Role of PH Monitoring in Laryngopharyngeal Reflux Patients with Voice Disorders | ||
| Iranian Journal of Otorhinolaryngology | ||
| مقاله 1، دوره 28، شماره 6 - شماره پیاپی 89، بهمن 2016، صفحه 377-382 اصل مقاله (464.79 K) | ||
| نوع مقاله: Original | ||
| شناسه دیجیتال (DOI): 10.22038/ijorl.2016.7765 | ||
| نویسندگان | ||
| Swati Maldhure1؛ Ramanathan Chandrasekharan* 2؛ Amit- Kumar Dutta3؛ Ashok Chacko4؛ Mary Kurien5 | ||
| 1Department of Otorhinolaryngology, Padhar Hospital, Padhar, Dist Betul, Madhya Pradesh, India. | ||
| 2Department of Otorhinolaryngology, Christian Medical College, Vellore, Tamilnadu, India. | ||
| 3Department of Gastroenterology, Christian Medical College, Vellore, Tamilnadu, India. | ||
| 4Department of Gastroenterology, Madras Medical Mission, Chennai, Tamilnadu, India. | ||
| 5Department of Otorhinolaryngology, Pondicherry Institute of Medical Sciences, Puducherry, India. | ||
| چکیده | ||
| Introduction: Laryngopharyngeal reflux (LPR) is considered an important cause of voice disorder. We aimed to determine the frequency of LPR in patients with voice disorder and the association between Koufman Reflux Symptom Index (RSI), Reflux Finding Score (RFS), gastroesophageal reflux disease (GERD), and proximal acid reflux in these patients. Materials and Methods: We performed a prospective study in patients aged more than 18 years presenting at the ear, nose, and throat (ENT) clinic with a change in voice lasting more than 3 weeks. All patients underwent nasopharyngolaryngoscopy and a dual-probe esophageal pH study. LPR was diagnosed by a Koufman RSI of >13 and/or RFS of >7. GERD was diagnosed according to a DeMeester Johnson score of >14.7. Proximal acid reflux was diagnosed if acid exposure time was >0.02% in a proximal pH probe. Results: The study included 30 patients with a voice disorder. The mean age of participants was 38.5 years and 40% of patients were female. Using either of the two criteria, LPR was present in 46.7% of patients, half of whom had GERD. Among the remaining 53.3% patients with a voice disorder and no evidence of LPR, GERD was present in 25%. There was no significant association between the presence of LPR based on RSI (P=1) and GERD or RFS and GERD (P=0.06). Proximal acid reflux was present in only 10% patients with a voice disorder, and there was no significant association of this test with RFS (P=1) or RSI (P=1). Conclusions: Approximately half of the patients with a voice disorder have LPR, and only a subset of these patients have evidence of GERD. Fiberoptic laryngoscopic findings (RFS) complementing RSI appears to be important in diagnosing possible reflux etiology in voice disorders and can be an indicator for instituting anti-reflux therapy. However, there is no significant association between RSI, RFS, and GERD suggesting that these tests evaluate different features of the disease. Proximal acid reflux is uncommon in patients with voice disorder based on current measurement criteria. Acid exposure time as measured in the proximal probe of a 24-hour dual pH probe may need to be re-evaluated as one of the diagnostic criteria for LPR. | ||
| کلیدواژهها | ||
| Dysphonia؛ Esophageal pH Monitoring Received؛ Gastroesophageal reflux؛ Laryngopharyngeal Reflux | ||
| مراجع | ||
|
1. Streets CG, DeMeester TR. Ambulatory 24-hour esophageal pH monitoring: why, when, and what to do. J Clin Gastroenterol 2003:37(1):14–22.
2. Vakil N, Van Zanten SV, Kahrilas P, Dent J, Jones R. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101 (8):1900–20.
3. Hopkins C, Yousaf U, Pedersen M. Acid reflux treatment for hoarseness. Cochrane Database Syst Rev 2006(1):CD005054.
4. Johnson LF, Demeester TR. Twenty-four-hour pH monitoring of the distal esophagus. A quantitative measure of gastroesophageal reflux. Am J Gastroenterol 1974;62(4):325–32.
5. Cesari U, Galli J, Ricciardiello F, Cavaliere M, Galli V. Dysphonia and laryngopharyngeal reflux. Acta Otorhinolaryngol Ital. 2004;24(1):13–9.
6. Mesallam TA, Stemple JC, Sobeih TM, Elluru RG. Reflux symptom index versus reflux finding score. Ann Otol Rhinol Laryngol. 2007;116(6):436–40.
7. Koufman JA, Amin MR, Panetti M. Prevalence of reflux in 113 consecutive patients with laryngeal and voice disorders. Otolaryngol Head Neck Surg 2000;123(4):385–8.
8. Park JH, Lee DH, Kim JY, Park SY, Yoon H, Park YS, et al. Gastroesophageal reflux disease with laryngopharyngeal manifestation in Korea. Hepato- gastroenterology 2012;59(120):2527–9.
9. Ozturk O, Oz F, Karakullukcu B, Oghan F, Guclu E, Ada M. Hoarseness and laryngopharyngeal reflux: a cause and effect relationship or coincidence? Eur Arch Otorhinolaryngol 2006;263(10):935–9.
10. Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reflux symptom index (RSI). J Voice. 2002; 16(2):274–7.
11. Belafsky PC, Postma GN, Koufman JA. The validity and reliability of the reflux finding score (RFS). Laryngoscope 2001;111(8):1313–17.
12. Koufman JA, Aviv JE, Casiano RR, Shaw GY. Laryngopharyngeal reflux: position statement of the committee on speech, voice, and swallowing disorders of the American Academy of Otolaryngology-Head and Neck Surgery. Otolaryngol Head Neck Surg. 2002;127(1):32–5.
