Submucosal Clustered Brownish Microvessels Based on NBI Endoscopy: A Characteristic of LPR

Otolaryngol Head Neck Surg. 2023 Apr;168(4):790-797. doi: 10.1177/01945998221109220. Epub 2023 Jan 27.


Objective: This study aimed to analyze the characteristics of laryngopharyngeal reflux (LPR) by using narrow band imaging (NBI) endoscopy.

Study design: A prospective study.

Setting: A large-volume practice with tertiary care providers.

Methods: A total of 67 patients with suspected LPR who underwent 24-hour multichannel intraluminal impedance-pH monitoring were included from June 2020 to March 2022. Manifestations of NBI endoscopy included submucosal clustered brownish microvessels (CBMs), spotted brownish microvessels, and no special microvessels; the latter 2 formed the non-CBM group. The manifestations of all patients and their changes were observed after 8 weeks of proton pump inhibitor and symptomatic treatment for patients with LPR, and symptomatic treatment for patients without LPR.

Results: According to the results of 24-hour multichannel intraluminal impedance-pH monitoring, the incidence of submucosal CBMs was significantly higher in patients with LPR (30 cases) than in those without LPR (37 cases, P < .001), particularly in the posterior cricoid area (P < .001). Besides Reflux Finding Score, the incidence of signs such as subglottic edema and vocal fold edema was significantly higher in the CBM group than the non-CBM group (P < .05). Finally, 22 patients with LPR (91.7%) and only 2 patients without LPR (28.6%) underwent a transformation from CBMs to spotted brownish microvessels after continuous medication for 8 weeks in the CBM group (χ2 = 15.916, P < .001), while no significant change was observed in patients with or without LPR in the non-CBM group (P > .05).

Conclusion: Submucosal CBMs in the posterior cricoid area under NBI endoscopy may be a characteristic of LPR.

Keywords: NBI endoscopy; RFS; RSI; laryngopharyngeal reflux; pH monitoring.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Edema
  • Endoscopy
  • Esophageal pH Monitoring
  • Humans
  • Laryngopharyngeal Reflux* / diagnosis
  • Narrow Band Imaging
  • Prospective Studies