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Study on laryngopharyngeal and esophageal reflux characteristics using 24-h multichannel intraluminal impedance-pH monitoring in healthy volunteers

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

Abstract

Objective

We aimed to analyze the results of 24-h multichannel intraluminal impedance and pH-monitoring (MII-pH) of the laryngopharynx and esophagus in asymptomatic volunteers. Moreover, we also aimed to gain insight into and establish a baseline for laryngopharyngeal reflux in the healthy population by quantitatively and qualitatively comparing the reflux and pH distribution in both the laryngopharynx and the esophagus.

Methods

Healthy volunteers were recruited and observed; they underwent 24-h ambulatory combined MII-pH monitoring. The proximal sensor (pH1) was positioned approximately 1 cm above the upper esophageal sphincter with the aid of a solid-state high-resolution esophageal manometer. Laryngopharyngeal reflux events were detected and characterized by the incidence and property of reflux both in the laryngopharynx and the esophagus.

Results

Thirty-eight asymptomatic volunteers who completed all the examinations were included in this study. The median pH detected by the proximal sensor was 6.6 (6.2, 7.0), with an average of 6.58 ± 0.74. A total of 814 laryngopharyngeal reflux events were detected, including 722 (89%) in the upright position and 92 (11%) in the supine position with incidence (0%) in the liquid state, 44 (5%) in the mixture, and 769 (95%) in the gaseous state. Furthermore, 5 incidences (1%) of acid reflux and 809 incidences of non-acid reflux (99%) were noted. A total of 5779 esophageal reflux events were detected, including 5020 (87%) in the upright position, 759 (13%) in the supine position, with 2051 (36%) in the liquid state, 2050 (35%) in the mixed condition, and 1678 (29%) in the gaseous state; adding up to 805 incidences (14%) of acid reflux and 4974 incidences (86%) of non-acid reflux.

Conclusion

Non-acid reflux in the upright position is characteristic of laryngopharyngeal reflux. Acid reflux is almost undetectable in healthy subjects. Hence, the diagnostic indicators of gastroesophageal reflux disease are not suitable for laryngopharyngeal reflux disease.

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Acknowledgements

We would like to thank Editage (www.editage.cn) for English language editing.

Funding

The study supported by the High-level hospital foster grants from Fujian Province Hospital, Fujian province, China (Grant number: 2019HSJJ13), 2018 Fujian Medical University Qihang Fund Project (Grant number: 2018OH1157), the National Natural Science Foundation of China (Grant no. 81970899) and supported by the training project of Fujian Province's health research talents Fund Project (Grant number: 2019-2-32).

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Author notes

  1. Chenjie Hou and Meixiang Chen contributed equally to this work.

Authors and Affiliations

  1. Department of Otorhinolaryngology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China

    Chenjie Hou, Ting Chen, Yang Yang, Xiaolong Yang, Liuqing Chen & Chaofeng Liu

  2. Department of Otorhinolaryngology, The First Hospital of Putian, Putian, 351100, Fujian, China

    Meixiang Chen

  3. Department of Gastroenterology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, Fujian, China

    Zhihui Lin & Yanling Zeng

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  1. Chenjie Hou
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Correspondence to Ting Chen.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (include name of committee + reference number) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of Fujian Provincial Hospital (Ethical approval number: K-2015–019-01).

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Hou, C., Chen, M., Chen, T. et al. Study on laryngopharyngeal and esophageal reflux characteristics using 24-h multichannel intraluminal impedance-pH monitoring in healthy volunteers. Eur Arch Otorhinolaryngol 277, 2801–2811 (2020). https://doi.org/10.1007/s00405-020-05969-x

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