The Experts below are selected from a list of 4311 Experts worldwide ranked by ideXlab platform
John M. Delgaudio - One of the best experts on this subject based on the ideXlab platform.
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Laryngopharyngeal Reflux: Managing the Unsuccessful Patient:
Otolaryngology–Head and Neck Surgery, 2012Co-Authors: Marvin P. Fried, Bradley F. Marple, John H. Krouse, Kenneth W. Altman, John M. Delgaudio, Gregory N. PostmaAbstract:Program Description: Using an interactive panel format, the moderator will prompt panelists to present a quick review of epidemiology, symptomatology, and comorbid conditions impacting Laryngopharyngeal Reflux (LPR); diagnosis/differential diagnosis; current evidence on diagnostic and therapeutic management; and future research and management implications. After laying out background, the moderator/panel will consider real-world patient management algorithms. Using an audience response system, audience participants will help define the following: Who is the typical “unsuccessful” patient presenting with Laryngopharyngeal Reflux (LPR) in an otolaryngology practice? What diagnostic testing options are or should be employed after first treatment failure? What are the common treatment pathways for the unsuccessful patient? What differential data should be considered? What healthcare costs impact diagnosis and treatment options? When is referral recommended?
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Laryngopharyngeal Reflux (LPR)
Otolaryngology–Head and Neck Surgery, 2011Co-Authors: Bradley F. Marple, Gregory N. Postma, Marvin P. Fried, John H. Krouse, Kenneth W. Altman, John M. DelgaudioAbstract:Program Description: Objective: Develop a working algorithm that effectively eliminates dangerous conditions while efficiently provides reasonable alternatives to address LPR symptoms. Methods: use an audience response system in combination with a structured set of questions directed to the audience. End result: a real world proposed treatment algorithm. White paper. Possible basis for outcomes assessment study. The overall goal of this session is to define current practice trends on the management of Laryngopharyngeal Reflux (LPR) based on actual audience participation/input, and the consideration of appropriate management for a typical patient. Using an interactive panel format, the moderator will prompt panelists to present a quick review of epidemiology, symptomatology, and co-morbid conditions impacting Laryngopharyngeal Reflux (LPR); diagnosis/differential diagnosis; current evidence on diagnostic and therapeutic management; and future research and management implications. After laying out backgroun...
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gastroesophageal Reflux and Laryngopharyngeal Reflux in patients with sleep disordered breathing
Otolaryngology-Head and Neck Surgery, 2005Co-Authors: Sarah K Wise, Justin C Wise, John M. DelgaudioAbstract:ObjectiveTo assess the relationship of gastroesophageal Reflux (GER) and Laryngopharyngeal Reflux (LPR) with obstructive sleep apnea (OSA).Patients and MethodsThirty-seven sleep-disordered breathin...
Gregory N. Postma - One of the best experts on this subject based on the ideXlab platform.
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Laryngopharyngeal Reflux: Managing the Unsuccessful Patient:
Otolaryngology–Head and Neck Surgery, 2012Co-Authors: Marvin P. Fried, Bradley F. Marple, John H. Krouse, Kenneth W. Altman, John M. Delgaudio, Gregory N. PostmaAbstract:Program Description: Using an interactive panel format, the moderator will prompt panelists to present a quick review of epidemiology, symptomatology, and comorbid conditions impacting Laryngopharyngeal Reflux (LPR); diagnosis/differential diagnosis; current evidence on diagnostic and therapeutic management; and future research and management implications. After laying out background, the moderator/panel will consider real-world patient management algorithms. Using an audience response system, audience participants will help define the following: Who is the typical “unsuccessful” patient presenting with Laryngopharyngeal Reflux (LPR) in an otolaryngology practice? What diagnostic testing options are or should be employed after first treatment failure? What are the common treatment pathways for the unsuccessful patient? What differential data should be considered? What healthcare costs impact diagnosis and treatment options? When is referral recommended?
