Laryngopharyngeal pH Monitoring – Correlation with Conventional 24-hour Eso pH Monitoring Using 100 Patients with Suspected GERD

Fuchs H, Brinkmann S, Mueller D, et al. SAGES 2017.

OBJECTIVES: 24-hour esophageal pH metry is not designed to detect laryngopharyngeal reflux (LPR). The new laryngopharyngeal pH-monitoring system (Restech) may detect LPR better. There is no established correlation between these two techniques as only small case series exist. Aim of this study is to examine the correlation between the two techniques with a large patient collective.

RESULTS: A total of 101 patients from 12/2013 - 02/2017 were included. All patients presented extraesophageal symptoms such as cough, hoarseness, asthma symptoms, and globus sensation. Classical reflux symptoms such as heart burn (71%), regurgitation (60%), retrosternal pain (54%), and dysphagia (32%) were also present. The 24-hour pH-metry was positive in 66 patients (65%) with a mean DeMeester Score of 66.7 [15-292]. Four different reflux scenarios were detected (group A-D): In 39% of patients with pathologic esophageal pH-metry, Restech evaluation was normal (group A, n=26, mean DeMeester-score=57.9 [15-255], mean Ryan score=2.6 [2-8]). In 23% of patients with normal pH-metry (n=8, group B), Restech evaluation was pathologic (mean DeMeester-score 10.5 [5-13], mean Ryan score 63.5 [27-84]). The remaining groups C and D showed corresponding results.

CONCLUSION: Restech Evaluation was positive in 48% of cases. As demonstrated by four reflux scenarios, esophageal pH-metry and Restech do not necessarily need to correspond. Especially in patients with borderline pathological 24-hour pH-metry, Restech may help to support the decision for or against laparoscopic antireflux surgery.

 

Topics: pH monitoring, ENT, GI, 2017

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