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Updated: May 13, 2026
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Histologic versus pH probe results in pediatric laryngopharyngeal reflux
Thomas M Andrews1, Nicklas Orobello
1All Children's Hospital/Johns Hopkins Medicine, St. Petersburg, FL, United States. tandrews@pohns.net
Insights
Pediatric laryngopharyngeal reflux (LPR) diagnosis can be confirmed using nasopharyngeal pH probe monitoring, which showed a high correlation with biopsy results in this study.
Area of Science:
- Pediatric Otolaryngology
- Gastroenterology
- Diagnostic Medicine
Background:
- Laryngopharyngeal reflux (LPR) is a condition affecting children, presenting with various symptoms.
- Accurate diagnosis of LPR in pediatric patients is crucial for effective management.
- Current diagnostic methods may have limitations in pediatric populations.
Purpose of the Study:
- To compare the diagnostic accuracy of nasopharyngeal pH probe monitoring with post-cricoid biopsies in pediatric patients with suspected LPR.
- To evaluate the utility of the Restech Dx-pH Measurement System in diagnosing LPR in children.
Main Methods:
- A retrospective review of 63 pediatric patients (6 months to 17 years) undergoing simultaneous post-cricoid biopsy and nasopharyngeal pH probe monitoring.
- Data analysis focused on 50 patients with complete data sets.
Main Results:
- Of 50 patients with complete data, 36 (72%) had a positive pH probe with a negative biopsy.
- Four patients (8%) had both positive probe and biopsy results.
- No patients had a negative probe with a positive biopsy, indicating high probe specificity.
Conclusions:
- Nasopharyngeal pH probe monitoring, particularly with the Restech system, is a useful and well-tolerated tool for confirming clinical suspicion of LPR in children.
- The pH probe demonstrated a high correlation with biopsy findings, supporting its role in LPR diagnosis.
Objective:
A comparison of histologic findings from the post-cricoid region versus nasopharyngeal pH probe results in the diagnosis of laryngopharyngeal reflux (LPR) in the pediatric patient.
Study Design:
Retrospective review.
Setting:
Outpatient pediatric otolaryngology private practice.
Subject And Methods:
63 consecutive patients, age 6-months to 17-years between June 1, 2009 and October 6, 2010, tested by simultaneous post cricoid biopsy and nasopharyngeal pH probe monitoring using the Restech Dx-pH Measurement System (Respiratory Technology Corporation, San Diego, CA).
Results:
Of the 63 total patients (age 6-months to 17-years), 11 (17%) were excluded due to a pulled probe, one additional patient did not have a biopsy taken and one probe failed after insertion making a total of 50 patients with complete data sets. Thirty-six of those 50 patients had a positive probe with a negative biopsy (72%). Four (8%) had both a positive probe and biopsy and 10 (16%) had a negative probe and negative biopsy. No patients had a negative probe and positive biopsy. Symptoms used to identify patients suspected of reflux included: throat clearing, nasal congestion, cough, history of recurrent sinusitis with negative radiographic findings, halitosis, culture negative sore throat, post nasal drip, otalgia, poor appetite and stomach ache.
Conclusion:
Eighty percent of our patients (40) were either positive for reflux by pH probe or by pH probe and biopsy. The Restech Dx-pH Measurement System appeared to be well tolerated in all age groups. There were no complications. We found this a useful tool in confirming clinical suspicion of LPR.
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