Department of Otolaryngology, Head and Neck Surgery, Comenius University, University Hospital, Bratislava, Slovakia.
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czech Republic.
Laryngoscope. 2024 Jan;134(1):62-68. doi: 10.1002/lary.30766. Epub 2023 May 29.
Mulberry-like changes of the posterior inferior nasal turbinate (MPINT) can lead to nasal obstruction. Extraesophageal reflux (EER) characterized by lower pH causes mucosal inflammation and therefore can contribute to sinonasal pathologies. No prior studies have objectively examined the possible association between acidic pH and MPINT formation. Therefore, this study is aimed to investigate the 24-h pharyngeal pH value in patients with MPINT.
Prospective case-control multi-center study.
Fifty-five patients with chronic EER symptoms were included in the study. They filled in questionnaires aimed at reflux and sinonasal symptoms (RSI®, SNOT-22) and underwent video endoscopy evaluating the laryngeal findings (RFS®) and the presence or absence of the MPINT. And, 24-h oropharyngeal pH monitoring was used to detect the acidic pH environment in the pharynx.
Out of the 55 analyzed patients, 38 had the MPINT (group 1), and in 17 patients, the MPINT was absent (group 2). Based on the pathological RYAN Score, in 29 (52.7%) patients, severe acidic pH drops were detected. In group 1, the acidic pH drops were diagnosed significantly more often (68.4%) compared with those in group 2 (p = 0.001). Moreover, in group 1, a significantly higher median total percentage of time spent below pH 5.5 (p = 0.005), as well as a higher median number of events lasting more than 5 min (p = 0.006), and higher median total number of events with pH drops (p = 0.017) were observed.
In this study, the MPINT was significantly more often present in patients with acidic pH events detected by 24-h oropharyngeal pH monitoring. Acidic pH in the pharynx might lead to MPINT formation.
3 Laryngoscope, 134:62-68, 2024.
后下鼻甲的桑椹样改变（MPINT）可导致鼻塞。以较低 pH 值为特征的食管外反流（EER）可引起黏膜炎症，因此可能导致鼻-鼻窦疾病。先前没有研究客观地检查酸性 pH 值与 MPINT 形成之间的可能关联。因此，本研究旨在研究 MPINT 患者的 24 小时咽 pH 值。
前瞻性病例对照多中心研究。
研究纳入 55 例有慢性 EER 症状的患者。他们填写了旨在评估反流和鼻-鼻窦症状（RSI®、SNOT-22）的问卷，并接受了视频内镜检查以评估喉部发现（RFS®）和 MPINT 的存在与否。同时，使用 24 小时咽部 pH 监测来检测咽部的酸性 pH 环境。
在分析的 55 例患者中，38 例有 MPINT（组 1），17 例无 MPINT（组 2）。根据病理性 RYAN 评分，29 例（52.7%）患者检测到严重酸性 pH 值下降。在组 1 中，酸性 pH 值下降的诊断明显更常见（68.4%），与组 2（p=0.001）相比。此外，在组 1 中，中位 pH 值低于 5.5 的时间总百分比显著更高（p=0.005），持续时间超过 5 分钟的事件中位数更多（p=0.006），pH 值下降的事件总数中位数也更高（p=0.017）。
在这项研究中，通过 24 小时咽部 pH 监测检测到酸性 pH 值事件的患者中，MPINT 的存在明显更为常见。咽中的酸性 pH 值可能导致 MPINT 的形成。
3 Laryngoscope, 134:62-68, 2024.
