Clinical Analysis of High Resolution Manometry (HRM) in Patients with Laryngopharyngeal Reflux Disease

Abstract

Received June 4, 2013 Revised August 6, 2013 Accepted August 16, 2013 Address for correspondence Sang Hyuk Lee, MD Department of OtolaryngologyHead and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 110-746, Korea Tel +82-2-2001-1924 Fax +82-2-2001-2273 E-mail entlsh@hanmail.net Background and ObjectivesZZHigh resolution manometry (HRM), a newly developed device that uses 36 channels to plot pressure topography of esophagus, has recently been applied to evaluate the esophageal and upper esophageal sphincter (UES) status; however, its definite role in laryngopharyngeal reflux disease (LPRD) is not well elucidated. The aim of this study was to evaluate clinical usefulness of HRM and to elucidate the association between HRM findings and dysphasia in LPRD patients. Subjects and MethodZZA total of 56 patients who had been diagnosed LPRD from July 2010 to July 2011 were prospectively enrolled in this study. Patients consisted of 20 men and 36 women, with the mean age of 51.4 years. Every patient performed the questionnaire and HRM examination. A comparative analysis was performed to evaluate the correlation between the HRM results and LPRD. ResultsZZOf 30 patients (53.6%), there were 11 peristaltic dysfunction (19.7%), 6 relaxation impairment of lower esophageal sphincter (LES)(10.7%), 4 diffuse esophageal spasm (7.1%), 4 hypotensive LES (7.1%), 3 Nutcracker esophagus (5.4%), and 2 relaxation impairment of UES (3.6%). The mean distance of UES from the nostril was 17.88±2.17 cm and the mean UES basal pressure was 63.10±24.49 mm Hg. Differences between the prevalence of abnormal findings shown by HRM and dysphasia symptoms were not statistically significant. ConclusionZZIn this study, a considerable amount of abnormalities in esophageal function were observed using HRM, and thus we think that HRM could provide useful information about esophagus dysfunction in LPRD patients. Korean J Otorhinolaryngol-Head Neck Surg 2013;56:637-41