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Min HK, Jeon SY, Lechien JR, Park JM, Park H, Yu JW, Kim S, Jeong SJ, Kang JW, Su Il K, Young Chan L, Eun YG, Ko SG. Translation and validation of the Korean Version of the Reflux Symptom Score. J Voice 2024; 38:545.e1-545.e8. [PMID: 34656394 DOI: 10.1016/j.jvoice.2021.08.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To assess the validity and reliability of the Korean version of the reflux symptom score (K-RSS). MATERIALS AND METHODS The English version of the RSS was translated into Korean and completed by 77 people (44 and 33 people in the patient group and control group, respectively). They completed the K-RSS (K-RSS-1) and reflux symptom index (RSI) questionnaires and answered questions about age, sex, underlying disease, smoking history, and alcohol and coffee consumption. They completed the K-RSS once more (K-RSS-2) after 1 - 2 weeks. Internal consistency was evaluated using Cronbach's α and test-retest reliability using the intraclass correlation coefficient (ICC). External validity was evaluated using the Spearman rank test between the RSI and K-RSS. The Mann-Whitney U test was used to assess internal validity by comparing the K-RSS-1 scores between the patient and control groups. RESULTS The most common symptoms were globus sensation, throat clearing, and throat pain. The K-RSS reported high internal consistency (α = 0.894). The ICC for the total score was 0.883, indicating excellent test-retest reliability. According to the Spearman analysis, there was a significant correlation between the total score of the K-RSS and that of the RSI (rs = 0.902; P < 0.001), demonstrating strong external validity. Furthermore, the patient group showed significantly higher values than the control group in all K-RSS scores, suggesting high internal validity. CONCLUSION The K-RSS is a patient-reported outcome questionnaire with excellent criterion-referenced validity and ideal reliability.
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Affiliation(s)
- Hye Kyu Min
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - So Young Jeon
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Jerome R Lechien
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France; Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Jung Min Park
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Hwanhee Park
- Department of English Language & Literature, College of Humanities, Kyung Hee University, Seoul, Korea
| | - Jung-Wan Yu
- Department of English Language & Literature, College of Humanities, Kyung Hee University, Seoul, Korea
| | - Suk Kim
- Department of English Language & Literature, College of Humanities, Kyung Hee University, Seoul, Korea
| | - Su Jin Jeong
- Statistics Support Part, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
| | - Jung Wook Kang
- Department of Biomedical science and technology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Kim Su Il
- Department of Biomedical science and technology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Lee Young Chan
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Young-Gyu Eun
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea; Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France; Department of Biomedical science and technology, Graduate School, Kyung Hee University, Seoul, Korea.
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
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Sui X, Deng C, Wang L, Li D, Chen S, Zhang B, Li B, Xi X, Hu Z, Wu W, Wu J, Li L. Medium-term clinical efficacy of endoscopic antireflux mucosectomy on laryngopharyngeal reflux: a retrospective multicenter cohort study. Gastrointest Endosc 2023; 98:893-900. [PMID: 37423534 DOI: 10.1016/j.gie.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/02/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND AND AIMS Studies on the effect of antireflux mucosectomy (ARMS) on laryngopharyngeal reflux disease (LPRD) are lacking. We conducted a multicenter retrospective study to explore the clinical efficacy of ARMS on LPRD. METHODS We retrospectively analyzed the data of patients diagnosed with LPRD by oropharyngeal 24-hour Dx-pH monitoring who underwent ARMS. The effects of ARMS on LPRD were evaluated by comparing the 36-Item Short-Form Survey (SF-36), reflux symptom index (RSI), and 24-hour Dx-pH monitoring scores before and 1 year after surgery. Patients were divided into groups according to gastroesophageal flap valve (GEFV) grade to explore the effect of GEFV on prognosis. RESULTS One hundred eighty-three patients were included in the study. The oropharyngeal pH monitoring results showed that the effective rate of ARMS was 72.1% (132/183). After surgery, the SF-36 score was higher (P = .000), RSI score was lower (P = .000), and the symptoms of constant throat clearing; difficulty swallowing food, liquids, and pills; coughing after eating or after lying down; troublesome or annoying cough; and breathing difficulties or choking episodes were significantly improved (P < .05). Upright reflux was dominant in GEFV grade I to III patients, and the SF-36, RSI, and upright Ryan index scores were significantly improved after surgery (P < .05). In GEFV grade IV patients, regurgitation was dominant in the supine position, and the above evaluation indexes were worse after surgery (P < .05). CONCLUSIONS ARMS is effective for LPRD. The GEFV grade can predict the prognosis of surgery. ARMS is effective in GEFV grade I to III patients, but the effect is not exact in GEFV grade IV patients and may even be aggravated.
