title: Flexible laryngoscopy-guided pharyngeal pH monitoring in infants.
abstract: OBJECTIVE
  To evaluate flexible laryngoscopy-guided pharyngeal pH probe monitoring as an alternative accurate and practical pharyngeal pH probe placement technique to eliminate the need for radiographs and esophageal manometry for pharyngeal pH monitoring in infants with extraesophageal reflux disease (EERD).
  
  
  METHODS
  Infants with suspected laryngopharyngeal acid reflux (LPR) who underwent pharyngoesophageal pH monitoring were included. Data analysis included description of the flexible laryngoscopy-guided pharyngoesophageal pH monitoring technique and pharyngoesophageal pH monitoring findings, including the number of acid reflux episodes and percent acid exposure time.
  
  
  RESULTS
  Six infants (3 boys, 3 girls, age range, 2 wk-7.5 mo) with suspected LPR underwent pharyngoesophageal pH monitoring. Flexible laryngoscopy was used, under direct vision, to guide pH probe placement in the laryngopharyngeal region. The esophageal pH probe was located 5 cm distal to the pharyngeal pH probe. All infants tolerated the procedure. Of the six infants, four had pharyngeal acid reflux, and six had esophageal acid reflux. The number of acid reflux episodes ranged from 4 to 81 in the pharynx and from 5 to 173 in the esophagus. The percentage of acid exposure time was between 0% and 1.2% in the pharynx and between 0.1% and 1.5% in the esophagus.
  
  
  CONCLUSIONS
  With the aid of flexible laryngoscopy, a pH probe can be placed in the laryngopharyngeal region in infants undergoing pharyngeal pH monitoring. Findings documented that not all esophageal acid reflux reach the pharynx. Flexible laryngoscopy-guided pharyngeal pH probe placement can be used to detect LPR in infants with EERD.
authors.affiliation: Pediatric Airway and Swallowing Disorders Laboratory, Division of Pediatric Otolaryngology and Department of Otolaryngology, UTMB Children's Hospital, University of Texas Medical Branch, Galveston, Texas, USA. seulualp@utmb.edu
authors.forename: Seckin O
authors.initials: SO
authors.lastname: Ulualp
authors.forename: Sarah
authors.initials: S
authors.lastname: Rodriguez
authors.forename: Camysha N
authors.initials: CN
authors.lastname: Holmes-Wright
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007231:Infant, Newborn; D007818:Laryngeal Diseases / Q000175:diagnosis; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D010614:Pharynx / Q000378:metabolism*