Traditional Diagnostic Criteria for Esophageal Reflux on Impedance-pH Monitoring Perform Poorly in Identifying Abnormal Pharyngeal Events in Patients with Laryngopharyngeal Reflux Symptoms

2017 ◽  
Vol 152 (5) ◽  
pp. S659
Author(s):  
Lawrence F. Borges ◽  
Kelly Hathorn ◽  
Thomas L. Carroll ◽  
Wai-Kit Lo ◽  
Natan Feldman ◽  
...  
2012 ◽  
Vol 142 (5) ◽  
pp. S-204 ◽  
Author(s):  
Kathleen Blondeau ◽  
Ans Pauwels ◽  
Veerle Boecxstaens ◽  
Clara Caenepeel ◽  
Stephanie Depeyper ◽  
...  

2021 ◽  
Vol 11 (11) ◽  
pp. 4753
Author(s):  
Gen Ye ◽  
Chen Du ◽  
Tong Lin ◽  
Yan Yan ◽  
Jack Jiang

(1) Background: Deep learning has become ubiquitous due to its impressive performance in various domains, such as varied as computer vision, natural language and speech processing, and game-playing. In this work, we investigated the performance of recent deep learning approaches on the laryngopharyngeal reflux (LPR) diagnosis task. (2) Methods: Our dataset is composed of 114 subjects with 37 pH-positive cases and 77 control cases. In contrast to prior work based on either reflux finding score (RFS) or pH monitoring, we directly take laryngoscope images as inputs to neural networks, as laryngoscopy is the most common and simple diagnostic method. The diagnosis task is formulated as a binary classification problem. We first tested a powerful backbone network that incorporates residual modules, attention mechanism and data augmentation. Furthermore, recent methods in transfer learning and few-shot learning were investigated. (3) Results: On our dataset, the performance is the best test classification accuracy is 73.4%, while the best AUC value is 76.2%. (4) Conclusions: This study demonstrates that deep learning techniques can be applied to classify LPR images automatically. Although the number of pH-positive images used for training is limited, deep network can still be capable of learning discriminant features with the advantage of technique.


2007 ◽  
Vol 122 (6) ◽  
pp. 603-608 ◽  
Author(s):  
S Elwany ◽  
Y A Nour ◽  
E A Magdy

AbstractIntroduction:Laryngopharyngeal reflux is increasingly being implicated in several otolaryngological disorders.Aims:To study a potential correlation between pre-operative laryngopharyngeal reflux and wound healing and recovery after tonsillectomy, based on subjective and objective findings.Materials and methods:A prospective, blinded study was undertaken, including 60 patients scheduled for tonsillectomy, divided into two equal groups: a study group (group A) with pre-operative laryngopharyngeal reflux documented using ambulatory 24-hour pH monitoring; and a control group (group B) without laryngopharyngeal reflux.Results:Group A had significantly higher pain scores on the seventh and 14th post-operative days (p = 0.022 and p = 0.000, respectively) and took a significantly longer time to return to normal eating (p = 0.013), compared with group B. Group A also showed significantly slower healing on the seventh and 14th post-operative days, as estimated by assessing the grade of post-operative slough formation (p = 0.016 and p = 0.029, respectively). A significant correlation between the number of pharyngeal reflux episodes and the degree of post-operative slough was also found.Conclusions:Laryngopharyngeal reflux can significantly decrease wound healing following tonsillectomy. Therefore, pre-operative recognition and management of this condition is desirable in order to eliminate its negative post-operative effect.


2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Jin-soo Park ◽  
Oleksandr Khoma ◽  
Hans Van Der Wall ◽  
Gregory Falk

Abstract   No gold-standard investigation exists for laryngopharyngeal reflux (LPR). Multichannel intraluminal impedance (MII)-pH testing has uncertain utility in LPR. Meanwhile, reflux scintigraphy allows immediate and delayed visualisation of tracer reflux in the esophagus, pharynx, and lungs. The present study aimed to correlate MII-pH and scintigraphic reflux results in patients with primary LPR. Methods Consecutive patients with LPR underwent MII-pH and scintigraphic reflux studies. Abnormal values for MII-pH results were defined from existing literature. MII-pH and scintigraphic data were correlated. Results 105 patients with LPR (31 males (29.5%), median age 60 years (range: 20–87)) were studied. Scintigraphic reflux was seen in the pharynx in 94 (90.4%), and in the proximal esophagus in 94 (90.4%). Delayed scintigraphic contamination of the pharynx was seen in 101 patients (96.2%) and in the lungs of 56 patients (53.3%). Abnormal reflux was seen in the distal esophagus in 12.4%, proximal esophagus in 25.7%, and in the pharynx in 82.9%. Patients with poor scintigraphic clearance had higher Demeester scores (p = 0.043), more proximal reflux episodes (p = 0.046), more distal acid reflux episodes (p = 0.023), and longer bolus clearance times (p = 0.002). Conclusion Reflux scintigraphy has a high yield in LPR patients. Scintigraphic time-activity curves correlated with validated MII-pH results. A high rate of pulmonary microaspiration was found in LPR patients. This study demonstrated a high level of pharyngeal contamination by scintigraphy and MII-pH, which supports the use of digital reflux scintigraphy in diagnosing LPR.


2021 ◽  
Author(s):  
Shumon Ian Dhar ◽  
Lee Akst

Since the early 1990s, the consequences of extra-esophageal reflux in the larynx have been recognized to be related to a variety of laryngeal symptoms with certain endoscopic manifestations. The paper by Dr. Koufman described various types of laryngeal injury which were attributed to extra-esophageal reflux also known as laryngopharyngeal reflux (LPR). The mechanism of injury was postulated to be a consequence of acid refluxate as well as from pepsin. Since that time there has been a surge of literature devoted to the topic of LPR seeking to refine its diagnosis, elucidate its pathophysiology, and treat its symptoms and sequelae. Our goal in this chapter is to provide a balanced, evidence-based framework for identifying LPR and providing treatment while balancing the benefits versus the risks of overtreatment and escalating therapy. This review contains 13 figures, 7 tables and 49 references. Key Words: LPR, GERD, PPI, RSI, TLESR


2017 ◽  
Vol 99 (3) ◽  
pp. 224-227 ◽  
Author(s):  
GL Falk ◽  
H Van der Wall ◽  
L Burton ◽  
MG Falk ◽  
H O’Donnell ◽  
...  

INTRODUCTIONFundoplication for laryngopharyngeal disease with oesophageal dysmotility has led to mixed outcomes. In the presence of preoperative dysphagia and oesophageal dysmotility, this procedure has engendered concern in certain regards.METHODSThis paper describes a consecutive series of laryngopharyngeal reflux (LPR) patients with a high frequency of dysmotility. Patients were selected for surgery with 24-hour dual channel pH monitoring, oesophageal manometry and standardised reflux scintigraphy.RESULTSFollowing careful patient selection, 33 patients underwent fundoplication by laparoscopy. Surgery had high efficacy in symptom control and there was no adverse dysphagia.CONCLUSIONSEvidence of proximal reflux can select a group of patients for good results of fundoplication for atypical symptoms.


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