Introduction
The gold standard for diagnosis of laryngeopharyngeal reflux is 24h MII-pH with localization of impedance nearby the upper esophageal sphincter.
Aims & Methods
The aim of the study was to evaluate high GER in patients with laryngeal symptoms of GERD.
Subjects and methods: 50 patients with extraesophageal manifestations of GERD underwent upper endoscopy, esophageal manometry and 24h MII-pH. Mean age 49,54 ±5,2 y.o. Females – 44%, males – 56%. We used new probes for 24h MII-pH with 2 impedance channels located above lower esophageal sphincter (LES) and 5 impedance channels located under and above upper esophageal sphincter (UES). There were 3 types of probes according to the length of esophagus: 1st type – for the length 20-22 cm, 2nd type – 23-25 cm, 3rd type – 26-28 cm. The pH electrodes were at 5 cm above LES and 1 cm above UES. The location of LES and UES was detected by manometry.
Results
According to the results of 24h MII-pHmetry in the lower third of the pharynx, 21 patients had more than 1 reflux (LFR+ group), 29 patients had no reflux in the pharynx (LFR-). Patients with LFR+ significantly more often complained of hoarseness, slightly more often noted cough, burning in the oral cavity, dysphagia. Patients with LFR- often complained of heartburn, regurgitation, sore throat, lump in the throat. The upper endoscopy showed that the frequency of occurrence of the erosive esophagitis was the equal in both groups, including Barrett's esophagus.
The pathologic GER in the lower third of the esophagus was more common in patients with LFR + (71%) than in patients without LFR (24%). A positive correlation was revealed (r=0.46). The ratio of the physiological amount of GER was 24 and 59%, respectively.
Conclusion
The new probes allow simultaneous assessment of reflux in the lower third of the esophagus and pharynx. The amount of reflux in the lower third of the pharynx correlates with the amount in the lower third of the esophagus. However, there are options when, with a normal number of them, there may be a high spread in the lower third of the esophagus.
