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Objective@#To evaluate the feasibility of pepsin strip test in the diagnosis of laryngopharyngeal reflux.@*Methods@#From August 2017 to September 2018,80 patients in Department of Otorhniolaryngology Head and Neck Surgery,Chinese People′s Liberation Army General Hospital-Six Medical Centre, underwent pepsin strip test and 24-hour multichannel intraluminal impedance(MII)-pH monitoring. The results of the two methods were analyzed for consistency,and 24-hour MII-pH monitoring was used as a statistical reference for the sensitivity and specificity of pepsin strip test in the diagnosis of laryngopharyngeal reflux. Data were analyzed by SPSS 19.0 software.@*Results@#There were 57 patients with positive pepsin test strip and 23 patients with negative pepsin test strip. The score of reflux symptoms and signs, and the positive rate of laryngopharyngeal reflux events in patients with positive pepsin strip test were significantly higher than those in patients with negative pepsin test strip. If there was one or more throat reflux events (including acid reflux,weak acid reflux and alkali reflux) as the positive results of 24-hour MII-pH monitoring,the consistency between the results of pepsin strip and 24-hour MII-pH was moderate (Kappa=0.614). The sensitivity and specificity of pepsin strip were 86.9% (53/61) and 78.9% (15/19) respectively.@*Conclusions@#Pepsin strip detection has the advantages of non-invasive,cheap and easy to operate.As an objective method for early diagnosis of laryngopharyngeal reflux, pepsin strip detectionis feasible,but can not be the final diagnosis for laryngopharyngeal reflux disease.
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Objective@#To observe the incidence and to determine the significance of laryngopharyngeal reflux (LPR) in laryngeal cancer and vocal leukoplakia.@*Methods@#The patients who had been diagnosed as laryngeal cancer or vocal leukoplakia between January 2014 and June 2017 were included in this study. All of them received 24-hour multichannel intraluminal impedance-pH monitoring. The prevalence of LPR and numerous parameters from the 24-hour pH monitoring in laryngeal cancer patient and vocal leukoplakia patient groups were analyzed. The chi-square test was used for counting data, t test and Mann-Whitney U were used for measuring data.@*Results@#In the 91 laryngeal cancer patients, the prevalence of pathologic LPR was 28.6%(26/91), the median number[P25, P75, P95]of acid reflux events was 0[0, 3, 5], time of acid exposure was 0[0, 14, 234]s, number of weakly acidic reflux events was 3[0, 6, 11]. In the 54 vocal leukoplakia patients, the prevalence of pathologic LPR was 29.6%(16/54), the number of acid reflux events was 0[0, 3, 4], time of acid exposure was 0[0, 13, 118]s, number of weakly acidic reflux events was 1.5[0, 5, 9]. The incidence of LPR did not vary in the laryngeal cancer patient and vocal leukoplakia patient groups, but were both higher than healthy Chinese volunteers according to a report in the other literature. Furthermore, all the three patients with no history of tobacco or alcohol existed acid or weakly acidic reflux episodes.@*Conclusions@#Laryngopharyngeal reflux might play a role as an etiologic factor in laryngeal cancer and vocal leukoplakia.
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OBJECTIVE@#The aim of this retrospective study was to analyze the recovery rate of sudden sensorineural hearing loss in children, and explore the prognostic factors in order to guide the clinical diagnosis and treatment.@*METHOD@#A retrospective review was conducted for the prognosis of children with sudden sensorineural hearing loss during the past 5 years (from November 2010 to May 2015) in Chinese PLA General Hospital. This paper have a complete clinical data of 101 patients (113 ears)with sudden hearing loss, ranging from 0 to 18 years old Patients were divided into four groups according to hearing recovery and eight putative prognostic factors were analyzed.@*RESULT@#Among 101 patients (113 ears), the ratio of male and female was 60:53. Treatment was initiated from 1 to 183 days after disease onset, with an average of (18.5 ± 22.1) d. Bilateral and unilateral hearing loss were 24 ears and 89 ears, respectively. The proportion of mild hearing loss, moderate hearing loss, severe hearing loss and profound hearing loss were 7.1%, 6.2%, 23.9% and 62.8%, respectively. Vertigo and tinnitus occurred in 54.9% and 77.9% of the patients, respectively. After the treatment, the complete recovery rate was 9.7% and the overall recovery rate was 36.3%. The degree of hearing loss, earlier treatment onset, sex and bilateral involvement were significantly associated with hearing recovery (P < 0.05).@*CONCLUSION@#Sudden sensorineural hearing loss in children was generally identified as severe and profound hearing loss, but after positive and timely treatment, it can be improved or even cured. The mild hearing loss, earlier treatment onset, unilateral hearing loss and female were positive prognostic factors. The concurrence of tinnitus or vertigo, the results of ABR and DPOAE had no significant influence on prognosis.