Results of 24-hour pH monitorization in laryngopharyngeal reflux cases presenting with various symptoms

Yıl 2012, Cilt: 2 Sayı: 3, 106 - 113, 01.09.2012

Murat Kar İmran San Baki Korkmaz Abdullah Özgönül İsmail İynen

https://doi.org/10.2399/jmu.2012003004

Öz

Objective: Laryngopharyngeal reflux (LPR), an atypical form of gastroesophageal reflux (GER), may present with non-specific symptoms of upper aerodigestive system. In this study, we aimed to show the LPR frequency of various symptom groups by 24-hour double-channel pH monitorization. Methods: A total of 125 patients and 20 healthy controls were enrolled to this study between July 2007 and July 2008. Patients were assigned to 5 different groups with respect to their chief complaints (gastrointestinal, bronchial, laryngeal, pharyngeal and rhinologic). All patients underwent 24-hour double-channel pH monitorization and diagnosis of LPR was confirmed if one or more pH results were below 4.0 in proximal channel. Results: Laryngopharyngeal reflux was detected in 18 of 19 patients (94%) in gastrointestinal group, 24 of 25 patients (96%) in bronchial group, 26 of 31 patients (83%) in laryngeal group, 27 of 29 patients (93%) in pharyngeal group, 19 of 21 patients (90%) in rhinologic group and 2 of 20 patients (10%) in the control group. The highest incidence of LPR was encountered in the bronchial group, whereas the lowest incidence for LPR was detected in laryngeal group. Conclusion: Laryngopharyngeal reflux may present with a wide spectrum of symptoms in daily otorhinolaryngology practice. With respect to our results, 24-hour double-channel pH monitorization turns out to be a reliable method in the diagnosis of LPR in cases suspected for laryngopharyngeal reflux.

Anahtar Kelimeler

Laryngopharyngeal reflux, gastroesophageal reflux, diagnosis, 24-hour pH monitorization

Farklı belirtilerle başvuran larengofarengeal reflü olgularında 24 saatlik pH monitörizasyon sonuçları

Öz

Amaç: Gastroözofageal reflünün atipik klinik şekillerinden biri olan larengofarengeal reflünün (LFR) kulak burun boğaz hastalıkları pratiğinde pek çok belirtiden sorumlu olduğu düşünülmektedir. Çalışmamızda farklı belirtiler gösteren gruplarda LFR sıklığını 24 saatlik çift kanallı pH metre monitörizasyonu ile göstermeyi amaçladık. Yöntem: Bu çalışma, Temmuz 2007–Temmuz 2008 arasında çeşitli kulak burun boğaz ve baş boyun semptomları ile başvuran olgular üzerinde yapıldı. Semptom ve bulgularına göre olgular 5 farklı grup (gastrointestinal, bronşial, larengeal, farengeal, rinolojik) ve herhangi bir yakınması olmayan bireylerden bir kontrol grubu oluşturuldu. Tüm olgulara 24 saatlik çift kanallı pH monitörizasyonu yapıldı. Proksimal kanalda bir ve daha fazla pH değerinin 4.0'ın altına düşmesi LFR pozitif olarak kabul edildi. Bulgular: Ölçüm sonuçlarına göre LFR, gastrointestinal semptom grubunda %94 (18/19), bronşial semptom grubunda %96 (24/25), larengeal semptom grubunda %83 (26/31), farengeal semptom %93 (27/29), rinolojik semptom grubunda %90 (19/21), kontrol grubunda ise %10 (2/20) sıklığında tespit edilmiştir. Semptomlara göre değerlendirildiğinde larengofarengeal reflü en sık bronşial grupta saptanırken, en düşük insidans larengeal grupta gözlenmiştir. Sonuç: Larengofarengeal reflü, klinikte oldukça farklı kulak burun boğaz semptomlarıyla karşımıza çıkabilmektedir. Larengofarengeal reflüden şüphelenilen olgularda kesin tanı için 24 saatlik çift kanallı pH monitörizasyonu etkin bir yöntem teşkil etmektedir.

Anahtar Kelimeler

Larengofarengeal reflü, gastroözefageal reflü, tanı, 24 saatlik pH monitörizasyonu

Kaynakça

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• Makalenin atıf künyesi: Kar M, San İ, Korkmaz B, Özgönül A, İynen İ. Farklı belirtilerle başvuran laringofaringeal reflü olgularında 24 saatlik pH
• monitörizasyon sonuçları. J Med Updates 2012;2(3):106-113.