Correlation between reflux and multichannel intraluminal impedance pH monitoring in untreated volunteers

Marie E. Jetté, Eric A. Gaumnitz, Martin A. Birchall, Nathan V. Welham, Susan L. Thibeault

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objectives/Hypothesis: Although probable causative agents have been identified (e.g., refluxate components, tobacco smoke), the definitive mechanism for inflammation-related laryngeal mucosal damage remains elusive. Multichannel intraluminal impedance combined with pH monitoring (MII/pH) has emerged as a sensitive tool for diagnosis and characterization of gastroesophageal reflux disease with laryngopharyngeal manifestations. To determine the relationship between laryngeal signs and MII/pH, we examined correlations between Reflux Finding Score (RFS) ratings of videostroboscopic laryngeal examinations and findings from MII/pH. Study Design: Correlational study. Methods: Healthy, untreated volunteers (n = 142) underwent reflux diagnosis using data acquired from MII/pH testing. Eight trained clinicians performed RFS ratings of corresponding laryngeal examinations. Averaged RFS ratings were compared to MII/pH data using Pearson correlation coefficients. The relationship between RFS and MII/pH findings and demographic/clinical information (age, sex, smoking status, reflux) was assessed using general linear modeling. Rater reliability was evaluated. Results: Posterior commissure hypertrophy was negatively correlated with minutes of nonacid refluxate (R = -0.21, P = .0115). General linear modeling revealed that 28% to 40% of the variance in ratings of ventricular obliteration, erythema/hyperemia, vocal fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, and granulation/granuloma could be explained by main and interaction effects of age, sex, smoking status, and reflux. Intra- and inter-rater reliability for RFS were poor-fair. Conclusions: These results support the theory that the RFS is not specific for reflux in healthy, untreated volunteers, suggesting there may be alternate explanations for inflammatory clinical signs commonly ascribed to reflux in this population.

Original languageEnglish (US)
Pages (from-to)2345-2351
Number of pages7
JournalLaryngoscope
Volume124
Issue number10
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

Fingerprint

Electric Impedance
Volunteers
Hypertrophy
Healthy Volunteers
Smoking
Laryngeal Edema
Vocal Cords
Hyperemia
Erythema
Larynx
Gastroesophageal Reflux
Granuloma
Smoke
Tobacco
Edema
Demography
Inflammation
Population

Keywords

  • Gastroesophageal reflux
  • Impedance monitoring
  • Laryngopharyngeal reflux
  • Laryngopharyngeal reflux diagnosis
  • pH monitoring
  • Reflux Finding Score

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Medicine(all)

Cite this

Jetté, M. E., Gaumnitz, E. A., Birchall, M. A., Welham, N. V., & Thibeault, S. L. (2014). Correlation between reflux and multichannel intraluminal impedance pH monitoring in untreated volunteers. Laryngoscope, 124(10), 2345-2351. https://doi.org/10.1002/lary.24737

Correlation between reflux and multichannel intraluminal impedance pH monitoring in untreated volunteers. / Jetté, Marie E.; Gaumnitz, Eric A.; Birchall, Martin A.; Welham, Nathan V.; Thibeault, Susan L.

In: Laryngoscope, Vol. 124, No. 10, 01.10.2014, p. 2345-2351.

Research output: Contribution to journalArticle

Jetté, ME, Gaumnitz, EA, Birchall, MA, Welham, NV & Thibeault, SL 2014, 'Correlation between reflux and multichannel intraluminal impedance pH monitoring in untreated volunteers', Laryngoscope, vol. 124, no. 10, pp. 2345-2351. https://doi.org/10.1002/lary.24737
Jetté, Marie E. ; Gaumnitz, Eric A. ; Birchall, Martin A. ; Welham, Nathan V. ; Thibeault, Susan L. / Correlation between reflux and multichannel intraluminal impedance pH monitoring in untreated volunteers. In: Laryngoscope. 2014 ; Vol. 124, No. 10. pp. 2345-2351.
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abstract = "Objectives/Hypothesis: Although probable causative agents have been identified (e.g., refluxate components, tobacco smoke), the definitive mechanism for inflammation-related laryngeal mucosal damage remains elusive. Multichannel intraluminal impedance combined with pH monitoring (MII/pH) has emerged as a sensitive tool for diagnosis and characterization of gastroesophageal reflux disease with laryngopharyngeal manifestations. To determine the relationship between laryngeal signs and MII/pH, we examined correlations between Reflux Finding Score (RFS) ratings of videostroboscopic laryngeal examinations and findings from MII/pH. Study Design: Correlational study. Methods: Healthy, untreated volunteers (n = 142) underwent reflux diagnosis using data acquired from MII/pH testing. Eight trained clinicians performed RFS ratings of corresponding laryngeal examinations. Averaged RFS ratings were compared to MII/pH data using Pearson correlation coefficients. The relationship between RFS and MII/pH findings and demographic/clinical information (age, sex, smoking status, reflux) was assessed using general linear modeling. Rater reliability was evaluated. Results: Posterior commissure hypertrophy was negatively correlated with minutes of nonacid refluxate (R = -0.21, P = .0115). General linear modeling revealed that 28{\%} to 40{\%} of the variance in ratings of ventricular obliteration, erythema/hyperemia, vocal fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, and granulation/granuloma could be explained by main and interaction effects of age, sex, smoking status, and reflux. Intra- and inter-rater reliability for RFS were poor-fair. Conclusions: These results support the theory that the RFS is not specific for reflux in healthy, untreated volunteers, suggesting there may be alternate explanations for inflammatory clinical signs commonly ascribed to reflux in this population.",
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