Objective: to investigate the reliability of laryngeal reflux finding score (RFS) and symptom index (RSI) in assessing gastroesophageal reflux (GER) in children and infants. Methods: patients with laryngeal or respiratory symptoms, who underwent laryngoscopy and esophageal pH-impedance (MII-pH) were recruited. RSI and RFS were correlated to MII-pH results. A RSI>13, RFS>7, acid exposure index>7%, total reflux episodes>100/24 h in infants or>70/24 h in children, or a positive symptom index or association probability, were considered pathological. Analysis considering age (12 months) was performed. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of the laryngeal scores were calculated. Results: 197 children (median 53 months, 61 infants) were enrolled. MII-pH was pathological in 5/10 patients with RFS>7, and in 17/31 with RSI>13. RFS>7 had 3.9% sensitivity, 93% specificity, a PPV of 50 and a NPV of 34 in predicting GER disease. RFS was inversely associated to weakly acidic and proximal GER. RSI>13 had 13% sensitivity, 83% specificity, and a PPV and NPV similar to RFS. RSI was significantly associated with the number of acid reflux episodes, and, in infants, with bolus exposure index. Conclusions: RSI and RFS aren't accurate in predicting GER in infants and children. Acid reflux relates to laryngeal symptoms, but neither acid, nor proximal and weakly acidic GER relate to laryngeal alterations.

Laryngeal signs and pH-multichannel intraluminal impedance in infants and children: the missing ring: LPR and MII-pH in children / Mantegazza, C.; Mallardo, S.; Rossano, M.; Meneghin, F.; Ricci, M.; Rossi, P.; Capra, G.; Latorre, P.; Schindler, A.; Isoldi, S.; Agosti, M.; Zuccotti, G. V.; Salvatore, S.. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 52:9(2020), pp. 1011-1016. [10.1016/j.dld.2020.05.001]

Laryngeal signs and pH-multichannel intraluminal impedance in infants and children: the missing ring: LPR and MII-pH in children

Mallardo S.;Rossi P.;Isoldi S.;
2020

Abstract

Objective: to investigate the reliability of laryngeal reflux finding score (RFS) and symptom index (RSI) in assessing gastroesophageal reflux (GER) in children and infants. Methods: patients with laryngeal or respiratory symptoms, who underwent laryngoscopy and esophageal pH-impedance (MII-pH) were recruited. RSI and RFS were correlated to MII-pH results. A RSI>13, RFS>7, acid exposure index>7%, total reflux episodes>100/24 h in infants or>70/24 h in children, or a positive symptom index or association probability, were considered pathological. Analysis considering age (12 months) was performed. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of the laryngeal scores were calculated. Results: 197 children (median 53 months, 61 infants) were enrolled. MII-pH was pathological in 5/10 patients with RFS>7, and in 17/31 with RSI>13. RFS>7 had 3.9% sensitivity, 93% specificity, a PPV of 50 and a NPV of 34 in predicting GER disease. RFS was inversely associated to weakly acidic and proximal GER. RSI>13 had 13% sensitivity, 83% specificity, and a PPV and NPV similar to RFS. RSI was significantly associated with the number of acid reflux episodes, and, in infants, with bolus exposure index. Conclusions: RSI and RFS aren't accurate in predicting GER in infants and children. Acid reflux relates to laryngeal symptoms, but neither acid, nor proximal and weakly acidic GER relate to laryngeal alterations.
2020
gastroesophageal reflux; pH-impedance; proton pump inhibitors; reflux finding score; reflux symptom index
01 Pubblicazione su rivista::01a Articolo in rivista
Laryngeal signs and pH-multichannel intraluminal impedance in infants and children: the missing ring: LPR and MII-pH in children / Mantegazza, C.; Mallardo, S.; Rossano, M.; Meneghin, F.; Ricci, M.; Rossi, P.; Capra, G.; Latorre, P.; Schindler, A.; Isoldi, S.; Agosti, M.; Zuccotti, G. V.; Salvatore, S.. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 52:9(2020), pp. 1011-1016. [10.1016/j.dld.2020.05.001]
File allegati a questo prodotto
File Dimensione Formato  
Mantegazza_Laryngeal-signs_2020.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 398.55 kB
Formato Adobe PDF
398.55 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1488740
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 9
  • ???jsp.display-item.citation.isi??? 7
social impact