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Affiliation(s)
- Xinke Sui
- Department of Gastroenterology, Strategic Support Force Medical Center, Beijing, China
| | - Changrong Deng
- Department of Gastroesophageal Surgery, Rocket Force Characteristic Medical Center, Beijing, China
| | - Lei Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Strategic Support Force Medical Center, Beijing, China
| | - Dou Li
- Department of Gastroenterology, Strategic Support Force Medical Center, Beijing, China
| | - Sheng Chen
- Department of Gastroenterology, Strategic Support Force Medical Center, Beijing, China
| | - Bin Zhang
- Department of Gastroenterology, Strategic Support Force Medical Center, Beijing, China
| | - Bing Li
- Department of Gastroenterology, Strategic Support Force Medical Center, Beijing, China
| | - Xiaoyu Xi
- Department of Gastroenterology, Strategic Support Force Medical Center, Beijing, China
| | - Zhiwei Hu
- Department of Gastroesophageal Surgery, Rocket Force Characteristic Medical Center, Beijing, China
| | - Wei Wu
- Department of Otorhinolaryngology Head and Neck Surgery, Strategic Support Force Medical Center, Beijing, China
| | - Jimin Wu
- Department of Gastroesophageal Surgery, Rocket Force Characteristic Medical Center, Beijing, China.
| | - Lianyong Li
- Department of Gastroenterology, Strategic Support Force Medical Center, Beijing, China.
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Al-Momani H, Mashal S, Al Balawi D, Almasri M, Al-Shudifat AE, Khasawneh AI, Pearson J, Ward C. A prospective study of extraesophageal reflux and potential microaspiration in patients hospitalized with COVID-19 in Jordan. BMC Pulm Med 2023; 23:341. [PMID: 37697259 PMCID: PMC10496175 DOI: 10.1186/s12890-023-02638-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/07/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lung infection has represented a global challenge. Intriguingly, it has been shown that the alveolar lung epithelium expresses little Angiotensin Converting Enzyme receptor protein (ACE2), the entry receptor for SARS-CoV-2. Upper airway establishment of infection and translocation to the lung is well documented but other anatomical niches may be relevant to potentially serious lung infection. ACE2 is heavily expressed in the gastrointestinal tract and gastrointestinal symptoms support a clinical diagnosis of Coronavirus disease 2019 (COVID-19). This suggests a research question and the need to gather patient data exploring potential aerodigestive links in SARS-CoV-2 tranlocation and infection which may be relevant in the peripheral lung. This recognizes anatomical proximity and concepts of bi-directional movement between the Gastrointestinal and lung systems in normal physiology and disease. We have therefore explored the potential for gastro oesophageal reflux disease (GORD) micro aspiration and aeorodigestive pathophysiology in a novel prospective investigation of patients hospitalized with COVID-19. METHODS This is a prospective descriptive cohort study of 210 patients who were hospitalized with a confirmed diagnosis of COVID-19. The cohort was divided into three groups of patients based on symptom severity and radiological results. The Reflux Symptom Index (RSI) was used to evaluate the presence and severity of GOR. An RSI greater than 13 is considered to be abnormal. Patients' saliva samples were tested using enzyme-linked immunosorbent assay (ELISA) to determine the level of salivary pepsin among the cohort of patients. RESULTS A total of 210 patients with COVID-19 were enrolled in the study with 55.2% (116/210) classified as mildly ill, 31.9% (67/210) moderately ill and 12.9% (27/210) as severely ill. 34% (72/210) of the patients had an RSI score of over 13 and a median salivary pepsin value of 54 ± 29 ng/ml which suggested an incidence of extraesophageal reflux (EOR) in around a third of patients. The presence of respiratory comorbid conditions, an RSI score of over 13 and a salivary pepsin level of > 76ng/ml increased the risk of developing a more severe COVID-19 infection. CONCLUSION The study showed a high prevalence of EOR among the study cohort and provide the first prospective evidence suggesting the potential for aerodigestive pathophysiology including microaspiration in COVID-19 disease. We believe that the results of our study support the need for more extensive research.
