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World Journal of Gastroenterology 2024年第16期30卷 2209-2219页

作者： Na Cui Ting Dai Yang Liu Ya-Yu Wang Jia-Yu Lin Qing-Fan Zheng Dong-Dong Zhu Xue-Wei Zhu Department of Otorhinolaryngology Head and Neck Surgery China-Japan Union Hospital of Jilin UniversityChangchun 130033Jilin ProvinceChina Department of Ultrasound China-Japan Union Hospital of Jilin UniversityChangchun 130033Jilin ProvinceChina Department of Gastroenterology China-Japan Union Hospital of Jilin UniversityChangchun 130033Jilin ProvinceChina

laryngopharyngeal reflux disease(LPRD)is an inflammatory condition in the laryngopharynx and upper aerodigestive tract mucosa caused by reflux of stomach contents beyond the *** commonly presents with symptoms such as hoarseness,cough,sore throat,a feeling of throat obstruction,excessive throat *** complex condition is thought to involve both reflux and reflex mechanisms,but a clear understanding of its molecular mechanisms is still ***,there is no standardized diagnosis or treatment *** strategies for LPRD mainly include lifestyle modifications,proton pump inhibitors and endoscopic *** paper seeks to provide a comprehensive overview of the existing literature regarding the mechanisms,pathophysiology and treatment of *** also provide an in-depth exploration of the association between LPRD and gastroesophageal reflux disease.

关键词： laryngopharyngeal reflux Gastroesophageal reflux Head neck surgery Laryngitis Otolaryngology

laryngopharyngeal reflux in patients with reflux esophagitis

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World Journal of Gastroenterology 2008年第28期14卷 4523-4528页

作者： Yung-Chih Lai Pa-Chun Wang Jun-Chen Lin Division of Gastroenterology Department of Internal Medicine Cathay General Hospital School of Medicine National Taiwan University School of Medicine Taipei Medical University Taipei 10630 Taiwan China Department of Otolaryngology Cathay General Hospital School of Medicine Fu Jen Catholic University Taipei 10630 School of Public Health China Medical University Taichung 40402 Taiwan China Department of Otolaryngology Cathay General Hospital Taipei 10630 Taiwan China

AIM: To assess the prevalence of laryngopharyngeal reflux (LPR) in patients with reflux esophagitis and dis-close factors contributing to the development of LPR. METHODS: A total of 167 patients who proved to have reflux esophagitis by endoscopy were enrolled. They received laryngoscopy to grade the reflux find-ings for the diagnosis of LPR. We used validated ques-tionnaires to identify the presence of laryngopharyn-geal symptoms, and stringent criteria of inclusion to increase the specificity of laryngoscopic findings. The data of patients were analyzed statistically to find out factors related to LPR. RESULTS: The prevalence rate of LPR in studied sub-jects with reflux esophagitis was 23.9%. Age, hoarse- ness and hiatus hernia were factors significantly as-sociated with LPR. In 23 patients with a hiatus hernia, the group with LPR was found to have a lower trend of esophagitis grading. CONCLUSION: laryngopharyngeal reflux is present in patients with reflux esophagitis, and three predicting factors were identified. However, the development of LPR might be different from that of reflux esophagi-tis. The importance of hiatus hernia deserves further study.

关键词： laryngopharyngeal reflux Gastroesophageal reflux disease reflux esophagitis

A combined treatment for patients with dry eye and associated laryngopharyngeal reflux:a real-life approach

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International Journal of Ophthalmology(English edition) 2023年第10期16卷 1616-1622页

作者： Giorgio Ciprandi Stefano Bonini Irene Schiavetti Valerio Damiani Study Group on Dry-Eye Pragmatical Management Allergy Clinic Casa di Cura Villa MontallegroGenoa 16145Italy Ophthalmology Complex Operative Unit University Campus Bio-MedicoRome 00100Italy Health Science Department University of GenoaGenoa 16142Italy Medical Department DMGPomezia 00070Italy 不详

AIM:To evaluate the efficacy and tolerability of administering a combined therapy in patients with dry eye syndrome(DES)and associated laryngopharyngeal reflux(LPR).METHODS:The study was retrospective,open,observational,and conducted in a real-life *** had pathological symptom assessment in dry eye(SANDE)and reflux symptom index(RSI)at *** were re-assessed after 1mo and at the end of *** treatment consisted of a three-month course based on the combined therapy:Gastroftal eye drops,one drop three times a day,and Gastroftal tablets,two tablets after lunch and two tablets after *** break-up-time(TBUT)test,Schirmer test,RSI,and SANDE questionnaire were ***:The study included 253 *** mean age was 58±*** test score and Schirmer’s test significantly increased(both P<0.001)after 1mo and at the end of *** RSI score and SANDE scores significantly decreased(both P<0.001)after 1mo and at the end of ***:The current,retrospective,and open study shows that combined therapy using Gastroftal eye drops and tablets could represent a valuable option in managing patients with DES associated with LPR.

