Impact of different pH thresholds for 24-hour dual probe pH monitoring in patients with suspected laryngopharyngeal reflux

2007 ◽  
Vol 122 (5) ◽  
pp. 485-489 ◽  
Author(s):  
O Reichel ◽  
W J Issing
Keyword(s):  
Healthy Volunteers ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Standard Test ◽  
Normative Values ◽  
Area Index ◽  
Gold Standard Test ◽  
Laryngeal Injury ◽  
Reflux Area Index ◽  
Dual Probe

AbstractObjectives:The gold standard test for laryngopharyngeal reflux is 24-hour pH monitoring, which determines the reflux area index with a pH threshold of less than four (i.e. the reflux area index four). However, refluxed pepsin is able to cause laryngeal injury at pH levels above five.Study design:Prospective study.Materials and methods:In order to establish normative values for a reflux area index with a pH threshold of less than five (i.e. the reflux area index five), 29 healthy volunteers underwent pH monitoring. In 45 patients with suspected laryngopharyngeal reflux, reflux area index four and reflux area index five were determined by pH study.Results:In healthy volunteers, the reflux area index five was 72.6 (95th percentile). In 29 of 44 patients, laryngopharyngeal reflux was diagnosed due to a reflux area index four of greater than 6.3. However, the reflux area index five revealed laryngopharyngeal reflux in six more patients.Conclusions:For exact analysis of pH monitoring results, two pH thresholds (less than four and less than five) must be considered. Further studies with a larger number of healthy volunteers are necessary in order to reveal normative values for the reflux area index five parameter.

scholarly journals Extraesophageal Reflux: What Is the Best Parameter for pH-Monitoring Data Analysis from the Perspective of Patient Response to Proton Pump Inhibitors?

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Karol Zelenik ◽  
Petr Matousek ◽  
Miroslav Tedla ◽  
Jakub Syrovatka ◽  
Pavel Kominek
Keyword(s):  
Proton Pump ◽  
Ph Monitoring ◽  
Demographic Data ◽  
Extraesophageal Reflux ◽  
Patient Response ◽  
Area Index ◽  
Best Parameter ◽  
Acid Exposure Time ◽  
Reflux Area Index ◽  
Dual Probe

Objectives. To analyze the pH-monitoring records of patients with suspected extraesophageal reflux (EER) using three different parameters (number of refluxes (NOR), acid exposure time (AET), and reflux area index (RAI)), with a view to determining which type of analysis is best at selecting the patients who will respond to a proton pump inhibitor (PPI).Methods. Demographic data were obtained and the level of the complaint was assessed using the Visual Analogue Scale. A dual probe pH-monitoring study was conducted. NOR greater than six, AET more than 0.1%, and RAI higher than 6.3 mpH were taken to be the thresholds for EER. Subsequently the response to a 12-week PPI trial was analyzed.Results. A total of 81 patients were analyzed. The percentages of patients with substantial EER based on NOR, AET, and RAI were 36%, 28% and 26%, respectively. Statistically significant, often positive PPI trials were confirmed in the group identified as having substantial EER using all three types of analysis. When using AET and RAI, the significance was more pronounced (P=0.012andP=0.013, resp.) in comparison with NOR (P=0.033).Conclusions. Patients with EER diagnosed using AET or RAI will respond to PPI significantly often.

Tu1326 COMBINED HYPOPHARYNGEAL-ESOPHAGEAL IMPEDANCE-PH MONITORING: A PILOT STUDY ON PHYSIOLOGY OF LARYNGOPHARYNGEAL REFLUX AND NORMATIVE VALUES

2020 ◽  
Vol 158 (6) ◽  
pp. S-1059-S-1060
Author(s):  
Rena H. Yadlapati ◽  
Thomas L. Carroll ◽  
Julie Fenn ◽  
Paul Menard-Katcher ◽  
Walter W. Chan
Keyword(s):  
Pilot Study ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Normative Values ◽  
Esophageal Impedance

scholarly journals Prevalence of laryngopharyngeal reflux in adult population using 24 hours ambulatory dual probe pH monitoring

2019 ◽  
Vol 5 (5) ◽  
pp. 1201
Author(s):  
Manoj Kumar L. ◽  
Anand K. H. ◽  
Raadhika Shree N.
Keyword(s):  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Adult Population ◽  
Adult Patients ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Laryngopharyngeal Reflux Disease ◽  
Study Population ◽  
Dual Probe

