Normative Ambulatory Reflux Monitoring Metrics for Laryngopharyngeal Reflux: A Systematic Review of 720 Healthy Individuals
Objectives To review the normative data for acid, weakly acid, and nonacid proximal esophageal (PRE) and hypopharyngeal reflux (HRE) events in diagnosing laryngopharyngeal reflux (LPR) using ambulatory reflux monitoring. Data Sources PubMed, Cochrane Library, and Scopus. Review Methods A literature...
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| Veröffentlicht in: | Otolaryngology-head and neck surgery 2022-05, Vol.166 (5), p.802-819 |
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| creator | Lechien, Jerome R. Chan, Walter W. Akst, Lee M. Hoppo, Toshitaka Jobe, Blair A. Chiesa-Estomba, Carlos M. Muls, Vinciane Bobin, Francois Saussez, Sven Carroll, Thomas L. Vaezi, Michael F. Bock, Jonathan M. |
| description | Objectives
To review the normative data for acid, weakly acid, and nonacid proximal esophageal (PRE) and hypopharyngeal reflux (HRE) events in diagnosing laryngopharyngeal reflux (LPR) using ambulatory reflux monitoring.
Data Sources
PubMed, Cochrane Library, and Scopus.
Review Methods
A literature search was conducted about the normative data for PRE and HRE on multichannel intraluminal impedance–pH monitoring (MII-pH), hypopharyngeal-esophageal MII-pH (HEMII-pH), or oropharyngeal pH monitoring using PICOTS (population, intervention, comparison, outcome, timing, and setting) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statements. Outcomes reviewed included device characteristics, impedance/pH sensor placements, study duration, number/average and percentiles of PRE or HRE occurrence, and the event characteristics (pH, composition, and position).
Results
Of 154 identified studies, 18 met criteria for analysis, including 720 healthy individuals. HEMII-pH, MII-pH, and oropharyngeal pH monitoring were used in 7, 6, and 5 studies, respectively. The definition and inclusion/exclusion criteria of healthy individuals varied substantially across studies, with 6 studies considering only digestive symptoms to exclude potential LPR patients. Substantial heterogeneity across studies was noted, including impedance/pH sensor placements/configurations and definitions of composition (liquid, gas, mixed) and type (acid, weakly acid, nonacid) of PRE/HRE. The 95th percentile thresholds were 10 to 73 events for PRE, 0 to 10 events for HRE on HEMII-pH, and 40 to 128 for events with pH |
| doi_str_mv | 10.1177/01945998211029831 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2555637582</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_01945998211029831</sage_id><sourcerecordid>2555637582</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3905-1bfe6de47e3273f3fc633da88684e89406b6897596f8884a81858a135e575613</originalsourceid><addsrcrecordid>eNqFkM1O3DAUhS1UVAbaB2BTedlNqB3Hf91NETBIA0iUfeRJrgejJJ7ayUDEy-NhpmyQYHV0r79z5HsQOqbkhFIpfxGqC661yikluVaM7qEJJVpmQlH5BU0279kGOECHMT4QQoSQ8is6YAWjjBM5Qc_XPrSmd2vA03YxNKb3YcS3YJvhCV_5zqXZdUt8BX1wVcTWBzw3YeyWfnX_qmCaHf8bT_HfMfawCazScu3gEXuLZU7wLHH9_Ygvu9qtXT2YJn5D-zYJfN_pEbo7P7s7nWXzm4vL0-k8q5gmPKMLC6KGQgLLJbPMVoKx2iglVAFKF0QshNKSa2GVUoVRVHFl0n3AJReUHaGf29hV8P8GiH3ZulhB05gO_BDLnHMumOQqTyjdolXwMQaw5Sq4Np1ZUlJuKi_fVZ48P3bxw6KF-s3xv-ME6C3w6BoYP08sb2bXf86JFpQn78nWG80Sygc_hC419cFvXgBKjpkr</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2555637582</pqid></control><display><type>article</type><title>Normative Ambulatory Reflux Monitoring Metrics for Laryngopharyngeal Reflux: A Systematic Review of 720 Healthy Individuals</title><source>Access via SAGE</source><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Lechien, Jerome R. ; Chan, Walter W. ; Akst, Lee M. ; Hoppo, Toshitaka ; Jobe, Blair A. ; Chiesa-Estomba, Carlos M. ; Muls, Vinciane ; Bobin, Francois ; Saussez, Sven ; Carroll, Thomas L. ; Vaezi, Michael F. ; Bock, Jonathan M.</creator><creatorcontrib>Lechien, Jerome R. ; Chan, Walter W. ; Akst, Lee M. ; Hoppo, Toshitaka ; Jobe, Blair A. ; Chiesa-Estomba, Carlos M. ; Muls, Vinciane ; Bobin, Francois ; Saussez, Sven ; Carroll, Thomas L. ; Vaezi, Michael F. ; Bock, Jonathan M.</creatorcontrib><description>Objectives
To review the normative data for acid, weakly acid, and nonacid proximal esophageal (PRE) and hypopharyngeal reflux (HRE) events in diagnosing laryngopharyngeal reflux (LPR) using ambulatory reflux monitoring.
