Airway Impedance: A Novel Diagnostic Tool to Predict Extraesophageal Airway Inflammation - 05/05/23
, Reza Rahbar, DMD, MD 2, Karen Watters, MD 2, Anne Hseu, MD 2, Carlos J. Munoz, MD 3, Lynne Ferrari, MD 3, Robert Holzman, MD 3, Shoaib Mohammad, MD 3, Alexandra Cohen, BA 1, Maritha Du, BA 1, Anna Akkara, BS 1, Andrea Catacora, BS 1, Tregony Simoneau, MD 4, Sarah Connearney, MSN, RN, CNP 1, Paul Mitchell, MS 5, Samuel Nurko, MD, MPH 1Abstract |
Objective |
To validate a novel biomarker, airway impedance for extraesophageal disease.
Study design |
We prospectively recruited patients with respiratory symptoms undergoing combined endoscopy and direct laryngoscopy for the evaluation of symptoms. The direct laryngoscopy was performed and videotaped for blinded scoring by 3 otolaryngologists and an impedance catheter was placed onto the posterior larynx to obtain measurements. Following this, an endoscopy was performed and impedance measurements and biopsies were taken at 3 esophageal heights. Impedance values were compared within and between patients.
Results |
Eighty-eight patients were recruited, of which 73 had complete airway and endoscopic exams. There was no significant correlation between airway impedance values and mean reflux finding scores (r2 = 0.45, P = .07). There was no significant positive correlation between airway impedance and esophageal impedance values (r2 = 0.097-0.138, P > .2). Patients taking proton pump inhibitors had significantly lower mean airway impedance values (706 ± 450 Ω) than patients not taking them (1069 ± 809 Ω, P = .06). Patients who had evidence of aspiration on video fluoroscopic swallow studies had lower airway impedance (871 ± 615 Ω) than patients without aspiration (1247 ± 360 Ω, P = .008). Inhaled steroids did not impact airway impedance levels (P = .7).
Conclusions |
Airway impedance may be an important diagnostic tool to diagnose gastroesophageal reflux or aspiration, eliminating the subjectivity of airway appearance alone.
Le texte complet de cet article est disponible en PDF.Keywords : impedance, gastroesophageal reflux disease, larynx, aspiration, proton pump inhibitor, extraesophageal reflux
Abbreviations : EGD, GERD, ICS, PPI, RFS, ROC, VFSS
Plan
| Funded by the NIH R01 DK097112-06A1. Mucosal impedance catheters were donated by Diverstek. There was no industry involvement in any aspects of this study including the design, data collection, analysis, or manuscript preparation. The authors declare no conflicts of interest. |
Vol 256
P. 5 - mai 2023 Retour au numéro
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