Gastroesophageal reflux (GER) play a role in the aetiology of otolary'ngological diseases including laryngitis, globns, cough and sinusitis. However, the correlation of supraesophageal (SE) complications with GER has been difficuh to determine due to technical failures caused hy loss of contact of the pH sensor with the pharyngeal mucosa. We evaluated a novel circumlerential antimony pH sensor for measurement of SE reflux in patients with otolaryngological disease. METHODS: 58 patients (23M:35F, mean 57yrs) with otolaryngological disease (34 sinusitis; 7 chronic cough; 9 laryngeal symptoms; 4 giobus: 2 nasal obstruction; 2 other) underwent 24hr pH monitoring using a 4-ch pH probe incorporating 2 circumferential sensors positioned in the naso/hypophary%x and 2 standard unidirectional sensors positioned in the proximal/distal esophagus. The probe was bifurcated with 3 proximal sensors (gcm apart; 2 circumferential and 1 standard) on one arm and a standard sensor located on a second arm, allowing independent positioning of the distal sensor 5cm above the LES. Acid GER episodes were identilled by a drop in distal esophageal pH to below pH 4 for > 4 sec. The proximal extent of GER was indicated by a sequential pH drop of >1 pH unit in the proximal channels RESUkTS: The pH recordings achieved using the circumferential pH sensors exhibited a stable baseline and were kee of artefact. The median(lQR) reflux index (%time pH 4% in the distal esophagus with 4(7%) also has, ing a RI >4% in the proximal esophagus. Of a total of 1151 acid reflux episodes recorded, 824(71 6%) were localised to the distal esophagus, 298(25.8%) reached the proximal esophagus, 27(2.4%) the h,~qmpharynx and 2(0.2%) the nasopharynx. Episodes of SE reflux were recorded in 16(29%) patients, but the incidence was low at only 1(1-23 episode(s)/patient. CONCLUSION: Circumtereutial pH sensors enable accurate continuous recording of pH within the hypo/nasopharymx of patients with otolaryngological disease. Although a high proportion of these patients had slgnihcant esophageal acid exposure, the, incidence of SE reflux, in particular into the nasopharynx, was extremely low. These data suggest that SE complications of GER, such as sinusitis, are unlikely to result from direct exposure of the nasal cavity to gastric refluxate but may result from other mechanisms.