Impact of age on laryngopharyngeal reflux disease presentation: a multi-center prospective study

• Published in: European archives of oto-rhino-laryngology Vol. 274; no. 10; pp. 3687 - 3696
• Main Authors: Lechien, Jérôme R., Finck, Camille, Huet, Kathy, Khalife, Mohamad, Fourneau, Anne-Françoise, Delvaux, Véronique, Piccaluga, Myriam, Harmegnies, Bernard, Saussez, Sven
• Format: Journal Article Web Resource
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2017; Springer Verlag
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles; 2-Pyridinylmethylsulfinylbenzimidazoles/administration & dosage; 2-Pyridinylmethylsulfinylbenzimidazoles/adverse effects; Adult; Age Factors; Aged; Esophageal pH Monitoring; Esophageal pH Monitoring/methods; Esophagitis, Peptic; Female; General Medicine; Head and Neck Surgery; Human health sciences; Humans; Laryngitis; Laryngology; Laryngopharyngeal; Laryngopharyngeal Reflux; Laryngopharyngeal Reflux/diagnosis; Laryngopharyngeal Reflux/physiopathology; Laryngopharyngeal Reflux/psychology; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Oto-rhino-laryngologie; Otolaryngology; Otorhinolaryngology; Pantoprazole; Prospective Studies; Proton Pump Inhibitors; Proton Pump Inhibitors/administration & dosage; Proton Pump Inhibitors/adverse effects; Quality of Life; Reflux; Sciences de la santé humaine; Surveys and Questionnaires; Symptom Assessment; Treatment Outcome; Voice; Voice Disorders; Voice Disorders/diagnosis; Voice Disorders/etiology; Voice Quality; Reflux; Laryngopharyngeal; Voice; Laryngitis
• ISSN: 0937-4477; 1434-4726; 1434-4726
• DOI: 10.1007/s00405-017-4671-z

The objective is to assess the differences in the severity of symptoms, signs, voice quality, and quality of life before and after treatment according to age in suspected laryngopharyngeal reflux (LPR) patients. The design used in this paper is prospective multi-center study. Eighty clinically diagnosed LPR patients with a reflux finding score (RFS) >7 and a reflux symptom index (RSI) >13 were treated with pantoprazole and diet recommendations for 3 months. Patients were subdivided into three groups according their age: group 1 (18–39 years, N  = 21), group 2 (40–59 years, N  = 31), and group 3 (≥60 years, N  = 28). RSI, RFS, Voice Handicap Index (VHI), Short Form 36 questionnaire (SF36), aerodynamic, and acoustic measurements were evaluated at baseline and after treatment. The response to the empiric treatment was also assessed. Significant improvements in RSI, RFS, and VHI were found in all patient groups. The elderly patients showed a significantly lower RSI score than younger subjects ( p  = 0.035) without RFS difference among groups. At baseline, the SF36 score was better in group 3 with respect to social functioning ( p  = 0.049). At the 3-month follow-up, we found significant improvement of acoustic parameters only in the younger age groups (group 1 and group 2). The rate of resistant patients to the empiric treatment was higher in the younger group than in the elderly patient group (42.9 versus 28.6%). Age appears to reduce the subjective LPR symptom perception, leading to a lower rate of uncured patients. The utilization of acoustic parameters as an indicator of treatment effectiveness seems less useful for elderly subjects, probably due to an overlap between an aging voice and LPR.