Abstract
Background: Laryngopharyngeal reflux (LPR) can display a variety of symptoms, and upper endoscopy is occasionally used for its investigation. The aim of the present study was to determine the value of transnasal esophagoscopy (TNE) in the workup of LPR. Methods: In 200 consecutive patients with suspected LPR, reflux symptom index (RSI), reflux finding score (RFS), oropharyngeal pH-monitoring (PHM) and transnasal esophagoscopy (TNE) were carried out and rated according to the Horvath Score. Results: In the investigation of LPR, TNE showed a sensitivity, specificity and accuracy of 96%, 85% and 95%, respectively. The most common pathologic TNE findings in LPR patients were an insufficient cardia, hiatal hernia, lymphoid follicles and visible reflux. Conclusions: TNE is a supportive method in the workup of LPR, which can display the underlying pathology and directly affect therapeutic decisions.
Highlights
Laryngopharyngeal reflux (LPR) differs from classic gastroesophageal reflux (GER) in various aspects and has been recognized as an independent clinical entity [1]
GER presents with lower esophageal sphincter insufficiency, whereas LPR shows a dysfunction of the upper esophageal sphincter [1]
The diagnosis of LPR is frequently based on the reflux symptom index (RSI), reflux finding score (RFS) and/or a trial of proton pump inhibitor (PPI) therapy [6,7]
Summary
Laryngopharyngeal reflux (LPR) differs from classic gastroesophageal reflux (GER) in various aspects and has been recognized as an independent clinical entity [1]. These aspects include pathologic mechanisms, symptoms of disease, clinical appearance and therapeutic response [2]. GER presents with lower esophageal sphincter insufficiency, whereas LPR shows a dysfunction of the upper esophageal sphincter [1]. While GER typically presents with heartburn and acid regurgitation, LPR shows a different clinical picture. The diagnosis of LPR is frequently based on the reflux symptom index (RSI), reflux finding score (RFS) and/or a trial of proton pump inhibitor (PPI) therapy [6,7].
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