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European Archives of Oto-Rhino-Laryngology

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01-03-2020 | Endoscopy | Laryngology

Narrow Band Imaging for lingual tonsil hypertrophy and inflammation, in laryngo-pharyngeal reflux disease

Authors: Jacopo Galli, Stefano Settimi, Giampiero Salonna, Dario Antonio Mele, Eugenio De Corso, Gaetano Paludetti

Published in: European Archives of Oto-Rhino-Laryngology | Issue 3/2020

Abstract

Purpose

The objective of this study is to analyse the relationship between the endoscopic signs of laryngo-pharyngeal reflux, the lingual tonsil hypertrophy (LTH) and its inflammation, adopting Narrow Band Imaging (NBI) technology.

Methods

We enrolled, as cases, patients with clinical diagnosis of laryngopharyngeal reflux disease (LPRD), a Reflux Symptom Index (RSI) ≥ 13, and a Reflux Finding Score (RFS) ≥ 7. Controls were enrolled among patients who underwent the same transnasal endoscopy, equipped with NBI, with a RSI < 13 and a RFS < 7. Nasopharynx, Lingual Tonsils (LT), Hypopharynx and Larynx were evaluated by two experienced otolaryngologists, who calculated the Reflux Finding Scale (RFS) score and focused their attention on the base of the tongue, observing its surface with NBI technology.

Results

82 patients with diagnosis of laryngopharyngeal reflux were enrolled as cases. Mean RFS was 11.7 (SD = 2.9). As controls, we enrolled 80 patients. Mean RFS was 2.7 (SD = 1.63). We found that RFS positivity was associated with a significant increase in LT dimension (2.5 vs 1.1, p < 0.001), with a higher LT crypt inflammation grading (1.8 vs 0.09, p < 0.001) and with a higher Roman Cobblestone pattern grading (1.48 vs 0.11, p < 0.001). A significant correlation between the crypt inflammation and the hyperemia subscore of RFS was present (r = 0.696, p < 0.0001), while it was not possible to find a correlation between crypt inflammation and either diffuse laryngeal edema (r = 0.166, p = 0.135) and posterior commissure hypertrophy (r = 0.089, p = 0.427).

Conclusions

NBI allowed us to identify endoscopically the presence of enlarged lingual tonsil, crypt inflammation and superficial mucosal changes, in patients affected by LPRD.

Level of evidence

2 (prospective, case–control study).

Souki FG, Yemul-Golhar SR, Zeyed Y, Pretto EA (2016) Lingual Tonsil Hypertrophy: rescuing the airway with videolaryngoscopy. J Clin Anesth 35:242–245. https://doi.org/10.1016/j.jclinane.2016.06.007 CrossRefPubMed

Sung M-W, Lee WH, Wee JH, Lee CH, Kim E, Kim J-W (2013) Factors associated with hypertrophy of the lingual tonsils in adults with sleep-disordered breathing. JAMA Otolaryngol Neck Surg 139(6):598. https://doi.org/10.1001/jamaoto.2013.3263 CrossRef

Hwang MS, Salapatas AM, Yalamanchali S, Joseph NJ, Friedman M (2015) Factors associated with hypertrophy of the lingual tonsils. Otolaryngol Neck Surg 152(5):851–855. https://doi.org/10.1177/0194599815573224 CrossRef

Abdel-Aziz M, Ibrahim N, Ahmed A, El-Hamamsy M, Abdel-Khalik MI, El-Hoshy H (2011) Lingual tonsils hypertrophy; a cause of obstructive sleep apnea in children after adenotonsillectomy: operative problems and management. Int J Pediatr Otorhinolaryngol 75(9):1127–1131. https://doi.org/10.1016/j.ijporl.2011.06.003 CrossRefPubMed

Galli J, Cammarota G, Rigante M et al (2007) High resolution magnifying endoscopy: a new diagnostic tool also for laryngeal examination? Acta Otorhinolaryngol Ital 27(5):233–236PubMedPubMedCentral

Friedman M, Yalamanchali S, Gorelick G, Joseph NJ, Hwang MS (2015) A standardized lingual tonsil grading system. Otolaryngol Neck Surg 152(4):667–672. https://doi.org/10.1177/0194599815568970 CrossRef

Vilaseca I, Valls-Mateus M, Nogués A et al (2017) Usefulness of office examination with narrow band imaging for the diagnosis of head and neck squamous cell carcinoma and follow-up of premalignant lesions. Head Neck 39(9):1854–1863. https://doi.org/10.1002/hed.24849 CrossRefPubMed

Sun C, Han X, Li X, Zhang Y, Du X (2017) Diagnostic performance of narrow band imaging for laryngeal cancer: a systematic review and meta-analysis. Otolaryngol Neck Surg 156(4):589–597. https://doi.org/10.1177/0194599816685701 CrossRef

Belafsky PC, Postma GN, Koufman JA (2001) The validity and reliability of the reflux finding score (RFS). Laryngoscope 111(8):1313–1317. https://doi.org/10.1097/00005537-200108000-00001 CrossRefPubMed

10.

La Mantia I, Andaloro C (2017) Cobblestone appearance of the nasopharyngeal mucosa. Eurasian J Med 49(3):220–221. https://doi.org/10.5152/eurasianjmed.2017.17257 CrossRefPubMedPubMedCentral

11.

