Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (5): 101-106.doi: 10.6040/j.issn.1673-3770.0.2019.114

• Original Article • Previous Articles    

Simultaneous Dx-pH monitoring of the oropharynx and esophagus for laryngopharyngeal reflux disease research

Lei WANG1,Gang WANG2,Wei WU1(),Hongdan LIU1,Bingxin XU1,Xin LI1,Haolun HAN1,Baowei LI1,Ruiying DING1,Lianyong LI3   

  1. 1. Department of Otolaryngology Head and Neck Surgery, Characteristic Medical Center of Strategic Support Army, Beijing 100101, China
    2. State Environmental Protection Key Laboratory of Environmental Sense Organ Stress and Health, Beijing 100101, China
    3. Department of Gastroenterology, Characteristic Medical Center of Strategic Support Army, Beijing 100101, China
  • Received:2019-03-11 Revised:2019-05-09 Online:2019-09-20 Published:2019-10-15
  • Contact: Wei WU E-mail:ent306ww@126.com

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Abstract: Objective

To investigate the relationship between laryngopharyngeal reflux disease（LPRD）and gastroesophageal reflux disease (GERD) by simultaneous Dx-pH monitoring of the oropharynx and esophagus.

Methods

This was a retrospective study of 56 patients, who had presented with suspected laryngopharyngeal reflux at the Department of Otolaryngology Head and Neck Surgery, Chinese PLA 306th Hospital, from June to December 2017. All patients were evaluated using the reflux symptom index (RSI), reflux finding score (RFS), gastroesophageal reflux disease questionnaire (GerdQ), simultaneous 24 hour Dx-pH monitoring of the oropharynx and esophagus, and gastroscopy.

 Results

Synchronous pH monitoring revealed 17 cases had a positive Ryan score, implying LRPD, of which, 12 cases (70.6%, 12/17) were diagnosed with LPRD alone. Further, 20 cases were diagnosed with GERD, of which, 15 cases (75%, 15/20) were GERD alone. The number of patients with only LPRD was higher than the number diagnosed with both LPRD and GERD (29.4%, 5/17). There were no statistical differences in total percent acid exposure time or the total number of oropharyngeal pH events between the “LPRD only” and the “LPRD+GERD” groups. Additionally, there were no statistical differences in the esophageal reflux indices between the “GERD only” group and the “LPRD+GERD” group. Eleven cases (64.7%, 11/17) of LPRD were negative for GERD, determined by the GerdQ, Dx-pH esophageal probe tests, and gastroscopy.

 Conclusion

LPRD and GERD can exist independently. Most LPRD cases are not accompanied by GERD and LPRD is not secondary to severe GERD.

Key words: Laryngopharyngeal reflux disease, Gastroesophageal reflux disease, Dx-pH monitoring.

CLC Number: 

  • R766

Table 1

Comparison of reflux indices between the LPRD +GERD group and the LPRD only group"

组别

口咽部探头

（pH<5.5）

食管LES上5 cm探头

（pH<4.0）
AET 酸反流总次数 AET

酸反流

总次数

 持续超过5 min酸反流次数

最长酸暴露

时间（min）
单纯LPRD组（x±s） 9.47±11.68 78.33±90.78 0.65±0.68 19.00 (2.75,33.50) 0.17±0.39 1.75±2.01
LPRD合并GERD组[M(P25,P75)] 2.26 (0.62,15.91)

123.00 (30.50,

237.50)

 11.80 (5.34,15.40)

132.00 (78.00,

190.00)

7.00 (2.50,

10.00)

23.00 (10.00,

31.00)
Z -0.422 -0.897 -3.166 -3.059 -3.543 -3.192
P 0.673 0.370 0.002 0.002 ＜0.001 0.001

Table 2

Comparison of reflux indices between the GERD only group and the LPRD only group"

组别

咽部探头

（pH<5.5）

食管LES上5cm探头

（pH<4.0）
AET 酸反流总次数 AET

酸反流

总次数

 持续超过5min酸反流次数

最长酸暴露

时间（min）

单纯GERD组

（x±s）

 0.44±1.10 2.67±6.32 19.81±14.54 153.00 (115.00;188.00) 8.00 (2.00;18.00) 70.47±93.84
LPRD合并GERD组[M(P25,P75)] 2.26 (0.62,15.91) 123.00 (30.50,237.50) 11.80 (5.34,15.40) 132.00 (78.00,190.00) 7.00 (2.50,10.00) 23.00 (10.00,31.00)
Z -3.005 -3.399 -0.829 -0.873 -0.395 -0.743
P 0.003 0.001 0.407 0.383 0.693 0.457
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