Data Sources
PubMed, Cochrane Library, and Scopus.
Review Methods
A literature search was conducted about the normative data for PRE and HRE on multichannel intraluminal impedance–pH monitoring (MII-pH), hypopharyngeal-esophageal MII-pH (HEMII-pH), or oropharyngeal pH monitoring using PICOTS (population, intervention, comparison, outcome, timing, and setting) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statements. Outcomes reviewed included device characteristics, impedance/pH sensor placements, study duration, number/average and percentiles of PRE or HRE occurrence, and the event characteristics (pH, composition, and position).
Results
Of 154 identified studies, 18 met criteria for analysis, including 720 healthy individuals. HEMII-pH, MII-pH, and oropharyngeal pH monitoring were used in 7, 6, and 5 studies, respectively. The definition and inclusion/exclusion criteria of healthy individuals varied substantially across studies, with 6 studies considering only digestive symptoms to exclude potential LPR patients. Substantial heterogeneity across studies was noted, including impedance/pH sensor placements/configurations and definitions of composition (liquid, gas, mixed) and type (acid, weakly acid, nonacid) of PRE/HRE. The 95th percentile thresholds were 10 to 73 events for PRE, 0 to 10 events for HRE on HEMII-pH, and 40 to 128 for events with pH <6.0 on oropharyngeal pH monitoring. Most HREs were nonacid and occurred upright. The mean HRE among healthy individuals was 1.
Conclusion
The low number of studies and the heterogeneity in inclusion criteria, definitions, and characterization of PRE and HRE limit the establishment of consensual normative criteria for LPR on ambulatory reflux monitoring. Future large multicenter studies are needed.</description><identifier>ISSN: 0194-5998</identifier><identifier>EISSN: 1097-6817</identifier><identifier>DOI: 10.1177/01945998211029831</identifier><identifier>PMID: 34313507</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Benchmarking ; Electric Impedance ; Esophageal pH Monitoring ; gastroesophageal ; Humans ; Hypopharynx ; impedance ; laryngopharyngeal ; Laryngopharyngeal Reflux - diagnosis ; metry ; monitoring ; normative ; reflux ; threshold</subject><ispartof>Otolaryngology-head and neck surgery, 2022-05, Vol.166 (5), p.802-819</ispartof><rights>American Academy of Otolaryngology–Head and Neck Surgery Foundation 2021</rights><rights>2022 American Association of Otolaryngology‐Head and Neck Surgery Foundation (AAO‐HNSF)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3905-1bfe6de47e3273f3fc633da88684e89406b6897596f8884a81858a135e575613</citedby><cites>FETCH-LOGICAL-c3905-1bfe6de47e3273f3fc633da88684e89406b6897596f8884a81858a135e575613</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/01945998211029831$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/01945998211029831$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>313,314,780,784,792,1417,21819,27922,27924,27925,43621,43622,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34313507$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lechien, Jerome R.</creatorcontrib><creatorcontrib>Chan, Walter W.</creatorcontrib><creatorcontrib>Akst, Lee M.</creatorcontrib><creatorcontrib>Hoppo, Toshitaka</creatorcontrib><creatorcontrib>Jobe, Blair A.</creatorcontrib><creatorcontrib>Chiesa-Estomba, Carlos M.</creatorcontrib><creatorcontrib>Muls, Vinciane</creatorcontrib><creatorcontrib>Bobin, Francois</creatorcontrib><creatorcontrib>Saussez, Sven</creatorcontrib><creatorcontrib>Carroll, Thomas L.</creatorcontrib><creatorcontrib>Vaezi, Michael F.</creatorcontrib><creatorcontrib>Bock, Jonathan M.</creatorcontrib><title>Normative Ambulatory Reflux Monitoring Metrics for Laryngopharyngeal Reflux: A Systematic Review of 720 Healthy Individuals</title><title>Otolaryngology-head and neck surgery</title><addtitle>Otolaryngol Head Neck Surg</addtitle><description>Objectives
To review the normative data for acid, weakly acid, and nonacid proximal esophageal (PRE) and hypopharyngeal reflux (HRE) events in diagnosing laryngopharyngeal reflux (LPR) using ambulatory reflux monitoring.
