ABSTRACT
To evaluate the positive pathological findings, patient satisfaction, pain, and complications of transnasal esophagoscopy (TNE) in laryngopharyngeal reflux (LPR) patients at HRH Princess Maha Chakri Sirindhorn Medical Center (MSMC), Thailand. A descriptive cross-sectional study. Forty adult LPR patients who had failed 3-months proton-pump inhibitor therapy were recruited to undergo TNE at Otolaryngology department, MSMC from January 1, 2019 to December 31, 2019. Data including demographics, Reflux Finding Score, Reflux Symptom Index, Eating Assessment Tool (EAT-10) scores, and endoscopic findings were recorded and compared between patients who had positive pathological findings and those who had negative findings. Sixteen patients (40%) had positive findings, which led to the changes in management of their conditions. Most positive findings included multiple esophageal and gastric ulcers (4/16), gastric ulcer (3/16), esophagitis (2/16), and esophageal candidiasis (2/16). There was no statistically significant difference in the baseline data between patients in the TNE positive and the TNE negative groups. The average patient satisfaction on VAS was 8.60 ± 1.43. Most patients were in the mild pain score group (18/40). Complications were not encountered. TNE is an efficient tool for evaluating LPR in Thai patients. The procedure was proven to be safe, well tolerated, and highly satisfied.
ABSTRACT
A new outpatient non-surgical method using Er:YAG laser for snoring has been demonstrated. The aim of this systematic review and meta-analysis was to investigate the effects of this treatment on snoring. Relevant 1548 articles were searched from various databases from 1 January 2000 to September 2018 including PubMed, MEDLINE, EMBASE, Cochrane Library, Web of Science, and Scopus and reference lists. Meta-analysis was performed with RevMan software. Cochran's Q and I2 statistics were used to assess heterogeneity. The overall effect was evaluated using z-tests. Seven studies and two hundred forty-seven participants treated with two to three sessions of Er:YAG 2940 nm laser (long pulse mode, 10 Hz, fluence 1.6 J/cm2) were included. There was a statistically significant reduction of pooled snoring VAS (mean difference (MD) (95% CI), - 6.89 (- 7.62, - 6.15)). Patient satisfaction rate after laser treatment was 80% (95% CI, 70.69, 89.05) of cases. A widening of the upper airway dimension was revealed; however, changes in apnea-hypopnea index (AHI) and respiratory disturbance index (RDI) were not significantly different. Mean follow-up period was 3 to 36 months. Patients tolerated the procedure well without anesthesia. There were minimal side effects without serious adverse effects. Er:YAG laser is shown to be effective in a way to reduce snoring without significant AHI or RDI changes. However, randomized controlled trials, objective data, multicenter cooperation, and long-term outcomes are needed to confirm the benefits of this laser for snoring.
