24-Hour Multichannel Intraluminal Impedance–pH in Proton Pump Inhibitor Nonresponders vs Responders in Patients With Laryngopharyngeal Reflux. (May 2022)

• Record Type: Journal Article
• Authors: Kim, Su Il; Jeong, Su Jin; Kwon, Oh Eun; Park, Jung Min; Lee, Young Chan; Eun, Young-Gyu; Ko, Seong-Gyu
• Is Part Of: Otolaryngology--head and neck surgery. Volume 166:Number 5(2022)
• Page Start: 910
• Page End: 916
• Publication Date: 2022-05
• Subjects: laryngopharyngeal reflux -- multichannel intraluminal impedance–pH (MII-pH) -- proton pump inhibitor -- nonresponder; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/01945998211026843
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: This study aimed to evaluate the characteristics of reflux in proton pump inhibitor (PPI) nonresponders vs responders in patients with laryngopharyngeal reflux (LPR) by using 24-hour multichannel intraluminal impedance–pH (MII-pH) monitoring. Study Design: Prospective cohort study. Setting: A tertiary care otolaryngology clinic. Methods: Patients with typical LPR symptoms showing >1 proximal reflux episode were considered to have LPR and investigated prospectively. Patients were prescribed high-dose PPI twice daily and followed up for at least 2 months. Patients with LPR showing a ≥50% decrease in the follow-up reflux symptom index score during treatment periods as compared with pretreatment were defined as responders; others were defined as nonresponders. Various parameters in 24-hour MII-pH monitoring between nonresponders and responders with LPR were compared with Student's t test and receiver operating characteristic curve. Results: Eighty patients were diagnosed with LPR and categorized as nonresponders (n = 19) and responders (n = 61). Proximal all reflux time and proximal longest reflux time in various MII parameters were higher in responders than in nonresponders ( P = .0040 and .0216, respectively). Proximal all reflux time >0.000517% was a better cutoff value to predict responders with LPR as compared with the proximal longest reflux time >0.61 minutes (sensitivity + specificity: 1.317 vs 1.291). Conclusion: Proximal all reflux time in various 24-hour MII-pH monitoring parameters can be helpful to predict the response to PPI therapy in patients with LPR. These findings will help establish a personalized therapeutic scheme for patients with LPR.