Marcel Kraft

Background: Laryngopharyngeal reflux (LPR) can display a variety of symptoms, and upper endoscopy is occasionally used for its investigation. The aim of the present study was to determine the value of transnasal esophagoscopy (TNE) in the workup of LPR. Methods: In 200 consecutive patients with suspected LPR, reflux symptom index (RSI), reflux finding score (RFS), oropharyngeal pH-monitoring (PHM) and transnasal esophagoscopy (TNE) were carried out and rated according to the Horvath Score. Results: In the investigation of LPR, TNE showed a sensitivity, specificity and accuracy of 96%, 85% and 95%, respectively. The most common pathologic TNE findings in LPR patients were an insufficient cardia, hiatal hernia, lymphoid follicles and visible reflux. Conclusions: TNE is a supportive method in the workup of LPR, which can display the underlying pathology and directly affect therapeutic decisions.

Background: Laryngopharyngeal reflux (LPR) is a prevalent disorder. The aim of the present retrospective cohort study was to evaluate oropharyngeal pH-monitoring using a novel scoring system for LPR. Methods: In a total of 180 consecutive patients with possible LPR, reflux symptom index (RSI), reflux finding score (RFS), oropharyngeal pH-monitoring and transnasal esophagoscopy were carried out for further investigation. Results: In our series, 99 (55%) patients had severe LPR, 29 (16%) cases presented with moderate and 23 (13%) with mild severity, 9 (5%) subjects revealed neutral values, and 7 (4%) individuals were alkaline, while 13 (7%) patients had no LPR. In detecting LPR, the sensitivity, specificity and accuracy of oropharyngeal pH-monitoring was 95%, 93% and 94%, respectively. Conclusion: Oropharyngeal pH-monitoring is a reliable tool in the assessment of LPR, but the pH graphs have to be precisely analyzed and interpreted in context with other validated diagnostic tests.

Background: Narrow band imaging (NBI) is a new imaging technique for the depiction of tumor‐specific neoangiogenesis. The purpose of the present study was to assess the value of NBI in the early diagnosis of laryngeal cancer.Methods: This prospective study includes 205 consecutive patients with a laryngeal lesion scheduled for microlaryngoscopy. NBI was immediately performed after white light endoscopy (WLE), whereas excisional biopsy was carried out for histologic verification of diagnosis.Results: In identifying laryngeal cancer and its precursor lesions, NBI with WLE showed a significantly higher sensitivity (97% vs 79%) and accuracy (97% vs 90%) than WLE alone, but the specificity (96% vs 95%) was essentially equal in both methods.Conclusion: NBI qualifies for rapid detection and delineation of suspicious lesions. Additionally, this noninvasive method is also beneficial in a variety of benign lesions. © 2015 Wiley Periodicals, Inc. Head Neck 38: 15–20, 2016

Background: Endosonography has been successfully used in staging gastrointestinal cancer, but its value is as yet undetermined in laryngology.Methods: This prospective study includes 84 patients undergoing microlaryngoscopy for laryngeal cancer. The results of endosonography were compared with those of CT and MRI in the 76 surgical cases.Results: In the assessment of laryngal cancer, endosonography was superior to current imaging techniques, whereas CT and MRI showed similar results (accuracy of 89% vs 77% and 77%, respectively).Conclusions: This study confirms that endosonography is highly effective in staging laryngeal cancer. Therefore, the latter may constitute a complementary diagnostic tool in these tumors and additionally may assist in choosing an adequate treatment. © 2012 Wiley Periodicals, Inc. Head Neck, 2013