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Laryngopharyngeal Reflux (LPR)
Otolaryngology–Head and Neck Surgery, 2011Co-Authors: Bradley F. Marple, Gregory N. Postma, Marvin P. Fried, John H. Krouse, Kenneth W. Altman, John M. DelgaudioAbstract:Program Description: Objective: Develop a working algorithm that effectively eliminates dangerous conditions while efficiently provides reasonable alternatives to address LPR symptoms. Methods: use an audience response system in combination with a structured set of questions directed to the audience. End result: a real world proposed treatment algorithm. White paper. Possible basis for outcomes assessment study. The overall goal of this session is to define current practice trends on the management of Laryngopharyngeal Reflux (LPR) based on actual audience participation/input, and the consideration of appropriate management for a typical patient. Using an interactive panel format, the moderator will prompt panelists to present a quick review of epidemiology, symptomatology, and co-morbid conditions impacting Laryngopharyngeal Reflux (LPR); diagnosis/differential diagnosis; current evidence on diagnostic and therapeutic management; and future research and management implications. After laying out backgroun...
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prevalence of esophagitis in patients with ph documented Laryngopharyngeal Reflux
Laryngoscope, 2002Co-Authors: James A Koufman, Peter C. Belafsky, Kevin K Bach, Elena Daniel, Gregory N. PostmaAbstract:Objective: To report the prevalence of esophagitis in patients with pH-documented Laryngopharyngeal Reflux. Study Design: Prospective study of 58 consecutive patients with documented Laryngopharyngeal Reflux, all of whom underwent transnasal esophagoscopy as part of their Reflux evaluations. Methods: All patients with a diagnosis of Laryngopharyngeal Reflux confirmed by abnormal pharyngeal pH monitoring over a 5-month period were included, and all subjects completed a self-administered Reflux symptom index and underwent transnasal esophagoscopy with directed biopsy. Results: Of the 58 study patients with pH-documented Laryngopharyngeal Reflux, the mean age was 49 years (± 13 y), and 53% (31 of 58) were women. Of the study group, 40% (23 of 58) had heartburn and 48% (28 of 58) had abnormal esophageal Reflux (by pH monitoring criteria); by transnasal esophagoscopy with biopsy, 12% (7 of 58) had esophagitis and another 7% (4 of 58) had Barrett's metaplasia. Thus, 60% of the study cohort had no heartburn, and 81% (47 of 58) had normal esophageal epithelium (i.e., no esophagitis or Barrett's metaplasia). Conclusions: In the present series of patients with documented Laryngopharyngeal Reflux the prevalence of esophagitis and Barrett's metaplasia was only 19%. These data confirm the clinical impression that the patterns, mechanisms, and manifestations of Laryngopharyngeal Reflux differ from those of classic gastroesophageal Reflux disease. Unlike gastroesophageal Reflux disease, patients with Laryngopharyngeal Reflux uncommonly have esophagitis. Thus, although esophagoscopy may be an excellent method for screening the esophagus, it is not the method of choice for diagnosing Laryngopharyngeal Reflux.
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Pediatric Laryngopharyngeal Reflux.
Ear nose & throat journal, 2002Co-Authors: Kevin K Bach, William F Mcguirt, Gregory N. PostmaAbstract:Laryngopharyngeal Reflux (LPR) is common in children. It often affects the airway, and it has been associated with life-threatening disease. The diagnosis and treatment of LPR in children is somewhat different from that in adults.
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Laryngopharyngeal Reflux testing.
Ear nose & throat journal, 2002Co-Authors: Gregory N. Postma, Peter C. Belafsky, Jonathan E. Aviv, James A KoufmanAbstract:Reflux testing is still evolving as new technology. New criteria for determination of clinical and subclinical Laryngopharyngeal Reflux are surfacing. The technique and interpretation of pH monitoring, the current gold standard, are still somewhat controversial. The authors' experience and opinions are presented herein.
