Diagnosis of laryngopharyngeal reflux in children with voice disorders using 24-hour pharyngeal pH monitoring
| Autor: | Danuta Raj-Koziak, Piotr H. Skarzynski, Elżbieta Włodarczyk, Tomasz Jetka, Aleksandra Panasiewicz, Henryk Skarżyński, Agata Szkiełkowska |
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| Rok vydání: | 2019 |
| Předmět: |
Nasal cavity
Male Supine position Esophageal pH Monitoring Adolescent Vocal Cords Laryngeal Edema Muscle hypertrophy Laryngopharyngeal reflux Edema Surveys and Questionnaires Laryngopharyngeal Reflux Medicine Humans Child Voice Disorders medicine.diagnostic_test Laryngoscopy business.industry Reflux General Medicine Hypertrophy Hydrogen-Ion Concentration medicine.disease Endoscopy medicine.anatomical_structure Otorhinolaryngology Laryngeal Mucosa Anesthesia Pediatrics Perinatology and Child Health Pharynx Female medicine.symptom business |
| Zdroj: | International journal of pediatric otorhinolaryngology. 121 |
| ISSN: | 1872-8464 |
| Popis: | Objectives The aim of this study was to assess the usefulness of 24-h pharyngeal pH monitoring in the diagnosis of laryngopharyngeal reflux (LPR) in children with voice disorders. Methods The study was conducted on 68 children aged 3–18 years old. In all cases, pH monitoring was successful; no child removed the probe from the nasal cavity or reported discomfort or other complaints. The following definitions were adopted: LPR in the upright position if Ryan Score upright >9.41; LPR in the supine position if there was at least one supine episode below pH 5.0 (equal to a Ryan Score supine >2.91). Results In 43 children (63%), vocal fold edema was strongly related to recorded reflux episodes, especially in the upright position. In 18 children (26%), vocal nodules were observed, but their occurrence did not significantly affect the Ryan Score, either upright or supine. The selected potential LPR markers were significantly correlated to all the pH monitoring variables and individual elements on the Reflux Symptoms Index and the Reflux Finding Score questionnaire. Conclusion Our findings indicate that, together with vocal fold edema, laryngeal edema and posterior commissure mucosal hypertrophy are important determinants of paediatric LPR. In fact, if LPR is suspected in a child, 24-h pharyngeal pH monitoring appears to be a valuable and welltolerated diagnostic tool. Vocal fold edema observed in laryngeal endoscopy can be considered a probable sign of LPR. The Reflux Finding Score appears to be helpful in diagnosing LPR in children, especially if a cut-off value of 4/5 is adopted. |
| Databáze: | OpenAIRE |
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