The Profiles of Laryngopharyngeal Reflux in Patients With Different Vocal Fold Lesions

Jinhong Zhang; Xiaoyu Wang; Jiasen Wang; Jing Zhao; Chun Zhang; Zhi Liu; Jinrang Li

doi:10.1016/j.jvoice.2022.08.002

The Profiles of Laryngopharyngeal Reflux in Patients With Different Vocal Fold Lesions

J Voice. 2022 Sep 1:S0892-1997(22)00235-1. doi: 10.1016/j.jvoice.2022.08.002. Online ahead of print.

Authors

Jinhong Zhang¹, Xiaoyu Wang², Jiasen Wang², Jing Zhao², Chun Zhang², Zhi Liu², Jinrang Li³

Affiliations

¹ Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, 100048; Department of otolaryngology, School of Medicine, South China University of Technology, Guangzhou, 510006.
² Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, 100048.
³ Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, 100048; Department of otolaryngology, School of Medicine, South China University of Technology, Guangzhou, 510006. Electronic address: entljr@sina.com.

PMID: 36058775
DOI: 10.1016/j.jvoice.2022.08.002

Abstract

Objectives: To investigate the profiles of laryngopharyngeal reflux (LPR) and the relationship between hypopharyngeal-proximal reflux episodes (HREs) and the positive rate of salivary pepsin testing in patients with vocal fold lesions (VFLs).

Methods: The enrolled patients were divided into vocal fold cancer group (VFCG), vocal fold leukoplakia group (VFLG), benign vocal fold lesion group (BVFLG) and control group (CG). Patients benefited from multichannel intraluminal impedance-pH monitoring (MII-pH) and multi-time point salivary pepsin testing (MTPSPT). The LPR profiles of patients with VFLs were studied by analyzing the MII-pH findings. The relationship between HREs and positive rate of MTPSPT was investigated through the nonparametric test.

Results: 177 patients were included. According to 24 h MII-pH, the occurrence of HREs tended to increase after meals. 55.75%, 63.98%, 66.82% and 55.77% of the HREs in the VFCG, VFLG, BVFLG and CG occurred within 3 h after meals, respectively. The overall positive rate of MTPSPT was higher in the VFCG than the remaining groups. In the VFCG, there was a significant correlation between overall positive results of MTPSPT and HREs occurring within 3 h after meals.

Conclusion: In the Chinese population, the occurrence of HREs tend to more frequently after meals in patients with VFLs, and most HREs occur within 3 h after meals. By analyzing the 24h MII-pH findings, we can develop a more individualized anti-reflux therapeutic strategy for LPR patients.

Keywords: Laryngopharyngeal reflux; Pepsin; Profiles; Vocal fold lesions.