“Does a Total Laryngectomy and/or Radiotherapy Increase Laryngopharyngeal Reflux”
September 8, 2017“Role of Nasopharyngeal Reflux in the Etiology of Otitis Media with Effusion”
September 8, 2017Friedman M, Pott TR, Waxman J. Otolaryngol Head Neck Surg. 2013;149:84.
OBJECTIVES: Laryngopharyngeal reflux (LPR) is commonly treated with twice-daily proton pump inhibitor (PPI) therapy. However, a significant number of patients do not achieve complete resolution of symptoms. In this study, we aimed to assess the effect of twice-daily PPI treatment on the oropharyngeal pH environment in patients with pH-probe confirmed LPR.
RESULTS: 34 women and 22 men were assessed pre- and post-treatment, with age of 51.9 } 16.8 years and BMI of 30.8 } 7.0 kg/m2 (mean } SD). Pre-treatment upright and supine Ryan scores were 142.3}161.9 and 14.21 } 17.14, respectively (mean }SD). Patients were treated with twice-daily PPIs for a duration of 105.7 } 88.2 days (mean } SD). Post-treatment upright and supine Ryan scores were 72.66}140.5 and 12.27 } 21.1, respectively (mean }S D). Paired T-tests showed a significant decrease in mean post-treatment upright Ryan scores (P = 0.0003). However, post-treatment Ryan scores normalized in only 26 subjects (46.4%). RSI scores were higher in non-responders.
CONCLUSION: While PPI therapy resulted in a significant decrease in mean upright Ryan score, the Ryan score was normalized in only 46.4% of patients. This suggests that twice daily PPIs may be insufficient to completely eliminate reflux and symptoms of LPR.