Nasopharyngeal pH monitoring in chronic sinusitis patients using a novel four channel probe.
OBJECTIVE
To determine the prevalence of acid reflux into the nasopharynx in patients with chronic sinusitis.


METHODS
Prospective study of patients presenting to a specialist rhinology practice with chronic sinusitis.


METHODS
Forty patients with chronic sinusitis underwent ambulatory 24 hour pH testing. The mean age of the patients was 56.3 years (25 Female, 15 Male). The studies were performed using a specially developed bifurcated 4 channel pH probe, incorporating 2 circumferential sensors positioned at the naso- and hypo-pharynx, and 2 unidirectional sensors positioned at the proximal and distal esophagus.


RESULTS
The circumferential band sensors yielded a stable recording largely free of artefact allowing meaningful recordings to be obtained from thirty-seven patients. Twelve patients (32.4%) were diagnosed with gastroesophageal reflux. A total of 809 reflux episodes were recorded. Of these, 596 (73.7%) reached the distal esophagus, with 187 (23.1%) and 24 (3.0%) reaching the proximal esophagus and hypopharynx respectively. Only 2 episodes (0.2%) were recorded in the nasopharynx. This occurred in 2 of 37 patients (5%).


CONCLUSIONS
Acid reflux into the nasopharynx is a rare event in patients with chronic sinusitis even though a significant proportion (32.4%) have abnormal 24 hour pH studies. It is likely that alternative mechanisms other than direct acid contact are involved in the pathogenesis of chronic sinusitis.
Department of Surgery--Otolaryngology, Head and Neck Surgery, Adelaide and Flinders Universities, South Australia.
I W Y
IW
Wong
T I
TI
Omari
J C
JC
Myers
G
G
Rees
S B
SB
Nair
G G
GG
Jamieson
P J
PJ
Wormald
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004566:Electrodes; D005260:Female; D005745:Gastric Acidity Determination / Q000295:instrumentation*; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D012852:Sinusitis / Q000175:diagnosis / Q000209:etiology*