The Journal of Laryngology & Otology

Main Articles

Empirical treatment with pantoprazole as a diagnostic tool for symptomatic adult laryngopharyngeal reflux

M Masaanya1 c1, M B Marinaa2, W P Sharifa Ezata3 and A Sania2

a1 Department of Otorhinolaryngology – Head and Neck Surgery, Hospital Sultanah Bahiyah, Alor Setar, Malaysia

a2 Department of Otorhinolaryngology – Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

a3 Department of Public Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

Abstract

Objective: To determine the sensitivity and specificity of intensive empirical treatment with pantoprazole in diagnosing laryngopharyngeal reflux in adults.

Study design: This was a prospective, double-blind study.

Subjects and methods: Fifty-five patients with either a Reflux Symptom Index of more than 13 or a Reflux Finding Score of more than 7 were enrolled. All patients underwent 24-hour, double-probe pH monitoring before commencing pantoprazole 40 mg twice daily; both investigators and patients were blinded to pH monitoring results. The Reflux Symptom Index and Reflux Finding Score were reassessed during the second, third and fourth month of follow up.

Results: The sensitivity of empirical pantoprazole treatment in diagnosing laryngopharyngeal reflux was 92.5 per cent. The specificity was 14.2 per cent, the positive predictive value 86 per cent and the negative predictive value 25 per cent. There was significant reduction in the total Reflux Symptom Index and Reflux Finding Score after the second, third and fourth month of treatment. There was no correlation between laryngopharyngeal reflux and body mass index.

Conclusion: Our results suggest that intensive empirical treatment with proton pump inhibitors is effective in diagnosing laryngopharyngeal reflux.

(Accepted September 14 2010)

(Online publication February 28 2011)

Correspondence:

c1 Address for correspondence: Dr Masaany Mansor, Department of ORL-HNS, Hospital Sultanah Bahiyah, 05460, Alor Setar, Malaysia Fax: 604 7407335 E-mail: masaanymansor@yahoo.com

Dr Masaany M takes responsibility for the integrity of the content of the paper

Competing interests: None declared

Related Content