Ezerarslan Hande, Çoban Mehmet, Kuran Sedef, Akmansu Şefik Halit, Özgüler Zişan, Beriat Güçlü Kaan, Erkan Gülbanu, Değertekin Bülent, Kocatürk Sinan
Department of Otolaryngology Medicine Faculty of Ufuk University, Ankara, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2012 Jan-Feb;22(1):6-11. doi: 10.5606/kbbihtisas.2012.002.
This study aims to investigate the possible correlations between the heterotopic gastric mucosa (HGM) islets in the cervical esophagus and laryngopharyngeal reflux (LPR).
Between May 2010 and April 2011, 45 patients (36 females, 9 males; mean age 39.8±14.1 years; range 18 to 72 years) who had reflux symptom index (RSI) >10 and reflux finding score (RFS) >7 were included. The study group consisted of 21 patients who were diagnosed with HGM islets in the cervical esophagus, while control group consisted of 24 patients without any HGM islets assessed by upper gastrointestinal system endoscopy. Esophagus manometric examination and dual-channel 24-hour pH monitoring were performed on all patients.
Pretreatment mean RSI and RFS were 25.6±3.5 and 15.1±3.4 in group 1, while it was found to be 21.1±4.4 and 11.9±2.6 in group 2 (p=0.001, p=0.001). A total of 29.7% of patients who underwent pH monitoring had distal reflux, whereas 43.2% of them had proximal reflux. In group 1, distal reflux was observed in 15.4% and proximal reflux was found in 54% of the patients, while distal reflux was observed in 38% and proximal reflux was found in 38% of the patients in group 2 (p=0.152; p=0.27). Fourteen patients diagnosed with HGM had antral- and seven patients had fundal-type epithelium.
Our study results suggest that HGM islets may be considered as an etiological factor in the patients with severe LPR with isolated proximal reflux based on the 24-hour pH monitoring.
本研究旨在探讨颈段食管异位胃黏膜（HGM）胰岛与喉咽反流（LPR）之间可能存在的相关性。
在2010年5月至2011年4月期间，纳入45例反流症状指数（RSI）>10且反流发现评分（RFS）>7的患者（36例女性，9例男性；平均年龄39.8±14.1岁；年龄范围18至72岁）。研究组由21例经上消化道系统内镜诊断为颈段食管HGM胰岛的患者组成，而对照组由24例经上消化道系统内镜评估无任何HGM胰岛的患者组成。对所有患者进行食管测压检查和双通道24小时pH监测。
治疗前，第1组的平均RSI和RFS分别为25.6±3.5和15.1±3.4，而第2组分别为21.1±4.4和11.9±2.6（p = 0.001，p = 0.001）。共有29.7%接受pH监测的患者存在远端反流，而其中43.2%存在近端反流。在第1组中，15.4%的患者观察到远端反流，54%的患者观察到近端反流，而在第2组中，38%的患者观察到远端反流，38%的患者观察到近端反流（p = 0.152；p = 0.27）。14例诊断为HGM的患者具有胃窦型上皮，7例具有胃底型上皮。
我们的研究结果表明，基于24小时pH监测，HGM胰岛可能被视为重度LPR且伴有孤立性近端反流患者的一个病因因素。
