pH Impedance and high-resolution manometry in laryngopharyngeal reflux disease high-dose proton pump inhibitor failures.

Objectives/hypothesis: Laryngopharyngeal reflux disease (LPRD) patients often fail empiric treatment with high-dose, twice-daily (BID) proton pump inhibitors (PPIs). Further testing is warranted to rule in or out nonacid reflux (NAR) or breakthrough acid reflux (BAR) as the etiology of the symptoms. Results of coordinated multichannel intraluminal pH impedance (MII) and high-resolution esophageal manometry (HRM) testing while patients are on high-dose BID PPIs is lacking in the LPRD population.

Frame by frame analysis of glottic insufficiency using laryngovideostroboscopy.

Objectives/hypothesis: Glottic insufficiency (GI) can be either grossly obvious or subtle in its presentation. Subtle GI is demonstrated by various Laryngovideostroboscopic (LVS) clues, including complete but "short" phase closure of the true vocal folds (VFs) during the glottic cycle. We used the frame by frame analysis (FBFA) technique to evaluate its effectiveness in objectively contributing to the diagnosis of subtle GI in patients with atrophic and/or paretic VFs.