Abstract:Reflux-associated laryngeal symptoms (RALS) is the process in which chronic laryngeal symptoms are related to gastroesophagopharyngeal reflux. Impairment of upper esophageal sphincter (UES) reflexes may predispose to esophagopharyngeal reflux. The novel noninvasive nonpharmacologic UES assist device (UESAD) applies external cricoid pressure to augment intraluminal UES pressure by 20 to 30 mm Hg and reduce esophagopharyngeal reflux events. This study aimed to assess the therapeutic efficacy of the UESAD in a pr… Show more
“…A retrospective study that compared suspected LPR patients with typical GERD patients has revealed that LPR was characterized by higher UES residual pressure . Findings on UES motility were further supported by the efficacy of UES assist device in the patients with laryngeal symptoms . However, another retrospective study that included 22 esophageal symptom patients, 22 extraesophageal symptom patients, and 44 healthy controls have found that both esophageal symptom patients and extraesophageal symptom patients had lower UES basal pressure and shorter UES length than healthy controls .…”
Background and Aim: Laryngopharyngeal reflux (LPR) is caused by the reflux of gastric contents beyond the esophagus into the larynx and pharynx. However, upper esophageal sphincter (UES) motility and proximal esophagus reflux parameters are poorly studied. This study aims to explore the characteristics of UES motility and reflux parameter among LPR patients. Methods: Patients with laryngopharyngeal symptoms only (L), patients with laryngopharyngeal symptoms and typical esophageal symptoms (L + E), patients with typical esophageal symptoms only (E), and healthy controls (H) were retrospectively included. Physiological profiles were studied and compared among groups using both high-resolution manometry and pH-impedance monitoring, including UES basal pressure, residual pressure, relaxation duration time, recovery time, the time to nadir pressure, UES length, proximal contractile integral, and proximal mean nocturnal baseline impedance (MNBI). Patients' symptom outcomes were also analyzed. Results: A total of 242 patients were included. Proximal MNBI was significantly lower in patients with both laryngopharyngeal and esophageal symptoms (17 cm above low esophageal sphincter [LES]: L vs L + E vs E vs H = 3689.7 vs 2500.0 vs 3073.0 vs 3996.0; 15 cm above LES: L vs L + E vs E vs H = 3155.9 vs 2553.4 vs 3198.9 vs 2985.2; P < 0.001). Patients responded to proton pump inhibitor treatment also had lower proximal MNBI than those who did not (17 cm above LES: 1834.0 vs 3500.0; 15 cm above LES: 1946.5 vs 3432.6; P < 0.001). Conclusion: Decreased proximal MNBI can not only identify LPR patients but also predict patients' symptom outcomes.
“…A retrospective study that compared suspected LPR patients with typical GERD patients has revealed that LPR was characterized by higher UES residual pressure . Findings on UES motility were further supported by the efficacy of UES assist device in the patients with laryngeal symptoms . However, another retrospective study that included 22 esophageal symptom patients, 22 extraesophageal symptom patients, and 44 healthy controls have found that both esophageal symptom patients and extraesophageal symptom patients had lower UES basal pressure and shorter UES length than healthy controls .…”
Background and Aim: Laryngopharyngeal reflux (LPR) is caused by the reflux of gastric contents beyond the esophagus into the larynx and pharynx. However, upper esophageal sphincter (UES) motility and proximal esophagus reflux parameters are poorly studied. This study aims to explore the characteristics of UES motility and reflux parameter among LPR patients. Methods: Patients with laryngopharyngeal symptoms only (L), patients with laryngopharyngeal symptoms and typical esophageal symptoms (L + E), patients with typical esophageal symptoms only (E), and healthy controls (H) were retrospectively included. Physiological profiles were studied and compared among groups using both high-resolution manometry and pH-impedance monitoring, including UES basal pressure, residual pressure, relaxation duration time, recovery time, the time to nadir pressure, UES length, proximal contractile integral, and proximal mean nocturnal baseline impedance (MNBI). Patients' symptom outcomes were also analyzed. Results: A total of 242 patients were included. Proximal MNBI was significantly lower in patients with both laryngopharyngeal and esophageal symptoms (17 cm above low esophageal sphincter [LES]: L vs L + E vs E vs H = 3689.7 vs 2500.0 vs 3073.0 vs 3996.0; 15 cm above LES: L vs L + E vs E vs H = 3155.9 vs 2553.4 vs 3198.9 vs 2985.2; P < 0.001). Patients responded to proton pump inhibitor treatment also had lower proximal MNBI than those who did not (17 cm above LES: 1834.0 vs 3500.0; 15 cm above LES: 1946.5 vs 3432.6; P < 0.001). Conclusion: Decreased proximal MNBI can not only identify LPR patients but also predict patients' symptom outcomes.
“…In our study patients with symptom response to PPI and the external UES compression device had a significantly higher concentration of salivary pepsin at baseline compared to those without symptom response. It is possible that salivary pepsin provides a surrogate measure of proximal refluxate beyond reliance on pH alone with ambulatory reflux monitoring [ 27 , 33 , 34 ]. Fig.…”
Background The Reflux Band, an external upper esophageal sphincter (UES) compression device, reduces esophago-pharyngeal reflux events. This study aimed to assess device efficacy as an adjunct to proton pump inhibitor (PPI) therapy in patients with laryngopharyngeal reflux (LPR). Methods This two-phase prospective clinical trial enrolled adults with at least 8 weeks of laryngeal symptoms (sore throat, throat clearing, dysphonia) not using PPI therapy at two tertiary care centers over 26 months. Participants used double dose PPI for 4 weeks in Phase 1 and the external UES compression device nightly along with PPI for 4 weeks in Phase 2. Questionnaire scores and salivary pepsin concentration were measured throughout the study. The primary endpoint of symptom response was defined as reflux symptom index (RSI) score ≤ 13 and/or > 50% reduction in RSI. Results Thirty-one participants completed the study: 52% male, mean age 47.9 years (SD 14.0), and mean body mass index (BMI) 26.2 kg/m 2 (5.1). Primary endpoint was met in 11 (35%) participants after Phase 1 (PPI alone) and 17 (55%) after Phase 2 (Device + PPI). Compared to baseline, mean RSI score (24.1 (10.9)) decreased at end of Phase 1 (PPI alone) (21.9 (9.7); p = 0.06) and significantly decreased at end of Phase 2 (Device + PPI) (15.5 (10.3); p < 0.01). Compared to non-responders, responders to Device + PPI had a significantly lower BMI (p = 0.02) and higher salivary pepsin concentration (p = 0.01). Conclusion This clinical trial highlights the potential efficacy of the external UES compression device (Reflux Band) as an adjunct to PPI for patients with LPR (ClinicalTrials.Gov NCT03619811).
“…Mali broj studija potvr dio je učinkovitost uređaja u smanjenju razine kon centracije pepsina u slini, smanjenju tegoba i poboljša nju lokalnog nalaza. 83,84 Primjena respiratornog treninga koji uključuje ak tivnu respiraciju i vježbe jačanja orofaringealne mu skulature u kombinaciji s IPPom pokazala se učinko vitijom od same primjene IPPa u liječenju LPRa, osobito u pacijenata kod kojih je vodeći simptom refraktorni kašalj ili laringospazam. 85 Povezanost ank sioznosti i razvoja LPRa nedvojbeno je dokazana, a dodatna blagodat respiratornog treninga jest smanje nje razine anksioznosti i povećanje opuštenosti koja ima blagotvoran učinak u procesu liječenja.…”
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
