Changes in Pharyngeal Baseline Impedance in Patients With Laryngopharyngeal Reflux

Abstract

Objective Few studies have investigated pharyngeal intraluminal baseline impedance (BI) levels in patients with laryngopharyngeal reflux (LPR). The aim of this study was to compare intraluminal BI levels between patients with LPR and healthy controls. Study Design Retrospective case series. Setting Tertiary care medical center. Subjects and Methods We conducted a retrospective analysis of 24-hour multichannel intraluminal impedance (MII)–pH monitoring results from patients with suspected LPR complaining of reflux symptoms. Patients with suspected LPR were divided into 2 groups according to the 24-hour MII-pH monitoring (LPR group: patients with symptoms with reflux events ≥1, symptom but no reflux [SNR] group: patients with symptoms but no reflux event). Healthy controls were recruited and also underwent 24-hour MII-pH monitoring. We compared the esophageal and pharyngeal BI levels and ratios between 3 groups. Results Pharyngeal BI levels in the LPR group were significantly higher than in the healthy controls. In addition, the pharyngeal BI levels in the SNR group were significantly higher than in the healthy controls. All ratios of pharyngeal to distal esophageal BI levels in the LPR and SNR group were significantly higher than in the healthy controls. However, there were no significant differences in esophageal BI levels and ratios between the 3 groups. Conclusion We found that the pharyngeal BI levels were higher in patients with LPR than in healthy controls. In addition, the pharyngeal BI levels measured by 24-hour MII-pH monitoring in patients with LPR symptoms, but without a reflux episode, were higher than in the healthy controls.

24‐Hour Multichannel Intraluminal Impedance–pH in Proton Pump Inhibitor Nonresponders vs Responders in Patients With Laryngopharyngeal Reflux

“…Reflux episodes were checked for liquid, gas, and mixed liquid-gas. 10 A liquid reflux episode was defined as a retrograde 50% fall in impedance from the mean baseline impedance between the 2 consecutive impedance sites. A gas reflux episode was defined as a rapid increase (3 kΩ/s) in 2 consecutive impedance sites, with 1 site showing an absolute value >7 kΩ without swallowing.…”

Characteristics of 24-h multichannel intraluminal impedance-pH monitoring in patients with laryngopharyngeal reflux refractory to proton pump inhibitor therapy: A prospective cohort study

“…Insertion and analysis of MII-pH probe was conducted as described in previous studies. 9,10 The dual-channel MII-pH catheter models (ZAI-BL-54, 55, 56, ComforTEC Z/PH single use probe with 2.3 mm diameter; Sandhill Scientific, Inc., WI, USA) were selected according to the esophageal length of each patient, and inserted by two ENT doctors. Recorded data were manually analyzed by one expert (EUN YG) using a software program (BioView Analysis, Sandhill Scientific, Inc., Highlands Ranch, CO, USA).…”

Does Pepsin Saliva Concentration (Peptest™) Predict the Therapeutic Response of Laryngopharyngeal Reflux Patients?

“…1 The LPR diagnosis is performed through hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring (HEMII-pH), which may detect acid, weakly acid, and nonacid hypopharyngeal events. 2 The deposit of pepsin into the laryngopharyngeal, 3 rhinological, 4 or otological 5 mucosa may lead to injuries, inflammation, and related symptoms. The key role of pepsin into the development of LPR led some authors to develop the Peptest ™ (RD Biomed Ltd., Hull, United Kingdom), which measures the saliva pepsin concentration.…”