Data Sources
PubMed, Cochrane Library, and Scopus.
Review Methods
A literature search was conducted about the normative data for PRE and HRE on multichannel intraluminal impedance–pH monitoring (MII-pH), hypopharyngeal-esophageal MII-pH (HEMII-pH), or oropharyngeal pH monitoring using PICOTS (population, intervention, comparison, outcome, timing, and setting) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statements. Outcomes reviewed included device characteristics, impedance/pH sensor placements, study duration, number/average and percentiles of PRE or HRE occurrence, and the event characteristics (pH, composition, and position).
Results
Of 154 identified studies, 18 met criteria for analysis, including 720 healthy individuals. HEMII-pH, MII-pH, and oropharyngeal pH monitoring were used in 7, 6, and 5 studies, respectively. The definition and inclusion/exclusion criteria of healthy individuals varied substantially across studies, with 6 studies considering only digestive symptoms to exclude potential LPR patients. Substantial heterogeneity across studies was noted, including impedance/pH sensor placements/configurations and definitions of composition (liquid, gas, mixed) and type (acid, weakly acid, nonacid) of PRE/HRE. The 95th percentile thresholds were 10 to 73 events for PRE, 0 to 10 events for HRE on HEMII-pH, and 40 to 128 for events with pH <6.0 on oropharyngeal pH monitoring. Most HREs were nonacid and occurred upright. The mean HRE among healthy individuals was 1.
Conclusion
The low number of studies and the heterogeneity in inclusion criteria, definitions, and characterization of PRE and HRE limit the establishment of consensual normative criteria for LPR on ambulatory reflux monitoring. Future large multicenter studies are needed.</description><subject>Benchmarking</subject><subject>Electric Impedance</subject><subject>Esophageal pH Monitoring</subject><subject>gastroesophageal</subject><subject>Humans</subject><subject>Hypopharynx</subject><subject>impedance</subject><subject>laryngopharyngeal</subject><subject>Laryngopharyngeal Reflux - diagnosis</subject><subject>metry</subject><subject>monitoring</subject><subject>normative</subject><subject>reflux</subject><subject>threshold</subject><issn>0194-5998</issn><issn>1097-6817</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkM1O3DAUhS1UVAbaB2BTedlNqB3Hf91NETBIA0iUfeRJrgejJJ7ayUDEy-NhpmyQYHV0r79z5HsQOqbkhFIpfxGqC661yikluVaM7qEJJVpmQlH5BU0279kGOECHMT4QQoSQ8is6YAWjjBM5Qc_XPrSmd2vA03YxNKb3YcS3YJvhCV_5zqXZdUt8BX1wVcTWBzw3YeyWfnX_qmCaHf8bT_HfMfawCazScu3gEXuLZU7wLHH9_Ygvu9qtXT2YJn5D-zYJfN_pEbo7P7s7nWXzm4vL0-k8q5gmPKMLC6KGQgLLJbPMVoKx2iglVAFKF0QshNKSa2GVUoVRVHFl0n3AJReUHaGf29hV8P8GiH3ZulhB05gO_BDLnHMumOQqTyjdolXwMQaw5Sq4Np1ZUlJuKi_fVZ48P3bxw6KF-s3xv-ME6C3w6BoYP08sb2bXf86JFpQn78nWG80Sygc_hC419cFvXgBKjpkr</recordid><startdate>202205</startdate><enddate>202205</enddate><creator>Lechien, Jerome R.</creator><creator>Chan, Walter W.</creator><creator>Akst, Lee M.</creator><creator>Hoppo, Toshitaka</creator><creator>Jobe, Blair A.</creator><creator>Chiesa-Estomba, Carlos M.</creator><creator>Muls, Vinciane</creator><creator>Bobin, Francois</creator><creator>Saussez, Sven</creator><creator>Carroll, Thomas L.</creator><creator>Vaezi, Michael F.</creator><creator>Bock, Jonathan M.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202205</creationdate><title>Normative Ambulatory Reflux Monitoring Metrics for Laryngopharyngeal Reflux: A Systematic Review of 720 Healthy Individuals</title><author>Lechien, Jerome R. ; Chan, Walter W. ; Akst, Lee M. ; Hoppo, Toshitaka ; Jobe, Blair A. ; Chiesa-Estomba, Carlos M. ; Muls, Vinciane ; Bobin, Francois ; Saussez, Sven ; Carroll, Thomas L. ; Vaezi, Michael F. ; Bock, Jonathan M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3905-1bfe6de47e3273f3fc633da88684e89406b6897596f8884a81858a135e575613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Benchmarking</topic><topic>Electric Impedance</topic><topic>Esophageal pH Monitoring</topic><topic>gastroesophageal</topic><topic>Humans</topic><topic>Hypopharynx</topic><topic>impedance</topic><topic>laryngopharyngeal</topic><topic>Laryngopharyngeal Reflux - diagnosis</topic><topic>metry</topic><topic>monitoring</topic><topic>normative</topic><topic>reflux</topic><topic>threshold</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lechien, Jerome R.