Role of laryngoscopy, dual ph probe monitoring, and laryngeal mucosal biopsy in the diagnosis of pharyngoesophageal reflux

J. Scott McMurray, Mark Gerber, Colin Rudolph, Yoram Stern, J. Paul Willging, David Walner, Robin T. Cotton

Research output: Contribution to journalArticlepeer-review

Abstract

There is no standard for determining significant pharyngoesophageal reflux. This prospective blind comparison study compared dual pH probe studies, direct laryngoscopy, and mucosal biopsy in children without symptoms of gastroesophageal reflux who underwent airway evaluation. Significant reflux to the lower esophageal probe did not correlate with statistical significance with reflux to the upper probe. In this group of asymptomatic patients, a positive lower pH probe finding did not correlate with upper or lower esophageal mucosal inflammation. Eosinophilia in the esophageal mucosa is diagnostic of gastroesophageal reflux disease, and was seen in 5 of the laryngeal biopsies. A weak correlation was seen between positive findings at laryngoscopy and positive posterior cricoid biopsy in this group. There may be no consistent way to predict significant pharyngoesophageal reflux in asymptomatic patients. Single-probe pH testing will not predict significant pharyngoesophageal reflux with mucosal changes. Laryngoscopy and upper pH probe findings only weakly correlate with significant histologic findings. Laryngeal and posterior cricoid biopsy may be the only sensitive test for mucosal injury. Clinical trials of empiric antireflux therapy should be used to determine whether the laryngeal changes seen in these patients are reversible.

Original languageEnglish
Pages (from-to)299-304
Number of pages6
JournalAnnals of Otology, Rhinology and Laryngology
Volume110
Issue number4
DOIs
StatePublished - Apr 2001
Externally publishedYes

Keywords

  • Intraepithelial eosinophils
  • Laryngoscopy
  • Mucosal biopsy
  • Pharyngoesophageal reflux
  • Subglottic stenosis
  • pH probe

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