James A Koufman - One of the best experts on this subject based on the ideXlab platform.
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prevalence of esophagitis in patients with ph documented Laryngopharyngeal Reflux
Laryngoscope, 2002Co-Authors: James A Koufman, Peter C. Belafsky, Kevin K Bach, Elena Daniel, Gregory N. PostmaAbstract:Objective: To report the prevalence of esophagitis in patients with pH-documented Laryngopharyngeal Reflux. Study Design: Prospective study of 58 consecutive patients with documented Laryngopharyngeal Reflux, all of whom underwent transnasal esophagoscopy as part of their Reflux evaluations. Methods: All patients with a diagnosis of Laryngopharyngeal Reflux confirmed by abnormal pharyngeal pH monitoring over a 5-month period were included, and all subjects completed a self-administered Reflux symptom index and underwent transnasal esophagoscopy with directed biopsy. Results: Of the 58 study patients with pH-documented Laryngopharyngeal Reflux, the mean age was 49 years (± 13 y), and 53% (31 of 58) were women. Of the study group, 40% (23 of 58) had heartburn and 48% (28 of 58) had abnormal esophageal Reflux (by pH monitoring criteria); by transnasal esophagoscopy with biopsy, 12% (7 of 58) had esophagitis and another 7% (4 of 58) had Barrett's metaplasia. Thus, 60% of the study cohort had no heartburn, and 81% (47 of 58) had normal esophageal epithelium (i.e., no esophagitis or Barrett's metaplasia). Conclusions: In the present series of patients with documented Laryngopharyngeal Reflux the prevalence of esophagitis and Barrett's metaplasia was only 19%. These data confirm the clinical impression that the patterns, mechanisms, and manifestations of Laryngopharyngeal Reflux differ from those of classic gastroesophageal Reflux disease. Unlike gastroesophageal Reflux disease, patients with Laryngopharyngeal Reflux uncommonly have esophagitis. Thus, although esophagoscopy may be an excellent method for screening the esophagus, it is not the method of choice for diagnosing Laryngopharyngeal Reflux.
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Laryngopharyngeal Reflux testing.
Ear nose & throat journal, 2002Co-Authors: Gregory N. Postma, Peter C. Belafsky, Jonathan E. Aviv, James A KoufmanAbstract:Reflux testing is still evolving as new technology. New criteria for determination of clinical and subclinical Laryngopharyngeal Reflux are surfacing. The technique and interpretation of pH monitoring, the current gold standard, are still somewhat controversial. The authors' experience and opinions are presented herein.
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Treatment of Laryngopharyngeal Reflux.
Ear nose & throat journal, 2002Co-Authors: Gregory N. Postma, Lawrence F Johnson, James A KoufmanAbstract:Proton-pump inhibitors form the cornerstone of antiReflux therapy for Laryngopharyngeal Reflux. In this article, we provide algorithms to guide the management of minor, major, and life-threatening cases.
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Clinical manifestations of Laryngopharyngeal Reflux.
Ear nose & throat journal, 2002Co-Authors: Jacob T. Cohen, Gregory N. Postma, Kevin K Bach, James A KoufmanAbstract:Laryngopharyngeal Reflux (LPR) is ubiquitous and associated with many head and neck symptoms and diagnoses. In some cases, the symptom is the diagnosis--for example, LPR can cause sore throat, chronic cough, globus pharyngeus, and laryngospasm. Alternately, LPR can be associated with specific histopathologic lesions--for example, vocal process granulomas. LPR can be the sole cause or an etiologic cofactor in the development of many disorders of the aerodigestive tract.
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Symptoms and findings of Laryngopharyngeal Reflux.