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Affiliation(s)
- Hafez Al-Momani
- Department of Microbiology, Pathology and Forensic medicine, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan.
| | - Safaa Mashal
- Department of Microbiology, Pathology and Forensic medicine, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan
| | - Dua'a Al Balawi
- Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan
| | - Muna Almasri
- Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan
| | - Abdel-Ellah Al-Shudifat
- Department of Internal and family Medicine, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan
| | - Ashraf I Khasawneh
- Department of Microbiology, Pathology and Forensic medicine, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan
| | - Jeffrey Pearson
- Translational and clinical research and Biosciences institutes, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Christopher Ward
- Translational and clinical research and Biosciences institutes, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
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Lin Y, Peng S. Current Treatment of Laryngopharyngeal Reflux. EAR, NOSE & THROAT JOURNAL 2023:1455613231180031. [PMID: 37296536 DOI: 10.1177/01455613231180031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
Objectives: Laryngopharyngeal reflux (LPR) is a complex syndrome characterized by the reflux of gastroduodenal contents into the pharynx or larynx, resulting in a range of symptoms, including chronic cough, throat clearing, pain, dysphagia, hoarseness, and dysphonia. Despite the lack of a gold standard for diagnosis or treatment, various strategies have been proposed to manage LPR. However, the effectiveness of these treatments is compromised by the lack of a uniform treatment protocol, which places a burden on patients, physicians, and the healthcare system. This study aims to systematically review the treatments of LPR and provide updated and useful clinical information to clinical physicians. Methods: The literature with an emphasis on LPR and related keywords is searched and reviewed in PubMed. Results: Treatment of LPR includes health education, lifestyle modification, dietary changes, medications, and surgery, as well as the emergence of a novel treatment method involving external upper esophageal sphincter compression devices. Conclusions: Currently, medication is the main treatment, supplemented with lifestyle and dietary changes, but there is still a lack of effective means for patients with drug-resistant or intolerant LPR. More high-quality and rigorous trials must continue to be conducted to determine the best treatment options and find novel treatments. Taking into account the complexity of LPR, this study proposes a simple algorithm to help clinicians with the initial management of this disease.
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Affiliation(s)
- Yang Lin
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China
| | - Shunlin Peng
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China
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Kang HJ, Noh JK, Lee MK, Woo SR, Park JM, Lee YC, Ko SG, Eun YG. Changes of Pepsin Concentration in Saliva Sample According to Storage Period. J Voice 2022:S0892-1997(22)00411-8. [PMID: 36588013 DOI: 10.1016/j.jvoice.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To determine whether the concentration of pepsin in the saliva sample changes according to the storage period of the sample. METHODS Forty eight patients with suspected laryngopharyngeal reflux were included in this study. Saliva samples were collected from each patient and each sample divided into six and stored for different period of time. Pepsin concentration was measured using enzyme-linked immunosorbent assay. A comparison was made between the pepsin concentration measured immediately and the concentration measured after storage for 1 week, 2 weeks, 1 month, 3 months, and 6 months. RESULTS No significant difference in pepsin concentrations were detected between the sample analyzed immediately and those analyzed at 1 week, 2 weeks, 1 month, and 3 months after saliva collection. A significant difference in pepsin concentration was observed in the sample analyzed immediately and the sample analyzed 6 months after saliva collection. CONCLUSIONS Pepsin concentration in saliva samples did not demonstrate a significant difference between the concentration measured immediately and the concentration measured 3 months after saliva collection, although a significant difference was observed in the concentration measured 6 months after collection.
