The clinical value of pharyngeal pH monitoring using a double-probe, triple-sensor catheter in patients with laryngopharyngeal reflux.

Abstract

OBJECTIVE:

To determine the clinical value of pharyngeal pH monitoring for the diagnosis of laryngopharyngeal reflux (LPR) by using a double-probe, triple-sensor catheter in patients with symptoms of LPR.

DESIGN:

Prospective review of pH values recorded at the pharyngeal sensor, with the sensor placed in the proximal esophagus in patients with suspected LPR.

SETTING:

Tertiary care university hospital.

PATIENTS:

Thirty-three consecutive patients with symptoms of LPR.

MAIN OUTCOME MEASURES:

A pH test result was considered abnormal if a single reflux episode was detected in the hypopharynx and if, in the proximal esophagus, the total percentage of time the pH value was below 4 was 1.0% or higher. Data obtained from sensors were compared to determine the validity of pharyngeal sensor. Correlation between patients' reflux finding scores, reflux finding indexes, and reflux episodes were analyzed.

RESULTS:

Of 33 patients, 17 had more than 1 reflux episode detected by the pharyngeal sensor and 19 had pathological reflux detected by the proximal esophageal sensor. Four patients who had pharyngeal reflux had a normal esophageal acid exposure time, and 6 patients who had pathological reflux detected by the proximal esophageal sensor did not experienced any pharyngeal reflux episode. Four patients would have had a false-negative test result and 6 subjects would have had a false-positive test result if a hypopharyngeal pH sensor was not implemented.

CONCLUSIONS:

The adjustable, bifurcated, triple-sensor pH probe allows identifying true hypopharyngeal reflux episodes. If single-probe, double-sensor pH monitoring is to be performed, the proximal probe should be placed in the pharynx, not in the upper esophagus.

• Authors: Togay Muderris, M Kursat Gokcan, Irfan Yorulmaz
• Journal: Archives of otolaryngology--head & neck surgery (Arch Otolaryngol Head Neck Surg) Vol. 135 Issue 2 Pg. 163-7 (Feb 2009) ISSN: 1538-361X [Electronic] United States
• PMID: 19221244 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Catheterization
• Female
• Humans
• Hydrogen-Ion Concentration
• Hypopharynx
• Male
• Middle Aged
• Monitoring, Ambulatory
• Monitoring, Physiologic (instrumentation, methods)
• Pharyngeal Diseases (diagnosis, physiopathology)
• Prospective Studies