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Oropharyngeale pH-Metrie

Überblick und Darstellung einer neuen pH-Metriemethode

Extraesophageal reflux

Overview and discussion of a new method for pH monitoring

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Zusammenfassung

Hintergrund

Die extraösophageale Refluxerkrankung (EÖR) muss häufig vom Hals-Nasen-Ohrenarzt oder Phoniater diagnostiziert und behandelt werden. Sie ist als eigenes Krankheitsbild von der gastroösophagealen Refluxerkrankung abzugrenzen.

Zielsetzung

Seit kurzem steht die oropharyngeale pH-Metrie als einkanaliges Messsystem zur Bestimmung extraösophagealer Refluxereignisse zur Verfügung. Dieses Messsystem soll in die bereits bestehenden diagnostischen Möglichkeiten eingeordnet und erste eigene Erfahrungen geschildert werden.

Methodik

Es wurde eine Literaturrecherche zur oropharyngealen pH-Metrie bei den Datenbanken NHS EED, HTA, DARE, Clinical Trials, Cochrane Reviews und Medline/PubMed durchgeführt. Eine selektive Literaturrecherche erfolgte zur Problematik der extraösophagealen Refluxerkrankung.

Ergebnisse

Zur Diagnostik der EÖR-Erkrankung können u. a. Bewertungsskalen, eine probatorische Protonenpumpeninhibitortherapie und die pH-Metrie eingesetzt werden. Die pH-Metrie kann mit Hilfe der bisher üblichen 2-Kanal-pH-Metrie erfolgen; seit kurzem besteht aber auch die Möglichkeit einer isolierten oropharyngealen pH-Messung. Diese Methode wurde in ersten Studien anhand von gesunden Probanden normiert und mit der klassischen 2-Kanal-pH-Metrie verglichen. Prospektive randomisierte Studien zur Diagnostik der extraösophagealen Refluxerkrankung mit der oropharyngealen Messsonde fehlen bisher noch.

Diskussion

Die oropharyngeale pH-Metrie hat im Vergleich mit der bisher eingesetzten 2-Kanal-pH-Metrie potenzielle Vorteile, allerdings sind hierzu noch einige Fragen offen. Dies wird anhand von eigenen Patientenbeispielen dargestellt und erläutert.

Abstract

Background

Extraesophageal reflux disease often requires diagnosis and treatment by a phoniatry or ear, nose and throat specialist. The disease needs to be differentiated from gastroesophageal reflux disease.

Objective

A new oropharyngeal pH measuring system with a single channel probe has recently been introduced. The aim of this study was to compare oropharyngeal pH-metry with the existing diagnostic methods for extraesophageal reflux disease and to present initial results in our own patients.

Methods

A literature search for oropharyngeal pH-metry was performed in the databases NHS EED, HTA, DARE, Clinical trials, Cochrane reviews and Medline/PubMed. A selective literature search was also carried out on the problem of extraesophageal reflux disease.

Results

Evaluation scales, trial proton pump inhibitor therapy or pH-metry, for example, can be used to diagnose extraesophageal reflux disease. pH-metry can be performed using a classical two-channel pH-metry system; a new oropharyngeal pH measuring system has recently been introduced. This new method has been evaluated in initial studies for normative data and has been compared to two-channel pH-metry. Prospective randomised studies to diagnose extraesophageal reflux disease with the new oropharyngeal pH-metry method are still lacking.

Discussion

Oropharyngeal pH-metry has some potential advantages compared to classical two-channel pH-metry; however, a lot of questions remain unanswered. These will be discussed and illustrated with the help of a number of own patient case reports.

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  1. Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    M. Jungheim & M. Ptok

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Correspondence to M. Jungheim.

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Jungheim, M., Ptok, M. Oropharyngeale pH-Metrie. HNO 59, 893–899 (2011). https://doi.org/10.1007/s00106-011-2329-5

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