Stapleton A, Brodsky L (2008) Extra-esophageal acid reflux induced adenotonsillar hyperplasia: case report and literature review. Int J Pediatr Otorhinolaryngol 72(3):409–413. https://doi.org/10.1016/j.ijporl.2007.11.003 CrossRefPubMed

12.

Kraus J, Nártová E, Pavlík E, Katra R, Šterzl I, Astl J (2014) Prevalence of Helicobacter pylori in adenotonsillar hypertrophy in children. Acta Otolaryngol 134(1):88–92. https://doi.org/10.3109/00016489.2013.840924 CrossRefPubMed

13.

Roberts AL, Connolly KL, Kirse DJ et al (2012) Detection of group A Streptococcus in tonsils from pediatric patients reveals high rate of asymptomatic streptococcal carriage. BMC Pediatr 12(1):535. https://doi.org/10.1186/1471-2431-12-3 CrossRef

14.

Proenca-Modena JL, de Souza CR, Criado MF et al (2019) Human adenovirus replication and persistence in hypertrophic adenoids and palatine tonsils in children. J Med Virol. https://doi.org/10.1002/jmv.25441 CrossRefPubMed

15.

Mikola E, Elenius V, Saarinen M et al (2018) Tonsillar cytokine expression between patients with tonsillar hypertrophy and recurrent tonsillitis. Clin Transl Allergy 8(1):22. https://doi.org/10.1186/s13601-018-0205-z CrossRefPubMedPubMedCentral

16.

Kim SY, Park B, Lim H, Kim M, Kong IG, Choi HG (2018) Gastroesophageal reflux disease increases the risk of chronic rhinosinusitis: a nested case-control study using a national sample cohort. Int Forum Allergy Rhinol. https://doi.org/10.1002/alr.22259 CrossRefPubMed

17.

Karyanta M, Satrowiyoto S, Wulandari DP (2019) Prevalence ratio of otitis media with effusion in laryngopharyngeal reflux. Int J Otolaryngol 2019:1–3. https://doi.org/10.1155/2019/7460891 CrossRef

18.

Salihefendic N, Zildzic M, Cabric E (2017) Laryngopharyngeal reflux disease—LPRD. Med Arch 71(3):215. https://doi.org/10.5455/medarh.2017.71.215-218 CrossRefPubMedPubMedCentral

19.

Galli J, Cammarota G, Volante M, De Corso E, Almadori G, Paludetti G (2006) Laryngeal carcinoma and laryngo-pharyngeal reflux disease. Acta Otorhinolaryngol Ital 26(5):260–263PubMedPubMedCentral

20.

Kelly EA, Samuels TL, Johnston N (2014) Chronic pepsin exposure promotes anchorage-independent growth and migration of a hypopharyngeal squamous cell line. Otolaryngol Head Neck Surg 150(4):618–624. https://doi.org/10.1177/0194599813517862 CrossRefPubMed

21.

Johnston N, Yan JC, Hoekzema CR et al (2012) Pepsin promotes proliferation of laryngeal and pharyngeal epithelial cells. Laryngoscope 122(6):1317–1325. https://doi.org/10.1002/lary.23307 CrossRefPubMed

22.

Samuels TL, Pearson ACS, Wells CW, Stoner GD, Johnston N (2013) Curcumin and anthocyanin inhibit pepsin-mediated cell damage and carcinogenic changes in airway epithelial cells. Ann Otol Rhinol Laryngol 122(10):632–641CrossRef

23.

Galli J, Cammarota G, De Corso E et al (2006) Biliary laryngopharyngeal reflux: a new pathological entity. Curr Opin Otolaryngol Head Neck Surg 14(3):128–132. https://doi.org/10.1097/01.moo.0000193198.40096.be CrossRefPubMed

24.

Kim JH, Jeong H-S, Kim KM et al (2016) Extra-esophageal pepsin from stomach refluxate promoted tonsil hypertrophy. Zissel G, ed. PLoS ONE 11(4):152336. https://doi.org/10.1371/journal.pone.0152336 CrossRef

25.

Wang W-H, Tsai K-Y (2015) Narrow-band imaging of laryngeal images and endoscopically proven reflux esophagitis. Otolaryngol Neck Surg 152(5):874–880. https://doi.org/10.1177/0194599814568285 CrossRef

26.

Harris MS, Rotenberg BW, Roth K, Sowerby LJ (2017) Factors associated with lingual tonsil hypertrophy in Canadian adults. J Otolaryngol - Head Neck Surg 46(1):32. https://doi.org/10.1186/s40463-017-0209-z CrossRefPubMedPubMedCentral

Title: Narrow Band Imaging for lingual tonsil hypertrophy and inflammation, in laryngo-pharyngeal reflux disease
Authors: Jacopo Galli
Stefano Settimi
Giampiero Salonna
Dario Antonio Mele
Eugenio De Corso
Gaetano Paludetti
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Endoscopy
Laryngopharyngeal Reflux
Published in: European Archives of Oto-Rhino-Laryngology / Issue 3/2020
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05765-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Narrow Band Imaging for lingual tonsil hypertrophy and inflammation, in laryngo-pharyngeal reflux disease

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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