J Neurogastroenterol Motil.
2023 Jan;29(1):49-57. 10.5056/jnm22047.
Validation of Pharyngeal Acid Reflux Episodes Using Hypopharyngeal Multichannel Intraluminal Impedance-pH
- Affiliations
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- 1Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan
- 2Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan
- 3School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- 4School of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan
- 5Department of Internal Medicine, Division of Gastroenterology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
- 6Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan
- 7School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- 8Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
- 9Computer Aided Measurement and Diagnostic Systems Laboratory, Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Yunlin, Taiwan
- 10Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan
- 11Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- KMID: 2537939
- DOI: http://doi.org/10.5056/jnm22047
Abstract
- Background/Aims
Hypopharyngeal multichannel intraluminal impedance-pH (HMII-pH) technology incorporating 2 trans-upper esophageal sphincter impedance channels has been developed to detect pharyngeal reflux. We used the HMII-pH technique to validate the candidate pharyngeal acid reflux (PAR) episodes based on the dual-pH tracings and determined the interobserver reproducibility.
Methods
We conducted a cross-sectional study in tertiary centers in Taiwan. Ninety patients with suspected laryngopharyngeal reflux and 28 healthy volunteers underwent HMII-pH test when off acid suppressants. Candidate PAR episodes were characterized by pharyngeal pH drops of at least 2 units and reaching a nadir pH of 5 within 30 seconds during esophageal acidification. Two experts manually independently identified candidate PAR episodes based on the dual-pH tracings. By reviewing the HMII-pH tracings, HMII-pH-proven PAR episodes were subsequently confirmed. The consensus reviews of HMII-pH-proven PAR episodes were considered to be the reference standard diagnosis. The interobserver reproducibility was assessed.
Results
A total of 105 candidate PAR episodes were identified. Among them 84 (80.0%; 95% CI, 71.0-87.0%) were HMII-pH-proven PAR episodes (82 in 16 patients and 2 in 1 healthy subject). Patients tended to have more HMII-pH-proven PAR episodes than healthy controls (median and percentile values [25th, 75th, and 95th percentiles]: 0 [0, 0, 3] vs 0 [0, 0, 0], P = 0.067). The concordance rate in diagnosing HMII-pH-proven PAR episodes between 2 independent observers was 92.2%.
Conclusion
Our preliminary data showed that 80.0% (71.0-87.0%) of the proposed candidate PAR episodes were HMII-pH-proven PAR episodes, among which the interobserver reproducibility was good.
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