Oropharyngeal pH-Monitoring with the Restech Probe for Laryngopharyngeal Reflux: A New Reliable Test Before PPI Therapy?

Vailati C, Mazzoleni G, Bondi S, Bussi M, Testoni PA, Passaretti S. J Voice. 2013;27(1):84-9.


OBJECTIVES: to evaluate the relationship between pathological oropharyngeal pH-monitoring and clinical response to a 3-month double dose PPI therapy in patients with GERD-related laryngeal symptoms.

RESULTS: 13 patients (72.2%) were considered responders; 9 patients (50.0%) had a pathological oropharyngeal pH-monitoring study. Groups of responder and non responder patients were comparable regarding to demographic aspects. All the patients with a positive Restech® study were responsive to PPI, and 5 out of 9 patients with a negative Restech® study were non responders, with this difference being statistically significant (p=0.03). Responder patients resulted also in a higher rate of oropharyngeal acid exposure, expressed as Ryan Score, both in orthostatic and in supine position, compared to non responders (49.74 and 9.64 vs 2.12 and 2.17, p<0.05). Mean RSI score before therapy was 16.6±3.1. Considering responder patients, RSI score dropped from 16.25±3.9 to 7.87±3.2 after PPI therapy (p<0.05), whereas a not statistically significant reduction was observed in non responder patients (17±3.2 to 10.4±3, p=0.13).

CONCLUSION: all patients with pathological oropharyngeal acid exposure assessed with the Restech® probe clinically responded to a 3 months course of double dose PPI therapy. In the light of these results, If confirmed by future larger studies, the Restech® evaluation could be proposed as a tool for a better stratification of patients with LPS before starting a long medical therapy, which is generally associated with low rates of treatment compliance.

 

Topics: pH monitoring, PPI, 2013

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