关键词： dry eye syndrome laryngopharyngeal reflux combined therapy hyaluronic acid alginate Camelia sinensis real-life

Nissen fundoplication vs proton pump inhibitors for laryngopharyngeal reflux based on p H-monitoring and symptom-scale

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World Journal of Gastroenterology 2017年第19期23卷 3546-3555页

作者： Chao Zhang Zhi-Wei Hu Chao Yan Qiong Wu Ji-Min Wu Xing Du Dian-Gang Liu Tao Luo Fei Li Zhong-Gao Wang Department of General Surgery Xuanwu HospitalCapital Medical University Department of Gastroesophageal reflux Disease Second Artillery General Hospital of Chinese People’s Liberation Army Department of Nutrition Xuanwu HospitalCapital Medical University

AIM To compare the outcomes between laparoscopic Nissen fundoplication(LNF)and proton pump inhibitors(PPIs)therapy in patients with laryngopharyngeal reflux(LPR)and typeⅠhiatal hernia diagnosed by oropharyngeal p H-monitoring and symptom-scale *** From February 2014 to January 2015,70 patients who were diagnosed with LPR and type I hiatal hernia and referred for symptomatic assessment,oropharyngeal p H-monitoring,manometry,and gastrointestinal endoscopy were enrolled in this *** of the patients met the inclusion *** of the patients underwent LNF or PPIs administration,and completed a2-year ***’baseline characteristics and primary outcome measures,including comprehensive and single symptoms of LPR,PPIs independence,and satisfaction,and postoperative complications were *** outcomes of LNF and PPIs therapy were analyzed and compared. RESULTS There were 31 patients in the LNF group and 39patients in the PPI ***-three patients(25 in the LNF group and 28 in the PPI group)completed reviews and *** p H-monitoring parameters were all abnormal with high acid exposure,a large amount of reflux,and a high Ryan score,associated reflux symptom index(RSI)*** was a significant improvement in the RSI and LPR symptom scores after the 2-year follow-up in both groups(Preflux *** in the RSI(P<0.005)and symptom scores of cough(P=0.032),mucus(P=0.011),and throat clearing(P=0.022)was significantly superior in the LNF group to that in the PPI *** LNF and PPIs therapy,13 and 53 patients achieved independence from PPIs therapy(LNF:44.0%vs PPI:7.14%,P<0.001)during follow-up,*** in the LNF group were more satisfied with their quality of life than those in the PPI group(LNF:62.49±28.68 vs PPI:44.36±32.77,P=0.004).Body mass index was significantly lower in the LNF group than in the PPI group(LNF:22.2±3.1kg/m^2 vs

关键词： laryngopharyngeal reflux Hiatal hernia Laparoscopic Nissen fundoplication Proton pump inhibitor p H-monitoring Gastroesophageal reflux disease

Therapeutic efficacy observation of acupuncture plus medicine for laryngopharyngeal reflux due to liver-qi stagnation and spleen deficiency

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Journal of Acupuncture and Tuina Science 2021年第3期19卷 226-230页

作者： Zhao Jing Wang Yi Yang Cui-rong Lou Qing Zhang Fu-qing First Affiliated Hospital of Chengdu Medical College Chengdu610500China 不详

Objective To observe the clinical efficacy of acupuncture plus medicine in treating laryngopharyngeal reflux due to liverqi stagnation and spleen *** A total of 70 patients were divided into a control group and an observation group by the random number table method,with 35 cases in each *** groups were treated with conventional medications,and the observation group was treated with additional acupuncture *** reflux symptom index(RSI)and reflux finding score(RFS)were *** motility indicators such as lower esophageal sphincter pressure(LESP)and upper esophageal sphincter pressure(UESP),and salivary pepsin level were *** clinical efficacy was also *** The total effective rate of the observation group was higher than that of the control group(P0.05),while LESP and UESP in the observation group increased significantly(both Plaryngopharyngeal reflux due to liver-qi stagnation and spleen deficiency,and regulate esophageal motility and salivary pepsin *** efficacy is more significant compared with medicine alone.