13. Sun G, Muddana S, Slaughter JC, Casey S, Hill E, Farrokhi F, Garrett CG, Vaezi MF. A new pH catheter for laryngopharyngeal reflux: Normal values. Laryngoscope 2009;119(8):1639–43.
14. Sataloff RT, Hawkshaw MJ, Gupta R. Laryngopharyngeal reflux and voice disorders: an overview on disease mechanisms, treatments, and research advances. Discov Med 2010;10(52):213–24.
15. Koufman, Blalock. Voice disorders: presentation and classification, Greene, Mathieson. Editors. The Voice and Its Disorders, 6th ed, Whurr Pubhlishers: 121–44.
16. Mostaghni A, Mehrabani D, Khademolhosseini F, Masoumi SJ, Moradi F, Zare N, Saberi-Firoozi M. Prevalence and risk factors of gastroesophageal reflux disease in Qashqai migrating nomads, southern Iran. World J Gastroenterol 2009;15(8):961–5.
17. Dufour MC: What is moderate drinking? Defining "drinks" and drinking levels. Alcohol Res Health 1999; 23(1):5–14.
18. Kempster GB, Gerratt BR, Verdolini Abbott K, Barkmeier-Kraemer J, Hillman RE. Consensus auditory-perceptual evaluation of voice: development of a standardized clinical protocol. Am J Speech Lang Pathol 2009;18(2):124–32.
19. Groome M, Cotton JP, Borland M, McLeod S, Johnston DA, Dillon JF. Prevalence of laryngopharyngeal reflux in a population with gastroesophageal reflux. Laryngoscope 2007; 117(8): 1424–28.
20. Makhadoom N, Abouloyoun A, Bokhary HA, Dhafar KO, Gazzaz ZJ, Azab BA. Prevalence of gastroesophageal reflux disease in patients with laryngeal and voice disorders. Saudi Med J 2007; 28(7):1068–71.
21. de Bortoli N, Nacci A, Savarino E, Martinucci I, Bellini M, Fattori B, Ceccarelli L, Costa F, Mumolo MG, Ricchiuti A, et al. How many cases of laryngopharyngeal reflux suspected by laryngoscopy are gastroesophageal reflux disease-related? World J Gastroenterol 2012; 18(32):4363–70.
22. Koufman JA, Belafsky PC, Bach KK, Daniel E, Postma GN. Prevalence of esophagitis in patients with pH- documented laryngopharyngeal reflux. Laryngoscope 2002;112(9):1606–9.
23. Spantideas N, Drosou E, Bougea A, Assimakopoulos D. Laryngopharyngeal reflux disease in the Greek general population, prevalence and risk factors. BMC Ear Nose Throat Disord 2015; 15:7. doi: 10.1186/s12901-015-0020-2. eCollection 2015.
24. Printza A, Kyrgidis A, Oikonomidou E, Triaridis S. Assessing laryngopharyngeal reflux symptoms with the Reflux Symptom Index: validation and prevalence in the Greek population. Otolaryngol Head Neck Surg 2011;145(6):974–80.
25. Kamani T, Penney S, Mitra I, Pothula V. The prevalence of laryngopharyngeal reflux in the English population. Eur Arch Otorhinolaryngol 2012; 269 (10): 2219–25.
26. Vardar R, Varis A, Bayrakci B, Akyildiz S, Kirazli T, Bor S: Relationship between history, laryngoscopy and esophagogastroduodenoscopy for diagnosis of laryngopharyngeal reflux in patients with typical GERD. Eur Arch Otorhinolaryngol 2012;
269(1):187–191.
27. Wiener GJ, Koufman JA, Wu WC, Cooper JB, Richter JE, Castell DO. Chronic hoarseness secondary to gastroesophageal reflux disease: documentation with 24-h ambulatory pH monitoring. Am J Gastroenterol 1989;84(12):1503–8.
28. Qua CS, Wong CH, Gopala K, Goh KL. Gastro-oesophageal reflux disease in chronic laryngitis: prevalence and response to acid-suppressive therapy. Aliment Pharmacol Ther 2007; 25(3):287–95.
29. Randhawa PS, Mansuri S, Rubin JS. Is dysphonia due to allergic laryngitis being misdiagnosed as laryngopharyngeal reflux? Logoped Phoniatr Vocol. 2010;35(1):1–5.
30. Dymek A, Dymek L, Starczewska-Dymek L, Bozek A, Dymek T, Nowak K. Laryngopharyngeal Reflux (LPR) in patients with persistent hoarseness. Otolaryngol Pol 2012;66(1):33–8.
31. Jette ME, Gaumnitz EA, Birchall MA, Welham NV, Thibeault SL. Correlation between Reflux and multichannel intraluminal impedance pH monitoring in untreated volunteers. Laryngoscope. 2014; 124(10): 2345–51.
32. Richardson BE, Heywood BM, Sims HS, Stoner J, Leopold DA. Laryngopharyngeal reflux: trends in diagnostic interpretation criteria. Dysphagia. 2004; 19(4):248–55.
33. Hila A, Agrawal A, Castell DO. Combined multichannel intraluminal impedance and pH esophageal testing compared to pH alone for diagnosing both acid and weakly acidic gastroesophageal reflux. Clin Gastroenterol Hepatol. 2007; 5(2):172–7.
34. Fass R, Achem SR, Harding S, Mittal RK. Quigley E. Review article: supra-oesophageal manifestations of gastro-oesophageal reflux disease and the role of night-time gastro-oesophageal reflux. Aliment Pharmacol Ther 2004;20(Suppl 9):26–38.
| ||
|
آمار تعداد مشاهده مقاله: 1,195 تعداد دریافت فایل اصل مقاله: 1,439 |
||