Ear nose & throat journal, 2002Co-Authors: Peter C. Belafsky, Gregory N. Postma, Milan R. Amin, James A KoufmanAbstract:Even though the symptoms and findings of Laryngopharyngeal Reflux (LPR) have been described, the clinical diagnosis is sometimes elusive. Symptoms can occur in the absence of conclusive laryngeal physical findings, and they can be nonspecific. For example, dysphonia can be caused not only by LPR, but also by neoplasia and by geriatric, neurologic, and behavioral disorders. The clinician must realize that the diagnosis of LPR is based on a combination of factors, including symptoms, laryngeal findings, and diagnostic test results.
C. Richard Stasney - One of the best experts on this subject based on the ideXlab platform.
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Vocal quality of life improves with treatment of Laryngopharyngeal Reflux
Otolaryngology–Head and Neck Surgery, 2004Co-Authors: Mary Es A. Beaver, Scott M. Kaszuba, Michael G. Stewart, C. Richard StasneyAbstract:Objectives: To determine if vocal quality of life improves with treatment of Laryngopharyngeal Reflux disease (LPRD). Methods: A prospective case series study was performed on patients with a diagnosis of Laryngopharyngeal Reflux disease at a tertiary center of laryngology from 6/01 to 12/03. Pre- and posttreatment Reflux symptoms, physical examination scores, and vocal quality of life scores were assessed using validated and standardized instruments (Voice Handicap Inventory-10 [VHI-10], Reflux Symptom Index [RSI], and Laryngopharyngeal Reflux Disease Index [LRDI]). Results: A significant improvement in posttreatment vocal quality of life as measured by the VHI-10 was noted (mean score, 8.3) as compared to pretreatment (mean score 13.48, P < 0.001). This improvement correlated significantly with improvement in the RSI (posttreatment 12.56 vs pretreatment 18.10, P < 0.001, Pearson correlation coefficient 0.359). Physical examination score as measured by the LRDI improved with treatment but the degree of improvement did not correlate with improvement in the VHI-10 or the RSI. Conclusions: Treatment of LPRD significantly improves vocal quality of life. Laryngeal Reflux symptoms improve with treatment and this improvement correlates with improvement in vocal quality of life.
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Diagnosis of Laryngopharyngeal Reflux Disease with Digital Imaging
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2003Co-Authors: Mary Es Beaver, C. Richard Stasney, Erik K. Weitzel, Miichael G. Stewart, Donald T. Donovan, Robert B. Parke, Margarita RodriguezAbstract:Abstract Objective: The study goal was to assess the use of digital laryngeal videostroboscopy (LVS) in the detection of objective improvement of the larynx after 6 weeks of proton pump inhibitor (PPI) therapy and to evaluate a clinical grading scale for findings of Laryngopharyngeal Reflux disease (LPRD). Study Design and Setting: We conducted a prospective analysis of digital LVS examinations from a tertiary referral center for laryngology by 3 independent blinded examiners. Results: The mean score on the Laryngopharyngeal Reflux Disease Index for experimental patients was significantly higher than that for control patients (9.50 versus 2.92, P
Kyung Tae - One of the best experts on this subject based on the ideXlab platform.
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The role of psychological distress in Laryngopharyngeal Reflux patients: a prospective questionnaire study.