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Affiliation(s)
- Hee Jin Kang
- Department of Otolaryngology Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Joo Kyung Noh
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Min Kyeong Lee
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Seon Rang Woo
- Department of Otolaryngology Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea; Central Laboratory, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Jung Min Park
- Department of Otolaryngology Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Young Chan Lee
- Department of Otolaryngology Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Young-Gyu Eun
- Department of Otolaryngology Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea; Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
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Jeon SY, Park JM, Lee YC, Ko SG, Eun YG. Differences in Diagnostic Rates After Hypopharyngeal-esophageal Impedance-pH Monitoring of Laryngopharyngeal Reflux Patients by Age and Sex. J Voice 2022:S0892-1997(22)00215-6. [PMID: 36085096 DOI: 10.1016/j.jvoice.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To evaluate the differences in diagnostic rates according to the age and sex of patients with suspected laryngopharyngeal reflux (LPR) symptoms and completed the 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH (24h-HEMII-pH) monitoring. METHODS Patients with LPR symptoms underwent the 24h-HEMII-pH monitoring. We compared the diagnostic rates of LPR in patients with LPR symptoms according to age and sex. The number of reflux episodes and type of reflux were compared among patients who were confirmed to have LPR according to age and sex. RESULTS A total of 249 patients with suspected LPR symptoms who completed 24h-HEMII-pH monitoring were analyzed. A total of 170 patients (68.3%) were diagnosed with LPR after 24h-HEMII-pH monitoring. There were 57 (67.1%) men and 113 (68.9%) women. The old age group (older than 55 years) showed a statistically significant higher diagnostic rate than the young age group (73.5%, 60.8%, p=0.034). Women's diagnostic rate was statistically higher in the old age group than that in the young age group (75% vs. 58.3%, p=0.026). There were no specific differences in the number of refluxes in the diagnosed patients between the age groups, and there were no differences in the initial reflux symptom index. CONCLUSIONS Among those who visited the clinic with suspected LPR symptoms and performed 24h-HEMII-pH monitoring, the diagnostic rate of LPR was higher in the older age group than that in the younger age group.
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Affiliation(s)
- So Young Jeon
- Department of Otolaryngology-Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Jung Min Park
- Department of Otolaryngology-Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Young Chan Lee
- Department of Otolaryngology-Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Young-Gyu Eun
- Department of Otolaryngology-Head & Neck Surgery, Kyung Hee University School of Medicine, Kyung Hee University Medical Center, Seoul, Korea.
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Clinical Update Findings about pH-Impedance Monitoring Features in Laryngopharyngeal Reflux Patients. J Clin Med 2022; 11:jcm11113158. [PMID: 35683545 PMCID: PMC9181144 DOI: 10.3390/jcm11113158] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 02/01/2023] Open
Abstract
Purpose: The diagnosis of laryngopharyngeal reflux (LPR) is commonly based on non-specific symptoms and findings and a positive response to an empirical therapeutic trial. The therapeutic response is, however, unpredictable, and many patients need pH-impedance monitoring to confirm the diagnosis. Methods: A review of the recent literature was conducted in PubMED, Scopus, and Embase about the pH-study features of LPR patients. A summary of last evidence was proposed. Results: The awareness of otolaryngologists about indications and interpretation of pH-impedance monitoring is low. The hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring (HEMII-pH) is the most reliable examination determining the type and composition of hypopharyngeal reflux events (HRE) and the LPR features. The use of HEMII-pH is important to confirm the diagnosis in selected patients because non-specificity of symptoms and findings. There are no international consensus guidelines for the LPR diagnosis at the HEMII-pH. However, most studies supported the occurrence of >1 acid/weakly acid/nonacid HRE as diagnostic threshold. HREs are more frequently gaseous, weakly/nonacid compared with reflux events of gastroesophageal reflux. HREs occurred as daytime and upright, which does not support the value of double proton pump inhibitors or bedtime alginate. Oropharyngeal pH-monitoring is another approach reporting different sensitivity and specificity outcomes from HEMII-pH. The use of Ryan score for the LPR diagnosis at the oropharyngeal pH monitoring may be controversial regarding the low consideration of alkaline HREs. Conclusions: The awareness of otolaryngologists about HEMII-pH indication, features, and interpretation is an important issue regarding the high prevalence of LPR in outpatients consulting in otolaryngology. The HEMII-pH findings may indicate a more personalized treatment considering type and occurrence time of HREs.
