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Flexible laryngoscopy-guided pharyngeal pH monitoring in infants

Seckin O Ulualp1, Sarah Rodriguez, Camysha N Holmes-Wright

  • 1Pediatric Airway and Swallowing Disorders Laboratory, Division of Pediatric Otolaryngology and Department of Otolaryngology, UTMB Children's Hospital, University of Texas Medical Branch, Galveston, Texas, USA. seulualp@utmb.edu

The Laryngoscope
|April 7, 2007
PubMed

Insights

Flexible laryngoscopy enables accurate pharyngeal pH probe placement for diagnosing laryngopharyngeal acid reflux (LPR) in infants with extraesophageal reflux disease (EERD). This method avoids radiographs and esophageal manometry, confirming LPR in affected infants.

Area of Science:

  • Pediatric Gastroenterology
  • Otolaryngology
  • Diagnostic Imaging

Background:

  • Extraesophageal reflux disease (EERD) in infants often involves laryngopharyngeal symptoms.
  • Accurate pharyngeal pH monitoring is crucial for diagnosing laryngopharyngeal acid reflux (LPR).
  • Traditional methods require radiographs and esophageal manometry, posing challenges in infants.

Purpose of the Study:

  • To evaluate flexible laryngoscopy-guided pharyngeal pH probe monitoring as an accurate and practical alternative.
  • To eliminate the need for radiographs and esophageal manometry in infant pharyngeal pH monitoring.
  • To assess the utility of this technique in diagnosing LPR in infants with EERD.

Main Methods:

  • Flexible laryngoscopy was used to guide pH probe placement in the laryngopharyngeal region in infants with suspected LPR.
  • Pharyngoesophageal pH monitoring was performed, with the esophageal probe placed 5 cm distal to the pharyngeal probe.
  • Data collected included the number of acid reflux episodes and percent acid exposure time in both regions.

Main Results:

  • The flexible laryngoscopy-guided technique was successfully used in six infants (age range, 2 wk-7.5 mo).
  • All infants tolerated the procedure; four had pharyngeal acid reflux, and six had esophageal acid reflux.
  • Acid reflux was detected in the pharynx (0-1.2% acid exposure time) and esophagus (0.1-1.5% acid exposure time).

Conclusions:

  • Flexible laryngoscopy allows for precise pH probe placement in the infant laryngopharynx.
  • Not all esophageal acid reflux extends to the pharynx, highlighting the importance of pharyngeal monitoring.
  • This technique effectively detects LPR in infants with EERD, offering a practical alternative to traditional methods.
Abstract

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