[Long-term esophageal and oropharyngeal pH-metry in ORL manifestations of gastroesophageal reflux in children].
Several studies published over the last few years have pointed out the importance of gastroesophageal reflux (GER) in the pathogenesis of certain cases of chronic or recurrent pharyngo-laryngitis. While the presence of an acid reflux at the level of the pharyngo-larynx has recently been demonstrated in certain cases, the real incidence and pathogenic impact of this reflux is not precisely known. A new technique of continuous 24 hour bi-level monitoring of endoluminal pH in the esophagus and the oro/hypopharynx has made it possible to observe the variations in acid-base balance in contact with the pathological mucosa. 21 patients, 2 months to 7.5 years old, presenting recurrent episodes of pharyngitis or laryngitis, underwent continuous pH monitoring during a 24 hour hospitalization. 6 control subjects, 1 month to 13 years old, presenting no chronic or recurrent ear, head or neck pathology and no sign or symptom of GER were subjected to the same monitoring regimen. A statistically significant difference between the 2 groups is evident for most of the parameters analysed. The most discriminative parameter is the fraction of the total recording time where the pharyngeal readings remain under ph6 (p < 0.0005). These results demonstrate that, in this clinical condition, acid of gastroesophageal origin is in contact with the pharyngeal mucosa. This suggests that the acid has a causal role in the pathological changes observed in the pharyngolaryngeal mucosa.
Contencin
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Service ORL, Hôpital Robert Debré, Faculté de Médecine Xavier Bichat, Université Paris VII.
Adjoua
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Viala
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Erminy
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Narcy
P
P
D002648:Child; D002675:Child, Preschool; D004947:Esophagus / Q000737:chemistry; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007827:Laryngitis / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008991:Monitoring, Physiologic; D009960:Oropharynx / Q000737:chemistry; D010612:Pharyngitis / Q000209:etiology / Q000503:physiopathology*
La pH-métrie couplée, oesophagienne et oro/hypopharyngée, de longue durée dans les formes ORL de reflux gastro-oesophagien de l'enfant.