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Influence of proton pump inhibitor therapy on occurrence of voice prosthesis complications

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

It has been shown that the reflux of the gastric content to the proximal oesophagus influences incidence of voice prosthesis (VP) complications in laryngectomized patients. We conducted prospective randomised study to investigate the relationship between pepsin concentration in saliva and occurrence of VP complications before and after 3 months of proton pump inhibitor (PPI) therapy.

Methods

60 laryngectomized patients with VP and 30 controls were included in the study. Saliva samples were collected in the morning and concentration of pepsin were measured by Human Pepsin (PG) ELISA kit. Thirty-Four (57%) patients reported one or more VP complication and were randomised in two groups, with and without PPI therapy, 40 mg pantoprazole per day for 3 months.

Results

Patients who had longer time since last VP change had higher incidence of periprosthetic and transprosthetic leakage and Candida colonisation. Pepsin was found in all saliva samples. Median saliva pepsin concentration level did not significantly differ between laryngectomized patients and control subjects, or between patients with and without VP complications, and there was no correlation between saliva pepsin concentration levels and type of VP complication. After 3 months therapy, there was no difference in median saliva pepsin level or incidence of VP complication between patients with and without PPI therapy.

Conclusion

Although reflux was proposed to be associated with VP complications and pepsin was proven as a most sensitive and specific marker of EER, we did not find any statistically significant correlation between pepsin levels and occurrence of VP complications. A 3 months 40 mg pantoprazole therapy was ineffective in reduction of VP complications in our study group.

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Acknowledgements

We would like to express our special thanks of gratitude to Robert Tičac, MD, Dijana Pedisić Maržić, MD, Marija Pastorčić Grgić,MD,PhD, Pavle Perše, MD, Tomislav Tomičević, MD, Assist. Prof. Željko Zubčić, MD, PhD and Tamara Živković, SLP, for help during patient inclusion in study.

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Authors and Affiliations

  1. Clinical Department for Otorhinolaryngology and Head and Neck Surgery, University Hospital Centre Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia

    Ana Danic Hadzibegovic & Drago Prgomet

  2. Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia

    Ana Danic Hadzibegovic & Irzal Hadzibegovic

  3. Faculty of Dental Medicine and Health Care, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia

    Ana Danic Hadzibegovic, Irzal Hadzibegovic & Davorin Danic

  4. Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia

    Ana Kozmar

  5. Department for Cardiology, University Hospital Dubrava, Zagreb, Croatia

    Irzal Hadzibegovic

  6. Department for Internal Medicine, University Hospital Dubrava, Zagreb, Croatia

    Irzal Hadzibegovic

  7. School of Medicine, University Zagreb, Zagreb, Croatia

    Drago Prgomet

Authors
  1. Ana Danic Hadzibegovic
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  2. Ana Kozmar
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  3. Irzal Hadzibegovic
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  5. Davorin Danic
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Correspondence to Ana Danic Hadzibegovic.

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Human and animal participant statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethics committee of the University of Zagreb, ethics committee of General Hospital Dr. Josip Bencevic, Clinical Hospital Centre Zagreb, Clinical Hospital Centre Rijeka, Clinical Hospital Centre Osijek, and Clinical Hospital Centre Sestre Milosrdnice, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Danic Hadzibegovic, A., Kozmar, A., Hadzibegovic, I. et al. Influence of proton pump inhibitor therapy on occurrence of voice prosthesis complications. Eur Arch Otorhinolaryngol 277, 1177–1184 (2020). https://doi.org/10.1007/s00405-020-05784-4

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  • DOI: https://doi.org/10.1007/s00405-020-05784-4

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