Jecker P, Schuon R, Mann W J
Hals-Nasen-Ohren-Klinik der Johannes-Gutenberg-Universität Mainz.
HNO. 2003 Sep;51(9):704-9. doi: 10.1007/s00106-002-0801-y. Epub 2003 Apr 9.
Laryngopharyngeal reflux disease (LPRD) can have various causes. Because LPRD differs from gastroesophageal reflux disease (GERD), the pH monitoring has to be performed directly next to the entrance of the larynx. This is now possible using a new system called pH-RESPONSE.
The ambulatory pH was monitored using the double probe pH-RESPONSE in 20 patients with suspected LPRD. The number of refluxes, the number of long refluxes and the period in which the pH was below 4 were compared at the level of the larynx with the data from the esophageal electrode. The DeMeester score was also determined.
The system was well tolerated by 19/20 patients. In 12 patients a GERD could be proved and ten also had LPRD. Surprisingly, these patients had no typical signs such as heart burn. The number of refluxes measured in the esophagus was a third that of the larynx. The average time of pH below 4 was 30 min.
The pH-RESPONSE easily allows ambulatory 24 -h double probe pH monitoring to diagnose LPRD. Because large differences were found between data form the esophagus from the level of the larynx, 24-h double probe pH monitoring should be a standard procedure before starting any therapy for LPRD.
喉咽反流病（LPRD）可有多种病因。由于LPRD与胃食管反流病（GERD）不同，pH监测必须在紧邻喉入口处进行。现在使用一种名为pH-RESPONSE的新系统可以做到这一点。
使用双探头pH-RESPONSE对20例疑似LPRD患者进行动态pH监测。将喉水平的反流次数、长时间反流次数以及pH低于4的时间段与食管电极的数据进行比较。还确定了DeMeester评分。
19/20的患者对该系统耐受性良好。12例患者证实患有GERD，其中10例也患有LPRD。令人惊讶的是，这些患者没有烧心等典型症状。食管中测得的反流次数是喉部的三分之一。pH低于4的平均时间为30分钟。
pH-RESPONSE能够轻松实现动态24小时双探头pH监测以诊断LPRD。由于在食管和喉部水平的数据之间发现了很大差异，24小时双探头pH监测应成为开始任何LPRD治疗前的标准程序。
