Yichen Wan1, Yan Yan2, Furong Ma3, Li Wang2, Peiquan Lu2, Allison Maytag4, Jack J Jiang4. 1. Department of Otolaryngology - Head and Neck Surgery, Peking University, Third Hospital, Beijing, People's Republic of China; Department of Otolaryngology- Head and Neck Surgery, Peking University, International Hospital, Beijing, People's Republic of China. 2. Department of Otolaryngology - Head and Neck Surgery, Peking University, Third Hospital, Beijing, People's Republic of China. 3. Department of Otolaryngology - Head and Neck Surgery, Peking University, Third Hospital, Beijing, People's Republic of China. Electronic address: furongma@126.com. 4. Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Abstract
OBJECTIVE: To seek a deeper and more comprehensive understanding of two major diagnostic methods for laryngopharyngeal reflux by exploring whether and how differences exist before and after treatment between patients diagnosed by either Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) or 24-hour pH monitoring. MATERIALS AND METHODS: Two groups of patients who confirmed laryngopharyngeal reflux disease (LPRD) by either a combination of RSI and RFS (Questionnaire group, 35 patients) or 24-hour multichannel intraluminal impedance (MII) pH monitoring (pH Group, 23 patients) were recruited. All patients were prescribed esomeprazole 20 mg twice a day for 1 month. RSI, RFS, and acoustic parameters before and after treatment were compared between the two groups. Intrinsic correlations involving multiple parameters were investigated as well. RESULTS: Except for excess throat mucus (P = 0.019) and subglottic edema (P = 0.042), most RSI and RFS items before treatment were not significantly different between the Questionnaire and pH Groups, and nearly all such items in both groups exhibited distinct remission after therapy (P < 0.05). Absolute value of remission in RSI after treatment was more prominent in pH Group than in the Questionnaire group (P = 0.007). Jitter (P = 0.252), shimmer (P = 0.815), and harmonics-to-noise ratio (P = 0.117) descended to normal value after treatment. Moderate to high levels of correlation were found between the patient's original status and the absolute value of remission in most items of RSI and RFS as well as voice parameters. CONCLUSION: The 24-hour MII pH monitoring and a combination of RSI and RFS are quite competitive with each other in selecting LPRD patients. Although treatment worked out on nearly all the symptoms, laryngeal images and voice parameters, 24-hour MII pH seems to be more promising in a greater symptom relief. The extent of relief that can take place in most of the measurements is considerably determined by their initial status.
OBJECTIVE: To seek a deeper and more comprehensive understanding of two major diagnostic methods for laryngopharyngeal reflux by exploring whether and how differences exist before and after treatment between patients diagnosed by either Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) or 24-hour pH monitoring. MATERIALS AND METHODS: Two groups of patients who confirmed laryngopharyngeal reflux disease (LPRD) by either a combination of RSI and RFS (Questionnaire group, 35 patients) or 24-hour multichannel intraluminal impedance (MII) pH monitoring (pH Group, 23 patients) were recruited. All patients were prescribed esomeprazole 20 mg twice a day for 1 month. RSI, RFS, and acoustic parameters before and after treatment were compared between the two groups. Intrinsic correlations involving multiple parameters were investigated as well. RESULTS: Except for excess throat mucus (P = 0.019) and subglottic edema (P = 0.042), most RSI and RFS items before treatment were not significantly different between the Questionnaire and pH Groups, and nearly all such items in both groups exhibited distinct remission after therapy (P < 0.05). Absolute value of remission in RSI after treatment was more prominent in pH Group than in the Questionnaire group (P = 0.007). Jitter (P = 0.252), shimmer (P = 0.815), and harmonics-to-noise ratio (P = 0.117) descended to normal value after treatment. Moderate to high levels of correlation were found between the patient's original status and the absolute value of remission in most items of RSI and RFS as well as voice parameters. CONCLUSION: The 24-hour MII pH monitoring and a combination of RSI and RFS are quite competitive with each other in selecting LPRD patients. Although treatment worked out on nearly all the symptoms, laryngeal images and voice parameters, 24-hour MII pH seems to be more promising in a greater symptom relief. The extent of relief that can take place in most of the measurements is considerably determined by their initial status.
Authors: Jérôme R Lechien; Camille Finck; Pedro Costa de Araujo; Kathy Huet; Véronique Delvaux; Myriam Piccaluga; Bernard Harmegnies; Sven Saussez Journal: Eur Arch Otorhinolaryngol Date: 2016-03-23 Impact factor: 2.503
Authors: Jerome R Lechien; Francois Mouawad; Maria R Barillari; Andrea Nacci; Seyyedeh Maryam Khoddami; Necati Enver; Sampath Kumar Raghunandhan; Christian Calvo-Henriquez; Young-Gyu Eun; Sven Saussez Journal: World J Clin Cases Date: 2019-10-06 Impact factor: 1.337