Study of Laryngopharyngeal Reflux Using pH-Metering in Immediate Post-op of Laryngectomized Patients

The management of periprosthetic leakage in the presence of supra-oesophageal reflux after prosthetic voice rehabilitation

“…Similar results were obtained by other authors who performed long-term pH monitoring in laryngectomised patients and detected supra-oesophageal reflux in 30% of the patients and oesophageal reflux in 40% [26,41]. Unlike the oesophageal mucosa, the tracheal mucosa does not possess protective mechanisms against gastric acid exposure and may therefore be substantially exposed to gastric acid in patients with periprosthetic leakage and pathological reflux.…”

Gastro-pharyngeal reflux and total laryngectomy. Increasing knowledge about its management

“…In this scenario, pathological gastro-pharyngeal reflux appears among the possible causes of speech fistula enlargement together with local inflammatory responses in the region of the fistula, atrophy of the tissue around the fistula as a result of adjuvant radiotherapy, micro-movements of the prosthesis and trauma in the region of the fistula during prosthesis replacement procedures [43]. These findings are supported by several results, which show a significantly higher incidence of esophageal or supraesophageal reflux events in patients who have undergone partial or total laryngectomy [22,44]. Thus the lack of protective mechanisms against gastric acid exposure, even minor exposure of the trachea, can lead to massive damage, which may be caused by a low pH value, pepsin, pancreatic enzymes, and bile acid [3,45].…”

Effect of perioperative proton pump inhibitors on the incidence of pharyngocutaneous fistula after total laryngectomy: A prospective randomized controlled trial

“…30,31 Evaluation of reflux by pH-monitoring for the first 48 hours of the immediate postoperative period after laryngectomy has also detected proximal reflux at the level of the pharyngeal closure in 40% of patients. 32 The effect of this refluxate upon the upper aerodigestive tract mucosal lining has been examined; mucosal erosion, ulceration, and submucosal hemorrhages were recorded as a result of exposure to pepsin or to pepsin and hydrochloric acid in animal models. 33,34 Experimental studies have also shown that intermittent reflux of only 3 episodes per week is sufficient to produce laryngeal damage when mucosal injury is present.…”