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2010Co-Authors: Kwang Soo Shin, Kyung Tae, Jin Hyeok Jeong, Seung Won Jeong, Kyung Rae Kim, Cheonghwan Park, Yong Chon ParkAbstract:Clin. Otolaryngol. 2010, 35, 25–30. Objectives: To determine the role of psychological distress in Laryngopharyngeal Reflux patients and evaluate the correlation between symptoms, laryngeal signs, pH monitoring results and psychological profile. Design: Prospective study. Setting: Hanyang University Hospital, a university teaching hospital and tertiary referral center. Participants: One hundred and six patients who were diagnosed with Laryngopharyngeal Reflux by 24-h ambulatory double probe pH monitoring and 119 healthy controls visiting our health promotion center from January 2006 to June 2007. Main outcome measures: The psychological profile of Laryngopharyngeal Reflux patients measured by the Symptom Checklist-90-Revised questionnaire were evaluated and compared with those of healthy controls. The correlation between Reflux symptom index, Reflux finding score, parameters of pH monitoring and the Symptom Checklist-90-Revised profiles were also evaluated. Results: On the Symptom Checklist-90-Revised questionnaire, the total mean T-scores of the nine symptom dimensions and three global indices of the Laryngopharyngeal Reflux patients were all below 50. The Global Severity Index, which indicates overall psychological distress, was normal in all of the patients. On comparison with the control group, no statistically significant difference was noted in the psychological profile except on the Somatisation scale where Laryngopharyngeal Reflux patients showed significantly higher scores. Reflux symptom index showed significant positive correlation with the number of Reflux episodes, percentage of time which pH fell below 4 in total positions, and DeMeester score of the upper probe. The nine symptom dimensions and three global indices of Symptom Checklist-90-Revised questionnaire did not show any correlation with Reflux symptom index, Reflux finding score and the parameters of the 24-h ambulatory double probe pH monitoring. Conclusions: Laryngopharyngeal Reflux patients did not demonstrate any significant level of psychological distress and their symptom severity showed significant positive correlation with Reflux severity.
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The significance of Laryngopharyngeal Reflux in benign vocal mucosal lesions
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2009Co-Authors: Jae Ho Chung, Kyung Tae, Jin Hyeok Jeong, Kyung Rae Kim, Yong Seop Lee, Seok Hyun Cho, Chul Won Park, Dong Soo HanAbstract:OBJECTIVE: To determine the significance of Laryngopharyngeal Reflux (LPR) in benign vocal mucosal lesions.STUDY DESIGN AND SETTING: A case-control study at the tertiary referral medical center.SUBJECTS AND METHODS: From April 2003 to December 2006, we studied 110 patients with benign vocal mucosal lesions who had undergone 24-hour ambulatory double pH monitoring. The control group included 200 patients who had undergone ambulatory 24-hour double-probe pH monitoring due to Laryngopharyngeal Reflux-related symptoms without specific findings of benign vocal mucosal lesions. Reflux symptom index and Reflux finding score were measured. We compared the prevalence of pathologic Laryngopharyngeal Reflux and various parameters of the pH monitoring such as total Reflux number, fraction time of pH below 4 in various positions, and DeMeester scores.RESULTS: The prevalence of pathologic Laryngopharyngeal Reflux was 65 percent in the control group, 66 percent in vocal nodule group, 75 percent in the vocal polyp group,...
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Change of acoustic parameters before and after treatment in Laryngopharyngeal Reflux patients.
The Laryngoscope, 2008Co-Authors: Bbong Joon Jin, Jin Hyeok Jeong, Seung Won Jeong, Yong Seop Lee, Seung Hwan Lee, Kyung TaeAbstract:Objectives: To evaluate the usefulness of acoustic parameters as an indicator of Laryngopharyngeal Reflux (LPR) treatment efficacy. Study Design: A prospective case series analysis. Materials and Methods: From January to September 2005, we prospectively analyzed 40 patients who were diagnosed with Laryngopharyngeal Reflux by 24-hour ambulatory double-probe pH monitoring. Laryngopharyngeal Reflux patients were treated medically and voice analysis was conducted three times: before treatment, 1 to 2 months after treatment, and 3 to 4 months after treatment. Jitter, shimmer, and harmonic-to-noise ratio (HNR) were analyzed as the acoustic parameters. Pre- and posttreatment Reflux symptom index and Reflux finding score were documented. Results: Jitter, shimmer, and HNR had improved significantly at 1 to 2 months after treatment and were maintained at 3 to 4 months after treatment. Jitter was significantly correlated with Reflux symptom index. Conclusion: Acoustic parameters can be used as indicators of treatment efficacy for Laryngopharyngeal Reflux disease.
