Evidence map›Paper›PMID 34980689›Full record

ArticleJournal of neurogastroenterology and motility2022

Reflux-related Extraesophageal Symptoms Until Proven Otherwise: A Direct Measurement of Abnormal Proximal Exposure Based on Hypopharyngeal Multichannel Intraluminal Impedance as a Reliable Indicator for Successful Treatment Outcomes.

Takeshi Suzuki, Yosuke Seki, Tomoaki Matsumura, Makoto Arai, Toyoyuki Hanazawa, Yoshitaka Okamoto, Haruhiko Suzuki, Kazunori Kasama, Akiko Umezawa, Yoshimoti Kurokawa and 1 more

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In one paragraph

Article in Journal of neurogastroenterology and motility, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Takeshi SuzukiDepartment of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan.
Yosuke SekiMinimally Invasive Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
Tomoaki MatsumuraDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan.
Makoto AraiDepartment of Medical Oncology, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan.
Toyoyuki HanazawaDepartment of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan.
Yoshitaka OkamotoChiba Rosai Hospital, Ichihara, Chiba, Japan.
Haruhiko SuzukiSuzuki ENT Clinic, Narashino, Chiba, Japan.
Kazunori KasamaMinimally Invasive Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
Akiko UmezawaMinimally Invasive Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
Yoshimoti KurokawaMinimally Invasive Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
Toshitaka HoppoEsophageal Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Chiba University · JPYotsuya Medical Cube · JPAllegheny Health Network · USChiba Rosai Hospital · JPSuzuki (Japan) · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimsThe Lyon Consensus defined parameters based on upper endoscopy and 24-hour combined multichannel intraluminal impedance-pH (MII-pH), that conclusively establish the presence of gastroesophageal reflux disease (GERD). However, the true role of upper endoscopy and MII-pH to evaluate patients with extraesophageal symptoms (EES) has not been well established. Hypopharyngeal MII (HMII), which directly measures laryngopharyngeal reflux (LPR) events, has been utilized to evaluate patients with EES suggestive of LPR.

methodsThis was a retrospective study involving patients with EES for > 12 weeks despite proton pump inhibitor therapy, and had no endoscopic confirmatory evidence for GERD and negative MII-pH. All patients were subsequently referred for further evaluation of EES with "unknown" etiology and underwent laryngoscopy and HMII. Based on HMII, abnormal proximal exposure (APE) was defined as LPR ≥ 1/day and/or full column reflux (reflux 2 cm distal to the upper esophageal sphincter) > 4/day. Patients with APE were offered antireflux surgery (ARS) and the outcome of ARS was objectively assessed using Reflux Symptom Index.

resultsOf 21 patients with EES which was thought to be GERD-unrelated based on endoscopy and MII-pH, 17 patients (81%) had APE. Eight patients with APE who had undergone ARS had significant symptomatic improvement in the Reflux Symptom Index score (19.6 ± 4.9 pre-ARS to 5.8 ± 1.4 post-ARS,

conclusionsA conventional diagnostic approach using endoscopy and MII-pH may not be sufficient to evaluate patients with EES suggestive of LPR. HMII is essential to evaluate patients with EES, and APE could be a reliable indicator for successful treatment outcomes.

Indexed as

HypopharynxLaryngopharyngeal refluxTreatment outcome

Identifiers

PMID34980689
PMCPMC8748846
OpenAlexW4205924261

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.