Comparative study of symptoms and clinical signs of laryngopharyngeal reflux with salivary pepsin concentration

Cilj: Ispitati simptome i znakove laringofaringealnog refluksa u ispitivanoj skupini prije i nakon terapije te usporediti koncentraciju pepsina u slini s navedenim. Nacrt studije: Provedeno je prospektivno longitudinalno kohortno istraživanje. Ispitanici i metode: U istraživanje je uključeno 50 ispitanika, podijeljenih u dvije skupine. Prvu skupinu činili su ispitanici sa laringofaringealnim refluksom, njih 25. Drugu skupinu činili su zdravi ispitanici bez simptoma i znakova laringofaringealnog refluksa, njih 25. Simptomi i znakovi prije i nakon terapije su prikupljeni pomoću RSI i RFS upitnika. Pepsin u slini je izmjeren pomoću Peptesta prije i nakon terapije. Rezultati: Prema spolu, 29 (58 %) je žena i 21 (42 %) je muškaraca. Od simptoma najizraženiji su promuklost, postnazalno slijevanje i osjećaj ''knedle u grlu''. Medijan RSI rezultata nakon tromjesečne terapije snižen je s 20 na 8. Iz prve skupine 7 ispitanika je imalo mjerljivu razinu pepsina u slini, a niti jedan nakon provedene terapije. U kontrolnoj skupini nijednom ispitaniku nije detektiran pepsin u slini. Zaključak: Uočeno je značajno poboljšanje u kliničkim nalazima (subglotički edem, hipertrofija stražnje komisure, edem glasnica, gusti endolaringealnog sekret). Nije uočena povezanost pepsina sa simptomima LPR-a ali postoji značajna pozitivna povezanost između pepsina i kliničkog nalaza eritema / hiperemije.Objectives: To examine symptoms and signs of laryngopharyngeal reflux in examined group before and after treatment and compare salivary pepsin concentration with symptoms and signs of LPR. Study design: Prospective longitudinal cohort study was carried out. Participants and methods: 50 examinee's were included in this research divided into two groups. First group was consisted of 25 patients with laryngopharyngeal reflux. Second group consisted of healthy participants, also 25 of them, without symptoms and signs of laryngopharyngeal reflux. Symptoms and signs were gathered before and after treatment with RSI and RFS questionnaire. Salivary pepsin was measured with Peptest before and after treatment. Results: According to sex, 29 were women and 21 were men. The most common symptoms were hoarseness, postnasal drip and ''lump in throat''. The mean value of RSI score after three-month treatment was reduced from 20 to 8. Seven participants had salivary pepsin before treatment but none of them after treatment. None of the participants from control group had salivary pepsin. Conclusion: There is significant improvement in clinical signs (subglottic edema, posterior commisure hypertrophy, vocal fold edema and thick endolaryngeal mucus. No connection is detected between salivary pepsin and symptoms but there is significant positive connection between pepsin and clinical sign erythema / hyperemia