<p class="abstract"><strong>Background:</strong> Laryngopharyngeal reflux disease is an under diagnosed condition due to unavailability of the diagnostic tool that is dual probe pH monitoring and is on the rise in adult population according to El Serag by 4% every year since 1976.</p><p class="abstract"><strong>Methods:</strong> Adult patients coming to the outpatient department between April 2017 to April 2018 were evaluated using reflux symptom index score (RSI). Score greater than 13 were suggestive of laryngopharyngeal reflux and patients underwent 24 hours ambulatory dual probe pH monitoring. 7 or more reflux events in study period were diagnostic of laryngopharygeal reflux.  </p><p class="abstract"><strong>Results:</strong> 3000 adult patients were screened for RSI and 1756 (58.3%) had scored greater than 13. Among these patients 893 patients had 7 or more reflux events in pH monitoring. We found a prevalence of 29.76% in our study population.</p><p class="abstract"><strong>Conclusions:</strong> Prevalence laryngopharyngeal reflux disease needs to assess periodically at regular intervals to create more awareness of the disease and patient education thus preventing from causing chronic illnesses.</p><p class="abstract"> </p>

Association of Nasopharyngeal and Laryngopharyngeal Reflux with Postnasal Drip Symptomatology in Patients with and without Rhinosinusitis

2006 ◽  
Vol 20 (3) ◽  
pp. 283-289 ◽  
Author(s):  
Sarah K. Wise ◽  
Justin C. Wise ◽  
John M. DelGaudio
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Laryngopharyngeal Reflux ◽  
Sinus Surgery ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Area Index ◽  
Postnasal Drip ◽  
Objective Evidence ◽  
Significant Difference ◽  
Reflux Area Index

Background Patients often report postnasal drip (PND), but objective rhinosinusitis and allergy findings are frequently absent. In this study, we evaluate the association between PND and pharyngeal reflux. Methods Sixty-eight participants underwent 24-hour pH testing, including chronic rhinosinusitis (CRS) patients persistently symptomatic after endoscopic sinus surgery, CRS patients successfully treated by endoscopic sinus surgery, and volunteers without a CRS history. The pH probes contained nasopharyngeal (NP), laryngopharyngeal (LP), and distal esophageal sensors. Participants completed the Sinonasal Outcome Test-20 (SNOT-20) and Modified Reflux Symptom Index (MRSI) questionnaires. Survey items addressing PND symptomatology were compared with NP reflux (NPR) below pH 4 and pH 5 (defined as ≥1 event), and LP reflux (LPR; defined as ≥7 events or reflux area index <6.3). Results Pearson analyses revealed a positive correlation of r = 0.87 between SNOT-20 and MRSI PND items. For NPR < pH 4, no significant difference existed between participants with and without reflux on the SNOT-20 or MRSI (p < 0.05). However, for NPR < pH 5, reflux-positive participants exhibited significantly more PND symptoms on the SNOT-20 (p = 0.030) and the MRSI (p = 0.018) compared with participants without reflux. Finally, participants with LPR had significantly more PND symptomatology on the SNOT-20 (p = 0.010) versus those without LPR. A borderline significant difference existed on the MRSI PND item between participants positive and negative for LPR (p = 0.055). Conclusion Objective evidence of NPR and LPR exists in patients reporting PND. Reflux treatment may reduce PND complaints.

Role of Reflux in Tracheoesophageal Fistula Problems after Laryngectomy

2010 ◽  
Vol 119 (11) ◽  
pp. 719-728 ◽  
Author(s):  
Kai J. Lorenz ◽  
Laura Grieser ◽  
Theresa Ehrhart ◽  
Heinz Maier
Keyword(s):  
Reflux Disease ◽  
Tracheoesophageal Fistula ◽  
Ph Monitoring ◽  
Absolute Number ◽  
Tracheal Mucosa ◽  
Area Index ◽  
Demeester Score ◽  
Voice Restoration ◽  
Fistula Problems ◽  
Dual Probe

Objectives The purpose of this 2-year prospective nonrandomized study was to investigate the relationship between pathological supraesophageal reflux and the occurrence of speech fistula complications, especially severe fistula enlargement, in patients who underwent total laryngectomy and prosthetic voice restoration. Methods We objectively assessed the presence of reflux disease using 24-hour dual-probe pH monitoring in 60 laryngectomized patients, correlated the incidence of tracheoesophageal fistula complications with the severity of reflux, and assessed the risk of problems by determining the absolute number of reflux events at the level of the speech fistula, the reflux area index score, and the DeMeester score. Results All patients with fistula enlargement showed highly pathological results in the diagnostic tests for reflux disease. Depending on reflux severity, the relative risk of developing fistula complications was up to 10 times higher for these patients. Conclusions We found a significant correlation between the occurrence of tracheoesophageal fistula complications and the severity of supraesophageal reflux. Potential chronic irritation of the esophageal and tracheal mucosa can possibly contribute to the development of these problems. If the presence of reflux disease has been confirmed by 24-hour dual-probe pH monitoring, patients with fistula complications should be treated with proton pump inhibitors.

