Oropharyngoesophageal scintigraphy in the diagnostic algorithm of laryngopharyngeal reflux disease: a useful exam?
OBJECTIVE
To evaluate the role of oropharyngoesophageal scintigraphy in the diagnostic approach to patients with laryngopharyngeal reflux (LPR).


METHODS
Forty-one patients with chronic laryngopharyngeal symptoms and a control group of 15 healthy volunteers were examined. All subjects underwent standard oropharyngoesophageal scintigraphy. The following parameters were considered: activity-time curves, presence of double peaks and reduced slope in oropharyngeal phase, presence of accelerated or slowed esophagogastric transit, persistence of radioactive material on the pharyngeal or esophageal mucosa, and presence of gastroesophageal reflux (GER) under exercise.


RESULTS
There were objective signs of laryngeal reflux in 80.5% of the patients. In 82.9%, scintigraphy documented several associated morphofunctional pathologic patterns: positive GER test (61.0%), presence of double peaks (36.6%), indirect signs of pharyngoesophageal inflammation (31.7%), hypotonic lower esophageal sphincter (17.1%), and slowed esophageal clearance (9.8%).


CONCLUSIONS
Oropharyngoesophageal scintigraphy may be used as preliminary examination in outpatients with signs and symptoms of LPR. Cases of classic gastroesophageal reflux disease could be separated from those of LPR disease and therefore submitted to more invasive instrumental examinations.
Galli
Jacopo
J
Department of Otolaryngology, Catholic University of the Sacred Heart, Largo Gemelli n. 8, 00168 Rome, Italy. iclot@rm.unicatt.it
Volante
Mariangela
M
Parrilla
Claudio
C
Rigante
Mario
M
Valenza
Venanzio
V
D000328:Adult; D000368:Aged; D000465:Algorithms; D005260:Female; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging; D006801:Humans; D007013:Hypopharynx / Q000000981:diagnostic imaging*; D007818:Laryngeal Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D011877:Radionuclide Imaging