</creatorcontrib><creatorcontrib>Chan, Walter W.</creatorcontrib><creatorcontrib>Akst, Lee M.</creatorcontrib><creatorcontrib>Hoppo, Toshitaka</creatorcontrib><creatorcontrib>Jobe, Blair A.</creatorcontrib><creatorcontrib>Chiesa-Estomba, Carlos M.</creatorcontrib><creatorcontrib>Muls, Vinciane</creatorcontrib><creatorcontrib>Bobin, Francois</creatorcontrib><creatorcontrib>Saussez, Sven</creatorcontrib><creatorcontrib>Carroll, Thomas L.</creatorcontrib><creatorcontrib>Vaezi, Michael F.</creatorcontrib><creatorcontrib>Bock, Jonathan M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Otolaryngology-head and neck surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lechien, Jerome R.</au><au>Chan, Walter W.</au><au>Akst, Lee M.</au><au>Hoppo, Toshitaka</au><au>Jobe, Blair A.</au><au>Chiesa-Estomba, Carlos M.</au><au>Muls, Vinciane</au><au>Bobin, Francois</au><au>Saussez, Sven</au><au>Carroll, Thomas L.</au><au>Vaezi, Michael F.</au><au>Bock, Jonathan M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Normative Ambulatory Reflux Monitoring Metrics for Laryngopharyngeal Reflux: A Systematic Review of 720 Healthy Individuals</atitle><jtitle>Otolaryngology-head and neck surgery</jtitle><addtitle>Otolaryngol Head Neck Surg</addtitle><date>2022-05</date><risdate>2022</risdate><volume>166</volume><issue>5</issue><spage>802</spage><epage>819</epage><pages>802-819</pages><issn>0194-5998</issn><eissn>1097-6817</eissn><abstract>Objectives
To review the normative data for acid, weakly acid, and nonacid proximal esophageal (PRE) and hypopharyngeal reflux (HRE) events in diagnosing laryngopharyngeal reflux (LPR) using ambulatory reflux monitoring.
Data Sources
PubMed, Cochrane Library, and Scopus.
Review Methods
A literature search was conducted about the normative data for PRE and HRE on multichannel intraluminal impedance–pH monitoring (MII-pH), hypopharyngeal-esophageal MII-pH (HEMII-pH), or oropharyngeal pH monitoring using PICOTS (population, intervention, comparison, outcome, timing, and setting) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statements. Outcomes reviewed included device characteristics, impedance/pH sensor placements, study duration, number/average and percentiles of PRE or HRE occurrence, and the event characteristics (pH, composition, and position).
Results
Of 154 identified studies, 18 met criteria for analysis, including 720 healthy individuals. HEMII-pH, MII-pH, and oropharyngeal pH monitoring were used in 7, 6, and 5 studies, respectively. The definition and inclusion/exclusion criteria of healthy individuals varied substantially across studies, with 6 studies considering only digestive symptoms to exclude potential LPR patients. Substantial heterogeneity across studies was noted, including impedance/pH sensor placements/configurations and definitions of composition (liquid, gas, mixed) and type (acid, weakly acid, nonacid) of PRE/HRE. The 95th percentile thresholds were 10 to 73 events for PRE, 0 to 10 events for HRE on HEMII-pH, and 40 to 128 for events with pH <6.0 on oropharyngeal pH monitoring. Most HREs were nonacid and occurred upright. The mean HRE among healthy individuals was 1.
Conclusion
The low number of studies and the heterogeneity in inclusion criteria, definitions, and characterization of PRE and HRE limit the establishment of consensual normative criteria for LPR on ambulatory reflux monitoring. Future large multicenter studies are needed.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>34313507</pmid><doi>10.1177/01945998211029831</doi><tpages>18</tpages></addata></record> |
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| ispartof | Otolaryngology-head and neck surgery, 2022-05, Vol.166 (5), p.802-819 |
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| language | eng |
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| source | Access via SAGE; MEDLINE; Access via Wiley Online Library |
| subjects | Benchmarking Electric Impedance Esophageal pH Monitoring gastroesophageal Humans Hypopharynx impedance laryngopharyngeal Laryngopharyngeal Reflux - diagnosis metry monitoring normative reflux threshold |
| title | Normative Ambulatory Reflux Monitoring Metrics for Laryngopharyngeal Reflux: A Systematic Review of 720 Healthy Individuals |
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