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Lechien JR, Barillari MR, De Marrez LG, Hans S. Dysphonia in COVID-19 patients: Direct or indirect symptom? Am J Otolaryngol 2022; 43:103246. [PMID: 34555788 PMCID: PMC8450233 DOI: 10.1016/j.amjoto.2021.103246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/05/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Jerome R Lechien
- Elsan Group, Paris, France; Department of Otorhinolaryngology-Head & Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France; Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Belgium.
| | - Maria R Barillari
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, L. Vanvitelli University, Naples, Italy
| | - Lisa G De Marrez
- Department of Otorhinolaryngology-Head & Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France
| | - Stephane Hans
- Department of Otorhinolaryngology-Head & Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France
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Lechien JR, Perazzo PS, Ceccon FP, Eckley CA, Lopes KDC, Maunsell R, Avelino MAG, Akst LM, Sant'Anna GD, Imamura R. Management of laryngopharyngeal reflux in Brazil: a national survey. Braz J Otorhinolaryngol 2020; 88:850-857. [PMID: 33461911 DOI: 10.1016/j.bjorl.2020.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/21/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Studies assessing the management of laryngopharyngeal reflux by otolaryngologists have reported an important heterogeneity regarding the definition, diagnosis, and treatment, which leads to discrepancies in the management of the patient. Information about the current knowledge and practices of Brazilian otolaryngologists in laryngopharyngeal reflux is lacking. OBJECTIVE To investigate the trends in management of laryngopharyngeal reflux disease among Brazilian otolaryngologists. METHODS A survey was sent by email to the members of the Brazilian Association of Otolaryngology-Head Neck Surgery. This survey has initially been conducted by the laryngopharyngeal reflux study group of young otolaryngologists of the International Federation of Otolaryngological Societies. RESULTS According to the survey responders, the prevalence of laryngopharyngeal reflux was estimated to be 26.8% of patients consulting in otolaryngology and the most common symptoms were globus sensation, throat clearing, cough and stomach acid reflux. Nasal obstruction, Eustachian tube dysfunction, acute and chronic otitis media, vocal fold nodules and hemorrhage were considered not associated with laryngopharyngeal reflux by the majority of responders. About 2/3 of Brazilian otolaryngologists based the diagnosis of laryngopharyngeal reflux on the assessment of both symptoms and findings and a positive response to empiric therapeutic trials. Proton pump inhibitor utilized once or twice daily, was the most commonly used therapeutic scheme. Only 21.4% of Brazilian otolaryngologists have heard about nonacid and mixed laryngopharyngeal reflux and the awareness about the usefulness of multichannel intraluminal impedance pH monitoring (MII-pH) was minimal; 30.5% of responders did not consider themselves as well-informed about laryngopharyngeal reflux. CONCLUSION Although the laryngopharyngeal reflux-related symptoms, main diagnostic and treatment approaches referred by Brazilian otolaryngologists are consistent with the literature, the survey identified some limitations, such as the insufficient awareness of the role of laryngopharyngeal reflux in many otolaryngological conditions and of the possibility of non-acid or mixed reflux in refractory cases. Future studies are needed to establish international recommendations for the management of laryngopharyngeal reflux disease.
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Affiliation(s)
- Jerome R Lechien
- Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Laryngopharyngeal Reflux Study Group, Paris, France; University of Mons (UMons), UMONS Research Institute for Health Sciences and Technology, Faculty of Medicine, Department of Human Anatomy and Experimental Oncology, Mons, Belgium; Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), School of Medicine, UFR Simone Veil, Foch Hospital, Department of Otorhinolaryngology and Head and Neck Surgery, Paris, France; Université Libre de Bruxelles, School of Medicine, CHU Saint-Pierre, CHU de Bruxelles, Department of Otorhinolaryngology and Head and Neck Surgery, Brussels, Belgium
| | - Paulo S Perazzo
- Universidade Estadual da Bahia, Faculdade de Ciências Médicas, Escola de Medicina, Departamento de Otorrinolaringologia, Salvador, BA, Brazil
| | - Fabio P Ceccon
- Universidade Federal de São Paulo (UNIFESP), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Claudia A Eckley
- Fleury Medicina e Saúde Laboratórios Diagnósticos, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Karen de Carvalho Lopes
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Disciplina de Otologia e Otoneurologia, São Paulo, SP, Brazil
| | - Rebecca Maunsell
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | | | - Lee M Akst
- Johns Hopkins Hospital, Department of Otolaryngology-Head Neck Surgery, Baltimore, MA, USA
| | - Geraldo D Sant'Anna
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Disciplina de Otorrinolaringologia, Porto Alegre, RS, Brazil
| | - Rui Imamura
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil.
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