technologies. It also evaluates published clinical studies, which investigated laryngopharyngeal reflux in asthma patients, both in adults and children. Journal of Allergy & Therapy Journ a l o f A llergy & T h e ra py ISSN: 2155-6121Citation: Dembiński Ł, Banaszkiewicz A, Albrecht P (2013) Laryngopharyngeal Reflux and Asthma. J Aller Ther S11: 008.

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The Value of Routine pH Monitoring in the Diagnosis and Treatment of Laryngopharyngeal Reflux

Cited by 42 publications

References 23 publications

Voice Problems among Laryngopharyngeal Reflux Patients Diagnosed with Oropharyngeal pH Monitoring

Voice Problems among Laryngopharyngeal Reflux Patients Diagnosed with Oropharyngeal pH Monitoring

A pilot study on diagnosing laryngopharyngeal reflux disease by pharyngeal pH probe monitoring

Laryngopharyngeal Reflux and Asthma

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