Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
Department of Otolaryngology, Polyclinic of Poitiers, Elsan Hospital, Poitiers, France.
Otolaryngol Head Neck Surg. 2024 Oct;171(4):1114-1122. doi: 10.1002/ohn.878. Epub 2024 Jul 4.
To investigate the minimum therapeutic duration for patients with primary laryngopharyngeal reflux disease (LPRD) through the evaluation of symptom changes at multiple time points.
Prospective uncontrolled.
University medical center.
Patients with LPRD at the 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring were recruited from the European Reflux Clinic. Depending on the type of LPRD, patients were treated with a combination of proton-pump inhibitors, alginate, or magaldrate. Symptoms were evaluated with the reflux symptom score (RSS) at baseline and throughout treatment (1-, 3-, 6-, and 9-month posttreatment). The most appropriate therapeutic duration was determined using the RSS changes. Signs were evaluated with the reflux sign assessment.
A total of 159 patients completed the study. The mean age was 49.9 ± 15.7 years. At 1-month posttreatment, 97 patients (61.0%) were considered as early responders to treatment, and the treatment was stopped for 52 patients (32.7%). Of the 62 early nonresponders, 34 patients (21.4%) reached responded to treatment after 3 to 9 months. The cumulative therapeutic success rate at 1-month posttreatment (61.0%) progressively increased to reach a range of 82.4% to 99.3% at 9-month posttreatment. The RSS mainly decreased in the first month of treatment in early responders. In early nonresponders, RSS progressively decreased throughout the 9-month treatment period. The baseline severity of RSS is a strong predictor of therapeutic response.
A therapeutic regimen of 1 month can be sufficient to treat one third of LPRD patients. The early nonresponders may require 3 to 9 months of treatment.
通过评估多个时间点的症状变化，探讨原发性喉咽反流病（LPRD）患者的最小治疗持续时间。
前瞻性非对照。
大学医学中心。
在 24 小时食管多通道腔内阻抗-pH 监测下招募 LPRD 患者，来自欧洲反流诊所。根据 LPRD 的类型，患者采用质子泵抑制剂、藻酸盐或镁铝碳酸盐联合治疗。在基线和整个治疗期间（治疗后 1、3、6 和 9 个月）使用反流症状评分（RSS）评估症状。使用 RSS 变化确定最合适的治疗持续时间。使用反流体征评估评估体征。
共有 159 例患者完成了研究。平均年龄为 49.9 ± 15.7 岁。治疗后 1 个月，97 例（61.0%）患者被认为对治疗有早期反应，52 例（32.7%）患者停止治疗。在 62 例早期无反应者中，34 例（21.4%）在 3 至 9 个月后对治疗有反应。治疗后 1 个月的累积治疗成功率（61.0%）逐渐增加，治疗后 9 个月的范围为 82.4%至 99.3%。早期反应者的 RSS 主要在治疗的第一个月下降。在早期无反应者中，RSS 在整个 9 个月的治疗期间逐渐下降。RSS 的基线严重程度是治疗反应的一个强预测因素。
1 个月的治疗方案可能足以治疗三分之一的 LPRD 患者。早期无反应者可能需要 3 至 9 个月的治疗。
