Journal article
Laryngopharyngeal Reflux in Patients Who Received or Declined Nissen Fundoplication
Journal of voice
03 Nov 2024
PMID: 39496530
Abstract
To evaluate whether Robotic or Laparoscopic Nissen Fundoplication (LNF) improves voice outcomes and symptoms in patients with Laryngopharyngeal Reflux (LPR) compared to patients who were candidates for surgery but elected to receive treatment with antireflux medical management alone.
Retrospective chart review.
A retrospective chart review was conducted of patients who visited the office of the senior author, received a diagnosis of LPR, and were candidates for LNF. Patients were categorized into two groups: those who received LNF surgery (Nissen-received, n = 50) and those who declined surgery (Nissen-declined, n = 54). Reflux Finding Scores (RFS) collected pre- and post-treatment were compared between groups. 24-hour pH-impedance results also were evaluated pre- and post-treatment.
24-hour pH-impedance testing from patients in the Nissen-received group showed a statistically significant decrease in six recording categories at the proximal sensor and five at the distal sensor, pre- to post-Nissen fundoplication. Proximal sensor categories included: (1) total reflux, (2) supine reflux, (3) acidic reflux, (4) weakly acidic reflux, (5) upright reflux, and (6) total postprandial reflux. Distal sensor categories included: (1) total reflux, (2) weakly acidic reflux, (3) supine reflux, (4) upright reflux, and (5) upright weakly acidic reflux. There were statistically significant differences in the changes from pre- to post-intervention when comparing between the Nissen-received and Nissen-declined groups at three proximal and three distal recordings. The proximal recording categories were (1) total reflux, (2) upright reflux, and (3) upright weakly acidic reflux, and the distal sensor categories were (1) upright reflux, (2) upright weakly acidic reflux, and (3) weakly acidic reflux. The Nissen-received group demonstrated statistically significant improvements in total RFS score, as well as the subcategory score of erythema, from pre- to post-Nissen fundoplication. There were statistically significant differences in the subcategory scores of erythema and diffuse laryngeal edema when comparing the changes from pre- to post-intervention between the Nissen-received and Nissen-declined groups.
LNF provides improved LPR control compared with treatment with antireflux medication alone.
Metrics
10 Record Views
Details
- Title
- Laryngopharyngeal Reflux in Patients Who Received or Declined Nissen Fundoplication
- Creators
- Adam Gardi - Drexel UniversitySriprachodaya Gaddam - Drexel University, Otolaryngology (and Head and Neck Surgery)Philip Maxwell - Drexel University, Otolaryngology (and Head and Neck Surgery)Lauren E. Melley - Philadelphia College of Osteopathic MedicineAllison Altman - Philadelphia College of Osteopathic MedicineParastou Ranjbar - Drexel UniversityOmar Ramadan - Drexel University, Otolaryngology (and Head and Neck Surgery)Robert T. Sataloff - Drexel University, Otolaryngology (and Head and Neck Surgery)
- Publication Details
- Journal of voice
- Publisher
- Elsevier Inc
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; Otolaryngology (and Head and Neck Surgery)
- Scopus ID
- 2-s2.0-85208096038
- Other Identifier
- 991022094669704721