关键词： Acupuncture Therapy Acupuncture Medication Combined laryngopharyngeal reflux Liver-qi Stagnation and Spleen Deficiency Esophageal Motility Disorders Randomized Controlled Trial

Clinical relevance of salivary pepsin detection in diagnosing gastroesophageal reflux disease subtypes

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Gastroenterology Report 2023年第1期11卷 446-453页

作者： Mengyu Zhang Tingting Wu Niandi Tan Songfeng Chen Qianjun Zhuang Yu Luo Yinglian Xiao Department of Gastroenterology The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongP.R.China

Background:Gastroesophageal reflux disease(GERD)is heterogeneous with a varied symptom spectrum and reflux *** definite diagnosis often requires invasive tools including endoscopy or reflux *** aim of this study was to investigate the clinical relevance of salivary pepsin detection as a non-invasive screening tool to diagnose GERD of different ***:A total of 77 patients with suspected GERD symptoms and 12 asymptomatic controls were *** participants performed symptom evaluation,upper endoscopy,esophageal manometry,and 24-hour multichannel intraluminal impedance-dual pH probe *** was self-collected across three different time points:at early fasting,postprandially,and at symptom *** pepsin levels were measured via *** optimal threshold of salivary pepsin for diagnosing distal or proximal reflux was determined according to a receiver-operating characteristic ***:The average salivary pepsin concentration of suspected GERD patients was significantly higher than that of controls(100.63[68.46,141.38]vs 67.90[31.60,115.06]ng/mL,P=0.044),although no difference was found among patients with different symptom *** distal reflux group had a higher average pepsin concentration than non-reflux patients(170.54[106.31,262.76]vs 91.13[63.35,127.63]ng/mL,P=0.043),while no difference was observed between the distal reflux group and the proximal reflux *** optimal cut-off value of salivary pepsin concentration for diagnosing pathological distal reflux was 157.10 ng/mL,which was higher than that for diagnosing pathological proximal reflux(122.65 ng/mL).The salivary pepsin concentration was significantly correlated with distal and proximal reflux ***:Salivary pepsin measurement can help in identifying true GERD with pathological distal reflux or proximal reflux,regardless of different symptom spectrums.A higher threshold should be applied for diagnosing distal reflu

关键词： salivary pepsin gastroesophageal reflux disease laryngopharyngeal reflux screening and diagnosis

Gastrointestinal function testing model using a new laryngopharyngeal pH probe(Restech)in patients after Ivor-Lewis esophagectomy

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World Journal of Gastrointestinal Oncology 2021年第6期13卷 612-624页

作者： Benjamin Babic Dolores T Müller Florian Gebauer Lars Mortimer Schiffmann Rabi R Datta WolfgangSchröder Christiane J Bruns Jessica M Leers Hans F Fuchs Department of General VisceralCancer and Transplant SurgeryUniversity of CologneCologne 50931Germany

BACKGROUND There is no established correlation between 24-h esophageal pH-metry(Eso-pH)and the new laryngopharyngeal pH-monitoring system(Restech)as only small case series ***-pH was not designed to detect laryngopharyngeal reflux(LPR)and Restech may detect LPR *** have previously published a dataset using the two techniques in a large patient collective with gastroesophageal reflux ***,patients after esophagectomy were reported to represent an ideal human reflux model as no reflux barrier *** To use a human reflux model to examine our previously published correlation in these *** Patients after Ivor Lewis esophagectomy underwent our routine follow-up program with surveillance endoscopies,computed tomography scans and further exams following *** patients with a complete check-up program and reflux symptoms were offered inclusion into this prospective study and evaluated using Restech and simultaneous ***,the relationship between the two techniques was evaluated RESULTS A total of 43 patients from May 2016-November 2018 were *** patients presented with mainly typical reflux symptoms such as heartburn(74%),regurgitation(84%),chest pain(58%),and dysphagia(47%).Extraesophageal symptoms such as cough,hoarseness,asthma symptoms,and globus sensation were also *** 24-hour pH-metry was abnormal in 88%of patients with a mean DeMeester Score of 229.45[range 26.4-319.5].Restech evaluation was abnormal in 61%of cases in this highly selective patient *** patients with abnormal supine LPR were also abnormal for supine esophageal reflux measured by conventional *** Patients following esophagectomy and reconstruction with gastric interposition can ideally serve as a human reflux ***,laryngopharyngeal reflux phases occur mainly in the upright *** this human volume-reflux model,results of simultaneous esophageal and laryngopharyngeal(Restech)pH

关键词： Gastroesophageal reflux disease laryngopharyngeal reflux Minimally invasive esophagectomy Surgical technology Restech Esophageal pH-metry

Link between pharyngeal acid reflux episodes and the effectiveness of proton pump inhibitor therapy

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World Journal of Gastroenterology 2024年第48期30卷 5162-5173页