Dual-probe 24-hour ambulatory pH monitoring for diagnosis of laryngopharyngeal reflux

2004 ◽  
Vol 118 (11) ◽  
pp. 845-848 ◽  
Author(s):  
W.J. Issing ◽  
P.D. Karkos ◽  
K. Perreas ◽  
C. Folwaczny ◽  
O. Reichel
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Burning Sensation ◽  
Upper Aerodigestive Tract ◽  
Ambulatory Ph Monitoring ◽  
The Impact ◽  
Dual Probe ◽  
Ambulatory Ph ◽  
Nose And Throat

Background: Patients with gastroesophageal reflux disease may suffer from a variety of symptoms from the upper aerodigestive tract. The objective of this study was to determine the impact of dual-probe 24-hr pH monitoring in the diagnosis of reflux-related otolaryngological disorders.Methods: Twenty-two patients with symptoms such as chronic cough, globus pharyngeus, heartburn,dysphonia and burning sensation of the tongue underwent a complete ear, nose and throat examination, 24-hr dual-probe pH monitoring, and oesophago-gastro-duodenoscopy.Results: pH monitoring revealed gastroesophageal (distal) reflux in all patients and pharyngeal (proximal) reflux in 21 patients. Treatment consisted of a proton pump inhibitor (esomeprazole). Within 4 weeks 68 per cent of patients had no laryngopharyngeal symptoms; within 8 weeks 95 per cent of patients were symptom-free.Conclusions: Patients with atypical reflux symptoms such as hoarseness, globus sensation or throat-clearing responded well to anti-reflux treatment.

Comparison of Two Tests to Determine the Maximal Aerobic Speed

2020 ◽  
Vol 60 (2) ◽  
pp. 252-262
Author(s):  
Benhammou Saddek ◽  
Jérémy B.J. Coquart ◽  
Laurent Mourot ◽  
Belkadi Adel ◽  
Mokkedes Moulay Idriss ◽  
...  
Keyword(s):  
Physiological Responses ◽  
Intraclass Correlation ◽  
Lactate Concentration ◽  
Blood Lactate Concentration ◽  
Random Order ◽  
Standard Test ◽  
Maximal Heart Rate ◽  
Distance Runners ◽  
Gold Standard Test ◽  
Maximal Aerobic Speed

SummaryThe aims of this study were (a): to compare maximal physiological responses (maximal heart rate: HRmax and blood lactate concentration: [La-]) and maximal aerobic speed (MAS) achieved during a gold standard test (T-VAM) to those during a new test entitled: the 150-50 Intermittent Test (150-50IT), and (b): to test the reliability of the 150-50IT. Eighteen middle-distance runners performed, in a random order, the T-VAM and the 150-50IT. Moreover, the runners performed a second 150-50IT (retest). The results of this study showed that the MAS obtained during 150-50IT were significantly higher than the MAS during the T-VAM (19.1 ± 0.9 vs. 17.9 ± 0.9 km.h−1, p < 0.001). There was also significant higher values in HRmax (193 ± 4 vs. 191 ± 2 bpm, p = 0.011), [La-] (11.4 ± 0.4 vs. 11.0 ± 0.5 mmol.L−1, p = 0.039) during the 150-50IT. Nevertheless, significant correlations were noted for MAS (r = 0.71, p = 0.001) and HRmax (r = 0.63, p = 0.007). MAS obtained during the first 150-50IT and the retest were not significantly different (p = 0.76) and were significantly correlated (r = 0.94, p < 0.001, intraclass correlation coefficient = 0.93 and coefficient of variation = 6.8 %). In conclusion, the 150-50IT is highly reproducible, but the maximal physiological responses derived from both tests cannot be interchangeable in the design of training programs.

scholarly journals Deep Learning for Laryngopharyngeal Reflux Diagnosis

2021 ◽  
Vol 11 (11) ◽  
pp. 4753
Author(s):  
Gen Ye ◽  
Chen Du ◽  
Tong Lin ◽  
Yan Yan ◽  
Jack Jiang
Keyword(s):  
Deep Learning ◽  
Speech Processing ◽  
Data Augmentation ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Binary Classification ◽  
Classification Problem ◽  
Learning Approaches ◽  
Learning Techniques ◽  
Auc Value

(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.

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