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J Korean Soc Laryngol Phoniatr Logop > Volume 22(2); 2011 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2011;22(2): 151-155.
양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석
이창희, 이현섭, 진성민, 이상혁
성균관대학교 의과대학 강북삼성병원 이비인후과교실
Analysis of High-Resolution Manometry Results in LPRD Patients who do not Response to PPI Medication
Chang-Hee Lee, Hyun-Sub Lee, Sung-Min Jin, Sang-Hyuk Lee
Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
ABSTRACT
Background and Objectives
: Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Subjects and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms.
Results
: In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance.
Conclusion
: Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.
KEY WORDS: Laryngopharyngeal reflux;Manometry;Diagnosis differential;
중심 단어: 인후두 역류질환;식도 내압 검사;진단;
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