作者： Yen-Yang Chen Chen-Chi Wang Chun-Yi Chuang Yung-An Tsou Yen-Chun Peng Chi-Sen Chang Han-Chung Lien Division of Gastroenterology Taichung Veterans General HospitalTaichung 402TaiwanChina Department of Otolaryngology Taichung Veterans General HospitalTaichung 402TaiwanChina School of Medicine National Yang Ming Chiao Tung UniversityTaipei 112TaiwanChina School of Speech Language Pathology and Audiology Chung Shan Medical UniversityTaichung 402TaiwanChina School of Medicine Chung Shan Medical UniversityTaichung 402TaiwanChina Department of Otolaryngology Chung Shan Medical University HospitalTaichung 402TaiwanChina Department of Otorhinolaryngology-Head and Neck Surgery China Medical University HospitalTaichung 400TaiwanChina Division of Gastroenterology and Hepatology Department of Internal MedicineTungs’Taichung Metro Harbor HospitalTaichung 435TaiwanChina Division of Gastroenterology Center for Functional Esophageal DisordersTaichung Veterans General HospitalTaichung 402TaiwanChina Department of Post-Baccalaureate Medicine College of MedicineNational Chung Hsing UniversityTaichung 402Taiwan

BACKGROUND Diagnosing laryngopharyngeal reflux(LPR)is challenging due to overlapping *** proton pump inhibitors(PPIs)are commonly prescribed,reliable predictors of their responsiveness are *** monitoring techno-server *** hypothesized that PAR episodes alone might also predict PPI *** To investigate whether PAR episodes alone predict a positive response to PPI *** Patients suspected of having LPR were prospectively recruited from otolaryngologic clinics in three Taiwan residents tertiary *** underwent a 24-hour esophagopharyngeal pH test using either 3-pH-sensor or hypopha-ryngeal MII-pH catheters while off medication,followed by a 12-week esomeprazole course(40 mg twice daily).Participants were categorized into four groups based on pH results:PAR alone,EAR alone,both pH(+),and both pH(-).The primary outcome was a≥50%reduction in primary laryngeal symptoms,with observers blinded to group *** A total of 522 patients(mean age 52.3±12.8 years,54%male)were *** these,190(mean age 51.5±12.4 years,61%male)completed the treatment,and 89(47%)responded to PPI *** rates were highest in the PAR alone group(73%,n=11),followed by EAR alone(59%,n=68),both pH(+)(56%,n=18),and both pH(-)(33%,n=93).Multivariate analysis adjusting for age,sex,body mass index,and endoscopic esophagitis showed that participants with PAR alone,EAR alone,and both pH(+)were 7.4-fold(P=0.008),4.2-fold(P=0.0002),and 3.4-fold(P=0.03)more likely to respond to PPI therapy,respectively,compared to the both pH(-)*** analyses using the definition of≥1 PAR episode were less *** In the absence of proven hypopharyngeal predictors,this post-hoc analysis found that baseline≥2 PAR episodes alone are linked to PPI responsiveness,suggesting the importance of hypopharyngeal reflux monitoring.

关键词： Pharyngeal acid reflux episodes laryngopharyngeal reflux Hypopharyngeal multichannel intraluminal impedance-pH 3-pH-sensor Proton pump inhibitors

Association of gastroesophageal reflux disease and laryngeal cancer

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2018年第4期4卷 278-281页

作者： Mursalin M.Anis Mir-Muhammad Razavi Xiao Xiao Ahmed M.S.Soliman Coastal Ear Nose and ThroatJersey Shore University Medical CenterNeptuneNJUSA Lewis Katz School of Medicine at Temple University PhiladelphiaPAUSA Department of Statistics Fox School of BusinessTemple UniversityPhiladelphiaPAUSA Department of Otolaryngology e Head and Neck Surgery Lewis Katz School of Medicine at Temple UniversityPhiladelphiaPAUSA

Objective:Studies examining the association of reflux disease with the risk of developing laryngeal cancer have both proven and disproven the null ***:This retrospective caseecontrol study examines the association of reflux in two populations exposed to similar risk factors,including tobacco,to the extent that end-organ malignant transformation has *** IRB approval was obtained,a search of our hospital’s cancer center’s database was performed from 2000 to 2013.A retrospective chart review was then performed and the prevalence of gastroesophageal reflux disease among patients with laryngeal cancer(n Z 290)was *** was then compared to the prevalence of gastroesophageal reflux disease among patients presenting with lung cancer(n Z 2440)during the same time period.A multivariate logistic regression was performed to determine the association of reflux with laryngeal ***:Taking into consideration tobacco use,there was a strong association between male gender and occurrence of laryngeal cancer as opposed to lung cancer(OR Z 3.30;95%CI 2.53e4.36,Preflux and laryngeal cancer(OR Z 1.65;95%CI 1.19e2.25,P Z 0.003).However,there was no association between reflux and the propensity for carcinoma in specific laryngeal subsites(P Z 0.47).Conclusions:In this study examining a heterogeneous population with end-organ malignancy there was a modest association between reflux and laryngeal *** research is necessary to determine the biologic relevance of this finding.

关键词： laryngopharyngeal reflux GERD Extraesophageal reflux Laryngeal cancer Lung cancer